A woman has left arm and leg weakness, left sensory loss, ignores objects on the left and has her eyes deviated to the right. Which diagnosis best fits?

Right middle cerebral artery infarction

Left anterior cerebral artery infarction

Left lateral medullary infarction

Right posterior cerebral artery infarction

A middle cerebral artery stroke typically causes:

Contralateral weakness and sensory loss, greater in the face and arm than the leg

Ipsilateral limb ataxia with vertigo

Contralateral leg weakness greater than the arm

Homonymous hemianopia with sparing of the macula only

What is the typical extensor synergy of the hemiplegic lower limb?

Hip extension, adduction and internal rotation, knee extension, ankle plantarflexion with inversion

Hip flexion, abduction and external rotation, knee flexion, ankle dorsiflexion

Hip flexion, adduction and internal rotation, knee extension, ankle dorsiflexion

Hip extension, abduction and external rotation, knee flexion, ankle plantarflexion

Functional electrical stimulation is applied to prevent or reduce shoulder subluxation. Which muscles should be stimulated?

Supraspinatus and posterior deltoid

Pectoralis major and latissimus dorsi

Stroke and brain injury rehabilitation

60 Gulf Prometric Physiotherapist (DHA, DOH, MOH, SCFHS, QCHP) practice questions on Stroke and brain injury rehabilitation, part of Neurorehabilitation. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
A woman has left arm and leg weakness, left sensory loss, ignores objects on the left and has her eyes deviated to the right. Which diagnosis best fits?
1. ARight middle cerebral artery infarction
2. BLeft anterior cerebral artery infarction
3. CLeft lateral medullary infarction
4. DRight posterior cerebral artery infarction
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Answer: A · Right middle cerebral artery infarction
Left-sided weakness and sensory loss point to the right hemisphere. Left neglect and gaze deviation toward the lesion, the right side, are typical of a large right middle cerebral artery stroke. The other territories do not explain the combination.
- B: A left anterior cerebral lesion would give right leg weakness.
- C: A left lateral medullary lesion gives crossed sensory loss and bulbar signs.
- D: A right posterior cerebral lesion gives a left field defect without hemiparesis.
Remember this
Left weakness, left neglect and rightward gaze deviation point to right MCA infarction.
Question 2 · Easy
Unilateral spatial neglect most commonly follows a stroke in which area?
1. ALeft occipital lobe
2. BLeft temporal lobe
3. CRight parietal lobe
4. DRight cerebellar hemisphere
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Answer: C · Right parietal lobe
Neglect of the left side of space is most often seen after right parietal damage, because the right hemisphere is dominant for spatial attention. The patient ignores stimuli on the contralesional side without a primary sensory or visual loss. It is more severe and persistent than neglect of the right side after left-sided lesions.
- A: Occipital lesions produce visual field loss rather than neglect.
- B: Left temporal lesions are linked to language problems.
- D: Cerebellar lesions cause ataxia, not inattention to one side of space.
Remember this
Left neglect is most often from a right parietal lesion.
Question 3 · Easy
A middle cerebral artery stroke typically causes:
1. AIpsilateral limb ataxia with vertigo
2. BContralateral weakness and sensory loss, greater in the face and arm than the leg
3. CContralateral leg weakness greater than the arm
4. DHomonymous hemianopia with sparing of the macula only
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Answer: B · Contralateral weakness and sensory loss, greater in the face and arm than the leg
The middle cerebral artery supplies the lateral cortex, so the face and arm area of the motor and sensory homunculus is affected more than the leg. Dominant-side lesions often add aphasia and non-dominant lesions neglect. Leg-predominant weakness points to the anterior cerebral artery.
- A: Ataxia with vertigo suggests a posterior circulation stroke.
- C: Leg greater than arm weakness suggests an anterior cerebral artery stroke.
- D: Macular-sparing hemianopia is a posterior cerebral artery pattern.
Remember this
MCA stroke weakens the face and arm more than the leg.
Question 4 · Medium
What is the typical extensor synergy of the hemiplegic lower limb?
1. AHip flexion, abduction and external rotation, knee flexion, ankle dorsiflexion
2. BHip extension, adduction and internal rotation, knee extension, ankle plantarflexion with inversion
3. CHip flexion, adduction and internal rotation, knee extension, ankle dorsiflexion
4. DHip extension, abduction and external rotation, knee flexion, ankle plantarflexion
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Answer: B · Hip extension, adduction and internal rotation, knee extension, ankle plantarflexion with inversion
The lower limb extensor synergy includes hip extension, adduction and internal rotation, with knee extension and plantarflexion with inversion of the foot. The flexor synergy is hip flexion, abduction and external rotation with knee flexion and ankle dorsiflexion. The extensor pattern explains the stiff leg and equinovarus foot of the hemiplegic gait.
- A: That set is the flexor synergy of the lower limb.
- C: That combination mixes both synergies and is not a recognised pattern.
- D: That combination also mixes both synergies.
Remember this
Lower limb extensor synergy: hip and knee extension, adduction, plantarflexion with inversion.
Question 5 · Medium
Functional electrical stimulation is applied to prevent or reduce shoulder subluxation. Which muscles should be stimulated?
1. ASupraspinatus and posterior deltoid
2. BBiceps brachii and brachialis
3. CTriceps and wrist extensors
4. DPectoralis major and latissimus dorsi
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Answer: A · Supraspinatus and posterior deltoid
Stimulating supraspinatus and posterior deltoid draws the humeral head up and back into the fossa. These muscles are the main dynamic stabilisers against inferior subluxation. Stimulating pectoralis major and latissimus dorsi would adduct and internally rotate the arm.
- B: Elbow flexors do not stabilise the glenohumeral joint.
- C: Triceps and wrist extensors act at the elbow and wrist.
- D: Pectoralis major and latissimus dorsi would pull the arm into adduction and internal rotation.
Remember this
FES for subluxation targets supraspinatus and posterior deltoid.
Question 6 · Medium
Which mechanical measure has the best evidence for preventing deep vein thrombosis in immobile stroke patients?
1. AIntermittent pneumatic compression
2. BGraduated compression stockings alone
3. CCalf massage twice a day
4. DElevating the legs on a pillow
Answer and explanation in LearnFree account
Question 7 · Medium
A physiotherapist notes coughing and a wet voice when a stroke patient sips water. What is the best action?
1. AEncourage thicker drinks and continue
2. BAsk the patient to lie flat to drink
3. CContinue oral intake because coughing protects the airway
4. DStop oral intake and refer for a swallowing assessment
Answer and explanation in LearnFree account
Question 8 · Medium
A patient has a right homonymous hemianopia with macular sparing after a stroke. Which vessel territory is most likely affected?
1. ARight posterior inferior cerebellar artery
2. BRight middle cerebral artery
3. CLeft anterior cerebral artery
4. DLeft posterior cerebral artery
Answer and explanation in LearnFree account
Question 9 · Medium
A carer pulls a hemiplegic patient up by the affected arm to move him up the bed. What advice should the physiotherapist give?
1. AUse the arm as a lever for all transfers to keep him active
2. BSupport the whole arm and scapula and never lift by the affected arm
3. CPull steadily on the hand because the arm is not painful
4. DLift him by the elbow instead of the hand
Answer and explanation in LearnFree account
Question 10 · Medium
A patient with left hemiplegia is positioned in side-lying on the affected side. How should the affected shoulder be placed?
1. AElevated above the head with the elbow flexed
2. BProtracted, with the arm forward and not lying on the point of the shoulder
3. CRetracted, with the arm tucked under the trunk
4. DInternally rotated, with the hand trapped under the body
Answer and explanation in LearnFree account
Question 11 · Medium
Oral baclofen reduces spasticity mainly by acting as:
1. AA blocker of calcium release in muscle fibres
2. BAn acetylcholine release blocker at the motor end plate
3. CA GABA-B receptor agonist in the spinal cord
4. DAn alpha-2 agonist acting on the brain stem
Answer and explanation in LearnFree account
Question 12 · Hard
A patient's Glasgow Coma Scale record shows eyes opening to voice, no recognisable words (incomprehensible sounds), and flexion withdrawal to pain. What is the total score?
1. A7
2. B10
3. C9
4. D8
Answer and explanation in LearnFree account
Question 13 · Medium
A hemiplegic patient catches her toes during swing phase because of weak dorsiflexors, although the knee is stable. Which device is most appropriate?
1. AA dorsiflexion-assist ankle-foot orthosis
2. BA hip abduction orthosis
3. CA knee-ankle-foot orthosis with locked knee
4. DA rigid cervical collar
Answer and explanation in LearnFree account
Question 14 · Hard
A hemiplegic patient shows genu recurvatum in stance, with a stiff plantarflexed ankle and weak quadriceps. Which orthosis setting best reduces the knee hyperextension?
1. AAn ankle-foot orthosis with a plantarflexion stop set in slight dorsiflexion
2. BAn ankle-foot orthosis set in 15 degrees of plantarflexion
3. CNo orthosis and heel lifts only
4. DA knee orthosis that allows free hyperextension
Answer and explanation in LearnFree account
Question 15 · Easy
The National Institutes of Health Stroke Scale is used mainly to:
1. ARate stroke severity from 0 to 42
2. BMeasure ability in daily living from 0 to 100
3. CGrade spasticity of a single muscle group
4. DAssess the risk of falls in the ward
Answer and explanation in LearnFree account
Question 16 · Easy
Which description fits Brunnstrom stage 1 of motor recovery after stroke?
1. ASpasticity at its peak with basic synergies
2. BMovement out of synergy appearing
3. CFlaccidity with no voluntary movement
4. DIsolated joint movements with near-normal speed
Answer and explanation in LearnFree account
Question 17 · Medium
A woman with left neglect after a right hemisphere stroke eats only the right half of her plate. Which approach is most helpful?
1. ATeach her to ignore the left side of the plate
2. BPlace everything on her right to make eating easier
3. CCue her to scan toward the left and place items to be used on the left side
4. DReduce all stimulation on the left side
Answer and explanation in LearnFree account
Question 18 · Hard
A man has an elbow flexor Modified Ashworth grade of 3 and an early flexion contracture, and he finds it hard to dress. Which plan is most appropriate?
1. AOral baclofen only, at a high dose, to reduce tone in all of the muscles
2. BPassive stretching alone, twice a week, with no splinting or other treatment
3. CBotulinum toxin A to the elbow flexors with stretching, serial splinting and task practice
4. DElbow immobilisation in a flexed position for comfort, with a sling worn day and night, long term
Answer and explanation in LearnFree account
Question 19 · Medium
A patient with a left homonymous hemianopia often bumps into objects on the left. What should the therapist teach?
1. AMove the furniture so everything is on the left
2. BTurn the head and eyes to the left to scan the affected field
3. CKeep the head still and look straight ahead
4. DWear a patch over the right eye permanently
Answer and explanation in LearnFree account
Question 20 · Medium
When testing tone with the Modified Ashworth Scale, how should the limb be moved?
1. APassively through the full range in about 1 second
2. BActively by the patient against resistance
3. CVery slowly over about 10 seconds
4. DQuickly with a sudden jerk to elicit the catch
Answer and explanation in LearnFree account
Question 21 · Easy
Which gait deviation is typical of hemiplegic walking?
1. ACircumduction of the affected leg with hip hiking
2. BShort, shuffling steps with festination
3. CTrendelenburg gait with the pelvis dropping on the stance side
4. DWide-based staggering gait with reeling
Answer and explanation in LearnFree account
Question 22 · Medium
A patient can place his hand behind his back, raise the arm forward to 90 degrees with the elbow straight, and rotate the forearm with the elbow flexed at 90 degrees. Which Brunnstrom stage fits?
1. AStage 3
2. BStage 5
3. CStage 4
4. DStage 6
Answer and explanation in LearnFree account
Question 23 · Easy
On the Modified Ashworth Scale, a grade of 1+ means:
1. AAffected part rigid in flexion or extension
2. BConsiderable increase in tone with passive movement difficult
3. CA slight increase in tone with a catch and minimal resistance through less than half of the range
4. DNo increase in muscle tone
Answer and explanation in LearnFree account
Question 24 · Medium
Which scale is based on the Brunnstrom stages and measures motor impairment after stroke, with a maximum motor score of 100?
1. AFugl-Meyer Assessment
2. BGlasgow Coma Scale
3. CBarthel Index
4. DFunctional Independence Measure
Answer and explanation in LearnFree account
Question 25 · Hard
A stroke patient has an elbow resistant to passive stretch at every speed, and tone does not change when the elbow is moved slowly or after a nerve block. What is the most likely cause?
1. AContracture of the muscle and connective tissue
2. BCerebellar hypotonia with pendular reflexes
3. CVelocity-dependent spasticity of the elbow flexor muscles
4. DFlaccid paralysis from a lower motor neuron lesion
Answer and explanation in LearnFree account

35 more Stroke and brain injury rehabilitation questions

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Stroke and brain injury rehabilitation

A woman has left arm and leg weakness, left sensory loss, ignores objects on the left and has her eyes deviated to the right. Which diagnosis best fits?

Unilateral spatial neglect most commonly follows a stroke in which area?

A middle cerebral artery stroke typically causes:

What is the typical extensor synergy of the hemiplegic lower limb?

Functional electrical stimulation is applied to prevent or reduce shoulder subluxation. Which muscles should be stimulated?

Which mechanical measure has the best evidence for preventing deep vein thrombosis in immobile stroke patients?

A physiotherapist notes coughing and a wet voice when a stroke patient sips water. What is the best action?

A patient has a right homonymous hemianopia with macular sparing after a stroke. Which vessel territory is most likely affected?

A carer pulls a hemiplegic patient up by the affected arm to move him up the bed. What advice should the physiotherapist give?

A patient with left hemiplegia is positioned in side-lying on the affected side. How should the affected shoulder be placed?

Oral baclofen reduces spasticity mainly by acting as:

A patient's Glasgow Coma Scale record shows eyes opening to voice, no recognisable words (incomprehensible sounds), and flexion withdrawal to pain. What is the total score?

A hemiplegic patient catches her toes during swing phase because of weak dorsiflexors, although the knee is stable. Which device is most appropriate?

A hemiplegic patient shows genu recurvatum in stance, with a stiff plantarflexed ankle and weak quadriceps. Which orthosis setting best reduces the knee hyperextension?

The National Institutes of Health Stroke Scale is used mainly to:

Which description fits Brunnstrom stage 1 of motor recovery after stroke?

A woman with left neglect after a right hemisphere stroke eats only the right half of her plate. Which approach is most helpful?

A man has an elbow flexor Modified Ashworth grade of 3 and an early flexion contracture, and he finds it hard to dress. Which plan is most appropriate?

A patient with a left homonymous hemianopia often bumps into objects on the left. What should the therapist teach?

When testing tone with the Modified Ashworth Scale, how should the limb be moved?

Which gait deviation is typical of hemiplegic walking?

A patient can place his hand behind his back, raise the arm forward to 90 degrees with the elbow straight, and rotate the forearm with the elbow flexed at 90 degrees. Which Brunnstrom stage fits?

On the Modified Ashworth Scale, a grade of 1+ means:

Which scale is based on the Brunnstrom stages and measures motor impairment after stroke, with a maximum motor score of 100?

A stroke patient has an elbow resistant to passive stretch at every speed, and tone does not change when the elbow is moved slowly or after a nerve block. What is the most likely cause?