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fall B 2024 > multi d final > Flashcards

multi d final Flashcards

1
Q

TIA (transient ischemic attack)

A

less than 24 hours
strong indicator of pending CVA (15% in 90 days)

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2
Q

how to manage TIA

A

observation
treatment of risk factors
anticoagulation
carotid endarterectomy

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3
Q

CVA

A

4th leading cause of death in US
sudden onset of neuro deficits within 24 hours

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4
Q

risk factors of CVA

A

older age
african american or hispanic
male
HTN
CAD
hyperlipidemia
elevated LDL levels
hyper-coagulable state
DMII
obesity
tobacco use
alcohol abuse
sedentary lifestyle

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5
Q

prevalence of strokes

A

12% of deaths globally
lifetime stroke risk is 25% for those >25 years of age

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6
Q

hemorrhagic stroke

A

blood leaks into brain tissue

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7
Q

ischemic stroke

A

clot stops blood supply to an area of brain
present with predetermined syndromes
can predict what vasculature will be affected

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8
Q

ICH (intracerebral hemorrhage)

A

10-15% of all strokes
from rupture of cerebral vessels
result of high BP

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9
Q

primary symptoms of ICH

A

spontaneous rupture of small vessels damaged by chronic hypertension

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10
Q

secondary symptoms of ICH

A

bleeding of cerebrovascular abnormalities, tumors, or impaired coagulation

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11
Q

ICH outcomes

A

associated with higher risk of fatality
damages brain cells
may increase pressure on brain or spasms in vessels

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12
Q

death prevalence in ICH

A

nearly half of all pts with primary ICH die within the first month after the acute event

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13
Q

lacunar stroke

A

25% of ischemic strokes
creates deep cavities in brain tissue
occlusion of vessels from the circle of willis

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14
Q

middle cerebral artery infarction presentation

A

contralateral hemiparesis
facial paralysis
sensory loss in face and UE

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15
Q

general info about MCAI

A

90% of all strokes
largest of the brain’s arteries
supplies most of outer frontal, parietal and temporal lobes

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16
Q

MCA syndrome

A

presents with neglect and poor motivation

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17
Q

MCA syndrome - Gerstmann syndrome

A

L/R disorientation
acalculia
agraphia
finger agnosia

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18
Q

anterior cerebral artery infarction

A

involves medial cerebral cortex
compromises motor and sensory of LE

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19
Q

ACAI left sided lesions

A

transcortical motor aphasia

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20
Q

ACAI right sided lesions

A

confusional state and motor hemineglect

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21
Q

superficial posterior cerebral artery infarction

A

visual and somatosensory deficits

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22
Q

larger PCAI

A

hemisensory loss
hemiparesis due to involvement of thalamus

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23
Q

where does the PCA supply?

A

occipital lobe
inferior temporal lobe
thalamus

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24
Q

vertebrobasilar infarction (VBI) presentation

A

ataxia
vertigo
headache
vomiting
oropharyngeal dysfunction
visual-field deficits
abnormal oculomotor findings

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25
VBI - mid basilar artery
locked in syndrome ipsilateral CN7 palsy decreases level of consciousness hemiparesis and hemitaxia oculomotor deficits arm posturing
26
VBI - intracranial vertebral artery
wallenburg syndrome dizziness diploplia
27
VBI - distal basilar artery
comatose state defective vertical gaze hemiparesis and hemitaxia diplolia speech difficulties altered mental state small, poorly reactive pupils weakness ataxia
28
VBI - origin of extracranial vertebral artery
dizziness blurred vision ataxia vomiting
29
cerebellar infarction
loss of coordination ataxia nausea vomiting headache dysarthria vertigo
30
BEFAST stroke signs
balance eyes face arms speech time
31
beyond BEFAST
numbness sudden confusion trouble seeing trouble walking severe headache
32
ischemic CVA management
cerebral hypo-perfusion BP control treatment of risk factors
33
prognosis of ICVA
85% of all stroke types 13-23% mortality in 30 days
34
tissue plasminogen activator
strongly recommended within 4-5 hours of stroke symptoms NOT for hemmoragic stroke
35
what scan is the earlier indicator for stroke?
MRI
36
prognosis of hemorrhagic CVA
poor compared it ICVA 30 day mortality rate - 35-50%
37
PT's role in strokes
history vitals are important other tests and measures dx, prog, POC EDUCATION of pt and family
38
national institutes of health stroke scale (NIHSS)
valid for size and severity 0 = no deficits 42 = worst deficits must be trained
39
NIHSS outcomes
very severe - >25 severe - 15-24 mild to moderate - 5-14 mild 1-5
40
correlation of NIHSS score to discharge disposition
<5: 80% discharged to home 6-13: typically require ARF >14: frequently require LT skilled care
41
describe damage to cerebellum
motor dysfunction postural control equilibrium coordination
42
common deficits of cerebellar damage
dysdiadochokinesia slurred speech ataxia unsteady gait nystagmus
43
conditions responsible for cerebellar damage
CVA head trauma alcoholism tumors toxins MS anything that causes oxygen deprivation
44
UE coordination tests
RAM tests for dysdiadochokinesia finger opposition finger to nose finger to clinician finger and back to nose
45
LE coordination tests
heel to shin toe to clinician finger RAM
46
balance observations
level of assistance required # times balance lost ability to maintain midline duration of stance use of support direction of deviation of movement presence of postural controls strategies
47
how does normal cognition help balance?
paying attention to surroundings making correct decisions about situations remembering dangerous situations
48
skin layers
epidermis dermis subcutaneous
49
integ function
temp regulation protection sensation excretion immunity blood reservoir vitamin D synthesis
50
cardiovascular conditions that affect integ
vascular insufficiency lymphedema
51
pulmonary conditions that affect integ
pulmonary edema CF
52
msk conditions that affect integ
osteomyelitis open fracture
53
neuromuscular conditions that affect integ
SCI CVA MS loss of sensation
54
endocrine conditions that affect integ
diabetes liver disease
55
general observation of integ
color condition temp scars hair loss lesions
56
common disorders of integ
dermatitis trauma infection skin cancer ulcers burns
57
most common type of skin cancer
basal cell carcinoma
58
deadliest skin cancer
melanoma
59
ABCDE rule
asymmetry borders color variants diameter elevation
60
benign lesions
< 6 mm uniform color distinct borders symmetric seldom bleed or ulcerate soft to firm slow rate of growth or change
61
malignant lesions
> 6 mm multiple shades irregular, blurred borders asymmetric often bleed or ulcerate firm to hard variable rate of growth
62
burns
thermal electrical chemical
63
superficial burns
epidermis only no blisters red painful
64
superficial partial thickness burns
epi and superficial dermis blisters red painful
65
deep partial thickness burns
majority of dermis hair follicles/sweat glands intact
66
full thickness burns
subcutaneous fat layer minimal pain susceptible infection increased depth = decreasing pain
67
subdermal burns
muscle, bone, adipose tissue insensate
68
arterial insufficiency wounds
intermittent claudication pain with activity decreased temp and pedal pulses
69
venous insufficiency wounds
localized limb pain pedal pulses present increase skin temp edema
70
peripheral neuropathy
nerve damage diminished sensation cannot sense trauma
71
neuropathic ulcers
PVD, peripheral neuropathy, infection painless absent pedal pulses if atherosclerosis deep wound bed at pressure points loss of sensation
72
decubitus (pressure ulcers)
tissue ischemia
73
stage 1 wound
intact, reddened skin that does not blanch
74
stage 2 wound
shallow open ulcer with red/pink wound bed, denoting partial-thickness loss of dermis, without slough. Can present as open or ruptured blister
75
stage 3 wound
subcutaneous fat may be visible but no bone, muscle or tendon exposed. May include tunneling or undermining
76
stage 4 wound
muscle/tendon/bone exposure. Tunneling/undermining, eschar/slough over at least part of wound bed
77
what to include in assessment for wounds
ROM sensation strength functional mobility NM coordination balance equipment used
78
PT intervention in wound care
wound treatment/protection strength/ROM/mobility training

fall B 2024 (19 decks)

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