Week 5 Flashcards
What are the types of disability according to the NDS?
Intellectual Physical Acquired Brain Injury (ABIs) Neurological (including epilepsy and Alzheimer's disease) Deafblind (dual sensory) Vision Hearing Speech Psychiatric Developmental Delay
What is disability?
- Total or partial loss of the person’s bodily or mental functions
- Total or partial loss of a part of the body
- Presence in the body of organisms causing disease or illness
- Malfunction, malformation, disfigurement of a part of the person’s body
- Disorder or malfunction that results in the person learning different from a person without the disorder or malfunction
- Disorder, illness or disease that affects a person’s thought processes, perception of reality, emotions or judgement, or that results in disturbed behaviour
- Impact daily activities
What is an Acquired Brain Injury (ABI)?
Any type of brain damage that happens after birth including:
- TBI
- Stroke
- Brain tumour
- Poisoning
- Infection & disease
- Near drowning or other anoxic episodes
- ETOH & Drug Abuse
What are the immediate effects of ABI?
- LOC
- Dizziness
- Drowsiness
- Vomiting
- Headache nausea
- Confusion
- Altered respiratory pattern
- Cushing Triad…
What are some long term effects of ABI?
- Short-term memory
- Altered sleep patterns
- Change in personality
- Depression
- Irritability
- Emotional and behavioural problems
- Seizures
- Motor / Sensory problems
- Paralysis / Quadriplegia
What is a seizure?
Rapid and uncoordinated electrical activity in the brain
Could be symptomatic, but also asymptomatic
How can illicit substances cause disability?
Illicit substances abuse could cause brain damages
• Affects neurotransmitters release / uptake (causes euphoric effects or ↑wakefulness + physical activities)
- Alterations of chemical concentrations
- Causes long term changes in neurotransmission
• ↑BP and/or ↑HR
- ↑Risk of cerebral bleed
• ↓ Perfusion
- ↑Risk of Hypoxic injuries
• ↓ Consciousness
- ↓ Respiratory drive, ↑ risk of aspiration
- ↑Risk of Hypoxic injuries
• Correlation with ↑hallucination + psychosis
What can ETOH cause?
Interfere absorption of thiamine (Vitamin B1)
↑ Dementia, Encephalopathy, Psychosis, Seizures
WHat are some potential issues of ETOH?
- -ve interaction with prescribed medications
- ↑ risk of overdose and alchol poisioning
- ↑depression, anger, emotional ups & downs, impulsivity, risk-taking and challenging behaviours
How can diabetets be considered disability?
A group of different conditions in which the body cannot maintain healthy levels of BGL
• Affects entire body
• Chronic hyperglycaemia could cause complications
- Peripheral neuropathy
- Nerve damages > Altered sensation
- Unable to realise injuries / ulcers
- Worsening injuries
- Delayed treatment
• PVD
- Altered blood flow to legs and feet
- Delayed wound healing
- Tissue damage or death (gangrene)
If infection cannot be stopped or damage is irreparable…
• Amputation may be necessary
What is the spinal cord?
Long, thin, tubular structure made up of nervous tissues
Extends from the medulla oblongata in the brainstem, to the lumbar region of vertebral column
- Connections between the brain the PNS (Peripheral Nervous System)
- Transit nervous impulses between PNS and the brain
What is autonomic dysreflexia?
A syndrome in which there is a sudden onset of excessively HTN (Could be life-threatening)
More common in people with T6 injuries or above
WHat are common triggers of autonomic dysreflexia?
- Overfull Bladder, UTIs
- Overfull bowel / Constipation
- GI problems
- Pressure injuries, ingrown nails, skin problems
- Trauma
- Tight clothing or devices
- Extreme temperature or quick temperature changes
What are the S&S of autonomic dysreflexia?
Pounding headache
Flushed face and/or red blotches on skin above the level of SCI
Sweating above the level of SCI
Nasal Stuffiness
Nausea
Bradycardia (could be tachycardia at times)
Goose bumps below the level of SCI
Cold, pale, clammy skin below the level of SCI
What are some complications of Autonomic Dysreflexia?
- Existing SCI (Commonly above T6)
- Over-activity of ANS by stimuli originated from below the level of SCI
- Nerve impulses travel up to the spinal cord until blocked by the lesion
- Reflex response activated below the level of SCI, promote vascular constriction below the SCI
- Overall HTN triggered inhibitory response from the brain, to promote vasodilation
- Signal from brain can’t pass below the SCI
- Therefore, unopposed vasodilation continues above injured point, and unopposed vasoconstriction
continues below injured point.
What is cerebral palsy?
A physical disability that affects movement and posture
No single cause, mostly unknown
Small percentage of cases are due to complication at birth (hypoxia)
Usually a result of a sequence of events that when combined can cause or accelerate injury to the developing brain
Most cases in Australia, brain injury leading to cerebral palsy occurs either in the uterus or before 1/12 of age
• Stroke is the most common cause in babies who acquire cerebral palsy after 1 month of age
What are risk factors of cerebral palsy?
- Males
- Premature babies
- Small Babies
- Twins, triplets and higher multiple birth
Whaty are the effects of cerebral palsy?
It can affect a person’s posture, balance and ability to move, communicate, eat, sleep and learn
3 in 4 people with cerebral palsy experience pain
• Contractures, abnormal postures, dystonia, skin breakdown, GORD, etc
What is motor neuron disease?
• A group of diseases in which the neurones undergo degeneration and die
- Also known as ALS (Amyotrophic Lateral Sclerosis), Lou Gehrig’s Disease (in the USA)
• Rapid progressing neurological disease
What causes MND
Causes still unknown, potentially related to:
- Exposure to viruses, certain toxins and chemicals
- Inflammation and damage to neurons caused by an immune system response
- Nerve growth factors
- Gene mutations
- Familial (hereditary) MND accounts for above 5-10% of cases
What are the effects of MND?
Often begins with weakness of the muscles in the hands, feet and voice
- Can start in different areas of the body
- Progress in different patterns and at different rates
- Life expectancy after Dx is 1-5 years, 10% could live ≥ 10 years
- Develop generalised paralysis (both sides of the body)
- Lose speech and have difficulty swallowing
- become breathless and experience sleep disturbance
- experience mild cognitive and behavioural change
- ↓ independence of ADLs
What happens with multiple sclerosis?
Immune system mistakenly attacks itself
- Damages myelin (demyelination)
- Causes inflammation and scarring (MS means ‘many scars’)
- Symptoms unique to individual, depends on area affected
- Affects nerves of CNS (Brain, spinal cord and optic nerves)
- Brain atrophy occurs at a much faster rate than aging
What are the symptoms of MS?
Motor Control - Difficulties in walking, balance or coordination, muscle spasms or tremors, muscle weakness, difficulty speaking, dysphagia, breathing difficulties, etc
Fatigue - Extreme lethargy, often in combination with heat sensitivity which can impact on physical, emotional and mental abilities
Neurological - Visual disturbance, altered sensation, neurological pain, sensitivity, etc
Elimination - Incontinence, frequency, less urgency, constipation and diarrhea
Neuro-psychological - impaired memory and concentration, change in processing speed and abilities, impaired cognitive function, mood changes, etc
What is Lupus?
Systemic Lupus Erythematosus (SLE)
Chronic condition that results from a malfunction of immune system
- Mistakenly attacks healthy tissue
Causing inflammation in parts of the body such as the skin, joint, kidneys, heart and lungs
- Symptoms could be mild to life-threatening
Certain ethnic groups are more likely to develop lupus
- Such as Alfro-Caribbean and Asian ancestry
What are symptoms of Lupus?
Rashes
Pain (Joint, muscle, abdominal, chest, etc)
Hair loss
Fatigue
Fever, headaches or migraines
Confusion, memory problems, anxiety and depression
Mouth and nose ulcers
Blood and blood vessels problems (such as, HTN, anaemia, ↑Blood clotting)
Breathlessness
Seizure or visual disturbance
Poor kidney function
What is Lyme disease?
Tick-borne bacterial infection
Infection by tick-bite
- Might have rashes, headache, joints pain and fever in 3 to 32 days post being bitten
- Could spread through blood stream if untreated
- Could affect brain (meningo-encephalitis), heart (endocarditis, myocarditis, pericarditis), etc
- Could result in long-term neurological symptoms
What is Autism Spectrum Disorder?
Neuro-developmental disability thought to have neurological or genetic causes (or both)
Includes Autism, Asperger’s syndrome and pervasive developmental disorder not otherwise specified (PPD-NOS)
Lifelong developmental disorder, characterised by:
- Difficulties with social interaction
- Difficulties with communication
- Restricted and repetitive behaviour
Also often characterised by sensory sensitivities
What are some challenges of patients with autism?
- Difficult to understand non-verbal communications (eg. Body language)
- Difficult to understand when and how to appropriately respond to social interaction
- Have repetitive use of movement, speech or objects to express themselves
- Very narrow and intense focus on limited area of interest
• Easily upset by changes to routine, environment and the familiar
- Like routine and predictability!
What is Down Syndrome?
Genetic condition (Not an illness / disease)
- Extra chromosome 21 in gene
- Not yet known why it happens
- Most common chromosome disorder
- Affects 1 in 1108 babies born in Australia (1 in 700 worldwide)
People with down syndrome have:
- Some characteristic physical features
- Some health and development challenges
- Some level of intellectual disability
what are some associated medical and health issues with down syndrome?
Large percentage of babies are born with congenital heart defect
Some babies are born with GI conditions
↑ chances of having thyroid abnormalities
↑ chances of having leukaemia
Tend to have relative narrower nasal passages (prone to URTI)
Tend to have narrower Eustachian tubes
More common to have visual defects
More likely to have teeth and gums issues
- More likely to have skin and hair issues (such as dermatitis, skin infection, eczema, etc)
- Tend to grow slower than others
Reduced muscle tone (hypertonia)
