week 12 part 1

Question 1

spinal cord injury

Answer 1

obstructs the transmission of neural messages through the spinal cord (loss of somatic and automatic control of the trunk, limds and viscera below the site of the injury

Question 2

primary injury of SCI

Answer 2

1. sudden trauma to the spine
   2.acute spinal cord compression, shear stress
2. acute impact to neurons,glial cells and neural parenchyma

Question 3

Secondary injury

Answer 3

-involves a cascade of biochemical/ metabolic and mechanical changes within the neural tissue
- secondary injury is a consequence of these downstream effects

Question 4

autonomic dysreflex

Answer 4

• the uncontrolled outflow of SNS activity due to a stimulus below the SCI
• result in life-threatening sudden hypertension followed by a reflex bradycardia

Question 5

SCI consideration for exercise

Answer 5

adat exercise based on the ability
- the importance of maintaining/ building strength and maintaining
- consider autonomic limitation that may impact exercise capacity
- consider medication that may impact exercise

Question 6

multiple sclerosis

Answer 6

• an inflammatory autoimmune disease that affects the conduction of neural impulse
• a chronic degenerative disease
• demyelination of the neuron within the CNS
• Brain, Spinal Cord & Cranial Nerves
• Affects all types: motor, sensory, autonomic
• Diffuse patches of demyelination
  throughout the CNS

Question 7

MS symptoms

Answer 7

this demyelination can occur anywhere in patches within the CNS
- symptoms depend on location, the severity of myelination
characterized by exacerbation and remissions

Question 8

MS treatment

Answer 8

-disease-modifying drugs minimize frequency of exacerbation, slow progression
-pharmaceuticals to treat the complications
-physio and exercise to maintain strength and mobility
-OT

Question 9

MS diagnosis

Answer 9

no defintive test but MRI can have useful info

Question 10

Altered physiological responses to exercise in MS

Answer 10

• Increased Submax VO2 during treadmill walking
• Attenuated Systolic BP during exercise
• Increased body temp
• Earlier skeletal muscle fatigue

Question 11

Considerations for exercise prescription

Answer 11

• Prescribe within physical limitations
• Consider use of supportive equipment e.g. arm poles for walking
• Variable strength from week to week
• Importance of stretching
• Resist heat stress
• Generally avoid exercise during an exacerbation

Question 12

Parkinson’s disease

Answer 12

• a disease of synaptic transmission where dopamine release is reduced
  -progressive and degenerative
• unknown etiology but thought to be a combo of environmental and genetic factors

Question 13

what is triggers secondary injury

Answer 13

it is triggered by the primary injury due to the acute inflammation

Question 14

acute phase

Answer 14

• Hemorrhage, inflammation & edema result in local ischemia
• Neural toxicity induces cellular damage
• Demyelination & cell death begins
  spinal shock due to the trauma that had occur in the area gets in the way to determine if it can return or not

Question 15

sub-acute phase

Answer 15

-Further neurotoxicity, inflammation, cell death, scar tissue formation
* Any undamaged tracts begin to resume function (incomplete injury)
* Axonal regrowth and sprouting begins if possible

Question 16

chronic phase

Answer 16

-continued cell death and scar tissue formation
-cyst development
-axonal degeneration and degeneration and demyelination
-continued regrowth and sprouting if possible

Question 17

MS pathophysiology

Answer 17

1. unknown trigger
2. activated t cells cross the blood-brain barrier
3. secrete cytokines
4. more immune cells recruited
5. attack oligodendrocytes
6. myelin is damaged and breaks down
7. plague formation
8. scar tissue formation and axonal destruction