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NEURO TX > FINAL EXAM > Flashcards

FINAL EXAM Flashcards

1
Q

progressive CNS conditions

A

Parkinson’s
MS

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2
Q

non-progressive CNS conditions

A

Hemiplegia
Spinal cord injuries (SCI)
Cerebral palsy

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3
Q

gait often present with hemiplegia or MS

A

circumduction gait

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4
Q

gait often present with Parkinson’s

A

festinating gait

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5
Q

spasticity can exist with…

A

hemiplegia
MS
SCI
cerebral palsy

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6
Q

what is spasticity?

A

-occurs when there is loss of inhibition of alpha motor neuron firing
-resistance of a limb to passive movement

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7
Q

flexor pattern of the upper body

A

-flexion of client’s head & trunk towards affected side
-depression of SH
-retraction of scapula
-int.R & ADD of GH joint
-flexion of elbow
-pronation of forearm
-flexion of wrist
-fingers with thumb ADD

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8
Q

extensor pattern of upper body

A

-slight ext of client’s NK & head with trunk bent away from affected side
-scapula retracted
-int.R of GH joint
-elbow rigidly extended
-pronation of forearm
-hand either in flexion forming tight fist, or in flexion at PIP & DIP joint
-palm faces backwards

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9
Q

flexor pattern of lower body

A

-ABD, ext.R & flexion of hip
-flexion of knee
-dorsiflexion & inversion of ankle
-flexion of toes

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10
Q

extensor pattern of lower body

A

-ADD, int.R & extension of hip
-extension of knee
-plantarflexion & inversion of ankle

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11
Q

causes person to vigorously extend limbs while arching back, triggered by stimulation or pressure to back of head or trunk

A

extensor thrust pattern

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12
Q

can accompany extensor thrust pattern, teeth clenched together with extreme force, most common with head injuries

A

bite reflex

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13
Q

stiffening of legs in extension or tight flexion, can occur in response to pressure on ball of foot or stretching of plantar surface by dorsiflexing toes

A

positive supporting reaction

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14
Q

stimulus to palmar surface of hand, results in withdrawal of entire arm into a tightly flexed position

A

grasp reflex

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15
Q

techniques to reduce spasticity

A

gentle, repetitive stroking, GTO release, rhythmical rocking

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16
Q

resistance to movement in flexion, extension & rotation, commonly present in clients with Parkinson’s, can result in painful cramps as well as P, numbness & achiness

A

rigidity

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17
Q

palpated as a uniform resistance throughout the ROM of an affected joint

A

lead pipe rigidity

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18
Q

ratchet-like movement of an affected limb, limb can be moved a short distance through ROM but movement is interrupted by a tremor, movement stops for a moment & then resumed again – cycle repeated throughout ROM

A

cogwheel rigidity

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19
Q

techniques to reduce rigidity

A

-decreasing SNS firing
-swedish techniques, followed by heat
-slow, passive stretches

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20
Q

non-progressive condition of paralysis on one side of the body as a result of a brain lesion

A

hemiplegia

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21
Q

causes of hemiplegia

A

-cerebrovascular pathology (cerebral thrombus, cerebral hemorrhage due to aneurysm & cerebral embolism)
-head trauma (fall/ MVA)
-brain tumor

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22
Q

hemiplegia - immediately after a stroke or head trauma, mm on affected side will be weak or flaccid – this is considered the ____ phase

A

acute

no spasticity or reflex patterns evident (gradually develop)

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23
Q

hemiplegia - most common pattern is ____ pattern in upper limbs combined with an ____ pattern in lower limbs

A

flexor

extensor

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24
Q

painful condition with shoulder in ADD & int.R combined with retracted scapula due to reflex patterns & spasticity – flaccidity in SH girdle mm & poor positioning of person’s body results in an inferior subluxation of humerus

A

hemiplegic shoulder

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25
Q

decreased ROM of SH & hand, followed by throbbing P & edema – elbow remains symptom free – syndrome usually occurs with a lesion of the premotor cortex

A

shoulder-hand syndrome

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26
Q

condition in which demyelination of the nerve occurs

A

MS

27
Q

mild form, few exacerbations followed by complete recovery & client remains asymptomatic

A

benign MS

28
Q

repeated cycles of exacerbation & remission, symptoms such as double vision, slurred speech, numbness & tingling anywhere in body can occur during these attacks

A

attack-remitting MS

29
Q

MS - causes only mild disability when attack subsides

A

benign or mild attack-remitting MS

30
Q

results in increased symptoms following attacks, in some cases, remission periods become less & less frequent, disability increases continuously

A

chronic progressive attack-remitting MS

31
Q

rapid progression of symptoms & disability, can be fatal within a few years, more severe form of MS, least common

A

acute progressive MS

32
Q

4 factors involved in the cause of MS

A
  1. genetic
  2. environmental
  3. viral
  4. immunological
33
Q

progressive disorder involving diminishing basal ganglia function, results in slow, increasingly difficult movement, accompanied by resting tremors & muscular rigidity

A

Parkinson’s

34
Q

cause of Parkinson’s

A

unknown, genetics do not appear to play a role

35
Q

Parkinsons as a symptom of some other brain condition

A

Parkinson’s plus syndrome

causes: repeated head trauma (boxing), toxins, medications that block dopamine receptors, brain tumor, Huntington’s disease, Alzheimer’s, hydrocephalus

36
Q

what is the progression of Parkinson’s?

A

progresses slowly or rapidly, with mild or severe symptoms

Stage 1: one side of body involved – rigidity or tremors – if symptoms mild, no Tx given, if moderate, PT & massage helpful
Stage 2: both sides of body involved – moderate tremors, rigidity & bradykinesia – balance not affected – levodopa drug therapy may begin
Stage 3: significant tremors, rigidity & bradykinesia – balance & walking impaired - unsteadiness, dystonia, freezing
Stage 4: severe disability results because of bradykinesia – walking still possible, marked impairment – some assistance required with ADL’s
Stage 5: loss of ability to function independently – person is immobile

37
Q

slow initiation & performance of movements

A

bradykinesia

38
Q

most often in hand, at a rate of 4/5-8 cycles per second – often start in one hand, then appear in foot on same side

A

resting tremors

may be accompanied by a “pill rolling” tremor

benign essential tremor: familial tendency & can begin at any age, trembling in both hands spreading to head & voice – does not occur at rest and will cease when limb is supported

39
Q

retropulsion & propulsion (Parkinson’s)

A

retropulsion: person unable to stop from falling backwards

propulsion: results in inability to stop from falling forward, leads to falls which can result in injury

40
Q

sudden inability of person to move – occurs if person becomes distracted or interrupted while doing an action (Parkinson’s)

A

freezing phenomenon

41
Q

an injury to the vertebral column, spinal cord or both due to a direct or indirect trauma

A

spinal cord injury (SCI)

42
Q

spinal cord begins from medulla oblongata, just superior to foramen magnum & ends at __, where it becomes the ____and then the cauda equina

A

L2

conus medullaris

43
Q

how many pairs of spinal nerves

A

31

44
Q

what are the most vulnerable segments of the spinal cord?

A

C4 to C6

T12 to L1

45
Q

affects 4 limbs, trunk & pelvic organs – results when spinal cord damage occurs in cervical segments – T1 & above

A

quadriplegia

46
Q

affects lower limbs – spinal cord lesion occurs in thoracic, lumbar or sacral segments – T2 & below – depending on specific area damaged, trunk or pelvic organs may be involved

A

paraplegia

47
Q

difference between complete & incomplete spinal cord injury

A

COMPLETE: lesion results in total loss of function below level of lesion

INCOMPLETE: lesion results in some function below level of lesion

48
Q

damage in the centre of the cord with the periphery of the cord unaffected

A

central cord syndrome

cause: hyperextension injury, usually C-spine, affects elderly with arthritic changes to spine

49
Q

central cord syndrome impairment

A

motor & sensory abilities of upper limbs affected, mm weak or flaccid, LL spared or less affected

50
Q

damage to one side of the cord

A

Brown Sequard Syndrome

cause: stabbing & gunshot wounds

51
Q

Brown Sequard Syndrome impairment

A

on same side of lesion, decreased or absent motor function, proprioception, vibration & two-point discrimination but normal P & temp perception

52
Q

damage to the anterior spinal artery or anterior aspect of the cord, resulting in corticospinal & spinothalamic tract injury

A

anterior cord syndrome

cause: direct trauma, often hyperflexion injury

53
Q

anterior cord syndrome impairment

A

variable bilateral loss of motor function & P, temp & crude touch perception, proprioception

54
Q

term used for motor function disorders that result from damage to the immature brain

A

cerebral palsy

55
Q

3 main causes of cerebral palsy

A
  1. hypoxia & ischemia
  2. trauma to, or rupture of, cerebral blood vessels
  3. toxicity & infection
56
Q

4 main types of movement disorders with cerebral palsy

A
  1. spastic (increased tone), most common
  2. athetoid (uncontrolled movement)
  3. ataxic (poor coordination), least common
  4. mixed (usually spastic & athetoid)
57
Q

many years after a recovery of polio, a client may begin experiencing a return of Sx & increasing disability, what is this called?

A

post-polio syndrome

58
Q

acute viral infection specifically affecting motor neurons in the spinal cord & brain stem

A

poliomyelitis

59
Q

most common type of polio

A

spinal poliomyelitis: inflammation & destruction of anterior horn cells may occur at any level of spinal cord

60
Q

most serious type of polio

A

bulbar poliomyelitis: involves cranial nerves & sometimes cardiorespiratory centre, has poor prognosis with very high mortality rate if paralysis of respiratory mm & failure of medulla occur

61
Q

seizure presents → blank stare, change on postural tone, short in time

A

Petite Mal (absence seizure)

62
Q

tonic contractions of mm, loss of consciousness, bladder & bowel incontinence, followed by bilateral, rhythmic contraction & relaxation of limbs

A

Grand mal (tonic-clonic seizure)

63
Q

causes of decubitus ulcers

A

pressure, friction damage, shear forces

64
Q

no impairment of consciousness, an aura or prodromal symptoms are only manifestation, could lead to a generalized seizure

A

partial seizures

NEURO TX (8 decks)

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