Term
| Two most common neurological disorders in older adults |
|
Definition
Cerebrovascular disease
Parkinson's disease |
|
|
Term
| Two types of cerebrovascular disease |
|
Definition
Stroke
Transient ischemic attach (TIA) |
|
|
Term
| Cerebrovascular disease is either _____ or _____ in nature |
|
Definition
|
|
Term
| Which race has the highest occurrence of stroke? |
|
Definition
|
|
Term
| Which race has the lowest occurrence of stroke? |
|
Definition
|
|
Term
| Which race(s) have the highest likelihood of death after an occurrence of stroke? |
|
Definition
| Hispanics and African Americans |
|
|
Term
| Which gender is likely to die after an occurrence of stroke? |
|
Definition
| Both genders are the same in this regard |
|
|
Term
| Four main causes of ISCHEMIC stroke |
|
Definition
Arterial disease
Cardioembolism
Hematological disorders
Systemic hypoperfusion |
|
|
Term
| Causes of HEMORRHAGIC stroke |
|
Definition
Uncontrolled hypertension
Malformations of the blood vessels (e.g. aneurysms) |
|
|
Term
| Most common type of stroke |
|
Definition
Ischemic (87%)
Hemorrhagic (13%) |
|
|
Term
| Most life threatening type of stroke |
|
Definition
|
|
Term
| How is a TIA different from stroke? |
|
Definition
Symptoms of TIA begin to resolve within minutes and all neurological deficits resolve within 24 hours.
TIA does not always precede a stroke. |
|
|
Term
| Stroke and TIA is often preceded by what? |
|
Definition
|
|
Term
| Subarachenoid hemmorhage is often preceded by what? |
|
Definition
Sudden, explosive, very severe headache without other neurological manifestations.
[image] |
|
|
Term
| Hemorrhagic strokes display more specific neurological changes including _____ than those with ischemic strokes |
|
Definition
| seizures and more depressed LOC |
|
|
Term
| If a person is _____ _____ following a stroke, he/she is unlikely to survive |
|
Definition
|
|
Term
|
Definition
Sudden numbness or weakness of face, arm, leg--especially on one side of body
Sudden confusion or trouble speaking/understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, or loss of balance/coordination
Sudden severe headache with no known cause |
|
|
Term
| Nausea and vomiting are suggestive of _____ _____ in response to a stroke of either type |
|
Definition
|
|
Term
| Confirmation f the type of stroke and it's location is done using which type of imaging technique |
|
Definition
Computed tomography (CT)
Magnetic resonance imaging (MRI) |
|
|
Term
| Complications of TIA include |
|
Definition
Increased chance of recurrence
Increased risk for stroke |
|
|
Term
| Long-term effects of stroke may be minimal but can include |
|
Definition
paralysis
hemiparesis
dysarthria
dysphagia
aphasia
Post-stroke depression
Spasticity
Contracture |
|
|
Term
| Medications to treat post-stroke symptoms in combination with post-stroke limitations increase the risk for _____ |
|
Definition
|
|
Term
| Less common complications of stroke include |
|
Definition
blood clots
DVT in the affected limb
pressure ulcers
aspiration pneumonia
UTI |
|
|
Term
| What is the mainstay preventative therapy for elders with history of TIAs? |
|
Definition
Aspirin 81-325 mg/day
For those who are aspirin sensitive, Clopidogrel (Plavix) may be used. |
|
|
Term
| What type of therapy is used to restore compromised circulation to the brain following an ischemic stroke? |
|
Definition
| Reperfusion therapy which uses recombinant tissue plasminogen activator (rt-PA) if the facility is equipped to do so. |
|
|
Term
| Limitations of reperfusion therapy include |
|
Definition
Ischemic occlusive stroke only
After CT confirms the absence of hemorrhage
Treatment can only be used within 3 hours of onset of event. |
|
|
Term
| Recovery from stroke is affected by which two factors? |
|
Definition
Location of stroke
Extent of the brain damage |
|
|
Term
|
Definition
Heart disease
Hypertension
Arrhythmias
Hypercholesterolemia
Diabetes
Smoking
Coagulopathies
Brain tumors
Family history |
|
|
Term
| Assessment of the person following a stroke or TIA |
|
Definition
General:
Vital signs
CV
Respiratory
Abdominal
Neuro:
Level of arousal, orientation, attention.
Speech (Dysarthria, dysphasia)
Cranial nerves
Motor strength
Coordination
Sensation
Gait
Reflexes |
|
|
Term
| Most common neurodegenerative disorder in older adults |
|
Definition
|
|
Term
| By the time the first symptoms of PD are seen, how many dopamine producing cells within the substantia nigra have been lost? |
|
Definition
|
|
Term
| Parkinson's disease is diagnosed most often at what age? |
|
Definition
|
|
Term
| Which gender is more affected by PD? |
|
Definition
|
|
Term
| Which race is most often affected by PD? |
|
Definition
|
|
Term
| Average time between diagnosis with PD and death is _____ |
|
Definition
|
|
Term
|
Definition
1) By ruling out other causes of symptoms
2) When no other explanations are possible, diagnosis is made on the presence of two of the four classic symptoms (One of which must be either tremor or bradykinesia).
3) Diagnosis is supported by a challenge test in which a person is given a dose of levodopa and if there is significant, rapid improvement, the diagnosis is confirmed. |
|
|
Term
|
Definition
| Characteristic gait of PD. Consists of very short steps and minimal arm movements. Turning is difficult and requires many steps. |
|
|
Term
|
Definition
T.R.A.P.
Tremors
Rigidity (Cogwheel)
Akinesia/bradykinesia
Postural instability |
|
|
Term
| How/when to give sinemet? |
|
Definition
To minimize GI side effects:
Must be taken 1hr before or 2hrs after meal
Must be given routinely and on time to prevent fluctuations in symptoms. |
|
|
Term
| What is the first line drug therapy for PD and what are it's goals? |
|
Definition
Carbidopa/Levodopa (Sinemet), Pramipexole (Miraplex), Selegiline (Eldepryl).
Goals: Replacement, Mimicking, or slowing of dopamine breakdown. |
|
|
Term
| When is Deep Brain Stimulation used in PD patients? |
|
Definition
| When patients have not responded to drug therapy or have intractable motor fluctuations, dyskinesias, or tremor. |
|
|
Term
| What is included in an annual medical exam for a patient with PD? |
|
Definition
Review of current meds and pt's complience
Assessment of mental health
Cognitive status
Autonomic assessment (Hypotension, constipation etc.)
Sleep quality
History of falls |
|
|
Term
| Goals of treatment of PD are |
|
Definition
| to preserve self-care abilities and prevent complications |
|
|
Term
|
Definition
| Word retrieval difficulties during spontaneous speech and naming tasks |
|
|
Term
|
Definition
| A communication disorder that can affect a person's ability to use and understand spoken or written words. Results from damage to the side of the brain responsible for language. |
|
|
Term
|
Definition
| Impairment in the ability to articulate words as the result of damage to the central or peripheral nervous system that affects the speech mechanism. Caused by a weakness or incoordination of the speech muscles. |
|
|
Term
| Three major categories of impaired verbal communication: |
|
Definition
Reception: Impaired by anxiety, hearing deficits, altered LOC.
Perception: Impaired by stroke, dementia, and delirium.
Articulation: Impaired by mechanical difficulties such as dysarthria, respiratory disease, destruction of larynx, strokes. |
|
|
Term
| Two areas of the brain responsible for speech. Also known as "Word factories." |
|
Definition
| Broca's and Wernicke's areas in the cerebral cortex. |
|
|
Term
| Define Fluent Aphasia and name three other names that it goes by. |
|
Definition
Results of a lesion in the Wernicke's area. Person speaks fluently but substitutes forgotten words with ones that do not make sense. This type of speech is reffered to as jabberwocky. Person may be unaware of their speech and be confused as to why others do not understand them.
Also known as sensory, posterior, or Wernicke's aphasia. |
|
|
Term
| Define Nonfluent Aphasia and name three other names that it goes by |
|
Definition
Involves damage to the Broca's area. Person understands others but speaks and writes very slowly and uses minimal numbers of words.
Also known as motor, anterior, or Broca's aphasia. |
|
|
Term
| Verbal apraxia or apraxia of speech |
|
Definition
| motor speech disorder that affects the ability to plan and sequence voluntary muscle movements. |
|
|
Term
|
Definition
| Associated with damage to dominant temporoparietal regions of the brain, no single location has been identified, however. Person understands and speaks readily but may have severe word-finding difficulty. Person has inability to name objects. |
|
|
Term
|
Definition
| Results of large left hemisphere lesions and affects most of the language areas of the brain. Person cannot understand words, or speak intelligibly. May use meaningless syllables repetitiously. |
|
|
