Neurological Conditions

Question 1

relapsing remitting (MS)

Answer 1

85% of new cases
worsening of symptoms followed by partial or complete improvement, then stable remission followed by another relapse.

maybe years apart btw exacerbation

cortico steroids shorten relapse (set pt. back to baseline)

Question 2

secondary progressive (MS)

Answer 2

50% of relapsing remitting developed into secondary progressive within 10 years
initial relapse remitting that converts to slow steady decline without periods of remission.
slow decline in pt fx.
meds may delay onset

Question 3

primary progressive (MS)

Answer 3

10% of those with MS
continuous worsening in disease symptoms and disability without exacerbation (no spike in disease severity)
steady decline over time

Question 4

progressive relapsing (minority) (MS)

Answer 4

5% of those with MS
steady worsening of symptoms since onset along with super imposed exacerbation without remissions
worst one!! slow decline

Question 5

demographics of MS

Answer 5

400,000 in US 
20-30 years peak onset 
women greater than men 
whites 
increase incidents with distance from equator

Question 6

neuropathy

Answer 6

tingling, numb, hyper sensitivity

Question 7

polyneuropathy

Answer 7

form of neuropathy, multiple peripheral nerves involved, dif with fine motor (cant feel tool in hand)

Question 8

myalgia

Answer 8

muscle tone (pain/stiffness)

Question 9

Akinesia

Answer 9

a lack of mvnt (loss of is temporary)

Question 10

rigidity

Answer 10

resistance to passive stretch

select muscle groups

Question 11

cogwheel rigidity

Answer 11

move through range then tighten up again

get resistance, work arm, move passively, then feel resistance again

Question 12

fasciculations

Answer 12

muscle twitch (can see it)

Question 13

clonus

Answer 13

muscle contraction in agonist and antagonist (wrist and ankle)
stretch reflex, WB through that part of body will help clonus -(count beats)

Question 14

muscle atrophy

Answer 14

muscle wasting, dis use, decrease ability

Question 15

Cardinal signs of MS

Answer 15

weakness
sensory changes
numbness/tingling
decrease balance
visual changes
room spinning/double vision
bowl and bladder (dif with frequency)
cognitive changes (cloudiness, decease memory, a typically happy, unrealistic with needs)
dyarthria- sound and feel like marbles in the mouth, decrease clear speech
dysphagia- puree diet, dif swollowning, pocketing food, drooling
dizziness
vertigo
ataxia - in coordination, gets worse as body fatigues
spasticity
decrease gait
fatigue*** number one symptom of all
pain, isolated- find out why (disuse?positional or mal alignment?)

Question 16

Cardinal signs of Parkinson’s

Answer 16

tremor at rest
rigidity, stiffness of trunk, arms or legs
bradykinesia or slowed mvnt.

Question 17

• Secondary clinical signs of Parkinson’s Disease

Answer 17

postural, instability- causing loss of balance and falls
retropulsion- tendency to fall backwards
micrographia- small cramped handwriting
shuffled gait- slight foot drag
freezing or being stuck when trying to walk
masked facial expressions-
hypophonia -loss of volume of speech or muffled voice
automatic reflexes impaired- blinking and swallowing.

Question 18

Assessment and intervention priorities for MS

Answer 18

ADLS
IADLS
life roles
balance
dysphagia
mobility 
fatigue
emotional
depression 
quality of life

Question 19

Assessment and intervention priorities for PD

Answer 19

mobility
mvnt quality
ADL 
dysphagia 
safety 
cognition
coordination
fatigue 
ROM
strength
act level
transfers
environmental mod.