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Neurology > Cerebrovascular Accident (CVA) (Exam 4) > Flashcards

Cerebrovascular Accident (CVA) (Exam 4) Flashcards

1
Q

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

A

CVA or Stroke

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2
Q

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

A

CVA

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3
Q

Paralysis

A

Hemiplegia

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4
Q

Weakness

A

Hemiparesis

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5
Q

Hemi refers to ____.

A

Side of the body effected.

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6
Q

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

A

Ischemic

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7
Q

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

A

Cerebral Infarct

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8
Q

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

A

Embolus

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9
Q

Blood clot. Associated with atherosclerosis.

A

Thrombosis

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10
Q

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

A

Hemorrhage

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11
Q

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

A

Hemorrhage

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12
Q

Subarachnoid, Berry Aneurysm, and Intracerebral.

A

Types of Hemorrhages

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13
Q

Abnormal dilation of bifurcation.

A

Berry Aneurysm

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14
Q

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

A

Arteriovenous Malformation

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15
Q

Risk Factors for Stroke

A

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

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16
Q

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

A

Ischemic Brain Edema (Swelling)

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17
Q

Swelling gradually subsides by _____.

A

3 Weeks

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18
Q

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.

A

Transient Ischemic Attack (TIA)

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19
Q

Stable, severe deficits.

A

Major Stroke

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20
Q

Deteriorating neurological status after admission.

A

Deteriorating Stroke

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21
Q

Affecting persons younger than 45.

A

Young Stroke

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22
Q

4 Stroke Syndromes

A

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

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23
Q

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

A

Anterior Cerebral Artery Syndrome

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24
Q

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

A

Middle Cerebral Artery

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25
Q

Supplies brainstem and cerebellum. Balance. Basic Needs.

A

Vertebrobasilar

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26
Q

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

A

Posterior Cerebral

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27
Q

Contralateral weakness and sensory loss LE.

A

Anterior Cerebral

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28
Q

Contralateral weakness and sensory loss face and UE.

A

Middle Cerebral

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29
Q

Cranial nerve involvement.

A

Vertebrobasilar

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30
Q

Contralateral sensory loss.

A

Posterior Cerebral

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31
Q

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

A

Pusher Syndrome

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32
Q

Motor function _____ at onset changing to _____.

A

Flaccidity, Spasticity

Hyporeflexia, Hyperreflexia

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33
Q

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

A

Abnormal Synergy Patterns

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34
Q

Most common UE synergy.

A

Flexor Synergy

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35
Q

Most common LE synergy.

A

Extensor Synergy

36
Q

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

A

Flexor Synergy UE

37
Q

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

A

Extensor Synergy UE

38
Q

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

A

Flexor Synergy LE

39
Q

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

A

Extensor Synergy LE

40
Q

Abnormal Reflexes

A

ATNR, STLR, STNR, TLR

41
Q

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

A

Positive Supporting Reaction

42
Q

UMNL, DF - PF Uncontrollably.

A

Clonus

43
Q

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

A

Souges’ Phenomenon

44
Q

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

A

Raimiste’s Phenomenon

45
Q

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

A

Homolateral Limb Synkinesis

46
Q

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

A

Apraxia

47
Q

Automatic movement, but no movement on command.

A

Ideomotor Apraxia

48
Q

No purposeful movement either automatic or on command.

A

Ideational Apraxia

49
Q

Inability to sustain movement or posture.

A

Motor Impersistence

50
Q

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

A

Aphasia

51
Q

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

A

Dysarthria

52
Q

Swallowing disorder.

A

Dysphagia

53
Q

Compulsive, Safety Issues, Poor Planning, Impaired Judgement

A

Left Hemi, Right CVA

54
Q

Double Vision

A

Diplopia

55
Q

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.

A

Homonymous Hemianopsia

56
Q

Bi-Temporal Hemianopsia

A

Can’t see temporal sides.

57
Q

Bi-Nasal Hemianopisa

A

Can’t see nose sides.

58
Q

L Homonymous Hemianopsia

A

Can’t see L sides.

59
Q

R Homonymous Hemianopsia

A

Can’t see R sides.

60
Q

Cautious, Anxious, Disorganized.

A

Right Hemi, Left CVA

61
Q

No awareness of that side from midline.

A

Neglect

62
Q

L Side Neglect

A

Most Common R CVA

63
Q

Secondary Impairments

A

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

64
Q

Acute Rehab 1. Strategy Development

A

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

65
Q

Acute Rehab 2. Feedback

A 
Early = Vision, Extrinsic (Mirror)
Mid = Proprioception
Late = Intrinsic (Self-correcting)
66
Q

Acute Rehab 3. Practice

A

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

67
Q

Task-specific Learning. Verbal instructions.

A

Carr and Shephard Stroke Programme

68
Q

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

A

Neurodevelopment Treatment (NDT)

69
Q

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

A

Movement Therapy in Hemiplegia (Brunnstrom)

70
Q

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

A

Proprioceptive Neuromuscular Facilitation (PNF)

71
Q

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

A

Coordination Exercise

72
Q

NDT primarily used in treatment of ____ patients.

A

Polio

73
Q

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

A

Prime Movers

74
Q

Conscious activation of single muscle.

A

Control

75
Q

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

A

Control Training

76
Q

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.

A

Coordination Training

77
Q

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

A

Proprioceptive Feedback

78
Q

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

A

Patterns

79
Q

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.

A

Compensatory Training

80
Q

Used for patients with increased tone, slow rhythmic rotation.

A

Inhibition Techniques

81
Q

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

A

Air Splints

82
Q

Provide sensory stimulation to the hemiplegia side. Schedule.

A

Positioning

83
Q

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

A

Avoid Positions

84
Q

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

A

Sensory Training Strategies

85
Q

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

A

UE Control

86
Q

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

A

LE Control

87
Q

Important motivational activity.

A

Gait Training

Neurology (19 decks)

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