CNS - Stroke vs. Hemiplegia

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What is the primary difference between a stroke and hemiplegia?

Hemiplegia is caused by blocked blood flow, while a stroke results from paralysis.
Hemiplegia is a type of brain bleeding, while a stroke is a blockage.
A stroke is a progressive condition, while hemiplegia is an acute event.
A stroke is an event that can cause hemiplegia, which is a resulting condition. (correct)

Why is it important to consider a stroke as an 'insult/injury/event' rather than a disease?

To focus on the genetic predispositions that cause strokes.
To emphasize the sudden and acute nature of the condition. (correct)
To highlight the progressive deterioration of brain function.
To minimize the perceived severity of the condition by patients.

Which of the following is the most accurate description of hemiplegia?

Sudden bleeding in one side of the brain that results in paralysis.
Temporary weakness on one side of the body due to muscle fatigue.
Progressive paralysis that affects both sides of the body.
Non-progressive paralysis on one side of the body. (correct)

If a patient presents with sudden paralysis on one side of their body, which condition should be suspected first?

An acute case of hemiplegia, possibly following a stroke. (B) Signup and view all the answers

How does understanding the difference between a stroke and hemiplegia impact treatment strategies?

It helps to prioritize immediate interventions for the stroke event versus managing the resulting paralysis of hemiplegia. (A) Signup and view all the answers

Which of the following statements is MOST accurate regarding the immediate post-stroke presentation of hemiplegia?

Muscles on the affected side are initially weak or flaccid, potentially progressing to spastic paralysis. (D) Signup and view all the answers

What is the underlying mechanism that leads to spastic paralysis in hemiplegia following the initial flaccid stage?

Interference with the brain's control over spinal cord activity, resulting in uninhibited alpha motor neuron firing. (B) Signup and view all the answers

In hemiplegia, what is the MOST common pattern of paralysis observed in the upper and lower limbs?

Flexor pattern in upper limbs combined with extensor pattern in the lower limb. (C) Signup and view all the answers

Which of the following gait patterns is MOST characteristic of hemiplegia?

Circumducted gait (D) Signup and view all the answers

What is a key factor that determines the level of impairment experienced by an individual following a stroke?

The location and degree of damage sustained in the brain. (A) Signup and view all the answers

What is the MOST likely cause of hemiplegia?

All of the above (D) Signup and view all the answers

Following a stroke resulting in hemiplegia, a patient exhibits decreased range of motion in the affected shoulder and hand, accompanied by throbbing pain and edema. This presentation is MOST indicative of which condition?

Shoulder-hand syndrome (B) Signup and view all the answers

A therapist observes a patient with hemiplegia consistently ignoring stimuli on their affected side and bumping into objects on that side. This behavior is MOST indicative of:

Neglect (C) Signup and view all the answers

A patient in Brunnstrom Stage 2 post-stroke exhibits developing spasticity and abnormal synergies. Which massage technique is MOST appropriate?

PROM with slow, gentle movements and massage for sensory stimulation. (B) Signup and view all the answers

A stroke patient is in Brunnstrom Stage 3. What is the PRIMARY focus of massage and related interventions at this stage?

Reducing stress and relaxing spastic/synergistic areas. (B) Signup and view all the answers

When progressing a stroke patient from Brunnstrom Stage 4 to Stage 5, what is the MOST significant change in therapeutic approach?

Transitioning from ROM-based exercises to a strengthening routine. (A) Signup and view all the answers

A therapist is using Proprioceptive Neuromuscular Facilitation (PNF) with a patient in Brunnstrom Stage 4. Which type of PNF patterning is MOST appropriate at this stage?

PROM and AROM (D) Signup and view all the answers

In Brunnstrom Stage 6 of stroke recovery, what is the MOST important goal to emphasize in therapy?

Restoring normal function with a focus on fine motor skills. (C) Signup and view all the answers

A patient post-stroke has a subluxed shoulder in Brunnstrom Stage 1. What is the priority intervention?

Positioning to support the upper limb, especially the shoulder. (A) Signup and view all the answers

What is the MOST accurate description of synergy as it relates to stroke recovery, according to the provided text?

Recruitment of a whole series of muscles when only a few are needed. (A) Signup and view all the answers

What is a key characteristic of Brunnstrom's stages of recovery following a stroke regarding the progression through the stages?

Many individuals may remain in one of the stages permanently. (A) Signup and view all the answers

Which of the following is the MOST likely combination of movements observed when a person attempts to reach forward, based on the principles of synergy?

Shoulder abduction and elevation, wrist flexion. (D) Signup and view all the answers

In the early stages following a stroke, which treatment approach would be LEAST appropriate for managing upper limb flexor synergy?

Aggressive strengthening of muscles within the flexor synergy pattern. (A) Signup and view all the answers

A stroke patient presents with edema in their affected upper limb. Addressing the edema is important for what primary reason?

Improving tissue health. (A) Signup and view all the answers

A therapist is planning treatment for a patient with upper limb spasticity post-stroke. Which of the following should be prioritized due to its direct impact on spasticity?

Relaxation and stress management. (A) Signup and view all the answers

A patient in Brunnstrom's stage 3 exhibits upper limb flexor synergy and spasticity. Besides spasticity management, what is another key focus of massage therapy at this stage?

Maintaining sensory mapping of the affected area. (A) Signup and view all the answers

A patient who is 4.5 months post-stroke and in Brunnstrom's stage 5 presents with minimal upper limb flexion synergy. What would be the MOST appropriate treatment goal?

To facilitate and improve movements outside of the established synergy pattern. (B) Signup and view all the answers

Why is 'full body integration' considered an important aspect of treatment planning for stroke patients with upper limb involvement?

It addresses the overall well-being of the patient and promotes functional movement patterns. (D) Signup and view all the answers

Which of the following is the MOST important reason to incorporate PROM (Passive Range of Motion) exercises in the treatment plan of a stroke patient with upper limb flexor synergy?

To prevent neglect of the affected limb and maintain sensory mapping. (A) Signup and view all the answers

Which of the following is the MOST critical action to take when someone exhibits sudden signs of a stroke?

Immediately calling emergency medical services (EMS/9-1-1). (B) Signup and view all the answers

A patient presents with sudden slurred speech and weakness on one side of their body. Which type of stroke should be suspected, regardless of the specific type?

Any type of stroke. (B) Signup and view all the answers

What TWO modifiable risk factors, if managed effectively, can significantly reduce the likelihood of both ischemic and hemorrhagic strokes?

Blood pressure and atherosclerosis. (D) Signup and view all the answers

A patient has regained some voluntary movement after a stroke, but their movements are still dominated by basic synergy patterns and spasticity is evident. According to the Brunnstrom stages of recovery, which stage BEST describes the patient's current condition?

Stage 2: Spasticity appears. (A) Signup and view all the answers

Which of the following is the PRIMARY difference between an ischemic stroke and a transient ischemic attack (TIA)?

TIA symptoms resolve within 24 hours, while ischemic stroke symptoms persist longer. (B) Signup and view all the answers

An elderly patient with a history of hypertension and atherosclerosis experiences a sudden, severe headache followed by a loss of consciousness. Which type of stroke is MOST likely?

Hemorrhagic stroke. (B) Signup and view all the answers

Why is controlling hypertension particularly important in preventing hemorrhagic strokes?

Hypertension directly damages blood vessels, making them more prone to rupture. (D) Signup and view all the answers

What is the MOST likely progression a stroke patient will experience in Brunnstrom's stages of recovery?

Flaccidity -> Spasticity appears -> Voluntarily controlling synergies. (D) Signup and view all the answers

Why is understanding a stroke as an 'insult/injury/event' valuable for healthcare providers?

It emphasizes the sudden nature, guiding immediate, critical interventions. (C) Signup and view all the answers

How might classifying hemiplegia as a 'non-progressive condition' influence rehabilitation strategies?

It suggests that intensive, early intervention is critical to maximize functional recovery. (C) Signup and view all the answers

A therapist is explaining the difference between a stroke and hemiplegia to a patient and their family. What analogy would MOST accurately depict their relationship?

A stroke is like a car accident, while hemiplegia is like the resulting damage to the car. (D) Signup and view all the answers

In the context of stroke and hemiplegia, why is it crucial to differentiate between the initial event and the resulting condition for effective patient care?

Differentiating influences acute medical management versus long-term rehabilitation strategies. (A) Signup and view all the answers

If a patient experienced a stroke that resulted in hemiplegia, but initially presents with minimal physical deficits, what implications does this have for their treatment plan?

Treatment should focus primarily on prevention of secondary complications despite minimal impairment. (B) Signup and view all the answers

Which factor MOST significantly influences the specific presentation of hemiplegia following a stroke?

The degree of damage and location of the brain lesion. (D) Signup and view all the answers

Why does flaccid paralysis often transition to spastic paralysis in hemiplegia after the acute phase following a stroke?

The brain's reduced control over spinal cord activity leading to increased alpha motor neuron excitability. (B) Signup and view all the answers

A patient with hemiplegia exhibits neglect and consistently ignores stimuli on their affected side. This symptom is MOST likely related to damage in which area of the brain?

Parietal Lobe (C) Signup and view all the answers

What is the underlying physiological mechanism that leads to the development of a combined flexor pattern in the upper limbs and an extensor pattern in the lower limbs in many hemiplegia cases?

Interference with the brain's control over spinal cord activity, resulting in uninhibited dominant reflexes. (C) Signup and view all the answers

How does the interruption of blood supply to the brain during a stroke directly lead to the diverse range of impairments observed in stroke patients?

By impairing brain cells due to oxygen and nutrient deprivation. (D) Signup and view all the answers

What is the PRIMARY reason for altered posture in individuals with hemiplegia?

Spasticity affecting muscle tone and balance. (B) Signup and view all the answers

A stroke patient develops shoulder-hand syndrome. What is the MOST likely underlying cause of the throbbing pain and edema associated with this condition?

Neurovascular dysfunction and inflammatory response. (B) Signup and view all the answers

Why are compensatory changes often observed in individuals with hemiplegia?

To maximize independence and function despite motor and sensory deficits. (A) Signup and view all the answers

In Brunnstrom Stage 3, besides techniques used in Stages 1 and 2, what additional massage emphasis is introduced?

Increased emphasis on stress reduction (A) Signup and view all the answers

What is the primary focus of massage therapy in Brunnstrom Stage 5, considering the progression of recovery?

Initiating a strengthening routine (C) Signup and view all the answers

During Brunnstrom Stage 4, what significant change in therapeutic approach is introduced concerning the affected arm?

Emphasis on using the recovering arm in home care and ADLs (C) Signup and view all the answers

Which of the following interventions aligns with the goals of PNF patterning in Brunnstrom Stage 5?

RROM (C) Signup and view all the answers

What is a realistic expectation regarding recovery for individuals progressing through Brunnstrom's stages?

Many people remain in one of the stages permanently (A) Signup and view all the answers

Which of the following is MOST characteristic of synergy as it relates to stroke recovery?

Recruitment of a whole series of muscles when only a few are needed (D) Signup and view all the answers

Which of the following stroke types is characterized by symptoms resolving within 24 hours?

Transient ischemic attack (TIA) (C) Signup and view all the answers

Which of the following is a modifiable risk factor that is MOST directly associated with an increased risk of hemorrhagic stroke?

Hypertension (D) Signup and view all the answers

What is the MOST important consideration when positioning a patient's upper limb in Brunnstrom Stage 1?

Supporting the upper limb, especially the shoulder, to prevent subluxation (A) Signup and view all the answers

A patient presents with sudden onset of right-sided facial droop, arm weakness, and slurred speech. According to the FAST protocol, what is the MOST crucial next step?

Immediately call emergency medical services (EMS/9-1-1) (D) Signup and view all the answers

In Brunnstrom Stage 2, what is the primary rationale for continuing PROM exercises?

Preventing contractures while carefully avoiding provocation of spasticity (A) Signup and view all the answers

In Brunnstrom Stage 2 of stroke recovery, which characteristic is observed?

Appearance of basic synergy patterns (C) Signup and view all the answers

During stroke rehabilitation, a patient is able to initiate some movements out of synergy, but synergy patterns still predominate. According to Brunnstrom's stages, which stage BEST describes the patient's current condition?

Stage 4 (A) Signup and view all the answers

Following a stroke, a patient exhibits no voluntary movement on the affected side. This presentation aligns with which Brunnstrom stage of recovery?

Stage 1 (B) Signup and view all the answers

A stroke patient is in Brunnstrom Stage 5. How would you BEST describe their motor control capabilities?

Learning complex movement combinations as basic synergies lose dominance (A) Signup and view all the answers

Which of the following statements BEST describes the progression of spasticity through Brunnstrom's stages of stroke recovery?

Spasticity appears in Stage 2, increases in Stage 3, and decreases in Stages 4 and 5. (A) Signup and view all the answers

In a patient with upper limb flexor synergy post-stroke, which movement pattern is MOST likely to be observed when they attempt to reach for an object?

Shoulder abduction, elbow flexion, forearm supination, and wrist flexion. (A) Signup and view all the answers

Why is addressing postural changes and muscle imbalances a crucial component of treatment for individuals post-stroke?

They contribute to improved alignment, stability, and movement patterns, preventing secondary complications. (B) Signup and view all the answers

A stroke patient in Brunnstrom's stage 3 with upper limb flexor synergy and spasticity would likely benefit MOST from interventions aimed at:

Managing spasticity while also stimulating muscles outside of the flexor synergy to regain motor control. (B) Signup and view all the answers

What is the MOST important reason to incorporate full body integration into the treatment plan of a stroke patient?

To promote overall wellbeing, improve balance, and address compensatory movement patterns. (D) Signup and view all the answers

A therapist is designing a treatment plan for a 39-year-old male, 1 month post-stroke, in Brunnstrom stage 3 with right-sided upper limb flexor synergy and spasticity. Which of the following goals is MOST appropriate at this stage?

Managing spasticity, promoting relaxation, and attempting movements outside of the flexor synergy. (A) Signup and view all the answers

For a stroke patient experiencing edema in the affected upper limb, what is the PRIMARY rationale for implementing edema management techniques?

To prevent contracture formation by maintaining tissue health. (A) Signup and view all the answers

In a stroke patient, PROM and stretching exercises of the affected limb are MOST important to:

Prevent neglect of the affected limb, maintain sensory mapping, and prevent contracture formation. (B) Signup and view all the answers

A 39-year-old male, 4.5 months post-stroke, is in Brunnstrom's stage 5 with minimal upper limb flexion synergy and has some control of movements outside of the synergy pattern. What is the MOST appropriate treatment goal at this stage?

Refining isolated movements, improving coordination, and increasing functional use of the affected limb. (A) Signup and view all the answers

Stroke Definition

Occurs when blood flow to the brain is blocked or there is sudden bleeding in the brain.

Hemiplegia Definition

Non-progressive paralysis on one side of the body.