Neuromuscular Flashcards
Charcot-Marie-Tooth Disease
a hereditary disorder with motor and sensory neuropathy, progressive muscular wasting, and diminished deep tendon reflexes
- initially affects ankle DF and evertors resulting in drop foot (steppage gait pattern), and will involve intrinsic musculature of hands (affecting fine motor skills)
Symptoms of UVH (Unilateral Vestibular Hypofunction)
- resting (spontaneous) nystagmus
- oscillopsia
- disequilibrium
- postural instability
- head tilt
Positive HI
Sx of Meniere’s Disease
tinnitus
deafness
sensation of fullness in ears
episodic vertigo
LOW frequency hearing loss
Tethered Cord Syndrome
due to tissue attachments that limit the movement of the spinal cord within the spinal column
SCOLIOSIS is huge
we’ll also see:
back pain (better with rest)
leg pain (posterior)
leg numbness/tingling
changes in leg strength
deterioration in gait
spine ttp
bowel bladder changes
Does a patient with a C4 spinal cord injury need a mechanical ventilator?
No not in later stages
Is the ability to cough and clear secretions independently with a C4 spinal cord injury maintained?
NO, they will be severely compromised in this
Best strategy for the initial eval of a patient with bilateral frontal lobe TBI?
DECREASING THE AMOUNT OF ENVIRONMENTAL STIMULI PRESENT
WHY: because a patient with damage to the frontal lobes will have poor short term memory, decreased executive functions, and decreased attention which would make providing feedback and following commands difficult during an initial eval
- simplify questions and instructions
What is the most appropriate wheelchair for a patient with a complete C6 SPC?
Manual wheelchair with hand rim progressions bc the patient can
- flex, extent, IR, and adduct shoulder
- scap abduction and protraction
- forearm pronation
- wrist extension
Would be limited in grip control but the hand rim could help the patient propel the chair
When is a power wheelchair with sip and puff adaptive controls most appropriate? Same with power wheelchair with head array adaptive controls
SPC C1-C4
Pt can perform
- cervical rotation
- blowing
- sipping
- talking
- mastication
Presentation of Bell’s Palsy
Weakness of paralysis of muscles of facial expression, inability to close eyelids, loss of taste to anterior tongue, and possible pain in or behind ear
CN7 is affected, potential loss of corneal reflex
Apraxia
Inability to perform motor activities upon command while the sensory and motor are intact
Ideomotor apraxia: refers to pts who are unable to perform activities upon command while these same motions can be performed spontaneously
Ideational apraxia: (no idea) cannot perform a purposeful motor act, either automatically or on command, because the patient no longer understands the overall concept of the act
Typical Impairments of Right Hemisphere Stroke
- Left hemiparesis/hemisensory loss
- visual-perceptual impairments
- NEGLECT
- Difficulty with visual cues
- QUICK, IMPULSIVE, SAFETY RISK BEHAVIOR
- rigidity of thought
- difficulty with negative emotions
- homonymous hemianopsia
Typical Impairments of Left Hemisphere Stroke
- R hemiparesis/hemisensory loss
- aphasias and so difficulty with verbal cues
- slow and cautious behavior
- highly distractible
- difficulty with positive emotions
- homonymous hemianopsia
Anterior Cerebral Artery Syndrome
Contralateral Hemiparesis and sensory loss (LOWER EXTREMITY)
urinary incontinence
trouble with imitation, apraxia, bimanual tasks
slowness delay, motor inaction
contralateral grasp reflex or sucking reflex
Middle Cerebral Artery Sigsn and Sx
Contralateral hemiparesis/sensory loss UE and face
Language speech impairments such as Broca, Wernicke, or Global aphasia (L)
perceptual disorders - neglect (R)
Contralateral homonymous hemianopsia
