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61 Cards in this Set
- Front
- Back
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How are the various visual, motor, sensory, cognitive and psychological deficits in MS caused?
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-autoimmune disease
-attacks myelin sheath around axons of brain and spinal chord -viral infection may trigger -dymyelination results in scarring, resulting in reduced ability to carry electric impulses - |
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What are the symptoms of ALS?
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-atrophy of small muscles in hands and feet
-foot drop -night cramps -hyperactive reflex -progressive loss of muscle movement, distal to proximal, lateral to medial |
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Where does the neurological damage occur with ALS?
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Deterioration of anterior horn cells of spinal cord
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Where does the neurological damage occur with Parkinsons?
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Areas of deep brain (melanin-pigmented dopamine-producing substantia nigra portion of basal ganglia in the brain) resulting in decreased stimulation of motor cortex
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What are the symptoms of Parkinsons?
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1. Resting tremor (pill rolling, cogwheel)
2. Muscle rigidity 3. Bradykinesia 4. Postural instability 5. Lack of eye blinking 6. Loss of facial expression 7. Gait disturbances (shuffling, reduced arm swing, difficulty turning) 8. Small handwriting 9. Temporary Immobilization 10. Cognitive impairments (visuospatial, memory, executive function - frontal lobe) 11. Sensory loss 12. Muffled speech 13. Frequent swallowing 14. Poor balance 15. Oculomotor impairments 16. Sleep disturbance 17. Reduced bowel and bladder function 18. Painful cramping 19. Sexual dysfunction 20. Low BP 21 Seborrhea 22. Depresson, anxiety, fatigue |
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In which neurological condition (MS, Parkinsons, ALS) are dopamine-related medications used to temporarily alleviate the symptoms
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Parkinsons
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What type of Occupational Performance of the LE might be affected by the early symptoms of ALS ?
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Early symptom - foot drop. Walking, running, dancing, going up steps, getting in and out of a bathtub
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What type of Occupational Performance of the UE might be affected by the early symptoms of ALS?
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Early symptom - atrophy of small muscles in hands
Buttoning a shirt, typing on a computer, putting in contact lenses, playing a piano, using a knife, writing |
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What type of Occupational Performance of the UE might be affected by the early symptoms of Parkinsons?
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early symptom: resting tremor
Brushing teeth, sewing, eating, drinking |
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What type of Occupational Performance of the LE might be affected by the early symptoms of Parkinsons?
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early symptom: shuffling gait, poor trunk control (posture)
Walking up stairs, dancing, getting in and out of cars, sitting, walking around house (throw rugs) |
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Of the three neurological conditions - MS, ALS, Parkinsons, which affects more women than men?
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MS
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A person complaining of visual deficits and other sensory impairments, difficulty speaking, coordination problems, emotional disturbances, memory and concentration problems and, especially, fatigue is most likely referring to symptoms of which of the three neurological conditions?
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MS
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The prevalence (in the US) of the three progressive neurological disorders (MS, ALS, Parkinsons) is lowest for which disorder?
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ALS
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In addition to resting tremor, one or two easily-observed signs strongly identified with advancing Parkinson's disease related to walking are what?
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Shuffling gait, poor postural control
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The progress of the disease is most rapid in which of the three diseases: MS, ALS, Parkinsons?
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ALS - death in 3 to 5 years from diagnosis
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If a person reported symptoms of foot drop, you might well suspect, of the three progressive neurological disorders studied, the initial signs of which condition?
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ALS
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It is not uncommon for some persons to have periods of complete remission of symptoms - for short or long periods - in which disease: MS, ALS, Parkinsons?
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MS
There are 4 patterns: benign, relapsing, relapsing-remitting-progressive, progressive |
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Life span is dramatically cut short for most persons diagnosed with which condition?
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ALS
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With all of the Progressive Neurological Disorders, as more and more deficits occurs, would an OTA be wise to focus more - or less - on leisure activities?
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more
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What is an "incomplete" spinal cord injury?
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The spinal cord is only partially damaged - partial transection
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Anterior Cord Syndrome
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Incomplete spinal cord injury
Loss of motor function Loss of heat, pain and tactile sensation Light touch and proprioceptive awareness preserved |
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Brown-Sequard's Syndrome
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Incomplete spinal cord injury
One side of spinal cord damaged, usually from stab or GSW Ipsilateral loss of motor function Ipsilateral reduction (not loss) of deep touch and proprioceptive (because many of the nerves cross) Contralateral loss of pain, temp and touch Challenge: extremities with greatest strength have poorest sensation |
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Central Cervical Cord Syndrome
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-UE more impaired than the lower
-hyperextension of the neck combined with narrowing of spinal cord -more prevalent in older pop due to spinal cord narrowing |
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In general, do muscles above the point of a spinal cord injury remain functional?
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Yes
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Upper motor neuron
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-Originate in motor region of cerebral cortex
-Carry information down spinal cord |
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Lower motor neuron
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-Nerves from spinal cord and brain stem that terminate in muscle fibers
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upper motor neuron injuries
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-Reflex arcs are intact below injury but are not mediated by the brain
-loss of voluntary function below level of injury -spastic paralysis -no muscle atrophy -hyperactive reflexes |
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Lower motor neuron injuries
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-involving spinal nerves after they exit the cord at any level
-reflexes cannot occur -loss of voluntary funciton -flaccid paralysis -muscle atrophy -absence of reflex. |
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If a lower motor neuron in the sacral area of the back was severed, would reflex activity of the muscles previously innervated by that nerve still be possible?
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NO
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If your SCI patient is experiencing sudden headache, sweating, blushing and/or goose bumps, you might suspect what?
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Autonomic Dysreflexia or Hyperreflexia (usually occurs in SCI above T6)
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If your SCI patient is experiencing sudden headache, sweating, blushing and/or goose bumps, what might that result in?
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Because blood pressure may elevate dramatically, risk of stroke or death if not treated
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If your SCI patient is experiencing sudden headache, sweating, blushing and/or goose bumps, what would be the correct course of action?
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-Find the cause and alleviate it.
-If from overfull bladder, empty bladder -check for kinks or blockages in urinary tubing -Check for infection such as ingrown toenails, bedsores -Check for bowel impaction -Lower blood pressure by sitting person upright |
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In SCI patients, what happens to temperature regulation in parts of the body affected by the injury?
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-In the first year after injury, body assumes temperature of external environment (poikilothermia). Body does adjust in time, although temperature regulation is a problem. In cold weather, blood vessels below injury do not constrict to conserve energy; conversely, in warm weather, excessive sweating may occur above the injury but not below.
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What is heterotrophic ossification, what what might it do to the patient's ROM?
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-Abnormal formation of bone deposits on muscles, joints and tendons
-Occurs mainly in hip and knee -Severely limits ROM |
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How often should a person with SCI perform (or have someone else perform) a visual skin inspection of bony prominences?
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At least twice daily
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What is the highest level of SCI at which a person could reasonably be expected (with adaptations) to ADLS and use a manually powered wheelchair?
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C-6 to C-7
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What is the highest level at which full use of the fingers might be expected?
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T-1
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Traumatic Brain Injury can occur due to sudden changes in the motion of the brain through space in what three ways?
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Acceleration, Deceleration, and Rotation
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Brain injury that occurs during the traumatic event at the point of impact is called?
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coup
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Brain injury that occurs on the opposite site of the initial rain impact (due to the rebound effect) is called?
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contrecoup
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Primary brain damage
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Damage caused directly by the traumatic injury
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Secondary brain damage
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Subsequent damage to the brain caused by physiological events that happen after impact
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Damage to the brain after the injury, due to things like swelling of the brain or the pressure of clotted blood on the brain are referred to as what type of damage?
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Secondary
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What type of treatment might be important for an OTA in working with a patient in a deep coma state? Why?
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PROM, positioning to promote sensory awareness, prevent contractures, provide stimulation
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If you are assigned to a Level II fieldwork placement in a hospital that specializes in TBI, the population you will be mostly likely to see (over) represented there is typically of what gender? What age group?
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Men 15-24 yo resulting from MVA
-secondarily, adults over 75, children under 5, inner city population |
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What is the name of the scale which describes a typical pattern of progression for recover of cognitive skills after a TBI?
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Rancho Los Amigos Level of Cognitive Functioning Scale (LFCS)
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What scale besides the Rancho Los Amigos is commonly used with TBI victims to predict outcomes?
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Disability Rating Scale (DRS)
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Order of Progression of Rancho Los Amigos Scale
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Level I - no response
Level II - Generalized response Level III - Localized response Level IV - Confused, agitated response Level V - Confused, inappropriate nonagitated response Level VI - confused, appropriate response Level VII - Automatic, appropriate response Level VII - purposeful, appropriate response |
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At which RLA (Rancho Los Amigos) stage might the patient be most potentially violent?
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Level IV
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What is monoplegia?
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paralysis of a single limb
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What is the best predictor of successful reemployment potential for a person who has experienced a TBI?
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return of good psychosocial skills
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Kuru facts
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Neuromuscular disease similar to mad cow, found in Papua New Guinea, from the tribes cannibalism. a prion disease
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Osteogenesis Imperfects facts
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Main symptom is brittle bones, water therapy is a great form of therapy, and there is no cure
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Syndactyly facts
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Found in males/females 2-1, women to avoid smoking in pregnancy, simple syndactyly involves the tissue, complex form involves the bone
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Gout facts
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More common in males, from high uric acid. Exercise, maintaining healthy weight and avoiding high purine foods to avoid. The main cause is uric acid crystals.
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Progeria facts
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Premature aging, affects 1 in 8 million, symptoms include pinched nose, hair loss and limited growth, caucasian males 1.5 times more likely
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Order of Progression of Rancho Los Amigos Scale
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Level I - no response
Level II - Generalized response Level III - Localized response Level IV - Confused, agitated response Level V - Confused, inappropriate nonagitated response Level VI - confused, appropriate response Level VII - Automatic, appropriate response Level VII - purposeful, appropriate response |
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At which RLA (Rancho Los Amigos) stage might the patient be most potentially violent?
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Level IV
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What is monoplegia?
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paralysis of a single limb
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What is the best predictor of successful reemployment potential for a person who has experienced a TBI?
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return of good psychosocial skills
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RDEB facts
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Recessive Dystrophic Epidermolysis Bullosa - rare skin disorder than causes skin blistering in response to minor injury - dermis fails to attach to basement membrane. Butterfly children, cotton wool babies. Daily skin care includes popping blisters applying ointment and wrapping
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