Cerebrovascular Accident (CVA) (Exam 4)

Question 1

A sudden, focal neurological deficit resulting from ischemic or hemorrhagic lesions in the brain. Disturbance of blood supply to the brain.

Answer 1

CVA or Stroke

Question 2

Characterized by motor deficits on the side of the body opposite the site of the lesion.

Answer 2

CVA

Question 3

Paralysis

Answer 3

Hemiplegia

Question 4

Weakness

Answer 4

Hemiparesis

Question 5

Hemi refers to ____.

Answer 5

Side of the body effected.

Question 6

Hypoxia due to poor blood supply. 70% _____ stroke.

Answer 6

Ischemic

Question 7

Death of brain tissue occurs when blood flow drops below 20% and can be caused by thrombosis or embolus.

Answer 7

Cerebral Infarct

Question 8

Traveling blood clot. Associated with atrial fibrillation, MI, valvular disease.

Answer 8

Embolus

Question 9

Blood clot. Associated with atherosclerosis.

Answer 9

Thrombosis

Question 10

Bleeding due to rupture of a blood vessel in brain causing compression of brain tissue and vessels. 20% of ____ stroke.

Answer 10

Hemorrhage

Question 11

_____ is caused by changes in the vessel integrity comply due to HTN, aging, or can just occur.

Answer 11

Hemorrhage

Question 12

Subarachnoid, Berry Aneurysm, and Intracerebral.

Answer 12

Types of Hemorrhages

Question 13

Abnormal dilation of bifurcation.

Answer 13

Berry Aneurysm

Question 14

Developmental defect that produces weakness in blood vessel walls; arteries and veins communicate without conjoining capillary beds. 10%.

Answer 14

Arteriovenous Malformation

Question 15

Risk Factors for Stroke

Answer 15

HTN, Heart Disease (Source of Emboli from walls and valves), Diabetes, Peripheral Arterial Disease, Smoking, Inactivity, Obesity, Alcohol Consumption, Elevated cholesterol and lipids.

Question 16

Begins shortly after onset of stroke and reaches maximum in 3-4 days.

Answer 16

Ischemic Brain Edema (Swelling)

Question 17

Swelling gradually subsides by _____.

Answer 17

3 Weeks

Question 18

This is not a CVA. Temporary interruption of blood supply to brain. Symptoms resolve in 24 hours. Indicative of thrombotic disease and increased risk for CVA.

Answer 18

Transient Ischemic Attack (TIA)

Question 19

Stable, severe deficits.

Answer 19

Major Stroke

Question 20

Deteriorating neurological status after admission.

Answer 20

Deteriorating Stroke

Question 21

Affecting persons younger than 45.

Answer 21

Young Stroke

Question 22

4 Stroke Syndromes

Answer 22

Anterior Cerebral Artery Occlusion
Middle Cerebral Artery Occlusion
Vertebrobasilar Artery Occlusion
Posterior Artery Occlusion

Question 23

Frontal and parietal lobes. Contralateral hemiparesis. Contralateral sensory loss. R Hemi (L CVA) aphasia, apraxia, agraphia, unilateral neglect.

Answer 23

Anterior Cerebral Artery Syndrome

Question 24

Lateral Cerebral Hemisphere. Most commonly affected. Contralateral spastic hemiparesis. Contralateral sensory loss. L CVA aphasia. R CVA perceptual problems.

Answer 24

Middle Cerebral Artery

Question 25

Supplies brainstem and cerebellum. Balance. Basic Needs.

Answer 25

Vertebrobasilar

Question 26

Supplies the occipital and temporal lobes, thalamus, and upper brain stem.

Answer 26

Posterior Cerebral

Question 27

Contralateral weakness and sensory loss LE.

Answer 27

Anterior Cerebral

Question 28

Contralateral weakness and sensory loss face and UE.

Answer 28

Middle Cerebral

Question 29

Cranial nerve involvement.

Answer 29

Vertebrobasilar

Question 30

Contralateral sensory loss.

Answer 30

Posterior Cerebral

Question 31

Patients with CVA in the posterolateral thalamus. Push and lean toward their hemiplegic side.

Answer 31

Pusher Syndrome

Question 32

Motor function _____ at onset changing to _____.

Answer 32

Flaccidity, Spasticity | Hyporeflexia, Hyperreflexia

Question 33

Unable to move isolated limb segment without movement in remainder of limb.

Answer 33

Abnormal Synergy Patterns

Question 34

Most common UE synergy.

Answer 34

Flexor Synergy

Question 35

Most common LE synergy.

Answer 35

Extensor Synergy

Question 36

Scapular Retraction/Elevation. Shoulder Abduction 90 Degrees with ER or hyperextension of shoulder. Elbow flexion. Forearm supination. Wrist and finger flexion.

Answer 36

Flexor Synergy UE

Question 37

Scapular Protraction. Shoulder adduction with IR. Elbow extension. Forearm pronation. Wrist extension with fist closure.

Answer 37

Extensor Synergy UE

Question 38

Hip flexion. Hip abduction and ER. Knee flexion 90 Degrees. Ankle DF, Inversion. Toe DF.

Answer 38

Flexor Synergy LE

Question 39

Hip extension. Hip adduction and IR. Knee extension. Ankle PF, Inversion. Toe PF.

Answer 39

Extensor Synergy LE

Question 40

Abnormal Reflexes

Answer 40

ATNR, STLR, STNR, TLR

Question 41

Pressure on bottom of foot results in co-contraction and rigidly extended and fixed limb.

Answer 41

Positive Supporting Reaction

Question 42

UMNL, DF - PF Uncontrollably.

Answer 42

Clonus

Question 43

Extension and separation of fingers when UE raised above 150 Degrees.

Answer 43

Souges' Phenomenon

Question 44

Resistance to hip abduction or adduction noninvolved side evokes same movement on involved side. (LE/LE Both)

Answer 44

Raimiste's Phenomenon

Question 45

A response in one extremity facilitates the same response in the other extremity. (UE/LE Same Side)

Answer 45

Homolateral Limb Synkinesis

Question 46

Patient may have the motor capabilities to perform movement combination but unable to determine or remember the steps necessary.

Answer 46

Apraxia

Question 47

Automatic movement, but no movement on command.

Answer 47

Ideomotor Apraxia

Question 48

No purposeful movement either automatic or on command.

Answer 48

Ideational Apraxia

Question 49

Inability to sustain movement or posture.

Answer 49

Motor Impersistence

Question 50

Acquired communication disorder caused by brain damage and characterized by impairment of language comprehension, oral expression, and the use of symbols to communicate ideas.

Answer 50

Aphasia

Question 51

Difficulty articulating words due to motor weakness and inability to control muscles that produce speech.

Answer 51

Dysarthria

Question 52

Swallowing disorder.

Answer 52

Dysphagia

Question 53

Compulsive, Safety Issues, Poor Planning, Impaired Judgement

Answer 53

Left Hemi, Right CVA

Question 54

Double Vision

Answer 54

Diplopia

Question 55

Blindness in outer half of the visual field of the other eye resulting in inability to receive info from either the R or L half of the visual environment.

Answer 55

Homonymous Hemianopsia

Question 56

Bi-Temporal Hemianopsia

Answer 56

Can't see temporal sides.

Question 57

Bi-Nasal Hemianopisa

Answer 57

Can't see nose sides.

Question 58

L Homonymous Hemianopsia

Answer 58

Can't see L sides.

Question 59

R Homonymous Hemianopsia

Answer 59

Can't see R sides.

Question 60

Cautious, Anxious, Disorganized.

Answer 60

Right Hemi, Left CVA

Question 61

No awareness of that side from midline.

Answer 61

Neglect

Question 62

L Side Neglect

Answer 62

Most Common R CVA

Question 63

Secondary Impairments

Answer 63

Urinary incontinence, bowel incontinence, seizures, flexibility, DVT, PE, de-conditioning, skin breakdown, shoulder dysfunction, shoulder impingement.

Question 64

Acute Rehab 1. Strategy Development

Answer 64

PTA assist with learning task. Begin with demonstration, practice, and progress with self-assessment and problem solving.

Question 65

Acute Rehab 2. Feedback

Answer 65

``` Early = Vision, Extrinsic (Mirror) Mid = Proprioception Late = Intrinsic (Self-correcting) ```

Question 66

Acute Rehab 3. Practice

Answer 66

Repetition. Adequate rest periods. Progression and challenge. Variable practice. Self-monitoring. Environment. Begin and end on positive note. Support and encourgagement.

Question 67

Task-specific Learning. Verbal instructions.

Answer 67

Carr and Shephard Stroke Programme

Question 68

Patient learns to control tone and movement through the use of patterns that promote normal selective movements during functional activities.

Answer 68

Neurodevelopment Treatment (NDT)

Question 69

Patient learns movement control through structured activities that promote function, utilize reinforcement and repetitions.

Answer 69

Movement Therapy in Hemiplegia (Brunnstrom)

Question 70

Select patterns to reinforce and develop selective patterns of control while avoiding synergy patterns.

Answer 70

Proprioceptive Neuromuscular Facilitation (PNF)

Question 71

Classical muscle re-educatoin is the most basic form of ______.

Answer 71

Coordination Exercise

Question 72

NDT primarily used in treatment of ____ patients.

Answer 72

Polio

Question 73

Kenny and Knapp developed and described the clinical techniques for training control of _____ _____.

Answer 73

Prime Movers

Question 74

Conscious activation of single muscle.

Answer 74

Control

Question 75

Discrete control of prime mover, minimal activity of synergists/stabilizers, no activation of antagonists or distant muscles, develop volitional control, ruling out undesired motion.

Answer 75

Control Training

Question 76

Number of muscles into smooth patterns of contraction, sequences of contraction and relaxation, developed only to the extent that the person can inhibit all undesired activity.

Answer 76

Coordination Training

Question 77

Control is developed by monitoring _______ ________ from muscle spindles and joint receptors.

Answer 77

Proprioceptive Feedback

Question 78

Developing coordination requires properly learned and frequently practiced ____ of activity.

Answer 78

Patterns

Question 79

Learn by using a new movement pattern, use the good side. Promotes learned nonuse - negative approach, most appropriate for patient with limited ability to actively particpate.

Answer 79

Compensatory Training

Question 80

Used for patients with increased tone, slow rhythmic rotation.

Answer 80

Inhibition Techniques

Question 81

Attack spasticity 24hrs a day. Reflex inhibition, specifically inhibiting tonic neck reflexes through the use of _____ and positioning.

Answer 81

Air Splints

Question 82

Provide sensory stimulation to the hemiplegia side. Schedule.

Answer 82

Positioning

Question 83

Pelvic/Trunk Malalignment, Scapular Downward Rotation, GH Depression/Subluxation, UE Flexion Synergy in Sitting, LE Synergy in Standing/Supine.

Answer 83

Avoid Positions

Question 84

Promote use of involved site to increase sensory input. Add sensory input by stretching, WB, etc. Safety education.

Answer 84

Sensory Training Strategies

Question 85

Emphasis on pelvic/trunk, scapular alignment, early weight bearing, wrist/hand, shoulder/elbow independent movements.

Answer 85

UE Control

Question 86

LE D1 Flexion/Extension emphasis patterns used in gait, break up synergies, dynamic balance.

Answer 86

LE Control

Question 87

Important motivational activity.

Answer 87

Gait Training