CVA Flashcards by Heather Stephens

Inappropriate initiation 
difficulty sequencing 
inappropriate timing
altered force production are problems with 
a. tone
b. primary impairments
c. changes in muscle activation
d. secondary impairments

changes in muscle activation

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This change in muscle activation is an inability to initiate either at the muscle level or apraxia

a. inappropriate initiation
b. difficulty sequencing
c. inappropriate timing
d. altered force production

inappropriate initiation

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A patient demonstrates coordination deficits, inability to sequence balance or postural control appropriately

a. inappropriate initiation
b. difficulty sequencing
c. inappropriate timing
d. altered force production

difficulty sequencing

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A patient demonstrates coactivation of muscles by initiating their proximal muscles before distal muscles, this can be classified as

a. inappropriate initiation
b. difficulty sequencing
c. inappropriate timing
d. altered force production

inappropriate timing

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A patient has difficulty scaling movement

a. inappropriate initiation
b. difficulty sequencing
c. inappropriate timing
d. altered force production

altered force production

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Changes in sensation are commonly found

a. only in the extremities
b. contralateral face and extremities
c. on the contralateral side
d. proximally more than distally

contralateral face and extremities

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What changes in sensation are common?

proprioceptive loss
tactile impairment
abnormal sensation

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A patient with left hemiplegia had a stroke affecting the

a. left parietal lobe
b. right parietal lobe
c. left temporal lobe
d. right temporal lobe

right parietal lobe

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Perceptual and cognitive problems can include

body scheme/body image
spatial relations
agnosia
attention deficit
memory impairment 
decision making

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Emotional problems is a (direct/indirect) cause

direct

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Depression is a direct impairment related to infarct (true/false)

true

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List difficulties with speech and language

aphasia
dysarthria
dysphagia

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Contraversive Lateropulsion is due to

a defect in posterolateral thalamus or in internal capsule

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Patients experiencing contraversive lateropulsion push

a. toward the center
b. away from the center
c. towards hemi side
d. towards uninvolved side

towards hemi side

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What scale can be used to assess contraversive lateropulsion?

Burke Lateropulsion Scale

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A patient is actively pushing toward the hemiplegic side

contraversive lateropulsion

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Contraversive lateropulsion is the subjective impression of falling to the

a. non-paretic side
b. paretic side

non-paretic side

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A shift to the hemiplegic side with no attempt to support but tend to maintain correct head orientation defines

a. pusher syndrome
b. hemiplegia
c. spatial neglect
d. postural asymmetry

postural asymmetry

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Rehab for patients with contraversive lateropulsion takes the same amount of time as a non-pushing stroke (true/false)

false

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Patients with contraversive lateropulsion also demonstrate what impairments?

hemiplegia
spatial and sensory neglect
postural asymmetry
abduction and extension of non-paretic

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Transfering to the (weak/strong) side is more difficult for a patient experiencing contraversive lateropulsion

strong

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Alignment and mobility changes is a

a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment

secondary impairment

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Changes in muscle and soft tissue is considered a

a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment

secondary impairment

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Pain is considered a

a. primary impairment
b. direct effect
c. secondary impairment
d. composite impairment

secondary impairment

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Edema is considered a a. primary impairment b. direct effect c. secondary impairment d. composite impairment

secondary impairment

Movement deficits are categorized as a. primary impairment b. direct effect c. secondary impairment d. composite impairment

composite impairments

Atypical deficits are categorized as a. primary impairment b. direct effect c. secondary impairment d. composite impairment

composite impairments

Undesirable compensations are a a. primary impairment b. direct effect c. secondary impairment d. composite impairment

composite impairment

Fractionated movements is also known as

atypical movements

It is common to develop shoulder pain due to a. contractures b. nonuse c. osteoporosis d. pusher syndrome

nonuse

Pieces of movement that are missing or the inability to move efficiently or move at all a. movement deficits b. atypical movements c. undesirable compensations d. none of the above

movement deficits

A deviation from normal movement sequence a. movement deficits b. atypical movements c. undesirable compensations d. none of the above

atypical movements

Inefficient movement strategies are a. movement deficits b. atypical movements c. undesirable compensations d. none of the above

undesirable compensations

A patient presents with flaccid paralysis, what stage of the Brunnstroms motor recovery stage do they fall under? a. stage 1 b. stage 2 c. stage 3 d. stage 4

stage 1

A patient demonstrates minimal voluntary movement, associated reactions, and the beginning of spasticity. What stage are they classified under Brunnstroms stages? a. stage 1 b. stage 2 c. stage 3 d. stage 4

stage 2

A patient shows movement in synergies and increased spasticity. What stage would you classify them as under Brunnstroms stages? a. stage 3 b. stage 2 c. stage 5 d. stage 4

stage 3

A patient is in the beginning stages of selective control and spasticity is declining. What stage of Brunnstroms stages would you classify them under? a. stage 4 b. stage 3 c. stage 5 d. stage 6

stage 4

Patient shows more difficult movement combinations and spasticity is decreasing, what stage in Bruunstroms stages? a. stage 4 b. stage 3 c. stage 5 d. stage 6

stage 5

The patient is approaching normal movement, selective control and tone is near normal. What stage of Brunnstroms stages are they classified as? a. stage 1 b. stage 2 c. stage 5 d. stage 6

stage 6

The Brunnstroms stages is good for

tracking motor recovery

A patients arm is at their side, internally rotated, elbow extended, pronated and subluxation is common this is a

low tone arm in acute hypotonic positon

A patient has a weak trunk, ribs flare and show a lateral trunk lean

acute hypotonic positon

The pelvis is dropped, the hip and knee collapse in standing

acute hypotonic positon

In the acute hypotonic position, patients will lean (towards/away) from weak side

away

In the acute hypotonic position, patients will shift their weight to the (involved/uninvolved) leg

uninvolved

In the acute movement deficit stage there is changes in _ _ and they cannot _

muscle activation | generate enough force to use muscles effectively

An unbalanced muscle return and deficits with muscle activation

atypical movement patterns

Inability to correctly activate muscle could be issues with

sequence timing scaling

What are the two potential problems with atypical movement patterns seen?

greater weakness | greater return

Unbalanced return with muscle shortening and poor alignment is a. greater weakness b. greater return

greater weakness

Problems with hypertonicity showing atypical movement patterns is a. greater weakness b. greater return

greater return

Atypical movement patterns and undesirable compensatory patterns are in the (earlier/higher) stages

higher

Movement deficits are in the (earlier/higher) stages

earlier

``` Scapular retraction/elevation shoulder abduction ER or hyperextension elbow flexion forearm supination wrist and finger flexion a. upper extremity flexion synergy b. upper extremity extension synergy c. lower extremity flexion synergy d. lower extremity extension synergy ```

upper extremity flexion synergy

``` Scapular protraction shoulder adduction, IR elbow extension forearm pronation wrist and finger flexion a. upper extremity flexion synergy b. upper extremity extension synergy c. lower extremity flexion synergy d. lower extremity extension synergy ```

upper extremity extension synergy

``` Hip flexion, abduction, ER knee flexion ankle DF and inversion toe extension a. upper extremity flexion synergy b. upper extremity extension synergy c. lower extremity flexion synergy d. lower extremity extension synergy ```

lower extremity flexion synergy

``` Hip extension, adduction, IR knee extension ankle PF and inversion toe flexion a. upper extremity flexion synergy b. upper extremity extension synergy c. lower extremity flexion synergy d. lower extremity extension synergy ```

lower extremity extension synergy

Which motion is the hardest to get back in the upper extremity? a. forearm pronation b. forearm supination c. wrist and finger extension d. wrist and finger flexion

wrist and finger extension

Which motion is missing in both synergy patterns for the UE? a. forearm pronation b. forearm supination c. wrist and finger extension d. wrist and finger flexion

wrist and finger extension

Which motion is the hardest to get back in the lower extremity? a. hip flexion b. knee extension c. ankle and foot eversion d. ankle and foot inversion

ankle and foot eversion

Which motion is missing in both synergy patterns for the LE? a. hip flexion b. knee extension c. ankle and foot eversion d. ankle and foot inversion

ankle and foot eversion

What is the strongest component of the UE flexion synergy pattern? a. forearm supination b. elbow flexion c. wrist and finger flexion d. shoulder elevation

elbow flexion

What is the strongest component of the UE extension synergy pattern? a. shoulder adduction and forearm pronation b. scapular protraction and forearm supination c. shoulder IR d. elbow extension

shoulder adduction and forearm pronation

What is the strongest component of the LE flexion synergy pattern? a. toe extension b. ankle eversion c. hip flexion d. knee flexion

hip flexion

What are the strongest components of the LE extension synergy pattern? a. hip extension and adduction, knee extension, ankle PF b. toe flexion and ankle inversion c. ankle PF and inversion d. hip adduction, knee extension, and ankle PF

hip adduction, knee extension, and ankle PF

There is (higher/lower) tone in the strongest component of a synergy pattern

higher

``` rely on use of uninvolved extremities balance precarious learned nonuse develops more severe spasticity increased severity of secondary problems increased chance of falls ```

undesirable compensatory problems

The Orpington Prognostic Scale is a measure for a. diagnosing b. prognosis c. independence d. impairment

prognosis

Which test is used to measure tone/reflexes?

Ashworth or Tardieu

Which test is used to measure strength? a. Ashworth b. Tardieu c. Timed up and Go d. 5 times sit to stand

5 times sit to stand

Which test involves doing a dual task?

walkie-talkie test

Which component of the ICF does the Fugl Meyer fall under? a. body structure and function b. activity c. participation d. environmental internal

body structure and function

Which component of the ICF is the Stroke impact scale categorized as? a. body structure and function b. activity c. participation d. environmental internal

participation

Which component of the ICF is the PASS classified as? a. body structure and function b. activity c. participation d. environmental internal

activity

The Ashworth test is used for which component of the ICF a. body structure and function b. activity c. participation d. environmental internal

body structure and function

The Fugl Meyer is an outcome measure (true/false)

false

Outcome measures fall under which categories in the ICF

either activity or participation

List the most likely movement system diagnosis for stroke

force production deficit movement pattern coordination deficit fractionated movement deficit sensory detection deficit

List the lesser likely movement system diagnoses for stroke

dysmetria postural vertical deficit cognitive deficit sensory selection and weighting deficit

Which movement system diagnosis is rarely used for stroke?

hypokinesia

A patient demonstrating contraversive lateropulsion would be diagnosed with a. force production deficit b. movement pattern coordination deficit c. postural vertical deficit d. fractionated movement deficit

postural vertical deficit

A patient demonstrating atypical movement patterns can be classified as

movement pattern coordination deficit or | fractionated movement deficit

What is the typical position in the acute phase?

arm at side, IR, elbow extended, pronation, subluxation common trunk weak, ribs flare, lateral trunk lean leg weak, pelvis dropped and hip and knee collapse in standing