Rehab II Stroke

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Rehab II Stroke
2014-03-13 11:34:34
Rehab II Storke
Rehab II Stroke
Rehab II Stroke
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  1. What are the most common sites for plaque formation leading to a stroke
    • origin of carotid artery
    • the transition into the middle cerebral artery
    • junction of the vertebral arteries at the basilar artery
  2. Contralateral hemiparesis, sensory loss with greater LE involvement than UE are typically seen in this syndrome of a stroke
    Anterior Cerebral Artery Syndrome
  3. This artery supplies the medial aspect of the cerebral hemisphere: frontal & pareital lobes, subcortical structures to include the basil ganglia, anteroir fornix and the a large majority of the corpus callosum
    Anterior cerebral artery
  4. Which artery is the most common site of occlusion leading to a stroke
    middle cerebral artery
  5. This syndrome results in contralateral spastic hemiparesis, sensory loss of the face, and the UE & LE. Face and UE are are more involved than LE
    Middle cerebral artery syndrome
  6. A patient is unable to see from the rights side of either eye what is the diagnosis of this patient relating to a stroke
    homonynous hemianopia
  7. A complete occlusion produces massive effects of the regions supplied by medial cerebral and anterior cerebral arteries, what syndrome is this
    Internal carotid artery syndrome
  8. If blockage is _______ to anterior communicating artery there are ____ deficits, if more _______ to the anterior communicating artery there are ______ deficits
    • proximal
    • less
    • distal
    • more
  9. Which stroke is more common hemorrhagic or ischemic and what is the percentage
    • hemorrhagic 20%
    • ischemic       80%
  10. There are 3 causes for ischemic stroke cerebral thrombosis, cerebral embolus and low systematic perfusion, which of these 3 has a global affect on the cerebrum and is catastrophic with bilateral neuro deficits
    low systematic perfusion
  11. This is a congenital defect of tangled arteries and veins, which results in bleeding often leading to death in 50% of cases
    arteriovenous malformation
  12. Viable but metabolic lethargic cells are
    ischemic penumbra
  13. What are the 4 management categories for a stroke
    • TIA - last a few minutes to a few hours
    • Major Stroke - usually severe impairments
    • Young Stroke - under 45 years of age
    • Deteriorating Stroke - neurological status deteriorates after hospital admission, due to cerebral edema or progressing thrombosis
  14. An increase in PaCO2 or a decrease in PaO2 will cause ___________ and an increase in ____
    • vasodilation
    • CBF
  15. An decrease in PaCO2 or an increase in PaO2 will cause ___________ and an decrease in ____
    • vasoconstriction
    • CBF
  16. This branch of the internal carotid artery supplies the entire lateral aspect of the cerebral hemisphere(frontal, temporal,
    parietal lobes), subcortical structures (basil ganglia, anteriror formix &
    anterior 4/5s of the corpus callosum
  17. This syndrome frequently results in coma and death
    internal carotid artery syndrome
  18. Branches of this artery supply the occipital lobes and medial and inferior temporal lobes
  19. Contralateral sensory loss (thalamic sensory syndrome) or thalamic pain will be caused when this branch of the posterior cerebral
    artery is occluted
    Thalamic branch
  20. Occlusion of this artery results in minimal deficits due to collateral blood supply
    • posterior communicating
    • artery
  21. What type of infarction produces homonymous hemianopsia and visual agnosia
    occipital infarction
  22. Decreased consciousness, widened pulse pressure (difference of 65 between systolic and diastolic), increased HR, Cheyne-Stoke respirations, vomiting,
    un-reacting puppils/ CNIII, papillaedema (swelling of the optic disc are all signs of an increase in
    cranial pressure
  23. Secondary brain damage and shifting of the brain to one side or distally as seen in brainstem herniation is caused by
    Edema which increases intercranial pressure
  24. What is the most frequent cause of death in acute stroke, caused by large infarctions in the
    middle cerebral artery and the internal carotid artery
    Cerebral edema
  25. A ________ in pH (increase acidity) produces a __________ and therefore an increase in bloodflow
    • decrease
    • vasodilation
  26. A ________ in pH (decrease acidity or rise in alkalinity) produces __________ and therefore a decrease in bloodflow
    • rise
    • vasoconstriction
  27. Perceptual deficits such as unilateral neglect anosognosia, apraxia, and spatial disorganization, homonymous hemianopsia are produce by a lesion to what hemispere of the brain
    nondominant (typically the right)
  28. This is a small vessel disease deep in the cerebral white matter associated with Lacunar Syndrome
    penetrating artery disease
  29. Pure motor lacunar stroke, pure sensory lacunar stroke, clumsy hand syndrome, sensory/motor stroke and dystonia are all types of this type of syndrome
    Lacunar syndromes
  30. Ischemia in the temporal lobe will result in what syndrome
    Amnesic syndrome with memory loss
  31. A complete occlusion of this artery is a catastrophic event: outcomes are  
    occipital HA, diplopia, progressive quadraplegia,
    bulbar paralysis, coma and death
    Vertebrobasilar Artery Syndrome
  32. Quadraplegia and anarthria with preserved consciousness and sensation with the only voluntary movement being vertical eye movement is known as what syndrome
    Locked-in Syndrome
  33. Aphasia (impairment of language comprehension, formulation and use) is caused by a lesion in what region of the brain
    the dominant hemisphere usually left
  34. Aphasia (impairment of of language comprehension , formulation and use) is caused by a lesions in what area of the brain
    the dominant hemisphere (usually LFT)
  35. A lesion in which area or lobe will create emotional changes
    • frontal lobe
    • hypothalamus
    • limbic system
  36. A patient shows with decreased
    spatial-perceptual task or grasping the whole activity, they are  quick and impulsive and tend to overestimate their own abilities. What area of the brain may be damaged
    Right hemisphere damage (left hemiplegia)
  37. A patient has difficulties processing information in sequential, linear manner. They are often cautious, anxious and disorganized. What hemisphere may be damaged
    Left hemisphere (right hemiplegia)
  38. An associated reaction in hemiplegia in which resistance to hip abduction or adduction in the uninvolved extremity evokes the same motion in the invloved extremity is known as what phenomenon
  39. A mutual dependency between hemiplegic limbs such as flexion of the UE elicits flexion of the LE on the same side is known as
    homolateral limb synkesis
  40. If a patient has finger extension on the hemiplegic side when the extremity is is raised to 90 of shoulder flexion or extension is known as what phenomenon
  41. What are the grades for spasticity on the ashworth scale
    • 1 - no increase in muscle tone
    • 2 - slight increase in tone "catch" when affected part is moved in flexion/extension
    • 3 - increase in tone but affected part is easily flexed
    • 4 - considerable increase in tone; passive movement difficult
    • 5 - Affected part is rigid in flexion and extension
  42. A lesion to the Lft lateral temporal lobe will cause what type of aphasia
    • Fluent aphasia - slow speech, halting, hesitant,
    • limited vocabulary
  43. A lesion to the premotor area of the Lft frontal lobe will cause what type of aphasia
    Non-fluent aphasia - Brocas or expressive speech
  44. Which aphasia is the most severe type of aphasia
    Global - impairments in production and comprehension of speech
  45. A lesion to the dominant hemisphere (left side)
    will cause what type language disorder
  46. This disorder affects 50% of CVA patients
    Dysarthria - motor speech disorders, respiration, articulation, phonation, resonance sensory feedback, chewing, swallowing and movements of the jaw and tongue