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LL Ox > Q4: SCI, GBS/Transverse Myelitis, & ALS/PD > Flashcards

Q4: SCI, GBS/Transverse Myelitis, & ALS/PD Flashcards

1
Q

Etiology

SCI

A

Usually blunt trauma (MVA, Falls, Sports, GSW)

  • 60% Male
  • 50% of cases involve neuro- deficit
  • Cervical Injury most common
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2
Q

Diagnosis

SCI

A

Can be difficult to originally diagnose (inflammation & spinal shock)
* Imaging (MRI, CT, xray)
* Sensory - highest dermatome intact
* Motor - level at which pt scores 3/5 MMT

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3
Q

Classification - Fx

SCI

A

Fx type:
* compression
* burst
* chance
* dislocation

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4
Q

Classification - ASIA Impairment Scale

SCI

A

A - Complete (M&S)
B - Sensory Incomplete (sense intact)
C - Motor Incomplete (motor intact)
D - Motor Incomplete (motor intact and more fucntional than “c”)
E - Normal

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5
Q

Worst Type of Incomplete SCI (prognosis)

SCI

A

Anterior Cord Syndrome

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6
Q

Clinical Presentation

SCI

A

Depends on the level of injury

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7
Q

Complications

SCI

A

Autonomic Dysreflexia
* usually in LOI T6 or higher
* increase in BP
* rapid symptoms
* will resolve if stimulus is removed

More susceptible to clots and ulcers

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8
Q

Non-Ox Treatment

SCI

A
  • Corticosteroids (3-8 hrs post injury)
  • PT/OT
  • Mental health

Depends on LOI

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9
Q

Ox Intervention

SCI

A

Depends:
* how proximal?
* goals?
* sensation status?
* UE involvement?

anywhere from AFO to FES to HKAFO…or Exoskeletons

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10
Q

Etiology

Guillain Barré Syndrome (GBS)

A

Most common cause of acute flaccid neuromuscular weakness in the world

  • post viral infection neuropathy
  • rare
  • most commonly present in young adult (males > females)
  • 20% mortality
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11
Q

Clinical Presentation (acute phase)

Guillain Barré Syndrome (GBS)

A
  • 1-6 weeks after initial illness
  • progressive weakness (max. at 4 weeks)
  • paresthia in hands/feet
  • pain is common
  • symmetrical lower motor neuron paralysis

ventilators are commonly needed; 2-5% die from complications

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12
Q

Clinical Presentation (post-acute phase)

Guillain Barré Syndrome (GBS)

A
  • complete recovery is common
  • slowly resolves (spontaneous)
  • may have residual paralysis

80% - full recovery between 1-12 months

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13
Q

Diagnostic Techniques

Guillain Barré Syndrome (GBS)

A
  • Clinical Exam - loss of reflexes
  • Differential Diagnosis (process of elimination) - nerve conductions, analysis of CSF, antibody tests, MRI
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14
Q

Non-Ox Interventions

Guillain Barré Syndrome (GBS)

A
  • Plasma exchange - remove pathogen
  • Intravenous Immunoglobulin
  • PT/OT/ST - contractures and neurorehab
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15
Q

Ox Intervention

Guillain Barré Syndrome (GBS)

A
  • Contracture prevention during acute phase
  • Lightweight/dynamic options
  • AFOs/KAFOs

Consider designs that can accommodate pt improvement rapidly

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16
Q

Similarities to GBS

Transverse Myelitis

A
  • often caused by infection
  • rapid onset (weakness)
  • bilateral
  • monophasic
  • similar treatments
  • short acute phase with long recovery phase
17
Q

Differences from GBS

Transverse Myelitis

A
  • idiopathic occurrences too
  • associated with other autoimmune disorders
  • very rare (1-8 per 1 million people per year)
  • 1/3 become permanently disabled
  • 1/3 recover with little deficit
  • symptoms dependent on spinal cord level
18
Q

Etiology

ALS

A

“Lou Gehrig’s Disease”
* progressive, neurodegenerative condition involving spine and brain
* Idiopathic but can have genetic link
* males more common
* 50-60 years old
* fatal - 50% die within 5 years of onset (failure of respiration)

19
Q

Diagnosis

ALS

A

Difficult to diagnose (variability in presentation)

Escorial Criteria
* based on presentation of UMN & LMN

20
Q

Clinical Presentation

ALS

A
  • Progressive weakness/atrophy (degen. of UMNs and LMNs)
  • Cognitive and behavioral changes
  • All muscles will become paralyzed - can still think
21
Q

History/Definition

PD

A

Progressive, neurodegenerative condition characterized by:
* tremor
* rigidity
* bradykinesia

22
Q

Etiology

PD

A
  • Idiopathic - caused by dopamine deficiency in basal ganglia
  • Similar onset and demographic to ALS
23
Q

Diagnosis

PD

A

No reliable test exists;
Based on clinical signs
* tremor
* bradykinesia
* rigidity

24
Q

Clinical Presentation

PD

A
  • Unilateral onset, bilateral when severe
  • Freezing gait
  • Use a walker with red laser line to help step length
  • sight, speech, and swallow difficulty
25
Q

Non-Ox Intervention

ALS/PD

A
  • Palliative - comfort care
  • Multidisciplinary
  • Pharma - slow disease or treat symptoms
  • Therapy - PT/OT/ST/RT/GC/psych/nutrition

LL Ox (24 decks)

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