WEEK 1- Stroke Flashcards
Name the acronym of FAST
F- face dropping
A- can you raise arms
S- slurred speech
T- time get to the hospital fast
The s in FAST stands for?
Slurred speech
Name some diagnostic tests to image the brain and spinal chord
● X-ray
● Computed tomography (CT Scan)
● Magnetic resonance imaging (MRI)
● Positron emission tomography (PET)
● Functional magnetic resonance imaging (fMRI)
What does an X- ray look at
bones
can detect some tumours
can look at chest (pneumonia)
what does a PET scan look at
working with people with cancer or tumours = uses radioactive tracers that measures growth in cells
what does an FMRI measure
can tedects areas of the brain with higher oxygen concentration
–> often used when surgeons do brain surgery = want to avoid touching those areas
–> more oxygen = high brain function!!!
True or false Ct is invasive
False , not invasive
How long does a typical ct scan take
5-10 minutes
A Ct scan uses….
Computer processing technology
what does Ct stand for
computed tomography
true or false in a Ct scan you get limited radiation exposure
true
Name 3 things A ct scan can differenciate between
- grey matter from white matter
- the ventricles
- Show many brain structures within several millimetres of each other (lower resolution).
Name some uses of the CT scan
- detect bleeding
- brain damage
- blood clot
- leaking aneyrism
- most brain tumours
- enlarged ventricles = hydrocephalus
- GUIDING NEEDLE FOR BRAIN BIPSY
What does MRI stand for
magnetic resonance imaging
what is the physics behind mri
Uses magnets to influence the magnetic field along 3 different spatial axes
true or false the MRI creates detailed spacial images
true
true of false, just like the CT , an Mri is non invasive and uses radiation
FALSE: non invasive BUT does not use radiation
how long does mRI last
30-45 min
can a patient do an MRI if they have metal implants in them?
NO!
Is an MRI expensive
Yes
Name some differences between MRI and Ct
Mri = more expensive and more detailed imaging , longer imaging (30-45 min)
What can Mris find?
- strokes
-tumours
-traumatic injuries
-atrophy of brain due to dimentia an dparkinsons or MS
Name soem other diagnotsic tests
blood urine
lumbar puncture or csf test
bipsy
electrophysiological measures
what does a blood urine test for
protein levels
what does a lumbar puncture tets
THE CSF
what is a biopsy
removal of a piec of muscle or tumour = chunk of cells to figure out whtas going on
name the 3 types of electrophysiological measurmenets
- Electroencephalography(EEG)
- Evoked potentials(EP)
- Electromyography(EMG)
what does EEG stand for and what does it do
Electroencephalography(EEG) –Measures brain/cortical activity through specific scalp electrodes. Used often with epilepsy and sleep studies
what does EP stand for and what does it do
○ Evoked potentials(EP) –Measures electrical activity after a stimuli to test the integrity of a sensory or motor pathway.
what is an emg and what doe sit do
○ Electromyography(EMG) –Measures the electrical activity in the nerve of the muscle to test muscle activity (actual signal and strength/speed of signal).
true or false an EP is used for epilepsy
false thats an EEG
true or false an EEG can look at consciousness through a vegerative state
true
true or false in an EMG were looking at the message form a nerve to the muscle to detect wher ethe issue is stemming from
TRUEEEEE
what am i describing?
“ series of tests and observations that examines the functional status of the nervous system”
THE NEUROLOGICAL EXAM
true or false, the neuro exam is the ONLY thing needed used ot make a clinical decision
thats so falseeee!
ypou need more tests than that
when is best to conduct a neuro exam
at the initial interview
who does the initial rapid screening pf the patient
the neurologist
can OT , PT and SLP do in depth exam
yes!
what are some of teh aspects tested in the neuro exam
- Mental Status (Cognitive Function)
- Cranial nerves
- Reflexes–upper and lower limbs
- Motor system
- Coordination and Gait
- Sensory system
how would you test mental status/ cognition? talk me through it
is patient alert, able to answer questions (language and attention), has a recent memory (ask question), oriented to date?
Learning and Memory (observations in functional tasks, cognitive screens
(ex: MoCA)
b. Attention (in session?)
c. Neglect (to 1 side)
d. Thinking, planning and deciding (complex tasks)
e. Emotions (Mood, participation)
f. Calculations (part of cognitive screen, or part of evaluating finances)
g. Apraxia (can they follow commands)
h. Perception (ex: MVPT)
how would u tets cranial nerves
pupil symmetry and eye movements, facial, neck and tongue movements
+ looking for disphagia
how would you test reflexes
upper and lower limbs -are they symmetric? Any primitive reflexes returned (ex: rooting)
how would you tets the motor system
hint: theres alot so just walk me through it
upper and lower body movement, looking for any abnormal muscle tone, movement or
strength
a. Observation of tremor or any involuntary movements
b. Inspection of muscle atrophy
c. Palpation
d. Range of motion (goniometry, edema, functional tasks)
e. Muscle tone testing (hypertonia, hypotonia, spasticity, modified
ashworth scale)
f. Fine and gross motor movements (functional tasks and specific
neuromotor tests)
g. Strength of individual muscle groups (MMT, grip strength)
how would you tets coordination and gait
a. Coordination (Ataxia, finger-nose, finger opposition, foot tap, heel-shin test…)
b. Gait abnormalities, transfers, tandem gait, turns, balance…
how would you test sensory sustem
a. Pain
b. Numbness
c. Touch
d. Stereognosis
e. Proprioception
verbal reports of symptoms (numbness, pain…), cotton and pin test, vibration*
true or false : as an OT or PT you should keep patient results to yourself and treat the patient by yourself without disvussing with your team
false , you need to talk to the team
is the neurological exam helpful for neurologists diagnosis ?
yes very
what are teh two main goals for neurological exam
- TO CONFIRM A SUSPECTED DIAGNOSIS
- TO RULE OUT A HYPOTHETICAL DIAGNOSIS
what is stereogenis
identify what soemthing is when your eyes are closed = perceive through touch
what is it called when you identify what soemthing is when your eyes are closed = perceive through touch
stereogenesis
true or false people with strokes have a hard time with proprioception
true
