CVA

Question 1

*Lacunar

Answer 1

• small holes in the brain
• pure motor, ataxic or sensory loss
• good prognosis/easier to rehab (depends on location and amount.)

Question 2

*Middle Cerebral

Answer 2

• most common
• more complicated/dense -INTENSIVE REHAB
• sensory loss of face & UE>LE- might be able to walk but unable to use hands/arms
• homonymous hemianopsia - half the visual field
• aphasia- receptive, global, expressive
• apraxia-dressing, bringing objects to body
• body scheme- weak side-(routine, hand over hand, sensory input)
• spatial relations- deph preception (hand over hand ass.)- vision screen, sensory input
• agnosia- doesn’t recognize objects, lost visual recognition (lose ability to feel objects)
• impulsivity- not going to wait for anybody, high fall risk

Question 3

*Anterior cerebral

Answer 3

• safety, no insight, behavioral issues
• contralateral US hemiparesis
• sensory loss LE>US or face-propreoceptive impairment
• LE paralysis/weakness
• frontal lobe damage
• apraxia- motor planning (hand over hand)
• aphasia- speech/language
• neglect

Question 4

Posterior cerebral

Answer 4

• more rare
• contralateral sensory loss
• homonymous hemianopsia
• contralateral
• hemiplegia

Question 5

Vertebral Basilar artery

Answer 5

• LOC
• brainstem or cranial nerve damage
• hemi or quadriplegia
• memory loss
• agitation
• comatose or vegetative state
• locked in syndrome- cant do anything

Question 6

Ischemic CVA

Answer 6

-blockage in artery by clot, 87%
-MOST COMMON BLOOD CLOT
Thrombotic- stationary clot
-build up of fatty tissue in vessel (stents)
Embolic- traveling clot formed else where in body (clot that travels to vessel and makes surgery risky)

Question 7

Hemorrhagic

Answer 7

• weakened vessel ruptures , 13%
• more rare (uncontrolled HTN)
• emergency surgery
• after brain injury/trauma

Question 8

Problems you would look for

Answer 8

• decrease posture (cant bend forward, stand, maintain balance)
• decrease biomechanical alignment (look @ scapula position, muscle loss)
• inefficient muscle recruitment (over activity in flexion, under activity in extension, both)
• decrease automatic adjustments and reactions
• spasticity (common, biggest frustration, over rides basic fx)
• pain (MOST PAIN IN SH., no pain w subluxation)- poor handling, hanging w gravity, positioning in bed

Question 9

Sh. pain types

Answer 9

• joint pain
• muscle pain
• altered sensitivity
• sh. hand syndrome (CRPS)
• brachial plexus traction
• rotator cuff tear
• adhesive changes
• joint pain
• muscle pain
• altered sensitivity
• sh. hand syndrome (CRPS)
• brachial plexus traction
• rotator cuff tear
• adhesive changes

Question 10

Sh. Eval

Answer 10

-hx
-age
-transfer techniques
-act. level
-available mvnt
-pain- type
-nature- rest or moving
-location
-elements that intensify and diminish pain
vision inspection
-posture
-atrophy
-early signs of CRPS
-GH mal-alignment
-neglect
-tone (hypotonic)
-PROM
- motor performance - over use certain patterns