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Neuromus 2 > Stroke epi > Flashcards

Stroke epi Flashcards

1
Q

is there increase in death rates associated with stroke

A

decrease mortality

there is better care following stroke

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2
Q

what does decrease mortality mean for us as PT

A

people are presenting with more sever deficits

shifting to improving peoples QOL

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3
Q

TPA is used for what kind of stroke

A

ischemic

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4
Q

what does TPA do

A

clot busting medication, used to dissolve the blood clot and restore regular blood flow to the brain

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5
Q

what is a ischemic stroke - simple

A

a blood clot stops the flow of any more blood to the brain

the tissue beyond this point needs o2 and the removal of Co2

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6
Q

what is a hemo stroke simple

A

when the blood vessel going to the brain bursts

the blood settle on the brain > this leads to compression of these structires

lead to disperse sysmtoms

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7
Q

risk factors that increase the liklehood stroke - everyone

A

HTN
smoking
CVD - heart disease
DM
previous stroke

age, sex, race

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8
Q

what is the greatest risk factor for a stroke

A

previous stroke

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9
Q

risks specific for women

A

birth control and preg

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10
Q

specific to black women

A

sickle cell disease

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11
Q

sex and risk factors

A

we have done lots of experiments on men and not women

that is why we know about men

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12
Q

age and stroke

A

risk doubles every 10 year after 55

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13
Q

75% of stroke occur in what population

A

65+

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14
Q

can stroke occur in a younger populations

A

yes

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15
Q

what is the relationship between race and stroke

A

social related factors

more then genetic differences

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16
Q

do strokes occur more in men or women

A

men

but more women die

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17
Q

what systoms to women report more with stroke

A

non focal:

headache
fatigue
cog changes
generalized malaise
weakness

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18
Q

APO

A

adverse preg outcomes

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19
Q

what is a endovascular thrombectomy

A

a minimally invasive surgical procedure used to treat acute ischemic stroke.

EVT involves the removal of a blood clot from a blocked artery in the brain, which can restore blood flow and prevent further brain damage.

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20
Q

why is HTN a risk factor for stroke

A

too much high pressure stretches the tissue

blood can add more tissue to protect from the damage (block)
or
the tissue cannot hold and breaks (rupture)

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21
Q

stroke and DM

A

there is more glucose in the blood then normal

increase in glucose leads to fatty deposists or clots in the blood vessels (block)

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22
Q

type 1 DM

A

not enough insulin produced by the pancreas

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23
Q

type 2 DM

A

the body is not receptive to insulin

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24
Q

what are the three factor the DM lead to the leads to atherlosis

A

systematic inflammation

arterial stiffness

endothelial dysfunction

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25
Q

CVD and stroke

A

CVD leads to atherosclerosis - thickening and hardening of the art (block)

plaque can break open and cause a clot - travels to the brain

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26
Q

what is CAD

A

plaque buildup in the arteries of your heart.

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27
Q

what is PAD

A

most often is plaque buildup in the arteries of the legs, but it can also build up in your arms or pelvis

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28
Q

what is Carotid artery disease

A

plaque buildup in the neck arteries.

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29
Q

what is the effect of carotid disease

A

It reduces blood flow to the brain.

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30
Q

Renal artery stenosis

A

plaque buildup in the arteries that supply blood to your kidneys

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31
Q

what is Vertebral artery disease

A

atherosclerosis in the arteries that supply blood to the back of the brain

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32
Q

what is the function of the back of the brain

A

controls body functions that are needed to keep you alive.

basic funtions

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33
Q

what is Mesenteric artery Ischemia

A

plaque buildup in the arteries that supply the intestines with blood.

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34
Q

what is the back defintion of a stroke

A

rapid onset of neuro symptoms

vascular territory

caused by underlying CVD

lasting longer 24 hours

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35
Q

signs of a stroke

A

numbness of the - face, arms, or leg, especially on onside of the body

confusion or trouble speaking

trouble seeing one or both eyes

trouble walking, dizziness, balance

server headache with no know cause

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36
Q

FAST

A

F - face droops while smiling

A - does on arm drift down when lifting arms up

S - speech is slurred or repeating the same phrase

T - time, if you see these call 911

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37
Q

what is hemiparesis

A

weakness or the inability to move on one side of the body

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38
Q

what is apraxia

A

pick up a comb and you want to brush your teeth with it

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39
Q

what is the most common type of stroke

A

MCA

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40
Q

what part of the brain does the mCA serve

A

lateral

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41
Q

what do we see with left hemisphere MCA

A

right hemiparesis

right sensory loss

right homo hemianopsia

dysarthria

aphasia

apriaxia

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42
Q

what is dysarthria

A

hard time speaking

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43
Q

what is reflective aphasia

A

wernickes

word salad

44
Q

what is expressive aphasia

A

can understand language but cannot express speech

45
Q

right hemiparesis what part of the brain

A

primary motor cortex and the internal capsule

46
Q

right sensory loss brain

A

primary sensory cortex and the internal capsule

47
Q

right homo hemianopsia brain

A

optic tract

optical radiation of the internal capsule

48
Q

dysarthria brain

A

corna radiada

hypoglossal and facial nerve

49
Q

apraxia brain

A

partial or premotor

50
Q

right hemp MCA symptoms

A

left hemiparesis, sensory loss, homo hemianopsia, dysarthria

left side neglect

flat effect

anosognosia

asomatognosia

poor decision making

51
Q

anosognosia

A

unaware of neuro defects

52
Q

asomatognosia

A

he experience that one’s body has faded from awareness.

loss of ownership of ones own body part

53
Q

neglect of the left environment brain

A

partial association cortex in right brain

54
Q

flat effect brain

A

frontal lobe and amygdala

55
Q

anosognosia brain

A

partial cortex

56
Q

asomatognosia

A

right posterior partial cortex

57
Q

what does the pCA supply

A

occiptal lobe

medial temporal lobe

thalamus

58
Q

what is the function of the thalamus

A

the bodies information relay station

59
Q

PCA effects

A
  • Contralateral homonymous hemianopsia
  • Visual agnosia
  • Prosopagnosia (difficulty naming people on sight)
  • Dyslexia (difficulty reading) without agraphia (difficulty writing), color naming (anomia), and color discrimination problems
  • Memory defect
  • Topographic disorientation
60
Q

what is Visual agnosia

A

an impairment in recognizing visually presented objects, despite otherwise normal visual field, acuity, color vision, brightness discrimination, language, and memory

61
Q

what is Topographic disorientation

A

an acquired inability to navigate the environment in daily life

62
Q

ACA supplies what

A

medial part of the brain

frontal lobe

63
Q

her ACA issues

A

personality

logical thought

contralateral voluntary movement

motor and sensory loss (

Mutism

64
Q

in ACA do we lose more UE or LE motor and sensory loss

A

more LE than UE

65
Q

what is mutism

A

the inablity to speak

becasue of brain

66
Q

book ACA symptoms

A

Contralateral hemiparesis involving mainly the LE (UE is more spared

Contralateral hemisensory loss involving mainly the LE (UE is more spared)

Urinary incontinence

Problems with imitation and bimanual tasks (two hand task), apraxia

Abulia (akinetic mutism), slowness, delay, lack of spontaneity, motor inaction

Contralateral grasp reflex, sucking reflex. Can be asymptomatic if circle of Willis is competent

67
Q

Contralateral hemiparesis involving mainly the LE (UE is more spared) brain

A

Primary motor area, medial aspect of cortex, internal capsule

68
Q

Contralateral hemisensory loss involving mainly the LE (UE is more spared) brain

A

Primary sensory area, medial aspect of cortex

69
Q

Urinary incontinence brain

A

Posteromedial aspect of superior frontal gyrus

70
Q

Problems with imitation and bimanual tasks (two hand task), apraxia brain

A

Corpus callosum

71
Q

right brain damage results in

A

left side neglect

spatial perceptual deficits

imparied judgement

72
Q

left brain damage results in

A

speech-lang impairment

73
Q

what is a lacunar stroke

A

occlusion of smaller vessels - penetrating branches of the circle of willis

cells distal to the occlusion dies - these are small areas

74
Q

critically located infract for lacunar stroke

A

this leads to greater deficits

including paralysis and sensory loss

75
Q

what happen a few months after a lacunar stroke

A

necrotic brain cells are absorbed by macrophage activity and a small cavity (lake)

76
Q

lacunar stroke: what happens if there is a infract of the corona radiata

A

leads to ataxic hemiparesis

77
Q

PICA CVA is also called a

A

wallenberg syndrome

78
Q

what area of the brain does the pICA serve

A

the inferior cere and dorsalateral medulla

79
Q

what is wallenburg

A

a neurological condition caused by a stroke in the brain stem, specifically in one of the arteries that provides blood to the cerebellum

80
Q

symtoms of a PICA or wallenburg syndrome

A

balance problems (leaning)

facial numbness and eye droop

hoarseness and trouble swallowing

dizzness

isplateral the lesion

81
Q

what do the vertobasilar arteries serve

A

lateral regions of the medulla and the cere

82
Q

what does the basilar artery supply

A

pons and the cere

83
Q

what does vestibularbasilar stroke present with

A

nausea and vertigo

isp face paralysis

contra limb paralysis

84
Q

what can you do to differenciate between nausea and vertigo

A

postive HIT - peri issue not a central issue

85
Q

what is the penumbra

A

the shadow around the dead cells

these cells ahve not decided whether they are going to die or live

86
Q

how do we resolve the physiological damage from stroke

A

decrease local edema

resorption of local toxins

evascularization of pnumbra

87
Q

what is neuroplascity

A

the sprouting of new synpatic connections

88
Q

where does neuroplascity occur

A

occurs next to the lesion and in random part of the brain

89
Q

what are the 10 tenents of neuroplascity

A

Use it or lose it
Use it and improve it
Specificity
Repetition matters
Intensity matters
Time matters
Salience matters
Age matters
Transference
Interference

90
Q

what is the acute phase

A

less then a month post stroke

91
Q

what is the subacute phase

A

1-6 months post stroke

92
Q

what is the chronic stage

A

longer than 6 months

93
Q

when does stroke recovery peak

A

1-3 months

94
Q

can you still make progress past the 1-3 month window

A

yes

95
Q

role of the PT in the iCU

A

mobilize the pt

discharge planning

96
Q

role of the PT in Acute care

A

mobilze and DC planning

97
Q

role of the IPR

A

get pt functional enough to get home, SNF, LTC

98
Q

role of the home

A

max home independence

prepare for community integration

99
Q

role of the OP

A

max community integration

100
Q

role of the community based

A

reduce loss of gains

improve health and wellness

101
Q

Role of PT SNF

A

functional enough to return home of LTC

102
Q

Role of PT in the LTC

A

maintain/improve function

103
Q

where do most stroke pt go after hospital stay

A

IPR next SNF

104
Q

acute to intermediate concerns following stroke

A

UI, UTI

pressure ulcers

blood clots

pneumonia

105
Q

chronic concerns following stroke

A

depression

sexual dysfunction

contractures -

106
Q

where do we see most contracture for stroke pt’s

A

ankles and shoulders

107
Q

what side do you gaurd on

A

the effected side

Neuromus 2 (17 decks)

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