CVA Flashcards
Inappropriate initiation difficulty sequencing inappropriate timing altered force production are problems with a. tone b. primary impairments c. changes in muscle activation d. secondary impairments
changes in muscle activation
This change in muscle activation is an inability to initiate either at the muscle level or apraxia
a. inappropriate initiation
b. difficulty sequencing
c. inappropriate timing
d. altered force production
inappropriate initiation
A patient demonstrates coordination deficits, inability to sequence balance or postural control appropriately
a. inappropriate initiation
b. difficulty sequencing
c. inappropriate timing
d. altered force production
difficulty sequencing
A patient demonstrates coactivation of muscles by initiating their proximal muscles before distal muscles, this can be classified as
a. inappropriate initiation
b. difficulty sequencing
c. inappropriate timing
d. altered force production
inappropriate timing
A patient has difficulty scaling movement
a. inappropriate initiation
b. difficulty sequencing
c. inappropriate timing
d. altered force production
altered force production
Changes in sensation are commonly found
a. only in the extremities
b. contralateral face and extremities
c. on the contralateral side
d. proximally more than distally
contralateral face and extremities
What changes in sensation are common?
proprioceptive loss
tactile impairment
abnormal sensation
A patient with left hemiplegia had a stroke affecting the
a. left parietal lobe
b. right parietal lobe
c. left temporal lobe
d. right temporal lobe
right parietal lobe
Perceptual and cognitive problems can include
body scheme/body image spatial relations agnosia attention deficit memory impairment decision making
Emotional problems is a (direct/indirect) cause
direct
Depression is a direct impairment related to infarct (true/false)
true
List difficulties with speech and language
aphasia
dysarthria
dysphagia
Contraversive Lateropulsion is due to
a defect in posterolateral thalamus or in internal capsule
Patients experiencing contraversive lateropulsion push
a. toward the center
b. away from the center
c. towards hemi side
d. towards uninvolved side
towards hemi side
What scale can be used to assess contraversive lateropulsion?
Burke Lateropulsion Scale
A patient is actively pushing toward the hemiplegic side
contraversive lateropulsion
Contraversive lateropulsion is the subjective impression of falling to the
a. non-paretic side
b. paretic side
non-paretic side
A shift to the hemiplegic side with no attempt to support but tend to maintain correct head orientation defines
a. pusher syndrome
b. hemiplegia
c. spatial neglect
d. postural asymmetry
postural asymmetry
Rehab for patients with contraversive lateropulsion takes the same amount of time as a non-pushing stroke (true/false)
false
Patients with contraversive lateropulsion also demonstrate what impairments?
hemiplegia
spatial and sensory neglect
postural asymmetry
abduction and extension of non-paretic
Transfering to the (weak/strong) side is more difficult for a patient experiencing contraversive lateropulsion
strong
Alignment and mobility changes is a
a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment
secondary impairment
Changes in muscle and soft tissue is considered a
a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment
secondary impairment
Pain is considered a
a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment
secondary impairment
Edema is considered a
a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment
secondary impairment
Movement deficits are categorized as
a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment
composite impairments
Atypical deficits are categorized as
a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment
composite impairments
Undesirable compensations are a
a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment
composite impairment
Fractionated movements is also known as
atypical movements
It is common to develop shoulder pain due to
a. contractures
b. nonuse
c. osteoporosis
d. pusher syndrome
nonuse
Pieces of movement that are missing or the inability to move efficiently or move at all
a. movement deficits
b. atypical movements
c. undesirable compensations
d. none of the above
movement deficits
A deviation from normal movement sequence
a. movement deficits
b. atypical movements
c. undesirable compensations
d. none of the above
atypical movements
Inefficient movement strategies are
a. movement deficits
b. atypical movements
c. undesirable compensations
d. none of the above
undesirable compensations
A patient presents with flaccid paralysis, what stage of the Brunnstroms motor recovery stage do they fall under?
a. stage 1
b. stage 2
c. stage 3
d. stage 4
stage 1
A patient demonstrates minimal voluntary movement, associated reactions, and the beginning of spasticity. What stage are they classified under Brunnstroms stages?
a. stage 1
b. stage 2
c. stage 3
d. stage 4
stage 2
A patient shows movement in synergies and increased spasticity. What stage would you classify them as under Brunnstroms stages?
a. stage 3
b. stage 2
c. stage 5
d. stage 4
stage 3
A patient is in the beginning stages of selective control and spasticity is declining. What stage of Brunnstroms stages would you classify them under?
a. stage 4
b. stage 3
c. stage 5
d. stage 6
stage 4
Patient shows more difficult movement combinations and spasticity is decreasing, what stage in Bruunstroms stages?
a. stage 4
b. stage 3
c. stage 5
d. stage 6
stage 5
The patient is approaching normal movement, selective control and tone is near normal. What stage of Brunnstroms stages are they classified as?
a. stage 1
b. stage 2
c. stage 5
d. stage 6
stage 6
The Brunnstroms stages is good for
tracking motor recovery
A patients arm is at their side, internally rotated, elbow extended, pronated and subluxation is common this is a
low tone arm in acute hypotonic positon
A patient has a weak trunk, ribs flare and show a lateral trunk lean
acute hypotonic positon
The pelvis is dropped, the hip and knee collapse in standing
acute hypotonic positon
In the acute hypotonic position, patients will lean (towards/away) from weak side
away
In the acute hypotonic position, patients will shift their weight to the (involved/uninvolved) leg
uninvolved
In the acute movement deficit stage there is changes in _ _ and they cannot _
muscle activation
generate enough force to use muscles effectively
An unbalanced muscle return and deficits with muscle activation
atypical movement patterns
Inability to correctly activate muscle could be issues with
sequence
timing
scaling
What are the two potential problems with atypical movement patterns seen?
greater weakness
greater return
Unbalanced return with muscle shortening and poor alignment is
a. greater weakness
b. greater return
greater weakness
Problems with hypertonicity showing atypical movement patterns is
a. greater weakness
b. greater return
greater return
Atypical movement patterns and undesirable compensatory patterns are in the (earlier/higher) stages
higher
Movement deficits are in the (earlier/higher) stages
earlier
Scapular retraction/elevation shoulder abduction ER or hyperextension elbow flexion forearm supination wrist and finger flexion a. upper extremity flexion synergy b. upper extremity extension synergy c. lower extremity flexion synergy d. lower extremity extension synergy
upper extremity flexion synergy
Scapular protraction shoulder adduction, IR elbow extension forearm pronation wrist and finger flexion a. upper extremity flexion synergy b. upper extremity extension synergy c. lower extremity flexion synergy d. lower extremity extension synergy
upper extremity extension synergy
Hip flexion, abduction, ER knee flexion ankle DF and inversion toe extension a. upper extremity flexion synergy b. upper extremity extension synergy c. lower extremity flexion synergy d. lower extremity extension synergy
lower extremity flexion synergy
Hip extension, adduction, IR knee extension ankle PF and inversion toe flexion a. upper extremity flexion synergy b. upper extremity extension synergy c. lower extremity flexion synergy d. lower extremity extension synergy
lower extremity extension synergy
Which motion is the hardest to get back in the upper extremity?
a. forearm pronation
b. forearm supination
c. wrist and finger extension
d. wrist and finger flexion
wrist and finger extension
Which motion is missing in both synergy patterns for the UE?
a. forearm pronation
b. forearm supination
c. wrist and finger extension
d. wrist and finger flexion
wrist and finger extension
Which motion is the hardest to get back in the lower extremity?
a. hip flexion
b. knee extension
c. ankle and foot eversion
d. ankle and foot inversion
ankle and foot eversion
Which motion is missing in both synergy patterns for the LE?
a. hip flexion
b. knee extension
c. ankle and foot eversion
d. ankle and foot inversion
ankle and foot eversion
What is the strongest component of the UE flexion synergy pattern?
a. forearm supination
b. elbow flexion
c. wrist and finger flexion
d. shoulder elevation
elbow flexion
What is the strongest component of the UE extension synergy pattern?
a. shoulder adduction and forearm pronation
b. scapular protraction and forearm supination
c. shoulder IR
d. elbow extension
shoulder adduction and forearm pronation
What is the strongest component of the LE flexion synergy pattern?
a. toe extension
b. ankle eversion
c. hip flexion
d. knee flexion
hip flexion
What are the strongest components of the LE extension synergy pattern?
a. hip extension and adduction, knee extension, ankle PF
b. toe flexion and ankle inversion
c. ankle PF and inversion
d. hip adduction, knee extension, and ankle PF
hip adduction, knee extension, and ankle PF
There is (higher/lower) tone in the strongest component of a synergy pattern
higher
rely on use of uninvolved extremities balance precarious learned nonuse develops more severe spasticity increased severity of secondary problems increased chance of falls
undesirable compensatory problems
The Orpington Prognostic Scale is a measure for
a. diagnosing
b. prognosis
c. independence
d. impairment
prognosis
Which test is used to measure tone/reflexes?
Ashworth or Tardieu
Which test is used to measure strength?
a. Ashworth
b. Tardieu
c. Timed up and Go
d. 5 times sit to stand
5 times sit to stand
Which test involves doing a dual task?
walkie-talkie test
Which component of the ICF does the Fugl Meyer fall under?
a. body structure and function
b. activity
c. participation
d. environmental internal
body structure and function
Which component of the ICF is the Stroke impact scale categorized as?
a. body structure and function
b. activity
c. participation
d. environmental internal
participation
Which component of the ICF is the PASS classified as?
a. body structure and function
b. activity
c. participation
d. environmental internal
activity
The Ashworth test is used for which component of the ICF
a. body structure and function
b. activity
c. participation
d. environmental internal
body structure and function
The Fugl Meyer is an outcome measure (true/false)
false
Outcome measures fall under which categories in the ICF
either activity or participation
List the most likely movement system diagnosis for stroke
force production deficit
movement pattern coordination deficit
fractionated movement deficit
sensory detection deficit
List the lesser likely movement system diagnoses for stroke
dysmetria
postural vertical deficit
cognitive deficit
sensory selection and weighting deficit
Which movement system diagnosis is rarely used for stroke?
hypokinesia
A patient demonstrating contraversive lateropulsion would be diagnosed with
a. force production deficit
b. movement pattern coordination deficit
c. postural vertical deficit
d. fractionated movement deficit
postural vertical deficit
A patient demonstrating atypical movement patterns can be classified as
movement pattern coordination deficit or
fractionated movement deficit
What is the typical position in the acute phase?
arm at side, IR, elbow extended, pronation, subluxation common
trunk weak, ribs flare, lateral trunk lean
leg weak, pelvis dropped and hip and knee collapse in standing
