Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
78 Cards in this Set
- Front
- Back
|
there is no change in life expectancy, after 10 yrs few are in the workforce |
what is the life expectancy of someone with MS? |
|
|
is an insulating sheath around nerve axons that speed up conduction from one node of ranvier to another |
what is myelin? |
|
|
- T-lymphocyte cells attach and destroy the myelin sheath. -disruption in the myelin sheath causes demylination -neural transmission is slowed and stopped -inflammation and edema surrounds the acute lesion and further interferes with nerve conductivity. |
what is the pathophysiology associated with MS? |
|
|
optic nerves, periventricular white matter, spinal cord, cerebellar penduncles |
what are the most susceptible areas associated w/ the pathophysiology of MS? |
|
|
highly variable , unpredictable
relapsing-remitting
new or recurrence lasting more than 24 hours
may not gain full recovery after |
how would you define an exacerbation in regards to your MS pt? |
|
|
-stress -adverse reaction to heat (known as Uthoffs symptoms which can bring on exacerbation of symptoms) |
what 2 factors can contribute to an exacerbation? |
|
|
-alternate days and times during lower core temps to prevent rapid fatigue -balance exercises with rest periods -submaximal exercise b/c of demyelination -resistance training -circuit training -borg scale: will help recognize the stage of fatigue -integrate functional and closed chain training -group exercise is motivational |
what are some strategies for MS pts that involve strength and conditioning? |
|
|
exercise to fatigue
heat modalities |
what are exercise contraindications for MS pts? |
|
|
-increase strength -increase endurance -prevent sedentary lifestyle |
what are the goals of exercise for MS pts? |
|
|
-strength and conditioning -cardiovascular conditioning -flexibility exercises
|
what is the focus of exercise for MS pts? |
|
|
chronic neuropathic pain (80%) -caused by demyelinating lesions along pain tracts (most commonly in spinothalamic tracts) |
what is most likely the cause of pain in a pt with MS? |
|
|
caused by demyelination of sensory division of trigeminal nerve, which innervates the face, cheek,and jaw |
what is trigeminal neuralgia? |
|
|
abnormal burning, aching pain (dysthesias) that can affect any part of the body but more common in the LEs but most commonly worse at night and after exercise. |
what is paroxysmal limb pain? |
|
|
-directly related to MS -side effect of drugs -reaction to stress |
what are the causes of depression w/ an MS pt? |
|
|
state of euphoria |
what affect characteristic is more common in later stages of MS? |
|
|
-mgmt of sensory deficits -mgmt of pain -exercise -strength and conditioning -CV exercise -flexibility exercise -mgmt of fatigue -mgmt of spasticity-mostly LE -coordination and balance -ataxia training -locomotor training and w/AD -orthotic devices -functional training -cog training -family ed - - |
what types of interventions should PT be focused on with a pt w/MS? |
|
|
power scooter or W/C b/c of the fatigue factor |
what assistive device is more appropriate for an MS pt? |
|
|
length of time in utero |
what is the gestational age (GA)? |
|
|
age based on birthday |
what is the chronological age (CA)? |
|
|
considers age baby is from due date |
what is the corrected or adjusted age (AA) |
|
|
AA prior to achieving term age = GA+CA |
how to determine post conceptual age? |
|
|
CA-# wks missed in utero |
how to determine the adjusted age? |
|
|
"well baby nursery" -minimal observation or care -small community hospitals -rarely consult PT (maybe for musculoskeletal ) |
what is a Level I NICU? |
|
|
-meds or alimantation, tube feedings, O2 -regional or community hospitals -intervention : handling for specific developmental needs, family ed |
what is a Level II NICU? |
|
|
-sickest most fragile infants -complex interventions,advanced diagnostics, surgery, respiratory support. -usually in teaching hospitals -PT consults: handling for developmental changes, family ed |
what is a Level III NICU? |
|
|
specialized services for child w/ (extracorporeal membrane oxygenation) |
what is the Level IV NICU? |
|
|
-learned oral aversion resulting from NICU -lack of flex/ext balance and chin tuck to assist w/sucking, swallowing, breathing -residual lung disease may cause tachynea interfering w/ sucking and swallowing -lack of self regulation and unable to calm self -apnea- stop breathing -bradycardia- slow HR -unable to coordinate sucking, swallowing and breathing. can aspirate -immature GI tract
|
what are some reasons that a pre-term baby may not feed? |
|
|
a mixture of fat and proteins made in the lungs. coats the alveoli (air sacs in lung where oxygen enters body). this prevents the alveoli from sticking together when your baby exhales (breathes out).pre mature infants may be born before their lungs make enough. lowers surface tension |
why is surfactant important? |
|
|
decreased bone density
cause : immature bone development .
bone is usually formed around the third trimester |
what is osteopenia and why does it occur? |
|
|
during delivery, fees may pass a BM into the amniotic fluid. as the infant gasps for his /her first breath , may aspirate the meconium tainted amniotic fluid.these particles (obstruct ) the airway |
what is meconium aspiration? |
|
|
cause : difficult delivery
waiters tip: erbs palsy
-shoulder add, IR, elbow ext, pronation, wrist and finger flex
-UE limp at infants side |
what position is a babies arm in with a brachial plexus injury? |
|
|
-gentle PROM -splinting -activities to promote mvmt, motor learning , strengthening, developmental skills (function) |
how should we treat a childs arm with a brachial plexus injury? |
|
|
chronic inflammatory demylenating disease of CNS
islands of sclerosis: areas of hardened tissue
unknown
onset: 15-50 yo |
what is MS? |
|
|
chronic , progressive- slow rate progression
age onset: 50-60 yo
sx deficits in: gait, sensation, speech, voice, swallowing, cog, behavior, ANS, GI, cardio pulmonary |
what is parkinsons disease? |
|
|
degeneration of neurons producing dopamine
abnormality of basal ganglia- where we plan mvmt and cog processes
|
what is the pathology of Parkinsons? |
|
|
group of abnormalities that produce abnormalities of BG
caused by: virus toxins, drugs, tumors |
what is parkinsonism? |
|
|
mimic PD but symptoms caused by neuro degenerative disorders |
what is parkinsons -plus syndrome? |
|
|
cogwheel rigidity, lead pipe rigidity, freezing, hypokinesia, resting tremor, pill rolling, postural tremor, increase sway posture, self initiation |
what are some clinical signs of parkinsons? |
|
on and off |
what can livadopa do for a parkinsons pt? |
|
|
abnormally small hand writing that is difficult to read |
what is microphagia from parkinsons pts? |
|
|
low protein diet as protein blocks L dopa effectiveness |
what type of diet should a parkinsons pt have? |
|
|
combined meds and PT, motor learning strategies, exercise training, adaptive devices, balance, GT, cardio pulmonary, BIG and LOUD |
what type of interventions can be used with a parkinsons pt. |
|
|
gentle rocking and slow rhythmic rotational movements of extremities |
what techniques can help with parkinsons relaxation? |
|
|
extensors are usually weaker |
what should be strengthened in a parkinsons pt to reduce there posture? |
|
|
pulmonary immaturity and inadequate pulamonary surfactant |
what is respiratory distress syndrome? |
|
|
if does not close, prevents oxygenation of blood. results in hypotension |
what is patent ductus arteriosus ? |
|
|
bilirubin can accumulate in the brain and cause neuronal damage |
what is hyperbilirubinemia? |
|
|
can lead to poor oral feeding patterns, oral aversion, and excessive crying.
frequent episodes can damage the lining |
what is gastroesophageal reflux? |
|
|
acute inflammation of the immature intestine causes intestinal necrosis
doubled in those exposed to cocaine |
what is necrotizing enterocolitis? |
|
|
hemorrhage deep in the brain that extends to the area between the lateral ventricles |
what is germinal matrix -intraventricular hemorrhage? |
|
|
areas of white matter adjacent to the lateral ventricles become necrotic |
what is periventricular leukomalacia? |
|
|
most common cause of pre term labor
bacteria invades the amniotic cavity causing inflammatory response in the membranes of the developing fetus |
what is chorioamnionitis? |
|
neck muscles contract on one side causing head and neck to stay there |
what is torticollis? |
|
|
femoral head exits the acetabulum during this maneuver to diagnosis hip dysplasia |
what is the barlow maneuver? |
|
|
hip cannot be relocated with this negative test |
what is the ortolani sign? |
|
|
3-4 components
-equinas -cavus -varus -forefoot add
cause: in utero positional changes |
what is talipes equinovarus
aka: clubfoot |
|
|
curved , hooked jt
cause: maybe lack of fetal mvmt in utero |
what is arthrogryposis? |
|
|
facial expression test scored from 0-2 |
what is the CRIES test? |
|
|
no one specific cause
injury occurs ante natal( vascular events, maternal infections and less commonly metabolic disorders) and perinatal
doctor waits often 12 months for definite answer |
what is the etiology of CP? |
|
|
most common 70%
-diplegic, hemiplegic, quadraplegic, combination of all
type of CP |
what is spastic CP? |
|
|
2nd most common group of CP 20%
uncontrolled involuntary mvmts |
what is dyskinetic CP? |
|
|
3rd most common CP 10%
deficits in balance and coordination |
what is ataxic CP? |
|
|
permanent
or transient as athetosis or spasticity develops |
what is hypotonic CP? |
|
|
-observation -postural control -postural tone -musculoskeletal -gait -fine motor and adaptive skills -speech and language |
what should be assessed w/ a CP pt? |
|
|
purpose : reduce spasticity
surgery: cut across selected nerve rootlets L2-S2 or L2 -S1 |
what is selective dorsal rhizotomy? |
|
|
implant pump into abdomen.insert catheter directly into intrathecal space
result: deliver bacolfen into CSF around SC to be absorbed by nerve root
managing spasticity |
what is intrathecal baclofen pump? |
|
|
water on brain
abnormal accumulation of CSF
possible causes: overproduction of CSF, failure to absorb CSF, obstruction of flow of CSF |
what is hydrocephalus? |
|
|
ventriculo peritoneal shunt, empties the CSF into the peritoneum |
what is the surgical management of hydrocephalus?
|
|
|
do not allow the head to be lowered below the abdomen. Occlusion |
what are the VP shunt precautions? |
|
|
posterior cerebellum herniates down through the foramen magnum |
what is arnold chiari malformation? |
|
|
neural tube birth defect
causes neuromuscular dysfunction
2nd most common birth defect
no cause |
what is spina bifid a? |
|
|
asymptomatic
dimpling of skin with hair
non fusion of halves of vertebral arches
most common in lumbar and sacral spine
|
what is spin bifida occulta? |
|
|
meninges of the spinal cord protrude through the opening int he vertebrae and form a fluid filled sac . no neuro deficits |
what is a meningocele? |
|
|
meninges and part of the spinal cord protrude through the opening in the vertebrae.causes neuro deficits |
what is myelomeningiocele? |
|
|
sterile care of lesion
surgical closure of sac within 72 hours |
what is the surgical intervention for spin bifid a? |
|
|
-MMT -Observe reflex patterns -ROM _positioning and handling -sensory |
what are the PT focus for SB pts? |
|
|
=syringomylelia
CSF collects in pockets along the SC and creates areas of pressure
can cause :
necrosis of peripheral nerves and scoliosis
signs: rapid progressing scoliosis, UE weakness, hypertonia |
what is hydromyelia? |
|
|
produces excessive stretch on the SC
SC adheres and anchors |
what is a tethered SC? |
