cerebellar dysfunction and special topics

Question 1

what is the most debilitating effect of damage to the cerebellum?

Answer 1

ataxia

Question 2

which cerebellar artery supplies the superior half of the dorsal cerebellum?

Answer 2

SCA

Question 3

which cerebellar artery supplies the middle and inferior peduncles?

Answer 3

AICA

Question 4

which cerebellar artery supplies the superior peduncle?

Answer 4

SCA

Question 5

which cerebellar artery supplies the inferior half of the cerebellum?

Answer 5

PICA

Question 6

what is a major difference in the impairements between MS and cerebellar CVAs?

Answer 6

fatigue. CVAs don’t suffer from fatigue as much because their axons still have myelin

Question 7

what side of the body is affected when a stroke affects the left side of cerebellum and why?

Answer 7

left side of the body b/c the tracts are either uncrossed or double-crossed

Question 8

what part of the cerebellum helps transmit all the info to and from the cerebellum?

Answer 8

peduncles

Question 9

what are some clinical signs of damage to the vestibulocerebellum?

Answer 9

nystagmus, impaired VOR, imbalance

Question 10

what are some clinical signs of damage to the spinocerebellum? (7)

Answer 10

oculomotor deficits, hypotonia, imbalance gait, gait ataxia, tremor, dysmetria, dysdiadocokinesia

Question 11

what are some clinical signs of damage to the cerebro/neo cerebellum? (4)

Answer 11

dysdiadocokinesia, dysmetria, dyssynergia, decomposition

Question 12

what is an alternate name for the vestibulocerebellum?

Answer 12

flocculonodular lobe

Question 13

what is an alternate name for the medial and intermediate zone?

Answer 13

spinocerebellum

Question 14

what is another name for the cerebro/neo cerebellum?

Answer 14

lateral zone

Question 15

explain the relation between feedforward control and the cerebellum

Answer 15

the cerebellum is the feedforward control center. this allows us to coordinate before even moving

Question 16

explain what “lack of check” is and what is may look like

Answer 16

it is a rebound. if a pt is having their MMT checked their limb will rebound when the pressure is released

Question 17

what type of tremor is associated with cerebellar damage?

Answer 17

action tremor

Question 18

what are 5 clinical manifestations of cerebellar dysfunction?

Answer 18

imbalance
ataxia
oculomotor deficits
speech impairments
impaired motor learning

Question 19

what test may be impaired with cerebellar dysfunctions?

Answer 19

smooth pursuit, gaze invoked nystagmus

Question 20

for cerebellar dysfunction, the prognosis for recovery depends highly on…

Answer 20

etiology and extent of the lesion

Question 21

what 3 things are important to include when documenting impairments and activity limitations?

Answer 21

level of assistance
degree of impairment
detailed description of the deficits

Question 22

in order to facilitate plasticity during intervention for cerebellar lesions, what must be done?

Answer 22

sufficient and increasing challenge. must monitor vitals

Question 23

talk about the significance of adding weight for people with cerebellar dysfunctions and whether it is beneficial or not

Answer 23

weight is added to pts with ataxia in order to slow down/lower the amplitude of their movement. it can work in the beginning but it is not good for the pt in the long run. they may fatigue quicker, their motor feedback may be affected, it can cause hypermetria, and once the weight is removed they will be off balance.

Question 24

explain the major difference between primary and secondary brain tumors

Answer 24

primary brain tumors originate in the CNS. Secondary brain tumors are metastatic and originate outside of the CNS.

Question 25

what are some symptoms of a brain tumor?

Answer 25

headache, seizure, cognitive/personality changes, or focal neuro signs

Question 26

explain papilledema

Answer 26

it is when the optic nerve is compressed d/t the swollen brain

Question 27

a tumor in this area will cause abnormal weight gain and/or amenorrhea

Answer 27

pituitary gland

Question 28

what are sxs of a frontal lobe brain tumor?

Answer 28

personality changes, balance difficulties, walking difficulties

Question 29

what are sxs of a parietal lobe brain tumor?

Answer 29

agnosia

Question 30

what are sxs of a temporal lobe brain tumor?

Answer 30

seizures, auditory changes, perceptual changes

Question 31

what are sxs of an occipital lobe tumor?

Answer 31

eye movement dysfunction, vision loss/changes

Question 32

explain meningitis

Answer 32

it is when an infection spread thru the CSF, caused by trauma or medical procedures

Question 33

what are some bacterias that can cause meningitis?

Answer 33

e coli, strep, flu, pneumonia

Question 34

explain how to perform the special tests for meningitis

Answer 34

kernig sign involves bringing their leg into 90/90 and then stretching the hamstrings. it is posiitve if they have LBP. Brudzinski involes hip flexion and passive neck flexion, positive is pain or increased headache

Question 35

what are 5 components of normal postural control?

Answer 35

vertical orientation anticipatory reactive sensory organization dynamic postural control

Question 36

during postural control interventions, what should we do if a pt is overreliant on vision for stability?

Answer 36

teach them a new strategy and then take vision away

Question 37

explain cystic fibrosis

Answer 37

an obstruction of the lungs by mucus

Question 38

what are some things PT can do for pts with cystic fibrosis?

Answer 38

postural drainage, percussion, vibration, breathing exercises

Question 39

what intensity of exercise is recommended for pts w/ CF?

Answer 39

vigorous

Question 40

what are some other organs affected by CF?

Answer 40

skin, liver, pancreas, intestines, reproductive organs

Question 41

explain what spinal muscular atrophy is

Answer 41

it is a progressive muscle weakness disorder, the anterior horn cells in the SC and brain stem degenerate

Question 42

what is spinal muscular atrophy type 1?

Answer 42

werdnig-hoffman disease. onset is <6 months. death before 2 y/o

Question 43

what is spinal muscular atrophy type 2?

Answer 43

onset of 6-18 months. better prognosis

Question 44

what is spinal muscular atrophy type 3?

Answer 44

onset >18 months, normal life span

Question 45

what is spinal muscular atrophy type 4?

Answer 45

onset >10 y/o. normal life expectancy.

Question 46

what are some PT interventions for spinal muscular atrophy?

Answer 46

prevent contractures and joint deformities, spinal alignment, w/c supports, breathing exercises, aquatic therapy

Question 47

what is the etiology of spinal muscular atrophy?

Answer 47

genetic

Question 48

what is the etiology of cystic fibrosis?

Answer 48

genetic

Question 49

what is the most common inherited neuromuscular disease?

Answer 49

charcot marie-tooth (CMT)

Question 50

explain charcot marie-tooth (CMT)

Answer 50

it is a genetic disorder that affects the motor and sensory peripheral nerves

Question 51

what is the prognosis for charcot marie-tooth (CMT)

Answer 51

it is good, they have normal lifespan

Question 52

explain what myasthenia gravis is

Answer 52

it is a progressive autoimmune disorder that causes weakness and fatigue

Question 53

explain prognosis of myasthenia gravis

Answer 53

it is a progressive disorder with no cure.

Question 54

is it appropriate for patients with myasthenia gravis to exercise?

Answer 54

yes, as long as it isn't during an exacerbation

Question 55

explain some strengthening guidelines for patients with post polio syndrome

Answer 55

minimal to moderate intensity. only strengthen muscles that move thru whole ROM. progress slowly monitor for fatigue

Question 56

what should PT do when post polio syndrome patients have signifigant weakness in a muscle?

Answer 56

stretch, do not strengthen.