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Special Topics in OT (OCTH 670) > Exam #2 > Flashcards

Exam #2 Flashcards

1
Q

What spinal nerves make up the brachial plexus?

A

C5-T1

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2
Q

What are the 3 connective tissue sheaths of a peripheral nerve?

A

endoneurium
perineurium
epineurium

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3
Q

The epineurium surrounds the ______ and the perineurium surrounds ______ and the endoneurium surrounds _______.

A

peripheral nerve; fascicle; and individual axon

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4
Q

Peripheral nerves connective tissue sheaths:

A
  1. Protect the axons and glia
  2. Support changes in length during movement
     Connective tissues stretch
     Axon unfolding
     Fascicle gliding
  3. Innervated with nociceptive free nerve endings
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5
Q

Peripheral nerves blood supply:

A
  1. Peripheral nerves supplied by arterial branches that enter the nerve trunk
  2. Movement promotes the flow of blood through the nerves
    - Blood supply is needed:
     Nutrition
     Oxygen
     Waste removal
  3. Movement promotes the flow of axoplasm through the axons
     Axoplasm thickens at rest
     Movement thins it
     Facilitates axoplasmic transport
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6
Q

where motor axons synapse with muscle fibers and have a 1:1 ratio (axon to fiber)

A

neuromuscular junction

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7
Q

Neuromuscular Junction:

A

 These synapses only require depolarization of the motor axon to release ACh and depolarize the muscle membrane
 No summation of action potentials is needed to depolarize the postsynaptic membrane
 Inhibition is not possible
 Miniature end-plate potentials

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8
Q

Peripheral nerve dysfunction: sensory changes

A

Decreased, altered, or lost sensation
(E.g., hyperalgesia, dysesthesia, paresthesia, allodynia)

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9
Q

Peripheral nerve dysfunction: autonomic changes

A
  1. Single severed nerve: Lack of sweating, loss of control of sympathetic control of vascular smooth muscle fibers
  2. Many affected nerves: impotence, HR & BP regulation issues, bladder/bowel dysfunction
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10
Q

Peripheral nerve dysfunction: motor changes

A
  1. Paresis or paralysis
  2. Muscle atrophy
  3. Fibrillation (spontaneous contraction of individual muscle fibers)
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11
Q

Peripheral nerve dysfunction: trophic (nutritional) changes

A
  1. Damaged nerves do not provide nutrition to the target tissues (remember those mini end-plate potentials?)

(E.g., muscle atrophy, shiny skin, dystrophic nails, thickening subcutaneous tissue, poor wound healing, blood supply changes,
lack of movement, loss of sensation, etc)

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12
Q

What does the spinal region consist of?

A

 Spinal cord
 Dorsal and ventral roots
 Spinal nerves
 Meninges

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13
Q

What does the gray matter consist of?

A

dorsal horn
ventral horn
lateral horn

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14
Q

What does the white matter consist of?

A

 Propriospinal neurons
 Tract cells
* Sensory
* Upper motor neurons

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15
Q

what gray matter horn is primarily sensory information

A

dorsal horn

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16
Q

what gray matter horn is primarily motor information

A

ventral horn (cell bodies of lower motor
neurons)

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17
Q

what gray matter horn is primarily autonomic information

A

lateral horn

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18
Q

axons of LMN cell bodies from a single segment

A

ventral root

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19
Q

sensory axons

A

dorsal root

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20
Q

carry all of the motor, autonomic, and sensory axons of a single segment.

A

spinal nerve

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21
Q

innervate paravertebral muscles, posterior vertebra, & overlying cutaneous areas

A

dorsal rami

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22
Q

innervate the skeletal, muscular, and cutaneous areas of the limbs; anterior & lateral trunk

A

ventral rami

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23
Q

the dorsal nerve root and ventral nerve root merge to form

A

spinal nerve

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24
Q

what two things branch off of the spinal nerve

A

dorsal ramus and ventral ramus

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25
Q

Segmental organization of the spinal cord:

A

medulla-> L1-L2 intervertebral space

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26
Q

Where does C1-C7 spinal nerves exit?

A

above the corresponding vertebra

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27
Q

C8 exits below ______ because there are no C8 vertebrae.

A

C7

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28
Q

Thoracic, lumbar, sacral spina nerves exit

A

below the
corresponding vertebra

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29
Q

Meningies:

A

 Pia mater  closely adheres to spinal cord
—- CSF in subarachnoid space —-
 Arachnoid
—- Subdural space —-
 Dura  tough outer layer
—- Epidural space —-
 Vertebrae

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30
Q

nerve compression injury (myelin injured) grade 1

A

neuropraxia

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31
Q
A

axonotmessis

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32
Q
A

neurotmesis

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33
Q

Neuropathy symptoms:

A

unusual sensation
numbness

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34
Q

nerve that is motor in the brachial part of the upper extremity and when it crosses the elbow it becomes sensory.

A

musculocutaneous nerve

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35
Q
A

ulnar nerve

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36
Q
A

radial nerve

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37
Q

Interneurons:

A

 Integrate activity from multiple
inputs
 Adjust output of lower motor
neurons
 Influence whether a motor neuron
fires
 Inhibitory interneurons provide:
* Reciprocal inhibition
* Recurrent inhibition

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38
Q

also known as claw hand

A

ulnar nerve palsy

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39
Q

decreases antagonist
opposition to the action of
agonist muscles

A

Reciprocal inhibition

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40
Q

focuses motor activity

A

Recurrent inhibition

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41
Q

a group of nerve fibers that share common origins, terminations, and functions

A

spinal tract

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42
Q

pathways that carry impulses from pain, thermal, tactical, muscle, and joint receptors to the brain

A

ascending pathways

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43
Q

What are the 3 neurons in ascending tracts?

A

1st order neuron
2nd order neuron
3rd order neuron

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44
Q

1st order neuron:

A

 Enters the spinal cord through the dorsal root (cell body in the dorsal root ganglion)
 Stays on the ipsilateral side of the spinal cord
 Terminates in a synapse with 2nd order neuron either in spinal grey matter OR medulla

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45
Q

2nd order neuron:

A

 Cell body in the spinal cord or medulla
 Axon decussates to contralateral side
 Ascends to thalamus and terminates with 3rd order neuron

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46
Q

3rd order neuron:

A

 Cell body in the thalamus
 Axon passes to the somatosensory cortex of the ipsilateral hemisphere

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47
Q

a tract that carries information about
touch and proprioception to
the ipsilateral side of the body

A

dorsal column tract

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48
Q

Where does the dorsal column decussate?

A

medulla

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49
Q

a tract that carries information about pain, thermal sensations, pressure, &
non-discriminate touch.

A

spinothalamic tract

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50
Q

a tract that carries information from
muscle spindles to the cerebellum and serve to control posture and coordination

A

spinocerebellar tract

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51
Q

tracts that originate from cerebral cortex and brain stem that controls movement, muscle tone, spinal reflexes, spinal autonomic functions, and modulation of sensory transmission to higher centers

A

descending tracts

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52
Q

a tract that is the central motor relay pathway – voluntary, selective,
discrete, skilled movements

A

corticospinal tract

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53
Q
A

reticulospinal tract

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54
Q

a tract that receive information about head movement and
position from the inner ear

A

Vestibulospinal tract

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55
Q

Autonomic system function:

A
  1. Maintain homeostasis of the internal environment
  2. Regulates reproduction
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56
Q

a hematoma that results from arterial bleeding between the skull and the dura mater. Most often this hematoma occurs when the middle meningeal artery is torn by a fracture of the temporal or parietal bone.

A

epidural hematoma

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57
Q

bleeding is slow in this hematoma because the hematoma is produced by venous bleeding, where the blood pressure is less than in arteries.

A

subdural hematoma

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58
Q

Epidural and Subdural Hematoma:

A

both types of hematoma are potentially life-threatening because neural tissue is compressed and displaced

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59
Q

A CSF disorder where CSF circulation is blocked, and pressure builds in the ventricles

A

hydrocephalus

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60
Q

a type of hydrocephalus that’s present at birth

A

congenital hydrocephalus

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61
Q

a type of hydrocephalus that occurs after birth

A

acquired hydrocephalus

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62
Q

a type of hydrocephalus where the ventricular system is intact (communicating), and a blockage exists beyond the fourth ventricle.

A

communicating hydrocephalus

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63
Q

a type of hydrocephalus (also called obstructive) where the blockage is within the ventricular system itself, most often the cerebral aqueduct

A

noncommunicating hydrocephalus

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64
Q

inflammation of the meninges that surround the brain and/or spinal cord

A

meningitis

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65
Q

a type of stroke that occurs when an embolus or thrombus lodges in a vessel, obstructing blood flow. Typically, an embolus abruptly deprives an area of blood, resulting in almost immediate onset of deficits

A

brain infarction

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66
Q

a type of stroke deprives the downstream vessels of blood, and the extravascular blood exerts pressure on the surrounding brain. Generally, hemorrhagic strokes present with the worst deficits within hours of onset; then improvement occurs as edema decreases and extravascular blood is removed

A

hemorrhage

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67
Q

What are the two types of strokes?

A

brain infarction
hemorrhage

68
Q

If the axon diameter is large the conduction speed will be ______.

A

fast

69
Q

If the axon diameter is small the conduction speed will be ______.

A

slow

70
Q

a plexus emerges between the anterior and middle scalene muscles, passes deep to the clavicle, and enters the axilla

A

brachial plexus

71
Q

What are the terminal branches (nerves) of the brachial plexus?

A

musculocutaneous
axillary
median
ulnar
radial

72
Q

condition or injury that impacts nerves
outside the brain and or spinal cord

A

peripheral nerve injury

73
Q

How does movement impact the health of peripheral nerves?

A

optimizes the health of nerves by promoting the flow of blood throughout the nerves and the flow of axoplasm through the axons by facilitating retrograde and anterograde transport

74
Q

What are some sensory changes of peripheral nerve damage?

A

decreased or lost sensation and/or abnormal sensations:
hyperalgesia
dysesthesia
paresthesia
allodynia

75
Q

What are some motor changes of peripheral nerve damage?

A

paresis (weakness) or paralysis

76
Q

What are some autonomic changes of peripheral nerve damage?

A

difficulty regulating:
blood pressure
heart rate
sweating
bowel and bladder functions

77
Q

What are some trophic changes of peripheral nerve damage?

A

muscle atrophy
shiny skin
brittle nails
thickening of subcutaneous tissues

78
Q

Mechanisms of peripheral injuries:

A

laceration
compression
stretch

79
Q

What are the symptoms of neuropathy?

A

tingling
numbness
burning
unusual sensations
pain from light touch
balance problems
twitching
muscle cramping

80
Q

What muscles does the radial nerve innervate?

A

o Triceps
o Brachioradialis
o ECRL
o ECRB
o Supinator

81
Q

Radial nerve injuries:

A

wartenbergs syndrome
radial nerve palsy

82
Q

a radial nerve injury that causes radial nerve compression and symptoms of paresthesia (pins and needles)

A

wartenbergs syndrome

83
Q

a radial nerve injury that causes the inability to lift the wrist or fingers (wrist drop)

A

radial nerve palsy

84
Q

What muscles does the median nerve innervate?

A

o PT
o FCR
o PL
o FDS

85
Q

Median nerve injuries:

A

carpal tunnel syndrome
AIN palsy
ape hand
hand of benediction

86
Q

a type of median nerve injury that causes median nerve compression at the carpal tunnel (paresthesia, weak grip, sleep disruption)

A

carpal tunnel syndrome

87
Q

a median nerve motor impairment that causes the inability to make the “okay” sign

A

AIN palsy

88
Q

a median nerve injury that causes wasting of the thenar eminence 2/2 median nerve palsy and inability to abduct and oppose the thumb

A

ape hand

89
Q

high median nerve injury at the level of elbow/forearm that impacts digits 2 and 3

A

hand of benediction

90
Q

What muscles does the musculocutaneous nerve innervate?

A

 Coracobrachialis
 Biceps
 Brachialis

91
Q

What muscles does the ulnar nerve innervate?

A

 FCU
 FDP RF/SF
 AddPol
 FPB – deep head
 Interossei Muscles: Dorsal, Palmar
 Lumbricals RF/SF
 Hypothenar Group

92
Q

Ulnar nerve injuries:

A

cubital tunnel syndrome
ulnar tunnel syndrome (guyon’s canal)
ulnar nerve palsy (claw hand)

93
Q

ulnar nerve compression at
medial elbow (cubital tunnel) that causes paresthesia, weak grip, and medial hand pain

A

cubital tunnel syndrome

94
Q

ulnar nerve compression at
Guyon’s canal that causes weakness and/or numbness ulnar side of hand/hypothenar area (gripping handle bars)

A

ulnar tunnel syndrome

95
Q

Ulnar nerve injury:
 MPJ hyperextension
 Intrinsic paralysis: interossei, lumbricals
 Intact extrinsic tendons: flexors, extensors

A

ulnar nerve palsy (claw hand)

96
Q

How does movement impact the health of peripheral nerves?

A

movement optimizes the health of nerves by promoting the flow of blood throughout the nerves and the flow of axoplasm through the axons (facilitates anterograde and retrograde)

97
Q

The musculocutaneous nerve innervates the following muscles in the arm: (Flexors)

A

Biceps brachii
Brachialis
Coracobrachialis

98
Q

The axillary nerve innervates the following muscles of the arm:

A

Deltoid
Teres minor
Part of the triceps

99
Q

The median nerve innervates the following muscles of the arm:

A

muscles in the forearm, hand, and intrinsic hand muscles (e.g. flexor carpi radialis, thenar muscles, abductor pollicis brevis, etc)

100
Q

The ulnar nerve innervates the following muscles of the arm:

A

muscles in the forearm, hand (e.g. Flexor carpi ulnaris, Palmaris brevis, lumbricals, hypothenar muscles, etc)

101
Q

The radial nerve innervates the following muscles of the arm:

A

many muscles in the arm and forearm, including: Triceps brachii, Brachioradialis, Extensor carpi radialis longus, etc)

102
Q

Associate axon diameter with conduction speed and innervated structures.

A

peripheral axons are classified into groups according to their speed of conduction and their diameter. Myelinated axons are generally much faster than unmyelinated.

103
Q

Explain how to determine if a lesion that causes motor, autonomic, and somatosensory signs and symptoms in the lower limb is in the peripheral or central nervous system.

A

prominent muscle atrophy, fasciculations, and reduced reflexes point toward a peripheral nerve lesion, while increased reflexes, spasticity, and a more diffuse sensory loss might indicate a central nervous system lesion

104
Q

Compare and contrast the neuromuscular junction with other synapses in the nervous system:

A

NMJ: synapse that connects a motor neuron to a muscle fiber
Other synapses: large postsynaptic membrane with a high concentration of acetylcholine receptors

105
Q

Describe the anatomic relationship between spinal cord segments and vertebrae in adults.

A

Because the spinal cord in the adult is significantly shorter than the vertebral column, the levels of spinal cord segments below C2 do not correspond with vertebral levels.

106
Q

What skeletal muscles does C2 innervate? (head & neck movements)

A

sternocleidomastoid
trapezius

107
Q

What skeletal muscles does C3 innervate? (breathing)

A

diaphragm

108
Q

What skeletal muscles does C4 innervate? (scapular elevation & retraction)

A

levator scapulae
rhomboids

109
Q

What skeletal muscles does C5 innervate?

A

Supraspinatus
Serratus anterior
Biceps
Brachialis
Deltoid
Pectoralis major

110
Q

What skeletal muscles does C6 innervate?

A

Supinator
Pronator teres
Latissimus
Long extensors of wrist/fingers
Pectoralis major

111
Q

What skeletal muscles does C7 innervate?

A

Triceps
Supinator
Pronator teres
Latissimus dorsi
Long extensors of wrist/fingers
Pectoralis major
Serratus anterior

112
Q

What skeletal muscles does C8 innervate?

A

Long flexors of wrist and fingers
Serratus anterior
Latissimus dorsi
Pectoralis major
Triceps

113
Q

What skeletal muscles does T1 innervate?

A

Hand intrinsics
Long flexors of wrist and fingers
Pectoralis major
Triceps

114
Q

What two tracts are located on the right side of a cross-section of the spinal cord?

A

dorsal column
lateral spinothalamic tract

115
Q

What tract is located on the left side of a cross-section of the spinal cord?

A

lateral corticospinal tract

116
Q

Dorsal Column:

A

Origin: Peripheral receptors
Decussation: Medulla
Function: light touch/conscious proprioception

117
Q

Spinothalamic tract:

A

Origin: Dorsal horn
Decussation:
Function: Pain and temperature

118
Q

Lateral corticospinal tract:

A

Origin: Motor/Premotor/Primary motor cerebral cortex
Decussation:
Function: motor control of hand movements

119
Q

Reticulospinal tract:

A

Origin: Reticular formation in the medulla/pons
Decussation:
Function: Posture & gross movements

120
Q

Vestibulospinal tract:

A

Origin: Vestibular nuclei in the medulla and pons
Decussation:
Function:

121
Q

A type of inhibition where a muscle relaxes on one side of a joint to allow the opposing muscle to contract. This prevents muscles from working against each other when an external load is applied.

A

Reciprocal inhibition

122
Q

A type of inhibition where a population of neurons excites another population, which then inhibits the activity of the first population

A

Recurrent inhibition

123
Q

Describe autonomic and somatic control for normal bladder filling and emptying

A

Autonomic:
*Sympathetic- regulates urine storage in the bladder
*Parasympathetic- relaxes the internal urethral sphincter allowing the bladder to empty.

Somatic:
external urethral sphincter keeps the bladder closed and prevents emptying. During urination (voiding), this tonic activity is temporarily inhibited, allowing the external sphincter muscle to relax

124
Q

Reflexive bladder function:

A

a bladder that empties automatically when it’s full, without conscious control. This happens when the bladder stretches and sends signals to the spinal cord, which then sends a message back to the bladder to contract and release urine

125
Q

A bladder dysfunction that causes a paralyzed bladder to overfill with urine, and when the bladder cannot stretch any further, urine dribbles out.

A

flaccid bladder function

126
Q

Explain the effects on sexual functioning in males and females above T12 spinal cord lesions:

A

affects psychogenic arousal in both, meaning they may not be able to achieve arousal through thoughts or mental stimulation

127
Q

Explain the effects on sexual functioning in males and females with between T12 & S1 spinal cord lesions:

A

may still allow for some psychogenic arousal but primarily rely on reflexogenic arousal

128
Q

Explain the effects on sexual functioning in males and females with below S1 spinal cord lesions:

A

significantly impact both psychogenic and reflexogenic arousal, leading to major difficulties with sexual function

129
Q

What impact does spinal cord injury have on male and female fertility?

A

fertility returns to normal after a few months and they can conceive and often have a normal pregnancy; however, they frequently require cesarean delivery due to impaired sensation and volitional control and to prevent autonomic dysreflexia.

130
Q

What impact does spinal cord injury have on male and female fertility?

A
131
Q

affects only one spinal cord segment

A

segmental dysfunction

132
Q

Signs of segmental dysfunction:

A
  • lose of sensation in a dermatome
  • decreased or lost of muscle power in a myotome
  • decreased of lost of phasic stretch
133
Q

affects everything below the lesion

A

vertical tract dysfunction

134
Q

Signs of vertical tract dysfunction:

A
  • altered or lost of sensation below the level of the lesion
  • altered or lost of descending control of BP, pelvic viscera, or thermoregulation
135
Q

a spinal region syndrome that is typically caused by a disruption of blood flow in the anterior spinal artery. The ischemia damages the anterior two-thirds of the spinal cord, affecting ascending spinothalamic tracts and descending upper motor neurons.

A

Anterior cord syndrome

136
Q

a spinal region syndrome that usually occurs at the cervical level as a result of trauma

A

Central cord syndrome

137
Q

a spinal region syndrome that results from a hemisection of the cord. Segmental losses are ipsilateral and include loss of lower motor neurons and all sensations

A

Brown-Séquard syndrome

138
Q

a spinal region syndrome that indicates damage to the lumbar and/or sacral spinal roots, causing sensory impairment and flaccid paresis or paralysis of lower limb muscles, bladder, and bow

A

Cauda equina syndrome

139
Q

a rare neurological condition caused by inflammation (swelling) of the spinal cord

A

Transverse myelitis

140
Q

a narrowing of the spinal canal that puts pressure on the spinal cord and nerves

A

spinal stenosis

141
Q

Symptoms of spinal stenosis:

A

tingling, prickling, burning, and/or electrical sensations), pain, and numbness, along with myotomal (lower motor neuron) distribution of weakness and atrophy in the upper limb

142
Q

Label a diagram of a spinal segment and explain how these:

A
143
Q

Describe the role of the autonomic nervous system in maintaining homeostasis:

A

regulating the activity of internal organs and vasculature including circulation, respiration, digestion, metabolism, secretions, body temperature, and reproduction

144
Q

What are the two routes used to transmit information from visceral receptors to the central nervous system?

A
  1. spinal cord
  2. cranial nerves “glossopharyngeal (CN 9) and vagus nerves (CN 10)
145
Q

Describe the spinal cord route used to transmit information from visceral receptors to the central nervous system:

A

visceral afferent fibers travel through spinal nerves to the spinal cord, then ascend to the brain via the spinothalamic tract (responsible for visceral information from the thoracic organs)

146
Q

Describe the cranial nerves route used to transmit information from visceral receptors to the central nervous system:

A

carries signals directly to the brainstem via the nucleus of the solitary tract (responsible for visceral sensations from the abdominal and pelvic regions)

147
Q

How does afferent autonomic information can cause referred pain?

A

nerve fibers carrying visceral (organ) sensations converge with somatic (skin) sensory fibers at the same spinal cord level, causing the brain to misinterpret the pain signal as originating from the somatic area instead of the visceral organ, leading to pain felt in a seemingly unrelated body region

148
Q

What is the role of the pons in the regulation of autonomic functions?

A

regulating respiration

149
Q

What is the role of the medulla in the regulation of autonomic functions?

A

regulates heart rate, respiration, vasoconstriction, and vasodilation via signals to autonomic efferent neurons in the spinal cord and by signals conveyed in the vagus nerve

150
Q

What is the role of the hypothalamus in the regulation of autonomic functions?

A

master control of HOMEOSTASIS, influences cardiorespiratory, metabolic, water reabsorption, and digestive activity by acting on the pituitary gland, control centers in the brainstem, and spinal cord

151
Q

What is the role of the emotion/motivation system in the regulation of autonomic functions?

A

produce autonomic responses. For example, we have increased BP due to anxiety.

152
Q

Compare the somatic motor system with the autonomic efferent system:

A
  1. Unlike with the somatic nervous system, regulation of autonomic functions is typically nonconscious and can be exerted by hormones.
  2. Unlike skeletal muscle, many internal organs can function independently of central nervous system input. Examples include independent activity of the heart and the GI tract.
  3. Somatic efferent pathways have one neuron in the peripheral nervous system; autonomic efferent pathways usually comprise two neurons that synapse outside the central nervous system.
153
Q

Sympathetic (Fight or Flight):

A

increases heart rate, dilates pupils, inhibits digestion, stimulates sweating, releases adrenaline, prepares the body for immediate action in a stressful situation

154
Q

Parasympathetic (Rest and Digest):

A

slows heart rate, constricts pupils, stimulates digestion, promotes urination, conserves energy, relaxes the body after a stressful event.

155
Q

Explain the autonomic responses to threat:

A

prepares the body for action in response to a perceived threat through a process called the fight-or-flight response. The ANS activates the sympathetic nervous system (SNS), which triggers a series of physiological changes that help the body cope with danger

156
Q

Compare sympathetic and parasympathetic effects on organ function:

A

Heart rate: The SNS increases heart rate, while the PNS slows it down.
Blood pressure: The SNS increases blood pressure, while the PNS decreases it.
Breathing: The SNS increases breathing rate, while the PNS slows it down.
Digestion: The SNS slows digestion, while the PNS increases it.
Pupils: The SNS dilates pupils, while the PNS constricts them.
Bronchi: The SNS dilates bronchi, while the PNS constricts them.
Blood vessels: The SNS constricts blood vessels, while the PNS stimulates vasodilation.

157
Q

Identify the types of receptors in the autonomic system and their clinical significance.

A
158
Q

Identify the types of receptors in the autonomic system and their clinical significance.

A

cholinergic receptors (which bind to acetylcholine)
adrenergic receptors (which bind to norepinephrine and epinephrine)

159
Q

Cholinergic Receptors:

A

Nicotinic receptors: Found at all autonomic ganglia, stimulating neurotransmitter release from postganglionic neurons; clinically, nicotine can activate these receptors, leading to effects like increased heart rate and blood pressure.

Muscarinic receptors (M1-M5): Primarily located on target organs innervated by the parasympathetic nervous system, responsible for functions like slowing heart rate, increased salivation, and smooth muscle contraction; medications targeting these receptors can be used to treat conditions like overactive bladder or glaucoma.

160
Q

Adrenergic Receptors (also called “Alpha” and “Beta” receptors):

A

Alpha-1 receptors: Primarily cause vasoconstriction when stimulated, leading to increased blood pressure; alpha-blockers are used to treat hypertension.

Alpha-2 receptors: Generally have inhibitory effects, including decreasing norepinephrine release; can be targeted for managing blood pressure.

Beta-1 receptors: Located mainly in the heart, increasing heart rate and contractility when stimulated; beta-blockers are used to treat conditions like tachycardia.

Beta-2 receptors: Primarily found in smooth muscle of the lungs and blood vessels, causing relaxation (bronchodilation and vasodilation) when activated; beta-2 agonists can be used to treat asthma.

161
Q

Describe trophic skin changes.

A

Skin: Thinning, wasting away, or glossy skin
Nails: Brittle nails or changes in the nail beds
Hair: Thickening or thinning of hair, or excess growth
Sensation: Loss of sensation, particularly pain and temperature
Healing: Slower healing

162
Q

Define autonomic dysreflexia and describe common causes and appropriate interventions.

A

Medical emergency affecting people with SCI above T6
 Occurs when an unperceived noxious stimulus BELOW the level of injury causes sympathetic overactivity
 Sweating/flushing above the lesion
 Pounding headache
 High blood pressure
 Pallor below the lesion level
 Lower HR
 Common

163
Q

What are the common causes of autonomic dysreflexia?

A

 Overstretched bladder or rectum
 Unperceived pain or infection of a pressure ulcer

164
Q
A

Position the patient upright
Loosen tight clothing
Monitor vital signs
Medications
Preventative measures:
*Regular bladder catheterization
*Bowel management program
*Skin care to prevent pressure ulcers
*Patient education on identifying triggers and managing symptoms

165
Q

occurs when the autonomic nervous system (ANS) fails to regulate blood pressure in response to standing up

A

Neurogenic orthostatic hypotension

166
Q

Explain the causes of neurogenic orthostatic hypotension.

A

 Spinal region disorders
 Autonomic degenerative disorders
e.g., Parkinson’s disease
 Peripheral neuropathies
e.g., Diabetes, toxin exposures,
nutritional deficiencies

Special Topics in OT (OCTH 670) (2 decks)

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