Lecture 3

Question 1

Anterior cerebral artery infarct

Answer 1

• contralateral hemiparesis (LE)
• sensory loss (LE)
• incontinence
• memory impairment if extensive frontal lobe damage
• contralateral neglect
• aphasia if dominant hemisphere
• apraxia

Question 2

Middle cerebral artery infarct

Answer 2

• most common
• contralateral hemiplegia (UE)
• sensory deficit (UE and face)
• homonymous hemianopsia
• can be fatal if sig. edema
• if left hemisphere - aphasia
• if right hemisphere - neglect

Question 3

Internal carotid artery infarct

Answer 3

Coma

Death

Question 4

Posterior cerebral artery infarct

Answer 4

• contralateral hemianesthesia
• homonymous hemianopsia if occipital lobe inv.
• memory loss if temp. Lobe inv.
• tremoring and athetosis if thalamus and midbrain inv.

Question 5

Basilar region infarct

Answer 5

• occipital headache
• diplopia
• hemi or quadriplegia
• coma
• locked in syndrome
  - quadriplegic
  - can’t speak yet full consc.
  - only vertical gaze

Question 6

Vertebrobasilar region infarct

Answer 6

• visual loss
• homonymous hemianopsia
• facial numbness
• tinnitus
• dysarthria
• dysphasia
• hemiparesis
• sensory loss
• loss of pain/temp on opp. side

Question 7

Ashworth scale for grading spasticity

Answer 7

0 - no increase in tone

4 - affected part(s) rigid in flexion or extension

Question 8

Motor programming deficits (left hemisphere)

Answer 8

• role is sequencing
• difficulty initiating movement
• harder to learn task
• apraxia

Question 9

Motor programming deficits (right hemisphere)

Answer 9

• role in sustaining movement

- difficulty sustaining movement or posture

Question 10

Cognitive and behavioural deficits

Answer 10

Orientation
Attention
Executive functioning
STM loss 
Learning
Emotional lability

Question 11

RSD (reflex sympathetic dystrophy)

Answer 11

12-25% of cases
Warm, red, glossy skin
Blanched nails
Stiffness, contractures, atrophy
Over time, osteoporotic changes
May use sympathetic nerve block injections, steroids

Question 12

Early CVA rehab goals

Answer 12

• maintain ROM
• promote awareness and active movement
• increase trunk control/symmetry
• increase functional mobility
• initial self-care
• increase respiratory and oromotor function

Question 13

Facilitation/inhibition techniques during various phases of rehab

Answer 13

Tactile
Proprioceptive, kinesthetic, and vestib stim
Visual stim
Auditory stim

Question 14

CVA etiology

Answer 14

Thrombus
Embolus
Hemorrhage