L CVA have difficulty w/ the following
Processing information in a linear, sequetial mannerDemonstrate Broca's expressive, non fluent aphasia, Wernicke's receptive, fluent aphasiaExhibilt negative, anxious , depressed, slow cautious, insecure reactionsTed to be realistic abou their disabilityCannot distinguis left from right sidesDemonstrate apraxia, alexia, dyslexia, agraphia, acalculia, visual field loss, and subject to emotional highs and lowsCoprhension is usally perserved
R CVA issues
temporaty or permanent paralysis to the lieft side of the bodyfrequently speak adequately and may appear to have a high degree of comprehension which is not trueshort attention spanpoor reading comprehensionunable to do arithmetic, use money, write checks or dial aphone w/o errosdifficulty in itme and space concepts dificulty grasping overall organization, are impulsive, deonstrate poor judgement in safety, are unrealistic
Expressive Aphasia
Broca's Aphasia
Broca's Aphasia
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.
Receptive Aphasia
Wernicke's Aphasia
Wernicke's Aphasia
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 elevationShoulder-abduction and external rotationelbow-flexionforearm-supinationwrist-flexionfinger-flexion
Flexion synergy patterns LE's
Pelvic-retractionHip-flexion, abuction, and external rotationKnee-flexionankle-dorsiflexion and inversiontoe-extension
Extensor synergy patterns UE's
Shoulder girdle-protraction or fixationShoulder-adduction and internal rotationElbow-extensionForearm-pronationWrist-flexionFinger-flexion
Extensor synergy patterns LE's
Pelvic-retractionHip-extension, adduction, and internal rotationknee-extensionankle-plantarflexion and inversiontoe-flexion
ACA CVA
Occlusion usually presents w/ greater involvement of the LE than UE or faceExtensive 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 aphasiaLesion of the ACA are uncommon
MCA CVA
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 legHomonymous hemianopsia (visual field defect) and deviation of the eyes away from the hemiplegic side also resultBroca's aphasiaWernicke's AphasiaApraxia, a disorder of voluntary learned movement is also commonInfarction of the non-dominant right hemisphere typicall produces a flat or expressionless effectMost common site of stroke
PCA CVA
Occlusion of thalamic branches (affecting pain and temperature the most) and persistent contralateral pain in response to any type of sensory inputeProprioception is severely involvedRight side infarcts produce hemianopsia and left-sided infarts produce alexia (word blindness) and anomia (word-finding difficulty