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Neuro II > CVA part 1 > Flashcards

CVA part 1 Flashcards

1
Q

Changes in muscle strength due to weakness is considered a

a. Primary impairment
b. Secondary impairment
c. Direct problem
d. Indirect effect of stroke

A

primary impairment

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2
Q

Changes in muscle activation is considered a

a. Primary impairment
b. Secondary impairment
c. Direct problem
d. Indirect effect of stroke

A

primary impairment

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3
Q

Abnormal tone in stroke patients is considered a

a. Primary impairment
b. Secondary impairment
c. Direct problem
d. Indirect effect of stroke

A

primary impairment

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4
Q

Sensory and perceptual issues are considered a

a. Primary impairment
b. Secondary impairment
c. Direct problem
d. Indirect effect of stroke

A

primary impairment

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5
Q

Cognitive, speech, emotional, behavioral problems are classified as

a. Primary impairment
b. Secondary impairment
c. Direct problem
d. Indirect effect of stroke

A

primary impairment

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6
Q

There is no weakness on the ipsilateral side (true/false)

A

false

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7
Q

Weakness is usually more proximal than distal (true/false)

A

false

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8
Q

This abnormal tone is seen due to cerebral shock initially

a. Hypertonicity
b. Spasticity
c. Hypotonicity
d. Tone

A

hypotonicity

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9
Q

This type of abnormal tone may persist with lesions to the primary motor cortex or cerebellum

a. Hypertonicity
b. Spasticity
c. Hypotonicity
d. Tone

A

hypotonictiy

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10
Q

This type of abnormal tone emerges in up to 90% of patients

a. Hypertonicity
b. Spasticity
c. Hypotonicity
d. Tone

A

hypertonicity

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11
Q

This type of abnormal tone is the greatest in antigravity and distal muscles

a. Hypertonicity
b. Spasticity
c. Hypotonicity
d. Tone

A

hypertonicity

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12
Q

Tone is defined as

a. The tension attained at any moment between the origin and the insertion of a muscle.
b. The sensation of [increased] resistance felt as one manipulates a joint through a range of motion, with the subject attempting to relax.
c. a velocity-dependent increase in the tonic stretch reflex with exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex as one component of the upper motor neuron syndrome.

A

The tension attained at any moment between the origin and the insertion of a muscle.

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13
Q

Hypertonicity is defined as

a. The tension attained at any moment between the origin and the insertion of a muscle.
b. The sensation of [increased] resistance felt as one manipulates a joint through a range of motion, with the subject attempting to relax.
c. a velocity-dependent increase in the tonic stretch reflex with exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex as one component of the upper motor neuron syndrome.

A

The sensation of [increased] resistance felt as one manipulates a joint through a range of motion, with the subject attempting to relax.

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14
Q

Spasticity is defined as

a. The tension attained at any moment between the origin and the insertion of a muscle.
b. The sensation of [increased] resistance felt as one manipulates a joint through a range of motion, with the subject attempting to relax.
c. a velocity-dependent increase in the tonic stretch reflex with exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex as one component of the upper motor neuron syndrome.

A

a velocity-dependent increase in the tonic stretch reflex with exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex as one component of the upper motor neuron syndrome.

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15
Q

What is the most common type of stroke?

a. hemorrhage
b. cerebral infarction
c. unspecified
d. none of the above

A

cerebral infarction

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16
Q

What are possible risk factors for stroke?

A

hypertension
heart disease
diabetes
smoking, obesity, diet, physical inactivity, excess alcohol

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17
Q

The most common sign of stroke is

a. dropping off the face
b. arm weakness or numbness
c. numbness or weakness
d. visual changes

A

numbness or weakness

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18
Q

FASTER stands for

A 
facial drooping or numbness
arm weakness or numbness 
stability 
talking
eyes
react
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19
Q

Sudden severe headaches with no known cause is an early sign of stroke (true/false)

A

true

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20
Q

This type of stroke is from either a thrombus or embolism

a. hemorrhagic stroke
b. TIA
c. ischemic stroke
d. sudden stroke

A

ischemic stroke

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21
Q

A blood clot ischemia causing stroke is defined as a

a. ischemic stroke
b. thrombus
c. embolism
d. hemorrhagic stroke

A

thrombus

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22
Q

A blood clot which breaks off and travels elsewhere is defined as

a. ischemic stroke
b. thrombus
c. embolism
d. hemorrhagic stroke

A

embolism

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23
Q

A rupture of a weakened blood vessel is classified as a

a. hemorrhagic stroke
b. TIA
c. ischemic stroke
d. sudden stroke

A

hemorrhagic stroke

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24
Q

Takes several hours and is in process, TIA comes before it

a. infarction
b. thrombus
c. embolism
d. hemorrhagic

A

thrombus

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25
Q

This type of stroke is of the internal carotid plaque and it indicates that cardiovascular disease is present

a. infarction
b. thrombus
c. embolism
d. hemorrhagic

A

embolism

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26
Q

Causes of this type of stroke could be an increased intracranial pressure or cuts off blood supply

a. infarction
b. thrombus
c. embolism
d. hemorrhagic

A

hemorrhagic stroke

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27
Q

The brain requires low energy and high metabolic reserves (true/false)

A

false
high energy
low metabolic reserves

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28
Q

What can alter the pH and blood concentrations of O2 and CO2?

A

vasoconstriction and dilation

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29
Q

Where does the blood supply for the brain come from?

A

internal carotid

vertebral arteries

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30
Q

What artery receives a majority of blood for the brain?

A

internal carotid

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31
Q

Internal carotid splints into _ and _ carotid arteries

A

middle

anterior

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32
Q

The vertebral artery arises from a branch of the _

A

subclavian

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33
Q

The basilar artery comes from the _ artery and splits to form _ cerebral and the _ part of the circle of willis

A

vertebral
posterior
posterior

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34
Q

Which artery within the circle of willis is often affected with stroke?

A

posterior cerebral artery

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35
Q

the anterior cerebral artery is a branch off of the _ _

A

internal carotid artery

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36
Q

The anterior cerebral artery supplies _ and _ parts of the brain

A

medial

anterior

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37
Q

The medial and anterior parts of the brain that are supplied by the anterior cerebral artery include

A

frontal lobe
parietal lobe
basal ganglia
internal capsule

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38
Q

The most common sign of anterior cerebral artery syndrome is

a. urinary incontinence
b. contralateral sensory loss
c. contralateral hemiplegia/paresis
d. contralateral grasp reflex

A

contralateral hemiplegia/paresis

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39
Q 
Signs and symptoms of 
contralateral hemiplegia/paresis
LE paralysis 
contralateral sensory loss of the LE
urinary incontinence 
apraxia 
abulia (kinetic mutism) 
contralateral grasp reflex, sucking reflex

a. anterior cerebral artery syndrome
b. middle cerebral artery syndrome
c. posterior cerebral artery syndrome
d. medial medullary syndrome

A

anterior cerebral artery syndrome

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40
Q

Which artery comes off the vertebral and basilar arteries and supplies the occipital and medial and temporal lobes?

A

posterior cerebral artery

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41
Q

This artery supplies the brainstem, midbrain and innervates the thalamus

A

posterior cerebral artery

42
Q 
Signs and symptoms of 
contralateral homonymous hemianopsia 
bilat homonymous hemianopsia 
visual agnosia 
prosopagnosia 
dyslexia without agraphia, anomia, and color discrimination problems
memory defect 
topographic disorientation

a. anterior cerebral artery syndrome
b. middle cerebral artery syndrome
c. posterior cerebral artery syndrome
d. medial medullary syndrome

A

posterior cerebral artery

peripheral territory

43
Q

Which territory of the posterior cerebral artery shows more profound effects?

a. central territory
b. anterior territory
c. peripheral territory
d. posterior territory

A

central territory

44
Q

Post stroke thalamic pain syndrome is a (primary/secondary) effect from the (thalamus/temporal lobe)

A

primary

thalamus

45
Q

Ipsilateral oculomotor with contralateral hemiplegia is called

A

Webers Syndrome

46
Q 
Signs and symptoms of 
central post-stroke thalamic pain 
sensory impairments 
involuntary movements 
contralateral hemiplegia/paresis 
webers syndrome 
paresis of vertical eye movements

a. posterior cerebral artery, central territory
b. middle cerebral artery syndrome
c. posterior cerebral artery, peripheral territory
d. medial medullary syndrome

A

posterior cerebral artery

central territory

47
Q

The _ artery comes off the internal carotid artery and supplies the lateral side of hemispheres and the subcortical area of the brain

A

middle cerebral

48
Q

The most common type of stroke occurs in which artery?

a. anterior cerebral artery
b. posterior cerebral artery
c. middle cerebral artery
d. internal carotid artery

A

middle cerebral artery

49
Q

The most common sign or symptom of a MCA stroke is

a. motor speech impairment
b. contralateral hemisensory loss of the UE and face more than the LE
c. perceptual deficits
d. contralateral hemiplegia/paresis of the UE and face more than the LE

A

contralateral hemiplegia/paresis of the UE and face more than the LE

50
Q

The MCA supplies the (middle/lateral) side of the brain so it affects the (UE/LE) more

A

lateral

UE

51
Q

The ACA supplies the (middle/lateral) side of the brain so it affects the (UE/LE) more

A

medial

LE

52
Q

If there is a lesion in the dominant hemisphere it will affect

a. vision
b. speech
c. perception
d. memory

A

speech

53
Q

If there is a lesion in the nondominant hemisphere it will affect

a. vision
b. speech
c. perception
d. memory

A

perception

54
Q

A patient has speech problems, which side is their dominant side? Which side is where the stroke occured?

A

right

left

55
Q

A patient has perceptual problems and presents with left sided hemiplegia, which side is their dominant side? Which side did the stroke occur on?

A

right

right

56
Q 
Signs and symptoms of 
contralateral hemiplegia/paresis - UE/face more than LE 
contralateral hemisensory loss - UE/face more than LE
motor speech impairment 
receptive speech impairment 
global aphasia 
perceptual deficits
limb-kinetic apraxia 
contralateral homonymous hemianopsia 
loss of conjugate gaze to opposite side 
ataxia of contralateral limbs 
pure motor hemiplegia

a. anterior cerebral artery syndrome
b. middle cerebral artery syndrome
c. posterior cerebral artery syndrome
d. medial medullary syndrome

A

middle cerebral artery

57
Q

A focal presentation or a small vessel disease can be classified as

a. Brainstem stroke
b. hemorrhagic stroke
c. TIA
d. lacunar syndromes

A

lacunar syndromes

58
Q

What is seen with lacunar syndromes?

A

dysarthrial clumsy hand syndrome
ataxic hemiparesis
dystonia/involuntary movements

59
Q

with lacunar syndromes you will see only _ signs

A

physical

60
Q

Lacunar syndromes also shows perceptual, visual or language signs (true/false)

A

false

61
Q

This type of stroke shows ipsilateral and contralateral signs

a. anterior cerebral artery
b. middle cerebral artery
c. hemorrhagic
d. vertebrobasilar artery syndrome

A

vertebrobasilar artery

62
Q

Locked in syndrome
medial medullary syndrome
lateral medullary syndrome
are the most common in:

A

vertebrobasilar artery syndrome

63
Q

A presentation of reserved consciousness and sensation but not able to move, except for blinking and eye movements

a. locked-in syndrome
b. medial medullary syndrome
c. lateral medullary syndrome
d. lacunar syndrome

A

locked in syndrome

64
Q

A presentation of ipsilateral paralysis of the tongue and contralateral hemiplegia and impaired tactile and proprioception

a. locked-in syndrome
b. medial medullary syndrome
c. lateral medullary syndrome
d. lacunar syndrome

A

medial medullary syndrome

65
Q

What is the most frequent reason for death with stroke?

A

cerebral edema

66
Q

What areas are more susceptible to ischemia?

A

hippocampus

cerebellar cortex

67
Q

Hypoxia due to a stroke results in

A

neural shock to nerve fibers

68
Q

Within the first _ it is critical to reverse the ischemic cascade

a. 3 hours
b. few minutes
c. 4 hours
d. 3-4 days

A

4 hours

69
Q

Cerebral edema occurs within the first _

a. 3 hours
b. few minutes
c. 4 hours
d. 3-4 days

A

3-4 days

70
Q

Recovery happens once _ decreases

A

cerebral edema

71
Q

Which type of imaging ruls out tumor, abscess or hemorrhage?

a. CT scan
b. MRI
c. PET
d. Doppler

A

CT scan

72
Q

Which type of imaging can see an infarction within 2-6 hours of stroke and picks up smaller lesions?

a. CT scan
b. MRI
c. PET
d. Doppler

A

MRI

73
Q

Which type of imaging looks at flow velocity and plaque formation of blood?

a. CT scan
b. MRI
c. PET
d. Doppler

A

Doppler

74
Q

TPA is contraindicated with _ stroke

A

hemorrhage

75
Q

TPA must be given within

a. 3-4 mins
b. 3-4 hours
c. 3-4 days
d. at any time

A

3-4 hours

76
Q

This is a clot dissolving enzyme intended to reverse and halt ischemic cascade, it greatly reduces the risk of disability and death

A

TPA

77
Q

Anticoagulants and antiplatelet drugs are contraindicated (true/false)

A

false

78
Q

What is the average length of stay in the hospital after a ischemic stroke?

a. 7 days
b. 2-4 days
c. 1-2 weeks
d. 2-4 weeks

A

2-4 days

79
Q

What is the average length of stay in the hospital after a hemorrhagic stroke?

a. 7 days
b. 2-4 days
c. 1-2 weeks
d. 2-4 weeks

A

7 days

80
Q

What is the average length of stay for inpatient rehabilitation?

a. 7 days
b. 2-4 days
c. 1-2 weeks
d. 2-4 weeks

A

2-4 weeks

81
Q

Which type of facility is recommended for older patients on medicare or those who need to go slower over a longer period of time?

a. acute care
b. home health
c. inpatient rehab
d. SNF/long term care

A

SNF/long term care

82
Q

The most spontaneous recovery occurs due to

A

cerebral edema decreasing

83
Q

The spontaneous recovery process due to a decrease in cerebral edema happens over

a. the first week
b. the first 2-3 weeks
c. the first 3-6 months
d. after 3-5 hours

A

the first 2-3 weeks

84
Q

Motor recovery is the greatest in _

a. the first-week
b. the first 2-3 weeks
c. 3-6 months
d. after 3-5 hours

A

3-6 months

85
Q

In what type of stroke is the spontaneous recovery process is the greatest?

a. ischemic stroke
b. thrombislm stroke
c. emoblic stroke
d. brainstem stroke

A

embolic stroke

86
Q

What percentage of patients are walking after stroke?

a. 58%
b. 80%
c. 99%
d. 25%

A

80%

87
Q

What percentage of patients are independent with ADL’s?

a. 58%
b. 80%
c. 30-60%
d. 25%

A

58%

88
Q

What percentage of patients have a non-functional arm?

a. 58%
b. 80%
c. 30-60%
d. 25%

A

30-60%

89
Q

Weakness is a (direct/indirect) effect with stroke

A

direct

90
Q

Velocity dependent increase in muscle tone with increased resistance to stretch

a. spasticity
b. rigidity
c. hypertonia
d. hypotonia

A

spasticity

91
Q

The longer and quicker the stretch, the stronger there resistance of the muscle

a. spasticity
b. rigidity
c. hypertonia
d. hypotonia

A

spasticity

92
Q

spasticity occurs as a result of a (UMN/LMN) syndrome

A

UMN

93
Q

involuntary movements resulting from activity occurring in other parts of the body

a. clonus
b. associated reactions
c. posturing
d. tone

A

associated reactions

94
Q

cyclical, spasmodic alternation of muscular contraction and relaxation in response to sustained stretch of a spastic muscle

a. clonus
b. associated reactions
c. posturing
d. tone

A

clonus

95
Q

Patient shows stiffness and resistance to movement that is independent of velocity of movement

a. spasticity
b. rigidity
c. hypertonia
d. hypotonia

A

rigidity

96
Q

resistance to passive movement is diminished, stretch reflexes are dampened or absent, and limbs are easily moved

a. spasticity
b. rigidity
c. hypertonia
d. hypotonia

A

hypotonia

97
Q

acute UMN lesions can produce temporary hypotonia which can be called

A

spinal shock or cerebral shock

98
Q

A patient seems to rely more on their uninvolved arm, has learned nonuse of their involved arm, and has increasingly more spasticity. What type of impairment is this?

a. primary impairment
b. secondary impairment
c. composite impairment
d. undesirable compensatory patterns

A

undesirable compensatory problems

99
Q

A patient has problems with muscle shortening, a loss of joint motion and is in an acute hypotonic position. Which composite impairment are they demonstrating?

a. atypical movements
b. undesirable compensations
c. movement deficits
d. unbalanced muscle return

A

movement deficits

100
Q

A patient is demonstrating timing and sequencing problems with muscle activation and shows some synergy patterns. Which composite impairment are they demonstrating?

a. atypical movements
b. undesirable compensations
c. movement deficits
d. unbalanced muscle return

A

atypical movements

101
Q

This type of impairment arises from either movement deficits or atypical movements

A

undesirable compensations

102
Q

A patient relies on their uninvolved arm and leg demonstrates asymmetrical postural trunk movements, and has learned nonuse of their UE. Which composite impairment are they showing?

a. atypical movements
b. undesirable compensations
c. movement deficits
d. unbalanced muscle return

A

undesirable compensations

Neuro II (11 decks)

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