CVA/ Stroke Flashcards
Neuro
What is Cerebral embolism
Ischemic
Traveling bits of matter (thrombi, tissue or fat, air, bacteria) that produce occlusion and infarction in the cerebral arteries
What is Cerebral Thrombosis
Ischemic
Formation or develpment of blood clot or thrombus within the cerebral arteries or their branches
What is a hemorrhagic stroke
Abnormal bleeding as a result of rupture of a blod vessel
What is a transient ischemic attack (TIA)
temporary period of symptoms resulting from decrease blood supply to the brain; No permanent damage
ACA stroke
Contralateral Hemiplegia LE>UE
Contralateral Hemisensory loss LE>UE
Urinary incontinence
Problems with bimanual task
Apraxia
MCA stroke
Contralaeral hemiplegia face, UE>LE
Contralateral hemisensory loss UE>LE
Homonymous hemianopsia
Motor speech involvement: fluent/non fluent global or conduction aphasia
PCA stroke
Contralateral sensory loss
Involuntary movements: choreothetosis, tremor, hemiballismus
Transient contralateral hemiparesis
Hemonymous hemianopsia
Other: Webers syndrom, visual agnosia
Stage 1
Stroke sequentual Recovery stage
1 is worse than 6
Initial flaccidity- no voluntary movement
Stage 2
Stroke sequentual Recovery stage
1 is worse than 6
Emerging spasticity
- hyperreflexia, synergy
Stage 3
Stroke sequentual Recovery stage
1 is worse than 6
Voluntary movement possible but ONLY in synergy
- Spasticity strong
Stage 4
Stroke sequentual Recovery stage
1 is worse than 6
Voluntary control in isolated joint movement EMERGING
-Decline in Spasticity and synergy
Stage 5
Stroke sequentual Recovery stage
1 is worse than 6
Increasing voluntary out of synergy
Coordination deficit
Stage6
Stroke sequentual Recovery stage
1 is worse than 6
Control and coordination near Normal
Left CVA
Behavior
- Right Hemipligia
- slow, cautious
- hesitant and insecure
- resulting in frustration
Right CVA
Behavior
-Left Hemiplegia
- impulsive, quick
- indifferent
- poor judgement of safety
- overestimating thier capability and underestimating the problem
Hip
Gait: Typical Deficits
-Poor hip position (retracted and FLXed)
-Tradelenburg limp (weak ABD)
-Scissoring (spastic ADD)
-Insufficient pelvic rotation
Knee
Gait: Typical Deficits
-Weak knee EXTnsors (may lead to compensatory lokcing of the knee in hyperextension)
-Spastic Quads may also yealed a hyperextended knee
Ankle
Gait: Typical Deficits
-Footdrop/ PF spasticity = euinus gait ( heel does not touch the ground)
- Varus foot= Weight is borne on lateral side of foot
Fugul-Meyer Assessment of Motor Performance
CVA Outcomes
Subtest for UE/LE function
Test: balance, sensation, ROM and Pain
Scoring: 0= cant perform, 1= partially perform, 2= fully perform
Functional Independence Measure (FIM)
CVA Outcomes
18 items
Captures: feeding, grooming, bathing, transfer, gait, stairs, cogitive, social interaction, expression, bowel and bladder
Postural Assessment scale for stroke Pt
CVA Outcomes
12 items that measure postural control and balance in pt recovering from stroke
- Scoring: 0-3 with higher socres reflecting better postural control
Trunk Impairment Scale
CVA Outcomes
Evaluates motor impairment of the trunk
- Static sitting, dynamic sitting, coordination
- Scoring: 0-23 with highter scores = increased trunk impairment
Stroke Impact Scale
CVA Outcome
Self reporting measure
Measures: physical problems, memory, changes in mood, emotion, communcation.
Aerobic conditioning
Interventions
- Cycle ergometry
- Treadmill
- Walking
Other
Intervention
-Isokinetic training: improvement timing deficits, volocity control of movement
- locomotor training: Body Weight Supported, motorized treadmill training
- Functional electrical stimulation (FES)- stimulate muscle action and reduce spasticity
- Constraint-induced movement therapy (CIMT)- must have wrist and finger movement
Left CVA
Learning
-Communication base: Words, gesture
Assess level of understanding
Give frequent feedback and support
Do not underestimate learning ability
Right CVA
Learning
- Communication: use verbal cues
- Give frequent feedback- focus on slowing and controlling movement
- Focus on safety
- Avoid environmental clutter
