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CVA Flashcards

1
Q

The patient presents with flaccidity and there is no activation of the limb at all. You know that the therapist is in this level of brunnstrom stages of motor recovery

a. Stage I
b. Stage II
c. Stage III
d. Stage IV
e. Stage V

A

Stage I

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2
Q

A patient presents with complete tetraplegia and locked in syndrome after sustaining CVA. The patient is unable to speak, but cognitively remains intact. The Most likely artery involved with the CVA is the:

a. Anterior cerebral artery
b. Middle cerebral artery
c. Posterior cerebral artery
d. Vertebral-basilar artery

A

Vertebral-basilar artery

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3
Q

A pure sensory stroke is most likely with damage to which of the following structures?

a. Internal capsule
b. Thalamus
c. Hippocampus
d. Globus pallidus
e. Pons

A

Thalamus

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4
Q

Occlusion of the posterior inferior cerebellar artery (PICA) will damage all of the following structures, EXCEPT:

Corticospinal tracts
Nucleus and descending tracts of CN V
Nucleus ambiguous
Lateral spinothalamic tracts
Spinocerebellar tract

A

Corticospinal tracts

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5
Q

Modifiable Risk Factors for Stroke include the following, except:

a. HTN
b. Hypercholesterolemia
c. Race
d. Atrial Fibrillations
e. Smoking

A

Race

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6
Q

Memory impairment results from occlusion of what artery?

a. ACA
b. MCA
c. PCA
d. ICA
e. lenticulostriate

A

PCA

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7
Q

You are performing a neurological evaluation on a patient that has vascular injury with the following impairments: loss of consciousness, coma, inability to speak and hemiplegia. Based on this information, which of the following areas does this vascular injury occur?

a. ACA
b. MCA
c. PCA
d. VBA

A

VBA

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8
Q

A 60-year-old male suddenly becomes ill during a meeting and is taken to the emergency room. The patient is later diagnosed with CVA involving a portion of the left middle cerebral artery. Which impairments would be expected based on the patient’s medical diagnosis?

a. Impaired right upper extremity motor function, impaired speech, and impaired right upper extremity sensation
b. Impaired right lower extremity motor function, impaired speech and impaired spatial awareness
c. Impaired left upper extremity function, impaired left upper extremity sensation, and impaired spatial awareness
d. Impaired left lower extremity motor function, impaired speech, impaired spatial awareness

A

Impaired right upper extremity motor function, impaired speech, and impaired right upper extremity sensation

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9
Q

The most common cause of hemorrhagic stroke is:

a. Ruptured aneurysm
b. Arteriovenous malformation
c. Hypertension
d. Saccular aneurysm

A

Hypertension

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10
Q

It is characterized by sudden severe headache, often described as “the worst headache of my life,” with or without focal neurologic deficit, and often with altered mental status

a. Subararachnoid hemorrhage
b. Atherothrombotic stroke
c. Cardioembolic stroke
d. Lacunar Stroke
e. Intracerebral Aneurysm

A

Subararachnoid hemorrhage

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11
Q

A patient has normal fluency and comprehension but upon repetition, expression is impaired. He has which of the following aphasia?

a. Broca
b. Global
c. Conduction
d. Wernicke
e. Anomia

A

Conduction

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12
Q

Brunstromm stage of motor recovery where in there is prominence of spasticity and the patient voluntarily moves the limb, but ms activation is all within the synergy patterns:

a. Stage I
b. Stage II
c. Stage III
d. Stage IV
e. Stage V

A

Stage III

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13
Q

Occurs in the presence of thromobolitic disease and is the result of temporary ischemia in the brain and surrounding tissues. Symptoms do not last long and do not show changes on CT scan or MRI:

a. Reversible Ischemic Neurologic Deficit
b. Complete Stroke
c. Stroke in Evolution
d. Transient schemic Attack
e. NOTA

A

Transient schemic Attack

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14
Q

The Most common site of occlusion in stroke:

a. MCA
b. ACA
c. PCA
d. Anterior communicating

A

MCA

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15
Q

Common sites of occlusion in thrombotic stroke except:

a. Common carotid artery
b. MCA
c. Lenticulostriate artery
d. VBA
e. None of these

A

Lenticulostriate artery

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16
Q

A patient cannot find his dentures when they are on his crowded bedside table. His visual acuity tests at 20/20 with the Snellen eye chart. The PT suspects problems with:

a. Figure-ground discrimination
b. Body scheme awareness
c. Agraphia
d. Vertical orientation

A

Figure-ground discrimination

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17
Q

Non-fatiguable clonus, less than 10 seconds when maintaining pressure, at a precise angle

a. 1
b. 2
c. 3
d. 4
e. None of these

A

None of these

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18
Q

A physical therapist examines a patient with a cerebrovascular disorder due to arterial occlusion. The patient exhibits an ataxic gait, intention tremors, and dysmetria. The MOST likely vessel affected is the:

a. anterior inferior cerebellar artery
b. anterior spinal artery
c. basilar artery
d. middle cerebral artery

A

anterior inferior cerebellar artery

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19
Q

A physical therapist treats a patient status post CVA. Which action would be MOST likely to facilitate elbow extension in a patient with hemiplegia?

a. Turn the head to the affected side
b. Turn the head to the unaffected side
c. Extend the lower extremities
d. Flex the lower extremities

A

Turn the head to the affected side

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20
Q

A physical therapist treats a patient with a CVA that presents with speech and language deficits. The therapist incorporates phonetics into the plan of care. This Intervention would be MOST essential for a patient diagnosed with:

a. Broca’s aphasia
b. Dysarthria
c. verbal apraxia
d. dysphagia

A

Dysarthria

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21
Q

A physical therapist treats a patient status post right cerebrovascular accident with resultant left hemiplegia for a colleague on vacation. A note left by the primary therapist indicates that the patient exhibits “pusher syndrome. When examining the patient’s sitting posture, which of the following findings would be MOST likely?

a. Sitting with increased lean to the left along with increased weight bearing through the left buttocks
b. Sitting with increased lean to the right along with increased weight bearing through the right buttocks
c. Sitting with increased weight bearing through the right buttocks and the head rotated to the right; unresponsive to stimuli on the left
d. Sitting with unequal weight bearing and the head rotated to the left; unresponsive to stimuli on the right

A

Sitting with increased lean to the left along with increased weight bearing through the left buttocks

22
Q

A 55-year-old patient, six months status post CVA with right hemiparesis, attends physical therapy on an outpatient basis. As the patient lies supine on the mat, the physical therapist applies resistance to right elbow flexion. The therapist notes mass flexion of the right lower extremity as the resistance is applied. The therapist should document this as:

a. Raimiste’s phenomenon
b. Souques’ phenomenon
c. Coordination synkinesis
d. Homolateral synkinesis

A

Homolateral synkinesis

23
Q

A physical therapist discusses common cognitive and behavioral changes associated with stroke with family members of a patient with right hemisphere damage and resultant left hemiplegia. Which term does NOT accurately describe the most typical patient presentation?

a. Poor judgment
b. Impulsive
c. Quick
d. Overly cautious

A

Overly cautious

24
Q

A patient is 2 days, post-left CVA and has just been moved from the intensive care unit to a stroke unit. When beginning the examination, the therapist finds the patient’s speech slow and hesitant. The patient is limited to one- and two-word productions, and expressions are awkward and arduous. However, the patient demonstrates good comprehension. What type of speech disorder is this patient exhibiting?

a. Fluent aphasia
b. Global aphasia
c. Nonfluent aphasia
d. Dysarthria

A

Nonfluent aphasia

25
Q

During an initial interview and history, a patient with a right CVA seems unconcerned about obvious paralysis of the left arm and leg. When the therapist asks the patient to describe what happened, the patient says “I must have slept wrong and my arm and leg fell asleep.” The patient further tells the therapist, “My family put me in this place so they could go on vacation.” Which type of perceptual disorder BEST characterizes the patient’s responses?

a. Anosognosia
b. Prosopagnosia
c. Spatial relations disorder
d. Somatoagnosia

A

Anosognosia

26
Q

In a stroke patient presenting with speech difficulties, with neglect of the contralateral side, and hemiplegia, the artery most likely affected is the

a. right middle cerebral artery
b. anterior cerebral artery
c. left middle cerebral artery
d. posterior cerebral artery

A

left middle cerebral artery

27
Q

Fluent spontaneous speech is found in what type of aphasia?

a. Transcortical motor
b. Global
c. Broca
d. Wernicke

A

Wernicke

28
Q

Left Hemispheric Strokes present with the following EXCEPT:

a. Difficulty with expression of positive emotions
b. Difficulty processing verbal cues
c. Apraxia
d. Difficulty processing visual cues

A

Difficulty processing visual cues

29
Q

Patients with this deficit may display difficulty following instructions that require distinguishing body parts and may be unable to imitate movements of the therapist.

a. Somatoagnosia
b. Body agnosia
c. Any of the choices
d. Autopagnosia

A

Any of the choices

30
Q

Lack of awareness, denial of a paretic extremity, or denial of illness is called

a. Body agnosia
b. Anosognosia
c. Autopagnosia
d. Somatoagnosia

A

Anosognosia

31
Q

The Posterior Cerebral artery stroke patient you are examining has left sided hemiplegia and oculomotor nerve palsy or weber’s syndrome. Which exact part of the brain is affected?

a. Midbrain
b. Medulla
c. Cerebellum
d. Pons

A

Midbrain

32
Q

Inability to identify objects in the hand is ___-

a. Anosognosia
b. Astereognosis
c. Aphasia
d. Apraxia

A

Astereognosis

33
Q

In a stroke patient with Global Aphasia, which one of the following is NOT true?

a. Associated signs include right sided weakness, sensory deficits and hemianopsia
b. Intact comprehension
c. Non-fluent verbal output
d. The region affected includes the frontotemporoparietal lobes

A

Intact comprehension

34
Q

Wernicke’s aphasia affects this area of the brain. What is it called?

a. Superior temporal gyrus
b. None
c. Both areas
d. Third frontal convolution

A

Superior temporal gyrus

35
Q

An elderly patient is recovering from a right CVA and demonstrates strong spasticity in the left upper extremity. The therapist wants to reduce the expected negative effects of spasticity in the left upper extremity while the patient is working on sitting control. What is the BEST position for the upper extremity?

a. Left elbow flexed with arm resting on supporting pillow, positioned on the patient’s lap
b. Affected upper extremity extended and internally rotated with the hand at the side
c. Left shoulder abducted and externally rotated with elbow extended and weight supported on the palm of the hand
d. Left shoulder adducted and internal rotation with arm extended and hand resting on the thigh

A

Left shoulder abducted and externally rotated with elbow extended and weight supported on the palm of the hand

36
Q

You are gait training a patient for the first time following a recent cerebrovascular accident. The patient is having great difficulty advancing the leg on the hemiplegic side. The type of feedback MOST SUITABLE in this situation is:

a. guided movement by actually advancing the affected extremity to the correct position.
b. demonstration followed by verbal feedback encouraging the patient to perform the gait pattern correctly.
c. intermittent feedback which allows for self correction.
d. positive feedback given only after correct behavior.

A

guided movement by actually advancing the affected extremity to the correct position

37
Q

As a result of a left cerebral vascular accident, an 83 year-old patient has right hemiplegia and severe global aphasia. As her therapist, you could use:

a. visual representations or pictographs of what you wish to communicate.
b. oral communication, since the patient is able to comprehend but is nonfluent in speech
c. written communication, since the patient is unable to comprehend oral speech.
d. oral communication that only requires simple yes or no responses.

A

visual representations or pictographs of what you wish to communicate.

38
Q

A 60-year old male suddenly becomes ill during a meeting and is taken to the emergency room. The patient is later diagnosed with a CVA involving a portion of the left middle cerebral artery. Which impairments would be expected based on the patient’s medical diagnosis?

a. Impaired right upper extremity motor function, impaired speech, and impaired right upper extremity sensation
b. Impaired right lower extremity motor function, impaired speech, and impaired spatial awareness
c. Impaired left upper extremity motor function, impaired left upper extremity sensation, and impaired spatial awareness
d. Impaired left lower extremity motor function, impaired speech, and impaired spatial awareness

A

Impaired right upper extremity motor function, impaired speech, and impaired right upper extremity sensation

39
Q

A PT works with a 78-year-old female who sustained a stroke three weeks ago. The patient presents with left-sided paresis and impaired balance. When sitting, the patient leans to her left with the right arm abducted and the elbow extended. When the therapist attempts to correct the patient’s posture by providing manual assistance, the patient resists and pushes to her left with her unaffected upper and lower extremities. The MOST appropriate intervention to address this patient’s balance deficit is:

a. Sitting on a therapeutic ball
b. Sitting using alternating isometrics with manual contacts at the upper trunk with resistance in a medial-lateral direction
c. Sitting using a full-length mirror to provide visual cues as to the patient’s body orientation
d. Sitting using slow reversals with manual contacts at the upper trunk in an anterior-posterior direction

A

Sitting using a full-length mirror to provide visual cues as to the patient’s body orientation

40
Q

A PT reviews the medical record of a patient rehabilitating from a CVA that involves the left hemisphere. Diagnostic imaging revealed that the stroke involved the middle cerebral artery. The MOST likely clinical finding based on the patient’s diagnosis is:

a. Aphasia
b. Visual agnosia
c. Perseveration
d. Dysmetria

A

Aphasia

41
Q

Computer tomography reveals that a patient admitted to the hospital two days ago sustained a stroke involving the left middle cerebral artery. Based on the identified area of involvement the patient would MOST likely demonstrate the following signs and symptoms EXCEPT:

a. Apraxia
b. Aphasia
c. Right hemiparesis
d. Neglect

A

Neglect

42
Q

A 65-year-old male status post CVA is relearning how to use his left upper extremity. The patient has minimal movement of the arm and hand and demonstrates mild left neglect. He can complete gross flexor movements. but has no active extension of the wrist and hand. When working with the patient, the therapist should:

a. Sit on the right side of the patient’s body to assure that the patient is attending to the therapy session
b. Avoid providing tactile cues to the patient’s involved hand and arm
c. Encourage the patient to look at his left hand and arm while performing therapeutic activities
d. Use the right upper extremity to compensate for the impaired left upper extremity

A

Encourage the patient to look at his left hand and arm while performing therapeutic activities

43
Q

A female patient who is status post stroke is working on ambulation in physical therapy. The patient has good sensation and her strength is within functional limits. When walking in the community, the patient is able to walk up stairs without supervision. Yet, when the patient practices this task in the therapy gym, the patient is unable to complete the activity. This is MOST likely a problem of:

a. Ideomotor apraxia
b. Impaired body schema
c. Impaired problem solving
d. Ideational apraxia

A

Ideomotor apraxia

44
Q

Slight increase in muscle tone, manifested by a catch followed by minimal resistance throughout the remainder of the range of motion.

a. 1
b. 1+
c. 2
d. 3
e. 4

A

1+

45
Q

Following a cerebrovascular accident involving the right hemisphere, a male patient is exhibiting unilateral neglect. What might he do as a result?

a. Eat food only from the left side of a plate
b. Bump his wheelchair into things on the right side
c. Ignore or deny the existence of the right upper extremity
d. Shave only on the right side of the face

A

Shave only on the right side of the face

46
Q

A patient recovering from stroke demonstrates dyspraxia. On what should physical therapy intervention optimally focus?

a. Reeducation of weak muscles using isokinetics before activity practice
b. Compensatory training strategies with maximum use of environmental cues
c. Task-specific practice of familiar activities progressing from parts to whole
d. Maximum use of manual facilitation of movements and new tasks

A

Task-specific practice of familiar activities progressing from parts to whole

47
Q

A patient with left hemiplegia is able to recognize his wife after she is with him for a while and talks to him, but is unable to recognize the faces of his children when they come to visit. The children are naturally very upset by their father’s behavior. The BEST explanation for his problem is:

a. Somatognosia
b. Anosognosia
c. Visual agnosia
d. ideational apraxia

A

Visual agnosia

48
Q

An elderly patient suffered a cerebral thrombosis 4 days ago and presents with the following symptoms: decreased pain and temperature sensation of the ipsilateral face, nystagmus, vertigo, nausea, dysphagia, ipsilateral Horner’s syndrome, and contralateral loss of pain and temperature sensation of the body. The MOST LIKELY site of the thrombosis is the:

a. Anterior cerebral artery
b. Posterior inferior cerebellar artery
c. Internal carotid artery
d. Posterior cerebral artery

A

Posterior inferior cerebellar artery

49
Q

A physical therapist examines an adult patient that recently suffered a stroke that involved the right internal capsule. In addition to hemiparesis of the contralateral extremities, the patient also exhibits a facial palsy. Which facial muscles would MOST likely be affected?

a. All muscles on the left side of the face
b. All muscles on the right side of the face
c. Only muscles on the lower half of the right side of the face
d. Only muscles on the lower half of the left side of the face

A

Only muscles on the lower half of the left side of the face

50
Q

Strongest component of UE flexor synergy?

a. Elbow flexion
b. Forearm supination
c. Finger flexion
d. Shoulder ER

A

Elbow flexion

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