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Memory problem are common with stroke patients. Pts. w/ stroke often have:
- short retention spans
- immediate, short-term memory impairment
- while long term memory remains intact
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Language impairments frequently result from a stroke involving the ______ _____ artery and the _____ _____ hemisphere
- middle crebral
- dominant left
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Aphasia is
general term used to describe problems w/ comprehension, speech, writing, gestures, or reading
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Aphasia is often classified into two main types:
- Broca's Aphasia (expressive)
- Wernicke's Aphasia (receptive)
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Broca's Aphasia (expressive) usually occurs
in the anterior portion of the crebrum
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Pts. w/ Broca's Aphasia (expressive) present 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.
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Wernicke's Aphasia (receptive) usually occurs
in the posterior portion of the first temporal gyrus
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Pts. w/ Wernicke's Aphasia (receptive) present w/
normal or hyperfluent (fast) rate of speech, normal amount of speech, overuse of function words, literal and verbal paraphasia, extended jargon (make up words), significant word finding problems, impaired auditory comprehension and auditory feedback difficulties, impaired error awareness, repetition is impaired by irreleveant insertions and comprehension is generally severly impaired
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Aphasia is also classified
as global or more localized
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In global lesions the site of the lesion causes
diffuse, localized damage
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Global lesion pts. exhibit
- little, if any, available language skills, but may have persistent, recurrent utterances that are spoken fluently.
- Localized lesions tend to leave a pt w/ more intact abilities for either receptive or expressive language.
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Apraxia
an inability to perform voluntary puposeful movements, although there is no sensory or motor impairment
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Lesions of the parietal lobe of the non-dominant hemisphere
(typically the right hemisphere of most individuals) produce perecptual disturbances
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Pts. w/ right ehmiplegia (L) (CVA) tend to be
- slow
- more cautious
- uncertain
- insecure
- they require more frequent feedback and support and tend to be realistic in their appraisal of their problems
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Pts. w/ left hemiplegia (R) (CVA) tend to be
- quick
- impulsive
- frequently overestimating their abilities while minimizing or denying their problems
- frequently cannot attend to visual spatial cues effectively, especially in a cluttered or crowded environment
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With either type of CVA contracutes and deformaties result from
- loss of movement
- spasticity
- improper positioning
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potential complications for all immobilized pts.
- Deep venous thrombosis (DVT)
- pulmonary embolism
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Tinetti and Speechley foudn 3 factors the correlated highly to falls:
- LE disabilities
- foot problems
- gait & balance abnormalities
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