Systems Final T3 Flashcards
Response to CNS damage that may persist for weeks or months after brain injury. Astrocytes migrate to the site of neuronal death, clustering together to create a soft scar structure which is called…
Gliosis
A.k.a astrocytosis, astrocitic gliosis
These myelinate axons in the CNS and are what get attacked in MS
Oligodendrocytes
Diminished sensation; the experience matched the nature of the stimulus but is less strong than expected. Lay term is numbness.
Hypaesthesia
Heightened or exaggerated sensation; the experience accurately matches the stimulus, but produces an exaggerated or unexpectedly strong response.
Hyperaesthesia
Define paraesthesia
Abnormal sensation e.g pins & needles, bugs crawling on skin
The sensation experience does not correlate with the stimulus
Define Dysaesthesia
When a paraesthesic sensation is painful e.g hot pokers, electric burning
Instead of the expected sensation, an innocuous stimulus results in pain. A usual pain experience is being created in response to a normally non-nociceptive stimulus. E.g feather like touch
Allodynia
Define hypalgesia
The response to a nociceptive stimulus is weak
Heightened sensitivity to painful stimuli. The person experiences an unexpectedly strong pain intensity as compared to the predicted response to stimulus. Often there is a continuation of the pain after the stimulation has ceased.
Hyperalgesia a.k.a hyperalgia
Rigidity is a manifestation of…
Basal ganglia dysfunction
What are some important treatment goals when working with rigidity in limbs.
- general relaxation; lowering sympathetic activation
- optimizing perfusion and draining; improve circulation
- reduce/minimize contracture
- MET/muscle fatigue in the target muscles to reduce tone
- using reflex techniques
What may be a reason for adapting positions while treating rigidity?
Rigidity can affect breathing muscles. A patient may have dysphasia or breathing difficulties, so adaptations may need to be made so the patient can feel comfortable and at ease. With dysphasia lying completely flat may promote choking.
What is the most effective reflex technique to for rigidity? What is the least effective?
- GTO release, light vibrations and stroking
- reciprocal inhibition, antagonist contraction techniques etc also mm approx
Sensory overload can help renormalize reflex sensitivity. This can be a combination of touch/pressure, movement and temperature.
True or false: Minimizing contracture and maximizing jt health are both key treatment aims when treating rigidity.
True
True or false: passive forced movements can be effective if done properly.
True
True or false: It is best to treat before the px’s rigidity- influencing meds are in full force.
False; It’s best to treat WHEN the px’s meds are in full force.
A lesion on pyramidal pathway will cause loss of distal motor function on the ___ side of the body
- opposite
Muscle hypertonia as a result of exaggerated, disregulation of reflex responses is…
Spasticity
Spasticity can be a result of…
UMN injury or disease-caused damage
Spasticity typically results from…
White matter lesions in the
Brain, brainstem & spinal cord
Spasticity vs Rigidity: which is typically seen in Extrapyramidal lesions ex. Parkinson’s?
Rigidity
Spasticity vs rigidity: which generally only occurs during muscle stretch and usually accompanied by increased tendon reflexes and a babinski response?
Spasticity
True or false: Rigidity is velocity dependent and more rapid movements triggers a stronger involuntary contraction or “catch” of affected mm.
False; this is spasticity
Alternating activation of agonist and antagonist stretch reflex responses acting on a joint causing a reverberating back & forth action. This is…
Clonus a characteristic of spasticity
Define spastic co-contractions…
Abnormal antagonist contractions that occur during voluntary agonist effort
What is spastic dystonia?
Muscle contraction present at rest, leading to a holding position very sensitive to stretch.
What characteristics of spasticity develop 6 months after the spastic-causing event?
- 1a neuronal sprouting
- reduced spinal cord availability of gaba
What is happening 6 months after spasticity causing event when there is reduced spinal cord availability of GABA?
- the strength/duration of the GTO reflex response is reduced. It’s still present but is weaker & shorter in duration
- Spasticity is intensified by reducing the GTO’s capacity to counteract the stretch reflex response
What do you want to avoid when treating a patient with spasticity?
- stress/agitation and a lot of physical movement/activity (keeps reactivity at a higher level)
- anything unexpected
- ‘pokey’ or stop-start quality techniques
- targeted reflex techniques like vibrations and tapotment
- techniques that stimulate nociception
- cold and hot extremes
- massaging and stretching at the same time
Give a summary of spasticity massage guidelines
- tx should be relaxation focused
- consistent, smooth, firm touch and techniques that aren’t painful
- tx in sidelying for most of tx, use lots of pillows to keep jts in flexed position
- use neutral flexion of jts
- hold mm in a tolerable shortened position for 30 seconds to calm its mm spindles
- Use GTO technique
- use warm hydro only no extremes of cold or hot
- use jt mobs, stretching but maybe interspersed through tx
- tx when anti spastic med are strongest in px’s system
What are some clinical problems that increase spasticity?
- ischemia
- altered biomechanics & degenerative jt change
- compensatory postures and movements
- contracture
- poor tissue healing
True or false: resistance exercise can help reduce tone levels in spastic muscles.
True
True or false: You should only check on cardiovascular status in px w/spasticity who also have a history of cardiovascular problems?
False: You should always check for px’s w/spasticity regardless of cause. Spasticity esp full body can generate stress on the heart.
True or false: Medically induced functional contractures should also be removed in a px with spasticity.
False; They should not be removed!
What is dysarthria?
Speech is slurred because articulation is not precise
Group of dysfunctions related to limited language output. Person may have normal or close to normal cognition but has limited or no capacity to produce language. May result in the production of sounds but not words. This is…
Broca’s aphasias
Group of dysfunctions where verbal output is not limited or constrained, however there are major problems with conveying meaning. This can range from word-finding and word- association m errors to producing jibberish. This is called…
Wernicke’s aphasias
