CNS: Strokes & Hemiplegia

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Questions and Answers

Which scenario most accurately describes the difference between an ischemic stroke and a hemorrhagic stroke?

An ischemic stroke involves the rupturing of a blood vessel, while a hemorrhagic stroke involves a blood clot blocking blood flow.
An ischemic stroke primarily affects younger individuals, while a hemorrhagic stroke is more common in older adults.
An ischemic stroke involves a blood clot blocking blood flow, while a hemorrhagic stroke involves the rupturing of a blood vessel. (correct)
An ischemic stroke is always preceded by a transient ischemic attack (TIA), while a hemorrhagic stroke occurs suddenly.

A patient experiences stroke-like symptoms that resolve within 20 hours. How should this event be classified, and what is its significance?

Underlying condition stroke, indicating a low risk of future stroke
Hemorrhagic stroke, indicating a severe rupture that requires immediate surgical intervention.
Transient ischemic attack (TIA), indicating a temporary blockage and a warning sign for future stroke. (correct)
Ischemic stroke, suggesting a minor blockage that requires long-term monitoring

Which of the following lifestyle choices contributes LEAST to the risk of stroke?

Smoking cigarettes regularly.
Consuming a diet high in saturated fats.
Maintaining a physically active lifestyle. (correct)
Engaging in excessive alcohol consumption.

Which of the following non-modifiable risk factors would increase an individual’s risk of having a stroke?

Family History (A) Signup and view all the answers

Why is hypertension a critical modifiable risk factor for stroke, and what type of stroke is it most strongly associated with?

Hypertension increases the risk of hemorrhagic stroke by weakening blood vessel walls and increasing the likelihood of rupture. (B) Signup and view all the answers

Which of the following statements accurately describes the relationship between stroke and hemiplegia?

Hemiplegia can be a consequence of stroke, among other potential causes such as spinal cord injury or genetics. (A) Signup and view all the answers

Immediately following a stroke, what is the typical presentation of muscles on the affected side of the body?

Weakness or flaccidity, representing the acute phase. (A) Signup and view all the answers

What is the underlying mechanism that leads to spastic paralysis after a stroke?

Brain's impaired control over spinal cord activity, resulting in uninhibited alpha motor neuron firing. (C) Signup and view all the answers

Which of the following is the most common paralysis pattern observed in stroke patients?

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

What is a 'circumducted gait,' commonly observed in stroke patients, and what causes it?

A gait characterized by lifting the affected leg in a circular motion due to spasticity or weakness. (A) Signup and view all the answers

Which of the following best describes 'Shoulder-Hand Syndrome' as a complication post-stroke?

Decreased range of motion of the shoulder and hand, followed by throbbing pain and edema. (C) Signup and view all the answers

What does 'neglect of the affected side' refer to in the context of stroke recovery?

A cognitive impairment where the patient is unaware of or disregards stimuli on the affected side. (B) Signup and view all the answers

Why is it important to observe muscle bulk differences between the affected and unaffected sides in stroke patients?

To evaluate the degree of muscle atrophy due to disuse or nerve damage. (C) Signup and view all the answers

How might altered posture present as a symptom following a stroke, and what is the cause?

Altered posture due to spasticity affecting muscle tone and balance. (A) Signup and view all the answers

What is the typical duration of intensive rehabilitation for stroke patients, as indicated in the material?

Approximately 18 months. (C) Signup and view all the answers

Which of the following is the MOST important action to take when someone is exhibiting signs of a stroke, according to the FAST acronym?

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

A patient in Brunnstrom stage 2 of stroke recovery exhibits spasticity and basic synergy patterns. Which of the following massage techniques is MOST appropriate?

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

During stroke rehabilitation, a patient is in Brunnstrom stage 4. Which intervention should be emphasized?

Encouraging use of the recovering arm in homecare and ADLs. (A) Signup and view all the answers

A therapist is working with a stroke patient experiencing flexor synergy in the upper limb. Which movement pattern would MOST likely be observed?

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

Which of the following is the MOST appropriate goal when addressing postural changes and muscle imbalances in stroke patients?

Promoting optimal alignment and balanced muscle tone. (C) Signup and view all the answers

What is the rationale behind using PROM and stretching in the treatment of stroke patients?

To maintain sensory mapping of the area and prevent contractures. (A) Signup and view all the answers

In stroke rehabilitation, why is decreasing edema considered important for tissue health?

Edema impairs nutrient delivery and waste removal. (C) Signup and view all the answers

A stroke patient is in Brunnstrom stage 3. Which of the following massage techniques would be MOST appropriate?

Techniques with increased emphasis on stress reduction. (A) Signup and view all the answers

Why is full body integration an important consideration in stroke rehabilitation treatment planning?

To facilitate overall wellbeing and functional recovery. (B) Signup and view all the answers

Which of the following would be LEAST appropriate during Brunnstrom's stage 1 of stroke recovery?

Strengthening exercises (B) Signup and view all the answers

What is the MOST accurate description of muscle synergy following a stroke?

A whole series of muscles are recruited when just a few are needed. (C) Signup and view all the answers

If progress continues, at which Brunnstrom stage will more complex movement combinations be learned as the basic synergies lose their dominance over motor acts?

Stage 5 (C) Signup and view all the answers

Which assessment techniques should be used when working with a stroke patient?

Palpation, ROM Sensory testing (A) Signup and view all the answers

Which of these is a key word when trying to recognize warning signs of a stroke?

Sudden (D) Signup and view all the answers

Which stage sees normal function restored?

Stage 7 (A) Signup and view all the answers

Which of the following scenarios would MOST likely result in a hemorrhagic stroke?

A patient with a history of hypertension experiences a sudden, severe headache followed by neurological deficits. (A) Signup and view all the answers

How does a transient ischemic attack (TIA) differ from a completed stroke in terms of duration and long-term impact?

A TIA resolves within 24 hours and typically doesn't cause permanent damage, while a stroke results in lasting neurological deficits. (A) Signup and view all the answers

Which combination of modifiable risk factors presents the HIGHEST overall risk for stroke?

Hypertension, smoking, and physical inactivity. (A) Signup and view all the answers

An individual with a family history of stroke is otherwise healthy. Which preventative measure would be MOST appropriate for them?

Adopting a physically active lifestyle, maintaining a healthy weight, and managing blood pressure. (D) Signup and view all the answers

What underlying mechanism explains why excessive alcohol and drug abuse are significant modifiable risk factors for stroke?

They can induce hypertension, cardiac arrhythmias, and damage to blood vessel walls, increasing the risk of both ischemic and hemorrhagic strokes. (B) Signup and view all the answers

Which of the following best describes the relationship between a stroke and hemiplegia?

Hemiplegia is a possible state resulting from a stroke, among other potential causes. (D) Signup and view all the answers

How does the progression of muscle tone typically manifest in the affected side immediately following a stroke?

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

What is the underlying physiological mechanism that leads to spastic paralysis following a stroke?

The brain's impaired control over spinal cord activity leads to uninhibited alpha motor neuron firing. (A) Signup and view all the answers

Following a stroke, a patient exhibits a pattern of flexor synergy in the upper limb and extensor synergy in the lower limb. How is this presentation best described?

The most common paralysis pattern, resulting from the uninhibited dominant reflexes. (D) Signup and view all the answers

What factors contribute to altered posture in stroke patients?

Spasticity and muscle imbalances on the affected side. (C) Signup and view all the answers

Which of the following is a key characteristic of circumducted gait often seen in stroke patients?

The affected leg swings outward in a semicircular motion due to stiffness or weakness. (D) Signup and view all the answers

A stroke patient presents with decreased range of motion, throbbing pain, and edema in the affected shoulder and hand. Which condition is MOST likely indicated by these symptoms?

Shoulder-Hand Syndrome (B) Signup and view all the answers

A therapist observes that a stroke patient consistently ignores stimuli and objects on their left side. How would this presentation be best described?

Neglect of the affected side. (C) Signup and view all the answers

Why is the assessment of muscle bulk differences between the affected and unaffected sides important in stroke patients during rehabilitation?

To determine the extent of muscle atrophy due to disuse on the affected side. (B) Signup and view all the answers

What is the typical timeframe for intensive rehabilitation following a stroke, as indicated in the material?

Approximately 18 months. (A) Signup and view all the answers

A patient displays sudden vision problems in one eye and difficulty walking. According to the warning signs for stroke, what should be suspected?

The patient is experiencing symptoms indicative of a possible stroke. (C) Signup and view all the answers

During an assessment, a stroke patient cannot initiate any voluntary movements in their affected arm. According to the Brunnstrom stages of recovery, which stage is the patient in?

Stage 1 (B) Signup and view all the answers

A stroke patient in Brunnstrom stage 3 is receiving massage therapy. What is the MOST appropriate focus of the massage?

Relaxing spastic/synergistic areas and stress reduction (C) Signup and view all the answers

A therapist is treating a stroke patient and wants to prevent neglect of the affected limb. Which treatment technique would be MOST appropriate?

PROM and stretching (C) Signup and view all the answers

Which statement describes the typical presentation of flexor synergy in the upper limb of a stroke patient?

Shoulder adduction/internal rotation, elbow flexion, forearm supination, wrist flexion (D) Signup and view all the answers

A patient is in Brunnstrom stage 5 of stroke recovery. Which of the following massage interventions is MOST appropriate?

Continue with techniques from previous stages and begin a strengthening routine using resistance. (C) Signup and view all the answers

What is the PRIMARY rationale for addressing postural changes and muscle imbalances in stroke patients during rehabilitation?

To reduce the risk of falls and improve functional movement patterns. (D) Signup and view all the answers

What is the MOST important action to take if you observe someone exhibiting sudden slurred speech?

Call EMS/9-1-1 immediately due to the time-sensitive nature of stroke treatment. (B) Signup and view all the answers

After a stroke, what is the likely cause of a patient's inability to perform precise, isolated joint movements?

The re-emergence of basic synergy patterns that dominate motor acts. (C) Signup and view all the answers

A stroke has affected a patient's ability to sense touch and position on their left side. Which assessment technique would MOST directly evaluate this sensory loss?

Sensory testing using monofilaments or vibration (D) Signup and view all the answers

In the context of stroke rehabilitation, why is edema reduction an important goal?

To promote tissue health and improve overall recovery outcomes. (B) Signup and view all the answers

A patient recovering from a stroke is experiencing increased spasticity due to stress at home. Which of the following treatment strategies would be MOST effective in addressing this issue?

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

When is it MOST appropriate to begin focusing on fine motor skills (hands/fingers) in stroke rehabilitation, according to the Brunnstrom stages?

Stage 6, when spasticity disappears and coordination reappears. (C) Signup and view all the answers

Which of the following stroke-related impairments would MOST directly benefit from joint traction and joint play techniques?

Reduced joint health and mobility (B) Signup and view all the answers

Flashcards

Stroke

Blocked blood flow or bleeding in the brain.

Hemiplegia

Paralysis on one side of the body; a state, not progressive.