Week 1 - Stroke

Question 1

What are the primary sensori-motor deficits? 4

Answer 1

Strength
Co-ordination
Sensation
Spasticity

Question 2

What are the primary non-motor deficits? 7

Answer 2

vision
speech/language (dysphasia, aphasia, dysarthria)
Perceptual function (neglect, agnosia)
Cognitive function (problem solving, motiviation, attention, memory)
Apraxia/dyspraxia
Behaviour
Emotion (lability, depression, anxiety)

Question 3

What are the seconday sensori-motor deficits? 8

Answer 3

Muscle length
Muscle strength (different to primary)
Fitness
Learned non-use
Compensatory behaviours
Swelling
Shoulder subluxation
Tissue damage

Question 4

What are the secondary non-motor deficits? 2

Answer 4

Depression

Fatigue

Question 5

Describe the anterior circulation.

Answer 5

Carotid arteries

Most of the hemispheres and the cortical deep white matter.

Question 6

Describe the poster circulation

Answer 6

Vertebrobasilar system

Brain stem, cerebellum and occiputal lobe

Question 7

Which deficits might you see in an anterior circulation stroke?

Answer 7

All of them:
Strength
Co-ordination
Sensation
Spasticity

Vision
Speech
Perception
Cognitive
Apraxia
Behaviour
Emotion

Question 8

What deficits might you see in a posterior circulation stroke?

Answer 8

All the sensori-motor:
Strength
Coordination
Sensation
Spasticity

And vision
But not the personality/cognitive ones

Question 9

What functions are covered by the left vs the right hemisphere?

Answer 9

Left (dominant)
Speech
Analytical functions

Right
Spatial awareness
Attention

Question 10

What would you see in a left anterior stroke?

Answer 10

Everything but perceptual problems (attention is on the R side)

Question 11

What would you see in a right anterior stroke?

Answer 11

Everything but language and apraxia.

Question 12

Describe the Bamford Classification of Stroke

Answer 12

TACS
PACS
LACS
POCS

THe S stands for syndrome, but can become I for infarct and H for haemorrhage.

Question 13

What are the three signs of PACS (must have all three)

Answer 13

Hemiplegia (+/- sensory loss)
Hemianopia
Cortical signs

Question 14

What are the signs of PACS?

Answer 14

2 out of 3 of:
Hemplegia
Hemianopia
Cortical signs

OR
Isolated cortical dysfunction

OR
Pure sensory/motor but less severe than lacunar.

Question 15

WHat are the signs of a LACS?

Answer 15

Hemiplegia of at least 2/3rds of arm/face/leg but NO cortical signs.

Question 16

Name some of the Principles Guiding Neuro Practice

Answer 16

1. Evidence based
2. Delivered within ICF framework
3. Delivered across the continuum of care (acute, rehab, community)
4. Person centred
5. Task oriented.
6. uses clinical reasoning and measurable outcomes.

Question 17

What are the five steps in the Clinical Reasoning Process (it’s a flow chart).

Answer 17

1. Initial assessment
2. Write a problem list
3. Set goals
4. Formulate a treatment plan
5. Reasses and go back to point 3.

Question 18

What does task centred mean? (4 point flow chart)

Answer 18

1. Functional task analysis
2. Part task
3. Whole task
4. Transfer training to different contexts