Certified Stroke Rehabilitation Specialist (CSRS 2023)
Questions With Complete Solutions
Types of stroke
(Lesson 2) - -Ischemic: 87%
-Thrombotic
-Embolic
-Lacunar
Hemorrhagic: 13%
-Intracerebral
-Subarachnoid
Thrombotic Stroke (Ischemic) - -48% of all strokes
-typically occurs during sleep
-slow progressive onset of deficits
-50% are associated with prior TIA
Embolic Stroke (Ischemic) - -26% of all strokes
-typically occurs while awake
-sudden, immediate deficits (sometimes seizures)
-11% are associated with prior TIA
Lucunar Stroke (Ischemic)
small vessel disease - -13% of all strokes
-small infarct (>15-20 cm) deep in the brain
-onset can be gradual or sudden
-23% associated with proceeding TIA
, Certified Stroke Rehabilitation Specialist (CSRS 2023)
Questions With Complete Solutions
-often pure sensory or motor symptoms
-typically no higher cortical functional involved
Intracerebral Hemmorhage (ICH) - -10% of all strokes
-90% happen with the patient is under "no stress"
-major cause of "hypertension"
-onset may be gradual or sudden
-8% are associated with prior TIA
-direct correlation with high blood pressure/ hypertension
Subarachnoid Hemorrhage (SAH) - -3% of all stroke
-occurs often during strenuous activity
-cause: rupture aneurysms and vascular malformations
-sudden onset
-7% are associated with preceding TIA
Left Stroke with Right Hemiplegia - --Language/Perceptual problems
-expressive aphasia
-receptive aphasia
-global aphasia
-alexia, agraphia , acalculia
-apraxias: motor planning perceptual problems
(Impaired verbal and math skills with word letter discrimination
, Certified Stroke Rehabilitation Specialist (CSRS 2023)
Questions With Complete Solutions
Left Stroke with Right Hemiplegia (BEHAVIORS) - --Slow, anxious, cautious, normal
attention span
-underestimated abilities
-emotionally labile ( abrupt mood changes)
-quick to anger and/or become frustrated
Right Stroke with Left Hemiplegia - -Perceptual problems/ Distortion of physical
reality
-visual spatial disorders :depth perception
-constructional relationships
-directional concepts
-neglect, drawing abilities
-body schema perception disorders;
-perceptual language disorders
language
Right Stroke with Left Hemiplegia (BEHAVIORS) - --fast and impulsive
-short attention span
-overestimate abilities/ judgement
-denial of illness (anosognosia)
-lack of inhibition
-inability to express emotions /affect is flat
Cerebrum - --frontal, parietal, temporal, and occipital lobes
, Certified Stroke Rehabilitation Specialist (CSRS 2023)
Questions With Complete Solutions
-consisting of two hemispheres, left and right, separated by a fissure
-responsible for the integration of complex sensory and neural functions and the initiation
and coordination of voluntary activity in the body.
initiates and coordinates movement and regulates temperature. Other areas of the
cerebrum enable speech, judgment, thinking and reasoning, problem-solving, emotions
and learning.
Frontal Lobe - --controls voluntary movement
-thinking problem solving
-reasoning judgement
-personality
Primary Motor Cortex
(motor homunculus) - --located on the pre-central gyrus
-controls voluntary movement
-lesion to this area results in motor deficits and/or paralysis to the contralateral side of the
body
Premotor Cortex - --located just anterior to the primary motor cortex
-controls actions of trunk and proximal limb muscles
-responsible for body part ownership
-lesion to this area result in unilateral neglect
Supplementary Motor Cortex - --located medial to the primary motor cortex
-motor planning region
-stores motor memories and directs activity of primary motor cortex
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