Chpt. 7. A little bit of everything Flashcards
What are 7 diseases/conditions that are described in this chapter.
- ALS
- Guillain Barre syndrome
- Myasthenia Gravis
- Post-Polio Syndrome
- Thoracic outlet syndrome
- Carpal Tunnel Syndrome
- Bell’s Palsy
What is ALS often referred to and what is it?
-“Lou Gehring’s disease” or (MND) Motor nueron Disease is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord…… in the later stages can become totally paralyzed
ALS is very ___
but the onset of the ____may be so slight that they are frequently overlooked
- rapid
- symptoms
What are some symptoms of ALS? What is affected first?
- muscle weakness (arms/hands/legs
- muscle of speech
- swallowing/breathing
2. HANDS+ FEETS
In a small number of people, ALS is known to ___or ____ its progression, though there is no scientific understanding as to how and why this happens.
- remit
- stop
**What is a hallmark initial sign in ALS, occurring in approximately 60% of patients?
-Muscle weakness
***___ of those diagnosed will die within ___ years. Less than 10 per cent of cases are ____ and are called __ ALS.
> 80%
2-5 years
hereditary (genetics is not a big factor)
familial
**__per cent of ALS cases have ___ and are referred to as ___ ALS. ALS is not contagious!!.
> 90 %
no known cause
sporadic
*What is the most common cause of neurological death in Canada?
-ALS
**What is an EMG (Electromyography) ?
measures the electrical activity of the nerve going to the muscle: an important part of the ALS diagnostic process
What are 5 Possible causes for ALS?
1Apoptosis: chemicals that destroy themselves
- Free radicals
- Viruses
- Toxins
- Exposure to heavy metals such as mercury
- mitochondrial disfunction (decrease of energy)
Is there a cure of ALS?
no
What are 4 Physiotherapy treatments for ALS?
- Light areobic exercises (below 10 reps)
- Pool program: Swimming provides a low-impact exercise to most muscle groups
- Regular STRETCHING can prevent contractures
- Chest Physio: so they can effectively cough
What is another term for Guillain Barre? What is it?
-“acute inflammatory
demyelinating polyneuropathy”
-rapid onset of weakness and, often aralysis of: legs, arms, breathing muscles, and face
___ is the most common cause of rapidly acquired paralysis (peripheral)
GBS- Guillain Barre Syndrome
What is a hallmark initial sign in GBS?
-begins with increasing weakness and/or abnormal sensations of the legs and arms
Fortunately GBS patients ___ but the __ of the hospital care is unpredictable
- recover
- length
___ __ and high dose ___ ___ ___ are often helpful to shorten the course of GBS
- Plasma exchange
- intravenous immune globulins
Is the cause known for GBS?
What percentage of cases for GBS occur shortly after a microbial (viral) infection?
no
-50%
What is another term for (MG) Myasthenia Gravis muscle weakness?
-“grave muscular weakness.”
*What is the cause for MG?
- immune attack
- 80% reduction of Ach (stimulator) receptor sites
- reduction in Ach is caused by an antibody that destroys/blocks the receptor site, preventing Ach to be able to bind to anything
Weakness may be limited to the ___ controlling eye movements and the eyelids. This form of myasthenia is referred to as ____ __.
- muscles
- occular MG
What are the extremes of the MG Class classification?
- Class 1: Any ocular (eye) muscle weakness; may have weakness of eye closure;(affects eyelids)
- Class 5: intubation, with or without mechanical ventilation
?What temporarily restores the Ach function?
-The edrophonium chloride test is performed by injecting this chemical into a vein; improvement of strength
Is there a cure for MG?
But does it have the most hope for cure from the other diseases mentioned so far?
- no
- yes
____ _____ are sometimes used to affect the function or production of the abnormal antibodies also (BLOOD TRANSFUSIONS)
-Intravenous immunoglobulins
*What is Post-Polio Syndrome?
Axonial Sprouting: “wiring-mechanism” musculotaneous nerve tries to grow, but EXTREME Fatigue due to slow deterioration of motor units
Estimated that Post-Polio Syndrome affects __ - __ percent of ___ survivors
25-50%
-polio (those that had Polio prior)
What causes PPS?
-no known cause but it’s almost like a “burn-out” after Polio, the nerve terminals degenerate
-
What is the Criteria for diagnosis of PPS?
- -SYMPTOMS THAT PERSIST FOR AT LEAST A YEAR
- EMG (electromyography)
- History
- progressive and persistent new muscle weakness
- follow trauma/surgery
Are there any effective treatments?
no; but what helps is LOW-PACKED AEROBIC exercises
Do you strengthen the affected or unaffected muscles in PPS?
-unaffected, because the affected muscles are already very weak
What is a VERY COMMON condition?
Thoracic Outlet Syndrome
What is Thoracic Outlet Syndrome?
-compression of nerves or blood vessels specifically by the brachial plexus (neurovascular), because of an inadequate passageway through an area (thoracic outlet) between the base of the NECK and the ARMPIT
What can cause Thoracic Outlet syndrome?
- any condition resulting in enlargement or movement of the tissues near the thoracic outlet
- pressure of pec minor can put pressure on brachial plexus
__ ___borders the thoracic outlet, and when pressure is put on pec minor it can put pressure on the __ __ and “strangle it”
- Scalene triangle
- Brachial Plexus
**What are the 3 MAIN causes of Thoracic Outlet Syndrome?
- Anterior scalene tightness (SPONDYLOSIS leading to muscle spasm)
- Costoclavicular approximation (compression from CARRYING HEAVY OBJECTS; compression of first rib, calvicle, etc.)
- Pectoralis minor tightness (REPETITIVE MOVEMENTS of arms above the head)
What sort of activities can cause compression syndromes (such as TOS)?
- working OVERHEAD or in 90 degrees abduction(Hairdressers)
- carrying heavy loads
***What is the Adson or Scalene Maneuver?
examiner locates the radial pulse
>The patient rotates their head toward the tested arm and lets the head tilt backwards
**> if radial pulse dissapears the test is Positive
What is the Allen test?
- patient’s elbow 90 degrees hoirzontally and turn head away from tested arm
- > if radial pulse dissapears the test is Positive
What is the treatment for thoracic outlet syndrome?
-stretch scaline (neck to the side)
What can you do with severe symptoms of TOS?
-surgically remove the first rib, to decrease compression on brachial plexus
What is Carpal Tunnel Syndrome caused by?
by compression of the median nerve in the carpal tunnel
-can also radiate up the arm
What are the 2 reasons you might get Carpal Tunnel Syndrome?
- Congenital (genes)
2. Repetitive work
What are 2 treatment for CTS?
- tap on transcerse carpal ligament (in the middle)
- transcerse carpal ligament can be cut, so median nerve isnt compressed/pinched
What is Bell’s Palsy and how is it caused?
- condition where facial muscles weaken or become paralyzed
- caused by trauma to &th cranial nerve=NOT PERMINENT
Diabetic are __ times more likely to develop Bell’s Palsy it than general pop.
4
What are 3 ways for increased chance of getting Bell’s Palsy
- Diabetics
- Last trimester of Pregnancy
- conditions with Immunity deficiency (ex. HIV)
Symptoms of Bell’s Palsy progress ___ ___, and are very obvious no longer than __ weeks. Signs of __ pain or behind the ___ show the beginning of palsy.
- very quickly
- 2
- neck, ear
What are 3 types of treatment for Bell’s Palsy?
- Pednisone
- Electrical stimulation
- Tapping and massage help to regenerate nerve
