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PT624 Neuro > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Neglect

A

Failure to report, respond, or orient to novel or meaningful stimuli presented on the side opposite of the brain lesion, when this failure cannot be attributed to either sensory or motor deficits

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2
Q

Contralateral pushing

A

Powerful leaning toward the hemiplegic side in sitting, during transfers, standing, and walking

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3
Q

Pathophysiology of neglect

A

Lesion in right/non-dominant hemisphere in the superior temporal lobe corresponding with Wernicke’s areas

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4
Q

Pathophysiology of contralateral pushing

A

Damage in left or right posterolateral thalamus. Distinctly different to parietal lobe, but anatomically close

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5
Q

Differential diagnosis of motor neglect

A

Full neuro exam to determine extent of primary motor deficits
Lesion location
Transcranial magnetic stimulation/diffusion tensor imaging (to determine integrity of CST)

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6
Q

Differential diagnosis of sensory neglect

A

Homonymous hemianopsia
Hearing loss
Somatosensory loss

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7
Q

Implications of neglect

A 
Poorer functional outcomes
Lower Barthel scores
Longer hospital stay
Less likely to be d/c home
Increased therapy needed
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8
Q

Recovery of neglect

A

Spontaneous recovery in 6 weeks in most cases, but usually lingering long-term effects

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9
Q

Prognosis with persistent neglect

A

Poor prognosis

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10
Q

Recovery mechanism of neglect

A

Unknown

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11
Q

Prognosis of contralateral pushing

A

Lower initial function
Take 63% longer to reach same outcome as patients without pushing
R CVA slower recovery than L CVA
Does not negatively affect overall outcome of rehab
Usually resolves within 6 months

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12
Q

Relationship between contralateral pushing and neglect and aphasia

A

Neglect and aphasia are commonly associated with contralateral pushing but not causative

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13
Q

LE contracture splint uses

A

Prevent equinovarus contracture (PF + inversion)

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14
Q

UE contracture splint uses

A

Prevent wrist and finger flexion contracture

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15
Q

Use for hand splints

A

Maintain wrist and hand position to support functional grasp

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16
Q

Use for knee immobilizer

A

Usually used in the acute stages of stroke to give enough stability so the patient can experience weight bearing. Can also be used for pushing syndrome when patients lean to the paretic side.

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17
Q

Tilt table is very common for those with

A

spinal cord injuries

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18
Q

Mechanical support system for standing frame

A

Stabilizes feet, extend knees and hips, support trunk

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19
Q

Advantages of standing frame

A

Permits upright functional position
Allows standing w/ hands free
Loads axial skeleton
Supports kidney and urinary systems

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20
Q

Disadvantages of standing frame

A

Bulky
Awkward
Expensive

21
Q

Metal orthosis upright component advantages/disadvantages

A

Heavy compared to plastic or carbon fiber

22
Q

Metal orthosis joint advantages/disadvantages

A

None over plastic orthosis

23
Q

Metal orthosis foundation advantages/disadvantages

A

One shoe type

24
Q

Plastic orthosis upright component advantages/disadvantages

A

Contraindicated for fluctuated edema, poor circulation, and inadequate hygiene/skin checks

25
Q

Plastic orthosis joint advantages/disadvantages

A

None over metal orthosis

26
Q

Plastic orthosis foundation advantages/disadvantages

A

Versatile for interchangeable shoes

27
Q

Advantages for solid AFOs

A

Provides the greatest control in the sagittal, frontal, and transverse planes

28
Q

Disadvantages for solid AFOs

A

Lose ankle, forefoot, and toe rockers

Patient may experience knee instability in loading response

29
Q

Indications for solid AFOs

A

Severe spasticity, absent proprioception, ankle/foot deformity in varus/valgus

30
Q

Contraindications for solid AFOs

A

Fluctuating edema (plastic upright), very weak quadriceps (loading response)

31
Q

Indications for floor reaction AFO

A

Excessive flexion at the knee during weight acceptance and single limb stance

32
Q

Contraindications for floor reaction AFO

A

Genu recurvatum/hyperextension during single limb stance

Upright: Contraindicated for fluctuated edema, poor circulation, and inadequate hygiene/skin checks

33
Q

Advantages of posterior leaf spring AFO

A

Lightweight and flexible to allow for heel, ankle, forefoot, and toe rockers

34
Q

Disadvantages of posterior leaf spring AFO

A

Provides no stability during weight acceptance or single limb stance

35
Q

Indications for posterior leaf spring AFO

A

Individuals with swing phase impairments only

36
Q

Contraindications for posterior leaf spring AFO

A

Medial/lateral ankle instability and knee instability (very weak quads and or PF group)

37
Q

What examinations must be done by PT when prescribing orthoses

A

Static and dynamic examination

38
Q

What should be inspected in static examination?

A

Orthotic ankle joint should be congruent with anatomical joint
Calf band/shell should terminate below the fibular head and not intrude on popliteal fossa
Inspect the skin
Inspect the motion available in the joint of orthosis

39
Q

What about the diagnosis should the PT consider when prescribing orthoses?

A

Is there potential for recovery or decline in function?

40
Q

Population at highest risk for brain injury

A

Adolescents and those over 75

41
Q

BI is the leading cause of death and disability in what population?

A

Children

42
Q

Majority of those with brain injury are between what ages?

A

15-24 years

43
Q

Risk factors for brain injury

A 
Younger
Poor
Minority
Unmarried
Inner-city male risk takers
44
Q

Passive tests for structural damage

A

Skull and C-spine radiographs to rule out fracture

CT and MRI to rule out structural brain damage

45
Q

Active tests for functional damage are done by

A

Neurophyschologists, PTs, OTs, STs, and RTs

46
Q

2 types of focal injury in TBI

A

Coup

Contre-coup

47
Q

2 causes of diffuse injury in TBI

A

Increased intracranial pressure

Diffuse axonal Injury (DAI)

48
Q

What are the 3 types of hematomas?

A

Epidural hematoma
Subdural hematoma
Subarachnoid hematoma/intraparenchymal hemorrhage

PT624 Neuro (13 decks)

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