Deck 18: Stroke

Question 1

Early recognition of and treatment for stroke are critical because

A)a thrombolytic agent can be given within the first 3 hours to decrease the chance of death and disability.
B)physical therapy can be started within 48 hours to decrease the risk of disability.
C)patients can be given antispasticity medications,which have been shown to prevent the development of abnormal tone.
D)patients can receive early evaluation for surgical correction.

Answer 1

A

Question 2

A patient recovering from stroke is beginning to demonstrate movement out of an obligatory synergy pattern.Based on this you would classify the patient as

A)Brunnstrom stage 2.
B)Brunnstrom stage 3.
C)Brunnstrom stage 4.
D)Brunnstrom stage 5.

Answer 2

C

Question 3

Alterations in tone are common following a stroke.Immediately following a stroke the patient will most commonly present with

A)flaccidity and hyporeflexia.
B)rigidity and hyperreflexia.
C)spasticity and hyperreflexia.
D)athetosis with hyporeflexia.

Answer 3

A

Question 4

Which of the following statements is true with regard to strengthening exercises for patients recovering from stroke?

A)Strengthening exercises are contraindicated post stroke if patients have spasticity.
B)Gravity-eliminated exercises using powderboard and/or sling suspension are appropriate for patients with less than 3/5 muscle strength.
C)Isometric exercises are the safest; both concentric and eccentric exercises increase risk of muscles tears in patients with hemiparesis.
D)Resistive exercise training should be initiated within 72 hours post stroke to prevent disuse atrophy.

Question 5

A therapist is teaching a community education class on the prevention and treatment of stroke.The participants are asked to identify the early warning signs of stroke or "brain attack." In addition to sudden numbness or weakness of the face,arm,or leg,especially on one side of the body,these early warning signs include

A)sudden confusion,trouble speaking or understanding.
B)sudden increase in tone/spasticity on one side of the body.
C)sudden loss of hearing out of one ear.
D)sudden pain in the face,arm,or leg,especially on one side of the body.

Question 6

Knee hyperextension during stance is a common gait deficit in patients following stroke.This is commonly due to all of the following impairments EXCEPT

A)weak knee extensors.
B)impaired proprioception.
C)hip flexor contracture.
D)ankle plantar flexor contracture.

Question 7

During the course of a patient's examination the therapist asks a patient recovering from stroke to show how he puts on his shoes.He is unable to complete the task.However,at the end of the session,when his wife suggests going to the gift shop,the patient spontaneously puts them on.The therapist immediately suspects

A)ideational apraxia.
B)ideomotor apraxia.
C)fluent/receptive aphasia.
D)ataxia.

Question 8

Which of the following statements are true with regard to the management of patients with stroke who exhibit pronounced UE flaccidity?

A)A sling should be worn 24 hours per day to provide support for the UE and prevent subluxation.
B)Subluxation will occur regardless of the level of UE support provided; slings are neither cost-effective nor recommended.
C)Taping and neuromuscular electrical stimulation can be considered as alternatives to the use of a sling to provide UE support and prevent subluxation.
D)Active and passive range-of-motion exercises are the most beneficial techniques available to provide shoulder support and prevent subluxation.

Question 9

Which of the following are true with regard to homonymous hemianopsia?

A)It results in a loss of vision in the contralateral half of each visual field.
B)It occurs most commonly in patients with anterior cerebral artery strokes.
C)It is commonly associated with nystagmus.
D)It affects anterior and middle cerebral artery strokes equally.

Question 10

A patient recovering from stroke has trouble clearing her foot during swing due to lack of active dorsiflexion.She also demonstrates knee hyperextension during stance.The therapist decides an ankle-foot orthosis can help with foot clearance.The ankle should be set at what range to help control for knee hyperextension?

A)5º of dorsiflexion
B)Neutral (0º of dorsiflexion)
C)5º of plantar flexion
D)10º of dorsiflexion

Question 11

Which of the following statements is NOT true with regard to sensory deficits following a CVA?

A)Sensory loss may contribute to symptoms of neglect.
B)Sensation is often lost in dermatome patterns.
C)Decreased proprioception is common.
D)Sensory loss is often impaired but rarely absent.

Question 12

Which of the following statements is true with regard to stroke?

A)Hemorrhagic stroke is the most common type of stroke.
B)Stroke is the most common cause of disability in the United States.
C)Strokes affect three times more men than women.
D)Whites have the highest risk of stroke.

Question 13

Components of the lower extremity extension synergy pattern in patients recovering from stroke include

A)hip extension,abduction and external rotation,knee extension,ankle plantar flexion and inversion.
B)hip extension,adduction and internal rotation,knee extension,ankle plantar flexion and inversion.
C)hip flexion,abduction and external rotation,knee extension,ankle plantar flexion and inversion.
D)hip flexion,adduction and internal rotation,knee extension,ankle plantar flexion and inversion.

Question 14

Components of the upper extremity flexion synergy pattern in patients recovering from stroke include

A)shoulder flexion and adduction,elbow flexion,forearm pronation,and wrist/finger flexion.
B)shoulder flexion and internal rotation,elbow flexion,forearm pronation,and wrist/finger flexion.
C)shoulder abduction and external rotation,elbow flexion,forearm supination,and wrist/finger flexion.
D)shoulder extension and external rotation,elbow flexion,forearm pronation,and wrist/finger flexion.

Question 15

Patients who exhibit ipsilateral pushing (pusher syndrome)

A)push posteriorly during all transfers and transitions,increasing risk of backward falls.
B)push toward their uninvolved side,resulting in decreased use of the hemiplegic side.
C)push toward their hemiplegic side,resulting in safety concerns and increased falls.
D)push strongly into extension during all transfers,limiting functional independence.

Question 16

Right hemisphere brain injuries commonly result in

A)aphasia.
B)apraxia.
C)visual-perceptual deficits.
D)multi-infarct dementia.

Question 17

Contralateral spastic hemiparesis and sensory loss with the face and upper extremity more involved than the lower extremity is most commonly associated with a/n

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

Question 18

The technique that is not appropriate to manage spasticity/decrease tone in patients recovering from stroke is

A)rhythmic rotation.
B)deep pressure to the muscle tendon.
C)slow rocking.
D)muscle tapping.

Question 19

Which of the following characteristics have been associated with less successful rehabilitation outcomes in patients recovering from stroke?

A)Aphasia,female gender,incontinence,initial flaccidity
B)Early development of spasticity,persistent medical problems,decreased level of prior function,low economic status
C)Male gender,anterior cerebral artery infarct,depression,pusher syndrome
D)Severe neglect,impaired cognition,severe motor impairments,advanced age

Question 20

A patient unintentionally moves his hemiparetic UE when he lifts his sound UE.This should be documented as

A)abnormal synergy.
B)primitive reflex.
C)associated reaction.
D)spasm.