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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
What causes a cerebellar hemorrhage?
high BP, arteriovenous malformation (tangle of blood vessels to cause bypass of capillaries), metastases
26
What are the symptoms of a cerebellar hemorrhage?
headache, nausea, vomiting, ataxia, nystagmus, hydrocephalus (too much CSF)
27
What is the most significant symptoms of a cerebellar lesion?
ataxia - irregular + uncoordinated movements (can be ipsilateral)
28
What are the symptoms of a midline lesion to the cerebellum?
truncal ataxia - unsteady gait, eye movement difficulties, vertigo, nausea + vomiting
29
What are the symptoms of a lesion lateral to the vermis?
appendicular ataxia
30
What are some characteristics of ataxia?
dysrhythmia -> abnormal timing dysmetria -> decreased control of distance, ROM + speed of movement
31
What is the result of a lesion in the lateral motor systems?
same side ataxia
32
What is the result of a lesion in the medial motor systems?
bilateral ataxia
33
What are some other causes of ataxia?
lesion to cerebellar peduncles, prefrontal cortex, or pons; hydrocephalous, SC disorder, damage to midbrain, frontal lobe, internal capsule, parietal lobe, or sensorimotor cortex
34
What causes sensory ataxia?
damage to DC/ML pathway (ipsilateral, loss of sense of joint position), nerves (ipsilateral), thalamus, or somatosensory cortex (contralateral)
35
What are the symptoms of sensory ataxia?
overshooting limb movement, unsteady gait, impaired joint sense
36
What are the signs and symptoms of cerebellar damage?
nausea, vomiting, vertigo, slurred speech, unsteady gait, ataxia, headache, decreased consciousness, head tilt, hydrocephalus
37
What are other types of brain damage that can affect ataxia?
UMN or LMN damage, sensory issues, movement disorders (Parkinson's)
38
What are some tests for appendicular ataxia?
precision finger tap, dysdiadochokinesia (rapid alternating movement), tremor, note myoclonus (rapid movement disorder)
39
What are some tests for truncal ataxia?
wide base + unsteady gait,tandem walking, Rhomberg test, titubation (head or trunk tremor)
40
What are some eye movement abnormalities?
ocular dysmetria -> over/undershoot eye gaze slow or jerky saccades nystagmus suppressed vestibulo-ocular reflex
41
What are some speech abnormalities and other findings?
fluctuations in rate + volume, slurred speech, difficult to understand, decreased muscle tone, cognitive deficits
42
What is a stroke?
decreased blood flow to brain leading to decrease O2 + tissue damage hemorrhagic or ischemic
43
What are some characteristics of a stroke?
cerebral vascular accident (CVA), 5th leading cause of death, major cause of disability
44
What are some causes and risk factors of a stroke?
cardiac disease, high BP, high cholesterol, diabetes smoking, obesity, physical inactivity, alcohol, drugs
45
What is a hemorrhagic stroke?
ruptured blood vessel causing increase pressure in brain (aneurysm)
46
What is a ischemic stroke?
blockage of blood vessel (infarction -> death of brain tissue due to blockage)
47
What are the types of blockages in the brain?
thrombosis -> blood clot embolism -> clot that breaks away from another body part transient ischemic attack -> mini stroke w/ no tissue death
48
What are the major structures that supply blood to the cerebral hemisphere?
anterior circulation -> internal carotid posterior circulation -> vertebral arteries circle of Willis -> internal + vertebral arteries meet
49
What are the symptoms of MCA clinical syndrome?
most common - aphasia, hemineglect, hemianopia, face, arm, or leg sensorimotor loss, gaze preference towards side of lesion
50
What are the symptoms of ACA clinical syndrome?
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
What are the symptoms of PCA clinical syndrome?
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
What are the impairments caused by stroke?
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
What are the motor impairments caused by stroke?
contralateral weakness + paralysis, ataxia, apraxia (coordination + motor planning), spasticity, contractures, dysphasia (swallowing), bowel + bladder control
54
What are the sensory impairments caused by stroke?
decreased tactile sensation + depth perception, paresthesia ( tingling, burning or pain), hemianopsia (1/2 visual field), difficulty recognizing objects
55
What are the cognitive impairments caused by stroke?
decreased memory, shorten attention span, difficulty w/ retention, EF, reading, writing or recognizing objects
56
What are the communication impairments caused by stroke?
dysarthria (speech motor), articulation, Broca's aphasia, Wernicke's aphasia, global aphasia (language) *on left side of brain
57
What are the emotional impairments caused by stroke?
partial loss of emotional control + depression
58
What is the difference between right vs. left side stroke?
right -> left side paralysis, visual + spatial difficulties, impulsivity, decreased memory life -> right side paralysis, slow behavior, language deficits, problem-solving
59
What are the treatments to support stroke?
motor -> exercise, PROM, stretching, splinting, muscle relaxers psychosocial + ADLs
60
What is a TBI?
acquired injury to brain from bump, blow, or jolt
61
What type of damage is caused by close head injuries?
focal or diffuse
62
What is the primary phase of damage?
caused by impact
63
What is the secondary phase of damage?
monitored after injury - swelling or bleeding
64
What are the types of injury from a blast TBI?
primary -> blast secondary -> flying debris tertiary -> blast throwing individual against object
65
How are TBIs categoried?
Glasgow Coma Scale - eye opening, verbal + motor response
66
What is a mild Glasgow score?
13+, concussion, inattention, decreased memory, headache, vertigo, tinnitus
67
What is a moderate Glasgow score?
9-12, loss of consciousness, confusion
68
What is a severe Glasgow score?
8-, coma, vegetative
69
What is the Los Amigos Scale of Cognitive Functioning?
determines level of independence + care needed
70
What are the physical effects of TBI?
decreased movement, balance, coordination + endurance
71
What are the physical treatments of TBI?
exercise, massage, orthotics, AE, medication, sleep support, etc.
72
What is cerebral palsy?
group of permeant disorders that effect movement + posture non-progressive, developed at birth
73
What are the causes of CP?
prenatal -> toxin, lack of O2, blood incompatibility perinatal -> birth trauma postnatal -> TBI, infection
74
What is the neuroscience of CP?
cerebral cortex, subcortical structures, axons next to lateral ventricles spastic diplegia -> BG + thalamus dyskinetic -> BG ataxic -> thalamus + cerebellum
75
What is spastic CP?
exaggerated muscle tone = stiffness, pain, contractures
76
What is hypotonic CP?
low muscle tone, inadequate contraction
77
What is dyskinetic CP?
jerk, fluctuating muscle tone, involuntary
78
What is ataxic CP?
clumsy, does not involve muscle tone
79
What are some complications from CP?
contractures, scoliosis, dental, osteoporosis, respiratory infection
80
How is CP identified?
observation, history + neuro exam

Neuro & OT (3 decks)

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