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Patho- > Mobility > Flashcards

Mobility Flashcards

1
Q

Complex activity is controlled by _______.

A
  • Cerebral cortex
  • Pyramidal system
  • Extrapyramidal system
  • Muscle motor units
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2
Q

Definition of hypotonia

A

Decreased muscle tone

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3
Q

Definition of hypertonia

A

Increased muscle tone

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4
Q

Definition of spasticity

A

Hyperexcitability of the stretch reflexes

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5
Q

Definition of Gegenhalten/paratonia

A

Resistance to passive movement

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6
Q

Definition of dystoia

A

Increased involuntary muscle contraction

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7
Q

Definition of rigidity

A

Firm and tense muscles

-cogwheel is an example

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8
Q

Definition of hyperkinesia

A
  • Excessive movement

- Chorea, wandering, tremors at rest, postural tremors

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9
Q

Definition of Paroxymal dyskinesias

A

-Abnormal, involuntary movements that occur as spasms

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10
Q

Definition of Tardive dyskinesia

A
  • Slow onset, usually from antipsychotic agents

- Continual chewing with intermittent tongue protrusions, lip smacking, and facial grimacing

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11
Q

Definition of hypokinesia

A

Decreased movement

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12
Q

Definition of Alkinesia

A

Absence, poverty, or lack of control of associated and voluntary muscle movements

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13
Q

Definition of Bradykinesia

A

Slowness of voluntary movements

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14
Q

Definition of loss of associated movements

A

Loss of movements that provide balance to voluntary movements

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15
Q

What is Parkinson’s disease described as

A

Severe degeneration of the basal ganglia involving the dopaminergic nigrostriatal pathway

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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

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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
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18
Q

What is the treatment for Parkinson’s disease?

A

Medication, surgery, rehab (physiotherapy + speech), therapies (OT, PT, language, swallowing)

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19
Q

What medications are used to treat Parkinson’s disease?

A

Levodopa, anticholinergic drugs, antihistamines, amantadine

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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

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21
Q

What changes can a TBI cause?

A

Physical, intellectual, emotional, social, and vocational changes

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22
Q

Who is at risk for a TBI?

A

Children (under 4)
Adolescents (15-19)
Adults (65+)
Men more than women

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23
Q

What are some causes of a TBI

A

Falls, MVC related, strike or blow to a head, unknown causes

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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.
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25
Q

Which is more common: open (penetrating) trauma or blunt (closed) trauma?

A

Blunt (closed) trauma

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26
Q

What type of brain injury does a blunt (closed) trauma cause?

A

Focal (local)

Diffuse (general)

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27
Q

What are the 2 types of TBI

A

Blunt (closed) trauma

Open (penetrating) trauma

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28
Q

How is an open (penetrating) trauma described?

A
  • Injury breaks the dura and exposes cranial contents to the environment
  • increased risk of infection
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29
Q

What type of brain injury does a open (penetrating) injury cause?

A

Focal (local)

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30
Q

What does the Glascow coma scale assess?

A

Assess severity of the injury cause by the TBI

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31
Q

What is a mild GSC score (Glascow coma scale)

A

13-15

associated with mild concusion

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32
Q

What is a moderate GSC score (Glascow coma scale)

A

9-12

associated with structural injury such as hemorrhage or contusion

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33
Q

What is a sever GSC score (Glascow coma scale)?

A

3-8

associated with cognitive and/or physical disability or death

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34
Q

What is the hallmark of sever brain injury?

A

Loss of consciousness for 6/more hours

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35
Q

Is a high or lower GSC score better?

A

Higher

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36
Q

Who is the most at risk for spinal cord injury

A

Young adult men

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37
Q

What are major causes of spinal cord injury

A

MVA
Falls
Violence

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38
Q

What are some consequences in extent of injury?

A

-Incomplete quadriplegia
-Complete paraplegia
-Incomplete paraplegia
-Complete quadriplegia
(in order of occurrence)

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39
Q

What is a spinal cord injury described as?

A

Damaged by hyperextension, hyperflexion, vertical compression, or rotation

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40
Q

What does a spinal cord injury commonly occur from? Why?

A

Vertebral injury

-Resulting from acceleration, deceleration, or forces that cause compression, traction, or shearing forces

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41
Q

What positions cause a spinal cord injury

A

hyperextention, hyperflexion, vertical effects, rotational effects

42
Q

What locations are most common for a spinal cord injury?

A

Cervical vertebrae
Thoracic-lumbar vertebrae
(the most mobile areas of the vertebrae)

43
Q

When does a spinal cord injury commonly occur

A

if an injured spine is not adequately mobilized

44
Q

What are some clinical manifestations of a spinal cord injury?

A

normal activity of spinal cord cells cease at and below the level of injury

45
Q

What is a focal brain injury

A

brain injury is observed and occurs in a precise location

46
Q

What are some examples of a focal brain injury

A

coup injury, contrecoup injury, contusion

47
Q

What is a coup injury

A

injury is directly below point of impact

48
Q

what is a contrecoup injury

A

injury is on the pole opposite the site of impact

49
Q

what does the force of impact on the brain usually produce

A

a contusion

50
Q

what is a contusion

A

blood leak from an injured vessel (bruising of the brain)

51
Q

What are manifestations of a brain contusion

A

loss of consciousness-usually less than 5 minutes

52
Q

How do you treat a brain contusion

A

Control of intracranial pressure

Possible surgery

53
Q

What can contusions cause

A

Extradural (epidural) hemorrhage or hematoma
Subdural hematoma
Intracerebral hematoma

54
Q

what happens with an intra-cerebral hematoma

A

bleeding into the brain

55
Q

what happens with a subdural hematoma

A

blood between dura mater and arachnoid membrane

-usually venous blood

56
Q

What happen with an Extradural (epidural) hemorrhage or hematoma?

A

Bleeding between dura mater and the skull

  • usually arterial
  • usually with a skull fracture
57
Q

What is a concussion described as?

A

Damage to delicate axonal fibers and white matter tracts that project to the cerebral cortex

58
Q

What is a mild concussion described as

A

mild TBI

Immediate but transitory effects

59
Q

What is a classic concussion described as

A

-Physiologic and neurologic dysfunction without substantial anatomic disruption

60
Q

How do you treat a spinal cord injury?

A
  • 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
Q

What is neurogenic shock?

What are symptoms of this?

A

Loss of sympathetic outflow

-vasodilation, hypotension, bradycardia, hypothermia

62
Q

What is spinal shock?

A

The complete loss of reflex function in all segments below the lesion level

63
Q

How long can spinal shock occur?

A

a few days or as long as 3 months

64
Q

What occurs with spinal shock?

A

Transient drop in blood pressure, loss of thermal control, and poor venous circulation

65
Q

What are clinical manifestations of spinal shock

A

flaccid paralysis, sensory deficit, loss of bladder and rectal control

66
Q

What happens with autonomic hyperreflexia (dysreflexia)?

Where does the imbalance occur?

A
  • Control of the sympathetic nervous system is disrupted.

- between the sympathetic and parasympathetic nervous systems

67
Q

What are the clinical manifestations of autonomic hyperreflexia (dysreflexia)?

A
  • 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
Q

What is the treatment for autonomic hyperreflexia (dysreflexia)?

A
  • Elevate the HOB
  • Stimulus should be found and removed (empty bladder or bowel)
  • Administer topical nitroglycerin paste, calcium channel blockers
69
Q

What are risk factors for low back pain?

A

occupations, exposure to vibrations, psychosocial workplace factors, obesity

70
Q

How much of the population does low back pain affect at some time?

A

75-90%

71
Q

What are the clinical manifestations of low back pain?

A

pain between the lower rib cage and gluteal muscles

-often radiates into thigh

72
Q

What is the treatment for acute lower back pain

A

analgesics, nonsteroidal antiinflammatory medications, exercises, physical therapy, education

73
Q

What is the treatment for chronic lower back pain

A

antiinflammatory and muscle relaxant medications, massage, topical heat, spinal manipulation, cognitive-behavioral therapy, interdisciplinary care, exercise programs

74
Q

what is surgical treatment for low back pain

A

discectomy and spinal fusions

75
Q

T or F: Radiotherapy can be used to treat low back pain

A

True

76
Q

What is cerebrovascular disorder

A

any abnormality of the brain caused by a pathologic process in the blood vessels

77
Q

What are the two types of brain abnormalities

A

Ischemia (with or without infarction)

Hemorrhage

78
Q

What is the most frequently occurring neurological disorder

A

cerebrovascular disorder

79
Q

What are examples of cerebrovascular disorders

A

CVA (stroke), transient ischemic attacks, aneurysms, malformations

80
Q

What are the two types of CVAs?

A

Thrombotic ischemic stroke

Embolic ischemic stroke

81
Q

What is the third leading cause of death in the U.S.?

A

CVAs (stroke)

82
Q

What is the greatest risk factor for CVA (stroke)?

A

Hypertension

83
Q

What is a transient ischemic attack described as

A

transient episodes of neurologic dysfunction

84
Q

When a person have a transient ischemic attack, what percent will have a CVA within a year?

A

30%

85
Q

T or F: Neurological deficits from transient ischemic attacks are permanent

A

False

86
Q

What is a thrombotic ischemic stroke described as

A

arterial occlusion are caused by thrombi formed in the arteries that supply the brain or in the intracranial vessels

87
Q

What is thrombotic ischemic stroke attributed to?

A

atherosclerosis and inflammatory disease processes

88
Q

What happens during an Embolic ischemic stroke?

What usually happens afterwards?

A
  • Fragments break from a thrombus that is formed outside of the brain
  • A second stroke usually occurs.
89
Q

What are the manifestations of a CVA?

A

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
Q

how is thrombolysis usually administered?

A

administered within 3 hours + up to 41/2 hours of symptom onset (embolic stroke)
-NOT ischemic stroke

91
Q

Is thrombolysis used to treat an ischemic stroke?

A

No!
Pharmacologic (Aspirin, Systemic anticoagulation, Thrombolysis, Antiplatelet therapy and statins to decrease recurrence, Surgery)

92
Q

What is another name for a hemorrhagic stroke

A

spontaneous intracranial hemorrhage

93
Q

What is a hemorrhagic stroke

A

-spontaneous bleeding in the brain

94
Q

what are the clinical manifestations for hemorrhagic stroke

A

focal neurologic deficits, altered consciousness, headache

95
Q

how do you treat a hemorrhagic stroke

A

needs to be initiate within 3-4 hours of symptoms onset, limit hematoma enlargement, prevent or control seizures and cerebral edema

96
Q

What is an intracranial aneurysm

A

is a weak bulging area of an arterial vessel wall

97
Q

where are most intracranial aneuryms located

A

bifurcations in or near the circle of Willis

98
Q

What are the clinical manifestations of intracranial aneurysms

A

usually asymptomatic

99
Q

What nerves are usually affected with a brain aneurysms?

A

Cranial nerves III, IV, V, And VI

100
Q

What is the treatment for a brain aneurysm

A

surgery

Patho- (5 decks)

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