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528 > Final - Stroke, Post Stroke Gait > Flashcards

Final - Stroke, Post Stroke Gait Flashcards

1
Q

Anterior cerebral artery CVA characteristics

A

-LE
-memory and behavioral impairments
-frontal lobe involvement
-probs w/ imitation, bimanual tasks, urinary incont, apraxia

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2
Q

Mid cerebral artery CVA characteristics

A

-UE and face
-contralateral homonymous hemianopsia
-dominant side (aphasia)
-R side (perceptual probs; unilateral neglect, depth perception, agnosia, apraxia)

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3
Q

What is homonymous hemianopsia

A

Visual field lost on B sides
R occipital lobe lesion

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4
Q

Wernicke’s aphasia

A

-fluent, sensory, receptive aphasia
-lesion in temporal lobe
-auditory comprehension impaired

Can’t understand but can speak

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5
Q

Broca’s aphasia

A

-expressive aphasia
-premotor area of L frontal lobe
-comprehension good
-speech is labored or lost

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6
Q

Define apraxia

A

Inability to carry out learned sequential movements on command

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7
Q

Define agnosia

A

Inability to recognize an object by sight, touch, or hearing

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8
Q

What are 4 main characteristics of vertebrobasilar artery stroke

A

-catastrophic
-comatose
-quadriplegic
-poor prognosis

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9
Q

What CN does the vertebrobasilar artery affect

A

CN V-XII

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10
Q

Locked in syndrome characteristics

A

-rapid progression from hemiparesis to tetraplegia
-progression from dysarthria to anarthria
-pt can’t move or speak, but is AO

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11
Q

Cause of lacunar syndrome

A

small vessel deep in cerebral WHITE matter

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12
Q

What structures are involved in lacunar syndrome for pure motor

A

Post limb of internal capsule, pons and pyramids

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13
Q

What structures are involved in pure sensory lacunar syndrome

A

Ventrolateral thalamus or thalamocortical projections

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14
Q

What are the results of a cerebellar stroke

A

DECREASED
-coordination of voluntary movements
-gross and fine motor coordination
-postural control
-balance and equilibrium
-coordination of eye movements

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15
Q

What are the results of a brain stem stroke

A

DECREASED
-alertness*
-ANS control
-arousal and sleep regulation
-swallowing
-balance and movements

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16
Q

Symptoms of right CVA

A

L AFFECTED
-weakness/paralysis
-neglect, spatial perceptual probs
-poor judgment, impulsive
-short attention span, short term memory loss
-weak facial mus
-cognitive probs

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17
Q

Symptoms of L CVA

A

R AFFECTED
-weakness/paralysis
-aphasia (wernike’s or broca’s)
-personality changes (cautious, compulsive, disorganized)
-difficulty with new info (decreased memory)

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18
Q

How is spasticity assessed and graded

A

-resistance to passive jt
-Ashworth or Modified Ashworth

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19
Q

What 4 outcome measures can be used to assess arm, hand, and/or finger fxn

A

-action research arm test
-box and block test
-nine hole peg
-wolf motor fxn test

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20
Q

Describe UE flexion synergy

A

-scap retract, elevation, or hyper extension
-sh ABD, ER
-elbow flexion
-forearm sup
-wrist and finger flex

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21
Q

Describe UE ext synergy

A

-scap protraction
-sh ADD, IR
-elbow ext
-forearm pro
-wrist and finger flexion

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22
Q

Describe LE flexor synergy

A

-hip flex, ABD, ER
-knee flex
-DF
-toe flex

23
Q

Describe LE extension synergy

A

-hip ext, ADD, IR
-knee ext
-PF, INV
-toe ext

24
Q

What is stage 1 of Brunnstrom’s stages of recovery

A

Flaccidity; no active limb movement

25
Q

What is stage 2 of Brunnstrom’s stages of recovery

A

Beginning of minimal voluntary movement; increased tone

26
Q

What is stage 3 of Brunnstrom’s stages of recovery*

A

-Voluntary control of movement synergy
*spasticity at peak

27
Q

What is stage 4 of Brunnstrom’s stages of recovery

A

*movement outside of synergy
-decreased tone

28
Q

What is stage 5 of Brunnstrom’s stages of recovery

A

-increased complex movement
-greater limb independence

29
Q

What is stage 6 of Brunnstrom’s stages of recovery

A

Individual jt movement, coordinated movement

30
Q

What is stage 7 of Brunnstrom’s stages of recovery

A

Normal function

31
Q

How to reduce common malalignments in supine

A

-affected UE: scap protracted, pillow under arm to keep every neutral
-affected LE: hip fwd (pelvis protracted), pillow under knee to prevent hyperext

32
Q

Reduce common malalignments SLying on more affected side

A

-affected UE: scap protracted, arm neutral in front
-affected LE: hip extension and knee flexed, supported by pillows

33
Q

Reduce common malalignments SLying on less affected side

A

-trunk: small pillow/towel placed under rib cage to elongate hemi side
-UE: scap protracted, arm supported on pillow in front

34
Q

Reduce common malalignments sitting

A

-UE: sh protracted and fwd, arm supported on pillow
-LE: hips 90

35
Q

What is another name for pusher syndrome

A

Contraversive pushing

36
Q

Pusher syndrome characteristics

A

strong side PUSH towards the weaker side

37
Q

Interventions for pusher syndrome

A

-PT sits on pt’s less involved side and instructs pt to lean towards them
-pt’s less involved side next to a wall and instructed to lean towards the wall

38
Q

2 clinical signs of a pusher

A

-spontaneous body tilting toward more affected side
-ABD and ext of less affected extremities

39
Q

What are 7 PT approaches for post stroke mgt

A

-tasks specific
-CIMT
-motor imagery and mental practice
-mirror
-TMS
-strength and aerobic
-treadmill/gait

40
Q

Typical gait deviations - initial stance

A

-limit DF
-lack knee flex (soleus contract, limited quad)

41
Q

Typical gait deviations - mid stance

A

-decreased knee ext (decreased calf act)
-knee hyperext (soleus contract)
-lat pelvic shift
-limit hip extension and DF

42
Q

Typical gait deviations - preswing

A

Decreased knee flex and PF (weak calf)

43
Q

Typical gait deviations - early and mid swing

A

-limit knee flex (stiff rec fem and decreased HS act)

44
Q

Typical gait deviations - late swing

A

Limit knee ext and DF (stiff calf, decreased DF act)

45
Q

What does treadmill training improve? What is the baseline speed for backward walking?

A

-gait speed, endurance, distance
-less than or equal to 0.4m/s

46
Q

What does fxnal e-stim do for gait?

A

-increase PF/DF mus recruitment
-improve gait biomechanics and walking fxn

47
Q

Advantages of biofeedback for gait

A

-increase quality and quantity of skilled reps
-valuable for telehealth and home based step ex

48
Q

What are the parameters for BWSTT?

A

-not exceed 30-40% BWS
-at least 2 mph

49
Q

Advantages of BWSTT

A

-decreased energy expenditure
-task specific practice
-decreased anxiety/fear of falling
-walk faster
-active problem solving

50
Q

Disadvantages of BWSTT

A

-harness discomfort
-false proximal stability
-treadmill limitations
-labor intensive for PT

51
Q

Which artery is the most common for ischemic stroke?

A

Middle cerebral

52
Q

What is ideomotor apraxia

A

Inability to execute gestures d/t deficits in action execution

-difficulty executing motor command despite knowing what to do

Ex. Unable to wave goodbye when asked, but can do it spontaneously

53
Q

What is ideational apraxia

A

Difficulty planning and sequencing complex motor actions

-difficult to understand concept of task

Ex. Using toothbrush to comb hair instead of brushing teeth

54
Q

Internal carotid artery stroke characteristics

A

-supplies MCS and ACA
-if ACA also affected, LOC d/t massive lesion
-warning signs: hx of transient ischemic attack, temporary fading of vision in ipsilateral eye

528 (6 decks)

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