3.2 - Neuro PPT - CVA Review

Question 1

Describe the motor & sensory changes w/ ACA syndrome vs MCA syndrome vs PCA syndrome

Answer 1

ACA Syndrome: LE > UE; hemiparesis & hemisensory loss

MCA Syndrome: UE > LE; hemiparesis and hemisensory loss

PCA: Visual changes (contralateral homonymous hemianopsia, visual agnosia)

Question 2

Which types of stroke (ACA, MCA, or PCA) is abulia most likely to occur with?

Answer 2

Abulia - lack of will / drive

ACA

Question 3

Which types of stroke (ACA, MCA, or PCA) is Broca’s or Wernicke’s aphasia most likely to occur with?

Answer 3

MCA of dominant hemisphere

Question 4

Which types of stroke (ACA, MCA, or PCA) are cerebellar changes (choreoathetosis, intention tremor, hemiballismus) most likely to occur with?

Answer 4

PCA

Question 5

What is hemiballismus?

Answer 5

Involuntary, violent, and ballistic or high-amplitude movements

Often caused by an infarct in or around the contralateral subthalamic nucleus

Question 6

Which hemisphere is likely affected when a patient demonstrates Broca’s or Wernicke’s aphasia?

Answer 6

Dominant hemisphere (often the L side)

Question 7

Review the differences in L vs R sided CVA

Question 8

What is stroke rehab focused on during each of the following phases?

Acute
Subacute
Chronic >6 months

Answer 8

Acute: early mobilization, education, functional mobility training

Subacute: intensive inpatient rehab, functional outcome training

Chronic >6 months: Transition to compensatory training (AFO, tie show w/ one hand, etc.); BIL training, strength, balance, endurance, UE function, locomotion

Question 9

What side will an individual w/ pusher syndrome push to?

Answer 9

Push w/ the strong extremity toward the hemiparetic side

Question 10

Describe intervention strategies for contraversive pushing

Answer 10

Restore normal vertical sensation (biofeedback mirror training)
Proprioceptive input from involved UE (prop involved UE onto table)

Question 11

Describe the synergy patterns of the UE following a stroke

Answer 11

Flexion synergy: scap retraction / elevation; should abduction, ER; elbow flexion; forearm supine; wrist & finger flexion

Extension synergy: scapular protraction; shoulder add, IR; elbow ext; forearm pronation; wrist/finger flexion

Question 12

Describe the synergy patterns for the LE following a stroke

Answer 12

Flexion synergy: hip flx, abd, ER; knee flexion; ankle DF, inv; toe DF

Extension synergy: Hip ext, add, IR; knee ext, ankle PF, inv; toe PF