Mngmt of Neuro

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  1. What is dysphagia?
    Difficulty swallowing, motor difficulty in oral muscles, delay in the swallowing reflex, can lead to aspiration.
  2. - Difficulties with communication
    - Difficulty processing information in a linear, sequential manner
    - Cautious, anxious, and disorganized
    - Realistic in appraisal of their problems
    Left hemisphere damage (R hemi)
  3. - Difficulty with spatial-perceptual tasks
    - Difficulty understanding overall pattern or organization
    - Quick and impulsive
    - Overestimate abilities, poor judgement
    - Difficulty attending to visuospatial cues
    Right hemisphere damage (L hemi)
  4. The tendency of some people with CVA to push very strongly away from the unaffected side is called?
    Pusher syndrome
  5. What is abnormal synergy patterns?
    Stereotyped mass movement patterns, primitive and automatic. May not be seen at rest.
  6. Which hemisphere is damaged in patients who have difficulty with communication?
    Left hemisphere damage
  7. Which hemisphere is damaged in patients who have difficulty processing information in a linear, sequential manner?
    Left hemisphere damage
  8. Which hemisphere is damaged in patients who are cautious, anxious, disorganized, and realistic in appraisal of their problems?
    Left hemisphere damage
  9. Which hemisphere is damaged in patients who have difficulty with spatial-perceptual tasks?
    Right hemisphere damage
  10. Which hemisphere is damaged in patients who have difficulty understanding overall pattern or organization?
    Right hemisphere damage
  11. Which hemisphere is damaged in patients who are quick & impulsive, overestimate abilities, and have poor judgement?
    Right hemisphere damage
  12. Which hemisphere is damaged in patients who have difficulty attending to visuospatial cues?
    Right hemisphere damage
  13. In abnormal synergy pattern, what are the flexion components of the UE?
    • Scapular retraction/elevation
    • Shoulder abd, ext. rotation, or hyperextension
    • Elbow flexion
    • Forearm supination
    • Wrist and finger flexion
  14. In abnormal synergy pattern, what are the extension components of the UE?
    • Scapular protraction
    • Shoulder adduction and int. rotation
    • Elbow extension
    • Forearm pronation
    • Wrist and finger flexion
  15. In abnormal synergy pattern, what are the flexion components of the LE?
    • Hip flexion, abduction, ext. rotation
    • Knee flexion
    • Ankle dorsiflexion
    • Toe dorsiflexion
  16. In abnormal synergy pattern, what are the extension components of the LE?
    • Hip extension, adduction, int. rotation
    • Knee extension
    • Ankle plantar flexion, inversion
    • Toe planter flexion
  17. What muscles are not usually involved in synergies in either position?
    • Latissimus dorsi
    • Teres major
    • Serratus anterior
    • Finger extensors
    • Ankle everters
  18. What is an associated reaction?
    Automatic responses of extremities that occur as the result of movement elsewhere in the body.
  19. What are the motor deficit impairments s/p CVA? (6)
    • Alterations in tone
    • Abnormal synergy patterns
    • Associated reactions
    • Altered reflexes
    • Altered muscle activation patterns
    • Disturbed balance and postural coordination
  20. What are the indirect impairments s/p CVA? (5)
    • DVT
    • Skin breakdown
    • Contracture and deformity
    • Deconditioning
    • Reflex sympathetic dystrophy
    • Shoulder subluxation
  21. What are the 2 suggested causes of shoulder subluxation and pain?
    • Flaccid stage
    • Spastic stage
  22. What are the 5 approaches to treatment to patients with CVA?
    • Positioning
    • ROM
    • Sensory training
    • Tone modification
    • Establish postural control and functional mobility
  23. When should positioning be addressed in treatment?
  24. How do you maximize awareness of the involved side of a patient with CVA?
    • WB on involved side for sensory sensory input.
    • Encouraging visual regard toward the hemiplegic side.
  25. When positioning a patient with CVA, you want to orient both sides of the body to ______ when possible.
  26. What is the common malalignment of the scapula after CVA?
    Downward rotation
  27. What is the common malalignement of the glenohumeral joint after CVA?
    Humeral depression with subluxation resulting from lateral trunk flexion and scapular downward rotation.
  28. What is the common malalignment of the UE after CVA?
    Shoulder internal rotation, adduction, elbow flexion, forearm pronation, wrist flexion, finger flexion
  29. What is the common malalignment of the LE in standing after CVA?
    • Pelvic retraction and elevation
    • Hip extension with internal rotation and adduction
    • Knee extension and ankle plantar flexion
  30. What is the common malalignment of the LE in sitting after CVA?
    • Hip flexion with abduction and external rotation
    • Knee flexion and ankle plantar flexion
  31. T or F: When doing ROM after CVA, AROM is always preferable to PROM when possible.
  32. What is the advantage of a sling/support to protect the UE?
    Provides support during upright activities when the arm is in a dependent position and decrease soft tissue stretching.
  33. What is the disadvantage of a sling/support in patients after CVA?
    Traditional slings position the arm in an undesirable position, impair balance and trunk mobility, and promote neglect and disuse.
  34. What treatment approach increases sensory input with stretch, touch, deep pressure, resistance, and other sensory modalities?
    Sensory training
  35. The treatment is setup so that the patient must rely on the hemiplegic side of the body to complete an activity, aka forced use.
    Constraint-induced treatment
  36. What are some techniques for tone modification after CVA?
    • Rotation
    • WB/joint approximation
    • Deep pressure/prolonged pressure
    • Joint mobilization techniques
    • Slow rocking combined with rotation and WB
  37. T or F: Once range and muscle tone are gained, active movement in a functional activity is necessary to reinforce normal movement with more normal alignment.
  38. What are some strategies for working with contraversive pushing?
    • Visual cues to give patient feedback about body orientation.
    • Work in area with many vertical structures.
    • Provide patient experiences in which he maintains vertical without losing balance.
  39. T or F: The patient only needs a foundation from which to attempt the next level of difficulty in movement.
  40. What is the abnormal foot posture after CVA?
    Inversion and ankle plantar flexion
  41. Patients with these characteristics do poorly in rehabilitation?
    • Advanced age
    • Severe motor impairments
    • Persistent medical problems
    • Decreased alertness
    • Inability to learn new tasks
  42. What are the most common characteristics of MCA syndrome?
    • Contralateral spastic hemiparesis
    • Sensory loss of the face, UE, LE
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Mngmt of Neuro
2011-12-12 05:49:13

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