Final Flashcards
Treatment: Pushers Syndrome
What is it?
What are signs?
Occurs when the pt pushes heavily to the affected side and resists passive correction
Signs:
Holding on to bed or mat as if they were falling
Head turned away from affected side
Decreased ability to detect stimuli from affected side
Resistance to attempts to transfer weight to stronger side
Assessment: PASS
Postural Assessment Scale for Stroke (PASS)
What’s assessed in the PASS?
12 items scored from 0 to 3
Higher scores = better performance
Sitting without support, standing with and without support,
standing on nonparetic leg, standing on paretic leg, supine to affected side, supine to non affected side, standing and picking up a pencil on the floor
What is neuroplasticity?
Neuroplasticity is the brain’s ability to change (for better or worse)
Cortical Maps:
Adult stem cells can generate new differentiated neurons in the hippocampus, dentate gyrus, and olfactory bulbs
Synaptogenesis
The formation of synapses between neurons in the nervous system
What’s Hebb’s rule?
Hebb’s Rule: it is a learning rule that describes how the neuronal activities influence the connection between neurons, i.e., the synaptic plasticity
“Neurons that fire together, wire together”
Competitive Plasticity
Natural selection process that occurs with use or disuse.
“Use it or lose it”
Positive Plasticity
take place at the cellular and molecular level that form new pathways for function (ex: taxi drivers- different route compare to bus drivers)
Negative Plasticity
Negative plasticity: learn things negatively, rigidity, neurons that fire out of sync and fail to link ( fear of falling after 1st fall, follow the same routine/rutt/increase tone/)
Competitive Plasticity
Natural selection process that occurs with use or disuse.
Cerebellum: critical for …
communicating with frontal lobe
Basal ganglia: critical for …
habit formation
Procedural learning
Occurs for tasks that are particularly automatic (without attention or consciousness).
Declarative Learning
Created knowledge that can be recalled.
What’s CVA/ Stroke
a disease of the cerebral vasculature where there is a failure to supply oxygen to the brain
What’s TIA: Transient Ischemic Attack?
Either thrombic or embolic with reversible defects, effects must resolve in less than 24 hrs
Define Infarct:
a localized area of tissue that is dying or dead, having been deprived of its blood supply because of an obstruction by.
Describe a Hemorrhagic stroke
A hemorrhagic stroke is when blood from an artery begins bleeding into the brain.
Bleeding from an arteriovenous malformation
Found throughout the body and can occur in any part of the brain.
Usually congenital.
Headaches and seizures are common
Ruptured saccular aneurysms
Characterized by acute,
abrupt onset of a severe headache,
brief loss of consciousness, nausea, vomiting, focal neurologic deficits, and stiff neck.
Spontaneous Lobar
Occur outside of the basal ganglia and thalamus in the white matter of the cerebral cortex.
Often associated with clients with AVMs (arteriovenous malformation), bleeding diatheses, tumors, aneurysms in the circle of Willis.
Acute onset of symptoms, coma/stupor much less common, headaches common
Deep Hypertensive Intracerebral
Small penetrating arteries in the deep brain that have damage from HTN.
Develops in minutes to an hour. Rapid recovery in first 2-3 months.
Pt usually awake and under emotional distress when it occurs. Vomiting and headache common.
What does FAST stand for?
F: Facial drooping
A: arm weakness
S: Speech difficulties
T: Time (call 911 ASAP)
What is an OT’s role in acute care hospital ?
OT role:
- Evaluate and make recommendations for d/c
- Patient and family education
- Decrease risk of complications
- Initiate OT rehabilitation
What’s dyad training?
Dyad training in which the person can observe and practice a task is beneficial to learning a new task
Define random practice:
-Random practice: (repetitive practice of several tasks in varied sequence, varied context, whole task) is better for motor learning than blocked practice (repetitive practice of the same task, same context, part of task)
Define Self controlled practice:
-Self controlled practice (person decides when and how feedback is given and if AD is used) is better than instructor-controlled practice.
Feedback:
Feedback: can interfere with long term learning, decreased feedback better than increasing, summary feedback after multiple trials is better than feedback after every trial
What’s the 5 steps for Using a top down approach
Step 1) Role Performance
Step 2) Occupational Performance Tasks
Step 3) Task Selection and Analysis
critical control parameters
Step 4) Perform specific assessments of client factors, performance skills, and performance patterns
Step 5) Evaluation of the environment: context and activity demands
pathologic joint condition
limiting factor be if evaluating extrinsics and no change in available digit extension occurs while the wrist is flexed
anterograde amnesia
unable to form new memories, days, weeks, or months after event
retrograde amnesia
loss of memory prior to event, can be days, weeks, or months prior
decorticate rigidity
internal roation of shoulders, elbow, wrist, and digits flexed, hips extended and IR, knees flexed, plantar flexion. Increased rigidity when awake. Lesion to cortical white matter, internal capsule, thalamus, cerebral penacal, and basil ganglia
decerebrate rigidity
extended and external rotation in shoulders, elbows extended, flexed wrist and digits, hip extension/IR, knee extension, ankle and plantar flexion. Increased rigidity when awake. Is due to a lesion in the midbrain pons or diancephalons
Chronic Traumatic Encephalopathy (CTE)
A neurodegenerative disease associated with repeated head trauma (football) Results in generalized global atrophy of the brain, ventricular dilation, thinning of the corpus collosum, and neurofibrillary bundles similar to AD (Alzheimer’s) Symptoms include headaches, difficulties with attention and memory, mood disorders, motor dysfunction, and dementia
Second impact syndrome (SIS)
Occurs when an individual suffers a second head injury before the initial injury has fully healed…leads to diffuse cerebral swelling
where consciousness, breathing, and heart rate are controlled, sometimes compromised by intercranial pressure (ICP), damage here can result in coma or death
brainstem
coma
absence of awareness of self and the environment there is no period of wakefulness this rarely lasts more than 4 weeks without medications, some people are placed into medical comas.
vegetative state
Wakefulness without awareness Characteristics: no awareness of self or environment, inability to interact with others, no sustained or voluntary behavioral responses, no language comprehension, sleep wake cycle varies, ability to regulate temp, breathing, and circulation with medical care, incontinence of bowels and bladder, variably preserved cranial nerves and spinal reflexes prognosis worst if lasts more than 12 months
minimally conscious state (MCS)
Evidence of awareness of self and/or environment. Must have 1 of the following: ability to follow commands, gesture or verbal yes/no responses, intelligible verbalization, and purposeful movement
secondary injury
Occur as a result of the effects of brain swelling in a closed space, loss of perfusion, and decreased delivery of oxygen
minimize secondary injury
Resuscitation of blood pressure and oxygenation, management of elevated intracranial pressure, nutrition after acute trauma and seizure prophylaxis
Multifocal and diffuse brain injury
Ataxia Diplopia Dysarthria Impulsivity, irritability Apathy, poor initiative Decreased mental processing speed & efficiency Impaired attention Impaired abstract reasoning, planning, problem solving
Diffuse axonal injuries (DAIs)/Traumatic axonal injury (TAI)
prototypic lesions caused by rapid deceleration and rotation of the brain in the skull
Intraventricaluar hemorrhage (IVH)
Large ones can block flow of cerebrospinal fluid that can result in hydrocephalus occur when the pia or arachnoid is torn
Subacrachnoid Hemorrhage (SAH)
caused by trauma less frequently associated with vasospasms and by ruptured aneurisms occur when the pia and arachnoid is torn
Intracerebral hemorrhage (ICH)
nearly always present with missile wounds and common after falls and assault
multifocal and diffuse injury
often caused by sudden deceleration of the body and head with variable forces and deeper portions of the brain
