Neuro Final CVA

Question 1

What are symptoms of a CVA?

Answer 1

Motor, Sensory, Speech, Reflexes

Question 2

What is an Ischemic Stroke?

Answer 2

Brain tissue dies from lack of blood supply. It can be thrombotic or embolic

Question 3

What is a thrombotic stroke?

Answer 3

Plaque in the artery (Atherosclerosis) blocks blood flow

Question 4

What is an embolic stroke?

Answer 4

Blood clot travels and gets stuck, blocking blood flow

Question 5

What is a hemorrhagic stroke?

Answer 5

It is the rupture of a blood vessel in the brain and causes damage. It can be an aneurysm (ballooning of a blood vessel) or an AVM (Arteriovenous Malformation), congenital, which many do not know they have until in 30’s and 40’s

Question 6

What is a TIA?

Answer 6

Trans Ischemic Attack
NOT A CVA
with symptoms resolving in 24 hours with NO damage to the brain because it has resolved. Recurrent TIA’s is a bad sign and 1/3 will end up having a major stroke.

Question 7

What is the demographics with a higher risk of having a stroke?

Answer 7

Over 55
Males > Females
African American, Pacific Islander, Hispanic

Question 8

What is the medical treatment for an Ischemic stroke?

Answer 8

dissolve/bypass clot
tPA can dissolve clot, need between 2-3 hours of stroke

Question 9

What is the medical treatment for hemorrhagic strokes?

Answer 9

stop bleeding, control BP, reduce brain swelling

Question 10

What are symptoms of a mini stroke?

Answer 10

Confusion, weakness, lethargy, paralysis, facial droop, vision loss

Question 11

Vertebrobasilar Stroke

Answer 11

Brain stem and Cerebellum
Diplopia, dysphagia, dysarthria, deafness, vertigo
Ataxia
Equilibrium disturbance
Headache
dizziness
locked-in syndrome

Question 12

PCA Stroke

Answer 12

Occipital/Temporal/Thalamus/UPPER Brainstem
Opposite Side Sensory loss
Memory
Homonymous Hemianopia
Visual Agnosia
Cortical Blindness

Question 13

MCA Stoke

Answer 13

Hemispheres, Deep Frontal and Parietal Lobes
Opposite Side sensory loss and weakness
Homonymous Hemianopia

Question 14

ACA Stroke

Answer 14

Superior Frontal and Parietal Lobes
Opposite side weakness and Sensory Loss
Incontinence
Aphasia
Apraxia
Impaired Judgement/Insight

presence of primitive grasp

Question 15

Apraxia

Answer 15

Motor Planning problems
(seen in damage to Left Hemisphere)

Question 16

Sensory impairments from a stroke?

Answer 16

Numbness
Loss of Proprioception
Vestibular Deficits
Visual fields cuts

Question 17

Bitemporal Hemianopia

Answer 17

tunnel vision
loss on both OUTSIDES of vision field

Question 18

Homonymous Hemianopia

Answer 18

LEFT is damage from the right visual cortex and vision loss on both left sides of the eyes

Question 19

Dysarthria

Answer 19

difficulty forming words

Question 20

Dysphagia

Answer 20

difficulty swallowing due to oral and facial muscles
Patients may pocket food in corners of their mouth and have a risk of aspiration

Question 21

Emotional Lability

Answer 21

Emotions are out of control and can be inappropriate
R hemisphere of brain injured by CVA

Question 22

What is the progression to ambulate a patient post stroke?

Answer 22

1. Standing (wt shift)
2. Advancing Uninvolved (WBing on the uninvolved side)
3. Advancing Involved (tactile cues for hip flexion not circumduct or hiking)
4. Step Backward involved LE
5. Several Steps together

Question 23

How do you help a patient post stroke with weight shifts in Gait training?

Answer 23

Pelvic Tactile Cues
Knee Control
Foot Clearance
Ability to Advance/pull back LE

Question 24

How do you help a patient post stroke with their first steps in gait training?

Answer 24

1. Diagonal weight shifting on uninvolved leg
2. Advancement of involved LE
3. Weight Shift onto involved
4. Wt acceptance onto involved with tactile cues
5. Bring COM over BOS
6. Advance over LE

Question 25

What are 3 main things to focus on in mid to late recovery phases for stroke patients?

Answer 25

Strength
Coordination
Balance