Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PT9121 - Acute Care 1 > Lecture 16 - Acute Stroke > Flashcards

Lecture 16 - Acute Stroke Flashcards

1
Q

What is a stroke/CVA

A

Interruption of cerebral blood flow resulting in cell death (infarction) and loss of brain function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 5 warning signs of a stroke

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes strokes in young adults

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the stroke outcomes

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the recurrence of strokes

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some modifiable and non-modifiable risk factors of stroke

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Majority of individuals will have [blank] impairment following a stroke

A

Moderate-severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Risk of stroke reoccurrence [blank] over time

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diet/Inactivity are examples of [blank] risk factors

A

Modifiable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Does the brain require higher or lower blood flow

A

Higher (50 cc/100 gm/min) and if blood flow decreases below 15 cc, neuron damage/death will occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 3 types of strokes

A
  1. Ischemic (87%): artery within the brain is blocked usually do to atherosclerosis (plaque build up). It can be thrombotic (60%) or embolic (30%) and cause generalized hypoperfusion. Can be TIA’s and lacunar stroke also.
  2. Hemorrhagic (13%): Artery bursts within or just outside the brain leading to increased pressure causing a cascade of cell death and inflammation. Typically occurs in the basal ganglia, brain stem, cerebellum, or cortex and can be caused by hypertension.
  3. Other (Dissection): cervical extension and rotation = dissect an artery (vertebral) -> usually traumatic injury or accident
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Severity and symptoms of strokes are related to (4)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Explain the ischemic core and penumbra

A

Red = core area where stroke occurs (ischemic core) = most tissue will die here
Ischemic Penumbra (other colors) = inflammatory cascade occurs because of stroke bringing additional fluid to the area causing compression of other areas of the brain impacting the brain function in this area. This tissue is salvable with intervention and time is crucial to catching a stroke to reduce amount of tissue affected by ischemic penumbra.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Compare thrombotic vs embolic strokes

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lacunar strokes

A

Small vessel thrombotic strokes that can be symptomatic or silent/asymptomatic in non-cortical areas of the brain (basal ganglia, subcortical white matter, pons) and is most commonly caused by hypertension and diabetes mellitus (other risk factors: smoking, LDL levels, PAD) and results in decreased cognition and post-stroke dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Transient Ischemic Attacks

A

Transient episode of neurological dysfunction due to focal ischemia without acute infarction or tissue injury that is less than 1 hour and is of sudden onset with similar stroke symptoms. It can be a warning sign for ischemic stroke with highest risk being within the first 4 hours. Treatment is focused on reducing risk of stroke.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are 2 complications post-ischemic stroke and there signs and symptoms

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Intracerebral hemorrhage

A

Rupture of small arteries within the brain increased intracranial pressure caused by hypertension, trauma, vascular malformations, amyloid angiopathy, and anticoagulated medications. Signs and symptoms (increase over time) are headache, nausea, vomiting, decreased level of consciousness, and papilledema.

NOTE:
Do not want to increase blood flow to the brain when it is already under a lot of pressure (increased ICP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Subarachnoid Hemorrhage

A

Rupture in subarachnoid space that is caused by either traumatic or non traumatic injuries. Signs and symptoms include severe headache, nausea, vomiting, nuchal rigidity, photophobia, and possible cranial nerve impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are 4 types of brain hemorrhages

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Aneurysms

A

Artery dilations that occur in weak points in the brain circulation (85% in anterior circulation especially in circle of willis). Can be small, med, or large and most are saccular (berry), but can also be fusiform (circumferential) Not all will rupture and but an increased risk of rupturing could be due to increased hypertension, smoking, larger size of aneurysm, location, growth, family history or a previous rupture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Locations for strokes (NEED TOO KNOW)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What happens if there is a stroke in the middle cerebral artery

A

-Contralateral face and UE motor impairment (possible sensory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What happens if there is a stroke in the anterior cerebral artery

A

Contralateral LE motor and sensory impairment, executive function (planning, working memory), emotions, possible frontal lobe reflexes (eg. Glabellar, snouting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What happens if there is a stroke in the posterior cerebral artery

A

Contralateral homonymous hemianopia, possible contralateral motor and sensory impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What happens if there is a stroke in the cerebellar artery

A

Ataxia, dizziness, tremors (test to use would be dysdiakonesia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Spinal Strokes

A

Rare because there is a high degree of collateral circulation in the spine but can be due to arthrosclerosis in the aorta and a significant increased risk with thoracoabdominal aortic surgery. More common in the anterior spinal artery than posterior spinal artery

NOTE:
Anterior spinal artery: spinothalamic and corticospinal tracts

Posterior Spinal Arteries: supplies dorsalcolumn tracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The most common type of stroke is

A

Ischemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Ischemic strokes can undergo [blank] transformation

A

Hemorrhagic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Normal intracranial pressure is

A

> 10 mmHG -> high is 25 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are 2 stroke prevention surgeries

A

Carotid Endarterectomy = CEA
Carotid Angioplasty and Stenting = CAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are strategies we use to determine the type of stroke

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are 2 ways to medically manage ischemic stroke

A

NOTE:
rTPA = makes a hemorrhagic stroke worse vs makes ischemic stroke better

34
Q

What are contraindications to rTPA

A
35
Q

What are post-treatment management strategies for rTPA

A
36
Q

What are post-treatment management strategies for EVT

A
37
Q

What are 3 medical management strategies for hemorrhagic strokes

A
38
Q

What is overall medical management strategies post-stroke

A
39
Q

What is overall pharmaceutical management strategies post-stroke

A
40
Q

What areas do we asses with stroke patients

A
41
Q

The first thing to do before medical treatment is

A

Determine the mechanism of stroke

42
Q

Immediately following treatment for an ischemic stroke [blank] may be indicated

A

Bed rest

43
Q

Medical management following a stroke is mainly focused on

A

risk factors

44
Q

What should an acute stroke PT assessment consist of

A
45
Q

What are the 7 stages of motor control for the CMSA

A
46
Q

What are some PT management strategies for cardiorespiratory function post-stroke

A

IPPA: Asymmetry in expansion, trunk and muscular tone will be different, cough impacted, swallowing impairment

47
Q

What are some PT management strategies for neuromuscular function post-stroke

A
48
Q

What are 3 areas to focus on for falls prevention for individuals post-stroke

A
49
Q

What are some PT management strategies for cognition and perception post-stroke

A
50
Q

A hemiplegic shoulder is at risk of

A

Shoulder pain and subluxation because the rotator cuff provides stability for shoulder, so in Stage 1 when muscles of the rotator cuff are flaccid = higher chance of subluxation

51
Q

What is some management strategies for a hemiplegic shoulder?

A
52
Q

Is early mobilization important for stroke recovery

A

YEs, an increased frequency (2x per day) and early mobilization resulted in early ambulation and greater independence

53
Q

What outcome measure do we use to measure prognosis of stroke recovery and describe it

A
54
Q

Describe the functional independence measurement scale

A

NOTE: There are stairs on the FIM, so if people cannot perform a task they automatically get a 1

55
Q

What are some risk factors for poor prognosis

A
56
Q

A common PT assessment post-stroke is the

A

CMSA

57
Q

The hemiplegic shoulder is at risk of {blank] post-stroke

A

Subluxation

58
Q

Early mobility is [blank] following a stroke

A

Safe

59
Q

What joints make up the shoulder complex

A
60
Q

The glenohumeral joint is

A
61
Q

What are thhe static stabilizer of the glenohumeral joint

A
62
Q

What is the anatomy of the glenohumeral joint

A
63
Q

What are the dynamic stabilizers of the glenohumeral joint

A
64
Q

Describe the force couple in the shoulder joint

A
65
Q

Describe what is happening during arm elevation from 0-30 degrees, 30-150 degrees, and beyond 150 degrees

A
66
Q

Can the supraspinatus become impinged

A

Yes

67
Q

Describe a lone tow shoulder

A
68
Q

Describe the pathoantomy of a subluxed shoulder

A
69
Q

What are consequences of shoulder subluxation

A
70
Q

How do we manage a low tone shoulder in terms of positioning

A
71
Q

How do we side-lie on the unaffected side (stroke)

A
72
Q

How do we lie on the hemiplegic side (stroke)

A
73
Q

How do we sit in a chair (stroke)

A
74
Q

How do we handle a low tone shoulder

A
75
Q

What is a high tone upper limb

A
76
Q

When does a high tone upper limb occur, its causes, and consequences

A
77
Q

How do we position a high tone upper limb

A
78
Q

What is the pharmacological management for a high tone upper limb

A
79
Q

What is the incidence of hemiplegic shoulder pain and its signs/symptoms

A
80
Q

What is the treatment for hemiplegic shoulder pain

A

PT9121 - Acute Care 1 (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions