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L CVA have difficulty w/ the following
- Processing information in a linear, sequetial manner
- Demonstrate Broca's expressive, non fluent aphasia, Wernicke's receptive, fluent aphasia
- Exhibilt negative, anxious , depressed, slow cautious, insecure reactions
- Ted to be realistic abou their disability
- Cannot distinguis left from right sides
- Demonstrate apraxia, alexia, dyslexia, agraphia, acalculia, visual field loss, and subject to emotional highs and lows
- Coprhension is usally perserved
R CVA issues
- temporaty or permanent paralysis to the lieft side of the body
- frequently speak adequately and may appear to have a high degree of comprehension which is not true
- short attention span
- poor reading comprehension
- unable to do arithmetic, use money, write checks or dial aphone w/o erros
- difficulty in itme and space concepts
- dificulty grasping overall organization, are impulsive, deonstrate poor judgement in safety, are unrealistic
usually occurs in the anterior portion of the crebrum and the pt. presents w/ non-fluent language (slow), apraxia of speech, word finding problems, poor functional oral expression skills, fair to good comprehension skills and poor writing skills.
- usually occurs in the posterior portion of the first temporal gyrus.
- Pt. presents w/ normal or hperfluent (fast) rae of speech, normal amount of speech, significant word finding problems, impaired auditory comprhension and auditory feedback difficulties, impaired error awareness, repetition is impaired by irrelevant inserions and coprehension is gnerally severely impaired.
Flexion synergy patterns UE's
- Shoulder girdle-retraction and elevation
- Shoulder-abduction and external rotation
Flexion synergy patterns LE's
- Hip-flexion, abuction, and external rotation
- ankle-dorsiflexion and inversion
Extensor synergy patterns UE's
- Shoulder girdle-protraction or fixation
- Shoulder-adduction and internal rotation
Extensor synergy patterns LE's
- Hip-extension, adduction, and internal rotation
- ankle-plantarflexion and inversion
- Occlusion usually presents w/ greater involvement of the LE than UE or face
- Extensive forntal lobe infarction produces significant behavioral changes.
- Right-side ddamage to the frontal lobe may cause contralateral neglect.
- Damage to the supplementary motor area may produce aphasia
- Lesion of the ACA are uncommon
- Occlusion results in drowsiness, contralateral hemiplegia, and cortical sensory loss of the face, ar and leg w/ the face and arm more involved than the leg
- Homonymous hemianopsia (visual field defect) and deviation of the eyes away from the hemiplegic side also result
- Broca's aphasia
- Wernicke's Aphasia
- Apraxia, a disorder of voluntary learned movement is also common
- Infarction of the non-dominant right hemisphere typicall produces a flat or expressionless effect
- Most common site of stroke
- Occlusion of thalamic branches (affecting pain and temperature the most) and persistent contralateral pain in response to any type of sensory inpute
- Proprioception is severely involved
- Right side infarcts produce hemianopsia and left-sided infarts produce alexia (word blindness) and anomia (word-finding difficulty