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23 Cards in this Set
- Front
- Back
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What do MS patients have adverse reactions to?
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Heat
Hyperventilation Dehydration Fatigue |
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Common impairments with MS
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Mild cognitive impairment
Dysarthria/dysphagia Vision (diplopia) Coordination issues (look like cerebellar) Balance and vestibular involvement Gait ataxic Fatigue UTI/resp infection |
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Basic etiology of parkinson's
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Loss of inhibitory dopamine results in excessive cholinergic (ACH) of BG
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Things to look for with pts on levodopa
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Fluctuations related to dosing
end-of-dose deterioration on-off phenomenon dyskinesias after 2-3 years of med |
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Meds for parkinson's
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Sinemet (levodopa/carbidopa): n/v, orthostatic, arrhythmias, dyskinesias
Domamine agonist: enhance effect of sinemet Anticholinergic drugs: for control of tremors Amantadine: enhances dopamine release Selegiline (MOI): inc's dopamine during eraly disease states |
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What is myasthenia gravis?
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Autoimmune attack on ACH receptors at NMJ
Generalized: usualy involves bulbar and proximal limb-girdle mm Lookout for myasthenic crisis (resp failure) |
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Things you want to examine with myasthenia gravis?
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CN's: diplopia, ptosis, dyarthria, etc.
Resp function mm strength: proximal > distal Fatigue is a big issue |
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Lesions of the archi/vestibulocerebellum result in what?
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This part receives sensory and visual info
Ocular dysmetria VOR impairments Impaired hand/eye coordination |
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Lesions of the paleo/spinocerebellum result in what?
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This area fine tunes body and limb movements
Hyptonoia and truncal/gait ataxia |
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Lesions of the neo/cerebrocerebellum result in wat?
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Intention remor
Dysdiadochokinesia Dysmetria Dyssnergia Timing errors related to perceptual tasks Motor learning impairments (decre'd anticipatory control, feedback, and learning delays) |
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Intervention ideas for cerbellar dysfunctions
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Eye-head coordination ex
Stability ex: graded resistance and approximation Dynamic stability ex: smooth reversals Coordination ex: PNF, Frnekel's ex Stationary bike: timing of reciprocal movments Use mo learning stategies that minimize distraction |
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Types of unilateral vestibular disorders
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1. trauma (common with TBI)
2. Neuronitis, labyrinthitis (infection) 3. Meniere's dx (episoidic attacks) 4. BPPV 5. Tumor |
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Mechanism of peripheral neuropathy
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Axonal degeneration
"dying back" of nerves from distal to proximal |
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3 classes of traumatic nerve injury
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1. Neurparxia: compression
2. Axonotmesis: crush injury 3. Neurotmesis: complete laceration |
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EMG signs of:
denervation atrophy reinnervation |
Denervation: spontaneous fibrillation potentials
Reinnervation: low amp, short-duration, polyphasic MU potentials) |
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What is trigeminal neuralgia and what are the s/s
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Neuralgia of one side CN V in older populations
Occurs to mandibular and maxillary portions (not opthalamic) Autonomic instability exacerbate by cold/heat Trigger points on face Mo function is normal |
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Bell's palsy s/s
PT? |
MM of facial expression
Loss of control of salivation and lacrimation Acute, and usually recovers fully, taste ant. 2/3 f'd PT: artifical tears, face sling, food retrianing, ESTIM to maintain tone |
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What is bulbar palsy?
PT? |
TUmor, vascualr or degenerative dx of LOWER bainstem
CN IX and X Watch out or pseudobulbar palsy (jaw reflex positive b/c UMN) Elevate HOB and dietary changes |
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Characeristics of GBS?
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Peripheral NS (hyporeflexive and such)
Distal to proximal, legs to arms CNs involved |
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Characteristics of ALS
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UMN and LMN signs (affects both)
ANT horn cells and descending corticospinal and corticobulbar (lower CNs affected the most) tracts B&B spared Cognition normal Not symmetrical like GBS Sensation not affected ANS affected 1/3 of ppl |
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How does post-polio syndrome present
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Asymmetrical, no pattern
Fatigue, pain Slow progression Cold intolerance Sensation unaffected |
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Which of the selected disorders do not have sensory symptoms?
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ALS, Parkinson's, post-polio
GBS and MS do have sensory losses |
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Examples of neuropathic pain
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Thalamic pain sydrome
CRPS Neuroalgia Radiculoagia Herpes zoster Phantom pain |
