Misc Flashcards
Spasticity is a ______ disorder characterized by an abnormal, _______-dependent increase in tonic stretch reflexes
motor;
velocity
Where does baclofen act? Main SE? Symps of withdrawal?
GABA agonist at GABA-B receptors;
can cause sedation/drowsiness, lowers seizure threshold;
can get seizures, hallucinations, rebound spasticity, “itchy, bitchy, twitchy”
Two agents used as chemoneurolysis?
Phenol and ethyl alcohol;
phenol will require higher concentrations for chemical denervation and neurolysis
Peak effect and duration overall for botox?
4-6 weeks;
Can last 2-6 months
What does SPLATT stand for and treat?
Split Anterior Tibial Tendon Transfer;
Treats equinovarus deformity of the foot due to spasticity of tib ant
Classic symps of Parkinson’s?
TRAP: Tremor (resting) Rigidity (cogwheel) Akinesia (bradykinesia) Postural instability (tendency to fall to side or backward)
Some surgical treatments for Parkinson’s?
- Destructive (includes thalamotomy and pallidotomy)
2. DBS (preferred): thalamic reduces tremor on contralateral side, while pallidal controls all the cardinal symptoms
Why SLP eval for Parkinson’s?
Evaluate for oropharyngeal dysphagia
For progressive supranuclear palsy, what is a hallmark sign and earliest symptom?
Supranuclear ophthalmoparesis;
gait and balance impairment
What is multiple system atrophy characterized by?
Combo of parkinsonism, cerebellar dysfunction, autonomic failure (CAP)
Inaccurate measurements of wheelchairs are major contributing factor to
increased deformity;
pressure injury development;
patient discomfort
How wide should seat width be for wheelchair?
Approx 1 inch wider than hip width; avoid pressure injury at greater trochanter of hips
Why is seat height in foot drive, or hemi-plegic height WC, lower?
Allows unaffected leg to propel the chair
What is the most commonly prescribed armrest for WC?
Removable desk length armrest
Benefits of tilt and space compared to recliner?
Patient remains in same position, but orientation in space changes; shear forces are minimized, and pressure re-distributed from seating surface to back support;
get pain relief, can remain seated during weight shifts, can mobilize secretions, smaller turning radius
How much should the WC system tilt to redistribute sufficient pressure for weight shift?
Ideally at least 45 degrees
For adjustable axle, what happens with moving it forward?
Allows for more efficient wheelchair propulsion; also can do wheelies
- Less rolling resistance
- Less energy to propel
- Smaller the turning radius
- Less stable the chair
What happens with moving axle posteriorly?
- Increased rolling resistance
- More energy required for propulsion
- Greater turning radius
- Stable chair
- Need more extension at GH joint