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Neuro By Ptdi Flashcards

1
Q

Pain perception testing

A

Assesses sharp/dull discrimination

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2
Q

Analgesia

A

Loss of pain sensitivity (inability to feel pain)

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3
Q

Tone

A

Resistance of muscle to passive elongation, while the individual is attempting to stay relaxed (residual contraction at rest)

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4
Q

Spasticity

A

Velocity-dependent resistance to passive elongation

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5
Q

Aneurysm

A

Weakening of the artery wall causing an abnormal localized dilation of an artery. Aneurysms can burst and create bleeding.

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6
Q

Dysarthria

A

Motor speech disorder affecting the muscles used to produce speech (e.g., lips, tongue, vocal cords)

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7
Q

Asthenia

A

Generalized muscle weakness commonly found in cerebellar lesions

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8
Q

Primary-progressive MS (PPMS)

A

Steady disease progression (no interruptions or distinct episodes)

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9
Q

Bradykinesia

A

Slowness in movement

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10
Q

Kinesthesia

A

Ability to sense motion of a joint or limb

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11
Q

Dysphonia

A

Physical disorder of the mouth, tongue, throat, and/or vocal cords, that makes it difficult for a person to speak

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12
Q

Location of Broca’s area

A

Left Frontal lobe

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13
Q

Pattern of distribution of weakness seen in ALS

A

Asymmetrical distribution with distal to proximal progression

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14
Q

Cardinal features of Parkinson’s disease

A

Tremor (at rest)
Rigidity
Akinesia/bradykinesia
Postural instability
TRAP

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15
Q

Upper Motor Neurons

A

Motor neurons that originate in the brain (cerebral cortex), brain stem, or spinal cord

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16
Q

Lower Motor Neurons

A

Motor neurons that originate in the cranial nerve nuclei and motor neurons distal to the anterior horn cells of the spinal cord (e.g., nerve roots and peripheral nerves)

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17
Q

Transient Ischemic Accident (TIA)

A

Ischemia without tissue death which causes a transient episode of neurological dysfunction

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18
Q

Pseudoexacerbation

A

Transient worsening of MS symptoms. Episodes lasts < 24
hours.

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19
Q

Dysmetria

A

Inability to judge length or distance of movements

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20
Q

Freezing gait

A

Moments where there is a sudden stop in movement with a temporary inability to move

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21
Q

Guillain-Barré Syndrome

A

An auto-immune disorder causing acute inflammation and demyelination of the cranial nerves’ and peripheral nerves myelin sheaths

Lower motor neuron syndrome

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22
Q

Post-polio syndrome

A

Poliomyelitis symptoms reappearing after at least 15 years of disease stability in people who had been affected by
Poliomyelitis

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23
Q

Aphasia

A

Impairment of language (speech or written) affecting comprehension and/or production

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24
Q

Motor dysfunction signs and symptoms seen in MS

A

Weakness, central fatigue, spasticity, impaired balance and coordination, impaired ambulation and mobility

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25
Q

Lower extremity post-stroke spastisity positions

A

Hip adduction, Hip extension, Hip internal rotation, Knee extension, Ankle plantarflexion and supination, and Toe flexion

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26
Q

Modified Ashworth Scale Grade 1+

A

Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM

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27
Q

Relapse (exacerbation) time in MS

A

At least 24 hours

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28
Q

Apraxia

A

A motor disorder causing difficulty planning and performing tasks or purposeful movements (provided that the request or command is understood and he/she is willing to perform the task)

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29
Q

Vertigo

A

An illusion of movement (i.e. sensation of moving or the
environment around you is moving when it’s not)

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30
Q

Length of time until symptoms of transient ischemic attack
(TIA) resolve

A

24 hours or less

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31
Q

Phases of Guillain-Barré Syndrome

A
  1. Progressive Deterioration, 2. Plateau, 3. Recovery
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32
Q

Decorticate rigidity posture

A

Shoulder adduction, Elbow flexion, Wrist flexion, Finger flexion, Leg extension and internal rotation, Ankle plantar flexion

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33
Q

Example of motion assistance AFOs

A

Posterior leaf spring, Steel dorsiflexion spring assist

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34
Q

Wernicke’s aphasia

A

Receptive aphasia

A type of aphasia characterized by impaired written and spoken language comprehension (despite fluent speech with normal rate and melody)

Left temporal lobe

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35
Q

Impairments seen in posterior cord syndrome

A

Loss of proprioception, pressure sense, and vibratory sense below level of lesion

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36
Q

Temperature awareness testing

A

Assesses the ability to distinguish between hot (warm) or cold stimuli

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37
Q

Dysphagia

A

Difficulty swallowing

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38
Q

Mofidied Ashworth Scale Grade 1

A

Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the ROM
when the affected part(s) is moved in flexion or extension

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39
Q

Relapsing-remitting MS (RRMS)

A

Relapses followed by recovery and disease stabilization

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40
Q

Spinal shock

A

A transient period of areflexia immediately following SCI

Caracterizado por total areflexia ~24hrs
W gradual return of reflexes and then hyperreflexia

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41
Q

Allodynia

A

Non-noxious stimulus produces pain

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42
Q

Vascular syndromes that may present with homonymous hemianopia

A

MCA syndrome and PCA syndrome

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43
Q

Wheelchair options for person with C5 ASIA A

A

Manual wheelchair with propulsion aids for short distances (flat surfaces), Power wheelchair with adapted joystick for community

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44
Q

Barognosis

A

Ability to evaluate weight of object or disciminate weights of obiect when holding objects

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45
Q

Foot orthosis used for pes planus

A

Longitudinal arch supports, scaphoid pad

Flat foot

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46
Q

Modifiable risk factors for CVA

A

Smoking, Physical inactivity, Obesity, Diet, Excessive alcohol use

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47
Q

Festinating gait

A

Gait disturbance seen commonly in people with Parkinson’s disease which is characterized by narrow base with shortened strides with progressively increasing speed

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48
Q

Modified Ashworth Scale Grade 2

A

More marked increase in muscle tone through most of the
ROM, but affected parts) easily moved

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49
Q

Wenicke’s aphasia is also referred to as

A

Receptive aphasia

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50
Q

Sialorrhea

A

Absence of spontaneous swallowing to clear excess saliva (drooling)

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51
Q

Abulia

A

An absence of willpower or an inability to act decisively

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52
Q

Graphesthesia

A

ability to identify writing traced on the skin purely by the sensation of touch

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53
Q

Progressive-relapsing MS (PRMS)

A

Progressive disease from onset with super imposed acute attacks or relapses that may or may not have recovery

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54
Q

Agnosia

A

Inability to process/interpret sensory information

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55
Q

Signs and symptoms of BPPV occur only with….

A

changes in head position (if head is still and dizziness occurs, it’s not BPPV)

Benign paroxysmal positional vertigo

56
Q

Broca’s aphasia

A

A type of aphasia characterized by a impaired written and spoken language expression (despite adequate language comprehension)

57
Q

Dysdiachokinesia

A

Impaired ability performing rapid alternating movements

58
Q

Pattern of distribution of weakness seen in GBS

A

Typically symmetrical distribution with distal to proximal progression (LE > UE)

59
Q

is a non-fluent type of aphasia

A

Broca’s aphasia

60
Q

Highest neurological level of injury that a person with a complete SCI is capable of living irdependently

A

C6

61
Q

Dystonia

A

A movement disorder that is characterized by involuntary twisting and repetitive movements, abnormal FIXED postures, and disordered tone

62
Q

Location of Wernicke’s area

A

Temporal lobe

63
Q

Type of wheelchairs used by people with CVA

A

Hemi-height wheelchair, one-arm drive wheelchair, power wheelchair

64
Q

Speech and Swallowing Dysfunctions seen in MS

A

Dysarthria, Dysphonia, Dysphagia, 1 risk of aspiration pneumonia, risk of poor nutrition and dehydration

65
Q

Difference between aphasia and dysphasia

A

Aphasia is supposed to mean full loss of language where as dysphasia is supposed to a less severe version which has partial loss of language, however they are now interchangeable. Aphasia is a more commonly used term now to describe language impairments (probably because dysphasia sounds like dysphagia and it gets confusing)

66
Q

Causalgia

A

Burning painful sensation, often along nerve distribution

67
Q

Decerebrate rigidity posture

A

Shoulder adduction, Elbow extension, Forearm pronation, Wrist flexion, Finger flexion, Leg extension, Ankle plantar flexion

68
Q

Modified Ashworth Scale Grade 4

A

Affected parts rigid in flexion or extension

Ultimo level scale 0-4
0- no increase of tone
1- slight increase in tone catch at end of rom

2- slight increases in tone. Catch through rest of rom

3-considerable increase in tone, passive mov difficulty

69
Q

Aggravating factors for relapse (exacerbation) in MS

A

Viral or Bacterial infection, Disease of major systems,
Emotional and bodily stress

70
Q

Most commonly prescribed AFO for drop foot

A

Posterior leaf spring AFO

71
Q

Unilateral neglect (aka hemi-neglect)

A

Lack of awareness of part of ones own body or of the external environment

72
Q

Secondary-progressive MS (SPMS)

A

Begins with relapsing-remitting course followed by steady disease progression with no distinct periods of remission

73
Q

Impairments seen in anterior cord syndrome

A

Loss of motor function, pain and temperature below level of lesion

74
Q

Upper extremity post-stroke spastisity positions

A

Scapular retraction, Shoulder adduction, Shoulder depression, Shoulder internal rotation, Elbow flexion, Forearm pronation, and Wrist and finger flexion

75
Q

What is the Horner’s Syndrome?

A

Horner’s Syndrome: Lesion of the nerves of the sympathetic trunk that supply the head and neck
• Can be congenital or acquired as a result of disease, injury (eg. tumor, stroke)

Presents with ipsilateral:
• Droopy eyelid (ptosis). constricted pupil (miosis). dry face
lannidrosis), red face

ICA internal carotid artery

76
Q

Loss of balance, intention tremor, and dysmetria are common clinical findings with lesions in the?
A.thalamus
B. cerebellum
C. spinal cord
D. lumbar plexus

A

B

77
Q

A squat pivot transter is performed by a patient with a diagnosis of CVA, left hemiplegia.
The therapist initiates the transfer to the patient’s affected side. The benefits of transferring to the affected side include all of the following except:

A. retrains motor control through weight shift and weightbearing on the affected side
B. decreases extensor synergy by weightbearing and maintaining minimal knee flexion
C.directs attention and vision to the affected side
D.allows affected upper extremity to remain unsupported which facilitates motion and decreases flexor synergy influence

A

D

78
Q

A realistic goal for a C5 spinal cord patient is:

А.independent sliding board transfer

B. forward raise in wheelchair using loops for pressure relief

C. independent rolling from prone to supine and supine to prone

D. independent scooting

A

B

79
Q

A therapist evaluates a patient rehab from a TBI. The therapist makes the following entry in the medical record: pt is able to respond to simple commands fairly consistently, however has difficulty with increasingly complex commands or lack of any extemal structure. Responses are nonpurposeful, random and fragmented.

According to the Ranchos Los Amigos Cognitive Functioning Scale the patient is most representative of level?

A. Ill - localized responses
B. IV - confused-agitated
C. V- confused-inappropriate
D. VI - confused-appropriate

A

C

No Response: I
Generalized response:2
Localized response:3
Confused-agitated:4
Confused-inappropriate:5
Confused-appropriate:6
Automatic-inappropriate:7
Purposeful and appropriate:8

80
Q

A patient is referred to physical therapy with a C6 nerve root injury. Which of the following clinical findings would not be expected with this type of injury?

А.diminished sensation on the anterior arm and the index finger
B.weakness in the biceps and supinator
C. diminished brachioradialis reflex
D. paresthesias of the long and ring fingers

A

D

81
Q

A therapist completes a vertebral artery test on a patient diagnosed wil-a cervical strain.
Which component of the vertebral artery test is most likely to assess the patency of the intervertebral foramen?
A. rolation
B. lateral flexion
C.flexion
D. extension

A

D

Teste: supine, perform neck extension and side flexion and hold for 10-30secs
Se nao tiver sintomas acrescenta ipsilateral neck rotation
Positive: dizziness or nystagmus

82
Q

A patient with complete C5 quadriplegia works on lower body dressing with his therapist.
Which muscles need to be particularly strong in order for the patient to be successful with dressing?

A. brachioradialis, brachialis
B. rhomboids, levator scapulae

C. biceps, deltoids
D. triceps, flexor digitorum

A

C
Asia scale c5 has elbow flexion different from miotome map onde so ocorre on c6

83
Q

A therapist treats a patient with complete C6 quadriplegia. Which of the following would not be considered an expected functional outcome for this patient?

A. independent transfers with a sliding board
B.independent bowel and bladder care

C.independent manual wheelchair propulsion
D. independent self feeding

A

B
Manual w/c w propulsion aids for short distance and flat surface can be used on C5***

84
Q

Sterognosis

A

Tactile object recognition

85
Q

What are the superficial sensations?

A

Pain- sharp/dull
Temperature- warm/cold
Light touch
Pressure

86
Q

What are the deep sensations?

A

Proprioception ( where joint is at REST)

Kinestesia ( where joint is during movement)

Vibration

87
Q

What are the combined sensations?

A

Sterognosis
Tactile localization
Two point discrimination
Double simultaneous stimulation
Graphesthesia
Recognition of texture
Barognosis

88
Q

Upper motor neurons syndrome

Spastic or flacid?

Atrophy yes/no

Fasciculation yes/no

Reflexes: hyperreflexive or hyporeflexive ou areflexia

Tone: hypertonia ou hypotonia

A

Spastic
No atrophy
No fascication
Hyperreflexive
Hypertonia

89
Q

Lower motor neurons syndrome

Spastic or flacid?

Atrophy yes/no

Fasciculation yes/no

Reflexes: hyperreflexive or hyporeflexive ou areflexia

Tone: hypertonia ou hypotonia

A

Flacid
Tem atrophy
Tem fasciculation
Hyporeflexive ou areflexia
Hypotonia

90
Q

Modified Ashworth scale for grading spasticity

Grade 3

A

Considerable increase in tone, passive movement difficult

91
Q

Difference between Berg and Romberg test?

A

Berg: dinamic balance test. Used to ax static and dynamic balancr and determine risk of falls in adults. Score 56(qto maior-menos risco)

Romberg: static balance test. Pt w feet together-20/30secs. EO and EC.
Positive: pt loose balance w EC.

Mininal sway IS ACCEPTABLE!- teste negativo

92
Q

How is performed the Functional reach test and what is it for?

A

Dynamic balance test.
Measures max distance pt can reach forward whilr standing on a fixed BOS.

3 metacarpal w sh flex 90degrees.
3 attempts. Average of last two.

93
Q

What is the purpose of Poma (Performance oriented mobility ax)?

A

Also know as TINETI TEST - static and dynamic balance + gait

94
Q

What is the purpose of GET UP AND GO TEST?

A

Dynamic balance and mobility

95
Q

What is the purpose of TUG( time up and go)

A

Ax mobility, balance,walking and fall risk i older adults

96
Q

Right CVA características

A

-L side weakness

-Visual agnosia ( inability to recognize visually objects)

-anosognosia ( denial they had a stroke)

-distorted awareness and impression of self

-decrease short attention span

-visual/spatial problems
-quick, impulsive, poor judgement,unaware of their deficits

97
Q

Left CVA características

A

-slow,cautins, anxious, disorganized, AWARW of their deficits
-r side weakness
- difficulty w numerical and scientific skills

-diminished functional speech( aphasias)

98
Q

Damage to the cerebelum
Ipsilateral ou contra lateral side affected?

A

Ipsilateral

99
Q

Damage to the cerebral hemisphere
Ipsilateral ou contra lateral side affected?

A

Contra lateral

100
Q

What is The Fugl-Meyer Assessment (FMA) used for?

A

The Fugl-Meyer Assessment (FMA) is a stroke-specific, performance based impairment index.

It is designed to assess motor functioning, balance, sensation and joint functioning in patients with post-stroke hemiplegia.

101
Q

When is used the The Functional Independence Measure (FIM) and for what purposes?

A

The Functional Independence Measure (FIM) is an assessment tool that aims to evaluate the functional status of patients throughout the rehabilitation process following a stroke, traumatic brain injury, spinal cord injury, cancer etc.

As such, FIM scores may be interpreted to indicate level of independence or level of care required. This scale is used to assess how well a person can carry out basic activities of daily living and how dependent they will be on help from others.
• Level 1: Total Assistance
• Level 2: Maximal Assistance
• Level 3: Moderate Assistance
• Level 4: Minimal Assistance
• Level 5: Supervision
• Level 6: Modified Independence

102
Q

What is a normal ICP?

A

Normal : 5-20
Acima 20 elevated
Acima de 25 critical

103
Q

Signs and symptoms of ICP elevated?

A

-Decrease consciousness
-Alteration in vital signs
-Widened pulse ( qdo se tem frande diferenca entre diastolic e sistolic p)

-irregular cheyne stones breathing
headache
-seizure

104
Q

Early signs of PD

A

Loss of sense of smell
Masked face
Dysphagia
Micropraphia
Disphonia
Festinating gait
Stooped posture

105
Q

What are the two disease specific measures for PD?

A

Unified parkison s disease tating scale
The parkinson s disease questionnaire PDQ39

106
Q

AML amyotrophic lateral sclerosis

A

Chronic degenerative disease of the motor neurons in the brain, brain stem and spinal cord.

Results in LMN UMN signs

Areas generally spared: sensory system and eyes movs

107
Q

AML what is affected first?

A

Maos e pes primeiro e depois trunk
Asymmetrical distribution
Distal to proximal

108
Q

Early signs of GBS

A

Distal sensonry disturbances-glove and or stocking distribution

Distal LE weakness

109
Q

Signs and symptoms of post polio syndrome

A

Fatigue
Cold intolerance
Muscle atrophy
Weakness
Pain

110
Q

Als
Amyotrophic lateral sclerosis

UMN OR LMN SYNDROME?

A

Can be both

111
Q

Brain injury

UMN OR LMN SYNDROME?

A

Umn

112
Q

Cerebral palsy

UMN OR LMN SYNDROME?

A

Umn

113
Q

Guillian barre

UMN OR LMN SYNDROME?

A

Lmn

114
Q

Ms

UMN OR LMN SYNDROME?

A

Umn

115
Q

Stroke

UMN OR LMN SYNDROME?

A

Umn

116
Q

Tumor
In brain or spinal cord?

UMN OR LMN SYNDROME?

A

Umn

117
Q

Bell palsy

UMN OR LMN SYNDROME?

A

Lmn
Afeta o nervo cranial

118
Q

Cauda equina syndrome

UMN OR LMN SYNDROME?

A

Lmn

119
Q

Peripheral
Nerve injury

UMN OR LMN SYNDROME?

A

Lmn

120
Q

Poliomyelitis

UMN OR LMN SYNDROME?

A

Lmn

121
Q

Amyotrophic lateral sclerosis
What is spared?

A

Sensory system and eye’s movements

122
Q

A patient presents with an incomplete spinal cord lesion after sustaining a cervical hyperextension injury in a motor vehicle accident. Motor loss that is greater in the upper extremities than the lower extremities, with very limited sensory impairments. Which type of spinal cord injury is MOST likely present?

  1. Brown-Sequard’s Syndrome
  2. Posterior Cord Syndrome
  3. Cauda Equina Syndrome
  4. Central Cord Syndrome
A

4

  1. This is an incomplete lesion where half of the spinal cord is severed.
  2. This is an incomplete lesion that affects pain sensation, proprioception, and two-point discrimination.
  3. This is an injury that occurs below L1 and usually results in loss of bowel or bladder function.
  4. This is the correct answer. Central cord syndrome damages the spinothalamic tract, corticospinal tract, and dorsal columns.
123
Q

A patient who is recovering from a traumatic brain injury following a motor vehicle accident is exhibiting signs of bizarre behavior that is nonpurposeful and incoherent. The patient is uncooperative and displays a short and selective attention span. Which level on the Rancho Los Amigos cognitive functioning scale BEST describes the state of this patient?

  1. Level III
  2. Level IV
  3. Level V
  4. Level VI
A

2

  1. This is the localized response stage where the patient inconsistently follows simple motor commands.
  2. This is the correct answer. This is the confused and agitated stage.
  3. This is the confused/nonagitated stage where commands are followed, but still not purposeful.
  4. This is the confused/ appropriate response stage There is no carry-over of information, but the patient behaves appropriately in familiar settings.
124
Q

You are working with a patient in the outpatient neurological clinic in your town. Your patient, Mrs.
Leymand, has sustained an upper motor lesion to the anterior spinal cord at the level of C5.

Which of the following most likely describes Mrs. Leymand’s presentation?

a. Bilateral loss of motor function primarily in the upper extremities.

b. Ipsilateral loss of tactile discrimination, pressure and vibration below the level of lesion; ipsilateral loss of motor function below the level of lesion; contralateral loss of pain and temperature below the level of lesion.

c. Bilateral loss of 2 pt discrimination, proprioception and vibration below the level of lesion; preservation of motor function, pain and temperature below the level of lesion.

d. Bilateral loss of motor function below the level of lesion; bilateral loss of pain and temperature below the level of lesion; preservation of proprioception, vibration and 2pt discrimination below the level of lesion.

A

D

• Bilateral loss of motor function primarily in upper extremities - Describes Central Cord Lesion

• Ipsilateral loss of tactile discrimination, pressure and vibration below the level of lesion; ipsilateral loss of motor function below the level of lesion; contralateral loss of pain and temperature below the level of lesion - Describes Brown-Sequard Syndrome

• Bilateral loss of 2 pt discrimination, proprioception and vibration below the level of lesion; preservation of motor function, pain and temperature below the level of lesion -Describes Posterior Cord Syndrome

• D: Correctly describes Anterior Cord Syndrome which results from a lesion affecting the anterior two-thirds of the spinal cord while preserving the posterior columns.
• Thus, DCML system is intact allowing proprioception, vibration, 2pt discrimination to remain intact while spinothalamic tracts (pain and temp) and corticospinal tracts (motor) are often injured.

125
Q

You are working with a patient in the outpatient neurological clinic in your town. Your patient, Mrs.
Leymand, has sustained an upper motor lesion to the anterior spinal cord at the level of C5.

Mrs. Leymand states that she is having bladder issues. Given her condition, which of the following statements would most likely describe her bladder dysfunction?

a. Her bladder has lost the ability to empty reflexively and will continue to fill.

b. Messages from the spinal cord and the bladder are interrupted as the reflex center is damaged.

c. In order to manage her symptoms, she must be catheterized as her bladder canot be trained to empty on its own.

d. Messages will continue to travel between the bladder and spinal cord since the reflex arc is intact, but she may need intermittent catheterization.

A

D

126
Q

Mrs. Leymand’s right shoulder has been bothering her over the past few weeks. She notifies you that she has been taking aspirin to reduce her pain for 2 weeks. She now reports significant epigastric pain, nausea, and feelings of abdominal distension. What is the most likely cause of the patient’s gastrointestinal symptoms?

a. Gastroesophageal reflux disease
b. Diaphragmatic hernia
c. Achalasia
d. Gastritis

A

D

127
Q

While examining a patient with a unilateral T10 traumatic spinal cord injury, the therapist notes that the patient has asymmetrical symptoms below the level of the lesion. The patient has ipsilateral loss of motor function and a contralateral loss of pain and temperature sensation.
Which of the following conditions is most likely present?

a. Anterior Gord Syndrome
b. Brown-Sequard Syndrome
c. Cauda Equina Syndrome
d. Central cord syndrome

A

B

• Anterior Cord Syndrome - Incorrect. Frequently related to flexion injuries of the spine, Anterior Cord Syndrome results in loss of motor function and pain/temp sensation below the lesion.
Proprioception and vibratory sense are preserved (dorsal columns).

• Brown-Sequard Syndrome - Correct
A unilateral spinal cord injury with ipsilateral motor loss, ipsilateral proprioception and vibration loss and contralateral pain/temp sensation deficits.

• Cauda Equina Syndrome - Incorrect
Incomplete injuries affecting the nerve roots in the cauda equina
Will result in lower extremity paralysis

• Central Cord Syndrome - Incorrect
This is the most common spinal cord injury resulting from cervical hyperextension injuries.
• The primary result is UE-LE deficits; motor-sensory

128
Q

Which of the following best represents the classification for a patient who scores a 10 on the Glasgow Coma Scale?

a. Mild brain injury.
b. Moderate brain injury.
c. Severe brain injury.
d. Profound brain injury.

A

B
• The GCS is a reliable and objective way of recording the initial and subsequent level of consciousness in a person after a brain injury.

• Clinicians use this scale to rate the best eye opening response, the best verbal response, and the best motor response an individual makes.

• Scores range from 3-15:
13-15= mild brain injury
9-12 = moderate brain injury
8 or less = Severe brain injury

129
Q

Your patient has sustained a traumatic brain injury 3 days ago. At rest, he presents with an increased heart rate, respiratory rate, and blood pressure in addition to excessive diaphoresis and hyperthermia. He scored a 10 on the Glasgow Coma Scale.

Which of the following terms would best document what the patient is experiencing?

a. Autonomic dysreflexia.
b. Dysdiadochokinesia.
C.Hypovolemia.
D.Paroxysmal sympathetic hyperactivity

A

D

• Autonomic dysreflexia - Incorrect
AD occurs in individuals with spinal cord lesions above T6, resulting in sympathefic nervous system overstimulation below the level of the lesion, and excessive parasympathetic activity above the level of the lesion Results in increased blood pressure and decreased heart rate

• Hypovolemia- Incorrect
Hypovolemia is a state of decreased blood volume resulting in decreased blood pressure and increased heart rate.

• Paroxysmal sympathetic hyperactivity - Correct
Following a TBI, sympathetic activity increases and may become overactive, resulting in paroxysmal sympathetic hyperactivity (PSH). PSH can result in signs like increased heart rate, respiratory rate, blood pressure, diaphoresis, hyperthermia, decorticate decerebrate posturing, hypertonia, and bruxism.

130
Q

A patient is receiving physiotherapy treatment after sustaining a crush injury to their right leg while at work. Injuries sustained include a fracture to the head of the fibula, abrasion to the lateral calf and global swelling. He displays moderate muscle atrophy and sensory loss in the right leg.

You patient has returned to you after electromyography testing. Testing reveals they have loss of axonal continuity but the connective tissue coverings remain intact. What type of nerve injury is this classified as?

a. Neurotmesis
b. Neurapraxia
c. Axonotmesis
d. Wallerian degeneration

A

C

• Neurotmesis - Incorrect
Although there would be muscle fiber atrophy and sensory loss, neurotmesis is a complete severance of nerve fiber with disruption of connective tissue coverings.

• Neurapraxia - Incorrect
Mildest form of nerve injury. It consists of loss of conduction without associated changes in axonal structure. This form of conduction block often occurs with compressive or ischemic nerve injuries, such as a mild entrapment syndrome or compression. Recovery is usually complete.
There is no muscle atrophy and only temporary sensory symptoms.

• Axonotmesis - Correct
Loss of axonal continuity but connective tissue covering remains intact. Causes muscle atrophy and sensory loss.

• Wallerian degeneration - Incorrect
“Dying back of a nerve” - which is not described above.
Is a process that results when a nerve fiber is cut or crushed and the part of the axon distal to the injury (i.e. farther from the neuron’s cell body) degenerates.

131
Q

A patient is receiving physiotherapy treatment after sustaining a crush injury to their right leg while at work. Injuries sustained include a fracture to the head of the fibula, abrasion to the lateral calf and global swelling. He displays moderate muscle atrophy and sensory loss in the right leg.

In which areas would the patient most likely experience sensory loss?

a.Anterolateral aspect of lower leg and entire dorsum of the foot - including web space between hallux and second digit.

b. Anterior and posterior aspect of lower leg and dorsum of foot - excluding web space between hallux and second digit.

c. Lateral and posterior aspect of lower leg and dorsum of foot - excluding web space between hallux and second digit.

d. Posterior aspect of lower leg and dorsum of foot - including web space between hallux and second digit.

A

A

The common peroneal nerve runs laterally around the fibular neck. Therefore, damage at the level of the fibular neck would cause issues in the common peroneal nerve distribution - which includes the superficial peroneal and deep peroneal nerve.

132
Q

A patient is receiving physiotherapy treatment after sustaining a crush injury to their right leg while at work. Injuries sustained include a fracture to the head of the fibula, abrasion to the lateral calf and global swelling. He displays moderate muscle atrophy and sensory loss in the right leg.

You ask your patient to demonstrate their gait. After he returns to sitting, he states that he is having severe cramping pain and tightness in his right lower leg. Upon palpation you notice the lower leg feels tight and the patient reports it as being tender. You suspect compartment syndrome.
Which of the following statements regarding compartment syndrome is false?

a. Pain increases with activity
b. Stretching decreases pain
c. Pain is often described as cramping
d. May experience muscle weakness, paralysis or altered sensation

A

B

133
Q

Which of the following signs are indicative of a cerebrovascular acident?

a. Headache
b. Dizziness
C.Slurred speech and motor weakness
d. All of the above

A

C

Slurred speech and motor weakness I the others are symptoms, not a sign

134
Q

The client’s medical records indicate that she has a lesion in the right hemisphere of the cerebellum. Which of the following would you expect to observe?

a) Truncal ataxia
b) Left limb ataxia
c) Right limb ataxia
d) All of the above

A

C

Pt would present truncal ataxia is MIDLINE of cerebelum gets affected.

135
Q

The physiotherapist would like to assess the patient’s level of independence with his activities of daily living (ADL’s). Which outcome measure will help determine the client’s performance in ADL’s?
a) Barthel Index
b) Gross motor function measure &
c) Functional Independence Measure
d) Fugi-Meyer Assessment

A

A
Barthel index: performance in adls

Gross motor function: avaliar motor changes and motor function changes in pts w CP and Down syndrome.

Fim: avaliar how much care pt need. Their capabilities of taking care of themselves.
Avalia physical,psychological and functional.

Fugi meyer: stroke pts

136
Q

Inattention and cognitive changes after a stroke typically cause which type of incontinence?

a. Functional
b. Overflow
c. Stress
d. Urge

A

A

Functional incontinence stems from cognitive changes, inattention, and immobility. These symptoms are often associated with a stroke.

• Overflow—Due to poor bladder contractions or urethra blockage.

• Stress - Caused by intraabdominal pressure and poor sphincter control.

• Urge Incorrect: Overactive bladder and detrusor activity.

137
Q

During your daily team meeting, you are updated on your patient’s status. They have suffered another stroke. Initially, they presented with only right sided weakness.

Now, on examination, they also present with weakness in the left lower limb. Which of the following conclusions can most likely be drawn from this observation?

a. Right anterior cerebral artery is involved .
b. Right middle cerebral artery is involved.
c. Right posterior cerebral artery is involved.
d. All of the above.

A

A

• Right anterior cerebral artery is involved - This results in weakness in the contralateral lower extremities

• Right middle cerebral artery is involved- This results in weakness in the contralateral upper extremities

• Right posterior cerebral artery is involved This more commonly results in visual deficits, thalamic pain syndrome and not lower limb weakness

PCE (40 decks)

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