Stroke symposium Flashcards

Question

What are the risk factors of stroke?

Answer 1

``` Smoking Diabetes High blood pressure Obesity Stress Hyperlipidemia LDL ```

Answer 2

Heart - echo (PFO), ECG (AF), ultrasound bifurcation (carotid stenosis)

Answer 3

Stent and remove the atherosclerotic plaque

Answer 4

Endothelial injury - Increased vascular permeability, leukocyte adhesion Accumulation of lipoproteins - Including LDL and its oxidised forms Monocyte adhesion to the endothelium - Followed by migration into the intima and transformation into macrophages and foam cells. Platelet adhesion Factor release - From activated platelets, macrophages inducing smooth muscle cell recruitment. Smooth muscle cell proliferation Lipid accumulation

Answer 5

``` ●Large artery atherosclerosis ●Cardioembolism ●Small vessel occlusion ●Stroke of other determined etiology ●Stroke of undetermined etiology ```

Answer 6

```  Nursing and medical staff  Functional and movement disability – OT/physiotherapy  Communication and swallowing function – S&LT  Nutritional support – Dieticians  Social service ```

Answer 7

Initial screen of swallow on admission - NG/NBM/PEG Swallow therapy Initial language/speech screen Follow up language therapy MDT working and support Discharge planning and hand over to rehab or community teams

Answer 8

``` Follow up on communication and swallow Usually at patients home Therapy Link to community support 6 month review Getting them back to hobbies ```

Answer 9

Difficulty swallowing An impairment at any of the 4 stages of swallowing: (pre-oral, oral, pharyngeal ,Oesophageal) Can lead to aspiration pneumonia, malnutrition, dehydration, choking and death. Assessed at bedside via observation and palpation and/or through instrumental techniques such as Videofluroscopy or Fiberoptic Endoscopic Evaluation of Swallow (FEES). Can have a negative impact on mood and social participation

Answer 10

Difficulty talking

Answer 11

Dysarthria | Apraxia of speech

Answer 12

- Adaptation of posture - Environmental changes e.g. reducing distractions - Modifying diet and fluids e.g. use of thickener in drinks - Educating family/carers e.g. feeding techniques - Compensatory strategies e.g. head turn, chin tuck- Swallow rehab exercises such as Massako manoeuvre for weak soft palate. - Adaptive equipment e.g. cutlery with large handles, plate guards, bolus limiting cups- Feeding at risk decisions

Answer 13

Coughing whilst eating or drinking Eyes watering, shortness of breath, choking episodes, reduced sats just after swallowing New and/or recurrent chest infections (predominantly right sided consolidation, may indicate aspiration pneumonia)

Answer 14

dependent on feeding and oral care, poor positioning, reduced dentition, comorbidities e.g. COPD, frailty, alertness, cognition

Answer 15

An acquired language impairment Can affect any of the 4 modalities of language: - speech/ auditory comprehension - reading/ writing Can have a devastating impact on the individual’s Quality of Life (QoL) and wellbeing

Answer 16

Usually associated with damage to the left cerebral hemisphere

Answer 17

``` take part in a conversation talk in a group or noisy environment read a book or magazine or road sign understand or tell jokes follow the television or radio write a letter or fill in a form use the telephone use the internet use numbers and money say their own name or the names of their family unable to express their immediate needs or ideas or words go out. ```

Answer 18

``` word finding difficulties non-fluent output short, staggered sentences difficulty with past/present, he/she may miss words out ```

Answer 19

Long muddled sentences Use of non-words e.g. ‘ploof’ for ‘dog’ Unable to understand what others are saying May not be aware of impairment

Answer 20

Specific impairments (usually 1:1) e.g. use of past tense - Functional communication e.g. practising how to order a coffee and then completing the task or learning compensatory strategies e.g. gesture and writing - Social participation e.g. developing communication techniques in group settings with family and friends or training carers to support communication.

Answer 21

Difficulty in speaking resulting from a weakness or loss of control of the muscles used to make the sounds of speech, e.g. lips, tongue, soft palate, larynx Speech can sound slurred or unintelligible Varies from individual to individual – some people may not be able to form any words at all and other people may have only slightly imprecise articulation

Answer 22

An inability to control the muscles used to form words. When the messages from the brain to the mouth are disrupted, the person cannot move his or her lips or tongue in the correct manner to make letter sounds. Speech is uncoordinated and effortful. Many sound and word errors e.g. ‘kitchen’ for ‘chicken’ Often very frustrating for the person

Answer 23

Result from damage to frontal regions of the brain (predominantly right-sided) The frontal lobes are particularly important for cognitive communication skills because of their role in the brain's 'executive functions', including planning, organisation, flexible thinking and social behaviour. People with CCD may: - talk too much or not enough - interrupt conversation - jump from topic to topic - give too much or not enough eye contact - Over or under-share - Show impulsive behaviours such as spending lots of money online in one go - Have reduced facial expression

Answer 24

``` Don’t pretend you understand Write down key words Say one thing at a time Relax – be natural Recap – check you both understand Don’t rush – slow down, be patient Draw diagrams or pictures Reduce background noise Ask what helps, e.g. some people would prefer that others don’t finish their sentences for them Use pen and paper ```

Answer 25

``` EARLY INDIVIDUALISED FOCUSED and SPECIFIC COMPLEX ONGOING ```

Answer 26

``` Joint/muscle stiffness Loss of muscle length Contractures Tissue Breakdown/Pressure Sores Unstable Shoulder Respiratory Complications Urinary Problems Pain Circulatory Problems Depression and Anxiety Osteoporosis CV Deconditioning Hygiene difficulties Oedema Constipation ```

Answer 27

Made up of 1. Neural component 2. Biomechanical component CNS Damage - Direct result of blood alteration, ischaemia/haemorrhage, causing neuronal change and disordered information to be sent via corticospinal pathways. 2. Biomechanical - Muscle shortening and lengthening for cross bridges in muscle fibres depending on direction of pull

Answer 28

Resistance in 1 direction Characteristic posture changes Sensitive to sensory input

Answer 29

Resistance in all directions No static postural changes Not Sensitive to sensory input Cogwheel = rigidity plus tremor

Stroke symposium Flashcards

(53 cards)