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Maturity II Final > CVA assessment > Flashcards

CVA assessment Flashcards

1
Q

What are the three parts of the Glascow Coma Scale? and what is min max point to all?

A

Eye response 1-4
Verbal response 1-5
Motor response 1-6

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2
Q

What screening can be used for mental status?

A

MMSE ( mini mental status exam)

NCSE (neurobehavioral cognitive status exam)

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3
Q

Take BP on which arm for CVA case?

A

uninvolved side

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4
Q

What screening can you use for tone?

A

MAS

Modified Ashworth Scale

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5
Q

What are 0-4 values on the MAS?

A

0 no increase in tone
1 slight increase in tone by a catch and release or minimal tone at end of ROM
1+ slight increase in tone by a catch and no release and tone to remainder of ROM (less than half)
2 more marked increase in tone throughout most of ROM
3 considerable increase in tone, PROM is difficult
4 rigid in flexion or extension

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6
Q

DTRs: C5-C6, C7-C8, L2-L4, L5-S2?

A

C5-C6: biceps/bracihoradialis
C7-C8: triceps
L2-L4: Patellar
L5-S2: Achilles

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7
Q

Grading of DTRs?

A 
0: no response
1+ somewhat diminished
2+ average
3+ hyperreflexive
4+ clonus, very brisk hyperreflexive
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8
Q

What is Righting rxn? What equilibrium rxn?

A

Righting: maintain head posture
Equilibrium: maintain balance in response to change in COG

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9
Q

What % of CVA cases present with paresis?

A

80-90%

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10
Q

Where and how is paresis most common in CVA cases and why?

A

UE>LE
contralaterally
distal>proximal
due to MCA is most common

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11
Q

What type of muscle fibers are lost and gained in CVA?

A

type II lost

type I gained

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12
Q

What are 4 major standardize test for CVA?

Which two are most commonly used for CVA?

A
  • Brunstromm Evaluation
  • FMA (Fugl-Meyer Assessment)
  • MAS (Motor Assessment Scale)
  • STREAM (Stroke Rehab Assessment of Movement)

Fugl-Meyer and STREAM is most common

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13
Q

What is min and max score of Fugl-Meyer?

A

0-226

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14
Q

What is STREAM X, 0, 1a, 1b, 1c, 2 scores?

A 
X= not tested secondary to pain
0= flicker, no movement, or less than 10% ROM
1a= can only do part of the movement, with deviation, also tremor or dysmetria
1b= can only do part of the movement but comparable to other side
1c= can complete movement, at least 90%, some deviation still
2= complete movement
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15
Q

What are the 3 vessels related in coordination aka cerebellum-basilar arteries?

A

PICA
AICA
superior cerebellar artery

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16
Q

What occurs in cerebellar stroke?

A

IPS intention tremor & action tremor

17
Q

How is Balance Tested?

A

Berg balance scale
TUG
Four square step test
funcitonal: sit to stand, walking

18
Q

Whare are ADL measurements for CVA?

A

Barthel Index

FIM (in IP)

19
Q

How often should you change CVA pt’s position in bed?

A

Q2

20
Q

What are the 6 stages of Brunnstrom’s Stages of Recovery?

A

1- flaccid during acute onset
2- basic limb synergies, 1st as associated rxn
3- voluntary control of synergy develop with some spasticity
4- move start to break synergy and spasticity decrease
5- difficult movement combinations develop and synergies lose dominance
6- no more spasticity and individual joint movement is now possible. almost normal

21
Q

What are the 3 stages of Bobath (NDT)?

A

1- initial flaccid stage
2- Stage of spasticity
3- stage of relative recovery

22
Q

What is NDT (bobath) treatment concept?

A

decrease abnormal reflex patterns, by inhibition of synergy patterns, facilitate WB and normal movement patterns.

23
Q

What is Compensatory Strategy treatment approach?

A

use of alt. strategies to complete a task, ie use unaffected UE to complete ADLs

24
Q

What is MRP? motor relearning program

A

neuro system is flexible therefore teach and advance function specific motions and actions.

25
Q

What is the method of progression in MRP?

A

dont waste time with easy stuff, progress and challenge and make more complex

26
Q

prerequisites for Constraint-induced therapy?

A
  • adequate balance with restraint
  • able to initiate 20 deg of wrist ext
  • at least 10 deg ext of MCP of 2 digits & 1 st digit
27
Q

What is the protocol for Constraint-induced therapy?

A
  • start for 14 days with chronic stroke
  • used 90% of waking hours
  • shaping aka practice/training up to 6h/day
  • therex based on prior interests.
28
Q

Is strength training okay with spasticity? why?

A

yes, it doesnt increase tone

29
Q

What type of exercise is not possible for CVA pts?

A

OKC

Maturity II Final (12 decks)

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