Neuromuscular Units 1-7 Finals Review Flashcards
What are potential impairments with Perceptual and Cognitive Impairments?
- Perceptual: Agnosia, Neglect, Apraxia
- Cognitive: Orientation, Memory, Arousal
What are potential impairments with Speech and Language Impairments?
- Aphasia
- Dysarthria
- Dysphagia
What are potential impairments with Composite Impairments?
This is both Motor and Sensory Impairments
- Postural control/balance (equilibrium coordination)
If a patient has a Upper Motor Neuron pathology, where would the patient be affected?
- The clinical presentation will be contralateral to the side of the deficit
If a patient has a Lower Motor Neuron pathology, where would the patient be affected?
- The clinical presentation will be on the ipsilateral side of the deficit
In terms of muscle weakness associated with UMN lesions, what is the def. of paralysis?
Complete absence of muscle strength or the inability to voluntarily recruit motor units.
In terms of muscle weakness associated with UMN lesions, what is the def. of Plegia?
The same as Paralysis:
- Complete absence of muscle strength or the inability to voluntarily recruit motor units.
In terms of muscle weakness associated with UMN lesions, what is the def. of Hemiplegia/Hemiparesis?
Hemiplegia: One-sided paralysis
Hemiparesis: One-sided Weakness
In terms of muscle weakness associated with UMN lesions, what is the def. of Paraplegia?
Lower Extremity Paralysis
In terms of muscle weakness associated with UMN lesions, what is the def. of Tetraplegia?
Both upper and lower extremity paralysis to include the trunk
Hypertonia in the form of muscle stiffness is an example of a Direct or Indirect impairment?
This will be an indirect impairment
A lot of times muscle stiffness will occur the longer the patient becomes chronic with their condition, ideally because they’ve become more sedentary
With involuntary movements, what is Dystonia?
Excessive twisting and bizarre repetitive movements caused by axial and proximal limb musculature, typical with basal ganglion lesions (Parkinson’s). Often exhibited in patients that have been using long term parkinson’s medications as a side effect.
With involuntary movements, what is Chorea?
Rapid and jerky movements, associated with basal ganglion lesions, hence the term Huntington’s Chorea
With involuntary movements , what is Athetosis?
Slow twisting, snakelike movements, often associated with Cerebral Palsy
With involuntary movements, what are Resting Tremors?
The tremor that occurs when the muscles and the patients body are at rest. Very common in patients with parkinson’s, especially with the upper extremity. Sometimes referred to as the “Pill Rolling Tremor”
With Visual defects, what are terms associated with UMN lesions?
- Blurred vision: loss of visual acuity
- Diplopia: double vision
- Strabismus: Eyes aren’t parallel, have altered visual axis
- Nystagmus: Rapid, rhythmic, repetitive involuntary eye movements
- Homonymous Hemianopsia: Partial blindness resulting in loss of vision in the same visual fields of both eyes
- Occipital Blindness: Legally blind, loss or absence of the ability to perceive images
What are the subcategories of Aphasia?
- Expressive Aphasia: (aka Broca’s or non-fluent/motor aphasia, occur when there is damage to broca’s area (Frontal lobe on left or dominant hemisphere) Have intact auditory comprehension. They have a hard time expressing what they want to say.
- Receptive Aphasia: (aka Wernicke’s or Fluent/Sensory Aphasia, occurs when there’s damage to Wernicke’s area (Association cortex in Temporal Lobe on left or dominate hemisphere). They have auditory comprehension that is impaired, they dont understand whats being said to them
- Global Aphasia: When patients have elements of both Expressive and Receptive Aphasia, there is going to be widespread, significant damage to the left or dominant hemisphere
With Composite Impairments, what are the main systems for Posture Control/Balance?
Somatosensory System (Dorsal Column-Median Lemniscal tract), Vestibular System (Peripheral sensory apparatus in inner ear), and Visual system
- All these systems will bring information to the CNS where both the brain, brainstem and cerebellum are going to integrate and understand for an appropriate motor plan
What are the 2 main types of stroke?
Type 1 - Ischemic Stroke (occlusive)
Type 2 - Hemorrhagic Stroke (Abnormal bleeding)
What is the Pathophysiology of Stoke? What is the area around the core area? What is the cascade of events that occurs in terms of deprivation of O2 to the cerebral tissue?
MUST KNOW
Complete occlusion of blood flow leads to a core area of neuronal cell death
- Around the core area is what’s referred to as the ischemic penumbra (area where neurons are lethargic, but remain viable)
- Firstly we have ischemia causing the neurons to release excessive glutamate, then we have altered Ca ion channels causing influx of Ca into neuron, because of this you have high levels of intracellular Ca it then activates a series of destructive Ca sensitive enzymes leading further neuronal cell death in ischemic penumbra area.
What are the risk factors and early signs for stroke? What are the 5 “sudden” warnings?
Balance
Eyes
Face
Arm
Speech
Time: Huge in terms of getting medical intervention
Warning signs:
- Sudden numbness or weakness of the face, arm or leg especially one side of the body.
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden sever headache with no known cause
What are common problems with ACA Strokes?
Common Problems with ACA stroke are:
- Contralateral Hemiparesis or Hemiplegia
- Contralateral Sensory loss (mostly in LE)
- Mental confusion because of frontal lobe involvement
What are common problems with MCA Strokes?
Common Problems with MCA stroke are:
- Contralateral hemiparesis or Hemiplegia
- Contralateral Sensory loss (mostly in UE)
Can include: - Homonymous Hemianopia or other visual and spatial perceptual deficits, that being neglect if its the non-dominant hemisphere and apraxia if its the dominant hemisphere
The MCA is the most common site for Infarct
What are common problems with PCA Strokes?
Common problems with PCA Stoke are:
- Visual Changes (Pt. may exhibit homonymous hemianopsia
- May have very transient contralateral hemiparesis or hemiplegia
- Transient contralateral sensory loss (mainly because of thalamus and diencephalon involvement)