CVA Assessment and Intervention Questions With Complete Solutions

Cerebrovascular Accident (CVA) correct answer: Sudden loss of neurological function caused by interruption of blood flow to the brain Ischemic Stroke correct answer: Blockage due to clot most common Hemorrhagic Stroke correct answer: rupture of vessels causing leakage of blood How long must neurological symptoms persist to be classified as a stroke? correct answer: >24 hours Paralysis correct answer: hemiplegia Weakness correct answer: hemiparesis Atherosclerosis correct answer: major contributory factor plaque formation on arterial walls Ischemic stroke can be caused by either? correct answer: Thrombus Embolus Thrombus correct answer: Results from platelet aggregation and adhesion of plaques Leads to vessel occlusion Embolus correct answer: Bits of matter formed elsewhere and released into bloodstream Can lodge in a vessel, causing occlusion Early Warning Signs of Stroke correct answer: F: face drooping A: arm weakness S: speech difficulty T: time to call 911 Other Stroke Symptoms correct answer: Sudden: numbness, weakness (especially on one side of the body), confusion, trouble speaking or understanding, trouble seeing in one or both eyes, trouble walking, dizziness, loss of balance or coordination, severe headache with no known cause tPA correct answer: Give to those that have had an ischemic stroke What is the time frame that tPA must be given in? correct answer: within 3 hours of symptom onset tPA can dramatically reduce? correct answer: death and disability Anterior Cerebral Artery (ACA) correct answer: Supplies the medial aspect of the cerebral hemisphere (frontal and parietal lobes) and some subcortical structures (BG, fornix, corpus callosum) Deficits of ACA CVA correct answer: Contralateral hemiparesis and sensory loss LE>UE Middle Cerebral Artery (MCA) correct answer: Supplies the entire lateral aspect of the hemisphere (frontal, temporal, and parietal lobes) and subcortical structures (internal capsule, globes pallid us, caudate/putamen) Deficits of MCA CVA correct answer: Contralateral spastic hemiparesis and sensory loss of the face, UE, LE (face and UE>LE) Aphasia Perceptual deficits (neglect, apraxia) Homonymous hemianopsia MCA CVA Lesions of Dominant Hemisphere correct answer: Aphasia (L) MCA CVA Lesions of Non dominant Hemisphere correct answer: Perceptual deficits (neglect, apraxia) (R) Posterior Cerebral Artery (PCA) correct answer: Supplies the occipital lobe and medial and inferior temporal lobe, upper brainstem, midbrain, thalamus Deficits of PCA CVA- Thalamic Branches correct answer: Hemianesthesia (contralateral sensory loss) Central-post stroke (thalamic) pain Deficits PCA CVA- Occipital Infarction correct answer: Homonymous hemianopia Visual Agnosia (bilateral would cause cortical blindness) Deficits PCA CVA- Temporal Lobe correct answer: Memory Loss Lacunar Strokes correct answer: Small vessel involvement in deep structures of the brain Strongly associated with hypertensive hemorrhage and diabetic microvascular disease Pure Motor Lacunar Stroke correct answer: Posterior limb of internal capsule, pons, pyramids Pure Sensory Lacunar Stroke correct answer: Involvement of the ventrolateral thalamus or thalamocortical projections Examination Purpose: correct answer: Determine PT dx Monitor recovery from stroke Identify pts who are most likely to benefit from rehab and most appropriate setting Develop POC (goals, outcomes, prognosis, interventions) Monitor progress toward goals and outcomes Determine if referral to another practitioner is needed Plan for DC Facial Sensation correct answer: CN V Facial Movements correct answer: CN V, VII