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Patients with lesions in this hemisphere are slow, cautious, hesitant, and insecure with contralateral hemiplegia. Aphasia
Left hemisphere lesion
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Patients with this side lesion are impulsive, quick, indifferent, have poor judgement and safety awareness. Overestimate abilities and underestate their problems. Perceptual deficits
Right hemisphere lesion
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What are the stages of CVA recovery?
- Flaccidity
- Spasticity, synergies
- Voluntary movements in synergy
- Voluntary control w/ decreased spasticity and synergies
- Increasing voluntary control out of synergy
- Control and coord near normal
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Most affected artery with CVA's?
- MCA: middle cerebral artery
- ACA: anterior cerebral artery
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Left hemi treatment for learning
- Develope appropriate communication base
- Frequent feedback and support
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Right hemi treatment for learning
- Verbal cues
- Frequent feedback to slow down
- Focus on SAFETY
- Avoid clutter
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Which artery is affected?:
Contralat hemiplegia mostly of UE's
Homonymous hemianopsia
Infart in left hemi= aphasia & apraxia
MCA: middle cerebral artery
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Which arterywas affected?:
Contralat hemiplegia mostly of LE's
Contralat neglect
Aphasia & mental confusion
ACA: anterior cerebral artery
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Which artery was affected?:
Peristent pain
Homonymous hemianopsia
Aphasia
PCA: posterior cerebral artery
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Which artery was affected?:
Often result is death
Locked in state
Vertebral-basilar artery
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Contralat loss of pain and temp
Ataxia
Vertigo
Dysphasia
Ptosis
- Anterior/ inferior cerebellar ateries
- Superior cerebellar artery
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Word repetition and Manuel cues should be used with which type of aphasia?
Receptive / wernicke's
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Simple yes and no questions should be used with which type of aphasia?
Expressive / broca's
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Symbolic gestures should be used with which type of aphasia?
Global
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CVA gait deviations:
1. weak hip ext/flex contracture a) knee hyperextension
2. weak abd on contralateral side b) equinus gait
3. flex contracture/weak extensors c) FWD trunk
4. PF contracture/spastic quads/weak extensors d) trendelenburg
5. gastroc soleus contracture e) excess knee flex
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What synergy?
elbow flex
shld abd
scap elev and retraction
forearm supination
wrist and finger flex
flexion synergy
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What synergy?
elbow ext
shld add
scap depression and protraction
forearm pronation
wrist and finger flexion
extension synergy
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