Stroke 101
These blockages are differentiated by the fact that one travels and becomes lodged and the other forms at the site of the blockage.
embolus and thrombus
Refers to the paralyzed side of the body
hemiplegia
Damage occurring to this artery can be fatal or have no impact d/t collateral blood supply
internal carotid artery
important part of treating synergies
get out of strongest position to relax: position out of comfort
Ex: put elbow into extension
List 2 stroke related risk factors
hypertension, diet high in sugar/fat, heart disease, inactivity, smoker, family history
Bleeding occurs when blood vessel rupture--specifically may occur when blood pressure runs too high
Hemorrhagic stroke
state of high tone, hyperactive reflexes, stronger in certain muscle and makes movement difficult
spasticity
Blood supply impacted in this artery leads to hemiplegia or quadriplegia, dysphagia, impaired sensation and ataxia
Vertebral or basilar artery
2 goals and treatments for early stroke recovery
E: Goals: prevent contractures/pressure sores, maintain ROM, improve bed mobility/trunk control/sit balance. TX: bed positioning, PROM, sit activities, transfers
define Brocas vs Wernickes
Brocas: expressive: difficulty producing words
Wernickes: receptive: difficulty understanding written and spoken language
Define the 3 stages of motor recovery
Initial flaccid: no muscle tone due to cerebral edema: no voluntary movement
Spasticity: abnormal processing of sensory input or lack of inhibition by brain: hypertonicity and hyperactive reflexes
Relative recovery: spasticity and synergies decrease: controlled movements possible
When the body lacks awareness on one side of the body due to failure to pay attention to sensory input
extra points: more common with which strokes
neglect syndrome
more common with strokes on R side of brain
3 common impairments following a stroke impacting the middle cerebral artery
significant cerebral edema, hemiplegia or hemiparesis, homonymous hemianopsia, aphasia, sensory impairment, neglect syndrome, spatial relations deficits, apraxia, dysphagia
List/describe 3 treatments of hemiplegic shoulder pain
Don't pull arm or lift under
position out of abnormal postures: protract shoulder to avoid rhomboid tightness
limit use of slings
have patient use arm
WBing activities: provides sensory stimuli and facilitates motor response
teach self ROM: put arm in WBing position and move body around it
define clonus
oscillatory contraction and relaxation of muscles in response to pressure on the sole of the foot and stretching
3 common gait impairments with CVA
Poor foot placement, foot clearance, unequal step length, resist weight shifting, compensate for losses
loss of visual field in one or both eyes
if R CVA, loss most commonly occurs where
homonymous hemianopsia
Left side of both eyes
A stroke impacting the anterior cerebral artery leads to these 2 stroke syndromes
hemiplegia/hemiparesis, mental impairments, sensory loss, urinary incontinence, aphasia
2 goals and treatments for advanced stage recovery
A: Goals: education, endurance, improve coordination, independence, final AD, AFO if needed. TX: increase amb, HLB, coordination, car transfers, stairs, outdoors
motor apraxia vs ataxia
apraxia: disorder of voluntary learned movement: problems performing purposeful motor skills on command
ataxia: poor ability to perform coordinated movements
3 key things to remember when treating a stroke
encourage early use of affected side
bilateral activity can improve learning
simple, clear instructions
low level activities to start
stress quality movements
work proximal to distal
dysarthria vs dysphagia vs aphasia
dysarthria: muscles of mouth/throat affected: difficulty forming words
dysphagia: difficulty swallowing food/water: paralysis/spasticity of muscles used to swallow
aphasia: impaired ability to comprehend language and/or orally express oneself
Elevated levels of this are thought to damage arterial walls and increase the risk of clot formation
homocysteine: amino acid
List 2 general goals and 2 treatments for mid-recovery stage with specific treatment examples
M: Goals: reduce spasticity, improve: postural stability/endurance/STS balance/WC mobility.
TX: mat activities: bridging, trunk rotation, BLE exercises. short sit activities: midline posture, moving b/t postures, balance activities. STS and pre gait: crossing midline, with and without support, weight shifting, knee control, stepping
I went into the woods and got it. I sat down to seek it. I brought it home with me because I couldn't find it.
a splinter