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Neuro & OT > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

What is dystonia?

A

co-contraction of agonist + antagonist causing abnormal + distorted positions of body parts

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2
Q

What is secondary dystonia?

A

caused by another disorder/disease

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3
Q

What are some characteristics of dystonia?

A

can cause twisting, repetitive movements, or abnormal posture

local/focal or generalized

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4
Q

What are some types of dystonia?

A

torticollis -> cervical dystonia

blepharospasm -> eye lid control

limb dystonia (ex. writer’s cramp)

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5
Q

What is the cause of primary dystonia?

A

basal ganglia dysfunction

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6
Q

How is dystonia diagnosed?

A

mostly observation - MRI can detect BG localization

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7
Q

What causes early onset dystonia?

A

gene deletion

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8
Q

What is dopa-responsive dystonia?

A

childhood onset that responds well to levodopa

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9
Q

What are some causes of secondary dystonia?

A

disorders that affect the BG - tumors, Huntington’s, Parkinson’s, infarct, abscess, carbon monoxide poisoning, neonatal hyperbilirubinemia, Wilson’s disease

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10
Q

How is dystonia treated?

A

anticholinergic medication (block ACh), botox + OT

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11
Q

What are some OT interventions for dystonia?

A

exercise, stretching, biofeedback, orthoses, relaxation techniques, sensory training

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12
Q

What is Huntington’s disease?

A

genetic condition of CNS

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13
Q

What are some characteristics of Huntington’s?

A

onset = 30-50 yo

slow progression

15-20 yr life expectancy

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14
Q

What causes Huntington’s?

A

degeneration of UMNs, BG atrophy + cortex degeneration

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15
Q

What are movement symptoms of Huntington’s

A

clumsiness, fidgety, tics, athetosis (wiggly), dystonia, bradykinesia (slowness), rigidity, chorea (jerky), decreased walking, speech + swallowing

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16
Q

What are eye symptoms of Huntington’s?

A

slow saccades (orientation to look), difficultly initiating saccades w/o head movement or blinking, impaired smooth tracking

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17
Q

What are the cognitive symptoms of Huntington’s?

A

decreased concentration + memory, impaired EF, dementia

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18
Q

What are the psychosocial/behavior symptoms of Huntington’s?

A

delusions, psychosis, impulsivity, depression, anxiety, OCD

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19
Q

How is Huntington’s diagnosed?

A

symptom review, family history, genetic testing

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20
Q

What occupations does Huntington’s affect?

A

social participation, ADLs, IADLs, leisure, health management, work

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21
Q

How is Huntington’s managed?

A

no cure - OT, medication, counseling

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22
Q

What are the functions of the cerebellum?

A

integrate sensory info from SC + brain, helps w/ cognition, coordinate movement + motor planning

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23
Q

What are the regions of the cerebellum?

A

inferior vermis + flocculonodular lobe -> balance + eye movement

vermis + flocculonodular lobe -> controls trunk

lateral cerebellum -> controls limbs, cognition + motor planning

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24
Q

What are the symptoms of a cerebellar artery infarct?

A

vertigo, nausea, vomiting, nystagmus, limb ataxia, unsteady gait, headache

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25
Q

What causes a cerebellar hemorrhage?

A

high BP, arteriovenous malformation (tangle of blood vessels to cause bypass of capillaries), metastases

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26
Q

What are the symptoms of a cerebellar hemorrhage?

A

headache, nausea, vomiting, ataxia, nystagmus, hydrocephalus (too much CSF)

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27
Q

What is the most significant symptoms of a cerebellar lesion?

A

ataxia - irregular + uncoordinated movements (can be ipsilateral)

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28
Q

What are the symptoms of a midline lesion to the cerebellum?

A

truncal ataxia - unsteady gait, eye movement difficulties, vertigo, nausea + vomiting

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29
Q

What are the symptoms of a lesion lateral to the vermis?

A

appendicular ataxia

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30
Q

What are some characteristics of ataxia?

A

dysrhythmia -> abnormal timing

dysmetria -> decreased control of distance, ROM + speed of movement

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31
Q

What is the result of a lesion in the lateral motor systems?

A

same side ataxia

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32
Q

What is the result of a lesion in the medial motor systems?

A

bilateral ataxia

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33
Q

What are some other causes of ataxia?

A

lesion to cerebellar peduncles, prefrontal cortex, or pons; hydrocephalous, SC disorder, damage to midbrain, frontal lobe, internal capsule, parietal lobe, or sensorimotor cortex

34
Q

What causes sensory ataxia?

A

damage to DC/ML pathway (ipsilateral, loss of sense of joint position), nerves (ipsilateral), thalamus, or somatosensory cortex (contralateral)

35
Q

What are the symptoms of sensory ataxia?

A

overshooting limb movement, unsteady gait, impaired joint sense

36
Q

What are the signs and symptoms of cerebellar damage?

A

nausea, vomiting, vertigo, slurred speech, unsteady gait, ataxia, headache, decreased consciousness, head tilt, hydrocephalus

37
Q

What are other types of brain damage that can affect ataxia?

A

UMN or LMN damage, sensory issues, movement disorders (Parkinson’s)

38
Q

What are some tests for appendicular ataxia?

A

precision finger tap, dysdiadochokinesia (rapid alternating movement), tremor, note myoclonus (rapid movement disorder)

39
Q

What are some tests for truncal ataxia?

A

wide base + unsteady gait,tandem walking, Rhomberg test, titubation (head or trunk tremor)

40
Q

What are some eye movement abnormalities?

A

ocular dysmetria -> over/undershoot eye gaze

slow or jerky saccades

nystagmus

suppressed vestibulo-ocular reflex

41
Q

What are some speech abnormalities and other findings?

A

fluctuations in rate + volume, slurred speech, difficult to understand, decreased muscle tone, cognitive deficits

42
Q

What is a stroke?

A

decreased blood flow to brain leading to decrease O2 + tissue damage

hemorrhagic or ischemic

43
Q

What are some characteristics of a stroke?

A

cerebral vascular accident (CVA), 5th leading cause of death, major cause of disability

44
Q

What are some causes and risk factors of a stroke?

A

cardiac disease, high BP, high cholesterol, diabetes

smoking, obesity, physical inactivity, alcohol, drugs

45
Q

What is a hemorrhagic stroke?

A

ruptured blood vessel causing increase pressure in brain (aneurysm)

46
Q

What is a ischemic stroke?

A

blockage of blood vessel (infarction -> death of brain tissue due to blockage)

47
Q

What are the types of blockages in the brain?

A

thrombosis -> blood clot

embolism -> clot that breaks away
from another body part

transient ischemic attack -> mini
stroke w/ no tissue death

48
Q

What are the major structures that supply blood to the cerebral hemisphere?

A

anterior circulation -> internal carotid

posterior circulation -> vertebral
arteries

circle of Willis -> internal + vertebral
arteries meet

49
Q

What are the symptoms of MCA clinical syndrome?

A

most common - aphasia, hemineglect, hemianopia, face, arm, or leg sensorimotor loss, gaze preference towards side of lesion

50
Q

What are the symptoms of ACA clinical syndrome?

A

sensory loss, contralateral leg, hemiparesis, motor aphasia, contralateral neglect, frontal lobe - grasp reflex, judgment, flat affect, apraxia, incontinence, alien hand syndrome (semiautomatic contralateral arm movements)

51
Q

What are the symptoms of PCA clinical syndrome?

A

contralateral homonymous hemianopsia (visual field deficits

thalamus or internal capsule - contralateral sensory + hemiparesis, aphasia

occipital lobe - alexia (reading deficits) w/o agraphia (writing deficits)

52
Q

What are the impairments caused by stroke?

A

varies by side of brain affected, damage to specific area of brain + amount of damage - may not know full effects until wks or months

53
Q

What are the motor impairments caused by stroke?

A

contralateral weakness + paralysis, ataxia, apraxia (coordination + motor planning), spasticity, contractures, dysphasia (swallowing), bowel + bladder control

54
Q

What are the sensory impairments caused by stroke?

A

decreased tactile sensation + depth perception, paresthesia ( tingling, burning or pain), hemianopsia (1/2 visual field), difficulty recognizing objects

55
Q

What are the cognitive impairments caused by stroke?

A

decreased memory, shorten attention span, difficulty w/ retention, EF, reading, writing or recognizing objects

56
Q

What are the communication impairments caused by stroke?

A

dysarthria (speech motor), articulation, Broca’s aphasia, Wernicke’s aphasia, global aphasia (language)

*on left side of brain

57
Q

What are the emotional impairments caused by stroke?

A

partial loss of emotional control + depression

58
Q

What is the difference between right vs. left side stroke?

A

right -> left side paralysis, visual + spatial difficulties, impulsivity, decreased memory

life -> right side paralysis, slow behavior, language deficits, problem-solving

59
Q

What are the treatments to support stroke?

A

motor -> exercise, PROM, stretching, splinting, muscle relaxers

psychosocial + ADLs

60
Q

What is a TBI?

A

acquired injury to brain from bump, blow, or jolt

61
Q

What type of damage is caused by close head injuries?

A

focal or diffuse

62
Q

What is the primary phase of damage?

A

caused by impact

63
Q

What is the secondary phase of damage?

A

monitored after injury - swelling or bleeding

64
Q

What are the types of injury from a blast TBI?

A

primary -> blast
secondary -> flying debris
tertiary -> blast throwing individual against object

65
Q

How are TBIs categoried?

A

Glasgow Coma Scale - eye opening, verbal + motor response

66
Q

What is a mild Glasgow score?

A

13+, concussion, inattention, decreased memory, headache, vertigo, tinnitus

67
Q

What is a moderate Glasgow score?

A

9-12, loss of consciousness, confusion

68
Q

What is a severe Glasgow score?

A

8-, coma, vegetative

69
Q

What is the Los Amigos Scale of Cognitive Functioning?

A

determines level of independence + care needed

70
Q

What are the physical effects of TBI?

A

decreased movement, balance, coordination + endurance

71
Q

What are the physical treatments of TBI?

A

exercise, massage, orthotics, AE, medication, sleep support, etc.

72
Q

What is cerebral palsy?

A

group of permeant disorders that effect movement + posture

non-progressive, developed at birth

73
Q

What are the causes of CP?

A

prenatal -> toxin, lack of O2, blood incompatibility

perinatal -> birth trauma

postnatal -> TBI, infection

74
Q

What is the neuroscience of CP?

A

cerebral cortex, subcortical structures, axons next to lateral ventricles

spastic diplegia -> BG + thalamus

dyskinetic -> BG

ataxic -> thalamus + cerebellum

75
Q

What is spastic CP?

A

exaggerated muscle tone = stiffness, pain, contractures

76
Q

What is hypotonic CP?

A

low muscle tone, inadequate contraction

77
Q

What is dyskinetic CP?

A

jerk, fluctuating muscle tone, involuntary

78
Q

What is ataxic CP?

A

clumsy, does not involve muscle tone

79
Q

What are some complications from CP?

A

contractures, scoliosis, dental, osteoporosis, respiratory infection

80
Q

How is CP identified?

A

observation, history + neuro exam

Neuro & OT (3 decks)

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