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611 Exam 1 > CVA > Flashcards

CVA Flashcards

1
Q

Risk Factors

A

HTN, Smoking , Obesity, SM, sedentary lifestyle, contreseptives w/ estrogen
OT push for primary care (lifestyle redesign)

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2
Q

CVA Survivors

A

10 have no impairment
40 have mild residual deficits
40 have long teem disabilities
10 need instutional care

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3
Q

Stroke Types: Ischemic

A

(Blockage in artery by clot, 87%)
Thrombotic: Stationary Clot
Embolic: traveling clot

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4
Q

Stroke Types: Hemorrhagic

A

Weakened vessel ruptures 13%

Usually due to increased HTN results in major surgery

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5
Q

Stroke Types: Transient Ischemic Attack

A

(TIA)

Sx. Resolve in 24 Hrs.

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6
Q

Lacunar Infarct : Deficits

A

Small holes
Pure motor ataxic of sensory loss
Good prognosis

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7
Q

Anterior Cerebral Artery Infarct: ACA Deficits

A 
Contralateral UE hemiparesis 
Sensory loss LE > UR or face 
LE Paralysis 
Frontal lobe damage 
Apraxia 
Aphasia 
Neglect 
**Sx. also include denile, decreased safety awarnesss, insight, propioseptive input in BLE
Apraxia is noted by hesitation use hand over hand A 
Use blocked practice
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8
Q

Middle Cerebral Artery : MCA Deficits

A 
Most common, more complicated, tx involves a lot of sensory input 
*Vision screens are very important 
Sensory loss of face and Ue > LE 
Contralateral hemiplegia 
Homonymous Hemianopsia (loss of 1/3 of visual) 
Aphasia 
Apraxia  
*Body scheme 
*Spatial Relations 
*Agnosia 
*Impulsivity
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9
Q

Posterior Cerebral Artery Infarct: PCA Deficits

A 
More rare 
**Contralateral sensory loss 
homonyous hemianopsia 
contralatral 
hemiplegia
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10
Q

Vertebral-Basilar Artery: VBA Deficits

A 
Locked in syndrome 
LOC 
Brainstem or cranial nerve damage 
hemi or quadriplegia 
memory loss 
agitation 
comatose or vegetative state
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11
Q

Acute Medical Management

A

Airway protection
Restore cerebral circulation : thrombolytic therapy, antiplatelet drugs, anticoagulation drugs, neuroprotective agents
Maintain BP
Correct Anemia

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12
Q

The Hemi Arm: Decreased postural tone and control

A

Can be weakness or sensory based

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13
Q

Hemi Arm: Decreased biomechanical alignment

A

Can be either increased or decreased tone which affect scapular alignment

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14
Q

Hemi Arm: Inefficent muscle recruitment

A

Either increased or decreased tone

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15
Q

Hemi Arm: Decreased automatic adjustments & reactions

A

Difficulty with WS and decreased fluididty & mvmt

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16
Q

Hemi Arm: Pain

A

Pain in sh. sublexations, gravity & poor handeling

17
Q

Sh, Pain types

A

Joint paint (where is pain coming from, what type aka harp dull)
Muscle pain (affected by speed of stretch)
Altered sensativity pain (tholamic pain) = distroffla program aka load and carry
Sh. hand syndrome ( CRPD) = increase pt mvmt
Brachial plexus traction (poor handeling)
Rotator cuff tear (ask about sh. hx) related to quick mvmts = use moist heat
Adhesive Changes = decreased AROM

18
Q

Sh. Pain Eval

A

Hx.
Age
Transfer Techniques (avoid using sh to mobilize)
Activity level (HEP for stretching & ROM)
Available mvmt
Eval of Pain : nature, location, elements that intensify & deminish pain.

19
Q

Sh Pain Eval : Visual Inspection

A 
Posture 
Atrophy 
Early signs of RSD 
GH malaignmant 
neglect 
tone 
PROM 
Motor Performance
20
Q

Sh. Pain Tx

A 
Normalize tone 
Proper handling 
ROM 
Functional use 
Sh. support 
address primary pain causes
21
Q

Sh. Subluxation

A

Partial Dislocation or separation of joint surfaces

22
Q

Causes of Subluxations

A

Abnormal scapular position
Loss of bilateral muscle firing
Weakness
Spasticity

23
Q

Inferior Subluxation

A

Scapula = Downward rotation
Humerus = IR, ADD, below inferior lip
Elbow = ext, pronation
(pic of guy in W/C)

24
Q

Inferior Subluxation TX ideas

A

ROM & Scap mobility
Rotate Scap upward & hold hand placement to maintain correct alignment
Trays/Armrest (pt must be able to unstrap it)
Support affected Sh. so gravity does not continue to over stretch muscles
Use estim tapping

25
Q

Anterior Subluxation

A

Scapula = Downward rotation, elevated, wining,
Humerus = hyper /, IR, humeral head inf & FWD
Elbow = flex, either pron or sup
(pic of old lady in black unitard)

26
Q

Anterior Subluxation Tx Ideas

A 
Dont allow arm to be behind back
Dont go to far Fwd 
use FF in Sh. 
Increase tricep activity 
Pt. education
Bed positioning
27
Q

Superior Subluxation

A

Scpula = elevated, ABD
Humerus = IR, ABD, humeral head lodged under acromion
Elbow - sup & wrist flexion
(Guy with his back turned in the pic)

28
Q

Superior Subluxation Tx Ideas

A

Teach FF vs HZ ABD or pt will get tendonitis
Teach prevenative motions to avoid tendonitis
Start with FF lower bc it is easier

29
Q

Subluxation Reducation

A

Moblize
Realign
Activate

30
Q

Sh. Slings: Pros

A 
Protection 
Control
Prevention
Pressure Relief
Support
31
Q

Sh Slings : Cons

A 
Learned nonuse 
Shortness of soft tissue 
dependence 
immoblize 
fails to correct malaignmeent 
interferes w/ normal mvmt 
Interfers w/ function 
blocks sensory input 
hinders balance 
physcological message
32
Q

UE Tx Principles

A 
hand leads motion 
teach visual tracking of UE 
Use common objects 
dissociation of hand 
variety 
vertical orientation 
challange BOS 
work at highest functional level 
practice
33
Q

Characteristic Deficits

A 
Motor 
Sensory 
Cognitive 
Perceptual 
Emotional 
Speech/Language
34
Q

CVA Evaluation

A 
Medical Hx 
Social HX 
Chief complaint 
Impact of disability on lifestyle 
COmmunication
Cognitive Status 
Mobility 
Sensation
Pain 
Posture
35
Q

CVA Evaluation Continued

A 
ADL's 
Visual status 
perception 
Motor control 
Voulntary movement patterns 
ROM 
Coordination 
Balance
36
Q

CVA Eval Continued Again

A 
Quality of mvmt 
strength 
endurance 
equipment 
gait
37
Q

CVA Tx focus

A

Optimize positioning
Increase ADL performance
Promote & Optimize use of hemioaretic side
Promote and Optimize use of hemiparetic side
Optimize good biomechanics
Optimize Voulntary Control

38
Q

CVA Tx focus continued

A 
Mazimize perception and cognition 
Remidial approach or Adaptive Approach 
Opitmize postural control 
Facilitate emotional adjustment to stroke 
Enhance pt. motivation in rehab 
Education pt, family & Caretakers

611 Exam 1 (6 decks)

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