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Advanced Procedures > Mod 3: CVA > Flashcards

Mod 3: CVA Flashcards

1
Q

2 main causes of stroke/CVA

A

ischemic (embolus or thrombus causes lack of oxygen)
hemorrhagic (artery bursts in brain)

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2
Q

3 areas of hemorrhagic stroke

A

intracerebral
subdural (venous)
subarachnoid (arterial & more severe)

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3
Q

atherosclerosis causes blood clot to form in cerebral arteries

A

cerebral thrombus

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4
Q

“mini stroke” & small clot with signs/symptoms that resolve quickly w/ no permanent residual neuro deficits

A

transient ischemic attack (TIA)

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5
Q

completed stroke vs. stroke in evolution

A

total neuro deficits at onset
vs
gradually progressing thrombus & neuro deficits delayed 1-2 days after onset

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6
Q

“gold standard” for Dx/imaging (2)

A

CT scan
MRI

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7
Q

F.A.S.T.

A

face (unilateral droop; numb/weak, HA)
arm (lagging movement; numb/weak)
speech (slurred, dysphagia)
Time (quick to ER)

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8
Q

purpose & timeline for tPA
-for which type stroke?

A

(tissue plaminogen activator)
clot-dissolving enzyme med
must be given within 3 hrs from onset
-for ischemic (not hemorrhagic*) stroke

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9
Q

anterior arterial blood supply to brain:
_____ branches into _____ & ______

A

internal carotid arteries
middle cerebral & anterior cerebral arteries (MCA & ACA)

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10
Q

posterior arterial blood supply to brain:
_____ becomes ______ & ______

A

vertebral arteries
basilar & posterior cerebral arteries (PCA)

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11
Q

arterial supply for collateral circulation that connects ACA & PCA

A

Circle of Willis

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12
Q

damage to ACA on ____ tract that causes _____ hemiplegia with sensory loss of ____ extremities more than _____ extremities

A

corticospinal tract
contralateral
LE > UE

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13
Q

damage to MCA causes ___ hemiplegia with sensory loss of ____ & ____ extremities more than ____ extremities

A

contralateral
face & UE more than LE

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14
Q

damage to ____ Artery causes contralateral hemiplegia, pain (thalamic sensory), Pushers syndrome (perception), involuntary movement & vision loss

A

Posterior Cerebral Artery (PCA)

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15
Q

damage to ___ Artery (combo of ___ & ____) results in death or mix of deficits of incomplete occlusion

A

Internal Carotid Artery (ICA)
anterior & middle

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16
Q

damage to ___ & ___ arteries causes mix of ipsilat/contralat signs, CN s/s of brainstem, paralysis of face, throat, trunk & limbs

A

vertebral & basilar arteries
(cerebellar involvement = ipsilat signs)

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17
Q

____ CVA lesion: quick/impulsive behavior, indifferent/denial mood, difficulty processing info visually, visual/spatial & body image problems; should encourage slowing down & safety

A

Right lesion

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18
Q

____ CVA lesion: slow/disorganized/frustrated behavior, anxious/aggressive/sad behavior, difficulty processing verbal info, idomotor & ideational apraxia; needs positive feedback

A

Left lesion

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19
Q

visual field cut- partial vision b/c part of retina not working
d/t MCA & PCA strokes

A

hemianopsia

20
Q

type of pain syndrome d/t PCA lesion
-chronic w/ constant burning, intermittent sharp pain
-indirect cause of musculoskeletal pain ___
-contraindication: ____

A

thalamic sensory syndrome
shoulder subluxation
no traction*

21
Q

mm tone initially is ____ then _____
-nature of reflexes when spasticity & synergies emerge: ____
weakness greater ____

A

flaccid then spastic
hyperreflexic
distal than proximal

22
Q

UE flexion synergy of scapula: (2)

A

elevation & retraction

23
Q

UE extensor synergy of scapula: (2)

A

depression & protraction

24
Q

involuntary movement of a body part d/t intentional active/resistive movement of another body part

A

associated reaction
(Brunnstrom)

25
Q

flexion of involved UE facilitates flexion of involved LE

A

homolateral synkinesis

26
Q

Stage which spasticity is at it’s peak & voluntary movement possible in synergistic patterns

A

Stage 3

27
Q

Stages which spasticity emerges ___ & spasticity declines ____

A

Stage 2
Stage 4

28
Q

difficulty planning/initiating movements: __ CVA
Difficulty sustaining movements: ___ CVA

A

Left CVA
Right CVA

29
Q

deficit in motor planning & completing a task though ROM, MMT & coordination may be intact

A

apraxia

30
Q

Ideational vs. ideomotor apraxia

A

ideational: “No idea how to perform;” no proprio input available to formulate motor plan & sequence tasks
ideomotor: movement plan but can’t perform it

31
Q

Types of Gait possible (5)

A

Trendelenburg (hip drop)
scissoring (spastic adductor)
Equinus (foot drop)
Ataxic
Circumducted (extension synergy)

32
Q

receptive vs. expressive aphasia
-vs. global aphasia

A

can’t understand language (but speaks well)
can’t speak/express language (but understands well)
global: impairment of speech production & comprehension

33
Q

when pt ignores stimuli on one side of body
-combo w/ anosognosia (dec. insight/awareness of one’s impairments)

A

unilateral neglect

34
Q

neurogenic bladder
spastic vs. flaccid

A

spastic: mm spasm, incomplete emptying, holds less urine
flaccid: distended bladder mm, overfills and then accident

35
Q

how to position on unaffected side

A

affected arm on pillow w/ protraction
affected leg forward w/ pillow support
*outside of synergies

36
Q

how to position supine

A

pillow under affected butt/thigh to bring side forward (hip ext)
pillow under affected scap for protraction & elbow extension

37
Q

how to position on affected side

A

head flexed, trunk rotated
shoulder protracted w/ arm 90* flexion & supination
sound leg flexed on pillow
*important position for elongation & inc. tactile awareness of that side

38
Q

interventions for spastic tone reduction

A

cryotherapy (no heat*)
stretch/positon/splint
PNF techniques for mobility
WB & joint approx for stability
activate antagonist mm
**dec. UE flex synergy pattern (starting point)

39
Q

interventions for mm facilitation (5)

A

quick stretch
resistance
joint traction for flexor pattern
joint approx for extensor pattern
tapping

40
Q

UE interventions for shoulder subluxation & management

A

WB positions (POE, mod plantigrade)
Postural stabilization
reaching w/ uninvolved side
external rotation
stroke & push for joint approx w/ PROM
tapping to facilitate tricep (elbow ext)
PNF scap patterns in sidelying

41
Q

2 main focuses of interventions for CVA pts

A

functional tasks (w/ symmetry & equal WB)
transitional movements (ex: side-sitting) w/ elbow/hand prop)

42
Q

Principles for ambulation training

A

tactile feedback/cues
first- weight shifting focus w/ diagonal forward movement
facilitate arm swing for trunk rotation
assist/strengthen hip extension to prevent knee hyperext
add dual-tasking

43
Q

weight shifts to weaker side d/t perceptual deficits from PCA CVA
-extends body & resists flexion
-avoids WB on strong side

A

ipsilateral pushing/ Pusher syndrome

44
Q

principles for pusher syndrome interventions

A

encourage active movements to strong side
visual feedback- mirror
strong hand in pt’s lap to dec pushing
verbal & tactile feedback
reorient to midline
lean strong side to therapist or wall

45
Q

intervention for ___ CVA:
use communication plan
assess level of understanding
give frequent feedback
don’t underestimate ability*

A

Left

46
Q

intervention for ___ CVA:
use verbal cues (not demonstrated)
frequent feedback
focus on slow, controlled movement
prioritize safety
don’t overestimate ability*

A

Right

Advanced Procedures (7 decks)

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