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UM - Neuro Conditions > CVA > Flashcards

CVA Flashcards

1
Q

What is Brunnstrom Stage 1

A

Flaccidity - absent associated rxns, tonic & phasic reflexes

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2
Q

What is Brunnstrom Stage 2

A

Associated reactions and/or beginning spasticity (no volitional movement)

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3
Q

What is Brunnstrom Stage 3

A

Synergy stage (volitional movement dominated by synergy)

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4
Q

What is Brunnstrom Stage 4

A

Movements deviating from the basic synergies

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5
Q

What is Brunnstrom Stage 5

A

Relative Independence of the Basic Synergies

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6
Q

What is Brunnstrom Stage 6

A

Near normal

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7
Q

What is the UE Extension synergy

A 
Scapular - depression and/or protraction
Shoulder - adduction and IR
elbow - extension
forearm- pronation
wrist + hand - wrist extension and mass finger flexion
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8
Q

Which synergy is more common in…

1) UE
2) LE

A

1) Flexion synergy

2) Extension synergy

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9
Q

What synergy do you test for first in UE? Why?

A

You place them into the flexion synergy and test the EXTENSION synergy first - because the flexion synergy is more common you do not want it to dominate and make them unable to complete extension

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10
Q

What synergy do you test for first in LE? Why?

A

You place them into the extension synergy pattern and test the FLEXION synergy first - because the extension synergy is more common you do not want it to dominate and make them unable to complete flexion

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11
Q

What is the UE flexion synergy?

A 
Scapular - elevation and/or retraction
Shoulder - abduction and ER
elbow - flexion
forearm - supination
wrist and hand - wrist flexion and mass finger flexion
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12
Q

What is the LE flexion synergy

A

Hip - Flexion, abduction, ER
Knee - flexion
ankle - DF
foot - inversion and mass flexion of toes

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13
Q

What is the LE extension synergy

A

Hip - extension, adduction, IR
Knee - extension
ankle - PF
foot- inversion and mass extension of toes (more common toe flexion)

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14
Q

What Brunnstrum stage do you typically start clinical testing at?

A

Stage 4 and then adjust up or down based on patient response

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15
Q

In the Left eye, where does light from __ visual field

a) Left
b) Right

A

a) nasal aspect

b) temporal aspect

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16
Q

What is the anatomy of the visual pathway

A

Light hits the back of retina
Optic nn starts
Some cross @ optic chiasm, others do not
From there travel through optic tract to lateral geniculate nucleus (LGN)
They synapse w/optic radiation that course through to occiput (primary visual cortex)
Through Parietal or Temporal lobe

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17
Q

What does a lesion of the optic nerve cause?

A

Ipsilateral total blindness

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18
Q

What does an injury at the optic chiasm cause

A

Bilateral heteronymous hemianopsia (Can see medial halves of eye)

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19
Q

Lesions that cause CL homonymous hemianopsia

A

Optic tract, both radiations, and/or occipital lobe

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20
Q

What is CL homonymous hemianopsia

A

Loss of one visual field in both eyes (ex damage on R side would cause loss of Left visual field on both eyes)

21
Q

What is CL lower quadratic anopsia

A

Loss of CL lower quadrant due to damage of optic radiations through the parietal lobe

22
Q

What is CL upper quadratic anopsia

A

Loss of CL upper quadrant due to damage of optic radiations through the temporal lobe

23
Q

What is CVA

A

A sudden loss of neurological function caused by an interruption of the blood flow to the brain

24
Q

How many Americans are killed by stroke each year

A

130k

25
Q

How many people have a stroke in the US each year?

A

795k

26
Q

T or F: Stroke is the leading cause of death in the US

A

False - it is the 5th

27
Q

T or F: Stroke is the leading cause of long-term disability in the US?

A

True

28
Q

What percent of strokes are 1st incidence? Recurrence?

A

77% and 23%

29
Q

How much does stroke cost each year

A

Approx 34 billion

30
Q

What are non-modifiable risk factors?

A 
Age
Gender
Race
TIAs
Sickle cell anemia
31
Q

What are modifiable risk factors

A 
High BP
High Cholesterol
A fib
Diabetes Mellitus 
Cigarette Smoking
Obesity
Poor diet
Physical inactivity
Carotid or other artery disease
32
Q

List the 2 types of Ischemic Stroke

A

Cerebral thrombus

Cerebral embolism

33
Q

What is the most common type of stroke

A

Ischemic Stroke

34
Q

List the 2 types of stroke

A

Hemorrhagic

Ischemic

35
Q

What is an AVM

A

A cluster of abnormally formed blood vessels - have potential to rupture and cause bleeding in the brain

36
Q

What is an aneurysm

A

Ballooning of a weakened blood vessel

37
Q

What are some signs of a MCA stroke

A

CL hemiparesis and sensory impairment (arm>leg)
Wernicke’s and Broca’s aphasia
Apraxia
Damage to internal capsule or basal ganglia
CL homonymous hemianopsia

38
Q

What are ACA stroke signs?

A

CL hemiparesis and sensory impairment (Leg> arm)
Loss of bowel/bladder
Apraxia
Mental impairment w/perseveration

39
Q

What is perseveration

A

Do the same thing or say the same words repeatedly

40
Q

What is PCA stroke

A 
CL homonymous hemianopsia
CL hemiparesis
Dyslexia
Memory deficits
Topographical disorientation
Cranial nerve III palsy
Thalamic Syndrome
Pain & temp sensory loss
Ataxia, athetosis or choreiform movements
Visual agnosia
41
Q

What is thalamic syndrome

A

Sensory impairment in all modalities - pain and paresthesia (abnormal sensation)

42
Q

What is athetosis

A

a symptom characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, rams, legs, neck and tongue

43
Q

What are choreiform movements

A

Involuntary, forcible, rapid, jerky movements which are mostly manifestations of BG disease

44
Q

What are symptoms of Vertebral Artery CVA

A 
Ataxia
Vertigo
Nausea
Vomiting
Nystagmus
Impaired pain and temp in IPSI face
Horner's syndrome
Dysphagia
Sensory impairment in CL arm, trunk & leg
45
Q

What is horner syndrome

A

a combination of signs and symptoms caused by the disruption of a nerve pathway from the brain to the face and eye on one side of the body - usually results in decreased pupil size, a drooping eyelid and decreased sweating on the affected side of your face

46
Q

What is Basilar Artery stroke signs

A 
Coma
Quadriplegia
"Locked in syndrome"
Bilateral cerebellar ataxia
Thalamic Pain syndrome
Diplopia or other visual field deficits including blindness
47
Q

What is the Henneman Principle

A

There is an order to unit to motor unit recruitment when Gradual Control of Tension is important

48
Q

What is the order of motor recruitment (gradual)

A

Small to Large

I (SO, S) IIA (FOG, FR) IIB (FG, FF)

UM - Neuro Conditions (12 decks)

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