Clinical Applications Flashcards
Anterior Cord Syndrome
Paralysis and variavle sensation loss
Brown Sequard Syndrome
-hemicord lesion
-proprioceptive and motor loss on same side of injury
-pain and temperatures loss on opposite side of injury
Autonomic Dysreflexia risk level
above T6
Spina Bifida Characteristics
-non progressive
-present at birth
-damage to nerves depends on type and trauma at birth
-usually only survivable in lower spine (paraplegia)
-high risk for development of scoliosis as they grow
Meningocele Spina Bifida
-opening of spinal canal
-incomplete vertebra formation
-no damage to spinal cord
myelomeningocele spina bifida
-opening of spinal canal
-herniation of nerves or spinal cord into the opening
-damages nerves and/or cord
Hydrocephalus spina bifida
-build up of CSF in brain leading to possible skull distortion and brain damage
Arnold-Chiari malformation Spina Bifida
-part of the cerebellum protrudes into spinal canal
Spina Bifida results
-muscle paralysis/weakness
-loss of sensation
-decreased muscle tone
-poor trunk control and balance
-spinal asymmetries
-decreased motor planning, coordination, and midline skills
-visual impairments (weak ocular motor control, poor fixation, impaired tracking, impaired scanning, impaired perception)
- cognitive impairment (normal to severe, learning disabilities, language difficulties, attention deficits, problems with memory)
Spina Bifida AT Applications for mobility
-ambulation aids
-manual or power wheelchairs
Spina Bifida AT Applications for positioning
-stability/support to maximize function
-pressure management
-prevention of scoliosis/other deformities
-tilt/recline/standing positioning systems
-24 hour positioning needs
Spina Bifida Other AT Applications
-ventilator if needed
-ADL equipment
-EADLs
-Alt drive for moblity
-Computer with alt access
-interfacing technology
-architectural modifications
-transportation technology
-recreational technology
Locked in syndrome - part of brain
damage to pontine area
Stroke R side of brain effects
-L hemiplegia
-visual field loss
-perceptual problems
-L neglect
-impulsivity
-emotional lability
Stroke L side of brain effects
-R hemiplegia
-language impairments
-poor motor planning
-poor math
-slow at tasks
CP Definition
non progressive disorder resluting from a lesion to the brain occurring anytime from fetal development to 2 years or age
CP causes
-damage to nervous system during fetal development
-maternal dysfunction
-premature separation of the placenta
-bleeding in the baby’s brain
-anoxia in utero or during birth
-injury to brain due to swelling
-post natal causes including meningitis and injury
Types of CP
-Spastic/hypertonic
-hypotonic
-dyskinetic
-mixed
Spastic/hypertonic CP
velocity dependent muscle tone
hypotonic CP
decreased muscle tone
Dyskenetic CP
movement disorder
with extraneous, non-volitional movement or ataxia
athetoid
extraneous, non-volitional movement
diplegic CP
more involvement in lower limbs
triplegic CP
both lower limbs, one upper limb
CP Mobility AT
-crutches
-gait trainers
-walkers
-strollers (when young)
-manual wheelchairs
-power wheelchairs
MS definition
an inflammatory disease of the CNS characterized by 2 or more lesions separated in time and space
MS higher prevalence in (males/females)?
females
MS age of diagnosis
between 20 and 50 yrs old
MS effect on CNS
causes demylenation in CNS. Where myelin is lost, scar tissue is left (sclerosis)
damaged areas in MS are called
plaques
Types of MS
-relapsing remitting (most common)
-secondary progressive
-primary progressive
-progressive relapsing
MS Mobility AT
-orthotics
-cane/walker
-manual wheelchair
-power mobility
-power assist
Age of onset of ALS
usually adult onset, late 50’s average
ALS types
-progressive bulbar palsy
-progressive muscular atrophy
-ALS with dementia
Progressive bulbar palsy
symptoms begin in motor neurons for cranial nerves
-much more rapid progression
Progressive muscular atrophy
symptoms begin in motor neurons
-somewhat slower progression
Spinal muscular atrophy definition
a group of genetic disorders that cause progressive muscle weakness due to damage to motor neurons in spinal cord
Spinal muscular atrophy affects [upper/lower] motor neurons?
lower
cause of spinal muscular atrophy
hereditary disease caused by autosomal recessive gene
Spinal muscular atrophy types
Type I
Type II
Type III
Adult SMA
Type I spinal muscular atrophy
-AKA Werdnig-Hoffman disease
-usually appears before the age of 6 months
-child frequently born with breathing problems
-fatal within a year without treatment
Type II spinal muscular atrophy
-symptoms usually appear at the age of 6-18 months
-life expectancy depends on whether or not breathing problems are present
-most survive into adolescence of young adulthood
Type III spinal muscular atrophy
AKA Kugelberg-Welander disease
-appears after age of 18 months
-may have normal life expectancy
Adult SMA
begins after age 21
normal life expectancy
Type I Osteogenesis Imperfecta
classic non-deforming osteogenesis imperfecta with clue sclerae of the eyes (mildest form)
Type II Osteogenesis Imperfecta
perinatally lethal osteogenesis imperfecta; most severe, most die as babies
Type III Osteogenesis Imperfecta
Progressively deforming osteogenesis imperfecta
Type IV Osteogenesis Imperfecta
Common variable osteogenesis imperfecta with normal sclerae (varying severity)
AT for Osteogenesis Imperfecta
-protective postitioning
-power mobility usually required
-ADL equipment
-depends on ROM limitations and strength
-think low impact!
