Hemiparesis Flashcards
which sided cortical stroke leads to dysarthria?
R
which sided cortical stroke leads to dysphagia?
L
what does the stroke screen BE FAST stand for?
Balance (LOB)
Eyes (vision changes)
Face (asymmetries)
Arm (symmetrical raise arm or feel)
Speech (dysarthria)
Time (fast transport to ER)
there is a ____ hour window form when the person has a stroke to administration of tPA
3 hour
what are the major sequellae of stroke?
motor impairments
sensory impairments
visual/perceptual impairments
cognitive/communicative impairments
the basis of movement is provided by
normal postural tone
(hold upright against gravity but not inhibit selective movements)
what movement pattern provides a basis for the movement patterns that progressively show more selective coordination and less stereotyping with time and maturation?
primitive movement paterns
purpose of righting reactions
provide orientation of head
alignment of body part to each other
development of trunk rotation
as the location of the CoG within the BoS changes, what movement patterns are in play?
protective extension reactions
i.e. parachute reaction (UE) and protective stepping (LE)
what movement pattern consists of the ankle, hip, step, and reach reactions?
equilibrium reactions
which movement patterns allow us to maintain our balance by adjusting the location of the CoG within the BoS whether by posturally fixating with strong cocontraction of mm or by making adjustment of trunk and limbs?
equilibrium reactions
what is the hierarchy of movement patterns?
- postural tone
- primitive reflexes
- righting reactions
- protective reflexes
- equilibrium reactions
what are atypical synergies?
loss of selective movement patterns;
predictable movement patterns occurring during volitional movement attempts or associated reactions
what 2 factors can atypical synergies be attributed to?
- altered biomechanical alignment d/t abnormal tone
- neurological disorganization of recruiting motor neurons
which action is included in both UE synergies?
finger flexion
what actions comprise the UE flexion synergy?
scapular elevation
scapular retraction*
shoulder abduction
shoulder ER
elbow flexion*
forearm supination
wrist flexion
finger flexion*
what actions comprise the UE extension synergy?
scapular depression*
scapular protraction
shoulder extension*
shoulder adduction*
shoulder IR*
elbow extension
forearm pronation*
wrist extension
finger flexion
what is the strongest component for UE resting synergy at the scapula?
depression and retraction
what is the strongest component for UE resting synergy at the shoulder?
extension
adduction
IR
what is the strongest component for UE resting synergy at the elbow?
flexion
what is the strongest component for UE resting synergy at the forearm?
pronation
what is the strongest component for UE resting synergy at the wrist/hand?
flexion
what actions comprise the LE flexion synergy?
pelvic elevation*
pelvic retraction*
hip flexion*
hip abduction
hip ER
knee flexion
ankle DF
foot inversion*
which motion is in both LE synergies?
foot inversion
what actions comprise the LE extension synergy?
pelvic depression
pelvic protraction
hip extension
hip adduction*
hip IR*
knee extension*
ankle PF*
foot inversion*
what is the strongest component for LE resting synergy at the pelvis?
elevation and retraction
what is the strongest component for LE resting synergy at the hip?
adduction
flexion
IR
what is the strongest component for LE resting synergy at the knee?
extension
what is the strongest component for LE resting synergy at the ankle/foot?
ankle PF
foot inversion
disorders of complex multimodal sensory mechanisms include what systems?
vestibular
visual
proprioception
interaction of systems for balance disrupt
what is required for motor learning or refinement?
feedback
what is the most common visual disorder associated with stroke?
homonymous hemianopsia
T/F: the “unaffected” side of a stroke will experience motor control and purposeful movement issues
T
(Ex: pusher syndrome)
what does the Fugl-Meyer Test assess?
voluntary movement
synergies
upright posture
what does the Modified Ashworth Scale assess?
muscle tone
ONLY ASSESS SPACICITY
T/F: the Modified Ashworth Scale can detect hypotonia
F
T/F: the National Institutes of Health Stroke Scale assess standing
F
which scale is used to determine stroke severity?
the National Institutes of Health Stroke Scale
which outcome measure is used to assess stroke recovery?
Orpington Prognostic Score
what is the most commonly used outcome measure of for strokes?
Scale for the Assessment and Rating of Ataxia (SARA)
which stroke scale measures the quality of movement including supine to gait, UE, LE, and mobility.
Stroke Rehabilitation Assessment of Movement (STREAM)
what is R1 on the Tardieu Scale?
PROM till catch point
what is R2 on the Tardieu Scale?
full PROM
which stroke scale scores the reaction to stretch at a particular stretch velocity for each muscle group?
Tardieu Scale
what are the activity and/or participation outcome measures for stroke?
action reach arm test
functional independence measure (FIM)
postural assessment scale stroke (PASS)
STREAM (also impairment)
stroke impact scale (SIS)
which stroke measure assesses grip?
action reach arm test
which stroke measure includes bed mobility?
functional independence measure (FIM)
/functional assessment measure (FAM)
which stroke measure is for general rehab pts and assess supine to wheelchair?
functional independence measure (FIM)
/functional assessment measure (FAM)
which stroke measure assesses sit to stand and change in posture?
postural assessment scale stroke (PASS)
which stroke measure is the patient’s perception?
stroke impact scale (SIS)
what are the predictors of poor rehab outcome in stroke?
dementia
global aphasia
previous stroke
older age
prolonged urinary & bowel incontinence
severe visuospatial deficits
persistent sensory deficits
T/F: motor sequellae are a poor outcome predictor of stroke
F!!!
_____ and _____ disturbances are much more devastating for stroke
cognitive and sensory
