Discussion Board Midterm Flashcards
how can a pt present with hypotonicity in the trunk but hypertonicity in the limb with a cerebellar lesion?
cerebellar regulation of axial mm is disrupted –> hypo
limb compensate –> hyper
why are multijoint movements challenging for pts with cerebellar lesions?
feedforward
balance
disconnect b/t vestibular syst
when can a phrenic nerve stimulator be used?
for pts that has LMN paths in tact
type 1 Chiari malformation
most common
cerebellum is pushed into foramen magnum
type 2 Chiari malformation
both the cerebellum and brain stem protrude into the foramen magnum
type 3 Chiari malformation
most severe
cerebellum and brain stem protrude into the SC
what is “boosting”?
practice of some athletes with spinal cord injuries where they purposefully inflict a state of autonomic dysreflexia in order to gain a competitive advantage
what SC syndrome can be d/t syringomyelia? how does it present?
central cord syndrome
UE > LE
mainly in C spine
what is the most common hereditary ataxia?
Friedreich ataxia
main PT conditions with autonomic neuropathy
gait deviations to velocity & balance
incorporate other med team
T/F: ALS pts usually have impaired cognition
F!!
ALS sx
UMN & LMN
UMN: pathological reflexes, spasticity, clonus
LMN: weakness, atrophy, fasciculations
what leads to a worse prognosis for Guillain Barre?
Diabetes, hypertension, requiring ventilatory support, and abnormal renal and hepatic function
Guillain Barre usually has a fully recovery within _____
1 year
sx must last ____ weeks for AIDP and ____ weeks for CIDP
AIDP - <4 weeks
CIDP - >8 weeks
what is the time frame for tPA?
3.5-4 hrs
Orpington Prognostic Scale
used to assess both the severity and prognosis of recovery from stroke;
1.6 to 6.8 and are based off of 4 items – motor deficits in arm, proprioception (eyes closed), balance, and cognition
Orpington Prognostic Scale categories
<3.2: mild impairments / high likelihood of returning home
3.2 to 5.2: moderate impairments / would respond better to rehabilitation
>5.2: severe impairments / dependent with an increased risk of institutionalization
The JFK coma/near coma scale is a standardized and systematic scale used to differentiate between rancheros levels ____. This scale is more sensitive to detecting change and can differentiate between ____and ___
1-3
coma and minimally conscious state
how does exercise benefit AD?
anti-inflammatory (T cells)
decrease oxidative stress
improve cognition
what is Sympathetic storming, also called neurostorming and paroxysmal sympathetic hyperactivity?
occurs after a TBI when the sympathetic nervous system becomes too active and the body cannot determine whether it is in danger
sx of hemorrhage post tPA
severe headache, severe hypertension, worsening neurological exam, & nausea/vomiting
NIHSS scoring
21-42: severe
16-20: moderate-severe
5-15: moderate
1-4: minor
0: no stroke symptoms
what is neuroradiological intervention?
placing small, thin metal coils into the aneurysm via a catheter inserted through an artery in the groin
Neurosurgery for brain aneurysms typically involves
clipping the aneurysm at the neck of the aneurysm
requires cutting into the skull cap and performing a craniotomy
Describe common swing phase gait deviations that people post stroke may likely display
preswing: decreased knee flexion
initial swing: decreased knee flexion and ankle plantarflexion, toe drag
mid-swing: excessive hip abduction, trunk lateral flexion away paretic side, increased stiffness
terminal swing: lack knee extension & DF
what is compensation?
using the same limb(s) and muscles as prior to the injury but with a different motor pattern
what is substitution?
accomplishing a task with the use of different body segments and muscles
Describe common stance phase gait deviations that people post stroke may likely display
initial contact: more than just heel contact, foot drop
loading response: Trendelenburg
mid stance: lock out knees, ipsi trunk lean, Trendelenburg, vaulting gait (increased PF), knees and/or hips excessive flexion
terminal stance: shorter step length on non-involved side
preswing: excess knee flexion to clear foot or decreased knee flexion, steppage gait, prolonged d/t motor planning deficits
what is pseudohypertrophy?
accumulation of adipose tissue and connective tissue that give the appearance of larger muscles but the pt has weakness
When a nerve is injured, it takes ______ weeks before we can see signs of damage
1 to 4 weeks
acute denervation is noted by
fibrillation potentials, positive sharp waves, and insertional activity
