Mobility Flashcards
1
Q
Complex activity is controlled by _______.
A
- Cerebral cortex
- Pyramidal system
- Extrapyramidal system
- Muscle motor units
2
Q
Definition of hypotonia
A
Decreased muscle tone
3
Q
Definition of hypertonia
A
Increased muscle tone
4
Q
Definition of spasticity
A
Hyperexcitability of the stretch reflexes
5
Q
Definition of Gegenhalten/paratonia
A
Resistance to passive movement
6
Q
Definition of dystoia
A
Increased involuntary muscle contraction
7
Q
Definition of rigidity
A
Firm and tense muscles
-cogwheel is an example
8
Q
Definition of hyperkinesia
A
- Excessive movement
- Chorea, wandering, tremors at rest, postural tremors
9
Q
Definition of Paroxymal dyskinesias
A
-Abnormal, involuntary movements that occur as spasms
10
Q
Definition of Tardive dyskinesia
A
- Slow onset, usually from antipsychotic agents
- Continual chewing with intermittent tongue protrusions, lip smacking, and facial grimacing
11
Q
Definition of hypokinesia
A
Decreased movement
12
Q
Definition of Alkinesia
A
Absence, poverty, or lack of control of associated and voluntary muscle movements
13
Q
Definition of Bradykinesia
A
Slowness of voluntary movements
14
Q
Definition of loss of associated movements
A
Loss of movements that provide balance to voluntary movements
15
Q
What is Parkinson’s disease described as
A
Severe degeneration of the basal ganglia involving the dopaminergic nigrostriatal pathway
16
Q
What are some signs + symptoms of Parkinson’s disease?
A
Loss of neurons in the substantia nigra, rigidity (cogwheel), bradykinesia + akinesia, resting tremor, postural abnormalities (postural fixation, equilibrium, righting),
autonomic-neuroendocrine symptoms, cognitive-affective symptoms + dementia
17
Q
What are the clinical manifestations of Parkinson’s disease?
A
- Wide-eyed, unblinking, staring expression with immobile facial muscles
- Frequent drooling
- Slow gait with short, shuffling steps + flexed and abducted arms held stiffly at the side
- slightly forward bending trunk
18
Q
What is the treatment for Parkinson’s disease?
A
Medication, surgery, rehab (physiotherapy + speech), therapies (OT, PT, language, swallowing)
19
Q
What medications are used to treat Parkinson’s disease?
A
Levodopa, anticholinergic drugs, antihistamines, amantadine
20
Q
What is a TBI described as?
A
-an alteration in brain function or other evidence of a brain pathologic condition caused by an external force
21
Q
What changes can a TBI cause?
A
Physical, intellectual, emotional, social, and vocational changes
22
Q
Who is at risk for a TBI?
A
Children (under 4)
Adolescents (15-19)
Adults (65+)
Men more than women
23
Q
What are some causes of a TBI
A
Falls, MVC related, strike or blow to a head, unknown causes
24
Q
How is a blunt (close) trauma described as?
A
- Head strikes a hard surface, or a rapidly moving object strikes the head
- Dura remains intact; brain tissues are not exposed to the environment.
25
Which is more common: open (penetrating) trauma or blunt (closed) trauma?
Blunt (closed) trauma
26
What type of brain injury does a blunt (closed) trauma cause?
Focal (local)
| Diffuse (general)
27
What are the 2 types of TBI
Blunt (closed) trauma
| Open (penetrating) trauma
28
How is an open (penetrating) trauma described?
- Injury breaks the dura and exposes cranial contents to the environment
- increased risk of infection
29
What type of brain injury does a open (penetrating) injury cause?
Focal (local)
30
What does the Glascow coma scale assess?
Assess severity of the injury cause by the TBI
31
What is a mild GSC score (Glascow coma scale)
13-15
| associated with mild concusion
32
What is a moderate GSC score (Glascow coma scale)
9-12
| associated with structural injury such as hemorrhage or contusion
33
What is a sever GSC score (Glascow coma scale)?
3-8
| associated with cognitive and/or physical disability or death
34
What is the hallmark of sever brain injury?
Loss of consciousness for 6/more hours
35
Is a high or lower GSC score better?
Higher
36
Who is the most at risk for spinal cord injury
Young adult men
37
What are major causes of spinal cord injury
MVA
Falls
Violence
38
What are some consequences in extent of injury?
-Incomplete quadriplegia
-Complete paraplegia
-Incomplete paraplegia
-Complete quadriplegia
(in order of occurrence)
39
What is a spinal cord injury described as?
Damaged by hyperextension, hyperflexion, vertical compression, or rotation
40
What does a spinal cord injury commonly occur from? Why?
Vertebral injury
| -Resulting from acceleration, deceleration, or forces that cause compression, traction, or shearing forces
41
What positions cause a spinal cord injury
hyperextention, hyperflexion, vertical effects, rotational effects
42
What locations are most common for a spinal cord injury?
Cervical vertebrae
Thoracic-lumbar vertebrae
(the most mobile areas of the vertebrae)
43
When does a spinal cord injury commonly occur
if an injured spine is not adequately mobilized
44
What are some clinical manifestations of a spinal cord injury?
normal activity of spinal cord cells cease at and below the level of injury
45
What is a focal brain injury
brain injury is observed and occurs in a precise location
46
What are some examples of a focal brain injury
coup injury, contrecoup injury, contusion
47
What is a coup injury
injury is directly below point of impact
48
what is a contrecoup injury
injury is on the pole opposite the site of impact
49
what does the force of impact on the brain usually produce
a contusion
50
what is a contusion
blood leak from an injured vessel (bruising of the brain)
51
What are manifestations of a brain contusion
loss of consciousness-usually less than 5 minutes
52
How do you treat a brain contusion
Control of intracranial pressure
| Possible surgery
53
What can contusions cause
Extradural (epidural) hemorrhage or hematoma
Subdural hematoma
Intracerebral hematoma
54
what happens with an intra-cerebral hematoma
bleeding into the brain
55
what happens with a subdural hematoma
blood between dura mater and arachnoid membrane
| -usually venous blood
56
What happen with an Extradural (epidural) hemorrhage or hematoma?
Bleeding between dura mater and the skull
- usually arterial
- usually with a skull fracture
57
What is a concussion described as?
Damage to delicate axonal fibers and white matter tracts that project to the cerebral cortex
58
What is a mild concussion described as
mild TBI
| Immediate but transitory effects
59
What is a classic concussion described as
-Physiologic and neurologic dysfunction without substantial anatomic disruption
60
How do you treat a spinal cord injury?
- Spine immobilization (FIRST)
- Decompression and surgical fixation may be necessary and performed early.
- Corticosteroids may be administered at the time of injury to decrease inflammation.
- Therapeutic hypothermia
- Nutrition, lung function, skin integrity, and bladder and bowel management
- Rehabilitation
61
What is neurogenic shock?
| What are symptoms of this?
Loss of sympathetic outflow
| -vasodilation, hypotension, bradycardia, hypothermia
62
What is spinal shock?
The complete loss of reflex function in all segments below the lesion level
63
How long can spinal shock occur?
a few days or as long as 3 months
64
What occurs with spinal shock?
Transient drop in blood pressure, loss of thermal control, and poor venous circulation
65
What are clinical manifestations of spinal shock
flaccid paralysis, sensory deficit, loss of bladder and rectal control
66
What happens with autonomic hyperreflexia (dysreflexia)?
| Where does the imbalance occur?
- Control of the sympathetic nervous system is disrupted.
| - between the sympathetic and parasympathetic nervous systems
67
What are the clinical manifestations of autonomic hyperreflexia (dysreflexia)?
- Hypertension (up to 300 mm Hg systolic)
- Bradycardia (30 to 40 beats/min)
- Pounding headache, blurred vision, sweating above the lesion with flushing of skin, piloerection
68
What is the treatment for autonomic hyperreflexia (dysreflexia)?
- Elevate the HOB
- Stimulus should be found and removed (empty bladder or bowel)
- Administer topical nitroglycerin paste, calcium channel blockers
69
What are risk factors for low back pain?
occupations, exposure to vibrations, psychosocial workplace factors, obesity
70
How much of the population does low back pain affect at some time?
75-90%
71
What are the clinical manifestations of low back pain?
pain between the lower rib cage and gluteal muscles
| -often radiates into thigh
72
What is the treatment for acute lower back pain
analgesics, nonsteroidal antiinflammatory medications, exercises, physical therapy, education
73
What is the treatment for chronic lower back pain
antiinflammatory and muscle relaxant medications, massage, topical heat, spinal manipulation, cognitive-behavioral therapy, interdisciplinary care, exercise programs
74
what is surgical treatment for low back pain
discectomy and spinal fusions
75
T or F: Radiotherapy can be used to treat low back pain
True
76
What is cerebrovascular disorder
any abnormality of the brain caused by a pathologic process in the blood vessels
77
What are the two types of brain abnormalities
Ischemia (with or without infarction)
| Hemorrhage
78
What is the most frequently occurring neurological disorder
cerebrovascular disorder
79
What are examples of cerebrovascular disorders
CVA (stroke), transient ischemic attacks, aneurysms, malformations
80
What are the two types of CVAs?
Thrombotic ischemic stroke
| Embolic ischemic stroke
81
What is the third leading cause of death in the U.S.?
CVAs (stroke)
82
What is the greatest risk factor for CVA (stroke)?
Hypertension
83
What is a transient ischemic attack described as
transient episodes of neurologic dysfunction
84
When a person have a transient ischemic attack, what percent will have a CVA within a year?
30%
85
T or F: Neurological deficits from transient ischemic attacks are permanent
False
86
What is a thrombotic ischemic stroke described as
arterial occlusion are caused by thrombi formed in the arteries that supply the brain or in the intracranial vessels
87
What is thrombotic ischemic stroke attributed to?
atherosclerosis and inflammatory disease processes
88
What happens during an Embolic ischemic stroke?
| What usually happens afterwards?
- Fragments break from a thrombus that is formed outside of the brain
- A second stroke usually occurs.
89
What are the manifestations of a CVA?
Neurons surrounding the ischemic or infarcted areas undergo changes that disrupt plasma membranes.
- Cellular edema causes compression of capillaries.
- Depend on the artery (Contralateral weakness in arms, legs, and/or face, Possible motor, speech, and/or swallowing problems)
90
how is thrombolysis usually administered?
administered within 3 hours + up to 41/2 hours of symptom onset (embolic stroke)
-NOT ischemic stroke
91
Is thrombolysis used to treat an ischemic stroke?
No!
Pharmacologic (Aspirin, Systemic anticoagulation, Thrombolysis, Antiplatelet therapy and statins to decrease recurrence, Surgery)
92
What is another name for a hemorrhagic stroke
spontaneous intracranial hemorrhage
93
What is a hemorrhagic stroke
-spontaneous bleeding in the brain
94
what are the clinical manifestations for hemorrhagic stroke
focal neurologic deficits, altered consciousness, headache
95
how do you treat a hemorrhagic stroke
needs to be initiate within 3-4 hours of symptoms onset, limit hematoma enlargement, prevent or control seizures and cerebral edema
96
What is an intracranial aneurysm
is a weak bulging area of an arterial vessel wall
97
where are most intracranial aneuryms located
bifurcations in or near the circle of Willis
98
What are the clinical manifestations of intracranial aneurysms
usually asymptomatic
99
What nerves are usually affected with a brain aneurysms?
Cranial nerves III, IV, V, And VI
100
What is the treatment for a brain aneurysm
surgery
