Neuro Rehab Exam 2 Flashcards

Question

Rancho Level 5 and 6

Answer 1

Confused but will follow simple commands Basic mobility and ADLs Task oriented and meaningful exercises Motor control- coordination, tone, and movement patterns

Answer 2

Concussion Acute management- rest and decreased physical/cognitive exertion Ongoing symptomalogy will depend on their specific deficits (dual tasks, vocational rehab, self-responsibility)

Answer 3

``` Vacant Stare Delayed motor and cognitive processing Disorientation Slurred Speech Memory Deficits LOC Nausea/vomiting Headache Dizziness ```

Answer 4

``` Cognitive Impairment Headache Balance Deficits Dizziness Fatigue Difficulty reading/focusing Photo/Phono-sensitivity Fogginess Amnesia Sleep disturbance(too much or too little) Irritability ```

Answer 5

``` Typically do better, earlier Loss of Consciousness Vomiting Age <13 y/o No previous concussions ```

Answer 6

Age>13 years old Amnesia History of: Previous concussions (exponential), Migraines, Anxiety, Ocular deficits (strabismus), Learning disability

Answer 7

History of | 1) Previous concussions (exponential (2) Migraines (3) Anxiety

Answer 8

Due to labyrinth or CN 8 problem

Answer 9

Due to brainstem, pons, medulla problem

Answer 10

``` Vestibular Neuronitis Labyrinthitis Meniere’s Disease Acoustic Neuroma Bilateral Vestibular Hypofunction (BVH) BPPV- mechanical problem of otoconia ```

Answer 11

``` Vestibular Migraine MS TBI Cerebellar degeneration Cerebellar or vertebral artery infarct Arnold-chiari malformation ```

Answer 12

Early symptoms may include twitching, cramping, stiffness of muscles, weakness of an arm or leg, slurred and nasal speech, difficulty chewing or swallowing Symptoms may affect one leg, contributing to awkwardness when walking, or more frequent tripping or stumbling; in the arm, individuals may have difficulty in simple manual dexterity tasks like buttoning the shirt, using a key These general complaints then develop into more obvious weakness or atrophy Abnormal reflexes may emerge, as well as fasciculations – both UMN and LMN involvement

Answer 13

Early stage-->ALS manifests as a variety of signs and symptoms recognized by the pt as abnormal – they may or may not cause some fxnl limitation Middle stage--> Increasing signs and symptoms and increasing number and severity of impairments – min to mod fxnl limitations Late stage-->Numerous and increasingly severe impairments, becomes dependent, requires a ventilator

Answer 14

Typical presentation is ascending symmetric weakness, tingling (LE > UE) These symptoms increase in intensity and can lead to total paralysis Involves PNS, so LMN signs

Answer 15

Application of exercise techniques and elements to an affected area

Answer 16

Application of exercise techniques and elements to an unaffected area to gain overflow excitation or relaxation effects to an affected part

Answer 17

(1) Activity- any developmental posture and the movements occurring within that posture (2) Technique- type of contraction used (3) Element- type of sensory input used in the treatment to facilitate/inhibit a response

Answer 18

External rotation

Answer 19

Internal rotation

Answer 20

Trunk extension

Answer 21

Trunk extension

Answer 22

Used to promote movement with pulling or antigravity movements and decrease pain Contraindications: increased pain, lig injury, unstable joints

Answer 23

Used to promote stability Contraindications: increased pain, fracture, joint replacements, and inflammatory conditions

Answer 24

Increased pain, fracture, valsalva, tendon surgeries, muscle flaps, and reconstructions

Answer 25

Used to trigger the stretch reflex to facilitate initiation of motion or enhance the muscle contraction Used to facilitate voluntary movements and increase the strength of voluntary contraction Contraindications: increased pain, fracture, joint instability, and creating dominant reflexes

Answer 26

Unidirectional technique to enhance initiation and promote motor learning Used to promote relaxation initially and treat people having difficulty initiating motion due to hypertonia "Let me move you" or "Help me move you"

Answer 27

Isometric technique used for stabilization of an unstable joint/posture by facilitating co-contraction at a joint "Hold and don't let me move you"

Answer 28

Utilizes slow, rhythmical, concentric contractions of the total agonistic patterns and then the antagonistic pattern without relaxing Used to promote increased strength, ROM, coordination, and power; also facilitates contraction of the antagonist "Pull or Push"

Answer 29

Utilize stretch reflex to promote initiation of muscle activity to reinforce and strengthen an existing contraction

Answer 30

Alternates between concentric and eccentric contractions of the agonistic movement pattern Does NOT facilitate opposing muscle group Used to increase strength and ROM

Answer 31

Isometric technique to increase ROM due to muscle tightness or pain

Answer 32

Combo of isometric and isotonic contractions to increase ROM due to muscle tightness Not good for pain because the build up of tension is immediate and release is aburpt

Answer 33

Trauma-induced alteration in mental status that may or may NOT involve a loss of consciousness From a direct OR indirect blow

Answer 34

Any signs or symptoms shown from the previous page warrants an immediate removal from activity NO athlete diagnosed with a concussion should be returned to sports participation on the day of the injury d/t second impact syndrome Cognitive and physical rest No exertion until all signs and symptoms resolve (symptoms > 7-10 days require additional treatment)

Answer 35

``` Light aerobic Sport Specific Non-contact training Full contact training RTP **Need 24 hours within each stage to account for rebound potential ```

Answer 36

``` Partial duty Lower productivity Slow return to machinery and heights Reduced screen time RTW ```

Answer 37

Functions during movement of visual images (smooth pursuit or saccades)

Answer 38

Functions during movement of head relative to the body

Answer 39

Generates appropriate tone to maintain upright position

Answer 40

Functions during movement of head relative to gravity Stabilizes images on the retina during head movement Produces eye movement in opposite direction of head movement to maintain image

Answer 41

Need a ratio of one to see clearly Eye movement/ Head movement

Answer 42

1. Clearly defined fast and slow components 2. Named for the direction of the fast phase 3. Not direction changing or position dependent 4. Increased by removal of fixation and gaze in direction of the fast phase

Answer 43

Definition: Illusion of movement of the of the visual environment Cause: impaired VOR leads to retinal slip (uni or bilat) Patient complaint: vision is blurry, everything bounces when I move

Answer 44

Etiology: viral infection, trauma, vascular insult, or tumor S+S: spontaneous nystagmus, constant vertigo, oscillopsia, and impaired balance Recovery: few days to few months

Answer 45

Reduction in the neural firing rate on the injured side The brain perceives this as a rotation to the strong side Resolves after 1-7 days

Answer 46

Impaired VOR creates dizziness with head movements Decreased dynamic visual acuity

Answer 47

Etiology: viral infection of CN 8 S+S: acute onset vertigo (48-72 hrs) , dizziness and oscillopsia with quick head movements for weeks, intense/ constant spinning vertigo Lesion Site: typically affects the superior vestibular nerve Treatment: vestibular suppressants and bed rest for 1-3 days, vestibular therapy, exercise

Answer 48

S+S: acute onset vertigo (48-72 hrs) , dizziness and oscillopsia with quick head movements for weeks, intense/ constant spinning vertigo Treatment: steroids for hearing loss, meds + bed rest for 3 days, vestibular therapy

Answer 49

Etiology: Due to anatomic, infections, immunologic/allergic factors S+S (during): sudden onset of vertigo (>20 min, <2g/d), diuretics or vestibular suppressants, intratympanic gentamycin injections, endolymphatic shunt/labyrinthectomy/vestibular neurectomy, PT for patients with chronic imbalance/dizziness between attacks

Answer 50

Etiology: tumor from Schwann cells of the vestibular portion of CN 8 S+S: progressive unilateral sensorineural hearing loss, tinnitus, brief vertigo/imbalance, facial paralysis/pain, cerebellar signs (HA, mental status changes, nausea/vom, ocular changes) Treatment: surgical resection of tumor or gamma knife radiation, monitor for 6 mo, PT for gaze stabilization, habituation, and balance training

Answer 51

Etiology: ototoxicity (aminoglycosides, aspirin, chemotherapeutic agents), presbystasis, meningitis, autoimmune disease, congenital malformation, otosclerosis, polyneuropathy, tumors, endolymphatic hydrops S+S: oscillopsia, disequilibrium, and head movement induced dizziness, NO VERTIGO Exam Findings: rotary chair test, impaired DVA (>2 line loss), increased sway with eyes closed, wide BOS with gait, positive head thrust bilaterally Treatment: Substitution exercises (recruiting non-vestibular capacities such as COR and proprioceptive and visual control for gaze stabilization, balance and gait), Fall prevention/compensatory strategies, Assistive device, Patient education (time frame for recovery is up to 2 years)

Answer 52

Symptoms: dizziness (true vertigo, motion sensitivity, lightheadedness, imbalance), nausea, HA, fatigue, photo/phono-phobia, motion sensitivity, tinnitus, aural pressure (B), visual fog Etiology: central (asym activation or deactivation of vestibular neuronal activity through release of NT) or peripheral (transient change in blood flow to labyrinth due to VC/VD) Lesion Site: labyrinth, vestibular nuclei, sensory collection, and processing centers of the brain Treatment: eliminate triggers (stress/anxiety, foods), meds, therapy, aerobic exercise

Answer 53

Vertigo lasts <60 seconds Otoconia are floating freely through the canals

Answer 54

Vertigo lasts >60 seconds Otoconia have adhered to the cupula

Answer 55

Beating down toward the ground when they're laying on that side

Answer 56

Beating down toward the ground when they're laying on the opp side

Answer 57

Vertigo- actual movement/rotation of the room or their head Lightheadedness- do they feel faint or their head is a "balloon on a string" Unsteadiness- dysequilibrium