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CVA Flashcards

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1
Q

Post CVA considerations
Resting SBP
Resting DBP
Rest HR

A

90

50

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2
Q

the chances for having a DVT post cvs is

A

30-75 percent

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3
Q

what are common problems post CVA

A 
seizures
cognitive problems
dysphagia
visuospatial and perceptual disturbances
language deficits
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4
Q

compensatory strategies for dysphagia

A

thickening liquids
chink tuck during swallow
small sips

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5
Q

treatment for dysphagia

A

vitalSTIM NMES
Biofeed with mirror
posture/environmental set up

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6
Q

visuospatial and perceptual disorders

A
  • attention deficits and distractibility
  • homonymous hemianopsia and other visual field cuts
  • body scheme (somatagnosia) and body image disorders/difficulty with R/L discrimination
  • depth, distance, or vertical perceptual deficits
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7
Q

what is agnosia

A

the inability to recognize familiar objects using one or more of the sensory modalities, while often retaining the ability to recognize the same object using other sensory modalities

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8
Q

what is anosognosia?

A

the severe denial, neglect, and the lack of awareness of the presence or severity of one’s deficits

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9
Q

anosognosia is most in _____ hemi’s

A

left

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10
Q

what is dysarthria?

A

muscle dysfunction that leads to impaired verbal communication

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11
Q

dysarthria may affect what 4 things?

A

respiration
phonation
articulation
resonance

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12
Q

what is the treatment of dysarthria?

A

tongue and oral motor exercises
functional speaking practice
posture

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13
Q

aphasia is a _______ hemisphere injury, and it impairs the _______ and _______ of language

A

dominant

expression, understanding

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14
Q

what are the different types of aphasia

A

brocas, wernickes, global

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15
Q

what is apraxia?

A

can’t perform a task despite having the desire and the physical ability to perform them. The patient is unable to accomplish the task even though the instructions are understood.

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16
Q

apraxia is found with _______ lobe injury

A

parietal

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17
Q

what is the most common form of apraxia? what are examples of this apraxia?

A

buccofacial or orofacial

licking lips, whistling

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18
Q

what is limb-kinetic apraxia

A

inability to make fine, precise movements with an arm or leg

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19
Q

what is ideomotor aparxia and provide an example?

A

inability to make proper movement in response to a verbal command
can’t walk…asked to get coffee and they can

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20
Q

what is ideational apraxia?

A

inability to coordinate activités with multiple sequential movements such as dressing,eating and bathing

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21
Q

what is verbal apraxia?

A

difficulty coordinating mouth and speech movements on command

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22
Q

what is constructional apraxia?

A

inability to copy, draw, or construct simple figures

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23
Q

what is oculomotor apraxia?

A

difficulty moving the eyes on command

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24
Q

what is the speed of a household ambulator

A

.4 m/sec

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24
what is the speed of a household ambulator
.4 m/sec
24
what is the speed of a household ambulator
.4 m/sec
25
to be a community amlbulator, one must have the ability to:
``` navigate changes in terrain avoid obstacles endure distance manage lighting changes manage visual and auditory distraction manage load carrying handle weather changes walk with sufficient velocity ```
25
to be a community amlbulator, one must have the ability to:
``` navigate changes in terrain avoid obstacles endure distance manage lighting changes manage visual and auditory distraction manage load carrying handle weather changes walk with sufficient velocity ```
25
to be a community amlbulator, one must have the ability to:
``` navigate changes in terrain avoid obstacles endure distance manage lighting changes manage visual and auditory distraction manage load carrying handle weather changes walk with sufficient velocity ```
26
what is the speed of a limited community ambulator
.4-.8 m/sec
26
what is the speed of a limited community ambulator
.4-.8 m/sec
26
what is the speed of a limited community ambulator
.4-.8 m/sec
27
what is the walking velocity for a community ambulatory?
1.2-1.4 m/sec
27
what is the walking velocity for a community ambulatory?
1.2-1.4 m/sec
27
what is the walking velocity for a community ambulatory?
1.2-1.4 m/sec
28
what is the velocity needed to cross a street at a spotlight?
1.2 m/sec velocity for 13-27 m | the ability to negotiate 7-8 curbs independently
28
what is the velocity needed to cross a street at a spotlight?
1.2 m/sec velocity for 13-27 m | the ability to negotiate 7-8 curbs independently
28
what is the velocity needed to cross a street at a spotlight?
1.2 m/sec velocity for 13-27 m | the ability to negotiate 7-8 curbs independently
29
Shoulder pain occurs in ____-____ percent of patients with stroke. Is this normal?
70-84% | no it is not normal
29
Shoulder pain occurs in ____-____ percent of patients with stroke. Is this normal?
70-84% | no it is not normal
29
Shoulder pain occurs in ____-____ percent of patients with stroke. Is this normal?
70-84% | no it is not normal
30
_____ is common in UE strokes with the presentation of downward rotation of the scapula with the glenoid fossa moving vertical to downward
subluxation
30
_____ is common in UE strokes with the presentation of downward rotation of the scapula with the glenoid fossa moving vertical to downward
subluxation
30
_____ is common in UE strokes with the presentation of downward rotation of the scapula with the glenoid fossa moving vertical to downward
subluxation
31
what can cause impingement?
marked spasticity superior subluxation muscle imbalance loss of scapulohumeral rhythm
31
what can cause impingement?
marked spasticity superior subluxation muscle imbalance loss of scapulohumeral rhythm
31
what can cause impingement?
marked spasticity superior subluxation muscle imbalance loss of scapulohumeral rhythm
32
if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation, then what two slings could be used?
GivMohr sling | Bobath Sling
32
if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation, then what two slings could be used?
GivMohr sling | Bobath Sling
32
if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation, then what two slings could be used?
GivMohr sling | Bobath Sling
33
if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation then what types of treatments can be used?
``` e-stim to reduce subluxation teach awareness of UE bed mobility PROM with massage with FLX limited to 90 degrees Weight bearing Use UE to stabilize objects ```
33
if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation then what types of treatments can be used?
``` e-stim to reduce subluxation teach awareness of UE bed mobility PROM with massage with FLX limited to 90 degrees Weight bearing Use UE to stabilize objects ```
33
if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation then what types of treatments can be used?
``` e-stim to reduce subluxation teach awareness of UE bed mobility PROM with massage with FLX limited to 90 degrees Weight bearing Use UE to stabilize objects ```
34
if patient is 1-2/ shoulder strength, hypotonia, and 2 cm inferior subluxation, what treatments can be used?
``` e-stim sling for standing PNF scapular patterns Fluidotherapy w/ physical and mental practice Weight bearing (isometric contractions) ```
34
if patient is 1-2/ shoulder strength, hypotonia, and 2 cm inferior subluxation, what treatments can be used?
``` e-stim sling for standing PNF scapular patterns Fluidotherapy w/ physical and mental practice Weight bearing (isometric contractions) ```
34
if patient is 1-2/ shoulder strength, hypotonia, and 2 cm inferior subluxation, what treatments can be used?
``` e-stim sling for standing PNF scapular patterns Fluidotherapy w/ physical and mental practice Weight bearing (isometric contractions) ```
35
if patient is 2-3/5 prox>distal strength, normal tone, no subluxation then what should patient do?
``` Use are for EVERYTHING Distal UE -self ROM, massage, isometrics Prox UE -AROM, theraband PNF patterns Weight bearings Functional Tasks (CIT) ```
35
if patient is 2-3/5 prox>distal strength, normal tone, no subluxation then what should patient do?
``` Use are for EVERYTHING Distal UE -self ROM, massage, isometrics Prox UE -AROM, theraband PNF patterns Weight bearings Functional Tasks (CIT) ```
35
if patient is 2-3/5 prox>distal strength, normal tone, no subluxation then what should patient do?
``` Use are for EVERYTHING Distal UE -self ROM, massage, isometrics Prox UE -AROM, theraband PNF patterns Weight bearings Functional Tasks (CIT) ```
36
1-2/5 prox>distal strength
Modified Ashworth=2 | 
1 cm anterior subluxation
``` E-stim for subluxation AAROM proximally WB isometrics distally PNF WB prone on elbows Aggressive PROM to shoulder capsule FES Manual support and guidance Bi-manual activities Use arm in stabilizing activities ```
36
1-2/5 prox>distal strength
Modified Ashworth=2 | 
1 cm anterior subluxation
``` E-stim for subluxation AAROM proximally WB isometrics distally PNF WB prone on elbows Aggressive PROM to shoulder capsule FES Manual support and guidance Bi-manual activities Use arm in stabilizing activities ```
36
1-2/5 prox>distal strength
Modified Ashworth=2 | 
1 cm anterior subluxation
``` E-stim for subluxation AAROM proximally WB isometrics distally PNF WB prone on elbows Aggressive PROM to shoulder capsule FES Manual support and guidance Bi-manual activities Use arm in stabilizing activities ```
37
3-4/5 prox>distal strength
Modified Ashworth=2
Pain with shoulder flex/ABD AROM >120
``` don't have patient push through pain! Enforce shoulder ER -PRE shoulder ER and depression Scapular ADD and retraction Scapular Taping ```
37
3-4/5 prox>distal strength
Modified Ashworth=2
Pain with shoulder flex/ABD AROM >120
``` don't have patient push through pain! Enforce shoulder ER -PRE shoulder ER and depression Scapular ADD and retraction Scapular Taping ```
37
3-4/5 prox>distal strength
Modified Ashworth=2
Pain with shoulder flex/ABD AROM >120
``` don't have patient push through pain! Enforce shoulder ER -PRE shoulder ER and depression Scapular ADD and retraction Scapular Taping ```
38
0-1/5 prox strength
 Modified Ashworth=4
 Unable to isolate muscle groups

``` PROM to maintain shoulder ext WB with inhib to biceps and facil to triceps Rhythmic rotation for spasticity Prone on elbows WB Scapular retraction E-stim to triceps ```
38
0-1/5 prox strength
 Modified Ashworth=4
 Unable to isolate muscle groups

``` PROM to maintain shoulder ext WB with inhib to biceps and facil to triceps Rhythmic rotation for spasticity Prone on elbows WB Scapular retraction E-stim to triceps ```
38
0-1/5 prox strength
 Modified Ashworth=4
 Unable to isolate muscle groups

``` PROM to maintain shoulder ext WB with inhib to biceps and facil to triceps Rhythmic rotation for spasticity Prone on elbows WB Scapular retraction E-stim to triceps ```
39
``` Shoulder-Hand syndrome incidence? first signs? Followed by? Pain when? ```
12-25% of patients with UE pain hand edema and tenderness localized tenderness in the shader during ROM activities Pain primarily with movement
39
``` Shoulder-Hand syndrome incidence? first signs? Followed by? Pain when? ```
12-25% of patients with UE pain hand edema and tenderness localized tenderness in the shader during ROM activities Pain primarily with movement
39
``` Shoulder-Hand syndrome incidence? first signs? Followed by? Pain when? ```
12-25% of patients with UE pain hand edema and tenderness localized tenderness in the shader during ROM activities Pain primarily with movement
40
Shoulder-Hand syndrome Later stages ____changes of the fingers muscle ___and ____ occur skin changes
sympathetic vasomotor changes (warmth,redness, glossy skin) tropic atrophy and contracture (atrophy of thenar and hypothenar muscles) cool, cyanotic, and damp
40
Shoulder-Hand syndrome Later stages ____changes of the fingers muscle ___and ____ occur skin changes
sympathetic vasomotor changes (warmth,redness, glossy skin) tropic atrophy and contracture (atrophy of thenar and hypothenar muscles) cool, cyanotic, and damp
40
Shoulder-Hand syndrome Later stages ____changes of the fingers muscle ___and ____ occur skin changes
sympathetic vasomotor changes (warmth,redness, glossy skin) tropic atrophy and contracture (atrophy of thenar and hypothenar muscles) cool, cyanotic, and damp
41
what is the speed of a household ambulator
.4 m/sec
42
to be a community amlbulator, one must have the ability to:
``` navigate changes in terrain avoid obstacles endure distance manage lighting changes manage visual and auditory distraction manage load carrying handle weather changes walk with sufficient velocity ```
43
what is the speed of a limited community ambulator
.4-.8 m/sec
44
what is the walking velocity for a community ambulatory?
1.2-1.4 m/sec
45
what is the velocity needed to cross a street at a spotlight?
1.2 m/sec velocity for 13-27 m | the ability to negotiate 7-8 curbs independently
46
Shoulder pain occurs in ____-____ percent of patients with stroke. Is this normal?
70-84% | no it is not normal
47
_____ is common in UE strokes with the presentation of downward rotation of the scapula with the glenoid fossa moving vertical to downward
subluxation
48
what can cause impingement?
marked spasticity superior subluxation muscle imbalance loss of scapulohumeral rhythm
49
if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation, then what two slings could be used?
GivMohr sling | Bobath Sling
50
if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation then what types of treatments can be used?
``` e-stim to reduce subluxation teach awareness of UE bed mobility PROM with massage with FLX limited to 90 degrees Weight bearing Use UE to stabilize objects ```
51
if patient is 1-2/ shoulder strength, hypotonia, and 2 cm inferior subluxation, what treatments can be used?
``` e-stim sling for standing PNF scapular patterns Fluidotherapy w/ physical and mental practice Weight bearing (isometric contractions) ```
52
if patient is 2-3/5 prox>distal strength, normal tone, no subluxation then what should patient do?
``` Use are for EVERYTHING Distal UE -self ROM, massage, isometrics Prox UE -AROM, theraband PNF patterns Weight bearings Functional Tasks (CIT) ```
53
1-2/5 prox>distal strength
Modified Ashworth=2 | 
1 cm anterior subluxation
``` E-stim for subluxation AAROM proximally WB isometrics distally PNF WB prone on elbows Aggressive PROM to shoulder capsule FES Manual support and guidance Bi-manual activities Use arm in stabilizing activities ```
54
3-4/5 prox>distal strength
Modified Ashworth=2
Pain with shoulder flex/ABD AROM >120
``` don't have patient push through pain! Enforce shoulder ER -PRE shoulder ER and depression Scapular ADD and retraction Scapular Taping ```
55
0-1/5 prox strength
 Modified Ashworth=4
 Unable to isolate muscle groups

``` PROM to maintain shoulder ext WB with inhib to biceps and facil to triceps Rhythmic rotation for spasticity Prone on elbows WB Scapular retraction E-stim to triceps ```
56
``` Shoulder-Hand syndrome incidence? first signs? Followed by? Pain when? ```
12-25% of patients with UE pain hand edema and tenderness localized tenderness in the shader during ROM activities Pain primarily with movement
91
Shoulder-Hand syndrome Later stages ____changes of the fingers muscle ___and ____ occur skin changes
sympathetic vasomotor changes (warmth,redness, glossy skin) tropic atrophy and contracture (atrophy of thenar and hypothenar muscles) cool, cyanotic, and damp
92
____ will die from a stroke
1/3
93
____-___ % of acute strokes have recurrences. Within 5 years post-stroke, recurrence is ____ percent with _____ being more high than ______.
25-35 40% men women
94
what ethnics group are at higher prevalence of strokes
African American>hispanic american> caucasian
95
what are risk factors for having a stroke
``` hypertension high serum cholesterol obesity heavy ETOH use cocaine use smoking diabetes mellitus heart disease ```
96
what are the three stroke classifications?
thrombic, embolic, and cerebral hemorrhage
97
what are the two causes for thrombotic CVA?
ASCHD (Arteriosclerotic coronary heart disease) and HTN
98
What is the difference between a CVA and TIA
a TIA is a brief episode that causes the same symptoms as a stroke but less severe and the symptoms are usually temporary or reversible. Cause is usually due to a partial obstruction of blood to the brain. CVA or stroke is caused by an event that causes more permanent damage to a larger region of the brain.Cause is usually blockage of a major vessel that feeds the brain.
99
In TIAs, it is indicative of _________ disease, possible _______, and transient systemic ______ ______.
thrombolytic vasospasm arterial hypotension
100
the main goal for medical management of a Thrombotic CVA and TIA is
to improve circulation ASAP
101
Embolic CVA is a sign of ______. It originates from what 3 places?
cardiac disease | heart, internal carotid artery, carotid sinus
102
In a embolic CVA the branches of the ______ are most commonly affected and have a ______ outcome.
MCA | poorer
103
the 3 ways to medically manage an Embolic CVA is
prevention long-term anticoagulant therapy surgery
104
what are the 3 main causes for a Hemorrhagic CVA?
HTN, Ruptured saccular aneurysm, AV malformation
105
how is the recovery time of a hemorrhagic CVA vs the other two forms?
Blood re-absorbed over 6 to 8 months making it a quicker recovery
106
Hemorrhagic CVA medical management
hypertensive by prevention and HTN management | Ruptured aneurysm by surgery
107
left brain damage may result in
right side paralysis speech and memory defects cautious and slow behavior
108
right brain damage may result in
left side paralysis perceptual and memory defects quick and impulsive behavior
109
three commonalties that are found between right and left sided brain damage are
sensory dysfunction visual field defect cognitive impairment
110
MCA
hemiplegia of contralateral side | if on the dominant side then global aphasia
111
ACA
infarction here is uncommon if both segments come from a single anterior cerebral stem then both sides of the body are affected, Contralateral hemiparesis and sensory lost are seen in the lower extremities
112
ICA
clinical picture depends if cause of ischemia is thrombus, embolus, or low blood flow. the cortex supplied by the MCA is affected most but the ACA can be affected too. With the collateral circulation from the circle of willis, the occlusion may be Aysmptomatic
113
PCA
if proximal, signs include thalamic syndrome including abnormal sensation of pain, temp, proprioception and touch. Personality changes
114
PICA
wallenberg syndrome: vertigo, nausea,

CVA (1 decks)

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