CSRS Stroke Pathophysiology & Patient Assessment 2

Question 1

A patient presents with contralateral leg weakness that is greater than arm weakness, plus urinary incontinence. Which artery is most likely occluded?

Accepted Answer

Anterior cerebral artery

Answer

The ACA supplies the medial frontal and parietal lobes, where the leg and foot are represented on the motor homunculus.

Question 2

Ipsilateral loss of facial pain and temperature, contralateral loss of body pain and temperature, dysphagia, and ipsilateral Horner syndrome suggest occlusion of which vessel?

Accepted Answer

Posterior inferior cerebellar artery or vertebral artery

Answer

This is lateral medullary (Wallenberg) syndrome, usually from PICA or vertebral artery occlusion.

Question 3

A pure motor hemiparesis affecting face, arm, and leg equally with no sensory, visual, or cognitive deficits most likely results from a lacune in which location?

Accepted Answer

Posterior limb of the internal capsule

Answer

The posterior limb of the internal capsule carries tightly packed corticospinal fibers, so a small lacune there causes pure motor stroke.

Question 4

A right-handed patient with right hemiparesis, worse in the face and arm, and nonfluent speech with relatively preserved comprehension most likely had a stroke in which territory?

Accepted Answer

Left MCA superior division

Answer

The left MCA superior division supplies Broca's area and the face and arm motor cortex in the dominant hemisphere.

Question 5

Contralateral homonymous hemianopia with macular sparing is most characteristic of occlusion of which artery?

Accepted Answer

Posterior cerebral artery

Answer

PCA occlusion infarcts the occipital cortex, and macular sparing happens because of collateral MCA supply to the occipital pole.

CSRS - Certified Stroke Rehabilitation Specialist Practice Test

CSRS - Certified Stroke Rehabilitation Specialist Practice Test

CSRS Stroke Pathophysiology & Patient Assessment 2