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Stroke protocols

Alberta Provincial Stroke Strategy

QuestionAnswer
What is the frontal lobes responsible for? Initiation, Judgement, Regulation of behavior/personality, problem-solving and attention
What 2 arterties supply the frontal lobe? The middle and anterior cerebral arteries
What 2 arteries supply the temporal lobe? The middle and posterior cerebral arteries
What is the temporal lobe responsible for? Memory, Language
What is the parietal lobe responsible for? Judging position, Tactile sensation,
Stroke is highly associated with what? Cognitive changes and dementia diagnosis
What fraction of strokes see a cognitive improvement? 1/5
What is attention? The ability to attend and process information
What abstact reasoning? The ability to see implied relations or symbolic meaning
What is judgment? The ability to consider probable outcomes of actions
What is insight? The ability to accurately assess one's abilities
What is memory? The ability to encode and retrieve information
Hypertension increases the risk of stroke how much? 4X
After a stroke, decreasing hypertension, decreases the risk of what? Cognitive decline
What reading is considered a sign of hypertension? Greater than 140/90
What is considered hypertension for a patient with renal failure or diabetes? 130/80
What are symptoms of Cerebral edema after a stroke? Worstening change in level of conciousness, nausea/vomiting, decreased pupillary response
What percentage of stroke patient's have dysphagia? 55%
How can OT assist a patient with dysphagia? Use feeding equipment, eliminate tablespoons and large forks (limit to smaller utensils), ensure upright posture
What precautions need to be followed for a hemiparetic shoulder? Avoid pulling or lifting shoulderHow
How can a hemiparetic arm be supported? Sitting-lab tray, arm rest Laying- with pillows Standing-sling, or pockets
What kind of therapies should be performed with a hemiparetic limb? Pain free range of motions, motions that use active range
What is hemorragic transformation? Bleeding into the brain 1-2 days after a stroke
What are signs of hemorragic transformation? Sudden progressive worstening of conciousness, pupillar response, vitals, sensory or motor symptoms
Pt's with dysphagia should sit at what angle? 90 degrees
How should Passive Range of motion (PROM) be performed with a hemiparetic shoulder? It should be limited to 90 degrees of flexion or abduction if the scapula doesn't rotate
What is aphasia/dysphasia? Inability to use language
What is dysarthria? difficulty pronouncing words due to lack of speech muscle control
What is dyspraxia? Only automatic speech Hi, Bye, your welcome, swears, remain but otherwise control isn't present.
How is speech different than language? Speech is the use of the muscles, Language is the dictionary of words.
What are the two types of aphasia? Expressive (left damage to BROCA's area) Receptive can't understand words (right Wernike's area)
What two tone changes are common in stroke? Low tone-flaccidity High tone- spacticity
When is the soonest a stroke survivor can/should be mobilized? As soon as their symptoms are no longer worstening
What techniques are often effective for communicating with a person with a stroke (3)? 1. Yes/No Questions. 2. Pointing to key words (eg. Yes/No/maybe) 3. Guestures
What 3 visual issues are common to stroke survivoers? 1. Diplopia 2. Hemianopia 3. Visual acuity
What is hemianopia? Loss of vision on one half of the body
How should changes in visual acuity in stroke survivors be treated ? referral to an optometrist
How can double vision or hemianopsia be treated? teach scanning, refer to an optometrist
Unilateral neglect is what? Inability to attend to objects (they don't exist) on one side
What are treatments for unilateral neglect? setting up stimulation at midline
What is apraxia? Engaging in inappropriate motor activities or sequences
What are 3 methods to deal with apraxia? 1. Diagrams of how to perform an activity 2. Use verbal cues NOT demonstration 3. Hand over hand guidance
What percentage of stroke survivors struggle with incontinence? 40-80%
What are the causes of incontinence in stroke? Inability to reach the washroom (environment and mobility), Decreased sensation, Decreased muscular use
What stategies can be used to help manage incontinence? Schedualed voiding, Pelvic exercises, Catheter removal ASAP, Compesatory Tech
Created by: swcherry