Discussions Flashcards
Recovery vs compensation
Recovery: Returning to preforming tasks in the exact same way you did prior to the injury
Compensation: Finding new ways to accomplish these same tasks, whether it’s with different muscles, different movements, or maybe an AD.
What is Post Dural Puncture Headache?
When is PT contraindicated?
common complication that can occur after a lumbar puncture, spinal anesthesia, or epidural catheter placement. It’s caused by low cerebrospinal fluid (CSF) pressure, or intracranial hypotension, due to a leak at the puncture site.
PT is contraindicated if: Fever, severe intensity Headache, confusion, change in mental, focal neuroloigical deficits, neck pain, swelling, redness, pain at insertion site.
What is hypertrophy vs pseudohypertrophy?
pseudohypertrophy involves fat and connective tissue accumulation, enlarging muscles without increased strength
This occurs in Duchenne Muscle Dystrophy, and is due to gene mutations
pt experiences progressing weakness, muscle wasting
How is an acute vs chronic nerve injury differentiated on an EMG?
acute denervation- fibrillation potentials, sharp positive waves
chronic denervation- none of these present, a large amplitude motor unit action potential can be seen
What conditions have both acute and chronic denervation?
ALS and Poliomyelitis
Why is it important to administer tpa within 3-4.5 hours
What are the risks?
Administering tPA within 3 to 4.5 hours of a stroke minimizes brain damage by restoring blood flow. Early intervention is crucial BUT poses bleeding risks, especially in patients with high blood pressure or head injuries.
What is the Orpington Prognostic Scale used for?
Used to assess both the severity and prognosis of recovery from stroke.
score from 1.6 to 6.8
4 items –
motor deficits in arm
proprioception (eyes closed)
balance
cognition
Used for predicting the patient’s outcomes after treatment
Why is the JFK coma scale so important to patients in a coma/PVS?
used to differentiate between rancheros levels 1-3
more sensitive to detecting change and can differentiate between coma and minimally conscious state
patients are often misdiagnosed without this sensitive measure.
Has large time requirement
JFK is very significant clinically when determining a patient’s discharge plan from acute care.
If a patient is deemed to be emerging from a persistent vegetative state by using the JFK scale, they have an increased chance for being placed in inpatient rehab after discharge from ICU/acute care
How is exercise neuroprotective?
Exercise is neuroprotective, promoting neurogenesis, angiogenesis, and increased cerebral blood flow, and combats aging-related inflammation.
Aerobic exercise boosts immune activity and has anti-inflammatory effects, improving cognition in Alzheimer’s patients.
What is sympathetic storming?
occurs after a TBI when the sympathetic nervous system becomes too active and the body cannot determine whether it is in danger. As a result, the body is in constant distress and causes the patient to have many severe symptoms such as hypertension, a fever over 101 F, increased basal metabolic rate, diaphoresis, rigid arms and legs, abnormal posture, tachycardia, and tachypnea
PT need to monitor vitals
Why is it important to keep an EVD in line with the patients head?
It is important to keep the monitor aligned with the ear when mobilizing a patient, as this is about the level of the interventricular foramen. This alignment ensures proper drainage of cerebrospinal fluid (CSF) to reduce intracranial pressure from excess CSF. The EVD (external ventricular drainage) should be clamped when the patient transfers to different positions to prevent rapid changes in drainage due to pressure shifts associated with positional changes. Once the patient is in a stable position, the EVD can be left open to allow CSF to drain at a safer rate.
Neurosurgery vs neuroradiological intervention
Neurosurgery for brain aneurysms typically involves clipping the aneurysm at the neck of the aneurysm.
Neuroradiological intervention, also know as endovascular coiling, involves placing small, thin metal coils into the aneurysm via a catheter inserted through an artery in the groin. Contrast is injected into the aneurysm and xrays are utilized throughout to monitor the aneurysm. This surgery is must less invasive than neurosurgery
