Term
| what activities does the barthel index measure |
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Definition
| feeding, bathing, grooming, dressing, bowels, bladder, toilet use, transfers, mobility, stairs |
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Term
| what is the range of scores of the barthel index |
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Definition
|
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Term
| what is the best score of the barthel index |
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Definition
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Term
| what is the best score of the NIH stroke scale |
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Definition
|
|
Term
| what does the NIH stroke scale look at |
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Definition
| level of consciousness, vision, motor, sensory, speech |
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Term
| what does the precentral gyrus do? |
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Definition
|
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Term
| what does the postcentral gyrus do |
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Definition
| controls sensory information |
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|
Term
| what is the area of expressive speech |
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Definition
|
|
Term
| what is the area of comprensive speech |
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Definition
|
|
Term
| what does anterior cerebral artery come from |
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Definition
|
|
Term
| what functions are supplied by aca |
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Definition
|
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Term
| what functions are supplied by mca |
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Definition
| speech, arm/head/trunk movement |
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Term
| which artery supplies brainstem, cerebellum |
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Definition
|
|
Term
| what type of stroke is tPA given for? |
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Definition
|
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Term
| what are the objectives for EMS |
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Definition
| stabilize patient (breathing/pulse), rapid identification of stroke, eliminate co-morbid conditions that could mimic stroke, rapid transport to ED, notify ED of stroke for preparation |
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|
Term
| what does EMS need to ask about |
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Definition
| onset of symptoms (time), recent events, comorbid disease, medications, allergies |
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|
Term
| what are some stroke screening tools done by ems |
|
Definition
| cincinnati prehospital stroke scale, los angeles prehospital stroke screen |
|
|
Term
| what does the cincinnati prehospital stroke scale contain |
|
Definition
| facial droop, arm lift, speech |
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|
Term
| what does the los angeles prehospital stroke screen look at |
|
Definition
| age, symptom duration, no history of seizures, others |
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|
Term
| how will you know if stroke is hemorrhagic or ischemic |
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Definition
|
|
Term
| what is the best treatment of ischemic stroke |
|
Definition
| tissue plasminogen activator (tpa) administered within 3-4.5 hours of symptom onset |
|
|
Term
| what other device can be used with ischemic stroke up to 8 hours after onset |
|
Definition
|
|
Term
|
Definition
| transient ischemic attack = reversible |
|
|
Term
| how long do signs/symptoms of TIA last |
|
Definition
|
|
Term
| what to do for patients who have had TIAs |
|
Definition
| urgent eval. Risk of stroke in 48 hrs is 5% |
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|
Term
| what are risk factors for ischemic stroke |
|
Definition
| atrial fibrillation, carotid stenosis, hypertension, dyslipidemia, diabetes, smoking, obstructive sleep apnea |
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|
Term
| what are causes of intracerebral hemorrhage |
|
Definition
| hypertension, bleeding problems, brain tumors |
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|
Term
| why must cat scan be re-checked 24 hours after tpa? |
|
Definition
| tpa puts you at risk for hemorrhagic stroke |
|
|
Term
| how are intracerebral hemorrhages managed conservatively |
|
Definition
| stabilize airway, BP control, intracranial pressure management, seizure control, fever control, glucose management |
|
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Term
| what are non-conservative ways to manage intracranial hemorrhages |
|
Definition
| Intracranial pressure monitoring, extraventricular drain for hydrocephaly, clot evacuation, hemicraniectomy to take off part of skull and allow brain, skull to swell |
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|
Term
| what are signs/symptoms of subarachnoid hemorrhage |
|
Definition
| severe headache, neck stiffness and rigidity, nausea/vomiting, photophobia/phonophbia, (like a bad migraine) |
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|
Term
| risk factors for hemorrhagic stroke |
|
Definition
| hypertension, diabetes, smoking, anticoagulation, use of statins |
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|
Term
| what impairments are seen after R CVA |
|
Definition
| hemispatial neglect, visual perception, knowing where they are in space (issue with safety) |
|
|
Term
| what impairments are seen after L CVA |
|
Definition
| language impairments, difficulty motor planing and motor programming |
|
|
Term
| why is MCA most likely to have a stroke |
|
Definition
| it's more of a straight shot from carotid to MCA |
|
|
Term
| which artery supplies temporal lobe |
|
Definition
|
|
Term
|
Definition
|
|
Term
| list impairments that could occur following MCA stroke |
|
Definition
| contralateral hemiplegia; contralateral loss of sensation; contralateral homonymous hemianopsia; paralysis of conjugate gaze to contralateral side; expressive aphasia; receptive aphasia; acalculia/anomia/finger agnosia/right-left confusion; loss of topographic memory; unilateral neglect |
|
|
Term
| list impairments that could occur following ACA stroke |
|
Definition
| contralateral hemiplegia with LE affected more than UE; contralteral loss of sensation in LE; gait apraxia; urinary incontinence; left limb dyspraxia bc of corpus callosum |
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|
Term
| list impairments following PCA occlusion |
|
Definition
| contralateral homonymous hemianopsia with macular sparing; visual hallucinations; memory loss; thalamic syndrome; hemiballismus; choreoathetosis; |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| ipsilateral loss of CN III, contralateral hemiplegia. |
|
|
Term
| by what point after a stroke is neurological recovery generally complete |
|
Definition
|
|
Term
| how long after a storke can you continue to have functional improvement |
|
Definition
|
|
Term
| describe outcome of patient with motor only vs motor and sensory impairments |
|
Definition
| having more impairments reduces lieklihood of good outcome |
|
|
Term
| what BI score indicates patient can live at home with some assistance |
|
Definition
|
|
Term
| what are negative prognostic indicators for stroke |
|
Definition
| prior history of stroke, abnormal muscle tone, initial motor deficit, loss of sitting balance, sensory deficits, visual spatial deficits, cognitive deficits, incontinence, depression/lack of support |
|
|
Term
| how does intensity of rehab relate to outcome |
|
Definition
| greater intensity leads to better outcomes |
|
|
Term
| what indicates that a storke patient will have useful arm function at 6 months |
|
Definition
| measureable grip strength at 24 days, shoulder shrug early on |
|
|
Term
| what are the stages in duncan's stroke recovery staging system |
|
Definition
| stage 1: very impaired; stage 2: semi-independent; stage 3: will need minimal assistance; stage 4: complete or almost complete recovery |
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|
Term
| what are the general considerations of the carr and shepherd approach? |
|
Definition
| context-specificity of muscle action; maintenance of balanced alignment of body segments; cognitive effort and active participation by the patient; consistency of practice |
|
|
Term
| what are the 4 steps in assessment and treatment according to carr and shepherd? |
|
Definition
| analysis of the task, practice of missing components, practice of the task, transference of training |
|
|
Term
| what to look for in task analysis |
|
Definition
| what components are missing. What compensations are being used |
|
|
Term
| what are the essential components of being able to reach and grasp according to carr and shepherd? |
|
Definition
|
|
Term
| considerations for practice to improve UE function according to Carr & Shepherd |
|
Definition
| begin early working with patient in supine with arm elevated for reaching. Shift from concentric to eccentric in different parts of range and at various speeds. Have patient consciously try to eliminate unnecessary muscle activity. If patient is unable to achieve control, use orthoses and/or biofeedback. introduce tasks using both arms as soon as possible. avoid compensatory strategies and learnednon-use; manage shoulder dysfunction |
|
|
Term
| what are techniques for improving upper limb control in sidelying |
|
Definition
| trunk elongation, scapular mobilization, active scapular movement |
|
|
Term
| what are techniques for improving upper limb control in supine |
|
Definition
| active elbow extension including eccentric control; controlled mobility at the shoulder with elbow extended; combined shoulder stability with distal movement; cane exercises |
|
|
Term
| what are some techniques for improving UE control in sitting |
|
Definition
| weightbearing through elbow, weightbearing through hand , trunk rotation with arms across chest, roll ball, pick up ball, reach arm across table, pick up glass, hold stick and touch ends to table for supination, make an impression in putty with 3rd metacarpal (supination), grasp and release a glass, push away an object with thumb, progress to picking up styrofoam cup, |
|
|
Term
| what are some techniques for improving UE control in standing |
|
Definition
| leaning against wall to weightbear on bilateral Ues |
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|
Term
| is the typical control after stroke proximal to distal or distal to proximal? |
|
Definition
|
|
Term
| how to determine which task is best for a patient. |
|
Definition
| ask what they like to do, make it relative and functional |
|
|
Term
| why is it harder for someone to touch their head than their chest? |
|
Definition
| touching their head requires ER |
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