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CVA > CVA > Flashcards

CVA Flashcards

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
Q

what is the speed of a household ambulator

A

.4 m/sec

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24
Q

what is the speed of a household ambulator

A

.4 m/sec

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25
Q

to be a community amlbulator, one must have the ability to:

A 
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
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25
Q

to be a community amlbulator, one must have the ability to:

A 
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
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25
Q

to be a community amlbulator, one must have the ability to:

A 
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
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26
Q

what is the speed of a limited community ambulator

A

.4-.8 m/sec

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26
Q

what is the speed of a limited community ambulator

A

.4-.8 m/sec

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26
Q

what is the speed of a limited community ambulator

A

.4-.8 m/sec

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27
Q

what is the walking velocity for a community ambulatory?

A

1.2-1.4 m/sec

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27
Q

what is the walking velocity for a community ambulatory?

A

1.2-1.4 m/sec

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27
Q

what is the walking velocity for a community ambulatory?

A

1.2-1.4 m/sec

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28
Q

what is the velocity needed to cross a street at a spotlight?

A

1.2 m/sec velocity for 13-27 m

the ability to negotiate 7-8 curbs independently

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28
Q

what is the velocity needed to cross a street at a spotlight?

A

1.2 m/sec velocity for 13-27 m

the ability to negotiate 7-8 curbs independently

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28
Q

what is the velocity needed to cross a street at a spotlight?

A

1.2 m/sec velocity for 13-27 m

the ability to negotiate 7-8 curbs independently

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29
Q

Shoulder pain occurs in ____-____ percent of patients with stroke. Is this normal?

A

70-84%

no it is not normal

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29
Q

Shoulder pain occurs in ____-____ percent of patients with stroke. Is this normal?

A

70-84%

no it is not normal

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29
Q

Shoulder pain occurs in ____-____ percent of patients with stroke. Is this normal?

A

70-84%

no it is not normal

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30
Q

_____ is common in UE strokes with the presentation of downward rotation of the scapula with the glenoid fossa moving vertical to downward

A

subluxation

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30
Q

_____ is common in UE strokes with the presentation of downward rotation of the scapula with the glenoid fossa moving vertical to downward

A

subluxation

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30
Q

_____ is common in UE strokes with the presentation of downward rotation of the scapula with the glenoid fossa moving vertical to downward

A

subluxation

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31
Q

what can cause impingement?

A

marked spasticity
superior subluxation
muscle imbalance
loss of scapulohumeral rhythm

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31
Q

what can cause impingement?

A

marked spasticity
superior subluxation
muscle imbalance
loss of scapulohumeral rhythm

31
Q

what can cause impingement?

A

marked spasticity
superior subluxation
muscle imbalance
loss of scapulohumeral rhythm

32
Q

if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation, then what two slings could be used?

A

GivMohr sling

Bobath Sling

32
Q

if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation, then what two slings could be used?

A

GivMohr sling

Bobath Sling

32
Q

if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation, then what two slings could be used?

A

GivMohr sling

Bobath Sling

33
Q

if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation then what types of treatments can be used?

A 
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
Q

if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation then what types of treatments can be used?

A 
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
Q

if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation then what types of treatments can be used?

A 
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
Q

if patient is 1-2/ shoulder strength, hypotonia, and 2 cm inferior subluxation, what treatments can be used?

A 
e-stim
sling for standing
PNF scapular patterns
Fluidotherapy w/ physical and mental practice
Weight bearing (isometric contractions)
34
Q

if patient is 1-2/ shoulder strength, hypotonia, and 2 cm inferior subluxation, what treatments can be used?

A 
e-stim
sling for standing
PNF scapular patterns
Fluidotherapy w/ physical and mental practice
Weight bearing (isometric contractions)
34
Q

if patient is 1-2/ shoulder strength, hypotonia, and 2 cm inferior subluxation, what treatments can be used?

A 
e-stim
sling for standing
PNF scapular patterns
Fluidotherapy w/ physical and mental practice
Weight bearing (isometric contractions)
35
Q

if patient is 2-3/5 prox>distal strength, normal tone, no subluxation then what should patient do?

A 
Use are for EVERYTHING
Distal UE
-self ROM, massage, isometrics
Prox UE
-AROM, theraband
PNF patterns
Weight bearings
Functional Tasks (CIT)
35
Q

if patient is 2-3/5 prox>distal strength, normal tone, no subluxation then what should patient do?

A 
Use are for EVERYTHING
Distal UE
-self ROM, massage, isometrics
Prox UE
-AROM, theraband
PNF patterns
Weight bearings
Functional Tasks (CIT)
35
Q

if patient is 2-3/5 prox>distal strength, normal tone, no subluxation then what should patient do?

A 
Use are for EVERYTHING
Distal UE
-self ROM, massage, isometrics
Prox UE
-AROM, theraband
PNF patterns
Weight bearings
Functional Tasks (CIT)
36
Q

1-2/5 prox>distal strength
Modified Ashworth=2


1 cm anterior subluxation

A 
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
Q

1-2/5 prox>distal strength
Modified Ashworth=2


1 cm anterior subluxation

A 
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
Q

1-2/5 prox>distal strength
Modified Ashworth=2


1 cm anterior subluxation

A 
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
Q

3-4/5 prox>distal strength
Modified Ashworth=2
Pain with shoulder flex/ABD AROM >120

A 
don't have patient push through pain!
Enforce shoulder ER
-PRE 
    shoulder ER and depression
    Scapular ADD and retraction
Scapular Taping
37
Q

3-4/5 prox>distal strength
Modified Ashworth=2
Pain with shoulder flex/ABD AROM >120

A 
don't have patient push through pain!
Enforce shoulder ER
-PRE 
    shoulder ER and depression
    Scapular ADD and retraction
Scapular Taping
37
Q

3-4/5 prox>distal strength
Modified Ashworth=2
Pain with shoulder flex/ABD AROM >120

A 
don't have patient push through pain!
Enforce shoulder ER
-PRE 
    shoulder ER and depression
    Scapular ADD and retraction
Scapular Taping
38
Q

0-1/5 prox strength
 Modified Ashworth=4
 Unable to isolate muscle groups


A 
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
Q

0-1/5 prox strength
 Modified Ashworth=4
 Unable to isolate muscle groups


A 
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
Q

0-1/5 prox strength
 Modified Ashworth=4
 Unable to isolate muscle groups


A 
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
Q 
Shoulder-Hand syndrome
incidence?
first signs?
Followed by?
Pain when?
A

12-25% of patients with UE pain
hand edema and tenderness
localized tenderness in the shader during ROM activities
Pain primarily with movement

39
Q 
Shoulder-Hand syndrome
incidence?
first signs?
Followed by?
Pain when?
A

12-25% of patients with UE pain
hand edema and tenderness
localized tenderness in the shader during ROM activities
Pain primarily with movement

39
Q 
Shoulder-Hand syndrome
incidence?
first signs?
Followed by?
Pain when?
A

12-25% of patients with UE pain
hand edema and tenderness
localized tenderness in the shader during ROM activities
Pain primarily with movement

40
Q

Shoulder-Hand syndrome
Later stages
____changes of the fingers
muscle ___and ____ occur

skin changes

A

sympathetic vasomotor changes (warmth,redness, glossy skin)

tropic

atrophy and contracture
(atrophy of thenar and hypothenar muscles)

cool, cyanotic, and damp

40
Q

Shoulder-Hand syndrome
Later stages
____changes of the fingers
muscle ___and ____ occur

skin changes

A

sympathetic vasomotor changes (warmth,redness, glossy skin)

tropic

atrophy and contracture
(atrophy of thenar and hypothenar muscles)

cool, cyanotic, and damp

40
Q

Shoulder-Hand syndrome
Later stages
____changes of the fingers
muscle ___and ____ occur

skin changes

A

sympathetic vasomotor changes (warmth,redness, glossy skin)

tropic

atrophy and contracture
(atrophy of thenar and hypothenar muscles)

cool, cyanotic, and damp

41
Q

what is the speed of a household ambulator

A

.4 m/sec

42
Q

to be a community amlbulator, one must have the ability to:

A 
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
Q

what is the speed of a limited community ambulator

A

.4-.8 m/sec

44
Q

what is the walking velocity for a community ambulatory?

A

1.2-1.4 m/sec

45
Q

what is the velocity needed to cross a street at a spotlight?

A

1.2 m/sec velocity for 13-27 m

the ability to negotiate 7-8 curbs independently

46
Q

Shoulder pain occurs in ____-____ percent of patients with stroke. Is this normal?

A

70-84%

no it is not normal

47
Q

_____ is common in UE strokes with the presentation of downward rotation of the scapula with the glenoid fossa moving vertical to downward

A

subluxation

48
Q

what can cause impingement?

A

marked spasticity
superior subluxation
muscle imbalance
loss of scapulohumeral rhythm

49
Q

if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation, then what two slings could be used?

A

GivMohr sling

Bobath Sling

50
Q

if pt has 0/5 strength, hypotonia/flaccidity, 2 cm inferior subluxation then what types of treatments can be used?

A 
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
Q

if patient is 1-2/ shoulder strength, hypotonia, and 2 cm inferior subluxation, what treatments can be used?

A 
e-stim
sling for standing
PNF scapular patterns
Fluidotherapy w/ physical and mental practice
Weight bearing (isometric contractions)
52
Q

if patient is 2-3/5 prox>distal strength, normal tone, no subluxation then what should patient do?

A 
Use are for EVERYTHING
Distal UE
-self ROM, massage, isometrics
Prox UE
-AROM, theraband
PNF patterns
Weight bearings
Functional Tasks (CIT)
53
Q

1-2/5 prox>distal strength
Modified Ashworth=2


1 cm anterior subluxation

A 
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
Q

3-4/5 prox>distal strength
Modified Ashworth=2
Pain with shoulder flex/ABD AROM >120

A 
don't have patient push through pain!
Enforce shoulder ER
-PRE 
    shoulder ER and depression
    Scapular ADD and retraction
Scapular Taping
55
Q

0-1/5 prox strength
 Modified Ashworth=4
 Unable to isolate muscle groups


A 
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
Q 
Shoulder-Hand syndrome
incidence?
first signs?
Followed by?
Pain when?
A

12-25% of patients with UE pain
hand edema and tenderness
localized tenderness in the shader during ROM activities
Pain primarily with movement

91
Q

Shoulder-Hand syndrome
Later stages
____changes of the fingers
muscle ___and ____ occur

skin changes

A

sympathetic vasomotor changes (warmth,redness, glossy skin)

tropic

atrophy and contracture
(atrophy of thenar and hypothenar muscles)

cool, cyanotic, and damp

92
Q

____ will die from a stroke

A

1/3

93
Q

____-___ % of acute strokes have recurrences. Within 5 years post-stroke, recurrence is ____ percent with _____ being more high than ______.

A

25-35
40%
men
women

94
Q

what ethnics group are at higher prevalence of strokes

A

African American>hispanic american> caucasian

95
Q

what are risk factors for having a stroke

A 
hypertension
high serum cholesterol
obesity
heavy ETOH use
cocaine use
smoking
diabetes mellitus
heart disease
96
Q

what are the three stroke classifications?

A

thrombic, embolic, and cerebral hemorrhage

97
Q

what are the two causes for thrombotic CVA?

A

ASCHD (Arteriosclerotic coronary heart disease) and HTN

98
Q

What is the difference between a CVA and TIA

A

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
Q

In TIAs, it is indicative of _________ disease, possible _______, and transient systemic ______ ______.

A

thrombolytic
vasospasm
arterial hypotension

100
Q

the main goal for medical management of a Thrombotic CVA and TIA is

A

to improve circulation ASAP

101
Q

Embolic CVA is a sign of ______. It originates from what 3 places?

A

cardiac disease

heart, internal carotid artery, carotid sinus

102
Q

In a embolic CVA the branches of the ______ are most commonly affected and have a ______ outcome.

A

MCA

poorer

103
Q

the 3 ways to medically manage an Embolic CVA is

A

prevention
long-term anticoagulant therapy
surgery

104
Q

what are the 3 main causes for a Hemorrhagic CVA?

A

HTN, Ruptured saccular aneurysm, AV malformation

105
Q

how is the recovery time of a hemorrhagic CVA vs the other two forms?

A

Blood re-absorbed over 6 to 8 months making it a quicker recovery

106
Q

Hemorrhagic CVA medical management

A

hypertensive by prevention and HTN management

Ruptured aneurysm by surgery

107
Q

left brain damage may result in

A

right side paralysis
speech and memory defects
cautious and slow behavior

108
Q

right brain damage may result in

A

left side paralysis
perceptual and memory defects
quick and impulsive behavior

109
Q

three commonalties that are found between right and left sided brain damage are

A

sensory dysfunction
visual field defect
cognitive impairment

110
Q

MCA

A

hemiplegia of contralateral side

if on the dominant side then global aphasia

111
Q

ACA

A

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
Q

ICA

A

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
Q

PCA

A

if proximal, signs include thalamic syndrome including abnormal sensation of pain, temp, proprioception and touch.
Personality changes

114
Q

PICA

A

wallenberg syndrome: vertigo, nausea,

CVA (1 decks)

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