Exam 1_Final Flashcards
Effects of stroke on the cardiopulmonary system
- Impaired hemodynamic response to exercise
- diminished oxygen saturation
Effects of stroke on cognition
- may take longer to learn a task
- memory (short and long term)
- emotional ability
- disorientation
Effects of stroke on the neuromuscular system
- movement disorders
- changes in reflexes
- balance impairments
- sensory impairments
- impairments in reflexes
- muscle tone changes
Effects of stroke on the musculoskeletal system
- loss of AROM
- muscle imbalance
- biomechanical results of neurological impairments
What are the primary joints affected by a stroke?
- wrist & hand
- shoulder
- ankle
- spine
- knee
- elbow
What are the effects of stroke on walking?
patients who are able to return to walking short distances (70-80%) will do so at slower speeds and at a higher energy cost to them
Gait impairments influencing slow speeds
- forward propulsion
- swing initiation
- power generation
Secondary impairments following stroke
- decreased ROM d/t contracture
- deep vein thrombosis d/t bed rest and pre-existing conditions
- shoulder subluxation/pain (possible CRPS)
- psychological (depression)
- cardiovascular and pulmonary deconditioning
- generalized pain
According to the article by Winstein, what are the three essential elements utilized in the ASAP?
- skill acquisition
- impairment mitigation
- motivational enhancements
be able to discuss Table 1 for the exam
What are the intervention for patients following ischemic stroke?
Immediately: injection of tissue plasminogen activation (tPA) within the initial 4-4.5 hrs.
Later: anticoagulants (Heparin, Coumadin, Plavix, Eloquis), reduction of cerebral edema (Aspirin), and/or surgery
What are the intervention for patients following hemorrhagic stroke?
surgery to alleviate intracranial bleeding and reduce compression of brain tissue
What are the two principles of neuroplasticity?
- use it or lose it
2. use it and improve it
What factors positively influence motor recovery and plasticity?
- skilled training (task challenge)
- specificity of task changes the brain
- repetition
- intensity
Aphasia
an acquired neurogenic language disorder that disrupts any or all language domains such as speaking, auditory comprehension, reading, and written expression; it is always both RECEPTIVE and EXPRESSIVE
Aphasia is usually caused by a ___ ______ in the ____ ________ __________
MCA stroke; left cerebral hemisphere
Non-fluent (Anterior) Aphasia
affecting Broca’s area; resulting in:
- effortful, labored speech
- reduced phrase length
- physical problems are common
- aphasia classifications: Broca’s, global, and transcortical
Fluent (Posterior) Aphasia
affecting Wernicke’s area; resulting in:
- fluent, effortless speech
- normal rate of speech
- semantic and phonologic errors are common
- aphasia classifications: Wernicke’s, anomic, and conduction
Motor Control Deficits
- difficulty initiating and performing sequences of mvmt
- slower mvmt overall
- more positioning errors
- inability to sustain a posture of mvmt
- inability to fractionate mvmt
- apraxia
- ataxia
Apraxia
inability to perform purposeful mvmt in absence of sensory or motor impairment
Ataxia
inability to modulate trunk/limb mvmt for stability, speed, and accuracy
Sensory Impairments
- touch and localization
- temperature
- position/movement
- vision
Dysarthria
mechanics of speech
Dysphagia
impairment in swallowing
Potential reasons for abnormal biomechanics
- loss of mm strength
- abnormal motor coordination
- balance, postural control deficits
- engrained behavior (i.e. learned nonuse)
