Discussion Board Midterm

Question 1

how can a pt present with hypotonicity in the trunk but hypertonicity in the limb with a cerebellar lesion?

Answer 1

cerebellar regulation of axial mm is disrupted –> hypo
limb compensate –> hyper

Question 2

why are multijoint movements challenging for pts with cerebellar lesions?

Answer 2

feedforward
balance
disconnect b/t vestibular syst

Question 3

when can a phrenic nerve stimulator be used?

Answer 3

for pts that has LMN paths in tact

Question 4

type 1 Chiari malformation

Answer 4

most common
cerebellum is pushed into foramen magnum

Question 5

type 2 Chiari malformation

Answer 5

both the cerebellum and brain stem protrude into the foramen magnum

Question 6

type 3 Chiari malformation

Answer 6

most severe
cerebellum and brain stem protrude into the SC

Question 7

what is “boosting”?

Answer 7

practice of some athletes with spinal cord injuries where they purposefully inflict a state of autonomic dysreflexia in order to gain a competitive advantage

Question 8

what SC syndrome can be d/t syringomyelia? how does it present?

Answer 8

central cord syndrome
UE > LE
mainly in C spine

Question 9

what is the most common hereditary ataxia?

Answer 9

Friedreich ataxia

Question 10

main PT conditions with autonomic neuropathy

Answer 10

gait deviations to velocity & balance
incorporate other med team

Question 11

T/F: ALS pts usually have impaired cognition

Answer 11

F!!

Question 12

ALS sx

Answer 12

UMN & LMN
UMN: pathological reflexes, spasticity, clonus
LMN: weakness, atrophy, fasciculations

Question 13

what leads to a worse prognosis for Guillain Barre?

Answer 13

Diabetes, hypertension, requiring ventilatory support, and abnormal renal and hepatic function

Question 14

Guillain Barre usually has a fully recovery within _____

Answer 14

1 year

Question 15

sx must last ____ weeks for AIDP and ____ weeks for CIDP

Answer 15

AIDP - <4 weeks
CIDP - >8 weeks

Question 16

what is the time frame for tPA?

Answer 16

3.5-4 hrs

Question 17

Orpington Prognostic Scale

Answer 17

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

Question 18

Orpington Prognostic Scale categories

Answer 18

<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

Question 19

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 ___

Answer 19

1-3
coma and minimally conscious state

Question 20

how does exercise benefit AD?

Answer 20

anti-inflammatory (T cells)
decrease oxidative stress
improve cognition

Question 21

what is Sympathetic storming, also called neurostorming and paroxysmal sympathetic hyperactivity?

Answer 21

occurs after a TBI when the sympathetic nervous system becomes too active and the body cannot determine whether it is in danger

Question 22

sx of hemorrhage post tPA

Answer 22

severe headache, severe hypertension, worsening neurological exam, & nausea/vomiting

Question 23

NIHSS scoring

Answer 23

21-42: severe
16-20: moderate-severe
5-15: moderate
1-4: minor
0: no stroke symptoms

Question 24

what is neuroradiological intervention?

Answer 24

placing small, thin metal coils into the aneurysm via a catheter inserted through an artery in the groin

Question 25

Neurosurgery for brain aneurysms typically involves

Answer 25

clipping the aneurysm at the neck of the aneurysm
requires cutting into the skull cap and performing a craniotomy

Question 26

Describe common swing phase gait deviations that people post stroke may likely display

Answer 26

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

Question 27

what is compensation?

Answer 27

using the same limb(s) and muscles as prior to the injury but with a different motor pattern

Question 28

what is substitution?

Answer 28

accomplishing a task with the use of different body segments and muscles

Question 29

Describe common stance phase gait deviations that people post stroke may likely display

Answer 29

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

Question 30

what is pseudohypertrophy?

Answer 30

accumulation of adipose tissue and connective tissue that give the appearance of larger muscles but the pt has weakness

Question 31

When a nerve is injured, it takes ______ weeks before we can see signs of damage

Answer 31

1 to 4 weeks

Question 32

acute denervation is noted by

Answer 32

fibrillation potentials, positive sharp waves, and insertional activity