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35 Cards in this Set
- Front
- Back
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Glasgow Coma Scale (GCS):
3 elements Score ranges |
Eye opening, mo. response, verbal response
Scores range from 3-15 with <8 = severe brain injury |
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Mini-mental status examination (MMSE) scoring
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Max score is 30
>=24 means no cognitive impairment at all <15 = severe cognitive impairment |
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8 levels of cognitive function after TBI: Rancho Los Amigos
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I = no response
II and III = decreased response levels IV, V, VI = confused levels VII = automatic, purposeful VIII = normal |
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Broca's vs. Wernickes aphasia
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Brocas = frontal lobe, can understand but can't talk. Nonfluent aphasia. Expressive aphasia
Wernickes: temporal lobe, fluent aphasia. Receptive aphasia. Can talk, but can't understand |
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"sings" of CNS inection or meningeal irritation
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Neck flexion in supine
Kernig's sign Brudzinski's sign |
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Signs of increased intrcranial pressure?
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Altered level of conciousness
Inc BP, dec HR Irregular respirations HA, vomiting Pupillary changes Inc'd weakness, paralysis, positive babinksis |
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How to test kinethesia?
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Movement sense
Ask pt to duplicate with other arm or hand when you put arm/hand in a certain position |
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How to test stereognosis?
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Identify familiar objects by manipulation/touch
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How to test barognosis?
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Identify size/shape/weight of objects
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How to test graphesthesia?
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Identiy numbers, letters, or symbols trace on skin
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What is anosognosia?
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Denial or lack of awareness of severity of condition
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What is agnosia?
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Inability to recognize a familiar object with one sensory modality
ie. clock example |
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Ideomotor apraxia vs. ideational apraxia
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Can not perform motor movement when asked to, but can do it spontaneoulsy (ideomotor)
Can't do it at all (ideational) |
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Type of tone seen with parkinson's?
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Leadpipe rigidity
Cogwheel rigidity (rachet-like) |
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Impairments with cerebellar lesions
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Intention tremor
Dysdiadochokinesia (can't perform rapid alt movts) Dysmetria Dyssynergia nystagmus Wide based, ataxic gait |
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Involuntary movts seen with UMN vs LMN lesion?
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UMN: spasms
LMN: fasciculations with denervation |
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MAS scale grading
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0 = no inc in mm tone
4 = affected part rigid |
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Decerebrate vs. decorticate
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Decerebrate: Ext of all 4 limbs
Decorticate: flexion of UEs and extension of LEs |
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3 types of fatigue
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1. CNS/central faituge: MS, ALS
2. Nueral: MS, postpolio, Giullain-barre, myasthenia gravis 3. mm contractile failure |
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UE EXT snyergy
FLEX synergy |
Waiter's tip with scapular protraction
Shoulder ABD/ER, lbow flexion, wrist/finger flexion |
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Involuntary movements
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Chorea: danc moves
Athetosis: slow, irregular, twisting movts especially in UE Myoclonus: single, quick jerk |
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CTSIB:
Vision dependent: when do they become unstable? |
2, 3, 5, 6
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CTSIB:
Somatosensory dependent: when do they become unstable? |
4, 5, 6 when platform is moving
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CTSIB:
What conditions do pts with vestbiular loss become dependent on? |
5, 6
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Scoring for BERG
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56 is max score
<45 are at high risk of falls |
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TUG normal scores
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<10 is normal for healthyadults
>20 = high falls risk |
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Forward reach high fall risk score
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<10
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POMA, Tinetti scoring
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28 is max
<19 = high fall risk |
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Pathological CSF findings?
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RBCs = hemorrhage
WBC = eleveated is infection Proteins = elveated is tumor or inflammation |
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LMN injury and EMG:
Insertional activity |
Instertional: increased in denervated mm
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2 types of spontaneous EMG activity with LMN injury
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1. Fibrillation: Individ mm fibers. evident with denervation for 1-3 weeks after losing nerve
2. Fasciculations: mm twitches of MU. Presen iwth partial LMN disorders and denervation |
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Change with reinnervation of of denervated nerves on EMG
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Inc in size and duration, polyphasic shape occurs
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When would you expect to see abnormal NCV?
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Peripheral neuropathies characterized by demyelination
Giullain-Barre, polyneuropahthy, charco-tooth_ Focal compression of peripheral nerve as well |
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What score indicates a falls risk:
POMA, tinetti Berg TUG Functional reach DGI |
Tinetti = 28 normal, <19high falls risk
Berg = 56 normal, <45 high risk TUG = <10 normal, 10-20 normal for elderly, >30 high risk Funtional reach = <10 high fall DGI = normal 21, <12 high risk |
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Brunstrom stages of recovery
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1 = flaccid
2 = emergence of spasticity 3 = vol movt in synergies 4 = mov begins outside synergies 5 = spasticity decreasing 6 = spasticity gone 7 = normal mo function |
