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128 Cards in this Set

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Cerebral Palsy
weakness, paralysis, poor muscle tone, coordination, normal reflexes appear uninhibited or axaggerated
occurs prior or at birth as a result of brain damage
quadraplegia
all 4 limbs
paraplegia
2 matching limbs (ie legs)
diplegia
Right arm, left leg
Left arm, right leg
hemiplegia
one side
triplegia
combo of di-hemiplegia
monoplegia
one, usually arm
Spasticity CP
lesion to motor cortex= hypertension
muscular contractions and postural deviation
voluntary movements
most prevalent
When lower limbs affected with spasticity CP
scissor gait
When upper limbs affected with spasticity CP
pronated forearms with flexion at elbows, wrists, and fingers
Anthetosis CP
lesion to basal gnaglia
costant involuntary, uncontrolable unpurposeful movement
excitement and tension exacerbate movements
uncontrolable head and facial movement
2 most common
affects head and neck
tremors very rhythmic and go away with relaxation
Ataxia CP
lesion in cerebellum
balance issues and proprioceptor deficits
falls and uncoordinated movement
poor kinesthetic movement
tend to walk unsteady and misjudge distances
3rd prevalent
Rigidity CP
lesion affecting motor cortex and basal ganglia
diminished stretch reflex, stiffness and hypertension of body parts
most severe form
Tremor CP
lesion affecting cerebellum or basal ganglia
involuntary uncontrolled rhythmic movement
Mixed CP
when more than one form of CP exists
MR appears with...
spastcity and rigidity
TR and CP
develop tolerance through fitness and cardio
relaxation and stress management
promote bi-lat motor functioning
Seizure
neurological condition resulting in abn. brain fuction
sudden change in consciousness or behavior characterized by involuntary motor activity
can only have one or have them all the time
Epilepsy
refers to a group of syndrome characteristics characterized by repeated seizures
40 types
cause is unknown
Partial Seizures
start in specific body site
one cerebral hemisphere
Simple Partial
consiousness not affected
Jacksonian Partial
most common, jerky muslce
Complex type
Psychomotor
unexplained short term behavior changes they are not aware
Generalized Seizures
involve all or several parts
both hemispheres
simple seizure can progress into this
Tonic Cloric Seizure (grand mal)
most common gen
preceeded by simple seizure
rigid (tonic) then jerky (clonic) movements
loss of consciousness then sleep or coma stage
Absence (petit mal)
brief lapses in conciousness
pause and then continue talking
Myclonic
violent muslce contractions
Atonic (drop)
resmeble absence except the person cannot have posture
What types of things should one consider when working with persons with seizure disorders?
stress, hypertension, hyperthermia, increase blood alkalinity, hypoglycemia, fatigue, infection, mestral periods, strobe lights
Seizures and TR
psych well being, lifestyle and functioning
no contact sports
Medication for Seizure
anticonvulsant, dialantin, tegretol and luminal
Side affects from meds
reduced coordination
zzz
slurred speech
irratability
dry mouth
gum and liver damage with prolonged use
Multiple Sclerosis
causes deterioration of myelin sheath that covers many nerve fibers in CNS
interupt blood flow to brain
depression and mood problems
Plaque
scar tissue that replaces myelin sheath
Period of exacerbation with MS
have periods of remssion and exacerbation, each exacerbation more severe than last
very progressive
Risk factors of MS
women
teporate climates
family history
living in midwest
immune disorder
Patters of Progression in MS
4
relapsing remitting
unpredictable attacks followed by months to years of no disease activity
deficits during attacks may or may not be permanent
85-90%
secondary progressive
begin to have neurological decline between attacks
most common
worsening cognitive function
causes greatest amount of disability
primary progressive
progressive disease with no remission
decline continues with no clear attack
40-60yo
10%
progressive relapsing
from absent of their MS, have a steady neurological decline but also sugger superimposed attacks
Things that affect relapse in persons with MS
spring/summer
common cold/flu
trauma/ injury
stress
heat
TR and MS
fucntioning after attack
preventing attack
dont overheat with exercise
balance
endurance
flexibility
stamina
contracture prevention
ADL skills
cognitive activities
adaptive lifestyle changes
family involvement
introduce adaptive equip
Intervention with MS
water exercise
community re-entry
ROM
deep breathing
sports
social
join support groups
leisure education
Medications for MS
betaseron
avoxhex
copasone
ACTH injections
vitamin therapy
steroids- corticostroids(prednisone)
mild CNS stimulants- caffine, ritalin, dextroamphetimine--reduces fatigue
Delivery settings
hospital, rehab, residential programs, community programs, skilled nursing facilities, outpatient day treatmet, home health
Brainstem
most people with disorders to brainstem, die
swallowing, respiration, HR
Cerebrum
divided into LR hemi
joined by corpus colosum
frontal, temportal, parietal, occipital
lobes receive and imput sensory info
Right hemi
non dominant, creativity, perceptual
Left hemi
dominant, language, logic
Frontal lobe
motor skills, speech, intellectual, behavioral, personality, temper
Broca's area
language
left frontal
Occipital
receive and process visual information
Right occ- interprets
Left occ- visa versa
how humans perceive colors and shapes
Parietal
interprets simultaneously signals received from other areas of the brain
gibing meaning to objects
Damage to right parietal
vision percetion
Damage to left parietal
understanding spoken or written language
Temportal
visual memory recognition objects and peoples faces
Damage to L Temo
verbal memory and understanding laguage
Damage to rear temporal
inability to interpret peoples emotions or actions
Damage to right temporal
visual pictures
cerebellum
motor coordination
movement is initiated in cerebral cortex but coordinated by cerebellum
ipsilateral (one sided)
Cerebral problems
balance and coordination problems are hallmarks
ataxia- speech
CVA
interuption of blood flow to the brain
caused by cerebral thrombosis, embolism or heammorhage
Occulated Strokes
blocked
Cerebral thrombosis
blood clot in brain that slowly stops the blood supply to one particular area
60%
cerebral embolism
bloot clot or fatty material that travels to the brain and interuppts blood supply
60%
hemmorhage strokes
occur when a blood vessle ruptures and leaks blood into the brain or surrounding areas
damage to brain comes from loss of blood beyond rupture point and from the pressure of the blood
Transient Ischemic Attack (TIA)
inconplete stroke
looks like a stroke, but will recover within 24 hrs
Left CVA Physical
right side physical effects
right hemiplegia/hemiparesis
decrease swallowing, dysphasia
sleep
occasional seizures
Left CVA Cognitive
aphasia
word finding problems
reading/writing problems
attention
diff with LR
memory
Left CVA Emotional
hard time expressing emotion
depression
Left CVA Social
easily frustrated
Right CVA Physical
Left body
decrease or increase in sensation
change in vision
dysphasia
sleeping
seizures
Right CVA Cognitive
time and space problems
perceptual
decrease in hand eye coor
body image distortion
decrease reading comprehension
increase confuion in new enviroments
poor safety
talk alot
impatient
repitition
hallucinations
Right CVA Emotional
depression
expression
denial
lack of awareness
Right CVA Social
uninhibited
lost social grace
lots of verbal outbursts
Brainstem strokes
HR, breating and other fucntions
very specific area of therapy--swallowing
no purposeful movement or communication
Complications of Strokes
2
Neglect
usually visual but also can occur with body
things on neglected side are not seen
Shoulder problems
subluxation/spasiticity-- shoulder drops
always support in all activities
Never grab someone at armpits to transfer
Meds for CVA
...
Beta-blockers
decrease HR and BP
side effects-- fatigue
Ca Channel Blockers
Cardisem, procardia, calan
Diuretics
work by getting fluids away
lasix, maxioretic
side effects-- muslce craps, headache, sun sensitivity, cry mouth, increase urination, vertigo, decrease K+
Anticoagulants
prevent clots and improve cerebral functioning
asprin, coumadin, heparin, persantine
side effects-- bruise easily, lost of bleeding with cuts, increase anxiety, weakness, dizziness
Anti-platelets
decrease platelet adhesiveness
asprin, ticlid
side effects- high fatigue, decreased frustration tolerance, GI
Areas of change
...
Psychosocial
loss of control
need help in times of stress
changes ability level
ways of interacting,socially
changed intrests, priority and roles
Physical
hemiparesis, weakness on a side
Hemiplegia- paralysis
weight baring appendages recover faster
Cognitive
changed ability to indentify errors in thinking
change in arousal and attention
ridlin used
memory
changed ability to demonstrate judgement and safety
sequencing
ADL's Activities of Daily Living
self care
house mangement
changed ability and leisure intrests
community re-entry
prevocational and vocational skills
sensorimotor
change in ability to perform ROM
muslce tone
endurance
upper and lower extremities may need to change handedness
sensory/perceptual
change in tactile
visual or auditory responses
visual percetion awareness and motor planning
awareness of body position
TR and CVA
leisure needs unique to indi
needs met in group or indi
lots of encouragement
adaptations
new learning with injured brain
language
apathy and depression
fatigue
1st year of recovery msot important
TR and Client/Family Involvement
adjust neglect
prevent contractures and spastcity
spactial, perceptual and bilat
strength
Short term goals with CVA
exercise, route finding, relaxation,
Long term goals with CVA
keep client and family reintegrate into community and social circles
FIM- Fucntional Independace measure
scale of 0-7, 7 being the most independent
TBI
permanent sudden damage caused by concussion, contusion, or hemmorhage and may result from trauma to the head
leading cause of death under 35
MVA, aneurysms, drup, falls, assults and sports
Closed Head injury
most
no visual damage but inward in skull
dural lining not penetrated
primary damage is blunt blow or concussion
Open head injury
penetrated by foreign object
Secondary Complications of TBI
...
Hematoma
bleeding occuring anywhere within the skull,extracted to release presssure
menigitis/encephalitis
infection can set in
Cerebral edema
holes to relieve ICP
Impairments of TBI
depends on affected area
impairments compared to CVA, but not as organized
Pediatric TBI
recover easier leaves more room for swelling
Cognitive and Emotional Recovery with TBI
agressive treatment
1st 6 mos critical
personality change
frustration
behavior
loose social contacts
Rancho Los Amigos
I No Response
II Generalized response
III Localized response
IV Confused-agitated
V Confused-inappropriate
VI Confused-appropriate
VII Automatic-inappropriate
VIII Purposeful and appropriate
Recommended interventions
• I, II, III= sensory stimulation, passive stretching, art, movement to music, cognitive retraining, RO
• IV,V, VI= aquatic therapy, expressive arts, leisure Ed, hort, behavior management, stretching, flexibility, table and board games
• VII,VIII- computer,leisure referral, community integration, expressive arts, social skills
Glasglow Coma Scale
quantifying level of consciousness following traumatic brain injury.

One determines the best eye opening response, the best verbal response, and the best motor response
Spinal Cord Injuries
...
complete
no motor fucntion
s4-5
incomplete
sc is not completely severed
so varying amount of control is still used below the injury
feeling with no movement
spinal cord bruised
not always complete recovery
severence of above T2
quadraplegia
severance above T2
paraplegia
vetebral breakdown
cervical- C1-8, control repiration
Thoracic- T1-12, upper body
Lumbar- L1-5, lower body
Saccrum- S1-4, bowel, bladder, sexual functions
Tumors
pts looks like they had SCI, TBI, CVA, but had tumor
malignent or benign
surgically remove them
most of the time the whole tumor does not come over
chemo, radiation
Craniotomy
surgical procedure to remove bone flap of the skull to access the brain
implant electrode
alot like TBI after craniotomy
Parkionson's
slow progressive neurological condition characterized by muscle rigidity
Bradykinesia
unique resting temor that starts at one extremity then spreading to the other extremities or the opposite side in a to and fro movement and instability
problems associated with parkinsons
speech swallow
depression
muscle rigigity
cognition/dememtia
order
Treament for Parkinson's
exercise
cognition challenges
adaptations
comm re-entry
Medications for Parkinson's
levodopa, bromocriptine, pergolicle, cogentin, sinement, carbidopa
--drugs are used to lessen muscle rigidity, balance problems, tremors,
Guillian's Berre
transient neuromuscular disease that affect young and adults with no known cause
can happen in 1-3 weeks
progression can happen so fast that you end up on repirator
flaccide paralysis and denervation atrophy
treatment for GB
dpends on degree of paralysis
muscle promoting activities
orthodics
sensory stimulation
medical options for GB
plasmaparesis- cleaning blood
IVIG- intraveneous immunoglobulin hormone
no cure, may return
amyotrophic lateral sclerosis (ALS)
progressive neurodegenerative disease
eventually leads to death
voluntary muscles affected
rapid progression
die within 1/10 years
legs decrease in use
fine motor stays in tact
breathing becomes labored
speech is slow and thick
swallow issues