Ch 12 - Spasticity Flashcards

1
Q

What is spasticity?

A

Velocity-dependent increase in the tonic stretch reflexes with exaggerated phasic stretch reflexes resulting from hyperexcitability of the stretch reflex

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2
Q

What is rigidity?

A

Resistance to stretch that is not velocity dependent

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3
Q

Describe MAS 0.

A

No increase in tone

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4
Q

Describe MAS 1.

A

Slight inc in muscle tone, manifested by a catch and release or minimal resistance at the end ROM when the affected part(s) is moved in flexion and extension

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5
Q

Describe MAS 1+.

A

Slight inc in muscle tone, manifested by a catch followed by min resistance throughout

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6
Q

Describe MAS 2.

A

Marked inc in tone throughout most ROM but easily moved

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7
Q

Describe MAS 3.

A

Considerable inc tone, passive ROM difficult

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8
Q

Describe MAS 4.

A

Affected parts rigid in flexion or extension

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9
Q

MOA of Baclofen.

A

GABA-B receptor agonist reducing Ca influx and supresses excitatory NT release

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10
Q

MOA of Diazepam.

A

GABA-A rec agonist

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11
Q

MOA of Dantrolene.

A

Blocks Ca+ release from sarcoplasmic reticulum

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12
Q

MOA of Clonidine.

A

Central acting alpha-2-adrenergic agonist with effects in locus ceruleus

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13
Q

MOA of Tizanidine.

A

Central acting alpha-2-adrenergic agonist

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14
Q

What is Phenol cause?

A

Transient, anesthetic effect due to demyelination with little axonolysis for >6 mo

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15
Q

MOA of botox

A

Block the presynaptic release of ACh primarily at the terminal portion of a motor nerve

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16
Q

What is the initial safe dose for first botox treatment?

A

400 units total or 6 units/kg for an adult

17
Q

What are typical doses of botox for adults?

A

25 to 200 units per muscle

18
Q

What are typical doses of botox for children?

A

4 to 8 units per kg

400 units max body dose

19
Q

What is the peak effect of botox?

A

Peak effect: 4 to 6 weeks

Effects last 2 to 6 months

20
Q

What are signs of baclofen overdose?

A
  • Hypotonia/severe weakness
  • Drowsiness/somnolence
  • Lightheadedness
  • Nausea/vomiting
  • Bradycardia • Hypotension
  • Seizures
  • Respiratory depression
  • LOC to coma
21
Q

What is the treatment of baclofen overdose?

A

Anticholinesterase physostigmine 2 mg IV to reverse the respiratory depression

22
Q

What are signs of baclofen withdrawal?

A
  • Fever
  • Nausea
  • Dizziness • Hyperthermia
  • Pruritis/itching
  • Insomnia
  • Altered mental status
  • Hallucinations
  • Seizures
  • Exaggerated rebound spasticity and muscle rigidity that can lead to rhabdomyolysis and multiple organ-system failure
23
Q

What is a Split Anterior Tibial Tendon Transfer (SPLATT) used for?

A

Equinovarus deformity of the foot. Spasticity in TA muscle provides an inverting and supinating force on the foot while spastic gastrocnemius and soleus muscles provide a plantar flexing force