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Neuro 1 > Terms > Flashcards

Terms Flashcards

1
Q

apraxia which side

A

L - dominant

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2
Q

aphasia which side

A

L dominiate

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3
Q

prosopagnosia

A

impaired facial recognition

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4
Q

neglect

A

R nondominate

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5
Q

agnosia which side

A

L dominate

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6
Q

watershed infarcts

A

severe drop in BP

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7
Q

pt interview componnets

A

hpi
pmhx
social hx

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8
Q

medial medullary syndrome cause

A

vertebral artery

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9
Q

lateral medullary syndrome cause

A

PICA or vertebral

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10
Q

medial inferior pontine

A

paramedian branches of basliar

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11
Q

lateral inferior pontine syndrome

A

AICA

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12
Q

lateral superior pontine

A

SCA

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13
Q

vertebrobasilar artery syndrome

A

locked in
complete basliar

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14
Q

hemiparesis

A

mild to mod weakness - contra side

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15
Q

hemiplegia

A

profound weakness contra side

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16
Q

first degree neuromuscular impairments

A

type one increase
type two decrease
loss of motor units and sync
dmg to descending cortical drive

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17
Q

motor control

A

The underlying substrates of neural, physical and behavioral aspects of movement

  • -> Reactive (feedback)
  • -> Proactive/anticipatory (feedforward)
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18
Q

motor plan

A

An idea or plan for purposeful movement that is made up of component motor programs

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19
Q

motor program

A

An abstract representation that, when initiated, results in the production of a coordinated movement sequence

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20
Q

motor learning

A

A set of internal processes associated with feedback or practice leading to relatively permanent changes in the capability for motor skill

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21
Q

motor recovery

A

The reappearance of motor patterns present prior to CNS injury performed in the same manner as prior to injury

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22
Q

motor compensation

A

The appearance of new motor patterns resulting from changes to CNS

  • -> Adaptation
  • -> Substitution
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23
Q

motor praxis

A

ability to plan and execute coordinated movements

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24
Q

apraxia

A

Inability to plan and execute purposeful movements that cannot be accounted for by any other reason

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25
Q

functional reserve

A

High fitness levels = minimal use of reserve with day-to-day tasks
Low fitness levels = small tasks require ↑ energy requirements, substantially reducing reserve

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26
Q

what makes a risk factor modifiable

A

if you can take medication, exercise, diet or do anything to lower it

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27
Q

age for high risk stroke

A

55 or older

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28
Q

demographic for higher stroke

A

black or hispanic 2x
american indian or alaskan natives also

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29
Q

other factors to increase stroke risk

A

prior stroke, TIA, and/or MI
genetics

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30
Q

sex for stroke risk

A

female higher

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31
Q

what is the most modifiable and common risk factor

A

HTN

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32
Q

obstructive sleep apnea does what to stroke

A

doubles your risk at SEVERE levels

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33
Q

CVA increases your risk by how much (afib or arrhythmias)

A

5x the risk!!!

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34
Q

smoking and strokes

A

2-4x higher at any level of smoking

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35
Q

Alcohol does what

A

j shaped curve for ischemic strokes
linear for hemorrhagic stroke

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36
Q

thrombotic vs embolic strokes

A

thrombotic - clot form within artery slower onset
Embolic - clot travels from elsewhere - common places Heart, large arteries, upper chest neck

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37
Q

ischemic stroke cause

A

atherosclerosis

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38
Q

hemorrhagic strokes

A

intracerebral

subarachnoid

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39
Q

Intracerebral Hemorrhage (ICH)

A 
Most common hemorrhagic CVA
#1 Cause: HTN
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40
Q

Subarachnoid Hemorrhage (SAH)

A

1 Cause: Aneurysm and Arteriovenous Malformation (AVM)

aneurysm - rupture of artery usually asymptomatic

AVM - tangled capillaries - congenital and seizures

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41
Q

TIA

A

mini stroke

•Symptoms last < 24 hours

warning sign for stroke

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42
Q

Ischemic Cascade (what happens after an ischemic stroke)

A
  1. Loss of ATP production
  2. Stoppage of Na/K pump
  3. Excess intracellular Na+ leads to influx of H2O, causing “cytotoxic edema”
  4. Excess intracellular Ca2+ build up due to stoppage of Na/K pump
  5. Breakdown of mitochondria in response to toxins and unstable cell membrane
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43
Q

what happens when too much Ca gets built up after Na/K pump stops

(3 things)

A
  1. Leads to excess glutamate release at axon terminal
  2. Hyper-excitability cycle transpires throughout nearby neurons
  3. =“Excitotoxicity” – it causes other neurons to have the same problem snowball effect
  4. Activates degradative enzymes that breakdown proteins in neuron and cell membrane – Ca build up usually means cell is dead
  5. Release of free radicles
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44
Q

Diagnosis of stroke

B.E F.A.S.T.

A

Balance

Eyes

Face

Arms

Speech

Time

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45
Q

National Institutes of Health Stroke Scale (NIHSS)

cut off scores and what is it

A

•Most commonly used in acute phases of CVA

  • Cut-Off Scores: identify stroke severity
  • >25 Very Severe - long term
  • 15-24 Severe - long term
  • 5-14 Mild-Moderately Severe - acute pt rehab
  • 1-5 Mild - most discharged home
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46
Q

MRI vs CT

A

MRI - longer

  • subtle areas
  • brainstem
  • ischemia
  • subacute or chronic
  • anatomy detail needed

CT - shorter cheeper

  • everything else
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47
Q

acute management of ischemic stroke

A
  • Major goal: Revascularization
  • Tissue plasminogen activator (tPA) – breaks down clots very well
  • 3-8 hour window
  • Permissive HTN•< 220/110

anti platelet for first 24-48 hrs

48
Q

acute management of hemorrhagic stroke

A

•Major goal: Reduce intracranial pressure (ICP)

  • Anti-hypertensives for BP control
  • Strict BP parameters (< 130/80)
  • Vasospasm prevention and management (SAH)
  • Antiseizure prophylaxis (ICH)
48
Q

acute management of hemorrhagic stroke

A

•Major goal: Reduce intracranial pressure (ICP)

  • Anti-hypertensives for BP control
  • Strict BP parameters (< 130/80)
  • Vasospasm prevention and management (SAH)
  • Antiseizure prophylaxis (ICH)
49
Q

surgical ischemic stroke

A
  • Mechanical Embolectomy
  • Mechanical Thrombectomy
  • Carotid Endarterectomy
50
Q

surgical hemorrhagic stroke

A

•Endovascular Coiling*

Surgical Clipping

  • Resection
  • Embolization
  • Endoscopic Evacuation
  • Craniotomy
  • Craniectomy• a lot of swelling
51
Q

what can you use for AVM

A
  • Resection•AVM
  • Embolization•AVM, hemorrhage (ICH)
  • Endoscopic Evacuation•Hemorrhage (ICH)
  • Craniotomy•Any

•Craniectomy• a lot of swelling•Any

52
Q

what surgeries could you use for aneurysm

A

•Endovascular Coiling*•Aneurysm•

Surgical Clipping•Aneurysm

•Embolization•AVM, hemorrhage (ICH)

  • Endoscopic Evacuation•Hemorrhage (ICH)
  • Craniotomy•Any

•Craniectomy• a lot of swelling•Any

53
Q

what is midline shift

A

poor prog

shifting of structures in to contralateral hemispheres

54
Q

vasospasm seen with

A

most commonly seen with subarachnoid hemorrhage - AVM or aneurysm

55
Q

seizure seen with

A

post ICH - intracerebral hemorrhage

Deferred until 24 hr after quiet EEG

56
Q

UE FL synergy

A
57
Q

LE fl synergy

A
58
Q

UE ex synergy

A
59
Q

LE ex synergy

A
60
Q

Fugl-Meyer assessment

test

MCD

MCID

A

test mvmt, cordination, reflexes

MCD - UE - 5.4

LE - 5

MCID - UE and LE - 10

61
Q

rivermead motor assessment

what is it

MCID

A

gross motor, performance based

MCID 3

62
Q

UE outcome measures

A

9 hole peg test

action research arm test

arm motor ability test

box and blocks test

motricity index

63
Q

LE outcome measure

A

five time sit to stand test

motricity index

64
Q

Recommend post CVA (cerebral vascular accident) protocol

A

no true CVA protocol but follow MI protocol

peak HR 120 or 70% age

BP <250/115

65
Q

if unable to do graded exercise test

A

stay light to moderate exercise (3-6 on mod BORG)

66
Q

dysdiadochokinesia

A

•impaired ability to perform rapid alternating movements•

67
Q

dysmetria

A

•: inability to judge distance or range of movement•Hypometria, Hypermetria

68
Q

dyssynergia

A
  • fragmented movement patterns
  • Movements occur in sequence of component parts rather than a single & coordinated smooth output
69
Q

asynergia

A
  • loss of ability to associate muscles together for complex movements
  • More severe form of dyssynergia
70
Q

rebound phenomenon

A

•inability to rapidly and sufficiently halt movement of a body part after a strong isometric force

71
Q

tremor

A

•unintentional, oscillatory movement•Resting, Intentional

72
Q

Ataxia

A

Uncoordinated movement that manifests when voluntary movements are attempted

you can have cerebellar (dmg to cerebellum) or sensory (proprioceptive)

73
Q

what effects coordination

A

weakness, MC, sensory, cog, vision

74
Q

tone vs spasticity

A

spasticity - velocity dependent

75
Q

MAS scale

A
76
Q

Spasticity and MC in terms of stroke

A

curvilinear relationship

usually developing spasticity is a sign of getting better

77
Q

patterns with spasticity

A

most are fl

add more common

ir more common

78
Q

Glasgow Coma Scale (GCS)

A

Measures level of consciousness

•< 8 severe•9-12 moderate•13-15 mild

79
Q

CGS predicts what

A

mortality rate with 88% accuracy

80
Q

pseudobulbar affect

A

inconsistent with actual mood

81
Q

Neglect most commonly presents as what

A

Visual neglect

81
Q

Neglect most commonly presents as what

A

Visual neglect

82
Q

Pushers Syndrome

A

Lesion to R hemisphere - PL thalamus

fall (push) toward involved side

83
Q

Tropia

A

overt deviation of the eye

All the time

84
Q

Phoria

A

ocular deviation occurs when dissociation occurs

happens as the eye begins to fatigue

85
Q

Esotropia

A

Medial

86
Q

exotropia

A

lateral

87
Q

hypertropia

A

Upward drift

88
Q

Hypotropia

A

downward drift

89
Q

TIA most common place

A

vertebrobasilar a.

90
Q

When do you see VOR affected

A

subcortical - when oculomotor or abducens is affected

91
Q

hypoesthesia

A

Decreased sensitivity to sensory stimuli

92
Q

hyperesthesia

A

Increased sensitivity to sensory stimuli

93
Q

paresthesia

A

Abnormal sensation such as numbness, prickling, or tingling

94
Q

dysethesia

A

Touch sensation experienced as pain

95
Q

allodynia

A

Pain produced by non-noxious stimulus

96
Q

analgesia

A

Complete loss of pain sensitivity

97
Q

hyperalgesia

A

Increased sensitivity to pain

98
Q

atopognosia

A

Inability to localize sensation

99
Q

what effcts balance

A

everything

100
Q

Post Stroke Fatigue

A

Lack of physical and mental energy

not an endurance impairment

closely associated with depression

101
Q

Thalamic pain syndrome most common site

A

VPL

102
Q

Orthopedic pain with stokes most common site

A

Shoulder

second most common LBP

103
Q

most common pt to get shoulder pain

A

UE hemiplegia

shoulder sublux

104
Q

examination of subluxation determination

A

Sublux = ½ fingerbreadth or more

105
Q

CPS

A

•Painful shoulder + painful and edematous hand/wrist•+Allodynia, hyperalgesia

R CVA> L CVA

106
Q

most common deficit found post stroke with cog

A

attention

107
Q

Pushers syndrome

where most likely

what heppens

A

RIght side most common

Push toward involved side

R - associated with left spatial and sensory neglect

L - associated with aphasia

108
Q

Pushers syndrome

where most likely

what heppens

A

RIght side most common

Push toward involved side

R - associated with left spatial and sensory neglect

L - associated with aphasia

109
Q

Indication for immediate cessation of exercise program

A

1.Lightheadedness2.Dizziness3.Chest heaviness, pain or tightness; angina4.Heart palpitations or irregular heart beat5.Sudden SOB not due to ↑ activity6.Volitional fatigue and exhaustion

110
Q

CIMT

A

contraint induced mvmt therapy

intact arm contained and unusable forced to use impaired arm

111
Q

AVERT study

A

•Early mobilization group not found to have any additional adverse events than standard care group

within 24 hours of stroke

112
Q

Acute endurance recommendations

A

•Goal: Prevent deconditioning, orthostatic intolerance, depression•• < 11-12 RPE (3-4 mRPE)•Resting HR + 10-20bpm••Duration & frequency as tolerated•Interval approach••Mode: walking, ADLs, standing activities

113
Q

IP rehab and outpt endurance recommendations

A

•Goal: Increased walking speed & efficiency, improve exercise tolerance, increased independence ADLs, reduce motor impairment, improve cognition, improve vascular health, etc…••RPE 11–14 (3-5/6 mRPE)•40%–70% VO2 reserve or HR reserve; 55%–80% HRmax••20-60min/session, 3-5x/week•+adequate warm-up and cool-down••Mode: large-muscle activities

Neuro 1 (4 decks)

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