final exam Flashcards
1
Q
what are the 4 causes of peripheral nerve lesions?
A
- compression (internally ie: bony callus/HT muscles; externally ie: crutches)
- trauma (crushing or wound)
- systemic disorders (lepsory)
- systemic edematous conditions (pregnancy, hypothyroidism, kidney & heart failure)
2
Q
at what rate does a nn regenerate per day?
A
1-2 mm per day
1/2 - 3/4 per week and 1 1/4 - 2 1/4 per month
3
Q
what is the prognosis for the 3 clasifying nerve injuries (neuropraxia, aconotmesis & neuromesis)
A
neuropraxia: good
aconotmesis: good
neurotmesis: poor
4
Q
first degree classification of nn injury
A
neuropraxia
5
Q
second degree classification of nn injury
A
aconotmesis
6
Q
third degree classification of nn injury
A
neurotmesis
7
Q
what causes Neuropraxia injuries
A
compression of a nn causing local conduction block, no structural damage to the axon or the tissue distal to the lesion
8
Q
what causes anconotmesis injuries
A
prolonged, severe compression of a nn that will cause a lesion at the site of compression, followed by degeneration of the axon distal to the injury; endoneurial tube remains in tact
9
Q
what causes neurotmesis injuries
A
injury involves severing of the nn trunk; including the endoneurial tube. results in degeneration of the nn, regeneration may be difficult due to scar tissue build up on lesion site
10
Q
how are Neurotmesis nn injuries repaired?
A
usually surgery
11
Q
what is hyperesthesia?
A
abnormal increase to sensitivity
12
Q
what is dysesthesia?
A
abnormal sense of touch
13
Q
how will symptoms present with partial and complete nerve lesions when edema is present
A
complete: edema present initially, due to injury. damage to autonomic fibers so edema remains until regeneration & vasomotor function returns.
partial: edema present initially, due to injury. less edema than with complete. because there is some local mm function, assists with lympathic return
14
Q
how will symptoms of altered tissue health present with partial and complete nerve lesions
A
complete: loss of autonomic function affects skin, hair, nails. fragile tissue, dystrophic & easily injuried. LOSS of piloerection. loss of sweating over area of denervation
partial: tissue changes, not as severe as complete. an INCREASE piloerection over area of denervation
15
Q
how will symptoms of motor function present with partial and complete nerve lesions
A
complete: flaccidity; mm wasting within 3 wks. spontaneous contraction of mm fibers within few weeks (fibrillations). LACK or DIMINISHED reflex
partial: mm weakness, diminished tendon reflex
16
Q
how will symptoms of holding patterns present with partial and complete nerve lesions
A
complete: drop foot with sciatic nn lesion, drop wrist with radial
partial: less apparent since some fibers are innervated. ex: partial radial nn lesion will have finger drop rather than full wrist drop
17
Q
how will symptoms of contractures present with partial and complete nerve lesions
A
complete: affected mm unable to exert force on joint they cross. contractures will develop in antagonists as they draw into shorter portion
partial: same as complete. less severe than complete because there is some opposition to antagoinist
18
Q
how will pain symptoms present with partial and complete nerve lesions
A
complete: pain variable. may be decreased or altered sensation
partial: likely area of hyperesthesia (abnormal increase to sensitivity) and dysesthesia (abnormal sense of touch)
19
Q
how will scar tissue symptoms present with partial and complete nerve lesions
A
complete&partial: present at lesion site; could interfere with healing/regeneration process
20
Q
Increased piloerector response is associated with which type of nerve lesion, complete or partial? and how is the other affected?
A
partial nn lesion.
complete is decreased response
21
Q
What category of classification does Carpal Tunnel Syndrome fall under?
A
Neuropraxia: Compression Syndrome
- Compression of the Medial Nerve as it passes through the carpal tunnel at the wrist
22
Q
What category of classification does Piriformis Syndrome fall under?
A
Neuropraxia: Compression Syndrome
- Piriformis syndrome is when the piriformis compresses the sciatic nerve.
23
Q
What category of classification does Thoracic Outlet Syndrome fall under?
A
Neuropraxia: Compression Syndrome
- Compression of the Brachial Plexus and artery between:
- the middle and anterior scalenes (anterior scalene syndrome)
- the coracoid process and the pec minor muscle (pec minor syndrome)
- the clavicle and 1st rib (costoclavicular syndrome)
24
Q
What are examples of external causes of compression in nerve lesions?
A
pressure from crutches, splints, backpack straps
25
What are examples of internal causes of compression in nerve lesions?
- HT mm. can be due to TP, postural imbalance, mm imbalance. if the nn penetrates the mm it is more susceptible. (ie: piriformis & sciatic nn)
- structural abnormalities (extra l cervical rib, callus at fracture site)
- trauma/overuse= edema & scar tissue
- poor positioning of limbs; while sleeping or during surgery (saturday night syndrome)
- systemic conditions; pregnancy, hypothyriodism, diabetes mellitus (systemic edema occurs)
26
What is Mononeuropathy? What are possible causes?
Mononeuropathy is damage that occurs to a single nerve.
- causes are the path the nerve travels, common points of compression, symptoms, muscles affected, causes and dysfunctions
27
what is the spinal innervation of the radial nerve?
C5-T1
28
what are the 2 branches of the radial nerve at the supinator?
posterior motor branch
superficial branch
29
what fracture causes a radial nerve injury
- primairly at the spiral groove of the humerus
- involved in approx 70% of humeral fractures. also involved in supracondylar & upper 1/3 radius fractures
30
what dislocation causes a radial nerve injury
head of the radius, humeroradal and radiaoulnar joint
31
what post-surgical complications causes a radial nerve injury
unrelieved pressure from poor positioning during surgery
32
what compression causes a radial nerve injury
- at axilla from crutches
- "saturday night palsy"
33
what is supinator syndrome? (radial nn injury)
- compression over the forearm
- fibrosis can occur on site where the nn penetrates supinator
- compression can lead to a first or second degree lesion
34
what nn is affected when someone has "wrist drop"
radial nerve
35
what causes wrist drop? what does it look like?
radial nn lesion.
wrist hands in flexion because the wrist flexors are unopposed due to flaccid extensors
36
where is the sensory dysfunction/altered sensation felt in a radial nn lesion
posterior arm, forearm and hand. the thumb, index, middle & half of the ring finger, finger tips;
- anesthesia is possible in the web of the thumb and 2nd finger
37
spinal innervation for the ulnar nerve
C8-T1`
38
what fractures cause the ulnar nerve to be affected?
medial condyle of the elbow, mid-forearm or wrist
39
what dislocation causes the ulnar nerve to be affected?
elbow
40
what are post-surgical complications involved with ulnar nerve
unrelieved pressure from arm hanging over the table or positioned improperly
41
what pathology affects the ulnar nerve
leprosy
42
what repetitive action affects the ulnar nerve
excessive stress with flexion/extension; compressions syndrome may develop due to fibrosis at the medial elbow or at guyons canal.
can result in first or second degree nn lesion
43
what direct trauma affects the ulnar nerve
contusion/laceration at wrist or hand; median nn can also be affected
44
what nerve lesion causes claw hand
ulnar
45
what is the presentation of claw hand
little finger hyperextended & abducted at MCP joint and the IP joint
ring finger is hyperextended at the MCP and a smaller amount of flexion at the IP joint
46
what special test is positive with ulnar nn lesion
forments sign
47
spinal innervation of the median nerve
medial cord (C8-T1)
lateral cord (C5-C7)
48
what fracture causes median nerve to be affected
at the elbow, wrist or carpals
49
what dislocation affects the median nn
elbow, wrist, carpals (specifically lunate & scaphoid)
50
what commpression affects the median nn
fibrosis & HT in overuse mm or entrapment of the nn at the carpal tunnel (pronator teres syndrome & carpal tunnel)
51
what trauma affects the median nn
traction injuries, contusions or lacerations (esp wrist/hand)
52
complete lesion of what nn causes ape hand
median
53
complete lesion of what nn causes oath hand
median
54
what is the presentation of ape hand
caused by median nn lesion.
thumb lies in the same place as the rest of the hand. loss of opposition
55
what is the presentation of oath hand
caused by median nn lesion.
occurs when person tries to make a fist; only the 3rd and 4th fingers can flex
56
what is compression of the median nn as it passes through the carpal tunnel?
carpal tunnel syndrome
57
what is the sensory area affected with carpal tunnel syndrome
numbness & tingling in the lateral 3 fingers and 1/2 of the fourth
58
what plexus does the sciatic nn originate
sacral
59
spinal innervation for sciatic nn
sacral plexus L4-S1
60
what two nerves do the sciatic nn branch into at the popliteal fossa?
tibial and fibular/peroneal division
61
what fractures affect the sciatic nn
pelvis, femur, tibia, fibula, ankle (usually inversion)
62
what dislocations affect the sciatic nn
hip, knee (usually peroneal), ankle
63
what adverse reactions affect the sciatic nn
injections into the glutes
hip surgery
meniscal repair
improper positioning during surgery or traction post-surgery
64
what compressions from internal sources affect the sciatic nn
- piriformis syndrome
- tarsal tunnel syndrome
- mortons foot
65
what compression from external source affects the sciatic nn
compression against the fibular head (cast, splint, crossing legs)
prolonged squatting
66
what type of trauma affects the sciatic nn
such as a contusion to the glutes
67
what nn is affected with foot drop
sciatic
68
what nn lesion can cause claw toe
sciatic tibial branch
69
what nn is affected with bells palsy
CN VII (7)
70
what are the 4 causes of bells palsy
compression from edema
conditions affecting the parotid gland
compression from inflammation (trauma)
exposure to a chill/draft
71
What is the diagnostic criteria for major depressive episode?
- persistent unpleasent mood
- depressed mood, anhedonia (inability to experience pleasure), feeling of worthlessness, excessive guilt, decreased concentration, psychomotor agitation or retardation (restlessness), insomnia or hypersomnia, decreased libido, changes in weight/appetite, thoughts of death/suicide
(five or more of these symptoms)
72
what are the two categories of depressive disorders?
major depressive disorder
dysthymia
73
what is characterized by chronic mild depression
dysthymia
74
what are the symptoms of dysthymia?
-mild depressive symptoms
- same as major depressive disorder but milder
- low self-esteem, sleep, energy & appetite distubances
- can lead to major depressive state if ignored or undiagnosed
75
What are the six various subclasses of depression symptoms?
1. melancholic
2. atypical
3. phychotic
4. catatonic
5. chronic
6. postpartum
76
______ features are when depression is worse in the morning, insomnia with early morning waking up, anorexia with weight loss, psychomotor agitation/retardation, excessive guilt, loss of interest in activities, inability to respond to pleasurable stimuli, loss of joy
melancholic features
77
_____ depression sx opposite of melancholic. depression tends to get worse as the day progresses. overeating & hypersomnia are a symtoms
atypical depression
78
______ feature symptoms involve delusions and hallucinations that may or may not be mood related
psychotic feature
79
______ depression symptoms involve excessive mobility or motoric immobility, extreme negativism, repetitive speech & peculiar voluntary movements
catatonic depression
80
_____ is used when referring to depression that has been present for 2+ years
chronic
81
______ refers to depression that occurs within 6 weeks of giving birth. hormones and stress play a role
postpartum
82
What is the role of hormones in postpartum depression?
they both play a part in postpartum depression.
83
what is an alternative name for bipolar disease
manic depression
84
what are the clinical manifestations for bipolar disease?
- decreased need for sleep & food
- labile mood
- irritability
- racing thoughts
- highly distracted
- rapid and pressured speech
- inflated self-esteem
- excessive involvement in pleasurable experiences
85
mania without depression is called ______
unipolar
86
Describe what is meant by mania. How quickly does this symptom manifest?
Mania is classified as episodes of elation and irritability, with or without periods of depression.
- Mania can begin abruptly within hours or days or develop over a few weeks. If left untreated it can get worse over time.
87
What is hypersomnia?
Hypersomnia is characterized by recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep.
88
_______ is characterized by intense fearfulness that occurs without a precipitating potentially dangerous event, accompanied by subjective as well as objective manifestation
anxiety disorders
89
what are the subjective manifestations of anxiety disorders?
heightened awareness to deep fear of impending disaster or death
90
what are the objective manifestations of anxiety disorders?
restlessness
sweating
palpitations
increase HR & BP
dry mouth
desire to run & escape
91
What percentage of people are affected by anxiety disorders? Who is statistically more at risk for experiencing anxiety disorders?
Anxiety disorders affect approximately 28.8% of all people, women more often than men
92
What are the five subdivided categories of Anxiety Disorders?
panic disorder
PTSD
GAD
social phobia
OCD
93
characterized by an experience of intense fear with neurologic, cardiac, respiratory & psychological symptoms
panic disorder
94
a stress response as a result of experiencing a traumatic event
PTSD
95
characterized by excessive, uncontrollable worry
GAD
96
characterized by an intense fear reaction to social interaction
social phobia
97
characterized by repetitive thoughts and actions
OCD
98
at what age do panic disorder typically develop?
The disease can peak at mid-adolescence and again in the
mid thirties
99
at what age do social phobia typically develop?
between ages 11-19
100
at what age do OCD typically develop?
20 years of age
101
What are common symptoms of panic attack?
- Neurological symptoms (light-headedness, dizziness, fainting)
- Cardiac symptoms (tachycardia, chest pain, palpitations)
- Respiratory symptoms (shortness of breath, feeling of being smothered or choked)
- Sweating
- Nausea or abdominal distension
- Psychological symptoms (fear of dying, sense of unreality, feeling of impending doom)
102
what is the duration for panic attacks?
These attacks are usually unexpected and not related to any external factors.
They usually last 15-30 minutes, some can last for an hour or more
103
What qualifies someone a diagnosis of social phobia?
- A generalized or specific, intense, irrational and persistent fear of being scrutinized or negatively evaluated by others
- The fear is irrational. Avoidance of social situations and avoidance behaviours are common signs of the disorder.
- The fear must not be related to any other physiologic effects of a substance and must be present for at least 6 months
104
is panic disorder more common in men or women?
women
105
is OCD more common in men or women?
affects men and women equally
106
is social phobia more common in men or women?
women
107
how long should fear be present to diagnose someone with social phobia?
The fear must not be related to any other physiologic effects of a substance and must be present for at least 6 months
108
what is social phobia also known as?
social anxiety disorder
109
what is a non-normative cognitive decline that can be caused by any disorder that permanently damages large association areas of the cerebral hemispheres or subcortical areas that serve memory and learning.
dementia
110
what are the features of dementia?
- Impairment of short and long term memory
- Deficits in abstract thinking, impaired judgment
- Personality changes
- Disturbance is usually high enough to significantly interfere with social and work activities
111
what are the 5 types of dementia?
- alzheimers
- vascular dementia
- Creutzfeldt-Jakob disease
- Wernicke-Korsakoff syndrome
- Huntington Chorea
112
at what time in life does Alzheimers disease happen? and what percentage of dementia is Alzheimers?
mid to late life
accounts for 60-80% of the cases of dementia
113
it is estimated that ___% of people over the age of 85 are affected by Alzheimers
50%
114
what is the main characteristic of Alzheimers?
The main characteristic of Alzheimer’s is plaque formation, neurofibrillary tangles and amyloid angiopathy present in the brain.
115
defined by the cortical atrophy and loss of neurons, particularly in the parietal and temporal lobes
Alzheimers
116
alzheimers has an average survival of ____ years after diagnosis
8-10 years after diagnosis
117
what are the hallmark of symptoms for Alzheimers disease?
- loss of short term memory
- denial of the memory loss
- difficulty with language
- changes in behaviour
118
this type of dementia occurs as a result of ischemia or hemorrhagic damage to the brain.
vascular dementia
119
Approximately ____% of dementias are vascular
20-25%
120
what age is the onset of vascular dementia?
Onset is usually 55-70 years of age
121
Related to a group of disorders associated with atrophy of the frontal and anterior temporal lobes of the brain
frontotemporal dementia
122
what was frontotemporal dementia originally known as?
picks disease
123
what is Creutzfeldt-Jakob Disease caused by?
an infectious protein (prion)
124
Rare, rapidly degenerative form of dementia thought to be caused by an infectious protein (prion)
Creutzfeldt-Jakob Disease
125
what are the 4 categories of Creutzfeldt-Jakob Disease?
- Sporadic- disease occurs without known risk factors, most common
- Hereditary- familial background of the disease, 10-15%
- Acquired- very rare, less than 1%
- New Variant CJD- similar to sporadic (except sensory and behavioural disturbances and occurs
in much younger people)
126
what type of dementia is caused by alcoholism?
Wernicke-Korsakoff syndrome
127
what is the age on onset for Wernicke-Korsakoff syndrome?
common in the 40-50s
128
what is the age of onset for Frontotemporal Dementia?
between 35 and 75 years of age
129
what is Wernicke-Korsakoff syndrome characterized by?
Characterized by weakness and paralysis of the extra-ocular muscles, nystagmus, ataxia and
confusion
130
Hereditary characterized by chronic progressive chorea, psychological changes, dementia
huntington disease
131
what is the age of onset for huntington disease?
40-50s
132
what are the 2 classifications of headaches?
primary & secondary
133
what are the primary/chronic types of headaches?
- Migraines
- Tension
- Cluster
- Chronic daily
134
What are possible red flags for secondary headaches?
- progression of the headache
- new headache in people under the age of 5 or over 50,
- women who are pregnant
- people who are on immunosuppressants
- or who has cancer
135
what are secondary headaches?
More often associated with a condition or illness
136
regards pain as a separate sensory modality by the activity of specific receptors that transmit information to pain centers or regions in the forebrain where pain is experienced
specificity theory
137
this theory postulated the presence of neural gating mechanisms at the segmental spinal cord level to account for interactions between pain and other sensory modalities
gate control theory
138
the idea that perception of physical pain is not a direct result of activation of nerves that do not transmit pain signals can interfere with signals from pain fibers and inhibit an individuals perception of pain
gate control theory
139
what theory is an example of repeated sweeping of a soft-bristled brush on the skin over or near a painful area may result in pain reduction for several minutes to several hours
gate control theory
140
Where are first, second and third order neurons located in relation to pain?
- first order neurons: and their receptive endings detect stimuli that threaten the integrity of innervated tissues
- second order neurons: are located in the SC and process nociceptive information
- third order neurons: project px information to the brain. the thalamus and somatosensory cortex integrate and modulate pain as well as the persons subjective reaction to the pain experience
141
project px information to the brain. the thalamus and somatosensory cortex integrate and modulate pain as well as the persons subjective reaction to the pain experience
third order neurons
142
located in the SC and process nociceptive information
second order neurons
143
_________ and their receptive endings detect stimuli that threaten the integrity of innervated tissues
first order neurons
144
_______ or pain receptors, are sensory receptors that are activated by noxious insults to peripheral tissues (ie. stubbing toe)
nocieceptors
145
what tract are myelinated A fibers associated with?
neospinothalamic tract
146
what tract are unmyelinated C fibers associated with?
paleospinothalamic
147
are myelinated A fibers faster than unmylinated C fibers?
yes. myelinated A fibers are fast, unmyelinated C fibers are slow
148
What region of the brain is the central pathway for pain modulation?
periaqueductal gray (PAG) region
149
______ are morphine-like substances, are found on the peripheral processes of primary afferent neurons and in many regions of the CNS.
endogenous opioid peptide
150
what three substances are found within families of opioid peptides?
enkephalins, endorphins, and dynorphins
151
closely associated with the point at which a stimulus is perceived as painful
pain thershold
152
__________ more to the total pain experience; it is defined as the maximum intensity or duration of pain that a person is willing to endure before the person wants something done about the pain. Psychological, familial, cultural, and environmental factors significantly influence the amount of pain a person is willing to tolerate.
pain tolerance.
153
What is the difference between pain threshold and tolerance?
The threshold to pain is fairly uniform from one person to another, whereas pain tolerance is extremely variable
154
______ is a sharp, burning pain that has its origin in the skin or subcutaneous tissues.
cutaneous pain
155
_______ is a diffuse and poorly defined pain that results from stretching, distention, or ischemia of tissues
in a body organ
visceral pain
156
_______ is a self-limiting pain that lasts less than 6 months.
acute pain
157
________ is persistent pain that lasts longer than 6 months, lacks the autonomic and somatic responses
associated with acute pain, and is accompanied by loss of appetite, sleep disturbances,
depression, and other debilitating responses.
chronic pain
158
_______ is pain that originated at a visceral site but is perceived as originating in the part of the body wall that is innervated by neurons entering the same segment of the nervous system
referrred pain
159
___________ (i.e., focusing a person's attention on stimuli other than painful stimuli or negative emotions) does not eliminate pain, but it can make pain more tolerable. Examples of distraction include counting, repeating phrases or poems, and engaging in activities that require concentration, such as. projects, activities, work, conversation, or describing pictures. Cognitive reappraisal is a form of self distraction or cognitive control in which individuals focus their attention on the positive aspects of the experience and away from their pain.
distraction
160
_________ consists of using one's imagination to develop a mental picture. In pain management, therapeutic guided imagery (i.e., goal-directed imaging) is used. It can be used alone or in conjunction with other cognitive behavioural interventions (e.g., relaxation or biofeedback) to develop sensory images that may decrease the perceived intensity of pain. Meditation also can be used, but itrequires practice and the ability to concentrate to be effective.
imagery
161
_____________ is used to provide feedback to a person concerning the current status of some body function
(e.g., finger temperature, temporal artery pulsation, blood pressure, or muscle tension). It involves
a process of learning designed to make the person aware of certain of his or her own body
functions for the purpose of modifying these functions at a conscious level. Interest in
biofeedback increased with the possibility of using this treatment modality in the management of
migraine and tension headaches or for other pain that has a muscle tension component.
biofeedback
162
What are various types of pharmacological analgesics? What are examples of each?
- Non-narcotic analgesics- aspirin, NSAIDS or acetaminophen.
- Opioid analgesics- (narcotics) morphine, codeine, etc.
- Adjuvant Analgesics- tricyclic antidepressants, anti-seizure medications, corticosteroids.
163
What are examples of Stimulus-Induced Analgesia discussed in class?
Stimulus-induced analgesia is one of the oldest known methods of pain relief. a Roman physician, Scribonius Largus, described how the stimulus from an electric eel was able to provide pain relief for headache and gout.
- Electrical stimulation methods of pain relief include transcutaneous electrical nerve stimulation (TENS),
electrical acupuncture, and neurostimulation.
164
_________ is characterized by severe, brief, often repetitive attacks of lightninglike or throbbing pain. It occurs along the distribution of a spinal or cranial nerve and usually is precipitated by stimulation of the cutaneous region supplied by that nerve
neuralgia
165
_________ is the term used for the puzzling phenomenon of pain that follows a non-noxious stimulus to apparently normal skin. Non-noxious stimuli may include wind, touching sheets, and showering.
allodynia
166
This is experienced as unpleasant hypersensitivity
hyperesthesia
167
________ is diagnosed as the presence of continuing pain, allodynia, or hyperalgesia after a nerve injury, not necessarily limited to the distribution of the injured nerve with evidence at some time of edema, changes in skin blood flow, or abnormal
sensorimotor activity in the region of pain.
causalgia
168
CRPS II is also known as...
causlgia
169
______ is the absence of pain on noxious stimulation or the relief of pain without loss of consciousness
Analgesia
170
Increased painfulness
Hyperalgesia
171
______ IS Reduced or lost temperature sensation
Athermia
172
Spontaneous, unpleasant sensations
Paresthesia
173
reduced or lost pain sensation
Hypoalgesia
174
reduced or lost tactile sensation
hypoesthesia
175
reduced or lost tactile sensation
Hypoesthesia
176
what is the cause of trigeminal neuroalgia?
One theory suggests that peripheral injury or disease of the trigeminal nerve increases afferent firing in the nerve. Failure of central inhibitory mechanisms may be involved as well.
177
what are the sx & sx of trigeminal neuroalgia?
Facial tics or spasms and characterized by paroxysmal attacks of stabbing pain that usually are limited to the unilateral sensory distribution of one or more branches of the trigeminal nerve, most often the maxillary or mandibular divisions.
Although intermittent, the pain often is excruciating and may be triggered by light touch, movement, drafts, and
eating.
178
what is the cause of Post-herpetic Neuralgia?
Herpes zoster (also called shingles)
179
what is the cause of intercostal neuralgia?
Diabetes & Shingles
180
with herpetic neuralgia the pain is present for more than __ - __ days
90-120 days
181
what are the two most important types of migraines?
1. migraine without aura
2. migraine with aura
182
what percentage of the population with migraines are affected by migraines without an aura?
85%
183
what are the symptoms of migraines without aura?
- pulsatile, throbbing, unilateral headache lasting 1-2 days
- aggravated by physical activity
- nausea, vomiting, sensitivity to light and sound
- visual disturbances; visual hallucinations such as stars, sparks, flashes of light
184
how long do migraines without aura typically last?
1-2 days
185
what are the symptoms of migraines with aura?
- similar to without aura but with additional visual symptoms including positive features (flickering lights, spots, lines) or negative features (loss of vision)
- fully reversible sensory symptoms, including positive features (feeling of pins & needles) or negative features (numbness)
- fully reversible speech disturbances/neurological symptoms that precede the headache
186
auras usually develop over a period of ______ minutes and last from __ minutes to ____
auras develop over a period of 5-20 mins, lasts from 5 mins to an hour
187
this is called a pre-headache, experiences hours or even days before a migraine
prodome
188
symptoms of the prodome are:
- food cravings
- constipation/diarrhea
- mood changes (depression, irritability, etc)
- muscle stiffness (esp. neck)
- fatigue
- increase urination
189
a familiar sign that separate migraine episodes from other headache disorders
aura
190
List the different ways an aura may be experienced
including positive features (ie: flickering lights, spots, or lines) or negative features (loss of vision)
191
What is the difference between a migraine and cluster headache?
- Migraine: lasts 1 to 2 days
- Cluster: tend to occur in clusters over weeks or months, followed by a long, headache-free remission period
192
Overuse of what two substances is hypothesized to be a potential cause of tension headaches?
overuse of analgesics or caffeine. - Daily use of caffeine can produce addiction, and a headache can develop in such persons who go without caffeine for several hours
193
What is whiplash?
A whiplash is an acceleration-deceleration injury to the head and neck
194
the term ____________ is used to refer to headaches that occur 15 days or more a month, including those due to medication overuse.
chronic daily headache
195
What are more modern terms for whiplash? What is the preferred term now for whiplash by most medical
and insurance professionals?
Most recent terms: cervical acceleration-deceleration (CAD) injury, whiplash associated disorder (WAD)
196
in phase 4 of injury of a MVA, what spinal segmenets are most frequently affected?
C5-C7
197
_________ is an abnormal positioning of the head and neck relative to the body
torticollis
198
what are the 3 types of torticollis?
acute acquired
congenital
spasmodic
199
What muscles are commonly affected by torticollis?
ipsilateral SCM, upper trapezius, levator scapulae, scalenes, contralateral splenius capitis/cervicis, multifidi & rotators, suboccipitals
200
_________ is a painful unilateral shortening or spasm of neck mm resulting in an abnormal head position
acute acquired toticollis
201
___________ is a contracturing of one SCM mm resulting in an abnormal head position
congenital torticollis
202
______ is a localized dystonic resulting in an involuntary spasm of cervical mm and an abnormal head position
spasmodic torticollis
203
______ is a degeneration of the annular fibres of the intervertebral disc.
DDD
204
What discs are the most common area of herniation?
Herniations at L4-L5 and L5-S1 accounts for 98% of cases
205
What are the most common age ranges for disc herniation?
Between the ages 30-45, it’s most common for a traumatic rupture in the lumbar spine to occur
(it’s possible for disc herniation to occur before age 20; less likely to occur after age 50 as disc has fibrosed)
206
Describe the stages of herniation. Protrusion, Prolapse, Extrusion and Sequestration
- Protrusion (posterolateral): annular fibres intact
- Prolapse: outermost annular fibres intact
- Extrusion: rupture of entire annulus fibrosus but no fragmentation of disc
- Sequestion: discal fragments in epidural space
207
_________________________ formerly known as reflex sympathetic dystrophy (RSD), is a rare disorder of the extremities characterized by autonomic and vasomotor instability.
The complex regional pain syndrome (CRPS)
208
what is another name for shingles?
herpes zoster
209
________ is caused by the same herpes virus (varicella-zoster virus) that causes chickenpox and is thought to represent a localized recurrent infection by the
varicella-zoster virus that has remained latent in the dorsal root ganglia since the initial attack of
chickenpox.
herpes zoster (shingles)
210
which type of neuralgia is shingles associated with?
post-herpetic neuralgia
211
What are possible contraindications to neuroma?
- Treatment generally includes a relaxation massage to decreases SNS firing and to provide emotional
support to the client
- If compression of the neuroma is painful, massage is locally contraindicated. AF & AA Rom of proximal
and distal joints are encouraged to maintain joint motion and health
212
_______________ is thought to be caused by sensitized helper T cells and an antibody directed attack on the acetylcholine receptor in the neuromuscular junction
Myasthenia Gravis
213
___________ is caused by a virus, but may also be caused by bacteria, fungi, or other organisms.
Encephalitis
214
_____ affects motor neurons in three locations:
- the anterior horn cells (LMNs) of the spinal cord
- the motor nuclei of the brain stem
- the UMNs of the cerebral cortex.
ALS
215
______ Interferes with delivery of oxygen and glucose, as well as the removal of metabolic wastes. and has two types
ischemia.
- Focal (i.e. stroke): Only a region of the brain is affected. Collateral circulation provides blood flow to uninvolved brain areas.
- Global (i.e. cardiac arrest): Blood flow to the entire brain is compromised.
216
______ is caused by an interruption of blood flow in the cerebral vessel due to thrombi or emboli OR to bleeding into the brain tissue
stroke
217
______ is Usually seen in condition such as exposure to reduced atmospheric pressure, carbon monoxide
poisoning, severe anemia, and failure to oxygenate blood
hypoxia
218
_______ is a term applied to a number of genetic disorders that produce progressive deterioration of skeletal muscles because of mixed muscle cell hypertrophy, atrophy, and necrosis
muscular dystrophy
219
______ disrupts complete closure of the neural tube, causing a malformation to develop
spina bifada
220
genetic, nutritional, and environmental factors play a role. Research studies indicate that insufficient intake of folic acid—a common B vitamin—in the mother’s diet is a key factor in causing _________ and other neural
tube defects.
spina bifada
221
_________ is believed to be an immune-mediated disorder that occurs in genetically susceptible people. Although the target antigen has not been identified, the data suggest an immune response to a protein in the CNS.
Multiple sclerosis
222
______ is the result of vascular injury and bleeding
hematoma
223
_________ is caused by uncontrolled cell growth.
brain tumor
224
_____ is caused by: Hypoxia and ischemia can occur in utero, Hypoxia and ischemia can occur post-partum, Trauma to or rupture of the cerebral blood vessels due to separation of the placenta, Difficult or prolonged delivery can result in trauma or injury to the brain & Toxicity and infection can lead to brain damage
cerebral palsy
225
Reduced or lost temperature sensation
Athermia
226
stroke and cardiac arrest can both result in _____
ischemia
227
deprivation of oxygen with maintained blood flow
hypoxia
228
______ is usually seen in conditions such as exposure to reduced atmospheric pressure, carbon monoxide poisoning, severe anemia, and faliure to oxygenate blood
ischemia
229
what is the most fatal type of stroke?
hhemorrhagic
230
______ is more constant as a brain tumor becomes larger
headaches
231
_____ is an infection of the parenchyma of the brain and SC
encephalitis
232
what is the most common type of encephalitis?
west nile & HSV
233
the mode of transportation for _______ can be through mosquitos (arbovirus), rabid animal (rabies) and ingestion (poliovirus)
encephalitis
234
____ is an excess growth of neural epithelial tissue
brain tumor
235
______ is a degenerative disorder of the basal ganglia
parkinsons
236
what disease causes demyelination?
MS
237
_____ is difficulty of speech
dysarthria
238
_____ is difficulty of chewing & swallowing
dysphagia
239
_____ is a term used for motor function disorders that result from damage to the immature brain
cerebral palsy
240
_____ is one of the best-evaluated cognitive-behavioural approaches to pain relief
relaxation
241
_____________ is a form of self-distraction or cognitive control in which individuals focus their attention on the positive aspects of the experience and away from their pain
cognitive reappraisal
242
______ is used to provide feedback to a person concerning the current status of some body function (finger temp, temporal artery pulsation, bp and mm tension)
biofeedback
243
finger temp, temporal artery pulsation, bp and mm tension are examples of
biofeedback
244
cold should be applied for no longer than ______ minutes
15-20
245
asprin, NSADIS and acetaminophen are examples of
non-narcotic analgesics
246
morphine, codine, etc are examples of
opoid analgesics
247
tricyclic anti-depressants, anti-seizure meds and corticosterioids are examples of
adjuvant analgesics
248
you can use a normal pain scale in children over the age of
8
249
with children between _______ scales with faces/cartoons are used
3-8
250
______ is a tumor composed of nerve cells
neuroma
251
if compression of a neuroma is painful, onsite work in CI'd. what type of ROM can be done instead?
AF & AA ROM of prox and distal joints in encourage and maintain joint motion and health
