Cerebrovascular Accident Flashcards

Flashcards reviewing key concepts related to Cerebrovascular Accidents (Stroke)

What is the impact of stroke in the United States regarding mortality and disability?

Fifth leading cause of death, leading cause of long-term disability.

Which type of stroke, ischemic or hemorrhagic, is more common?

Ischemia.

What is ischemia?

Poor blood supply leading to decreased oxygenation of tissue.

What are the two major categories of ischemic strokes?

Thrombosis and Embolus.

What is a major contributory factor in cerebrovascular disease, characterized by plaque formation?

Atherosclerosis.

What are common sites for lesions related to atherosclerosis in the cerebral blood supply?

Origin of the common carotid artery, bifurcation of the middle cerebral artery, junction of vertebral arteries with the basilar artery.

What conditions are frequently associated with embolic strokes?

Cardiovascular disease, atrial fibrillation, myocardial infarction, or valvular disease.

What is the ischemic penumbra?

Area surrounding infarcted cerebral tissue where cells are damaged but still viable.

What causes hemorrhagic strokes?

Abnormal bleeding from rupture of a cerebral vessel.

What are the types of hemorrhagic strokes?

Intracerebral and subarachnoid hemorrhage, and arteriovenous malformation (AVM).

What are primary causes of subarachnoid hemorrhages?

Aneurysms and vascular malformations.

What are arteriovenous malformations (AVMs)?

Congenital anomalies with a tangle of arteries and veins without a capillary system.

What are major risk factors for stroke?

Hypertension, diabetes mellitus (DM), disorders of heart rhythm, high blood cholesterol, smoking, heart disease (HD).

What are methods of medical intervention used to determine the etiology of stroke?

Physical examination, CT scan, MRI.

What are the major cerebral arteries affected in stroke syndromes?

Anterior cerebral, middle cerebral, vertebrobasilar, and posterior cerebral arteries.

What are typical patient deficits associated with anterior cerebral artery stroke?

Contralateral weakness and sensory loss primarily in the lower extremity, incontinence, aphasia, and apraxia.

What are typical patient deficits associated with middle cerebral artery stroke?

Contralateral sensory loss and weakness in the face and upper extremity, homonymous hemianopia, and aphasia.

What are typical patient deficits associated with vertebrobasilar artery stroke?

Cranial nerve involvement, ataxia, equilibrium disturbances, headaches, and dizziness.

What are typical patient deficits associated with posterior cerebral artery stroke?

Contralateral sensory loss, pain, memory deficits, homonymous hemianopia, visual agnosia, and cortical blindness.

Which area of the brain does the anterior cerebral artery supply?

Supplies the superior border of the frontal and parietal lobes.

Which area of the brain does the middle cerebral artery supply?

Supplies the surface of the cerebral hemispheres and deep frontal and parietal lobes.

Which area of the brain does the vertebrobasilar

Supplies the brainstem and cerebellum.

Which area of the brain does the posterior cerebral artery supply?

Supplies the occipital and temporal lobes, thalamus, and upper brainstem.

What is left hemianopia?

Sensory loss on the left half of each eye

What is locked-in syndrome?

Patient is aleart and oriented but unable to move or speak, eye movement may be preserved.

What is hemianesthesia?

Contralateral sensory loss

What is the definition of visual agnosia?

Inability to recognize or name objects despite being able to see them.

What is thalamic pain syndrome?

Intolerable burning pain and senosry perseveration.

What is pusher syndrome?

Patients actively push and lean toward their hemiplegic side and have an increased risk for falls.

What characterizes lacunar strokes?

Located in the deep regions of the brain and associated with hypertensive hemorrhage and diabetic microvascular disease.

What is hemiplegia/hemiparesis?

Paralysis or weakness on one side of the body, opposite the side of the lesion.

What is spasticity?

Exaggerated deep tendon reflexes and velocity-dependent increased muscle tone.

What is the Modified Ashworth Scale?

Tool used to assess the degree of resistance during passive movements.

What are the stages of motor recovery according to Brunnstrom?

Flaccidity, spasticity begins to develop, spasticity increases, spasticity begins to decrease, spasticity continues to decrease, spasticity is essentially absent, return to normal function.

What is Apraxia?

Difficulty performing purposeful movements despite having the motor and sensory ability.

What conditions are include in impairments of body scheme/ body image?

Unilateral neglect, anosognosia, somatagnosia, right-left discrimination, finger agnosia.

What is angnosia?

Inability to recognize incoming information despite intact sensory capacities

What is aphasia?

Impairment of language comprehension, oral expression, and use of symbols to communicate ideas.

What is dysarthria?

Difficulty articulating words due to weakness and inability to control the muscles associated with speech production.

What is dysphagia?

Difficulty or inability to swallow foods and liquids.

What is aspiration?

Penetration of food, liquid, saliva, or gastric reflux into the airway.

What is the response to the flexor withdrawal reflex?

Toe extension, ankle dorsiflexion, hip and knee flexion due to noxious stimulus applied to the bottom of the foot.

What is the repsonse to the cross extension reflex?

Flexion and then extension of the opposite lower extremity due to noxious stimulus applied to the ball of the foot with the lower extremity prepositioned in extension.

What is the response to the startle reflex?

Extension and abduction of the upper extremities due to sudden loud noise.

What is the response to the grasp reflex?

Flexion of the toes or fingers when pressure applied to the ball of the foot or the palm of the hand.

What is repsonse to Symmetric tonic neck reflex?

Flexion of the arms and extension of the legs with neck flexion and extension of the arms and flexion of the legs with neck extension.

What is repsonse to Asymmetric tonic neck reflex?

Extension of the left arm and leg and flexion of the right arm and leg with rotation of the head to the left and Extension of the right arm and leg and flexion of the left arm and leg with rotation of the head to the right.

What is repsonse to Tonic labyrinthine reflex?

Prone position facilitates flexion and supine position facilitates extension.

What is repsonse to Tonic thumb reflex?

Thumb extension is facilitated with forearm supination when the involved extremity is elevated above the horizontal.

What is Vital Capacity (VC)?

Maximum amount of air a person can expel from the lungs after a maximum inhalation.

What are associated reactions?

Automatic movements that occur as a result of active or resisted movement in another part of the body.

What is Souques phenomenon?

Flexion of the involved arm above 150 degrees facilitates extension and abduction of the fingers.

What is Raimiste phenomenon?

Resistance applied to hip abduction or adduction of the uninvolved lower extremity causes a similar response in the involved lower extremity.

What is Homolateral limb synkinesis?

Flexion of the involved upper extremity elicits flexion of the involved lower extremity.

What are examples of cognitive deficits?

Impairments in alertness, attention, orientation, memory, or executive functions.

What are Executive functions?

Abilities that enable a person to engage in purposeful behaviors; include volition, planning, purposeful action, and effective performance.

What is abnormal posturing and positioning?

Spasticity in specific muscle groups leading to contractures and deformities.

What are the signs and symptoms includes in complex regional pain syndrome?

Pain, autonomic nervous system signs and symptoms, edema, movement disorders, weakness, and atrophy.

What are outcome measures identified in the Core Set endorsed by the Academy of Neurologic Physical Therapy?

Berg Balance Scale, Functional Gait Assessment, 10 Meter Walk Test, 6 Minute Walk Test, Five Times Sit to Stand Test, Activities Specific Balance Confidence Scale.

What are examples of caridopulmonary retraining methods?

Diaphragmatic strengthening, deep-breathing exercises, use of incentive spirometers, stretching activities to the lateral trunk.

What are the benefits of positioning?

Stimulating motor function, increases sensory awareness, improves respiratory and oromotor functions, and assists in maintaining normal range of motion in the neck, trunk, and extremities.

What is a Cerebrovascular Accident (CVA) or Stroke?

Sudden loss of neurological function caused by an interruption of blood flow to the brain.

How long must neurological deficits persist to be classified as a stroke?

At least 24 hours.

What is a transient ischemic attack (TIA)?

Temporary interruption of blood supply to the brain, resolving within 24 hours.

What thrombolytic agent is used in acute medical management of stroke?

Recombinant tissue plasminogen activator (rt-PA).

Rehabilitation approach for stroke patients

Cardiopulmonary retraining methods, positioning, and range of motion exercise.