Stroke Flashcards by Kelly Lough

What is a stroke?

the sudden death of brain cells due to lack of oxygen

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What are the two causes of lack of oxygen in a stroke?

blockage of blood flow (ischemic)
rupture of artery (hemorrhagic)

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What are the three non-modifiable risk factors for a stroke?

age
sex
family and medical history

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What are the recognizing stroke signs?

Face- drooping
Arms- can you raise both?
Speech- slurred?
Time- to call 911

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What is a transient ischemic attach (TIA) caused by?

small clot which temporarily blocks an artery causing dysfunction of the brain

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How long can TIA’s last?

anywhere from a few minutes to 24 hours

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Is a TIA a stroke?

no, but a TIA is a medical emergency and a warning sign for a higher risk of a stroke

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What are the two types of ischemic strokes?

Thrombotic
Embolic

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What are the two types of hemorrhagic strokes?

intracerebral
subarachnoid

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Are ischemic or hemorrhagic strokes more common?

Ischemic strokes

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What is a thrombotic ischemicstroke?

caused by a thrombus (blood clot) that develops in the arteries supplying blood to the brain

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What is an embolic ischemic stroke?

caused by a blood clot or another solid mass forming from another part of the body travelling to the brain

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What is a thrombotic ischemic stroke in a small vessel called?

lucunar stroke

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What is an intracerebral hemorrhage?

caused by a rupture of a weak blood vessel in the brain resulting in bleeding in the brain tissue

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What is a subarachnoid hemorrhage?

caused by ruptured aneurysm or arteriovenous malformation resulting in bleeding in the subarachnoid space

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What is required to differentiate between ischemic and hemorrhagic strokes?

Imaging

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Is hypertension present in ischemic vs. hemorrhagic strokes?

Ischemic- often present
Hemorrhagic- usually present

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Is a preceding TIA present in ischemic vs. hemorrhagic strokes?

Ischemic- occasionally
Hemorrhagic- no

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Explain the onset in ischemic vs. hemorrhagic strokes.

Ischemic- usually at night, not activity induced
Hemorrhagic- activity induced

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Explain the clinical course in ischemic vs. hemorrhagic strokes.

Ischemic- stepwise or static
Hemorrhagic- severe at onset, progressive

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Explain the CT scan in ischemic vs. hemorrhagic strokes.

Ischemic- normal or subtle
Hemorrhagic- blood visible

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What is the mortality rate at 30 days in ischemic vs. hemorrhagic strokes?

Ischemic- ~10%
Hemorrhagic- ~35%

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What are some functions of the left side of the brain?

Study These Flashcards

right hand control
spoken language
math
written language
science
logical reasoning

What are some functions of the right side of the brain?

Study These Flashcards

left hand control
music awareness
3D forms
art awareness
insight
imagination

What 3 areas are in the frontal lobe?

- premotor cortex - prefrontal area - broca's area

What is the function of the premotor cortex?

Motor patterns

What is the function of the prefrontal area?

- concentration - judgement - inhibition - personality

What is the function of Broca's area?

language production

What is the function of the parietal lobes?

- processing sensory input - sensory discrimination - body orientation

What is the function of the temporal lobes?

- auditory reception - receptive speech - memory

Where is Wernicke's area?

temporal lobes

What is the function of Wernicke's area?

language comprehension

What is the function of the brainstem?

- digestion - breathing - heart control - alertness

What is the function of the cerebellum?

coordination and control of voluntary movement

What is the function of the occipital lobes?

- visual reception - visual interpretation

What are the three options for management of ischemic strokes?

- restoring blood flow to penumbra - pharmacological management (tPA, Aspirin) - surgical management (stents

What are the two options for hemorrhagic strokes?

- pharmacological management (antihypertensive meds) - surgical management (aneurysm clipping, evacuation)

What are 3 physical factors influencing stroke recovery?

- type and severity of stroke - age - health

What are the two emotional factors influencing stroke recovery?

- mood - motivation

What is a social factor influencing stroke recovery?

- support of friends and family

What are two therapeutic factors influencing stroke recovery?

- availability of rehab services - early start of rehab

What are three options for stroke prevention?

- medical management of risk factors - education - lifestyle modifications

What is the aim of rehab post-stroke?

facilitating achievement of optimal function and participation goals identified by a person with a stroke

What are the 5 components of the Canadian Stroke Best Practices for PT?

- use standardized, validated assessments - Mobilization when medically stable (b/w 24-48 hrs) - Individualized, culturally appropriate and client-centered care - 3 hours/day of direct task-specific therapy, 5 days/week - meaningful, goal-oriented, specific, engaging, repetitive, progressively-adapted therapy

can patients continue to recover after 30 days?

Yes, changes will be much smaller, however change can still occur

What is a medical precaution for post-endovascular thrombectomy procedures?

patients should not be mobilized for at least 4 hours post-removal of femoral sheath

What are the recommendations for aerobic activity post-stroke?

- individually-tailored aeorbic training - involving large muscle groups - to enhance cardiovascular endurance and cognitive function

What has aerobic exercise been shown to do post-stroke?

- reduce CV risk factors - Improve physical functioning for individuals with an acute-chronic stroke

Why is improving CV fitness post-stroke becoming more vital?

the prevalence of stroke in young adults is rising

Why is it important to address the CV deconditioning in 70% of individuals with stroke?

if not addressed, low CV fitness can contribute to a cyclical pattern of low PA and functional decline and increased risk for secondary events

What is the frequency of aerobic exercise recommendations post-stroke?

minimum of 3 days/week

What is the intensity of aerobic exercise recommendations post-stroke?

- determined on an individual basis - % of HRR, % of HRmax, RPE

What is the type of aerobic exercise recommendations post-stroke?

any mode of exercise activating a large muscle mass for a prolonged period

What is the time of aerobic exercise recommendations post-stroke?

- sessions of > 20 minutes - Warm-up and cool-down periods of 3-5 minutes

What level of intensity has evidence for greater recovery outcomes in post-stroke patients?

high intensity training

What types of outcome measures are the most meaningful to patients?

those that align with everyday life or easily show progress

What can be a cornerstone in supporting partnership between you and your patient?

effective communication

Stroke Flashcards

(57 cards)