Stroke Complications and Dysphagia Flashcards
What are the stages of Brunnstrom motor recovery after stroke?
- Flaccidity 2. Spasticity appears 3. Paient gains voluntary control over synergies 4. Some movement patterns out of synergy are mastered 5. If progress continues, more complex movement combinations learned as the basic synergies lose their dominance over motor acts 6. Disappearance of spasticity 7. Normal function is restored
What are the MCC of shoulder pain in stroke?
CRPS/Shoulder hand syndrome and soft tissue injury (subluxation, tendon tears, etc)
What physical exam finding procedes the start of CRPS/shoulder hand syndrome?
Rapid loss of ROM
What is the most valube clinical sign to suggest CRPS/shoudler hand syndrome?
MCP tenderness with compression
What is the gold standard diagnostic test to diagnose CRPS?
Ipsilateral horner syndrome with Stellate Ganglion block
50-75% of patient has urinary incontience during the ____ post stroke
First month post stroke
What are possible voiding disorders post-stroke?
Areflexia, unihibited spastic bladder, bladder outlet obstruction
Wha are signs of poor prognosis for motor recovery after stroke?
No grip by 4 weeks, severe proximal spasticity, prolonged flaccidity, Proprioceptive facillitation (tapping) > 9 days, proximal traction >13 days
What are the 3 parts of a bedside swallow test?
- Cognitive screen 2. Follow one-step commands 3. Oral-motor exam
Risk factors for aspiration PNA
Decreased LOC, trach, NGT, dysphagia
Treatment for dysphagia
Diet modification, NPO, aspiration precuations, Chin tuck, rotate head to paretic side, supraglottic swallow
Complications of dysphagia
Dehydration, malnutrition, higher stress reaction, higher frequency of infection and pressure ulcers
Why does Dr. Wong test spasticity and finger extension in strokes on consults?
To help determine motor recovery and prognositication
