stroke Flashcards
anterior cerebral artery
- contralateral hemiparesis in LE
- contralateral hemisensory in LE
- urinary incontinence (ACA-ABCD-baby/kids-diapers=pee=UI
- problems with imitation, bimanual tasks, apraxia
- slowness, delay motor inaction
- contralateral grasp reflex, sucking reflex
think of LA (low on the map, thereferoe LE) and babies
middle cerebral artery
- contralateral hemiparesis in UE
- contralateral hemisensory loss in UE
- Language speech impairments - brocas, wenickes, global aphasia
- Perceptual disorders - unilateral neglect
- contralateral homonynous hemianopsia
think MCA=MPH (miles per hour), mph= mouth, perceptual disorder, homonymous hemianopsia
most common
where is broca’s aphasia located
frontal lobe
non fluent aphasia =
brocas aphasia,
broken speech
where is weknicke’s aphasia located
temporal lobe
receptive aphasia =
wernicke’s aphasia
speech is intact; they canot understand what is being said
if the superior division of the MCA is affected, what kind of aphasia do you see
brocas
if the inferior division of the MCA is affected, what kind of aphasia do you see
wernickes
unilateral neglect is seen with which CVA
R MCA
posterior cerebral artery (syndrome)
peripheral territory
- - contralateral homonymous hemianopsia
- visual agnosia - prosopagnosia (cant identify faces/recognize)
- dyslexia WITHOUT agraphia
cant read but can write
- memory deficits
- topographical disorientation
everything is a maze
central territory
- central post stroke
- thalamic pain syndrome
posterior - occiptal lobe - o SEE pi tal — visual defecits is common
R hemisphere CVA
- L hemiparesis and hemisensory loss
- visual - perceptual impairments (neglect)
- difficulty with visual cues
- quick, impulsive, safety risk
- rigidity of thought
- diffculty with negative emotions
- homonymous hemianopsia
think baby
L hemisphere CVA
- R hemiparesis/hemisensory loss
- language impairments (aphasias)
- difficulty with verbal cues
- slow and cautious
- highly distractible
- difficulty with positive emotions
- homonymous hemianopsia
Think old people
compare R v L hemisphere CVA
difference between synergy and spasticity
spasticity - rest - PROM
synergy - energy - AROM
synergy is compensatory movement
brunnstrom stages of stroke recovery
brunnstrom stage 1
flaccid
- no active limb movement
brunnstrom stage 2
beginning of minimal voluntary movement
- in synergy, with associated reactions
- increased tone
brunnstrom stage 3
voluntary control of movement synergy (spasticity at peak)
- further increased tone to peak level
brunnstrom stage 4
movement outsided of synergy
- tone starts to decrease
brunnstrom stage 5
increased complex movement, greater independence from limb synergies
brunnstrom stage 6
individual joint movement, coordinated movement
hold 6 fingers up with hands, you have one hand that has 1 finger = individual mvoement
brunnstrom stage 7
normal function
spasticity pattern of UE
scap: retraction, downward rotation
sh: adduction, IR, depression
elbow: flexion
forearm: pronation
wrist: flexion, adduction
hand: finger flexion, clenched fist thumb, adducted in palm
seen at rest
spasticity pattern in LE
pelvis: retraction (hip hike)
hip: adduction (scissoring), IR, extension
knee: extension
foot and ankle: PF, inversion, equinovarus, toes claw, toes curl
toes claw: tarsometatarsal extension and MTP flexion
toes curl: tarso and MTP flexion
think ballerina’s back leg when in rellevay
flexion synergy of UE
- scapula retraction/elevation or hyperextension
- shoulder abduction, ER
- elbow flexion
- wrist and finger flexion
extension syngery of UE
- scapular protraction
- shoulder adduction, IR
- elbow extension
- forearm pronation
- wrist and finger flexion
flexion synergy patterns for LE
- hip flexion, abduction, ER
- knee flexion
- ankle DF, inversion
- toe DF
think of man sitting in figure 4 stretch
extension synergy of LE
- hip extension, adduction, IR
- knee extension
- ankle PF, inversion
- toe PF
same as ballerina, LE spasticity
