stroke and tbi

Question 1

stroke overview of symptoms

Answer 1

UMN
increase in reflexes or abnormal (babinski, clonus)
spasticity

Question 2

what does the MCA supply

Answer 2

lateral part of the brain (face and UE)

Question 3

what does the ACA supply

Answer 3

medial part of the brain (LEs)

Question 4

what does the PCP supply

Answer 4

posterior part of the brain

Question 5

ischemic stroke

Answer 5

occurs when a clot blocks or impairs blood flow, depriving the brain of essential oxygen and nutrients

more common

Question 6

hemorrhagic stroke

Answer 6

occurs when blood vessels rupture, causing leakage of blood in or around the brain

Question 7

ACA syndrome signs and symptoms

Answer 7

ACA .. ABCD.. baby

contralateral hemiparesis and hemisensory loss (LE)
urinary incontinence (diaper)
problems with imitation, bimanual tasks, apraxia (babies imitate others and need to use both sides)
slowness, delay, motor inaction
contralateral grasp reflex, sucking reflex

Question 8

MCA signs and symptoms

Answer 8

contralateral hemiparesis and hemisensory loss (UE and face)

MPH
mouth - Language (L MCA) speech impairments (brocas, wernickes, global)
PeRceptual disorder (unilateral neglect) (R.MCA)
contralateral Homonymous Hemianopsia (half no vision)

Question 9

what side of the brain is dominantt

Answer 9

left

Question 10

superior MCA causes what type of aphasia

Answer 10

Broca’s

Question 11

inferior MCA causes what type of aphasia

Answer 11

wernickes

Question 12

Broca’s aphasia

Answer 12

Broken speech
Expressive aphasia
Non Fluent aphasia

frontal lobe
patient has slow hesitant speech
Tx: yes/no q
L brain lesion

Question 13

Wernicke’s aphasia

Answer 13

receptive aphasia
fluent aphasia
can’t understand
word salad

Tx: gestures/demos
temporal lobe
L brain lesion

Question 14

Perceptual deficit: unilateral neglect

Answer 14

more common in R MCA
lack of awareness of weak side
encourage awareness and use of environment on hemiparetic side and extremities

active visual scanning > turning head and trunk to more involved side

Question 15

if a pt has L MCA describe the Homonymous Hemianopsia

Answer 15

HH would occur on right side, pt unable to see out of R side of both eyes. L visual field would block nose, R visual field would block temporal

Question 16

PCA signs and symptoms - peripheral territory

Answer 16

PCA - vision impairments
contralateral homonymous hemianopia
visual agnosia - PROSOPagnosia (can’t interpret familiar faces)
dyslexia WITHOUT agraphia (can’t read w eyes closed but can write)
memory deficits
topographic disorientation (direction)

Question 17

PCA signs and symptoms - central territory

Answer 17

thalamus pain syndrome - sensations everything is painful

Question 18

right stroke overview

Answer 18

child like symptoms
left hemiparesis/hemisensory loss
visual-perceptual impairments: neglect, difficulty with VISUAL cues
L homonymous hemianopsia

quick, impulsive, safety risk
rigidity of thought
difficulty with negative emotions

Question 19

left stroke overview

Answer 19

oLder individuals symptoms
right hemiparesis/hemisensory loss
Language impairments: aphasias, difficulty with VERBAL cues
R homonymous hemianopsia

slow, cautious
highly distractible
difficulty with positive emotions

Question 20

spasticity versus synergy

Answer 20

spasticity: increase in tone, PROM to check tone
synergy: ENERGY - AROM to check

Question 21

spasticity pattern in UE

Answer 21

scapular retraction, downward rotation
shoulder ADD, IR, depression
elbow flexion
pronation
wrist flexion, ADD
finger flexion, clenched fist, thumb adducted in palm

T rex arm
chicken dance

Question 22

spasticity pattern in LE

Answer 22

pelvis retraction (hip hiking)
hip ADD, IR, EXT (scissoring)
knee extension
PF, inversion, equinovarus, toes claws, toes curl

ballerina

Question 23

Brunnstrom stage 1

Answer 23

flaccidity, no active limb movement

Question 24

Brunnstrom stage 2

Answer 24

in synergy, with associated reactions
increase tone

beginning of minimal voluntary movement

synergies, some spasticity

Question 25

Brunnstrom stage 3

Answer 25

spasticity at PEAK voluntary control of movement synergy further increase tone to peak level *marked spasticity*

Question 26

Brunnstrom stage 4

Answer 26

movement outside of synergy decrease tone *out of synergy, less spasticity*

Question 27

Brunnstom stage 5

Answer 27

increase complex movement, greater independence from limb synergies

Question 28

Brunnstom stage 6

Answer 28

individual joint movement, coordinated movement *selective control of movement*

Question 29

Brunnstrom stage 7

Answer 29

normal function *isolated/coordinated movement*

Question 30

Obligatory Synergy Flexion Pattern in UE

Answer 30

scapula retraction/elevation or hyperextension shoulder ABD, ER elbow flexion wrist and finger flexion

Question 31

Obligatory Synergy Flexion Pattern in LE

Answer 31

hip flexion, ABD, ER knee flexion ankle DF, inversion toe DF

Question 32

Obligatory Synergy Extension Pattern in UE

Answer 32

scapular protraction, shoulder ADD, IR elbow extension forearm pronation wrist and finger flexion

Question 33

Obligatory Synergy Extension Pattern in LE

Answer 33

hip extension, ADD, IR knee extension ankle PF, inversion toe PF

Question 34

TBI overview

Answer 34

UMN increase in reflexes or abnormal