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711: Neurological Rehabilitation > CVA Worksheet > Flashcards

CVA Worksheet Flashcards

1
Q

What are 5 early warning signs of stroke?

A
  • Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe hypertension with no known cause
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2
Q

What regions of the brain does the anterior cerebral artery syndrome supply?

A

Superior border of frontal and parietal lobes

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3
Q

What are 4 symptoms of anterior cerebral artery syndrome?

A
  • Contralateral weakness & sensory loss primarily in the LE
  • Incontinence
  • Aphasia
  • Memory & behavior deficits
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4
Q

What regions of the brain does the middle cerebral artery supply?

A

The surface of the cerebral hemispheres

The deep frontal & parietal lobes

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5
Q

What are 2 symptoms of middle cerebral artery syndrome?

A
  • Contralateral sensory loss and weakness in the face and UEs (less involvement in LE)
  • homonymous hemianopia
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6
Q

What regions of the brain does the posterior cerebral artery supply?

A
  • Occipital lobe
  • Temporal lobes
  • Thalamus
  • Upper brain stem
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7
Q

What are 4 symptoms of posterior cerebral artery syndrome?

A 
- Contralateral sensory loss
Thalamic pain syndrome
- Homonymous hemianopia
- Visual agnosia
- Cortical blindness
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8
Q

What regions of the brain does the internal carotid artery supply?

A

The internal carotid artery enters the cranial cavity bilaterally and divides into the anterior and middle cerebral arteries

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9
Q

What are the symptoms of internal carotid artery syndrome?

A

Combination of anterior and middle cerebral artery stroke symptoms

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10
Q

What are the symptoms of lacunar syndrome?

A
  • pure motor hemiparesis
  • pure sensory stroke
  • sensorimotor stroke
  • ataxic hemiparesis
  • clumsy-hand dysarthria
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11
Q

What regions of the brain does the vertebrobasilar artery supply?

A
  • Brain stem

- Cerebellum

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12
Q

What are the symptoms of vertebrobasilar artery syndrome?

A
  • CN involvement (diplopia, dysphagia, dysarthria, deafness, vertigo)
  • Ataxia
  • Equilibrium disturbances
  • Headaches
  • Dizziness
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13
Q

What is a synergy pattern?

A

An abnormal, stereotyped set of movements that occur in response to a stimulus or voluntary movement

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14
Q

What is the flexion synergy pattern at the scapula?

A

elevation and retraction

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15
Q

What is the extension synergy pattern at the scapula?

A

depression and protraction

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16
Q

What is the flexion synergy pattern at the shoulder?

A

abduction and ER

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17
Q

What is the extension synergy pattern at the shoulder?

A

Horizontal adduction and IR

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18
Q

What is the flexion synergy pattern at the elbow?

A

flexion

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19
Q

What is the extension synergy pattern at the elbow?

A

extension

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20
Q

What is the flexion synergy pattern at the forearm?

A

supination

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21
Q

What is the extension synergy pattern at the forearm?

A

pronation

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22
Q

What is the flexion synergy pattern at the wrist?

A

flexion

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23
Q

What is the extension synergy pattern at the wrist?

A

extension

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24
Q

What is the flexion synergy pattern at the fingers?

A

flexion and adduction

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25
Q

What is the extension synergy pattern at the fingers?

A

flexion and adduction

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26
Q

What is the flexion synergy pattern at the hip?

A

Flexion, abduction and ER

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27
Q

What is the extension synergy pattern at the hip?

A

Flexion, adduction, and IR

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28
Q

What is the flexion synergy pattern at the knee?

A

Flexion

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29
Q

What is the extension synergy pattern at the knee?

A

extension

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30
Q

What is the flexion synergy pattern at the ankle?

A

dorsiflexion with inversion

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31
Q

What is the extension synergy pattern at the ankle?

A

plantarflexion with inversion

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32
Q

What is the flexion synergy pattern at the toes?

A

dorsiflexion

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33
Q

What is the extension synergy pattern at the toes?

A

plantarflexion

34
Q

What is the most dominant synergy pattern in the UE?

A

flexion

35
Q

What is the most dominant synergy pattern in the LE?

A

extension

36
Q

What is an associated reaction?

A

Stereotyped movements in which effortful use of one extremity influences the posture and tone of another extremity (usually the opposite extremity).

In other words, voluntary movements of one extremity produce unintentional movements in another extremity.

37
Q

What are Brunnstrom’s 7 stages of recovery?

A

1) Flaccidity
2) Spasticity appears
3) Spasticity increases (reaches its peak)
4) Spasticity declines
5) Further decrease in spasticity
6) Spasticity disappears
7) Normal function is restored

38
Q

Describe flaccidity (step 1)

A

There are no voluntary or reflex activities present

39
Q

Describe the appearance of spasticity (step 2)

A

Synergy patterns begin to develop. Some of the synergy components may appear as associated reactions.

40
Q

Describe the increase in spasticity (step 3)

A

Patient gains voluntary control over synergies

41
Q

Describe the decline in spasticity (step 4)

A

Some movement patterns out of synergy are mastered, however synergy patterns still predominate.

42
Q

Describe the further decrease in spasticity (step 5)

A

More complex movement combinations are learned as the basic synergies lose their dominance over motor acts

43
Q

Describe the disappearance of spasticity (step 6)

A

Individual joint movements become possible and coordination approaches normal

44
Q

Describe the restoration of normal function (step 7)

A

Fine motor skills return

45
Q

Define Homonymous Hemianopia

A

Defect or loss of vision in the temporal half of one vision field and the nasal portion of the other

46
Q

Define Conjugate Eye Gaze

A

Eyes move in parallel

47
Q

Define diplopia

A

double vision

48
Q

Define dysarthria

A

Difficulty forming words secondary to weakness of the tongue & muscles of the face

49
Q

Define ataxia

A

Uncoordinated movement, equilibrium deficits, & headaches

50
Q

Define Locked-in Syndrome

A

Patient is alert & oriented but is unable to move or speak because of weakness in all muscle groups. Eye movements are the only active movement possible and thus the patient’s only means of communication

51
Q

What is visual agnosia?

A

The inability to recognize familiar objects or individuals

52
Q

What is cortical blindness?

A

Inability to process incoming visual information even though the optic nerve remains intact

53
Q

______ infarcts are small infarcts in the deep cerebral white matter, basal ganglia, or pons, presumed to result from the occlusion of a single small perforating artery supplying the subcortical areas of the brain

A

Lacunar

54
Q

Describe thalamic pain syndrome

A

Condition that follows an infarction or hemorrhage in which the patient experiences intolerable burning pain and sensory perseveration. Sensation is perceived as noxious & exaggerated.

55
Q

Describe pusher syndrome

A

a clinical disorder following brain damage in which patients actively push toward their hemiplegic side, leading to a loss of postural balance

56
Q

Define perseveration

A

repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus

57
Q

What is the left hemisphere responsible for?

A
  • allows individuals to process information sequentially and to observe detail
  • speech and reading comprehension
58
Q

What is the right hemisphere responsible for?

A
  • process nonverbal information
  • perceives emotions
  • awareness of body image
59
Q

Which side of the brain is Wernicke and Broca’s area typically found?

A

It is found in the dominant cerebral hemisphere, which is the left hemisphere in about 95% of right handed individuals and 60% of left handed individuals.

60
Q

CVA in the parietal lobe can cause what?

A

Neglect

61
Q

If a CVA occurs in the left hemisphere what visual changes can be expected?

A

Left nasal and right temporal field vision loss

Homonymous Hemianopia

62
Q

Your patient is supine on the mat. His UE and LE are flaccid and his trunk has low tone. You begin to range his arm and notice some tone in his biceps. You think:

A) The predominant pattern of motor return in the UE following a CVA is flexion
B) Increased biceps tone and elbow flexion is part of the UE synergy pattern
C) You should stretch his biceps to stimulate his triceps
D) Both A & B
E) All of the above

A

D

63
Q

You tap on your patient’s left biceps to try to facilitate movement. This technique is considered to be:

A) Brunstrum
B) Bobath
C) Rood
D) Proprioceptive Neuromuscular Function

A

C

64
Q

A short term goal for a patient with neurological deficit is as follows: The patient will transfer from tall kneeling to half kneeling with supervision. This activity is an example of:

A) mobility
B) Stability
C) Controlled mobility
D) skill

A

C

65
Q

Your patient developed an UE synergy pattern. This includes:

A) shoulder retraction, elevation, supination, elbow, wrist, and finger flexion
B) Shoulder retraction, elevation, pronation, elbow, wrist, and finger flexion.
C) Should protraction, depression, elbow flexion, wrist and finger extension.
D) Shoulder retraction, depression, elbow extension, wrist and finger flexion.

A

A

66
Q

You patient also has speech problems. The speech therapist told you that your patient slurs his words, because he has weakness of the muscles used in speaking. He has no trouble understanding your directions. This is called:

A) Broca’s apasia
B) Dysarthisa
c) Anomia
D) Global aphasia

A

B

67
Q

Your patient is unable to form a motor plan in order to carry out a task. This condition is called:

A) ideomotor apraxia
B) Ideational apraxia
C) constructional apraxia
D) Akinetic apraxia

A

B

68
Q

A patient is unable to sing on command, but you heard him singing to commercials on tv. The same patient cannot walk after being taught while in the rehab department, but has been observed walking in the bathroom. This condition is called:

A) Ideational apraxia
B) Ideomotor Apraxia
C) Constructional Apraxia
D) Dressing apraxia

A

B

69
Q

True or False

The most important modifiable risk factor for stroke is high blood pressure.

A

True

70
Q

True or False

Strokes rarely occur in people under 65.

A

False

71
Q

True or False

Most people who have a stroke don’t survive.

A

False

72
Q

True or False

Women are more likely to die of stroke than men.

A

True

73
Q

True or False

People who smoke daily double their risk of stroke.

A

True

74
Q

What does FAST stand for?

A

Face: Ask the person to smile. Does one side of the face droop?

Arms: Ask the person to raise both arms. Does one arm drift downward?

Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

Time: If you observe any of these signs, call 911.

75
Q

Why do associate reactions occur?

A

Because there is an overflow of activity into the opposite limb due to the inability to selectively inhibit the interneurons that synapse with the motor cell bodies of the opposite limb.

76
Q

Locked-in Syndrome results from the blockage of what artery?

A

basilar

77
Q

Cortical blindness results when there is damage to the _____ lobe

A

occipital

78
Q

Thalamic pain syndrome follows an infarction or hemorrhage in one of what 3 areas?

A
  • lateral thalamus
  • posterior limb of the internal capsule
  • parietal lobe
79
Q

When does pusher syndrome develop?

A

in Right CVA of the posterolateral thalamus

80
Q

CN damage is considered a(n) ____ motor neuron lesion.

A

lower

711: Neurological Rehabilitation (10 decks)

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