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32 Cards in this Set
- Front
- Back
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What is the most common site for CVA's?
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Middle Cerebral artery
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What is a CVA?
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*Permanent reduction of blood flow
*Infarct of brain tissue caused by oxygen deprevation |
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What is the most common diagnosis seen by OTs
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CVA
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What is hemiplegia?
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paralysis of one side. The side opposite the CVA
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What is hemiparesis?
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weakness; partial motor loss on one side. The opposite side of the CVA
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What is a TIA?
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Trans Ischemic Attack
It is a temporary reduction of blood flow, a mini-stroke |
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Define:
Ischemia |
blockage (reduction in flow)
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Define:
Necrosis |
Death (tissue dies)
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Name 3 etiologies of CVA
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1 Thrombus
2 Embolus 3 Hemorrhage |
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Which etiology is the most common?
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Thrombus 53-58% of CVA
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Which etiology is the most deadly?
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Hemorrahge type CVA's
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Describe Thrombus
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-Due to blockage from blood clot
-atheroscherosis: fatty deposits in arteries -Due to lifestyle choices -Occurs at night, & pt's unaware |
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Describe Embolus
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-Traveling blood clot
-clot can be a piece from thrombus or other material |
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Describe Hemorrhagic
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-Ruptured aneurysm or caused by a trauma (MVA)
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Characteristic of Strokes are?
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-come on suddenly
-symptoms are focal (specific area of brain) -can be mild or severe |
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What are the Risk Factors for a CVA? 2 most common
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1- age
2- cardiac disease |
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What are the controllable factors:
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-stress
-birth control w/headaches and smoking -HTN -alcohol -smoking -obesity -diabetes (along w/other unhealthy habits) |
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What are the UNcontrollable factors:
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Usually genetics.
Chinese, Japanese and African Am -Age |
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What is the most modifiable risk factor
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High blood pressure
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What are the 2 effects of a stroke?
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-Motor and sensory
(problems with movement) |
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What are the warning signs?
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TIA
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How long do TIAs last? And what are they a prelude to?
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*they can last 2-15 minutes, rarely over 30 minutes.
* A major stroke! may follow after 1 or more TIA's |
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How long before a major stroke after TIA's
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major stroke can follow hours, weeks or months after TIA
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Dysfunctions following a CVA
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- flaccidity/hypotonicity
- sensation loss/chg - cognition deficits - behavior/personality chgs - speech/language deficits - vision impairments/chgs |
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What do the outcomes and severity of CVA depend on?
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It depends on the
type, size, location, and density of the brain damage |
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Poor Prognosis is indicated by what factors?
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1. the amt of edema causing intracranial pressure
2. edema in comatosed pts. 3. How long the pt is flaccid |
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What can cause a favorable prognosis?
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Early spasticity
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How long before the brain stops swelling due to CVA?
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Usually reaches at peak in 3-4 days then subsides
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What is the recovery period for small infarcts vs severe infarcts?
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small infacts(mini-strokes): 1-2 days
In severe CVA's: spontaneous recovery of motor func can occur in 3 months. But typically it takes pt's 5-6 months then they plateau. Studies do show that improvments continue years post CVA |
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What type of medical complications are stroke pt's prone too?
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-DVT
-Subluxation of the GH joint 1. due to spasticity 2. due to flaccidity -Decubitus Ulcers |
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What are the problem areas?
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-abnormal reflexes
-abnormal MS tone -motor skills deficits (recovery begins proximal to distal) -balance impairments -motor problems (fine & gross) |
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OT treatment techniques: 11 of them
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-PROM/AROM: maintain ROM to prevent deformity; serial casting
-Treat pain and subluxation: rest arm on lap trays, arm trough, use a sling only when walking -Motor retraining: work on posture and movement (include the affected arm- it can hold things down, up, stablizer) -normalize MS tone: facilitate for flaccilidity & inhibit for spasticity -bilateral integration -strength and endurance -edema control: elevation, retrograde massage,PAMS (cold) -compensatory techniques: one-handed techniques -sensory retraining- rubbing area, exposing to diff textures -visual: hemianopsia-use anchoring technique, diplopia-patch one eye -tactile: (any of the sensory losses) compensate w/vision -olfactory and gustatory: safe guard the environment |
