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82 Cards in this Set
- Front
- Back
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TRANSIENT ISCHEMIC ATTACK
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Transitory stroke that lasts only a few minutes
Symptoms include: numbness or weakness in the face, arm, or leg, especially on one side of the body; confusion or difficulty in talking or understanding speech; trouble seeing in one or both eyes; difficulty with walking, dizziness, and/or loss of balance and coordination |
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CEREBRAL INFARCTION
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Due to either embolism or thrombosis of the intra or extracranial artires
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CEREBRAL HEMORRHAGE
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Bleed secondary to hypertension or aneurysm
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CEREBRAL ARTERIOVENOUS MALFORMATION (AVM)
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Abnormal, tangled collection of dilated blood vessels that result from congenitally malformed vascular structures
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MIDDLE CEREBRAL ARTERY (MCA) STROKE
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Results in contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, aphasia and/or apraxia
Hemianesthesia: Loss of sensation on one side of the face and loss of pain and temperature sense on the opposite side of the body. |
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INTERNAL CAROTID ARTERY (ICA) STROKE
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Results in contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, aphasia and/or apraxia
Hemianesthesia: Loss of sensation on one side of the face and loss of pain and temperature sense on the opposite side of the body. |
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ANTERIOR CEREBRAL ARTERY (ACA) STROKE
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Results in contralateral hemiplegia, grasp reflex, incontinence, confusion, apathy and/or mutism
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POSTERIOR CEREBRAL ARTERY (PCA) STROKE
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Results in homonymous hemianopsia, thalamic pain, hemisensory loss, and/or alexia
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VERTEBROBASILAR SYSTEM STROKE
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Results in pseudobulbar signs: dysarthria, dysphagia, emotional instability and tetraplegia
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LEFT HEMISPHERE STROKE DEFICITS
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Movement of right side of body
Processing of sensory infromation from right side of body Visual reception from right field Visual verbal processing Bilateral motor praxis Verbal memory Bilateral auditory reception Speech Processing of verbal auditory information |
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RIGHT HEMISPHERE STROKE DEFICITS
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Movement of left side of body
Processing of sensory information from left side of body Visual reception from left field Visual spatial processing Left motor praxis Nonverbal memory Attention to incoming stimuli Emotion Processing of nonverbal auditory information Interpretation of abstract information Interpretation of tonal inflections |
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TRAUMATIC BRAIN INJURY (TBI)
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Damage results from penetration of the skull or from rapid acceleration or deceleration of the brain
Symptoms: Concussion, hemiplegia/monoplegia, abnormal reflexes, decorticate or decerebrate rigidity, fixed pupils, coma, changes in vital signs |
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GLASGOW COMA SCALE
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Highest total: 15 (fully conscious)
> 13: minor 9-12: moderate < 8: severe Lowest possible score: 3 (coma/death) |
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SPINAL CORD SYMPTOMS
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Spinal Shock
Sensory deficits may be partial loss or complete Loss of bowel/bladder control Loss of temperature control below the lesion Decreased respiratory function Sexual dysfunction Change in muscle tone; spasticity in upper motor neuron lesion, flaccidity in lesions below L1 Loss of motor function resulting in quadriplegia or paraplegia; may be complete or incomplete |
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SPINAL SHOCK
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4-8 weeks after injury; all reflex activity is obliterated below the level of the injury presenting as flaccid paralysis
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CENTRAL CORD SYNDROME
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Resulting from hyper-extension injuries and presenting as more upper extremity deficits vs. lower extermities
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BROWN-SEQUARD
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Hemi-section of the cord resulting in ipsilateral spastic paralysis, ipsilateral loss of position sense and discrimitive touch, contralateral loss of pain and thermal sense
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ANTERIOR CORD
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Caused by flexion injuries; motor function, pain, and temperature sensation are lost bilaterally below the lesion
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CONUS MEDULLARIS
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Injury of the sacral cord and lumbar nerve roots resulting in lower extremity motor and sensory loss and a reflexic bowel and bladder
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CAUDA EQUINA
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Injury at the L1 level and below resulting in a lower motor neuron lesion; flaccid paralysis with no spinal reflex activity
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AUTONOMIC DYSREFLEXIA
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An abnormal response to a noxious stimulus that results in an extreme rise in blood pressure, pounding headache, and profuse sweating. The complication is deemed a medical emergency if not reversed by removing the irritating stimulus quickly
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RANCHO LEVEL I
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No response: Total Assist
Complete absence of observable in behavior when presented visual, auditory, tactile, proprioceptive, vestibular or painful stimuli |
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RANCHO LEVEL II
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Generalized Response: Total Assistance
Generalized reflex to painful stimuli Responds to repeated auditory stimuli with increased or decreased activity Responses may be significantly delayed |
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RANCHO LEVEL III
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Localized Response: Maximal Assistance
Demonstrates withdrawal or vocalization to painful stimuli Responds inconstantly to verbal commands May respond to familiar persons but not to others |
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RANCHO LEVEL IV
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Confused/Agitated: Maximal Assistance
Alert and in heightened state of activity Absent short term memory May exhibit aggressive or flight behavior Unable to cooperate with treatment efforts |
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RANCHO LEVEL V
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Confused, Inappropriate Non-Agitated: Maximal Assistance
Alert, not agitated but may wander randomly or with a vague intention of going home No orientation to person, place or time Unable to learn new information Able to respond to simple commands fairly consistently with external structures and cues |
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RANCHO LEVEL VI
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Confused, Appropriate: Modified Assistance
Inconsistently oriented to person, time and place Able to attend to highly familiar tasks in non-distracting environment for 30 with moderate redirection Shows carry over for relearned familiar tasks/self-care Maximum assistance for new learning with little or no carry over |
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RACHO LEVEL VII
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Automatic, Appropriate : Minimal Assistance for Daily Living Skills
Consistently oriented to person and place, with highly familiar environments. Moderate assistance for orientation to time Able to attend to highly familiar tasks in a non-distraction environment for at least 30 minutes with minimal assist to complete tasks Minimal supervision for new learning, demonstrates carry over Superficial awareness of his/her condition but unaware of impairments that limit ability to safety and accurately carry out his/her routines Minimal supervision for ADLs/routines |
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RANCHO LEVEL VIII
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Purposeful, Appropriate: Stand By Assistance
Consistently oriented to person, place and time Independently attends to and completes familiar tasks for 1 hour in distracting environments Able to recall and intergrate past and recent events Requires no assistance once new activity is learned Depressed, irritable, argumentative, self-centered |
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RANCHO LEVEL IX
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Purposeful, Appropriate: Stand by Assistance on Request
Independently shifts back and forth between tasks and completes them accurately for at least two consecutive hours Preforms familiar occupations with assistance when requested Accurately estimates abilities but requires stand by assistance to adapt to task demands May be easily irritable and have low frustration tolerance |
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RANCHO LEVEL X
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Purposeful, Appropriate: Modified Independent
Able to handle multiple tasks simultaneously in all environments but may require periodic breaks Preforms familiar and unfamiliar occupations, may need extra time to complete Periodic periods of depression may occur Irritability and low frustration tolerance when sick, fatigue and/or under emotional stress |
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CEREBRAL PALSY (CP)
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Caused by injury and/or disease prior to, during or shortly after birth resulting in brain damage and secondary neurological and muscular deficits
Motor Cortex Lesion: Results in spasticity with flexor and extensor imbalance Basal Ganglia Lesion: Fluctuations in muscle tone causing dyskinesia, dystonia or athetosis Cerebellar Lesion: Ataxic movements and is characterized by a lack of stability so co-activation is difficult resulting in more primitive total patterns of movement |
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PARKINSON'S DISEASE
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A hypokinetic CNS movement disorder that is idiopathic, slowly, progressive and degenerative
Beings with a resting pill-rolling tremor of one hand, other signs include: rigidity, resistance to passive motion that is not velocity dependent (cogwheel rigidity), akinesia, postural instability, festinating gait, falling backwards (retropulsion) or forwards (propulsion), mask face and micrographia |
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HOEHN AND YAHR'S FIVE STAGE SCALE
(PARKINSON'S DISEASE) |
Stage 1- Unilateral tremor, rigidity, akinesia, minimal or no functional impairment
Stage 2- Bilateral tremor, rigidity or akinesia with or without axial signs, independent with ADL, no balance, impairments Stage 3- Worsening of symptoms, first signs of impaired righting reflexes, onset of disability in ADL performance, can lead to independent life Stage 4- Requires help with some or all ADLs, unable to live alone without some assistance, able to walk and stand unaided Stage 5-Confined to a wheelchair or bed, maximally assisted |
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SPINA BIFIDA OCCULTA
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A bony malformation with separation of vertebral arches of one or more vertebrae with no external manifestations
Does not usually result in any symptoms Occasionally slight instability and neuromuscular impairments, such as mild gait involvement and bowel or bladder problems may occur |
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OCCULT SPINAL DYSRAPHISM (ODS)
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When external manifestations such as a red birthmark, patch of hair, a dermal sinus, a fatty benign tumor, or dimple covering site are present
May result in spinal cord being split (diplomyelia) or being tied down teathered (diastematomyelia) which may lead to neurological damage and developmental abnormality as the child grows |
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SPINA BIFIDA CYSTICA
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An exposed pouch
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SPINA BIFIDA WITH MENINGOCELE
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Protrusion of a sac through the spine, containing cerebral spinal fluid and meninges; however, does not include the spinal cord
Does not usually result in any symptoms Occasionally slight instability and neuromuscular impairments, such as mild gait involvement and bowel or bladder problems may occur |
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SPINA BIFIDA WITH MYELOMENINGOCELE
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Protrusion of a sac through the spine, containing cerebral spinal fluid and meninges as well as spinal cord or nerve roots
Results in sensory and motor deficits occurring below the level of the lesion, and may result in lower extremity paralysis and/or deformities, and bowel and bladder incontinence |
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DUCHENNE'S MUSCULAR DYSTROPHY
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Most common form of muscular dystrophy
Detected between 2 and 6 years of age Symptoms: Enlargement of calf muscles and at times enlargement of the forearm muscles Weakness of the proximal joints progesses to the point that the child has to crawl up his thighs with his hands to stand from a kneeling position (known as Grover's sign) Weakness occurs in all voluntary muscles Individuals rarely survive beyond their early 20s due to respiratory problems, infections and cardiovascular complications |
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ARTHROGRYPOSIS MULTIPLEX CONGENITA
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Detected at birth; associated with loss of anterior horn cells
Presence of weakness, deformities and associated joint contractures Position of rest for the upper extremities tends to be internal rotation of the shoulders, extension of the elbows, and flexion of the wrists; for the lower extermities, there is flexion and internal rotation of the hips and clubfeet May be stable, mildly progressive or may improve Related problems include congenital heart defects, spinal defects,torticollis and involvement of the diaphragm |
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LIMB-GIRDLE MUSCULAR DYSTROPHY
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Onset begins between the first and third decades of life
PRoximal muscles of the pelvis and shoulder are initially affected Typically progresses slowly |
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FASCIOSCAPULOHUMERAL MUSCULAR DYSTROPHY
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Occurs in early adolescence
Involves the face, upper arms and scapular region, causing masking and decreased mobility of the face and the inability to life the arms above shoulder level |
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SPINAL MUSCULAR ATROPHY
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Infantile form known as Werdnig-Hoffman disease has a life expectancy up to approximately two years of age
The intermediate form is detected six months to three years of age and progresses rapidly with life expectancy to early childhood |
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CONGENITAL MYASTHENIA GRAVIS
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A disorder involving transmission of impluses in the neuromuscular juction
Onset starting near birth and occuring more frequently in males |
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CHARCO-MARIE-TOOTH DISEASE
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A disease involving the peripheral nerves marked by progressive weakness, primarily inperoneal [fibular] and distal leg muscles
Typically occurs in the teenage years or earlier |
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MYOPATHIES
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Symptoms are similar to dystrophies; however, myopathies progress slowly; resulting in a better prognosis
Weakness of the face, neck and limbs in characteristics |
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MUSCULAR DYSTROPHIES/ATROPHIES - SPECIFIC SYMPTOMS
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Low muscle tone and weakness contribues to abnormal movement patterns and delayed developmental milestones
There may be difficulty with oral motor feeding, necessitating a nasogastric or gastroomy tube Weakness contributes to deformities of the extremities and spine Difficulty with breathing may require tracheostomies or mechanical ventilators, and frequently results in death |
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PROGRESSIVE SUPRANUCLEAR PALSY
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Etiology: Manifested by loss of voluntary, but preservation of reflexive eye movements, bradykinesia, rigidity, axial dystonia, pseudobulbar palsy and dementia
Onset: later in life, death occurs 15 years after onset |
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HUNTINGTON'S CHOREA
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Etiology: An autosomal dominant disorder
Onset: Begins in middle age Characterized by choreiform movements and progressive intellectual deterioration Psychatric disturbances (personaility change, manic-depressive symptoms, and schizophreniform illness) may precede the onset of the movement disorder |
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CEREBELLAR/SPINOCEREBELLAR DISORDERS
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Characterized by ataxia, dysmetria, dysdiadochokinesia, hypotonia, movement decomposition, tremor, dysarthria and nystagmus
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STRUCTURAL CEREBELLAR LESIONS
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Includes vascular lesions (stroke) and tumor deposits, producing symptoms and sings appropriate to their locus within the cerebellum
Demyelinating plaques of multiple sclerosis may also arise in the cerebelum white matter and give rise to cerebellar symptoms Alocholism and nutritional deprivation can cause degeneration of the vermis and anterior cerebellum |
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FRIEDRICH'S ATAXIA
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Etiology: autosomal recessive inheritance
Onset occurs in childhood or early adolescence Symptoms: the prototype of spinal ataxia This process is characterized by gait unsteadiness, upper extremity ataxia and dysarthria Tremor may be a minor feature Presentation also include areflexia and loss of large fiber sensory modalities As the disease progresses scoliosis and cardiomyopathy are common |
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CEREBELLAR CORTICAL DEGENERATION
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Etiology: pathologic changes are seen in the cerebellum and their inferior olives
Onset being between 30 and 50 Symptoms: cerebellar symptoms are the only signs detectable |
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MULITPLE STSTEM DEGENERATION (OLIVOPONTOCEREBELLAR ATROPHIES)
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Etiology: Characterized by spasticity, extrapyramidal, sensory, lower motor neuron, and autonomic dysfunction
Onset occurs in young to middle life |
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AMYOTROPHIC LATERAL SCLEROSIS (ALS)
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Etiology: Motor neuron disease of unknown etiology
Onset occurs at an average age of 57 Symptoms: Muscle weakness and atrophy, evidence of anterior horn destruction Cramps and fasciculations precede weakness Signs usually being in the hands Lower motor neuron sings are soon accompanied by spasticity, hyperactive deep tendon reflexes and evidence of corticospinal tract involvement Dysarthria and dysphagia are evident Sensory systems, eye movemetns and urinary sphincters are often spared |
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ERB'S PALSY
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Brachial Plexus Disorder
A paralysis of the upper brachial plexus including the fifth and sixth cervical nerves; C7 may also be involved in some cases Muscles most often paralyzed include the supraspinatus and infraspinatus a well as the detoid, biceps, brachialis and subscapularis The arm cannot be raised , elbow flexion is weakened and weakness in retraction and protraction of the scapula may be noted The arm grossly presents with the arm straight and wrist fully bent After 6 months, contractures may being to develop Positioning and ROM exercises are necessary to retain external rotation, abduction and flexion |
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KLUMPKE'S PALSY
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A paralysis of the lower brachial plexus including the seventh and eighth cervical and first thoracic nerves
Relatively rare when compared to Erb's Palsy It results in paralysis of the hand and wrist, often ipsilateral Horner's syndrome (miosis, ptosis and facial anhidrosis [profuse sweating]) Hand is limp and fingers do not move |
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PERIPHERAL NEUROPATHIES
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Etiology: Peripheral neuropathy of a single nerve may be the result of trauma, pressure paralysis, forcible over extension of a joint, hemorrhage into a nerve, exposure to cold or radiation, or ischemic paralysis
Symptoms: A syndrome of sensory, motor, reflex and vasomotor symptoms Symptoms include pain, weakness and paresthesias in the distribution of the affected nerve |
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GUILLAIN-BARRE SYNDROME
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Etiology is unknown
Onset: any age Symptoms: Acute, rapidly progressive form of polyneuropathy characterized by symmetric muscular weakness and mild distal sensory loss/paresthesias Weakness is always more apparent than sensory findings and is a first more prominent distally Relatively minor sensory sings and symptoms occur Deep tendon reflexes are lost and sphincters are spared Respiratory failure and dysphasia may be seen in some cases |
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MYASTHENIA GRAVIS
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Disease caused by an autoimmune attack on neuromuscular joints
Symptoms: Common symptoms include ptosis, diplopia, muscle fatigue after exercises, dysarthria, dysphagia, and proximal limb weakness Sensation and deep tendon reflexes are intact Symptoms fluctuate over the course of the day In relapsing periods, quadriparesis may develop Life threatening respiratory muscle involvement may occur |
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POST-POLIO SYNDROME
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Some motor neurons infected with the polio virus die, others recover, recovering cells may break down years after recovery causing new muscle weakness
Typically develops 15 years after recovery from polio Symptoms: New onset of weakness Easily fatigued Muscle pain Joint pain Cold intolerance Atrophy Loss of functional skills |
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MULTIPLE SCLEROSIS (MS)
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Myelin damage
Occurs between the ages of 15 and 50 it is more often diagnosed when persons are in their 30s Symptoms: Multiple and varied neurological symptoms and signs, usually with remission and exacerbations Onset of symptoms is usually insideous Paresthesias in one or more extermeties, on the trunk, or in the face Weakness or clumsiness in the leg or hand is common Visual disturbances (diplopia, partial blindness, nystagmus, eye pain, etc) Emotional disturbances (lability, euphoria, and reactive depression) Vertigo Bladder dysfunction Cognitive features may include apathy, memory loss, lack of judgement and inattention Sensorimotor findings may include: spasticity, increased reflexes, ataxia, weakness, gait instability, easy fatigue, hemiplegia or quadriplegia |
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TREATMENT FOR PAINS
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Education about contributing factors
Assist the individual in identifying and responding adaptively to pain Assist the individual in developing strategies and using technies to manage pain (coping skills, stress management, yoga, etc) Refer to other professionals for direct pain/symptom control intervention Establish a realistic activity program |
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THALAMIC PAIN
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Continuous, intense pain occurring on the contralateral hemiplegia side; the result of a stroke involving the ventral posterolateral thalamus poor rehabilitation protential
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HERPES ZOSTER (SHINGLES)
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An acute, painful mononeuropathy caused by the varicella-zoster virus
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PSYCHOSOMANTIC PAIN
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The origin of the pain experience is due to mental or emotional disorders
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REFERRED PAIN
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Pain arising from deep visceral tissues that is felt in a body region remote from the site of pathology, resulting in tenderness and cutaneous hypperalgesia; eg medial left arm pain with heart attack; right subscapular pain from gallbladder attack
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SEIZURE ETIOLOGY
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Abnormal bursts of electricity interfere with normal brain function
Seizures are usually idiopathic; they can be hereditary Seizures are often associated with conditions that involve scarring in the brain: 1. Severe head injury 2. Cerebral palsy 3. Hydrocephalus 4. Metabolic disorders 5. Infections, meningitis, encephalitis, congenital infections 6. Rubella |
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SEIZURES- OCCUPATIONAL THERAPY EVALUATION AND TREATMENTS
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1. Assess and intervene for any developmental delays as necessary
2. Observe all medical and safety precautions 3. Document and report any seizure activity, medication side effects, or behavioral changes |
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STAGE 1
REISBURG'S STAGES FOR DEMENTIA |
No disability found
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STAGE 2
REISBURG'S STAGES FOR DEMENTIA |
The person complains about forgetting normal age-related information (location of objects: keys, wallet, etc)
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STAGE 3
REISBURG'S STAGES FOR DEMENTIA |
Beginning signs and deficits are noted in this stage
Strengths 1. Remains independent in IADL 2. Can recognize challenging situations to avoid, in order to minimalize manifested deficits 3. Can utilize compensation as an adaptive mechanism Weaknesses 1. Forgets important information for first time in one's life 2. Experiences difficulty completing complex 3. Experiences difficulty negotiating directions to new location |
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STAGE 4
REISBURG'S STAGES FOR DEMENTIA |
Deficits are noted in all IADL
Strengths 1. Can still perform simple, repetitive ADL independently 2. Can live at home with support 3. Can follow simple verbal and demonstrational cues Weaknesses 1. Becomes increasingly forgetful 2. Becomes unable to follow and sequence written cues 3. Becomes unable to perform familiar, challenging activities 4.Experiences difficulty in word finding 5. Cannot manage at home without assistance |
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STAGE 5
REISBURG'S STAGES FOR DEMENTIA |
Person cannot function independently
Strengths 1. Can perform ADL and some IADL with correct cues and assistance 2. Can respond to encouragement 3. Becomes unable to safely drive an automobile Weakness 1. Demonstrates poor judgement 2. Experiences difficulty with all decision making 3. Forgets to take care of hygiene |
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STAGE 6
REISBURG'S STAGES FOR DEMENTIA |
Person cannot preform ADL without cues
Strengths 1. Can perform components of familiar tasks 2. Can follow demonstration/hand over hand cues Weaknesses 1. Demonstrates significant deficits in following 2 steps of a task 2. Cannot sequence steps of ADL tasks 3. Cannot speak in full sentences 4. Becomes incontinent of bowel and bladder |
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STAGE 7
REISBURG'S STAGES FOR DEMENTIA |
The person can be in a vegetative state. He/she is usually bedbound and unable to respond verbally or non-verbally to question or commands
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A: ASIA SCALE
(SPINAL CORD INJURY) |
Complete, no sensory or motor function is preserved in the sacral segments S4-S5
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B: ASIA SCALE
(SPINAL CORD INJURY) |
Incomplete, sensory but no motor function and extends through the section is preserved below the neurological level an extends through the sacral segments
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C: ASIA SCALE
(SPINAL CORD INJURY) |
Incomplete, motor function is preserved below the neurological level, and the majority of the key muscle groups below the neurological level have a muscle grade less than 3/5
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D: ASIA SCALE
(SPINAL CORD INJURY) |
Incomplete, motor function is preserved below the neurological level have a muscle grade greater or equal to 3/5
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E: ASIA
(SPINAL CORD INJURY) |
Normal, sensory and motor function are normal
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