Exam 4 Flashcards
What is Pushers Syndrome?
When a patient who has had a stroke leans toward the hemiplegic side.
What are the characteristics of a Left CVA?
-Aphasia (Language involvement)
-Apraxia (Difficulty with motor planning)
-Difficulty with sequencing
What is the Modified Ashworth Scale used for?
Grading Spasticity
What are the Modified Ashworth Scale grades and what do they mean?
0 = No increase in muscle tone
1 = Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part is moved in flexion or extension
1+ = Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the range of motion
2 = More marked increase in muscle tone through most of the range of motion, but affected part easily moved.
3 = Considerable increase in muscle tone, passive movement difficult
4 = Affected part rigid in flexion or extension
What are the Brunnstrom Stages of Recovery?
The accepted 7 stages of stroke recovery
Name the Brunnstrom Stages of Recovery
I = Flaccidity: No voluntary or reflex activity is present in the involved extremity
II = Spasticity begins to develop: Synergy patterns begin to develop. Some of the synergy components may appear as associated reactions
III = Spasticity increases and reaches its peak: Movement synergies of the involved upper or lower extremity can be performed voluntarily
IV = Spasticity begins to decrease: Deviation from the movement synergies is possible. Limited combinations of movement may be evident.
V = Spasticity continues to decrease: Movement synergies are less dominant. More complex combinations of movements are possible.
VI = Spasticity is essentially absent: Isolated movements and combinations of movements are evident. Coordination deficits may be present with rapid activities
VII = Return to normal function: Return of fine motor skills
What is the definition of Associated Reactions?
Automatic movements that occur as a result of active or resisted movement in another part of the body.
What is Souques Phenomenon in terms of associated reactions?
Flexion of the involved arm above 150 degrees which facilitates extension and abduction of the fingers
What is Raimiste Phenomenon in terms of associated reactions?
Resistance applied to hip abduction or adduction of the uninvolved LE causes a similar response in the involved LE.
What is Homolateral Limb Synkinesis in terms of associated reactions?
Flexion of the involved UE elicits flexion of the involved LE
What is the Clinical Presentation of a patient with an Acute CVA?
-Flaccidity/Hypotonicity
-GH subluxation
-Pain and edema distally
-SC/Brainstem level reflexes (ATNR, STNR, Tonic Lab)
-Aphasia (L CVA)
What are the safety concerns for a patient with an Acute CVA?
-GH subluxation
-Bed sores/ skin integrity
-Increased ICP
-Decreased sensation
-Seizures
-Fall risk
-Pain
What are the Treatment Considerations for a patient with an Acute CVA?
-Positioning and handling (work on involved side) (make sure to leave call bell, food, water on uninvolved side)
-Skin protection
-Early ROM
-Weight bearing on affected side
-Sensory neglect
What are some suggestions for interventions or related motor control techniques for a patient with an Acute CVA?
-Early mobilization
-Ramiste Phenomenon (for AROM)
-Clasped hands with affected thumb on outside
-Supine hook lying
-Bed mobility and positioning
What is the Clinical Presentation of a patient with a Subacute CVA?
-Instability in joints
-Synergistic patterns
-Volitional overflow
-Elbow flexion synergy
-Re-emergence of primitive reflexes
-Pushing tone into the involved extremity
