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Combined- Everything Neuro > Everything > Flashcards

Everything Flashcards

1
Q

What is the role of a physio with regards to falls?

A
  • Fall prevention
  • Harm prevention
  • Risk identification and assessment
  • Falls plan develop
  • Intervention strategies
  • Equipment
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2
Q

Falls and its effects on hips?

A

20% mortality rate at 12 months
<50% will return to pre-# function

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3
Q

What percentage of falls in older people cause neck of femur #?

A

25%

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4
Q

Financial burden of Falls- Cost of Falls?

A

Roughly $4000 per stay, exceeds road trauma

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5
Q

What does a fear of falling do?

A

Leads to decreased activity, which decreases balance, increases weakness and risk of falls.

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6
Q

Fall Assessment Algorithm. What does it include?

A

If only 0-1 falls, check for balance and vision. If recurrent, then do full assessment which includes
- History
- Vision
- Gait and balance
- Lower limb joints

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7
Q

Taking a history of falls. What is the acronym?

A

SPLATT
Symptoms of time at all
Previous number of falls
Location of falls
Activity engaging in at time of fall
Time of day of falls
Trauma sustained during fall

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8
Q

Falls Assessments- Neurological. When looking for UMN or LMN pathologies, what do you assess?

A

Tone
Reflexes
Proprioception
Sensation
Coordination
Vision

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8
Q

Fall Assessment- Vision. What do you check for?

A

Visual acuity
Depth perception
Contrast sensivity
Multifocal lens can cause falls

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9
Q

Fall Assessment- Lower limb joint. What do you test for?

A

Range of motion
Strength
- Weak tib ant implicated in falls
- MMT vs Functional assessment
Muscle length

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10
Q

Fall Assessment- Cardiovascular. What do you measure?

A

Blood pressure- Done both supine and standing after 2 minutes
Pulse- rate and rhythm.

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11
Q

Fall Assessment- Gait and analysis. What does it include?

A

Gait- General observation. Initiation, foot clearance, step symmetry, dual tasking.

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12
Q

Fall Assessment- Gait and analysis. Whats an objective measure for gait?

A

DGI- Dynamic Gait Index. <19 out of 24, indicative of high falls risk

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13
Q

Falls Assessment- Balance. What tests to use?

A

TUG- Timed up and go >13.5 second = 90 accurate in predicting falls
BBS- Berg Balance Scale.
Step Test

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14
Q

Falls Prevention and Management- Low Risk Fallers. What is this stage called and what do you promote?

A

‘Immunisation stage’
Promote weight bearing, balancing challegning or strengthening exercise.
Promote nutrition- Calcium, Vitamin D or diabetes management

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15
Q

Falls Risk. What dose of exercise?

A

2 x weekly for 6 months.

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16
Q

Falls Prevention- What exercises to improve?

A

Pilates
Tai Chi
Otago

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17
Q

Dementia- Definition

A

A syndrome that causes a progressive decline in a persons functioning, including loss of memory and the ability to reason and learn. Loss of four things
- Personality
- Loss of intellectual capacity
- Memory
- Perform ADL’s

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18
Q

Dementia- Diagnosis.

A

Detailed history
Cognitive testing- MMSE
Functional assessment
Exclusion of other issues
Cerebral imaging MRI

19
Q

Dementia- Risk factors?

A

Mental activity
Physical activity
Diet- High cholesterol, saturated fat
Diabetes

20
Q

Dementia- What are the four main types?

A

Alzheimers Disease
Vascular Dementia
Frontotemporal Dementa
Diffuse Lewy Body Dementia

21
Q

What is the most common form of Dementia?

A

Alzheimers Disease (50-75%)

22
Q

Alzheimers Disease is characterised by?

A

Short term memory loss, apathy and depressin in early stages

23
Q

Alzheimers Disease- What parts of the brain affected most?

A

Cerebral atrophy of the cortex and especially in the hippocampus- Formation of new memories.

24
Q

How common is Vascular Dementia? (VaD)

A

Second most common dementia 20-30%

25
Q

How is Vascular Dementia (VaD) caused?

A

White matter infarcts- Can begin with gait abnormality

26
Q

Difference between Vascular Dementia and Alzheimers?

A

Alzheimers is gradual progression while VaD is step wise, sudden drops.

27
Q

Frontotemporal Dementia. Prevalence and when does it occur?

A

5-10 % and happens in younger people 45-65 years old

28
Q

Frontotemporal Dementia- What is it characterised by?

A

Personality changes
Dysfunctional social behaviour and excutive dysfunction (Planning)

29
Q

Frontotemporal Demention- How do they perform on the Mini Mental State Examination?

A

Usually perform well. Too basic as personality changes aren’t the focus of MMSE

30
Q

Diffuse Lewy Body Dementia- What is it caused by and prevalence?

A

Accounts for 20-30 percent of dementia. Caused by denergative death of nerve cells in the brain and the presence of spherical bodies called Lewy Bodies.

31
Q

Diffuse Lewy Body Dementia- Characterised by?

A
  • Flunctating levels of consciousness
  • Hallucinations
  • Parkinsonian symptoms- Gait and Bradykenesia
  • Rapid onset
  • Poor response to antipsychotics and L-Dopa
32
Q

Stages of Dementia?

A

Early- First year or two
Middle- Second to 4th or 5th year
Late- 5th year and after

33
Q

Dementia and Physiotherapy Implications. How do you help with sequencing of tasks?

A

Part practice with one stage instructions.

34
Q

Dementia- What are some medications used to moderate symptoms?

A

Cholinesterase inhibitors (ChEls). Reduce rate of cognitive decline

35
Q

Dementia- Non-pharmacological management of BPSD?

A

Based on 3 theories of BPSD
- Unmet needs
- Learned behaviours
- Environmental vulnerability and low stress threshold.

36
Q

Dizziness- How common is it?

A

15-20% of adults yearly reported

37
Q

Dizziness- Why is it important to physios?

A

Dizzy people fall over, functional limitations, reduced quality of life, limiting of activities and associated deconditioning

38
Q

Dizziness- Subjective assessment. What do you ask about?

A

Cardiac history
Drug interactions- Coinciding with new medication
Orthostatic hypotension
Anxiety disorders
VBI- Cervical rotational issues
Somatosensory loss- Peripheral neuropathy and diabetes
Central problems- Basal artery area- Ischemia (Potential stroke or tia)
Cervical vertigo-

39
Q

Dizziness- Common symptoms of vesitbular deficiets?

A

Nausea, vertigo, visual impairrments, gait and balance disorders, nystagmus

40
Q

Dizziness- Nystagmus. How does it occur and how is it defined?

A

Stimulation of the semi-circular canals (SSC) when the head isn’t in motion.
Direction of nystagmus is defined as the direction of the quick phase.

41
Q

VOR- Stands for?

A

Vesitbular occular reflex.

42
Q

Two types of physiological nystagmus

A

Opticokitentic- Induced by looking at moving visual stimuli
Postratory- Induced by spinning around then stopping

43
Q

Functions of the Vestibular System

A

Sensing and percieving self motion
Orientation to vertical
Controlling the centre of mass (balance)
Stabilising the head

44
Q

Central processing of the vestibular system- What is primary processor? And Secondary processor?

A

Vestibular nuclei complex in the brainstem- Pons in particular. Process sensory input concurrently.
Cerebellum is adaptive processor, readjusts output. (Tends to be inhibitive effect)
Both help maintain and calibrate VOR and posture

Combined- Everything Neuro (1 decks)

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