Rehab Exam 4 Review Flashcards
1
Q
Life expectancy of someone with MS
A
- No change in life expectancy with proper maintenance
2
Q
Pathophysiology of MS
A
- T-lymphocytes attach to and destroy myelin sheath
- Disruption causes demyelination
- Neural transmission is slowed or stopped; nerves fatigue rapidly
- Inflammation, edema, infiltrates surround acute lesion and interfere with nerve conductivity
- Most susceptible areas: Optic nerves, periventricular white matter, spinal cord, cerebellar peduncles
3
Q
Exacerbation (regarding MS patient)
A
- Significant decline in functional capability, sudden increase in clinical signs (8 manifestations - sensory, pain, visual, motor, speech and swallowing, cognitive, affective, autonomic)
4
Q
2 factors that can contribute to an exacerbation
A
- Heat
- Stress
5
Q
Strategies that can be used during interventions involving strengthening and conditioning exercises
A
- Start interventions early
- Alternate days and during times of lower core temps (am) to prevent rapid fatigue (outpatient)
- Balance exercise with rest periods
- Incorporate resistance/circuit training
- Manage core temp and prevent overheating
- Consider cog deficits when implementing program
- Integrate functional training and closed chain
- Incorporate group exercise
6
Q
Most likely cause of pain in MS patient
A
- Demyelination (demyelinating lesions) of pain tracts (most common in spinothalamic tracts)
- 80% pts Chronic neuropathic pain
7
Q
Causes of depression in MS patient
A
- Loss of function
- Disease itself (related directly to MS)
- Side effect of medication
- Lesion located - whatever affect is controlled can lead to depression
8
Q
Which affect characteristic is more common in later stages of MS?
A
- Euphoria
9
Q
Focus of PT interventions for MS patients
A
- Education (increase awareness of sensory deficits)
- Compensation (for sensory loss)
- Neuroplasticity
- Depends if pt is exacerbated or not
10
Q
More appropriate for MS pt that has declined significantly in function - power of manual w/c
A
- Power w/c: Need to conserve energy, pt fatigues faster
11
Q
Pathology of Parkinson’s Disease
A
- Abnormality of basal ganglia
12
Q
PD is due to a decline in the production of dopamine - true or false?
A
- True. Degeneration of neurons producing dopamine.
13
Q
Impairments characteristic of PD
A
- Rigidity
- Pill-rolling tremor
- Difficulty initiating movement (bradykinesia)
- Postural instability
14
Q
“On-Off” State in PD
A
- Refers to medication (Levodopa) - when on, it causes increase in dopamine and a return to normal function, eventually shuts off when L-Dopa wears off)
15
Q
Posture of PD pt
A
- Presents with flexed, stooped posture; increased kyphosis; COM forward to limits of stability
- Narrow BOS
- Increased sway
16
Q
Clinical presentation of sensation in PD patient
A
- No primary sensory loss (ex: light touch)
- Restlessness
- Impaired proprioception
17
Q
Ortolani’s Sign
A
- Attempts to reduce hip dislocation by relocating the hip
- Postiive sign: Positive for hip dysplasia - hip is subluxed or dislocated and can be reduced - palpate hip moving over acetabular ridge
- Negative sign: Hip cannot be relocated (hip dislocation)
18
Q
Barlow Maneuver
A
- PTA flex, adduct hip
- Attempts to dislocate/sublux the hip
- Femoral head exits acetabulum; Positive is click with flex/add, also with abd as hip clicks back in
19
Q
Causes of hydroencephalus
A
- Overproduction of CSF
- Failure of absorption of CSF
- Obstruction of the CSF flow
20
Q
Arnold Chiari Malformation
A
- Posterior cerebellum herniates through the foramen magnum
- Brainstem displaced caudally
- Obstructs CSF flow in the 4th ventricle
- Traction on lower CN
21
Q
Most severe type of Spina Bifida
A
- Myelomeningocele
22
Q
Syringomyelia (Hydromyelia)
A
- CSF collects in pockets along SC and creates areas of pressure
- Signs include rapidly progressing scoliosis, progressive UE weakness, hypertonia
- Can occur with SB or in isolation
23
Q
Post-conceptual age of newborn (5 wks old) who was birthed at 28 weeks
A
- AA prior to achieving term age
- GA + CA
- 33 PCA
24
Q
Adjusted Term Age of Newborn in prior example
A
- CA - #wks missed in utero
- 5 - 14 = -9 TAA
25
Q
NICU Levels
A
- Level 1: Minimal observation or care; small community hospital; “Well-baby nursery”
- Level 2: Step down from Level III; continued care from Level III, IV meds or alimentation, tube feedings, O2; regional or community hospitals
- Level 3: Highly specialized services for sickest and most fragile infants - complex, medical interventions, advanced diagnostic testing, surgery, resp. support; Teaching hospitals and affiliated with medical schools
- Level 4: Level III plus ECMO (extracorporeal membrane oxygenation)
26
Q
Reasons pre-term baby might not feed
A
- Learned oral aversion resulting from NICU care
- Lack of flex/ext balance and chin tuck to assist with sucking, swallowing, breathing
- Residual lung disease may cause tachynea; interferes with sucking and swallowing
- Lack of self-regulation; unable to calm self with environmental stressors
- Apnea
- Bradycardia
- Unable to coordinate sucking, swallowing, breathing, and becomes physiologically unstable
- Immature GI Tract
27
Q
Importance of surfactant
A
- Lowers the surface tension in lungs and allows alveoli to maintain its shape
- Prevents respiratory distress syndrome (RDS)
28
Q
Osteopenia
A
- Decrease in bone density
- Occurs because of immature bone development
- 80% of bone formed between 24 and 40 weeks; 3rd semester essential for bone formation
29
Q
Meconium Aspiration Syndrome
A
- During delivery, fetus may pass BM into amniotic fluid; as infant gasps for first breath, may aspirate meconium-tainted fluid
- Meconium particles obstruct airway, interfere with gas exchange; leads to respiratory distress
30
Q
Brachial Plexus Injury - Position of baby’s arm
A
- Baby’s arm in “waiter tip” position
- Shoulder ADD, IR, elbow ext, pronation, wrist and finger flexion
- UE limp at infant’s side
