Deck 15: Stroke

Question 1

A patient who is 5 weeks post-left cerebrovascular accident presents in stage 3 of motor recovery for the upper extremity with spasticity of elbow flexors.Which of the following combinations of treatment is MOST effective for achieving active elbow extension (single joint isolation)of the right upper extremity?

A)Rhythmic rotation of right upper extremity with tapping of elbow extensors
B)Rhythmic rotation of right upper extremity with sustained stretching of right biceps
C)Alternating chopping patterns to the left and right in sitting
D)Alternating lifting patterns to the left and right in sitting

Answer 1

A

Question 2

A patient who is 2 months post-left cerebrovascular accident tends to lean toward the involved side while in sitting or standing,but is in good alignment when looking at a mirror.Given this presentation,which of the following scales should be used?

A)Berg Balance Scale
B)Clinical Assessment Scale for Contraversive Pushing
C)Timed Get-Up-and-Go Test
D)Motor Assessment Scale

Answer 2

B

Question 3

Upon examination,a patient presents with left upper extremity hemiplegia and left lower extremity hemiparesis and apraxia.Upon skin inspection,bruising on the left arm is noted.Which of the following is the MOST likely cause of this clinical presentation?

A)Right internal carotid artery syndrome
B)Right anterior cerebral artery syndrome
C)Right middle cerebral artery syndrome
D)Right posterior cerebral artery syndrome

Answer 3

C

Question 4

Upon examination,it is noted that a patient appears to understand the physical therapist's questions,but hesitates and is slow when answering.Based on this presentation,what is the MOST likely location of the lesion and what is the impairment noted?

A)Wernicke's area,expressive aphasia
B)Wernicke's area,receptive aphasia
C)Broca's area with fluent aphasia
D)Broca's area with nonfluent aphasia

Question 5

A patient presents with difficulty transitioning from sit-to-stand secondary to left anterior cerebral artery infarct.Upon creating a treatment plan,which of the following should be focused on FIRST?

A)Have the patient practice initiating hip and knee extension from a high-seating surface.
B)Patient is instructed to clasp upper extremities together and reach forward toward an object located in front of and slightly lower than the knees.
C)Position the right foot slightly behind the left foot and have the patient practice pushing into standing.
D)Position the left foot slightly behind the right foot and have the patient practice pushing into standing.Chapter 15.Stroke

Question 6

A patient who is 5 weeks post-left cerebrovascular accident presents with no volitional movement of the right upper extremity but movement is noted as a result of a reflex response or as an associated reaction.When examining the right lower extremity,the patient can move the hip and knee but only in a flexion synergy.What is this patient's stage of motor recovery?

A)The upper extremity is in stage 3 and the lower extremity is in stage 3.
B)The upper extremity is in stage 2 and the lower extremity is in stage 4.
C)The upper extremity is in stage 2 and the lower extremity is in stage 3.
D)The upper extremity is in stage 3 and the lower extremity is in stage 4.

Question 7

A patient who is 5 weeks post-right middle cerebral artery infarct presents for rehabilitation with the primary goal of regaining use of the left upper extremity that is in stage 2 of motor recovery.Given this presentation,which of the following activities should be done FIRST on the involved upper extremity?

A)Starting from a weightbearing position of elbow flexion and wrist extension,the patient is asked to push into elbow extension and back to flexion.
B)Starting from a weightbearing position of elbow and wrist extension,the patient is asked to reach for objects with the right upper extremity.
C)Starting from a weightbearing position of elbow and wrist extension,approximation is applied through the left upper extremity.
D)Starting from a weightbearing position of elbow flexion and wrist extension,the patient is asked to reach for objects with the right upper extremity.

Question 8

A patient who is 7 weeks post-right anterior cerebral artery infarct presents with movement of the left upper extremity into an obligatory extension synergy.When examining the left lower extremity,the patient can extend the knee with the hip positioned at 90 degrees of flexion in sitting,but is unable to perform ankle dorsiflexion.What is this patient's stage of motor recovery?

A)The upper extremity is in stage 3 and the lower extremity is in stage 4.
B)The upper extremity is in stage 3 and the lower extremity is in stage 3.
C)The upper extremity is in stage 4 and the lower extremity is in stage 3.
D)The upper extremity is in stage 4 and the lower extremity is in stage 4.