WEEK 1- Stroke

Question 1

Name the acronym of FAST

Answer 1

F- face dropping
A- can you raise arms
S- slurred speech
T- time get to the hospital fast

Question 2

The s in FAST stands for?

Answer 2

Slurred speech

Question 3

Name some diagnostic tests to image the brain and spinal chord

Answer 3

● X-ray
● Computed tomography (CT Scan)
● Magnetic resonance imaging (MRI)
● Positron emission tomography (PET)
● Functional magnetic resonance imaging (fMRI)

Question 4

What does an X- ray look at

Answer 4

bones
can detect some tumours
can look at chest (pneumonia)

Question 5

what does a PET scan look at

Answer 5

working with people with cancer or tumours = uses radioactive tracers that measures growth in cells

Question 6

what does an FMRI measure

Answer 6

can tedects areas of the brain with higher oxygen concentration
–> often used when surgeons do brain surgery = want to avoid touching those areas
–> more oxygen = high brain function!!!

Question 7

True or false Ct is invasive

Answer 7

False , not invasive

Question 8

How long does a typical ct scan take

Answer 8

5-10 minutes

Question 9

A Ct scan uses….

Answer 9

Computer processing technology

Question 10

what does Ct stand for

Answer 10

computed tomography

Question 11

true or false in a Ct scan you get limited radiation exposure

Answer 11

true

Question 12

Name 3 things A ct scan can differenciate between

Answer 12

• grey matter from white matter
• the ventricles
• Show many brain structures within several millimetres of each other (lower resolution).

Question 13

Name some uses of the CT scan

Answer 13

1. detect bleeding
2. brain damage
3. blood clot
4. leaking aneyrism
5. most brain tumours
6. enlarged ventricles = hydrocephalus
7. GUIDING NEEDLE FOR BRAIN BIPSY

Question 14

What does MRI stand for

Answer 14

magnetic resonance imaging

Question 15

what is the physics behind mri

Answer 15

Uses magnets to influence the magnetic field along 3 different spatial axes

Question 16

true or false the MRI creates detailed spacial images

Answer 16

true

Question 17

true of false, just like the CT , an Mri is non invasive and uses radiation

Answer 17

FALSE: non invasive BUT does not use radiation

Question 18

how long does mRI last

Answer 18

30-45 min

Question 19

can a patient do an MRI if they have metal implants in them?

Answer 19

NO!

Question 20

Is an MRI expensive

Answer 20

Yes

Question 21

Name some differences between MRI and Ct

Answer 21

Mri = more expensive and more detailed imaging , longer imaging (30-45 min)

Question 22

What can Mris find?

Answer 22

• strokes
  -tumours
  -traumatic injuries
  -atrophy of brain due to dimentia an dparkinsons or MS

Question 23

Name soem other diagnotsic tests

Answer 23

blood urine
lumbar puncture or csf test
bipsy
electrophysiological measures

Question 24

what does a blood urine test for

Answer 24

protein levels

Question 25

what does a lumbar puncture tets

Answer 25

THE CSF

Question 26

what is a biopsy

Answer 26

removal of a piec of muscle or tumour = chunk of cells to figure out whtas going on

Question 27

name the 3 types of electrophysiological measurmenets

Answer 27

- Electroencephalography(EEG) - Evoked potentials(EP) - Electromyography(EMG)

Question 28

what does EEG stand for and what does it do

Answer 28

Electroencephalography(EEG) –Measures brain/cortical activity through specific scalp electrodes. Used often with epilepsy and sleep studies

Question 29

what does EP stand for and what does it do

Answer 29

○ Evoked potentials(EP) –Measures electrical activity after a stimuli to test the integrity of a sensory or motor pathway.

Question 30

what is an emg and what doe sit do

Answer 30

○ Electromyography(EMG) –Measures the electrical activity in the nerve of the muscle to test muscle activity (actual signal and strength/speed of signal).

Question 31

true or false an EP is used for epilepsy

Answer 31

false thats an EEG

Question 32

true or false an EEG can look at consciousness through a vegerative state

Answer 32

true

Question 33

true or false in an EMG were looking at the message form a nerve to the muscle to detect wher ethe issue is stemming from

Answer 33

TRUEEEEE

Question 34

what am i describing? " series of tests and observations that examines the functional status of the nervous system"

Answer 34

THE NEUROLOGICAL EXAM

Question 35

true or false, the neuro exam is the ONLY thing needed used ot make a clinical decision

Answer 35

thats so falseeee! ypou need more tests than that

Question 36

when is best to conduct a neuro exam

Answer 36

at the initial interview

Question 37

who does the initial rapid screening pf the patient

Answer 37

the neurologist

Question 38

can OT , PT and SLP do in depth exam

Answer 38

yes!

Question 39

what are some of teh aspects tested in the neuro exam

Answer 39

1. Mental Status (Cognitive Function) 2. Cranial nerves 3. Reflexes–upper and lower limbs 4. Motor system 5. Coordination and Gait 6. Sensory system

Question 40

how would you test mental status/ cognition? talk me through it

Answer 40

is patient alert, able to answer questions (language and attention), has a recent memory (ask question), oriented to date? Learning and Memory (observations in functional tasks, cognitive screens (ex: MoCA) b. Attention (in session?) c. Neglect (to 1 side) d. Thinking, planning and deciding (complex tasks) e. Emotions (Mood, participation) f. Calculations (part of cognitive screen, or part of evaluating finances) g. Apraxia (can they follow commands) h. Perception (ex: MVPT)

Question 41

how would u tets cranial nerves

Answer 41

pupil symmetry and eye movements, facial, neck and tongue movements + looking for disphagia

Question 42

how would you test reflexes

Answer 42

upper and lower limbs -are they symmetric? Any primitive reflexes returned (ex: rooting)

Question 43

how would you tets the motor system hint: theres alot so just walk me through it

Answer 43

upper and lower body movement, looking for any abnormal muscle tone, movement or strength a. Observation of tremor or any involuntary movements b. Inspection of muscle atrophy c. Palpation d. Range of motion (goniometry, edema, functional tasks) e. Muscle tone testing (hypertonia, hypotonia, spasticity, modified ashworth scale) f. Fine and gross motor movements (functional tasks and specific neuromotor tests) g. Strength of individual muscle groups (MMT, grip strength)

Question 44

how would you tets coordination and gait

Answer 44

a. Coordination (Ataxia, finger-nose, finger opposition, foot tap, heel-shin test...) b. Gait abnormalities, transfers, tandem gait, turns, balance...

Question 45

how would you test sensory sustem

Answer 45

a. Pain b. Numbness c. Touch d. Stereognosis e. Proprioception ***verbal reports of symptoms (numbness, pain...), cotton and pin test, vibration****

Question 46

true or false : as an OT or PT you should keep patient results to yourself and treat the patient by yourself without disvussing with your team

Answer 46

false , you need to talk to the team

Question 47

is the neurological exam helpful for neurologists diagnosis ?

Answer 47

yes very

Question 48

what are teh two main goals for neurological exam

Answer 48

1. TO CONFIRM A SUSPECTED DIAGNOSIS 2. TO RULE OUT A HYPOTHETICAL DIAGNOSIS

Question 49

what is stereogenis

Answer 49

identify what soemthing is when your eyes are closed = perceive through touch

Question 50

what is it called when you identify what soemthing is when your eyes are closed = perceive through touch

Answer 50

stereogenesis

Question 51

true or false people with strokes have a hard time with proprioception

Answer 51

true