Carrie CNS Flashcards

1
Q

Seizures definition

A

Spontaneous uncontrolled abnormal discharge of neurons in the brain

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2
Q

Seizure causes

A

Primarily idiopathic

Secondary to cerebral scarring from head injury, birth trauma, or infection

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3
Q

Generalized seizure

A

Petite mal
Absence seizure

Grand mal
Tonic colic seizure

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4
Q

Seizure
status elipticus?

A

Status elipticus is a seizure that does not stop spontaneously

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5
Q

Massage treatment considerations for seizure

A

May perform on floormat if seizures involve large uncontrolled movements

Remove objects in vicinity

Keep pillows nearby in case seizure occurs

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6
Q

Hemiplegia definition

A

Non-progressive condition of paralysis on one side of the body as a result from a CNS lesion

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7
Q

Hemiplegia occurs side? Why?

A

Occurs on opposite side to which the brain lesion has occurred

Due to the crossover of nerves at the pyramidal tracts in medulla oblongata

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8
Q

Hemiplegia CVA

A

CVA is a cerebral vascular accident also referred to as a stroke

Last for less than 24 hours TIA, which is a transient ischaemic attack

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9
Q

Hemiplegia causes

A

Cerebral thrombosis, cerebral haemorrhage due to aneurism and cerebral embolism

Most common cause of stroke leading to hemiplegia

Thrombotic stroke 66%
Embolism 5 to 14%
Haemorrhage 14 to 20%

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10
Q

Hemiplegia causes specific

A

Head trauma from fall or MVA can result in haemorrhage

Brain tumour can lead to erosion which leads to haemorrhage and then hemiplegia

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11
Q

Hemiplegia commonly affected areas

A

Internal capsule and vestibular system

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12
Q

Circumduct gate

A

Swing affected leg forward to clear the floor

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13
Q

Hemiplegic shoulder

A

Adduction and internal rotation of shoulder with retraction of scapula

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14
Q

Hemiplegia neglect

A

Neglect of affected side. Can disassociate with affected limb and deny ownership.

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15
Q

Apraxia

A

Inability to properly organize attempts at movement

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16
Q

Hemiplegia contraindications

A

Results of CVA make modifications to treatment and Hydro as per hypertension protocol

Tech not on neck, one side at a time

Do not place head in extension or rotation

With tissue fragility, modify Hydro and weight

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17
Q

Multiple sclerosis definition

A

A condition in which demyelination of a nerve occurs

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18
Q

Sclerotic plaques

A

Scar tissue, which can cause a slowing, disruption, or blockage of nerve transmission

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19
Q

Multiple sclerosis what is affected?

A

White matter is affected, lesions found in brainstem, cerebellum, and spinal cord

Some cranial nerves can be affected optic and trigeminal

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20
Q

Multiple sclerosis types

A

Benign

Attack remitting
(benign or mild attack remitting)
(chronic progressive attack remitting)

Acute progressive

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21
Q

Multiple sclerosis causes

A

Unclear, but some factors include

Genetic
Environmental
Viral
Immunological

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22
Q

Multiple sclerosis cure?

A

No cure but strategies include massage therapy increase physical awareness, temporary decrease spasticity, improve soft tissue and joint health decrease contractures decrease stress and increase emotional well-being

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23
Q

Parkinson’s definition

A

Movement disorder involving the progressive degeneration of nerve tissue and a reduction in neurotransmitters producing in the CNS

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24
Q

Primary signs and symptoms of Parkinson’s

A

Resting tremor
Bradykinesia
Rigidity
Nonspecific weakness, achiness, or fatigue
Poor postural reflexes

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25
Q

Secondary signs and symptoms of Parkinson’s

A

Fascinating gait
Disfunction with speech and eating
Handwriting changes
Sleep disorders
Depression
Mental degradation

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26
Q

Bradykinesia

A

Difficulty with initiation and sustaining movement

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27
Q

Freezing phenomenon

A

Sudden inability to move feet as if they are rooted to the ground

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28
Q

Festinating gait

A

Small steps with leaning forward posture

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29
Q

Parkinson’s handwriting changes

A

Micrographia is progressive, shrinkage, and cramping of handwriting

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30
Q

Parkinson’s progression stage one

A

Unilateral presentation
Rigidity or tremors
If mild symptoms, no treatment is needed
If moderate symptoms, Massage and Physio are used

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31
Q

Parkinson’s progression stage two

A

Bilateral
Moderate tremors, rigidity, and bradykinesia
Balance is not affected
Levodopa therapy started

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32
Q

Parkinson’s progression stage three

A

Significant tremors, rigidity, and bradykinesia
Balance and walking impairment occurs
Unsteadiness, Dystoria and freezing occurs

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33
Q

Parkinson’s progression stage four

A

Severe bradykinesia
Walking is still possible, but highly impaired
Some assistance with daily activity may be required

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34
Q

Parkinson’s progression stage five

A

Complete loss of ability to function and independence
Person is immobile

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35
Q

Parkinson treatment

A

Levodopa is the active form of dopa and a precursor to dopamine

Carbidopa allows more levodopa to access the brain

36
Q

Cerebral palsy types

A

Spastic
Athetoid
Ataxic
Dystonic
Mix

37
Q

Cerebral palsy three causes

A

Prenatal causes
Birth trauma
Acquired CP

38
Q

Anoxia

A

Absence of oxygen

39
Q

Strabismus

A

Lack of parallel alignment of eyes

40
Q

Cerebral palsy muscles

A

Muscles are chronically tight, causing tight restrictive contractures

41
Q

Cerebral palsy signs and symptoms. Athetoid

A

Slow writhing movements

42
Q

Cerebral palsy signs and symptoms. Choreform.

A

Quick uncontrolled movements without purpose

43
Q

Cerebral palsy sensory loss. Agnosia

A

Inability to distinguish objects by touch. Decrease in proprioception.

44
Q

Cerebral palsy treatment

A

Physical or occupational therapy
Swimming horseback riding
Surgeries
Massage therapy

45
Q

Spinal cord injury definition

A

is an injury to the vertebral column, spinal cord or both, due to a direct or indirect trauma

46
Q

Spinal cord injury, structure of spinal cord

A

Motor and sensory pathway tracts

Corticospinal tract is descending tract, motor control, movements of neck, trunk, and limbs

Ascending tract is sensory info to the brain

47
Q

Spinal cord injury, most common place

A

Between C4 and C6
Between T12 and L1

48
Q

Quadriplegia

A

All four limbs, trunk, pelvic organs at T1 or higher

49
Q

Paraplegia

A

Lower limbs at T2 and below

50
Q

Spinal cord injury causes

A

MVA
Diving
Sports
Penetrating wounds
Occupational hazards
Spinal stenosis
Non-traumatic injury

51
Q

Spinal shock

A

Loss of voluntary motor control, sensory, and autonomic disfunction below lesion

Resolves within 24 hours to several weeks

52
Q

Poliomyelitis definition

A

Acute viral infection, specifically affecting the motor neurons in the cord and brainstem

53
Q

Spinal poliomyelitis

A

Inflammation and destruction of anterior horn cells at any level of spinal cord

54
Q

Post polio syndrome

A

Late complications of paralytic polio
Occurs long after initial infection, 10 to 40 years later
Unknown

55
Q

Central nervous system comprised of

A

Brain and spinal cord

56
Q

Autonomic dysreflexia

A

Excessive sympathetic response to specific stimuli

57
Q

Dysphasia

A

Impaired speech

58
Q

Aphasia

A

Inability to speak

59
Q

Spasticity

A

This occurs when there is a loss of inhibition of alpha motor, neurons firing

60
Q

Upper body flexor pattern

A

Flexion of head/trunk toward effective side
Depression of shoulder
Retraction of scapula
Internal rotation and adduction of GH joint
Flexion of elbow
Pronation of forearm
Flexion of wrist and fingers with thumb adduction

61
Q

Upper body extensor pattern

A

Slight extension of neck head
Trunk bent away from affected side
Retraction of scapula
Internal rotation of glenohumeral joint
Rigid extension of elbow with pronation of forearm
Flexion of hand with tight fist
PIP and DIP flexion
Palm facing backwards

62
Q

Lower body flexor pattern

A

Abduction External rotation and flexion of the hip
Flexion of the knee
Dorsey flex and inversion of an
Flexion of toes

63
Q

Lower body extensor pattern

A

Adduction, internal rotation, and extension of hip
Plantar flexion and inversion of ankle
Extension of knee

64
Q

Extensor thrust pattern

A

Vigourously extend limbs while arching back

65
Q

Positive supporting reaction

A

Stiffening of leg and extension or flexion

66
Q

Grasp reflex

A

Withdrawal of the entire arm and tightly flexed position

67
Q

How is spasticity useful?

A

Spasticity and legs can assist with standing or transferring from wheelchair to a bed.

68
Q

Spasticity Massage techniques

A

Variety of Swedish techniques
Slow rhythmic, shaking of limb
GTO release
Passive range of motion of affected joint (perform carefully so not to cause stretch reflex)

69
Q

Rigidity definition

A

Described as resistance to movement inflection extension, and rotation

70
Q

Leaded pipe rigidity

A

Uniform resistance throughout range of motion

71
Q

Cog wheel rigid

A

Ratchet like movement of an affected limb

72
Q

Encourage whole body integration

A

Stand on weaker side, so Client looks toward weaker side

Encourage client to visualize and feel movement during passive movement

If able, ask Client to do same movement on unaffected side

73
Q

Diplopia

A

Double vision

74
Q

Nystagmus

A

Constant involuntary cyclical motion of the eye

75
Q

Dysarthria

A

Inability to coordinate the muscles of speech

76
Q

Comprehension difficulty

A

Speak slowly and clearly rather than loudly

Short sentences are more easily understood

Repetition for instructions of a particular task

Be mindful not to be condescending

77
Q

Echolalia

A

Mimicking or passively repeating

78
Q

Postural imbalances. Scoliosis.

A

Tendency to collapse on weaker side

79
Q

Postural imbalances. Hyper kyphosis.

A

Slumping forward from weak trunk extensors

80
Q

Decubitus ulcers definition

A

Skin lesions caused by external pressure, shearing, or friction forces

81
Q

Decubitus ulcers factors

A

Sensory and motor loss due to neurological disorders place persons at high risk

May not notice and don’t take action to rectify

May not be able to physically change position

82
Q

Decubitus ulcers

A

Commonly occurs over, boney prominences such as sacrum, ischial tuberosity, greater trochanter, spin process, calcaneus, elbow

83
Q

Decubitus ulcers stage one

A

Local arrhythmia followed by warmth and hardening swelling over fragile, but intact area

Usually redness will diminish upon release of pressure

If redness does not resolve within 30 minutes may indicate pressure source could also present reddish, brown, or purple blue

84
Q

Decubitus ulcers stage two

A

More tissue affected epidermis to dermis

Partial thickness

Blister abrasions or shallow ulcer may be present

Area is moist, pink and painful

85
Q

Decubitus ulcers stage three

A

Full thickness, skin loss down to subcutaneous layer

Cavity is created with exudate and crust forming

Crust or eschar is thick and leathery, necrotic tissue

86
Q

Decubitus ulcers stage four

A

Full thickness, wound with damage and necrosis into underlaying muscles and bone

Deep cavity that may be covered with eschar

May lead to sepsis