stroke Flashcards

1
Q

when does ABI occur?

A

when brain is damaged through trauma, stroke, infection, lack of oxygen, tumour, drug/alcohol abuse or degenerative neurological disease

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2
Q

what is a TBI?

A

a traumatic brain injury is a traumatically induced structural injury and/or physiological disruption of brain function as a result of external force

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3
Q

what is the OTs aims with ABI?

A
  • enable and empower people to be competent, enhance wellbeing and minimise effector dysfunction
  • address issues using interventions.
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4
Q

what is the glascow coma scale?

A

most common scoring system to describe level of consciousness following TBI

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5
Q

what is the glascow coma scale used to gauge?

A

severity of acute brain injury

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6
Q

what is a severe score on the glascow coma scale?

A

GCS 8 or less

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7
Q

what is a moderate score on the glascow coma scale?

A

GCS 9-12

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8
Q

what is a mild score on the glascow coma scale?

A

GCS 13-15

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9
Q

what is PTA considered?

A

stage of brain recovery process

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10
Q

what are typical effects of PTA?

A
  • disorientation about time/location/identity
  • distractible
  • difficulty thinking/memory/concentration
  • anxiety, agitation, mood. changes
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11
Q

what is the OTs role in ABI?

A

assess impact of cognitive impairment on performance of meaningful activities and participation

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12
Q

what are some areas of ABI should be tested for cognitive impairment?

A
  • attention
  • visuospatial function
  • executive function
  • social cognition
  • language/social communication
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13
Q

what are personal factors that should be considered during assessment of ABI?

A
  • culture
  • fluency/literacy
  • education
  • intellectual level
  • occupational/vocational history
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14
Q

what are pre-injury medical factors that should be considered during assessment of ABI?

A
  • substance use
  • mental health
  • neurological disorders
  • nutrition
  • psychosocial trauma
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15
Q

what are injury-related factors and conditions that should be considered during assessment of ABI?

A
  • medical conditions
  • fatigue
  • psychiatric conditions esp. mood disorders
  • pain
  • seizures
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16
Q

what are some challenging behaviours following ABI?

A
  • verbal/physical aggression
  • inappropriate behaviour
  • repetitive behaviour
  • risk-taking
  • wandering
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17
Q

what are five principles of managing behaviour?

A
  • manage: day-to-day
  • structure and routine
  • consistency
  • add positives
  • seek assistance
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18
Q

what do the clinical guidelines GRADE for the assessment of stroke stand for?

A

grading of recommendations assessment, development and evaluation

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19
Q

what skills should be observed during assessment of occupational performance in a familiar task?

A
  • motor performance
  • perceptual
  • cognitive
  • affect
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20
Q

what is dys/aphasia?

A

impaired expression and comprehension of language

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21
Q

what is dysarthria?

A

weakness/incoordination of muscles used in speech

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22
Q

what is dyss/apraxia?

A

difficulty controllign speech organs, resulting in impaired production and sequencing of speech sounds and breathing

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23
Q

what is dysphagia?

A

swallowing impairment

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24
Q

what is buccofacial apraxia?

A

inability to perform skilled movements involving lips, mouth, and tongue in absence of paresis, impacts language and facial expression

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25
what is praxis?
ability to plan and perform purposeful movement
26
what part of brain is responsible for praxis?
frontal and parietal lobes
27
what is apraxia?
impaired planning and sequencing of movement not due to weakness, incoordination or sensory loss
28
what is ideational apraxia?
person does not have ideas what to do
29
what is ideomotor apraxia?
person does. know. what to do but cannot carry it out
30
what types of errors are included in ideational apraxia?
- misuse - dislocation - sequence errors - omission
31
what are people with ideomotor apraxia observed to have?
awkward and clumsy movements and impairment may be evident with timing, sequencing and spatial organisation of movement
32
how is ideomotor apraxia assessed?
presented with 24 movements that they reproduce immediately using limb ipsilateral to side of lesion
33
what is strategy training?
patient learns to use intact cognitive functions to compensate for loss of motor planning
34
what is errorless training focus?
for client to train doing specific ADL task without error
35
what are some considerations you may need when working with people with aphasia?
may need language to be emphasised or simplified when learning
36
what personal factors should be considered in apraxia intervention?
- attention and motivation - pre-morbid skilled motor ability - level of insight
37
what enviro factors should be considered in apraxia intervention?
- context in which task is performed - distractions - presence of cues
38
what are types of apraxia?
- ideational - ideomotor - buccofacial
39
what task factors should be considered in apraxia intervention?
- familiarity with movements/objects - number of task components - level of skill required - repetitive elements - speed required
40
what stroke does apraxia originate from?
left or right hemisphere stroke
41
how is apraxia diagnosed?
based on differential diagnosis of what it is not, therefore assess all other modalities first
42
what intervention strategies are recommended for apraxia?
- strategy training - errorless learning - gesture training
43
what are the two types of memory processing?
- explicit (declarative) | - implicit (non-declarative)
44
what types of memory is explicit or declarative memory processing linked with?
- perceptual - semantic - episodic-autobiographical
45
what types of memory is implicit or non-declarative memory processing linked with?
- procedural | - primary memory systems
46
what does explicit or declarative memory processing require?
conscious recollection of previous experience and info
47
does implicit or noon-declarative memory processing occur subconsciously or consciously?
subconsciously
48
what is implicit or non-declarative memory assessed by?
- learning motor skills - recognising degraded pictures - word-stem completion
49
what is procedural learning?
acquisition of perceptual-motor or mechanical 'doing' skills
50
what is the ultimate goal of ADL retraining?
decrease level of assistance required and promote independence
51
what is physical support for ADL retraining?
use verbal prompts
52
what is guided movement support for ADL retraining?
guides patient to complete task, client participates in motor actions of task
53
what is verbal prompting as a support for ADL retraining?
clear direction
54
what is physical support for ADL retraining?
uses visual aid, enviro set up to cue task components
54
what is physical support for ADL retraining?
uses visual aid, enviro set up to cue task components
55
what is supervised support for ADL retraining?
able to complete elements of task, initiate and move between components,
56
what is independent support for ADL retraining?
demonstrates consistent performance within ADLs supervision no longer needed
57
what are some considerations for skills retraining?
- emotional issues | - behavioural changes: apathy, impulsivity, agitation, socially innappropriateness
58
what are some considerations for routine practice?
- frequent practices promotes self-maintenance - regularity of practice - use of feedback
59
what are some challenges of engagement for stroke patients?
- confused/disorientated - distractibility - difficulty retaining info - fatigue - agitation - impulsive