The Evaluation of Persons with Brain Injury Flashcards
the pt presentation with CVA can vary based on what factors?
cause of stroke
area of infarct
setting
what are the 2 types of stroke?
ischemic and hemorrhagic
which stroke is more common?
ischemic stroke
what is the most common area of infarct?
MCA (middle cerebral artery)
a stroke of the cerebellum will result in what deficits?
coordination deficits
what is the focus of acute/subacute CVA care?
medical stability (hemodynamics, respiratory fxn)
in acute/subacute stroke rehab, which is more common, flaccid or spastic hemiplegia?
flaccid hemiplegia
what are the characteristics of chronic CVA care?
stable but CV impaired
spastic hemiplegia
loss of fractionated movement
what is normal CBF?
60
what is the threshold for synaptic transmission for CBF?
20
what is the CBF levels indicative of irreversible damage?
12
what is the CBF range for reversible damage/suboptimal fxn?
12-20
what is the CBF range for adequate function?
20-60
why will a pt’s BP be kept high post CVA?
to increase perfusion
what is the penumbra?
the area of vulnerability around the dead tissue post CVA that is silent, not dead from a lack of blood flow
with adequate restoration of perfusion, it can be reversed
what are the characteristics of a left hemisphere lesion?
difficulty communicating
difficulty processing info in a sequential, linear manner
cautious, anxious, and disorganized when trying new tasks
realistic in appraisal of problems
what are the characteristics of a right hemisphere lesion?
difficulty in spatial-perceptual tasks
overestimation of their abilities (decreased awareness of limitations)
may have L neglect and even pusher
geographically challenged
what are common s/s following a stroke?
impaired motor control (flaccidity vs spasticity, decreased activation on the involved side, decreased contralateral strength)
impaired sensation and proprioception
limited ability to ambulate
limited postural stability
limited fxnal mobility
limited ability to perform self-care and ADLs
what are some less common, lesion-specific s/s following a stroke?
impaired language and communication
dysphagia (deep and posterior, more severe)
impaired cognition/memory
impaired behavioral control and judgement
visual/perceptual deficits ; unilateral neglect
apraxia (sequencing issue)-premotor injury
limbic: fear, emotional lability, depression
impaired B/B control
pain (MSK, neuro)
sleep disturbances
is the issue post CVA more so strength or activation of muscles?
activation of muscles
what is the first step in treatment post CVA?
postural alignment!!!
what are the primary impairments in CVA?
changes in muscle tone, muscle activation, muscle strength, and sensation
what are the muscle tones that can result from CVA?
flaccidity, hypotonicity, and spasticity
what are the deficits in muscle activation that can result from CVA?
poor initiation, muscle sequencing, timing, or firing