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PTA II (Lecture) > Chapter 3. Cerbrovascular Accidents (CVA) > Flashcards

Chapter 3. Cerbrovascular Accidents (CVA) Flashcards

1
Q

Define STROKE

A

Sudden, FOCAL neurologic deficit, resulting from ISCHEMIA (clogged blood vessel) or HEMORRHAGE (ruptured blood vessel)

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2
Q

What are (3) Etiologys of a CVA

A
  1. Thrombosis (solid mass of platelets and/or fibrin that forms locally in a vessel-clogging blood flow)
  2. Embolus (a piece of a thrombus that has broken free and is carried toward the brain by the bloodstream-blood clot, air bubble, piece of fatty deposit
  3. Hemorrhage (ruptured blood vessel in brain)
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3
Q

It is important to know if you have a __ or ___ before giving a drug against CVA

A

-HEMORRHAGE or CLOT

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4
Q

What is the Mechanism of a Stroke

A
  • Atherosclerosis is formation of PLAQUE
  • vessel narrowing
  • stenosis (abnormal narrowing) ulceration of lesions, thrombus, EMBOLI
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5
Q

What percentage of formation of clot is in Cerebral arteries or smaller branches in a THROMBUS?

A

60%

-can still have COME Collateral formation

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6
Q

What is collateral formation

A

Extra PATHWAYS for blood to flow during a Thrombus etc.

-survival technique by the body

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7
Q

WHERE does an embolism come from and WHAT is it

A
  • 16% comes from heart, internal carotid, or carotid sinus

- it is a dislodged thrombus

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8
Q

What is the most common place for a stroke

A

MCA- Middle Cerebral Artery

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9
Q

How do Thrombus form

A

Forms from platelet adhesion and coagulations, leading to ischemia with infarct

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10
Q

What is a Hemorrhage

A

abnormal bleeding due to vessel rupture

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11
Q

Is there a chance to develop new Collaterals when an EMBOLISM is formed

A

No, because the embolism happens so quickly

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12
Q

A Thrombus can lead to ___ and then further on even lead to an __

A
  • ischemia with infarct

- Embolism

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13
Q

WHAT occurs within hours, peaks at 4 days due to tissue necrosis/rupturing of cell membranes and can push against your pons (breathing center), making it extremely hard to breath

A

Cerebral edema (swelling in the brain)

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14
Q

What is the acronym for TIA and what is the possible cause

A
  • Transic Ischemic Attack

- Transient Systemic Arterial hyoptension

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15
Q

What are some symptoms/signs of ANTERIOR Cerebral Artery Infarct

A
  • LEFTside neglect
  • Contralateral hemiparesis (LE)
  • Sensory loss (LE)
  • Incontinence
  • Apraxia (can’t move arm)
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16
Q

What are some symptoms/signs of MIDDLE Cerebral Artery Infarct (most common!!)

A
  • Contralateral hemiplegia (UE)
  • Sensory deficit (UE and face)
  • Homonymous Hemianopsia (loss of half of the field of view in both eyes)
  • If left hemi»aphasia
  • if right hemi» neglect on left side
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17
Q

What are the 2 possibilities for an Internal Carotid Artery Infarct

A
  • Comma

- Death

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18
Q

What is ‘Contralateral Hemianesthesia’ in POSTERIOR Cerebral Artery

A

Contralateral (opp. side of body)

-anesthesia on one side of the body

19
Q

‘Locked in syndrome’ comes from which artery infarct; and what is it?

A

VERTEBRAL Artery Infarct

  • can last for months/weeks/years
  • quadraplegia
  • only has vertical gaze
  • can’t speak, yet full consciousness
20
Q

What are the (5) Artery infarcts?

A
  1. Anterior
  2. Middle
  3. Posterior
  4. Internal
  5. Vertebral
21
Q

What is Ashworth’s Scale for Grading SPASTICITY for 0 and 4

A

0- no increase in tone

4-affected parts RIGID in FLEXION or EXTENSION

22
Q

What is Brunnstrom Synergy Pattern for UPPER extremity flexion

A
  • scapular retraction
  • shoulder external rotation
  • shoulder abduction to 90 degrees
  • elbow flexion
  • forearm supination, wrist and finger flexion
23
Q

What is Brunnstrom Synergy Pattern for LOWER extremity extension

A
  • hip extension
  • adduction and internal rotation
  • knee extension
  • anke plantar flexion and inversion
24
Q

Define Dysarthria

A 
Difficulty speaking (but physically)
-may have affected respiration, articulation, possible impaired chewing/swallowing
25
Q

Define Dysphasia/Aphasia

A

Difficulty speaking- but it affects the BRAINSTEM

26
Q

What are some LEFT hemisphere Motor Programming deficits

A
  • apraxia
  • difficulty in squencing
  • difficulty initiating movement
  • harder to learn task
27
Q

What is a RIGHT hemisphere Motor Programming deficits

A

-difficulty in sustaining movement/posture

28
Q

What are some COGNITIVE and BEHAVIORAL deficits

A
  • orientation
  • attention
  • STM
29
Q

What are 5 deficits with a stroke?

A
  1. Speech and Language
  2. Motor Programming
  3. Cognitive and behavioral
  4. Perceptual
  5. Psychological
30
Q

What are 3 Psychological difficulties after a stroke

A
  • frustration
  • depression
  • anxiety
31
Q

What is RSD and what does it stand for?

A
  • Reflex Sympathetic Dystrophy
  • warm, red,glossy skin
  • stiffness
32
Q

What are (5) early CVA Rehab Goals

A
  • mouth and breathing exercises
  • maintain ROM
  • increase trunk control, symmetry
  • increase functional mobility
  • initiate self-care
33
Q

What are 3 way to treat spasticity

A
  • dont tuch palm/sole of foot
  • heat
  • tapping/stroking antagonist muscle
34
Q

What is an AFO

A

Ankle Foot Orthotic: mots COMMON lower extremity brace

35
Q

What are 2 important factors in the Acute Phase sessions in Rehab

A

-Keep it SHORT and FREQUENT

36
Q

What are (4) treatments techniques used in the ACUTE Phase

A
  • TACTILE (frequent contact, diff. materials)
  • PROPRIOCEPTIVE, KINESTETHIC AND VESTIB STIM (position, keep head in midline, frequent body position changes
  • VISUAL STIM (decorate room with familiar objects)
  • AUDITORY STIM (speaking to patient)
37
Q

What are some treatment techniques in the SUBACUTE Phase for agitated patients ?

A
  • human contact
  • familiar voices (sudden loud voices should be avoided)
  • excessive sensoy stim should be avoided due to confusion
38
Q

INHIBITION techniques appropriate for SUBACUTE PHASE

A
  • wrap limbs in warms blankets
  • slow rocking
  • have patient in “reflex inhibiting postures”- have sternum and lumbar spine allignment
39
Q

Know 2 inhibition techniques for the lower extremity (to break up spasticity)

A
  • hip and knee flexion
  • ankle dorsiflexion and eversion
  • exactly opp. of Brunnstrum Synergy Pattern
40
Q

List 2 techniques for general inhibition for stroke patients

A
  • calm colours

- change positions Gradually

41
Q

What are (4) Goals at a LATE Phase of Rehab

A
  1. Increase cognitive skills
  2. Improve patients time management skills
  3. Improve patients Fine motor coordination
  4. Increase the patients speed of performance
42
Q

What is one of the most important factor in the LATE Phase of Rehab

A

-provide a PURPOSE for each activity

43
Q

What are 5 ways in which to refine motor control

A
  • biofeedback
  • electrical stim
  • cutaneous (skin) stim
  • PNF
  • Joint mobility

PTA II (Lecture) (13 decks)

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