[Neuro] CVA, SCI Flashcards by Mind Med

Spatial attention is a component process needed for mobility. Its role in mobility is?

a. Necessary for awareness of both sides of space.
b. Necessary for turning plans into action
c. Necessary for using previous experience of routes and locations
d. Necessary for environmental navigation

a. Necessary for awareness of both sides of space.

How well did you know this?

Not at all

Perfectly

The most common cause of hemorrhagic stroke is?

a. Ruptured aneurysm
b. Arteriovenous malformation
c. Hypertension
d. Saccular aneurysm

c. Hypertension

How well did you know this?

Not at all

Perfectly

As a result of a left cerebral vascular accident, an 83-year-old patient has right hemiplegia and severe global aphasia. As her therapist, you could use:

a. Visual representation or pictograph of what you wish to communicate
b. Oral communication that only requires simple yes or no responses.

a. Visual representation or pictograph of what you wish to communicate

How well did you know this?

Not at all

Perfectly

You are gait training a patient for the first time following a recent cerebrovascular accident. The patient is having great difficulty advancing the leg on the hemiplegic side. The type of feedback MOST SUITABLE in this situation is:

a. Guided movement by actually advancing the affected extremity to the correct position
b. Demonstration followed by verbal feedback encouraging the patient to perform the gait pattern correctly

b. Demonstration followed by verbal feedback encouraging the patient to perform the gait pattern correctly

How well did you know this?

Not at all

Perfectly

A physical therapist examines a patient with a cerebrovascular disorder due to arterial occlusion. The patient exhibits an ataxic gait, intention tremors, and dysmetria. The MOST likely vessel affected is the:

a. Anterior inferior cerebellar artery
b. Posterior inferior cerebellar artery
c. Basilar artery

a. Anterior inferior cerebellar artery

How well did you know this?

Not at all

Perfectly

Patient has normal fluency and comprehension but upon repetition, expression is impaired. He has which of the following aphasia?

a. Anosmic
b. Global
c. Conduction
d. Wernicke

c. Conduction

How well did you know this?

Not at all

Perfectly

Memory impairment results from occlusion of what artery?

a. ACA
b. MCA
c. PCA

c. PCA

How well did you know this?

Not at all

Perfectly

Occlusion of the posterior inferior cerebellar artery (PICA) will NOT damage which of the following structures:

a. Corticospinal tracts
b. Spinothalamic tract
c. Nucleus ambiguous

a. Corticospinal tracts

How well did you know this?

Not at all

Perfectly

Which objective finding is the strongest indication that a C6 spinal cord injury is not complete?

A. Intact sensation on the lateral portion of the shoulder
B. Diminished sensation on the hypothenar eminence

B. Diminished sensation on the hypothenar eminence

How well did you know this?

Not at all

Perfectly

In a C6 lesion, the following may be expected of the client, EXCEPT:

A. Bed mobility independent
B. Involves the deltoid, biceps, rhomboids, supinator and supraspinatus

B. Involves the deltoid, biceps, rhomboids, supinator and supraspinatus

How well did you know this?

Not at all

Perfectly

A 43-year-old patient is recovering from a complete SCI at L2 level. The expected outcome would MOST LIKELY include_______

A. Some recovery of function since damage is to peripheral nerve roots
B. Loss of arm function is greater than leg function with early loss of pain and temperature sensation

A. Some recovery of function since damage is to peripheral nerve roots

How well did you know this?

Not at all

Perfectly

SCI patient A: deficits are 0/5 both biceps and the entire UE; 0/5 both LE; sensory 50% over neck area only. What is the injury?

A. C4
B. Jefferson fracture (atlas)
C. C3

B. Jefferson fracture (atlas)

How well did you know this?

Not at all

Perfectly

In a C5 lesion, the following may be expected of the client, EXCEPT:

A. Can propel manual wheelchair on level surfaces with the assistance of projection hand trims
B. Can assist with limited transfer due to involved musculature

B. Can assist with limited transfer due to involved musculature

How well did you know this?

Not at all

Perfectly

Compute for the total sensory index score of a patient who has intact sensation from T6 and above; impaired sensation from T7 to L2 and absent sensation from L3 and

A. 70
B. 68

B. 68

How well did you know this?

Not at all

Perfectly

Compute the total motor index score of an SCI patient whose muscles at L2 and above are graded 5/5, L3 and L4 levels are graded 3/5 and remaining muscles are graded zero

A. 70
b. 68
C. 66
D. 72

D. 72

How well did you know this?

Not at all

Perfectly

A realistic functional outcome for a patient with a complete lesion at the C8 neurological level is independent in:

A. Using an electrical wheelchair for navigation
B. Using a manual wheelchair with rim projections
C. All self and personal hygiene

C. All self and personal hygiene

How well did you know this?

Not at all

Perfectly

In mat activities for a T11 paraplegic who wishes to roll from supine to prone, he may use the following techniques, EXCEPT:

A. Crossing the ankles
B. Extension of the head and neck

B. Extension of the head and neck

How well did you know this?

Not at all

Perfectly

A patient is prescribed with BFO. What level of spinal cord injury does he have?

A. C6 to C7
B. C4 to C5
C. C5 to C6
D. C2 to C3

B. C4 to C5

How well did you know this?

Not at all

Perfectly

The therapist receives an order to treat a 42yo man admitted to the hospital 3 days ago with a stab wound to the left lower thoracic spine. The patient is unable to move the left LE and cannot feel pain or temperature differences in the right LE. What is the most likely type of the lesion?

A. Anterior Cord Syndrome
B. Brown Sequard Syndrome

B. Brown Sequard Syndrome

How well did you know this?

Not at all

Perfectly

Potential serious side effect of autonomic hyperreflexia is:

A. Myocardial infarction
B. UTI
C. Pneumonia
D. Spasticity
E. Cerebral hemorrhage

E. Cerebral hemorrhage

How well did you know this?

Not at all

Perfectly

The normal diameter of the spinal cord

A. 10- 15 mm
B. 10 - 15 cm
C. 15 - 20 mm
D. 1- 1.5 cm

D. 1- 1.5 cm

How well did you know this?

Not at all

Perfectly

Where does the spinal cord terminate in adults?

A) L2 vertebral lower border
B) T12 vertebral lower border
C) L4 vertebral lower border
D) L1 vertebral lower border

A) L2 vertebral lower border

How well did you know this?

Not at all

Perfectly

What is the normal diameter of the spinal cord?

A) 5-7 mm
B) 10-15 mm
C) 20-25 mm
D) 30-35 mm

B) 10-15 mm

How well did you know this?

Not at all

Perfectly

Which artery is the largest radicular artery supplying the spinal cord?

A) Artery of Adamkiewicz
B) Posterior spinal artery
C) Anterior spinal artery
D) Radiculomedullary artery

A) Artery of Adamkiewicz

How well did you know this?

Not at all

Perfectly

Which spinal cord segment corresponds roughly to the skeletal level of L2 vertebra? A) Cervical 1 B) Thoracic 3 C) Lumbar 1-2 D) Sacral 2

C) Lumbar 1-2

What is the rate of peripheral nerve regrowth? A) 0.1-0.2 mm/day B) 1-2 mm/day C) 5-10 mm/day D) 10-15 mm/day

B) 1-2 mm/day

What is the conus medullaris? A) The diaphragmatic innervation center B) The pointed conical end of the spinal cord C) A ligament anchoring the spinal cord D) Collection of nerve roots below L2

B) The pointed conical end of the spinal cord

Which spinal segments are involved in the micturition reflex center? A) S1-S3 B) L1-L3 C) S2-S4 D) C5-C7

C) S2-S4

What type of bladder dysfunction is expected with a lesion above the conus medullaris? A) Flaccid bladder B) Reflexogenic spastic bladder C) Atonic bladder D) No effect on bladder function

B) Reflexogenic spastic bladder

Which ligament stabilizes the spinal cord by connecting the pia mater to the dura mater? A) Filum terminale B) Denticulate ligament C) Ligamentum flavum D) Anterior longitudinal ligament

B) Denticulate ligament

The filum terminale connects the tip of the spinal cord to which bony structure? A) Sacrum B) Coccyx C) L5 vertebra D) Ilium

B) Coccyx

What shape characterizes the gray matter of the spinal cord? A) Circular B) Oval C) H-shaped D) Triangular

C) H-shaped

Which REXED laminae contain the substantia gelatinosa important in the pain pathway? A) Lamina I B) Lamina II C) Lamina IV D) Lamina IX

B) Lamina II

What is the function of the dorsal horn of gray matter? A) Motor output B) Sensory input C) Autonomic control D) Reflex coordination

B) Sensory input

Alpha motor neurons (AHC) innervate which type of muscle fibers? A) Intrafusal fibers B) Extrafusal fibers C) Cardiac muscle D) Smooth muscle

B) Extrafusal fibers

Which area is affected in poliomyelitis? A) Dorsal horn B) Anterior horn cells C) White matter tracts D) Filum terminale

B) Anterior horn cells

Which tract carries pain and temperature sensation? A) Dorsal column pathway B) Lateral spinothalamic tract C) Anterior corticospinal tract D) Rubrospinal tract

B) Lateral spinothalamic tract

Which spinal tract is primarily responsible for motor control? A) Spinothalamic tract B) Corticospinal tract C) Dorsal column medial lemniscus D) Posterior spinocerebellar tract

B) Corticospinal tract

What is the decussation point of the lateral corticospinal tract? A) Midbrain B) Pons C) Medullary pyramid D) Spinal cord segment level

C) Medullary pyramid

Which tract is involved in conscious proprioception? A) Lateral spinothalamic tract B) Anterior spinothalamic tract C) Dorsal column medial lemniscus D) Tectospinal tract

C) Dorsal column medial lemniscus

What type of sensation is transmitted by the anterior spinothalamic tract? A) Pain and temperature B) Conscious proprioception C) Light touch and crude touch D) Vibration and pressure

C) Light touch and crude touch

What is the typical mechanism of injury (MOI) in anterior cord syndrome? A) Hyperextension injury B) Hyperflexion injury C) Lateral cord trauma D) Compression injury from posteriorly

B) Hyperflexion injury

What symptoms are seen in Brown-Sequard syndrome? A) Ipsilateral loss of pain and temperature B) Contralateral motor loss only C) Ipsilateral motor and proprioception loss, contralateral pain and temperature loss D) Bilateral motor and sensory loss

C) Ipsilateral motor and proprioception loss, contralateral pain and temperature loss

Which group is more affected in central cord syndrome? A) Lower extremities B) Upper extremities C) Both extremities equally D) Neither extremity

B) Upper extremities

What does ASIA A classification indicate? A) Normal motor and sensory function B) Incomplete injury with sensory but no motor function C) Complete loss of motor and sensory function below the lesion D) Incomplete injury with motor function preserved

C) Complete loss of motor and sensory function below the lesion

Sacral sparing sign includes which of the following? A) Absent perianal sensation B) Presence of voluntary anal sphincter contraction C) Loss of anal wink D) Absence of toe flexor activity

B) Presence of voluntary anal sphincter contraction

What is the most common level of spinal cord injury admitted in hospitals? A) C1 B) C5 C) T6 D) L1

B) C5

What characterizes incomplete spinal cord injury compared to complete? A) Loss of all sensation and motor below the lesion B) Partial preservation of motor and/or sensory function below injury C) Only motor loss below injury D) Only sensory loss below injury

B) Partial preservation of motor and/or sensory function below injury

Which of the following is NOT a classification basis of SCI? A) Level of injury B) Completeness of injury C) Patient's age D) ASIA classification

C) Patient's age

How many dermatomes are there on each side of the body? A) 28 B) 31 C) 56 D) 62

A) 28

What sensory modality is tested using pinprick sensation? A) Light touch B) Proprioception C) Pain D) Vibration

C) Pain

What is the motor grading scale maximum score for each muscle group in SCI evaluation? A) 3 B) 4 C) 5 D) 6

C) 5

Which myotome is responsible for elbow flexion? A) C4 B) C5 C) C6 D) C7

B) C5

What sensory level corresponds approximately to the xiphoid process? A) T4 B) T6 C) T10 D) L1

B) T6

What reflex is the first to return after spinal shock? A) Knee jerk reflex B) Bulbocavernosus reflex C) Babinski reflex D) Cremasteric reflex

B) Bulbocavernosus reflex

Which is the best pharmacologic treatment for spasticity in SCI? A) Riluzole B) Baclofen C) Dantrolene D) Diazepam

B) Baclofen

What is the hallmark symptom of autonomic dysreflexia in SCI? A) Low blood pressure B) Bradycardia and hypertension C) Tachycardia and hypotension D) Loss of sweating

B) Bradycardia and hypertension

Which complication is the most common cause of death in SCI patients? A) Cardiac complications B) Respiratory complications, especially pneumonia C) Deep vein thrombosis D) Pressure ulcers

B) Respiratory complications, especially pneumonia

Which joint is most commonly affected by heterotopic ossification in SCI? A) Knee B) Hip C) Shoulder D) Elbow

B) Hip

Which level of injury usually results in quadriplegia? A) Thoracic B) Cervical C) Lumbar D) Sacral

B) Cervical

What type of wheelchair control is likely for a C4 level SCI patient? A) Manual hand rim B) Power wheelchair with chin or sip-and-puff control C) Friction surface hand rim D) Standard manual wheelchair

B) Power wheelchair with chin or sip-and-puff control

Which is the highest level for independent sliding board transfers? A) C5 B) C6 C) C7 D) T1

B) C6

Which functional level corresponds to independent upper and lower garment dressing? A) C5 B) C6 C) C7 D) T1

C) C7

At what level is community ambulation with a wheelchair commonly possible? A) C4 B) C6 C) C7-C8 D) T12

C) C7-C8

what spinal cord segment is affected in a skeletal level involvement of C7 a. C5 b. C6 c. C7 d. C8

d. C8 Skeletal Level - Spinal Cord Segment ○ Cervical: +1 ○ Upper Thoracic: +2 ○ Lower Thoracic: +3 ○ T10: L1-L2 ○ T11: L3-L4 ○ T12: L5 ○ L1: Sacral & Coccygeal Segments

what spinal cord segment is affected in a skeletal level involvement of T10 a. T9-10 b. T10-12 c. L1-L2 d. L3-L4

c. L1-L2

what spinal cord segment is affected in a skeletal level involvement of T11 a. T9-10 b. T10-12 c. L1-L2 d. L3-L4

d. L3-L4

what spinal cord segment is affected in a skeletal level involvement of T12 a. T11 b. T12 c. L1 d. L5

d. L5 Skeletal Level - Spinal Cord Segment ○ Cervical: +1 ○ Upper Thoracic: +2 ○ Lower Thoracic: +3 ○ T10: L1-L2 ○ T11: L3-L4 ○ T12: L5 ○ L1: Sacral & Coccygeal Segments

what spinal cord segment is affected in a skeletal level involvement of T9 a. T11 b. T12 c. T10 d. T9

b. T12

what spinal cord segment is affected in a skeletal level involvement of T2 a. T1 b. T2 c. T3 d. T4

d. T4

TRUE OR FALSE: L2 vertebral fracture is considered a PNI

True This is because the spinal cord terminates at L2, and nerve passing through the spinal level are peripheral nerves, which has good prognosis for recovery

TRUE OR FALSE: Females who incur SCI suffer from loss of menstruation for 7 months. Fertility in unaffected a. both true b. both false c. only 1st statement is true d. only 2nd statement is true

d. only 2nd statement is true Loss of menstruation for 3 months only

normal length of spinal cord: a. 35-40 cm b. 40-50cm c. 42-45cm d. 48-50cm

c. 42-45cm

which spinal level is considered are the watershed area: a. C5-7 b. T4-6 c. T8-12 d. L1-4

b. T4-6 Area of SC with the poorest blood supply

At T10 SCI, what kind of bladder do you expect? a. spastic b. atrophic c. flaccid d. depends on syndrome

a. spastic

maneuvers for a spastic bladder, except: a. Suprapubic tap b. Credé maneuver c. Lower abdominal stroking d. Hair pulling

b. Credé maneuver

The tip of the SC is attached to the coccyx via a. Pachymeninx b. Leptomeninx

b. Leptomeninx

ligament that comes from the pia mater and goes outward to the dura mater to stabilize the spinal cord a. Medullary Ligament b. Coronary Ligament c. Infraspinous Ligament d. Denticulate Ligaments

d. Denticulate Ligaments

ability to perform erection: a. LMNL b. UMNL c. AOTA d. NOTA

b. UMNL

ability to perform ejaculation: a. LMNL b. UMNL c. AOTA d. NOTA

a. LMNL

ability to father children: a. LMNL b. UMNL c. AOTA d. NOTA

a. LMNL This is done using Psychogenic erection (L1, L2, L3) → sympathetic NS

Which REXED laminae contain the Lissauer’s Zone? A) Lamina I B) Lamina II C) Lamina IV D) Lamina IX

A) Lamina I

Which REXED laminae contain the Nucleus Proprius? A) Lamina I B) Lamina II C) Lamina IV D) Lamina IX

C) Lamina IV This is with Lamina III

Which REXED laminae contain the Central Gray Commissure? A) Lamina IX B) Lamina VII C) Lamina X D) Lamina IX

C) Lamina X

Which REXED laminae contain the Anterior Horn Cells/LMN A) Lamina IX B) Lamina VII C) Lamina X D) Lamina IX

A) Lamina IX ○ Most ventral portion of the gray matter ○ Affected in polio & SMA

Which REXED laminae contain the Clarke’s/Nucleus Dorsalis A) Lamina IX B) Lamina VII C) Lamina X D) Lamina IX

B) Lamina VII

Parkinson’s Disease a. UMNL b. LMNL c. NOTA d. AOTA

c. NOTA Not part because general UMN manifestations involve the pyramidal tract; PD is under extrapyramidal lesions.

(+) Fasciculation/fibrillation a. UMNL b. LMNL c. NOTA d. AOTA

b. LMNL

(+) Secondary Atrophy a. UMNL b. LMNL c. NOTA d. AOTA

a. UMNL

First muscle affected in polio: a. biceps b. gastrocnemius c. quadriceps d. heart

c. quadriceps

Virus in polio: a. picornavirus b. rhinovirus c. adenovirus d. herpes viruses

a. picornavirus

a cadaveric hand is seen in: a. CMTD b. CVA c. GBS d. ALS

d. ALS

pt with ALS would have difficulty with which ADLs? a. Ascending stairs b. Gross motor tasks c. Fine motor tasks d. AOTA

c. Fine motor tasks

Which is the best pharmacologic treatment for spasticity in ALS? A) Riluzole B) Baclofen C) Dantrolene D) Diazepam

A) Riluzole

unconscious proprioception: a. DCML b. Spinocerebellar c. NOTA d. AOTA

b. Spinocerebellar Conscious Proprioception - DCML

which of the following is NOT an epicritic sensation: a. Pallesthesia b. Graphesthesia c. Barognosis d. Stereognosis

a. Pallesthesia ■ Epicritic sensations = easily localized sensations ■ Pallesthesia = vibration

Which of the following comprise the pyramidal tract: a. Corticospinal b. Corticobulbar c. NOTA d. AOTA

d. AOTA

Affectation of this tract leads to Decorticate and Decerebrate posturing a. Rubrospinal b. Vestibulospinal c. Corticospinal d. Tectospinal

a. Rubrospinal

Locomotion and postural reflexes a. Rubrospinal b. Vestibulospinal c. Reticulospinal d. Tectospinal

c. Reticulospinal

Head turning in visual and auditory reflexes a. Rubrospinal b. Vestibulospinal c. Reticulospinal d. Tectospinal

d. Tectospinal

Upper extremity flexor facilitation a. Rubrospinal b. Vestibulospinal c. Reticulospinal d. Tectospinal

a. Rubrospinal

Which sensations is first to recover after SCI: a. pain & temperature b. proprioception c. vibration d. light touch & pressure

a. pain & temperature Lateral Spinothalamic tract has the best chance to recover

Incomplete SCI syndrome with WORST prognosis a. anterior cord syndrome b. central cord syndrome c. posterior cord syndrome d. brown sequard syndrome e. NOTA

a. anterior cord syndrome

○ “Walking SCI” ○ Bowel, bladder, & sexual functions are usually spared a. anterior cord syndrome b. central cord syndrome c. posterior cord syndrome d. brown sequard syndrome e. NOTA

b. central cord syndrome

○ I/L Pain and Temp loss ○ I/L Motor loss ○ I/L Proprioception loss a. anterior cord syndrome b. central cord syndrome c. posterior cord syndrome d. brown sequard syndrome e. NOTA

e. NOTA

○ C/L Pain and Temp loss ○ I/L Motor loss ○ I/L Proprioception loss a. anterior cord syndrome b. central cord syndrome c. posterior cord syndrome d. brown sequard syndrome e. NOTA

d. brown sequard syndrome

May be caused by Syphilis or Vit B12 deficiency a. anterior cord syndrome b. central cord syndrome c. posterior cord syndrome d. brown sequard syndrome e. NOTA

c. posterior cord syndrome

most common incomplete SCI a. anterior cord syndrome b. central cord syndrome c. posterior cord syndrome d. brown sequard syndrome

b. central cord syndrome

SCI common in Children A. SCIWORA B. SCIORA

A. SCIWORA Spinal Cord Injury Without Radiographic Abnormalities

the following statements is true about SCI, except: a. lower the level of the lesion, the more functional b. Insult to the spinal cord resulting in alterations of motor, sensory, and autonomic functions at the level of the lesion c. more common occurrence is on the weekends d. more common occurrence is between summer months

b. Insult to the spinal cord resulting in alterations of motor, sensory, and autonomic functions at the level of the lesion it must be BELOW increased incidence occurs btwn april to may

Most common SCI a. Incomplete quadriplegia SCI b. Complete quadriplegia SCI c. Complete diplegic SCI d. Incomplete diplegic SCI

a. Incomplete quadriplegia SCI Indication: (+) Sacral Sparing sign

(+) sensory. (-) motor A. ASIA A B. ASIA B C. ASIA C D. ASIA D

B. ASIA B

At least 50% of key muscles below level of lesion are graded ≥ 3 A. ASIA A B. ASIA B C. ASIA C D. ASIA D

D. ASIA D

○ Level - R/L ○ C5 - 5/5 ○ C6 - 4/5 ○ C7 - 3/5 ○ C8 - 2/5 ○ L2 - 1/5 ○ L3 - 1/5 ○ L4 - 1/5 ○ L5 - 1/5 ○ S1 - 1/5 what is the motor level and asia classification?

● Motor Level: C6 ● ASIA C

○ Level - R/L ○ C5 - 5/5 ○ C6 - 4/5 ○ C7 - 3/5 ○ C8 - 3/5 ○ L2 - 3/5 ○ L3 - 3/5 ○ L4 - 2/5 ○ L5 - 1/5 ○ S1 - 1/5 what is the motor level and asia classification?

● Motor Level: C6 ● ASIA D

Total Sensory Index Score (TSIS): a. 100 b. 105 c. 112 d. 120

c. 112

dermatome of groin: a. L2 b. L1 c. L4 d. L3

b. L1 inguinal is T12

dermatome of xiphoid: a. T2 b. T6 c. T8 d. T10

b. T6

dermatome of Ischial Tuberosity: a. S3 b. L4 c. S1 d. S2

a. S3

dermatome of Popliteal Fossa: a. L2 b. L5 c. S1 d. S2

d. S2

myotome of EHL: a. L2 b. L3 c. L4 d. L5

d. L5

myotome of ECRL: a. C4 b. C6 c. C8 d. T1

b. C6

myotome of FDP: a. C4 b. C6 c. C8 d. T1

c. C8

myotome of Tibialis Anterior: a. L2 b. L3 c. L4 d. L5

c. L4

Total Motor Index Score (TMIS): a. 100 b. 105 c. 112 d. 120

a. 100

What is the first reflex that returns after spinal shock? a. (+) BCR (bulbocavernosus reflex) b. (+) CCR (clitocavernosus reflex) c. both d. NOTA

c. both Neurologic level of BCR and CCR: S1-S2

Angiography of a patient reveals impaired blood flow and ischemia of the central branches of the posterior cerebral artery. Which of the following is MOST likely expected to occur? A. Hemiballismus B. Homonymous hemianopsia with macular sparing Correct Answer:

A. Hemiballismus

In a persistent vegetative state, a patient with traumatic brain injury has an intact reticular formation with a nonfunctioning cerebral cortex. Therefore, it is possible to be wakeful without having awareness, as well as to have awareness without wakefulness. A. Both statements are true B. Both statements are false C. Only the first statement is true D. Only the second statement is true

C. Only the first statement is true

A patient sustained a lesion on the ® frontal eye field after an anterior circulation stroke. During examination, which of the following would the therapist MOST likely expect to observe from the patient? A. Loss of conjugate gaze to the right side B. Inability to direct eyes to the left side

B. Inability to direct eyes to the left side

Memory impairment results from occlusion of what artery? A. ACA B. MCA C. PCA

C. PCA

A spinal cord injured patient was noted to have the following on physical examination: motor preservation greater than 3 levels below the neurologic level and greater than half of the key muscles below the single neurologic level were less than3. This would be classified as an American spinal injury association (ASIA) level: A. ASIA A B. ASIA B C. ASIA C D. ASIA D

C. ASIA C

Which is the best pharmacologic treatment for spasticity in CP? A) Riluzole B) Baclofen C) Dantrolene D) Diazepam

C) Dantrolene

● Lower BP ● Inc HR (Tachycardia) a. AD b. OH

b. OH

● Pounding Headache ● Piloerection ● Miosis a. AD b. OH

a. AD

● High BP ● Low HR (Bradycardia) a. AD b. OH

a. AD

pharmacologic mx for HO: a. Acetic Acid b. Hydrochloric Acid c. Travelase d. Disodium Etidronate

d. Disodium Etidronate

Elevation of serum alkaline phosphatase a. HO b. MO

a. HO

Traumatic MOI a. HO b. MO

b. MO

Neurologic MOI a. HO b. MO

a. HO

mc site of pressure sores in SCI when in supine: a. olecranon b. sacrum c. scapula d. heel

b. sacrum

Virchow’s Triad, except: a. Hypercoagulability b. Intimal Damage c. Clot Formation d. Venous Stasis

c. Clot Formation

oblique HRP a. C5 b. C6 c. C7 d. C8

a. C5

vertical HRP a. C5 b. C6 c. C7 d. C8

b. C6

Community ambulation with a wheelchair a. C5 b. C6 c. C7 d. C8

c. C7

Highest level for wheelie a. C5 b. C6 c. C7 d. C8

c. C7

Wrist Driven Flexion Hinge Orthosis/Tenodesis Orthosis a. C5 b. C6 c. C7 d. C8

b. C6

Highest level for independent sliding board transfer a. C5 b. C6 c. C7 d. C8

b. C6

Balance Forearm Orthosis (BFO)/Mobile Arm support a. C5 b. C6 c. C7 d. C8

a. C5

Highest level for independent skin inspection and pressure relief a. C5 b. C6 c. C7 d. C8

b. C6

Highest level for independent bed mobility without equipment a. C5 b. C6 c. C7 d. C8

c. C7

Highest level for independent LE PROMEs a. C5 b. C6 c. C7 d. C8

c. C7

independent car driving with hand controls a. C5 b. C6 c. C7 d. C8

c. C7

Stroke weakness usually affects the facial muscles as: A) Whole ipsilateral face (Bell’s palsy) B) Whole contralateral face C) Contralateral lower half of the face D) Upper half of contralateral face

C) Contralateral lower half of the face

The most common etiology of CVA is: A) Thrombotic ischemic stroke B) Embolic stroke C) Hemorrhagic stroke D) Lacunar stroke

A) Thrombotic ischemic stroke

Transient Ischemic Attack (TIA) is best described as: A) Sudden loss of function lasting <12 hours B) Temporary loss of function lasting <24 hours C) Permanent loss of function D) Progressive neurological deficit

B) Temporary loss of function lasting <24 hours

Normal value for total cholesterol in the body is: A) 100 mg/dL B) 120 mg/dL C) 200 mg/dL D) 250 mg/dL

C) 200 mg/dL

Stage 1 hypertension is defined by systolic blood pressure of: A) 100-119 mmHg B) 120-139 mmHg C) 140-159 mmHg D) 160-199 mmHg

C) 140-159 mmHg

The most commonly occluded artery in stroke is: A) Anterior cerebral artery B) Middle cerebral artery C) Posterior cerebral artery D) Vertebral artery

B) Middle cerebral artery

Hemorrhagic stroke most frequently affects which vessel site? A) Putamen B) Hippocampus C) Amygdala D) Red nucleus

A) Putamen

Prominent symptom of MCA syndrome includes: A) Contralateral hemiplegia of UE more than LE B) Ipsilateral facial weakness C) Visual agnosia D) Hemiballismus

A) Contralateral hemiplegia of UE more than LE

Wallenburg syndrome is associated with infarct of which vessel? A) Middle cerebral artery B) PICA C) Lenticulostriate D) AICA

B) PICA

Berry aneurysm is classically associated with which clinical presentation? A) Fainting and weakness B) “Worst headache of my life” C) Sudden blindness D) Ataxia

B) “Worst headache of my life”

In ACA syndrome, the most affected extremity is: A) Both arms B) Both legs C) Contralateral lower extremity D) Contralateral face

C) Contralateral lower extremity

Locked-in syndrome is due to occlusion of which artery? A) Middle cerebral B) Vertebrobasilar C) Posterior cerebral D) Internal carotid

B) Vertebrobasilar

The five D’s of vertebrobasilar syndrome exclude: A) Dysphagia B) Dizziness C) Dyspnea D) Dysarthria

C) Dyspnea

Pure motor stroke, most common type of lacunar stroke, affects which brain structure? A) Putamen B) Thalamus C) Posterior limb of internal capsule D) Amygdala

C) Posterior limb of internal capsule

Which scale is used to assess spasticity? A) Modified Ashworth Scale B) Barthel Index C) Glasgow Coma Scale D) Mini-Mental State Exam

A) Modified Ashworth Scale

Which of the following is TRUE about Glasgow Coma Scale? A) Used for aphasia B) Assesses loss of consciousness C) Evaluates degree of spasticity D) Used in sensory stroke

B) Assesses loss of consciousness

Contralateral homonymous hemianopsia sparing the macula is seen in stroke of which vessel? A) ACA B) MCA C) PCA D) AICA

C) PCA

Wernicke’s aphasia lesion is found in: A) Superior frontal gyrus B) Inferior frontal gyrus C) Superior temporal gyrus D) Angular gyrus

C) Superior temporal gyrus

True apraxia is most commonly a lesion of: A) Left hemisphere B) Right hemisphere C) Both hemispheres D) Cerebellum

A) Left hemisphere

Figure-ground discrimination deficit is defined as: A) Inability to copy objects B) Inability to recognize objects against background C) Neglecting the left side of body D) Denial of paralysis

B) Inability to recognize objects against background

The strongest component of typical upper limb (UE) synergy in stroke is: A) Shoulder abduction B) Elbow extension C) Scapula retraction D) Shoulder adduction and elbow flexion

D) Shoulder adduction and elbow flexion

Sterling’s phenomenon describes synkinesis in the: A) Lower extremity B) Upper extremity C) Face D) Trunk

B) Upper extremity

In Wallenberg syndrome, “crossed hemianesthesia” means: A) Both face and body lose pain and temperature on same side B) Ipsilateral face and contralateral body lose pain and temperature C) Contralateral face and ipsilateral body lose pain sensation D) Only body loses pain sensation

B) Ipsilateral face and contralateral body lose pain and temperature

Prominent stage of spasticity in Brunnstrom motor recovery is: A) Stage 1 B) Stage 3 C) Stage 5 D) Stage 7

B) Stage 3

Aphasia involving problem with repetition only is called: A) Broca’s B) Wernicke’s C) Conduction D) Global

C) Conduction

Pusher syndrome treatment involves: A) Muscle strengthening B) Use of visual feedback such as a mirror C) Oral medications D) Isolated joint movements practice

B) Use of visual feedback such as a mirror

Subclavian Steal Syndrome, except: a. Seen at the costoclavicular space b. Stealing of blood supply into the brain c. Stealing of blood supply into the LE d. Leads to fainting during exercise e. Classified as TIA

b. Stealing of blood supply into the brain SSS = loss of blood supply to the brain

The most common etiology of CVA IN THE YOUNG is: A) Thrombotic ischemic stroke B) Embolic stroke C) Hemorrhagic stroke D) Lacunar stroke

C) Hemorrhagic stroke

Normal value for HDL in the body is: A) >100 mg/dL B) >20 mg/dL C) >60 mg/dL D) >50 mg/dL

C) >60 mg/dL

Normal value for LDL in the body is: A) <100 mg/dL B) >120 mg/dL C) <80 mg/dL D) >150 mg/dL

A) <100 mg/dL

Which systolic blood pressure fits into Pre-hypertension: A) 100-119 mmHg B) 120-139 mmHg C) 140-159 mmHg D) 160-199 mmHg

B) 120-139 mmHg

Ischemic stroke, except: a. Large vessel thrombosis b. Common in the evening c. Onset is gradual d. Affects MCA, ICA, VBA

d. Affects MCA, ICA, VBA more common in CCA mnemonic: Main Character Vibes

arteries affected in lacunar stroke, except: a. AICA b. Recurrent artery of Huebner c. PCA d. Lenticulostriate e. PICA

e. PICA mnemonic: Let’s Ride A Plane

sites affected in lacunar stroke, except: a. Basal Ganglia b. External Capsule c. Thalamus d. Internal Capsule e. Cerebellum

b. External Capsule

“hypertensive hemorrhage" a. ICH b. SAH

a. ICH

Congenital defect of blood vessel with progressive degeneration of tunica adventitia leading to the ballooning of the blood vessel up to 10 mm in diameter a. ICH b. SAH

b. SAH

lead to Charcot-Bouchard Aneurysm Pseudoaneurysm a. ICH b. SAH

a. ICH

Triad of AV malformation, except: a. Hemorrhage b. Migraine c. Seizure d. LOC

d. LOC

(+) Monocular Blindness a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

a. ICA syndrome also known as Amaurosis Fugax

asymptomatic stroke a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

d. ACA syndrome

Visual Agnosia Alexia without agraphia Prosopagnosia a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

b. PCA syndrome

Most common syndrome a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

c. MCA syndrome

Frontal Gaze Palsy with Disconnection apraxia a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

d. ACA syndrome

C/L homonymous hemianopsia with spared macula a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

b. PCA syndrome

Simultanagnosia / Balint’s Syndrome a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

b. PCA syndrome

Abulia Urinary Incontinence Gegenhalten syndrome a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

d. ACA syndrome

Spared: upward gaze LOC / Coma d/t affectation of RAS a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

e. VBA syndrome

Contralateral Homonymous Hemianopsia with impaired macula a. ICA syndrome b. PCA syndrome c. MCA syndrome d. ACA syndrome e. VBA syndrome

c. MCA syndrome

Pt has R ACA syndrome; where is the head turning? a. To the R b. To the L c. Forward d. Backward

a. To the R

Pt has L LE weakness, where is the head turning? a. To the R b. To the L c. Forward d. Backward

a. To the R

Force-dependent resistance to passive movement / motion a. Balint’s Syndrome b. Gegenhalten syndrome

b. Gegenhalten syndrome

Inability to recognize more than one object at a time a. Balint’s Syndrome b. Gegenhalten syndrome

a. Balint’s Syndrome

Lateral Pons I/L CN 6,7 palsy a. Weber Syndrome b. Benedikt Syndrome c. Locked-In Syndrome d. Millard-Gubler Syndrome e. Wallenburg Syndrome

d. Millard-Gubler Syndrome

Crossed hemianesthesia Horner’s syndrome I/L ataxia a. Weber Syndrome b. Benedikt Syndrome c. Locked-In Syndrome d. Millard-Gubler Syndrome e. Wallenburg Syndrome

e. Wallenburg Syndrome

Tegmentum of the Midbrain a.Weber Syndrome b. Benedikt Syndrome c. Locked-In Syndrome d. Millard-Gubler Syndrome e. Wallenburg Syndrome

b. Benedikt Syndrome

C/L ataxia C/L chorea I/L CN 3 palsy a.Weber Syndrome b. Benedikt Syndrome c. Locked-In Syndrome d. Millard-Gubler Syndrome e. Wallenburg Syndrome

b. Benedikt Syndrome

Medial Basal Midbrain a. Weber Syndrome b. Benedikt Syndrome c. Locked-In Syndrome d. Millard-Gubler Syndrome e. Wallenburg Syndrome

a. Weber Syndrome

Bilateral Basal Pons a. Weber Syndrome b. Benedikt Syndrome c. Locked-In Syndrome d. Millard-Gubler Syndrome e. Wallenburg Syndrome

c. Locked-In Syndrome

Affects Superior cerebellar peduncle, Dorsal Column Pathway (Medial lemniscus), and Red nucleus a. Weber Syndrome b. Benedikt Syndrome c. Locked-In Syndrome d. Millard-Gubler Syndrome e. Wallenburg Syndrome

b. Benedikt Syndrome

Quadriplegia Affects Corticobulbar tract a. Weber Syndrome b. Benedikt Syndrome c. Locked-In Syndrome d. Millard-Gubler Syndrome e. Wallenburg Syndrome

c. Locked-In Syndrome

MAS grading: minimal resistance throughout the remainder of the ROM a. 1 b. 1+ c. 2 d. 3 e. 4

b. 1+

MAS grading: slight increase in muscle tone manifested by catch and release, followed by minimal resistance at the end of ROM a. 1 b. 1+ c. 2 d. 3 e. 4

a. 1

MAS grading: considerable increase in muscle tone, passive movement is difficult a. 1 b. 1+ c. 2 d. 3 e. 4

d. 3

Tardieu Scale: slight resistance with clear catch a. 0 b. 1 c. 2 d. 3 e. 4

c. 2

Tardieu Scale: non-fatigable clonus, > 10 seconds a. 0 b. 1 c. 2 d. 3 e. 4

e. 4

Tardieu Scale: fatigable clonus in < 10 seconds a. 0 b. 1 c. 2 d. 3 e. 4

d. 3

Tardieu Scale: slight resistance without clear catch a. 0 b. 1 c. 2 d. 3 e. 4

b. 1

Posterior circulation stroke Brainstem lesion a. Pontine Gaze Palsy b. Frontal Gaze Palsy

a. Pontine Gaze Palsy

Head turning towards the lesion and away from the hemiplegic side a. Pontine Gaze Palsy b. Frontal Gaze Palsy

b. Frontal Gaze Palsy

affects MCA, ACA a. Pontine Gaze Palsy b. Frontal Gaze Palsy

b. Frontal Gaze Palsy

Thalamic pain syndrome manifests ____ mos after the onset of stroke / initial attack a. 2 b. 3 c. 4 d. 5

b. 3

(-) Naming (+) Fluency (-) Comprehension (+) Repetition a. Broca’s Aphasia b. Conduction Aphasia c. Mixed Aphasia d. Wernicke’s Aphasia e. Transcortical sensory aphasia f. Transcortical motor aphasia g. Anomic Aphasia h. Global Aphasia

e. Transcortical sensory aphasia

(-) Naming (-) Fluency (-) Comprehension (+) Repetition a. Broca’s Aphasia b. Conduction Aphasia c. Mixed Aphasia d. Wernicke’s Aphasia e. Transcortical sensory aphasia f. Transcortical motor aphasia g. Anomic Aphasia h. Global Aphasia

c. Mixed Aphasia

(-) Naming (+) Fluency (-) Comprehension (-) Repetition a. Broca’s Aphasia b. Conduction Aphasia c. Mixed Aphasia d. Wernicke’s Aphasia e. Transcortical sensory aphasia f. Transcortical motor aphasia g. Anomic Aphasia h. Global Aphasia

d. Wernicke’s Aphasia

(-) Naming (+) Fluency (+) Comprehension (-) Repetition a. Broca’s Aphasia b. Conduction Aphasia c. Mixed Aphasia d. Wernicke’s Aphasia e. Transcortical sensory aphasia f. Transcortical motor aphasia g. Anomic Aphasia h. Global Aphasia

b. Conduction Aphasia

(-) Naming (-) Fluency (-) Comprehension (-) Repetition a. Broca’s Aphasia b. Conduction Aphasia c. Mixed Aphasia d. Wernicke’s Aphasia e. Transcortical sensory aphasia f. Transcortical motor aphasia g. Anomic Aphasia h. Global Aphasia

h. Global Aphasia

Posterior Aphasia a. Wernicke’s Aphasia b. Broca’s Aphasia

a. Wernicke’s Aphasia

BA lesion in visual agnosia a. BA Right 18 & 19 b. BA Left 18 & 19 c. BA Right 40 / 5 & 7 d. BA Left 40 / 5 & 7 e. BA Right 22 f. BA Left 22

a. BA Right 18 & 19

BA lesion in tactile agnosia a. BA Right 18 & 19 b. BA Left 18 & 19 c. BA Right 40 / 5 & 7 d. BA Left 40 / 5 & 7 e. BA Right 22 f. BA Left 22

c. BA Right 40 / 5 & 7

BA lesion in auditory agnosia a. BA Right 18 & 19 b. BA Left 18 & 19 c. BA Right 40 / 5 & 7 d. BA Left 40 / 5 & 7 e. BA Right 22 f. BA Left 22

e. BA Right 22

False Apraxia a. (L) Hemisphere b. (R) Hemisphere

b. (R) Hemisphere

Visuospatial Deficit Neglect Syndrome a. (L) Hemisphere b. (R) Hemisphere

b. (R) Hemisphere

Aphasia Aware of their impairment a. (L) Hemisphere b. (R) Hemisphere

a. (L) Hemisphere

UE flexor synergy except: a. scapular protraction b. shoulder ABER c. elbow flexion d. FA supinated e. wrist & finger flexion

a. scapular protraction

UE extensor synergy except: a. scapular protracted b. shoulder ABIR c. elbow extended d. FA pronated e. wrist & finger flexion

b. shoulder ABIR

typical arm posture except: a. scapular protraction b. shoulder IR c. elbow flexion d. FA pronation e. wrist & finger flexion

a. scapular protraction no scapular positioning mentioned

LE extensor synergy except: a. hip EXADIR b. knee extension c. ankle PF, EV d. foot PF e. NOTA

c. ankle PF, EV ankle is in INVERSION

LE flexor synergy except: a. hip FABER b. knee flexion c. ankle DF, INV d. foot DF e. NOTA

e. NOTA

muscles spared in spasticity, except: a. Lats Dorsi b. Ankle Evertors c. Finger Extensors d. Teres Minor e. Serratus Anterior

d. Teres Minor Teres Major

Arm elevation beyond 90º facilitates finger extension a. Soque’s Phenomenon b. Sterling’s Phenomenon c. Homolateral Limb Synkinesis d. Raimeste’s Phenomenon

a. Soque’s Phenomenon

synergistic patterns start to appear in Brunnstrom motor recovery is: A) Stage 1 B) Stage 2 C) Stage 3 D) Stage 4

B) Stage 2

Pronation-supination with elbow extended in Brunnstrom motor recovery is: A) Stage 5 B) Stage 6 C) Stage 7 D) Stage 4

A) Stage 5

Horner’s Syndrome, except: a. Miosis b. Anhydrosis c. Ptosis d. Exophthalmus e. NOTA

d. Exophthalmus must be Enophthalmus

MAS grading: rigid in flexion and extension a. 1 b. 1+ c. 2 d. 3 e. 4

e. 4

MAS grading: more marked increase in muscle tone, joint is still easily moved a. 1 b. 1+ c. 2 d. 3 e. 4

c. 2

Can talk to them but out of context Fluent Aphasia a. Wernicke’s Aphasia b. Broca’s Aphasia

. Wernicke’s Aphasia

Agnosia Quick & Impulsive Impaired Judgement & Insight a. (L) Hemisphere b. (R) Hemisphere

b. (R) Hemisphere

(+) Lateral prehension in Brunnstrom motor recovery is: A) Stage 5 B) Stage 6 C) Stage 7 D) Stage 4

D) Stage 4

(+) Palmar prehension & cylindrical grasp in Brunnstrom motor recovery is: A) Stage 5 B) Stage 6 C) Stage 3 D) Stage 4

A) Stage 5

(+) Hook Grasp in Brunnstrom motor recovery is: A) Stage 5 B) Stage 6 C) Stage 3 D) Stage 4

C) Stage 3

[Neuro] CVA, SCI Flashcards

(253 cards)