Module 2

Question 1

_ or _ is defined as an acute onset of neurological dysfunction due to an abnormality and cerebral circulation that results in signs and symptoms that correspond to involvement of specific focal areas of the brain

Answer 1

Stroke or cerebral vascular accident (CVA)

Question 2

Stroke is the_cause of death in the US and the_cause of disability. _ are affected at a greater rate than_until the age of?

Answer 2

Stroke is the #4 cause of death

Stroke is the #1 cause of disability

Males are affected at a greater rate than females, up until the age of 85

Question 3

TIAs, HTN, obesity, alcohol, smoking, heart disease, and diabetes myelitis are all_for stroke. Age, race, gender, prior stroke, and family history of stroke are?

Answer 3

Modifiable risk factors: TIAs, HTN, obesity, alcohol, smoking, heart disease, and diabetes myelitis

Unmodifiable risk factors: age, race, gender,’s prior stroke, and family history of stroke

Question 4

What is the acronym and meaning of the warning signs or stroke?

Answer 4

FAST:

Facial weakness – uneven smile or facial droop

Arm weakness – uneven arm reach

Speech – slurred or unintelligible

Time – time to call 911

Question 5

With a _, symptoms may last a few minutes to several hours but resolve within 24 hours. Common causes are? (Four)

Answer 5

TIA – transient ischemic attack

For common causes: (CORE) cerebrovascular spasm, overmedication, reduced perfusion, and emboli

Question 6

_% five strokes are preceded by a TIA

Answer 6

15%

Question 7

Two classifications and associated percentages for stroke

Answer 7

Ischemic stroke – 80%

Hemorrhagic stroke – 20%

Question 8

Which type of stroke is caused by a cerebral thrombus or emboli? Which type is categorized as intracerebral, subarachnoid, or arteriovenous malformation (AVM)?

Answer 8

Ischemic (cerebral thrombosis and embolus)

Hemorrhagic (intracerebral, subarachnoid, arteriovenous malformation)

Question 9

Stroke of the_hemisphere is characterized by: visual – perceptual deficits, impulsive/poor judgment, poor awareness of deficits, and difficulty with problem-solving & grasping tasks. Requires?

Answer 9

Stroke in the right hemisphere ( left hemiparesis/sensory loss)

Requires constant reminder to look/ be aware of left side

Question 10

Strength of the left hemisphere results in right? (Two) slow and cautious?_/_Deficits. Difficulty?_Emotions/lability

Answer 10

Results in right hemiparesis and sensory loss

Slow and cautious behavior

Speech/language deficits

Difficulty initiating tasks

Negative emotions/lability

Question 11

The _ _ _ is a branch of the internal carotid artery that supplies the medial cerebral hemisphere (frontal and parietal lobe’s) and subcortical structures.

Answer 11

Anterior cerebral artery -ACA

Question 12

Arterial cerebral artery syndrome results in_hemiplegia/hemiparesis, sensory loss- with the _ being affected more than then _, and usually no?

Answer 12

Results in contralateral hemiplegia/hemiparesis

Sensory loss is usually greater in the lower extremity than the upper extremity,o

Usually no facial involvement

Question 13

The _ _ _, is a branch of the internal carotid artery that supplies the lateral cerebral hemisphere (frontal, Temporal, and parietal lobe’s) and the sub cortical structures.

Answer 13

Middle cerebral artery – MCA

Question 14

Middle cerebral artery syndrome results in_hemiplegia/hemiparesis, sensory loss, and the_ and_ are usually more involved than the _.

Answer 14

Results in contralateral hemiplegia/hemiparesis

Sensory loss

Upper extremity and face are usually more involved than the lower extremity

Question 15

The internal carotid artery supplies? (Two) complete occlusion? Incomplete occlusion?

Answer 15

Supplies the ACA and MCA

Complete occlusion: usually results in death

Incomplete occlusion: produces combination of ACA and MCA characteristics

Question 16

The_ _ _ supplies the occipital, medial and inferior temporal lobe’s, upper brainstem, midbrain, and posterior diencephalon

Answer 16

Posterior cerebral artery – PCA

Question 17

Posterior cerebral artery syndrome causes_ hemiplegia/hemiparesis,_loss,_impairments, and?

Answer 17

Contralateral hemiplegia/hemiparesis

Sensory loss

Visual impairments

Thalamic pain syndrome

Question 18

What is the most common site of occlusion in stroke?

Answer 18

Middle cerebral artery

Question 19

_ _ are caused by deep small vessel disease and are consistent with specific anatomical sites. Are associated with? (Two)

Answer 19

Lacunar syndromes

Associated with hypertensive hemorrhage and diabetic microvascular disease

Question 20

Lacunar syndromes usually SPAIRS? (Three) four examples?

Answer 20

Usually SPAIRS: consciousness, language, and visual fields

Four examples: pure motor lacunar stroke, pure sensory Lacunar stroke, ataxic hemiparesis, dysarthria/clumsy hand syndrome

Question 21

The _ _ supplies the cerebellum, medulla, pons, and internal ear. Complete occlusion frequently results in?

Answer 21

Vertebrobasilar artery

Complete occlusion frequently results in death

Question 22

Incomplete occlusion of the vertebrobasilar artery produces a tremendous variety of symptoms that can be _ and/ or _, and includes?(4)

Answer 22

Can be ipsilateral and/or contralateral

Includes: locked in syndrome, bulbar palsy, Wallenberg syndrome, and vestibular & cerebellar deficits

Question 23

_ _ causes tetraplegia and lower bulbar paralysis (CN V-VII)

Answer 23

Locked in syndrome

Question 24

_ _ causes ipsilateral pain and temperature lost in the face and contralateral pain and temperature lost over 50% of the body. A.k.a.? Can also cause? (Two)

Answer 24

Wallenberg syndrome

AKA: lateral medullary syndrome

Can also cause: ataxic gait and nystagmus

Question 25

_ _ can cause miosis, ptosis, and increased sweating.

Answer 25

Horner’s syndrome

Question 26

_ _ for strokes includes: improving cerebral profusion (increase O2 & blood thinning meds), BP management, neurosurgical management, and prevention of secondary impairments (dVT’s, pressure ulcers, contractures).

Answer 26

Medical management for stroke

Question 27

Common prescription for: thrombus? Hypertension? Cholesterol?

Answer 27

Thrombus – Coumadin or tPA

Hypertension – Procardia

Cholesterol – Lipitor

Question 28

Common prescription for seizures? Spasticity?

Answer 28

Seizures – Dilantin

Spasticity – baclofen

Question 29

Common prescriptions for pain? Insomnia? Depression?

Answer 29

Pain – Vicodin

Insomnia – Ambien

Depression – Paxil

Question 30

Standard descriptive terminology for levels of consciousness? (Five) – in increasing order of severity

Answer 30

Normal

Lethargic

Obtundation

Stupor

Coma

Question 31

_ is described as drowsy and able to respond briefly._Is described as difficult to arouse and confused.

Answer 31

Lethargic – drowsy and able to respond briefly

Obtundation- difficult to arouse and confused

Question 32

_ as described as unresponsive but can be awakened by intense stimuli._Is just unresponsive

Answer 32

Stupor – unresponsive but can be awakened by intense stimuli

Coma – unresponsive

Question 33

What three parameters are included in the Glasgow coma scale? Three Ranges?

Answer 33

Parameters: eye-opening, best motor response, and verbal response

Ranges:

13–15 = mild, 9–12 = moderate, less than or equal to 8 = severe

Question 34

Three types of neuromotor disorders associated with communication and swallowing problems?

Answer 34

DVD

Dysarthria, verbal apraxia, dysphagia

Question 35

Three types of aphasia associated with communication and swallowing problems?

Answer 35

GWB

Global aphasia, Wernicke’s aphasia, Broca’s aphasia

Question 36

Broca’s aphasia is aka?(2) Wernicke’s aphasia is aka? (2)

Answer 36

Broca’s- Nonfluent or expressive aphasia

Wernicke’s- fluent or receptive aphasia

Question 37

_ involves an impaired motor – speech system._ does not impair speech muscles.

Answer 37

Dysarthria – impaired motor – speech system

Verbal apraxia – non-impaired speech muscles

Question 38

_ is defined as impaired swallowing

Answer 38

Dysphagia