LECTURE 5 - Stroke and Stroke Rehabilitation [UPDATED]

Selective attention is the ability to attend to stimuli or messages that are meaningful or address a need while ignoring other stimuli.

One goal is to improve general endurance and activity tolerance.

Cognition refers to mental processes involved in gaining knowledge or learning, thinking, understanding, remembering, judging, and problem-solving.

Ataxia is the lack of muscle coordination when a voluntary movement is attempted, affecting motions that require muscles to work together, such as walking or picking up objects.

The most commonly reported age-related pattern is increased recruitment of lateral aspects of the prefrontal cortex bilaterally.

TRUE

Medication, maintenance of an open airway, improvement of breathing, hydration with intravenous fluids, treatment of hypertension, evaluation of coexisting diseases, prevention of DVT, and addressing bowel/bladder dysfunction.

Neuroplasticity is the brain's capacity to reorganize itself by forming new neural connections and pathways throughout life.

The left hemisphere is typically associated with logical reasoning and analytical tasks.

Divided attention is the ability to attend to more than two things simultaneously, often referred to as multi-tasking.

TRUE

The incoordination of the organs of speech causes slurred and slow speech.

The right hemisphere is primarily concerned with nonverbal functions of communication, such as the analysis of spatial, temporal, and emotive forms of communication.

Cognitive skills and abilities are mental functions required to carry out any task, ranging from the simplest to the most complex, including attention, memory, executive functioning, perception, language, and visual and spatial processing.

Dementia is a group of symptoms affecting memory, thinking, reasoning, and social abilities, which interfere with daily functioning.

Delirium is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment.

Delirium has a rapid onset, significantly impaired attention, and fluctuating symptoms throughout the day, while dementia begins gradually, maintains general alertness in early stages, and has more stable memory and thinking skills.

Brain lateralization refers to the specialization of certain functions in either the left or right hemisphere of the brain.

Sustained attention is the ability to remain focused on a task or specific stimuli, with problems arising when distractions occur.

Hypotonia is decreased muscle tone, causing the arm, for example, to appear flaccid or limp.

Apraxia is a neurological disorder characterized by the inability to perform learned, familiar movements on command, despite understanding the request and being physically able to do so.

The ability to learn and remember new skills can be maintained well into a person's 70s, 80s, and beyond.

A stroke can lead to communication and language impairments, such as aphasia, which affects a person's ability to speak, understand, read, or write.

Skills such as attention, memory, and problem-solving may be affected by spina bifida.

The main structures of the brain include the cerebrum, cerebellum, and brainstem.

Episodic memory captures the 'what, where, when' of our daily lives, including memories of experiences and specific events.

Ischemic strokes

Unilateral Neglect is a failure to attend to the side opposite of the brain lesion, most often seen with right hemisphere brain damage, particularly in the right parietal lobe.

Research indicates altered patterns of brain activity in older versus younger adults when performing executive functioning tasks.

The main pathological features of Alzheimer's Disease include neuritic plaques, which are clusters of degenerating nerve endings, and neurofibrillary tangles, which are tangles of nerve fibers within nerve cells.

A stroke occurs when blood flow to a part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients.

Weakening of an artery wall that creates a bulge of the artery.

Apraxia is usually associated with damage to the parietal lobes.

Agnosia is usually caused by damage to the parietal, temporal, or occipital lobes.

Short-term memory is information stored temporarily for a very short period; it has limited storage.

Aphasia typically results from damage to the left hemisphere of the brain.

Older adults selectively attend to positive stimuli.

Dysphasia is an impairment of language and communication, considered a less severe form of aphasia.

Perseveration is repetitive and continuous behavior, speech, or thought.

The primary focus is on sensory processing and its implications in health care.

Ischemic stroke and Hemorrhagic stroke

Unilateral Spatial Neglect refers to not seeing objects or parts of objects on the neglected side, such as failing to see parts of a shirt while dressing.

The brain's ability to change can occur as a result of learning and experience, as well as damage, disease, or injury to the brain.

Alzheimer's Disease causes cognitive difficulties that progressively worsen over time due to the degeneration of brain cells.

Memory, learning, and attention begin to decline as we get older.

Agnosia is characterized by an inability to interpret sensory stimuli and recognize objects, faces, sounds, or places.

Memory involves the storage and recall of information.

Semantic memory often improves, procedural memory typically stays the same, and remote memory for distant past events is okay.

Attention and other non-cognitive factors influence the ability to learn.

Broca’s Aphasia, also known as Expressive Aphasia or Non-fluent Aphasia, involves impairment in the production of speech and language.

It depends on the nature of the stroke and functional impact & limitations.

Dysarthria is an articulation or speech disorder that results from impaired movement of the muscles used for speech.

The onset of delirium is usually rapid, occurring within hours or a few days.

Parts of the brain may shrink, such as the prefrontal cortex; communication between neurons may change; and blood flow may be affected.

Unilateral Body Neglect is the failure to attend to the neglected side of the body, such as not dressing or completing dressing on that side.

Inadequate blood supply to a body part or organ.

Common functional impacts include weakness or paralysis on one side of the body, difficulties with speech and language, and sensory deficits.

A blood clot that develops elsewhere in the body, breaks loose, travels to the brain, and blocks blood flow in an artery.

A stroke caused by a blood clot that develops in the arteries supplying blood to the brain.

Practicing retrieval strengthens memory by reinforcing neural connections and making it easier to access information later.

Visual agnosia is the inability to recognize familiar objects by sight.

Global Aphasia is characterized by the loss of all language skills.

Semantic memory is the ability to recall concepts, general knowledge, facts, and meanings.

Perseveration is often associated with frontal lobe injury to the brain.

Symptoms of dementia include memory loss, impaired judgment or language, and the inability to perform some daily activities.

Broca's area is linked to speech production.

Wernicke's area is responsible for speech comprehension.

Functional imaging studies suggest increased recruitment of brain areas in older adults that may reflect a form of compensation.

The Middle Cerebral Artery Stroke primarily affects the lateral aspects of the cerebral hemisphere, impacting motor and sensory functions.

Common symptoms include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body, confusion, trouble speaking, and difficulty seeing.

Chunking involves breaking down large pieces of information into smaller, manageable units to make them easier to remember.

Ideomotor Apraxia is the impaired ability to correctly mime tool use or imitate hand gestures.

Common symptoms of dementia include memory loss, difficulty communicating, and changes in mood or behavior.

Anxiety, dehydration, depression, infections, medication side effects, poor nutrition, stress, substance abuse, and thyroid imbalance.

Remote memory is the recall of prior events that occurred in the distant past, such as years or decades ago.

Anomic Aphasia is characterized by difficulties with word retrieval.

Sensory processing influences patient interactions, treatment approaches, and overall care strategies.

Engaging in regular exercise, eating a healthy diet, and getting enough sleep.

Attention is the ability to sustain concentration on particular stimuli, object, action, or thought.

Lifestyle, overall health, environment, and genetics.

Tissue death (necrosis) due to inadequate blood supply to the body part.

A Middle Cerebral Artery Stroke can lead to aphasia, which is a language impairment affecting the ability to speak, understand, read, or write.

There is a modest decline in the ability to learn new things.

Older adults may perform worse on complex tasks and exhibit slower information processing speed.

The ability to organize steps for an activity and anticipate outcomes.

Auditory agnosia is the inability to identify objects through sound.

Wernicke’s Aphasia, also known as Receptive Aphasia or Fluent Aphasia, involves impairment of language comprehension.

Strategies include verbal/visual feedback, compensatory strategies, and environmental modifications.

The nature and severity of the stroke.

Wernicke's area is commonly in the temporal lobe on the left side of the brain.

Additional brain regions may be activated.

Hypertonia refers to too much muscle tone, resulting in stiff and difficult-to-move arms or legs.

Techniques such as visualization, chunking information, using mnemonic devices, and practicing retrieval can enhance memory retention.

Stroke rehabilitation is a process that helps individuals recover skills lost due to stroke, focusing on improving mobility, speech, and daily living activities.

The primary focus is on cognition and its impact on individuals with spina bifida and hydrocephalus.

Hydrocephalus can lead to challenges in cognitive development, impacting learning and memory.

Aphasia is a language disorder resulting from neurological impairment that affects speech production, comprehension, reading, writing, auditory comprehension, gesture interpretation, and mathematical skills.

Long-term memory is information stored and retrievable over a long period of time, with unlimited storage.

Gustatory agnosia is the inability to identify tastants through taste.

Assessments include trunk control, movement of upper/lower extremities, and cognitive assessment.

Hemiparesis is a condition characterized by weakness on one side of the body, often resulting from a cerebrovascular accident (CVA) such as a stroke.

The left hemisphere focuses on verbal functions of communication, including the analysis of language and processing cognitive information.

They help maintain cognitive function and keep the brain engaged.

Distractions can divert attention and hinder the process of acquiring, rehearsing, and retrieving information.

The right hemisphere is generally associated with creativity, intuition, and spatial abilities.

Brain lateralization affects cognitive skills by allowing different hemispheres to specialize in different types of processing, enhancing overall cognitive function.

The ability to enable goal-oriented behavior such as planning and carrying out a task.

Mnemonic devices are memory aids that use associations, such as acronyms or rhymes, to help remember information.

Ideational Apraxia involves difficulty carrying out a sequence of actions to perform a learned, complex, multi-step task, and impairment of object or action knowledge.

Working memory refers to processes used to temporarily store, organize, and manipulate information.

The ability to define a problem correctly in order to generate solutions and select the right one.

The ability to break down actions into manageable units and prioritize them in the correct order.

Equipment may include splints, mobility aids, and assistive devices for self-care.

Alzheimer's Disease is the most common cause of dementia, a progressive disease where connections between brain cells and the cells themselves degenerate and die, leading to a decline in memory and mental function.

Maintaining close relationships and interactions with family, friends, and community supports mental health and cognitive function.

The brain's ability to operate effectively even when some function is disrupted or the amount of damage the brain can sustain before changes in cognition are evident.

Visualization helps by creating mental images that make information more memorable and easier to recall.

Common therapies include physical therapy, occupational therapy, speech therapy, and recreational therapy.

Aspects of episodic and long-term memory decline somewhat over time, such as forgetting names or keys.

Older adults may improve in vocabulary and other forms of verbal knowledge.

The ability to identify and manage one’s emotions for successful or good performance.

The ability to plan a series of maneuvers for obtaining a specific result.

Rehabilitation interventions may involve optimizing mobility, strength, range of motion, assessing trunk control, improving endurance, self-care tasks, cognitive assessment, speech therapy, and more.

Cognitive reserve may explain the differences in cognitive health among older adults.

Key components of cognition include perception, attention, memory, reasoning, and decision-making.

Aging can lead to slower processing speeds, decreased memory capacity, and challenges in multitasking.

Tactile agnosia is the inability to recognize familiar objects by touch.

Early intervention can help address cognitive challenges and support better developmental outcomes.

Olfactory agnosia is the inability to identify odors through smell.

Procedural memory involves remembering how to do things.

Cognitive declines can be slowed or even reversed if cognitive abilities are exercised appropriately.

The ability to make decisions based on incomplete information or problem-solving.

The capacity to efficiently switch to an appropriate mental function and adopt multiple approaches.

A cerebrovascular accident (CVA), commonly known as a stroke, occurs when blood flow to a part of the brain is interrupted.

As we age, we become more distractible and may perform poorly on tasks requiring inhibition of interference.

Older adults may be less sensitive to interference when making emotional judgments.

Preventative measures include fall prevention, contracture prevention, and pressure sore prevention.