Stroke (CVA) Flashcards
What is the pathophysiology of a stroke?
Stroke is caused by a lesion in the brain causing oxygen to not be delivered to teh neurons in that area. Lack of oxygen causes cell death and therefore loss of function.
What is the difference between ischemic and hemorrhagic stroke?
An ischemic stroke occurs when there is a blockage or clot in a blood vessel supplying blood to the brain. This blockage can be due to a blood clot formed within a blood vessel in the brain (thrombus) or a clot that travels from elsewhere in the body to the brain (embolus).
A hemorrhagic stroke occurs when there is bleeding in the brain. This can result from the rupture of a blood vessel (hemorrhage) within the brain or on its surface. The bleeding creates pressure on the brain and can damage surrounding tissues.
Which is more common (80% of cases): ischemic or hemorrhagic stroke?
Ischemic stroke
What are the 2 types of ischemic strokes?
Embolic stroke: a blood clot forms elsewhere breaks loose and travels to the brain.
Thrombosis involves blow flow being affected by the narrowing of vessels due to atherosclerosis.
Atherosclerosis: plaque build-up eventually constricts the vascular chamber and forms clots.
What is hemorrhagic conversion?
An ischemic stroke transforms into a hemorrhagic stroke.
Hemorrhagic conversion refers to the transformation of an ischemic stroke, which is initially caused by a lack of blood flow (ischemia), into a hemorrhagic stroke characterized by bleeding in or around the affected area. This conversion can occur when the tissue affected by reduced blood flow becomes damaged and fragile, leading to the rupture of blood vessels (increased pressure) and subsequent bleeding.
What is hemiparesis?
Hemiparesis is a neurological symptom commonly associated with stroke. It refers to weakness or partial paralysis affecting one side of the body, usually the arm, leg, and sometimes the face. The term “hemi” means half, and “paresis” refers to weakness or partial paralysis. Therefore, hemiparesis implies a weakness affecting one-half of the body.
List some common symptoms of stroke:
10+
- contralateral hemiplegia
- impacted communication –> aphasia and dysarthria
- decreased coordination
- decreased balance / decreased postural control (shift to one side)
- decreased sensation
- decreased cognitive abilities
- increased muscle spasticity
- increased pain which can cause contractures and non-use
- altered cognition (decreased executive functioning skills)
- altered visual-perception
- psychosocial symptoms related to adjustment to disability
- headaches
- numbness
- confusion
- dizziness
What is dysarthria?
Dysarthria is a motor speech disorder in which the muscles you use to produce speech are damaged, paralyzed or weakened.
Slurred speech
What is global aphasia?
MOST SEVERE TYPE
Caused by injuries to multiple parts of the brain that are responsible for processing language. Consequences:
- Can only produce a few recognizable words.
- They can understand very little or no spoken language.
- May have fully preserved cognitive and intellectual abilities that are not related to language or speech.
What is Broca’s Aphasia?
PARTIAL LOSS of their language ability
- Difficulty speaking fluently
- Limited speech; a few words at a time.
- Oral and reading comprehension is intact
- Written expression is limited
What is Wernicke’s Aphasia?
Can speak fluently but what they say makes no sense. Poor oral and reading comprehension.
- Poor oral comprehension
- Can producing connected speech easily but content does not make sense due to use of nonsense or irrelevant words in their sentences
- impaired ability to read and write
What 3 vital signs should be checked before starting an OT intervention with a stroke patient?
- HR
- BP
- O2 level
Name an assessment tool that can be used as a outcome measure for OT interventions with stroke patients?
Set goals. Evaluate priority, performance, and satisfaction
COPM
Name an outcome measure/ assessment that can be used to to measure a patient’s level of independence in activities of daily living (ADL).
The Functional Independence Measure (FIM)
List the 2 subscales in the FIM
- Motor Subscale
- Cognitive Subscale
List the 7 levels of assistance/independence in the FIM
1: Total assistance
2: Maximal assistance
3: Moderate assistance
4: Minimal assistance
5: Supervision or setup assistance
6: Modified independence
7: Complete independence
What is the Montreal Cognitive Assessment (MoCA) used for?
Screening tool to assess cognitive function; memory, attention, visuospatial abilities, language, and executive functions.
Post-stroke:
- screen for cognitive impairment
- establish a baseline for cognitive function to assess for progress over time
- identify specific cognitive deficits
What is the Activity Card Sort (ACS) used for?
It is used to evaluate an individual’s participation in various activities and to gather information about their interests and priorities.
It is often used in occupational therapy to assess a person’s functional abilities, preferences, and the impact of health conditions on their daily life.
What are the 3 card sorting piles called in the Activity Card Sort (ACS)?
- “I do regularly,”
- “I do, but not regularly,”
- “I don’t do.”
These categories help capture the range of activities an individual is engaged in and those they may have stopped or reduced due to health conditions.
