Overview of Hemiplegia

Question 1

causes of hemiplegia

Answer 1

vascular

space occupying lesions

infections

trauma

Question 2

vascular –> causes

Answer 2

thrombus

embolus

hemorrhage

Question 3

space occupying lesions –> causes

Answer 3

cysts

abscess

benign tumors

malignant tumors

Question 4

infections –> causes

Answer 4

meningitis

encephalitis

Question 5

stroke recognition

Answer 5

FAST

Question 6

FAST

Answer 6

face

arms

speech

time

Question 7

face –> FAST

Answer 7

is it drooping

Question 8

arms –> FAST

Answer 8

can you raise both

Question 9

speech –> FAST

Answer 9

is it slurred or jumbled

Question 10

time –> FAST

Answer 10

to call 911 right away

Question 11

initial signs/sxs

Answer 11

head ache

vision change

funny feeling in one half of body

weakness of body half

numbness of body half

Question 12

funny feeling in one body half–> sxs

Answer 12

UE

LE

face

trunk

or any combo

Question 13

weakness of body half –> sxs

Answer 13

UE

LE

face

trunk

or any combo

Question 14

numbness of body half –> sxs

Answer 14

UE

LE

face

trunk

or any combo

Question 15

if any sxs are suspected

Answer 15

get to ED ASAP

Question 16

initial tx –> if thrombus or embolus

Answer 16

TPA w/in 1st 1.5 hours may significantly improve outcomes

Question 17

initial tx –> hemorrhage

Answer 17

may do craniotomy to relieve pressure

but TPA is contraindicated

Question 18

initial tx –> infection

Answer 18

antibiotics

Question 19

initial tx –> space occupying lesion

Answer 19

craniotomy to remove

Question 20

impairments

Answer 20

motor

tone alterations

abnormal reflexes

sensory

vision

neglect

communication

Question 21

what stroke is the most common –> motor

Answer 21

MCA stroke

UE is usually more affected than LE

Question 22

where does weakness often occur –> motor

Answer 22

mild weakness on ipsilateral side

less involved and not non-involved

only 75-90% of corticospinal tract fibers cross over

Question 23

what may pts have –> motor

Answer 23

pathological synergy patterns

Question 24

always start –> tone alterations

Answer 24

flaccid

neurological shock

Question 25

progression --> tone alterations

Answer 25

flaccid --> hypotonic --> spastic

Question 26

tone alterations may

Answer 26

return to normal

Question 27

abnormal reflexes

Answer 27

dominated by ATNR, labyrinthine reflexes

Question 28

sensory

Answer 28

often impaired either or both cutaneous proprioception

Question 29

vision

Answer 29

homonymous hemianopsia

Question 30

secondary impairments

Answer 30

pain contracture pneumonia decubiti

Question 31

right CVA has

Answer 31

left side weakness left side sensory loss visual-perceptual problems left side unilateral neglect agnosia visuospatial impairments

Question 32

right CVA --> difficulties

Answer 32

sustaining movement problem solving/synthesizing visual cues

Question 33

right CVAs are

Answer 33

often unaware of impairments inability to self correct poor judgement increase safety risk

Question 34

left CVA--> impairments

Answer 34

right sided weakness right sided sensory loss speech/language impairment

Question 35

speech/language impairment --> left CVA

Answer 35

expressive (brocas) aphasia receptive (wernicks) aphasia global aphasia

Question 36

left CVAs have difficulties

Answer 36

planning/sequencing verbal cues

Question 37

left CVAs are

Answer 37

apraxia more common disorganized problem solving often very aware of impairments anxious about poor performance

Question 38

right CVA

Answer 38

not cautious

Question 39

left CVA

Answer 39

overly cautious