Neurologic Conditions Flashcards
Leading causes of TBI
falls
MVA
primary prevention of TBI
- at moment of impact
- safety mechanisms such as safety belts
secondary prevention of TBI
- days to weeks after injury
- medical interventions controlling BP, O2 levels and intracranial pressure
Stages of TBI
- Primary- at moment of impact
- secondary- days to weeks after injury
focal TBI
direct blow to the head resulting from collision with external object
multifocal and diffuse TBI
sudden deceleration of body and head
clinical symptoms of TBI
- abdnormal tone
- primitive reflexes
- muscle weakness
- decreased functional endurance
- ataxia
- changes in sensation
decorticate rigidity
- UE flexed, internal rotation, adduction
- LE extended internal rotation and adducted
decerebrate rigidity
UE and LE extended, adducted, internal rotation
primitive reflexes with TBI
- impaired righting reflexes
- absence of equilibrium reactions and protective extension
W/c positioning for TBI
- prevent skin breakdown
- improve respiration, swallowing, interaction iwth environment
Splinting intervention for TBI
- resting splint alternating 2 hr periods
- Cone splint for palm protection
- antispasticity splint
- elbow cast for loss of PROM in elbow flexors
when do TBI patients typically begin inpatient rehab
when they reach Rancho level V or greater
Goals of inpatient rehab for TBI
- optimize motor function
- visual abilities
- cognition
- speech, dysphagia, feeding
- mobility
- community and home reintegration
- behavioral and emotional adaptation
treatments for ataxia
- compensatory strategies
- weighting body parts with tools
treatments for apraxia
hand-over-hand exercises to repair damaged neural pathways
treatment of expressive aphasia
recognize errors and have them verbalize what they meant to say
Goals for post-acute rehab phase of TBI
- home-based therapy
- cognition
- visual funciton
- Maximizing ADL and IADL skills
- Leisure and social participation
- behavioral and emotional regulation
teaching technique for maximizing I/ADL skills in TBI
errorless learning, fading cues, positive encouragement
describe stroke
nontraumatic acquired brain injury caused by a lesion in the brain
neurological impairments resulting from stroke
- motor dysfunction
- trunk/postural control impairments
- communication
- cognitive impairmnt
- UE impairments
global aphasia
loss of all language ability
broca’s aphasia
broken, slow, labored speech with misprononciations
Wernicke’s/receptive aphasia
- impaired auditory reception
- speech may be fluent but nonsensical
Anomic aphasia
difficulty with word finding
dysarthria
difficulty with speech d/t paralysis of speech organs
cog impairment with spatial relations
difficulty perceiving distance and object placement
spatial neglect
inability to recognize stimuli in a particular area, generally on the contralateral side of the body
body neglect
spatial neglect of client’s own body generally on the contralateral side
motor apraxia
difficulty completing planned movements
ideational apraxia
difficulty conceptualizing planned multistep movements
figure-ground difficulties
difficulty differentiating an object from its background
visual agnosia
difficulty recognizing objects
what causes subluxation
humeral head moving down from joint d/t paralyzed muscles
abnormal muscle movements after a stoke may cause what
- edema
- overstretching
- muscle shortening
- damage to joints and soft tissues
lesion site of quadraplegia
T1 or higher
Lesion site of paraplegia
T2 or lower
complete lesion deficits
no motor or sensory funciton below level on injury
incomplete lesion deficits
may involve number of neurological segments and sensorimotor function may be partially or completely intact
what is the zone of partial preservation
complete injury with some innervation of dermatomes below the level of injury
what happens during spinal shock
- 24 hrs - 6 weeks
- absence of reflexes below the level of injury
prognosis of spinal cord injury
- if sensory or motor fxn occur in 24-48 hours, motor fxn less likely to return
- most recovery within 3 months and up to 18 months
zone of partial preservation recovery
- strengthening muscles here can dramatically improve functional performance
at what SCI level is orthostatic hypotension a risk
T6 or higher
how to position SCI patients with orthostatic hypotension
elevate feet
what is heterotropic ossification
abnormal growth of bone where it wouldn’t typically grow
At what SCI level is bowel and bladder function affected
S2-S5 and above
Nociceptive pain
pain caused by damage to body tissue
neuropathic pain
nerve damage that causes noxious sensation below injury level
