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NeuroRehab > CVA > Flashcards

CVA Flashcards

1
Q

TIA

A

Transient ischemic attack:

Briefly episode of neuro dysfunction caused by a focal disturbance of brain or retinal ischemia, w/ clinical symptoms lasting less than 1 hour and WITHOUT EVIDENCE OF INFARCTION

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2
Q

Mini stroke

A

Very minor stroke

Small lesion size -> minimal to no functional deficit

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3
Q

CVA management - clot

A

Restore blood flow and perfusion to damaged area

TPA, asprin and other anti-coagulants
Carotid endarterectomy, angioplasty, stents

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4
Q

CVA management - bleed

A

Control bleeding, reduce pressure in brain

Transfusion of clotting product
Bed rest
Surgical BV repair

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5
Q

TPA

A

Plasminogen activator
Pt must be >18 yo w/ dx of CVA and symptoms <3hours

Contras: internal bleeding, minor stroke, heparin w/in 48 hours

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6
Q

CVA- AVA

A 
Not very common 
Contra hemiplegia (LE>EU)
Minimal sensory loss
Apraxia (L inf parietal, frontal, corpus callosum)
Cog. Deficits
Aphasia (broca’s)
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7
Q

CVA- MCA

A

Most common site

Contra hemiplegia w/ hemisensory loss 
UE>LE
Head/eye deviation toward side of lesion
Homogenous hemianopia contralateral
Global aphasia
Inattention/neglect
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8
Q

CVA - PCA

A

Contralateral hemisensory loss
Contralateral homogenous hemaniopshia
Unilateral neglect

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9
Q

CVA - lacuna infarction

A

Small vessel
Affect subcortical structures
Can be pure motor, pure sensory, silent
20% of all strokes

Good outcome b/c few deficits
Low mortality

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10
Q

CVA - cerebellar

A

Ipsi hemiparesis
May have gen. Weakness/decrease tone in trunk
Poor extensor strength
Impaired coordination (dysmetria, ataxia)
Impaired proprioception

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11
Q

> 1 TIA w/in 1 week

A

30% greater risk of stroke w/in the week

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12
Q

NIH stroke scale

A

Neurologist performs

Decision making related to use of thrombolytic therapy

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13
Q

NIH stroke scale scoring

A

<5 mild
5-14 moderate
15-24 moderate to severe
>25 neuro impairment

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14
Q

NIHSS D/c predictions

A

<5 d/c home
6-13 d/c to rehab
>13 strongly assoc w/ rehab

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15
Q

NIHSS cutoff for function

A

Initial score of 7 found to be important cut off - 45% functionally normal at 48 hours

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16
Q

VCA functional assessments

A

Mobility - FIM, transfers 5x sit to stand, STREAM
Gait - analysis, speed, 6 min walk test
Balance - romberg, berg, TUG, FGA, ABC

17
Q

CVA testing

A

Functional! Get them upright and allow them to move so you see what they’re actually capable of

18
Q

Supine hip extensor test

A

Not true mmt, gross functional assessment

Knock one grade off formal MMT

19
Q

Supine hip extensor test grade 5

A

Netural pelvis, full hip ext

20
Q

Supine hip extensor test grade 4

A

Hip flexion before pelvis elevates

21
Q

Supine hip extensor test grade 3

A

Full elevation of leg w/out lift of pelvis

Good resistance

22
Q

Supine hip extensor test grade 2

A

Full elevation of leg w/out lift of pelvis,

Poor resistance

23
Q

Upright motor control - hip and knee flexion grades

A

Strong- >60, 3x in 10 sec
Mod- 30-60, 3x in 10 sec
Weak - no motion/<30, 3 takes over 10 sec

24
Q

Upright motor control - ankle flexion

A

Strong - at least 0 deg of DF 3x in 10 sec

Weak - no motion/ less than right angle OR 3 reps in >10 sec

25
Q

Upright motor control -hip ext grades

A

Weak - uncontrolled trunk flex
Mod - unable to maintain fully erect trunk
Strong - pt remains erect trunk at end of available hip flex range

26
Q

Upright motor control knee ext

A

Strong - able to hold weight and stand into full knee ext
Mod - able to hold weight but not stand on the one left
Weak - knee collapses

27
Q

Upright motor control test - ankle ext

A

Strong - lift heel of floor w/ neutral knee
Mod - pt can control knee and ankle in neutral
Weak - knee collapse, knee wobble, ext thrust

28
Q

UE flex synergy

A 
Scap retraction
Shoulder AB, ER
Elbow flex
Forearm sup
Wrist/finger flex
29
Q

LE flexion synergy

A

Hip flex, AB, ER
Knee flex
Ankle DF

30
Q

UE ext synergy

A

Shoulder IR
Elbow ext
Pronation

31
Q

LE ext synergy

A

Hip ext, ad, IR
Knee ext
PF

32
Q

Cause of synergy

A

Lack of voluntary muscle control
Spasticity
Weakness

NeuroRehab (33 decks)

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