Dz: Neuro Disorders Flashcards
(3) Classifications of Nerve Injuries
Depends on length of time damaged
Neuropraxia: temporary, no structural change
Axonotmesis: prolonged pressure = mm atrophy, neuron degeneration
Neurotmesis: no path to follow to grow back
Median & Radial Nerve Injury
Median: repetitive stress, pregnancy, narrowing of carpel tunnel (weakness of thenar eminence of hand)
Radial: damaged by pressure
- Saturday Night Palsy
- Crutch Palsy
Tests for Neurological System
Posttraumatic Amnesia Scale
Rancho Los Amigos Levels of Cognitive Fxn (problem solve ability & behave appropriately)
Phalen’s wrist flex test (median n injury- tingle)
Reverse Phalen’s (pressure against carpel tunnel- tingle/burn)
Tinel Sign (tap over n)
Thoracic Outlet Tests
Allen test: head rotated opposite side, elbow flex - pulse disappears
Adsons maneuver: head rotated on same side, elbow ext - pulse disappears when breathing
Provacative elevation test: arms elevated, open/close hand - cramping, tingling
Vertebral Artery Test: passive neck ext/rotation - dizzy, pupil changes (limit PT to neck area)
Seizures
Spontaneous excessive discharge of neurons
Involuntary repetitive movements
Increased Intracranial Pressure (ICP)
Skull is rigid, Brain tissue dies
Brain compressed from incr fluid or a mass
First S/S: decreased LOC
- projectile vomit, papilledema, severe HA
Guillain-Bare Syndrome
PNS inflammation
Mostly affects motor n
Ascends from legs > cranial n
Can cause paralysis (n>major organs)
(3) Chronic Congenital Disorders
Hydrocephalus
Spina Bifida
Cerebral Palsy
(3) Chronic Seizure Disorders
Multiple origins (cerebral hemisphere)
Cautions:
- don’t restrain
- put nothing in their mouth
- clear the area
Absence (petit mal): loss of awareness for 5-10sec, eyelid twitch
Tonic-clonic (grand mal): full body movement
Partial: simple (one focal origin- limb), complex (multiple origins - waving/clapping)
Tx: sedatives
Hydrocephalus
Excessive CSF within ventricles, water on the brain
Babies: head can expand
Adults: pressure incr rapidly (skull can’t expand)
S/S: Infant - white sclera visible, high cry
Adults - pupils fixedly dilated
Noncommunicating: CSF flow is blocked
Communicating: CSF absorption impaired
MI: shunts (drainage)
Spina Bifida - (3) types
Neural tube defects
Vertebral posterior spinous process fail to fuse
Types:
- Spina Bifida Occulta (not seen visually,
hair patch)
- Meningocele (herniation of meninges, sac
formation)
- Myelomeningocele (herniation of spinal
cord & n)
Etiology: multifactorial (genetics/environment, low folic acid/Vit-A)
Thoracic Outlet Syndrome
Brachial Plexus compression, subclavian blood vessels compressed
Alzheimer’s Dz
Senile plaque/neurofibrillary tangle (brain abnormality)
4 gene mutations
S/S: memory/language decline, late stage- family unrecognizable
Tx: moderate stim, daily ex, routine
Survival 7-20yrs
Can lead to Dimentia
Cerebral Palsy - (4)Types
Brain damage (before/during/after birth)
S/S: motor deficits, seizers, poor commun
Types:
- Spastic (hyperflexia)
- Dyskinetic (athetoid- writhing movements)
- Atoxic (loss of balance/coordination)
- Mixed
Dimentia
Loss of memory (short-term initially)
Causes: VD, Infxn, Toxins = treatable, Alzheimer’s (not treatable)
Types:
- Vascular (small brain infractions)
- Creutzfeldt-Jakob Dz (alter coding gene, mad cow dz,empty spaces in brain)
- AIDS
Schizophrenia
Viral infx from mother to fetus (brain damage)
S/S: delusions, bizarre behavior, flat emotions, hallucinations, persecution
Panic Attack/Disorder
Develop many fears
Panic Attack: brief episode of discomfort/anxiety
Panic Disorder: long/freq episodes of panic attacks
LMN Disorders
Associated N: cranial n, anterior horn cell of spinal cord, spinal n roots, peripheral n
Arnold-Chiari Malformation
Cerebellum protrudes spinal canal = CSF blocked
S/S: impaired skin sensation, paralysis
Autistic Spectrum Disorder
Neurodevelopment Disorder
Poor verbal comm/good nonverbal comm
Strict routine
Tx: multidisciplinary- family involved as well
Fetal Alcohol Syndrome
Alcoholism during pregnancy
S/S: small eyes, cleft palate/lip, low IQ
Poor attention
PT: ataxia, pron/sup, tremors, posture
Spinal Cord Injury (SCI)
Traumatic: MVA, Falls, Gun shot wounds
Nontraumatic: Dz - accounts for 30% of SCI (white males 16-30yrs)
Tetraplegia: all 4 extremities
Paraplegia: comp/partial paralysis trunk/bil LE
Causes:
- Cervical Lesions: 51%
- Compression (burst) fx - C5-7 (common)
- Shearing - fx dislocation at thoracolumbar
SCI (Damage, S/S, Classify, Tx)
Damage Sequence:
- Spinal shock (temporary) - n conduction
stops
- LOF < injury site (usually permanent)
S/S: flaccid initially»_space; spastic paralysis (no brain signal - closed reflex loop)
- LOF of body temp/BP/Resp fxn
- Autonomic dysreflexia (no reflex to pain,
unable to determine location)
- Secondary: pneumonia, HO, shoulder inj
- decorticate/decerebrate supine posture
Classification: ASIA impairment scale
Tx: orthotics
CVA (TIA/Stroke)
Damage to brain due to lack of Ox
Ischemic: most common, caused by thrombus/embolus, very quick, damage 3-4hrs
Hemorrhagic: rupture of cerebral artery, sever
TIA: neuro sympt 24hrs
Stroke
Classified: thrombosis, embolus, hemorrhage
Permanent damage possible >3wks
Most common cause of disability
Males - African American most common
S/S: unilat numbness/weakness (Hemiparesis) opposite of lesion, trouble speaking/seeing, LOC/LOB, severe headache
Stroke (damages)
Supratentorial Lesions: within cerebral hemisphere
- L-side: logic, Aphasia (no compreh/express
to language)
- R-side: impulsive, problem solving,
personality, confusion, contralat neglect
(what arm?)
Infratentorial Lesion: within brainstem (widespread impair of sense/motor - RAS)
LOC: coma (Glasgow scale), vegetative state (brain damage, brainstem is fxn)
UMN: hyperreflexia
LMN: flaccid (unilat weakness)
Hemianopia (stroke S/S)
Hemianopia: Lose vision on med-half of one eye and lat-half on another eye (if damage is in optic chiasma)
