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From Flashcardlet > -O04 E:2. > Flashcards

-O04 E:2. Flashcards

0
Q

Describe a lower motor neurone lesion

A

Low tone/paralysis

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1
Q

Describe an upper motor neurone lesion

A

Increased tone/spasticity

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2
Q

Describe cerebral palsy

A

Non-progressive and non-degenerative neurological damage to the brain caused by damage to the infant/developing brain

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3
Q

What presentations can be seen with cerebral palsy?

A

Hypertonia (increased muscle tone)
Hypotonia (decreased muscle tone)
Balance and co-ordination and balance
Involuntary movements

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4
Q

What are the four classifications of cerebral palsy?

A

Spastic
Ataxic
Athetoid
Mixed

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5
Q

Describe spastic cerebral palsy

A

Most common type
Increased spasticity is visible when muscles are active
Velocity eliminated muscles tend to have increased tone

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6
Q

Describe ataxic cerebral palsy

A

Less common
Difficulty with coordination of fine motor skills
Balance and depth perception impaired
Wide walking base

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7
Q

Describe athetoid (dyskinetic) cerebral palsy

A

Caused by damage to basal ganglia
Mixture of both hypertonia and hypotonia with involuntary muscle movements
Difficulty maintaining posture

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8
Q

Describe mixed cerebral palsy

A

Combination of: spastic, ataxic and athetoid/dyskinetic

Tends to present as spastic CP with addition of involuntary movements from ataxic CP

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9
Q

What further classifications are there of cerebral palsy?

A 
Diplegia
Hemiplegia
Quadriplegia
Triplegia
Monoplegia
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10
Q

Describe diplegia cp

A

Effects both lower limbs with some upper limb involvement

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11
Q

Describe hemiplegia cp

A

Effects one side of the body

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12
Q

Describe quadriplegia cp

A

Effects all four limbs

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13
Q

Describe Triplegia CP

A

Effects three limbs

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14
Q

Describe monoplegia cp

A

Effects one limb

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15
Q

Describe the gross motor function classification system

A 
1- walks without limitations
2- walks with limitations
3- walks using hand-held mobility device
4- self-mobility with limitations, may use powered mobility
5- transported in manual wheelchair
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16
Q

What are 2 examples of cp gait?

A

Spastic hemiplegia

Spastic diplegia

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17
Q

Describe spastic hemiplegia cp gait

A

Ic- made with forefoot
Mst- shank reclined, hyperextension of knee
Tst- early heel rise
Swing- equinus ankle, increased hip and knee flexion

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18
Q

Describe spastic diplegia cp gait

A

Classified as crouched gait
Ic- made with forefoot
Stance- increased knee and hip flexion, forefoot in contact

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19
Q

Describe charcot marie tooth disease

A

Progressive hereditary muscle atrophy

Also referred to as HMSN or peroneal muscular atrophy

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20
Q

What are the symptoms of charcot marie tooth disease?

A

Bi-lateral and symmetrical presentation
Tends to appear in lower limbs primarily
Weakness around leg/foot and loss of sensation

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21
Q

Describe the presentation of cmt

A

Pes cavus foot
Claw toes
Equinovarus foot in swing
Varus foot posture

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22
Q

Describe spina bifida

A

Lower motor neurone lesion

Congenital disorder causing incomplete closure of embryonic neural tube

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23
Q

What are the three types of spina bifida?

A

Spina bifida occulta
Spina bifida meningocele
Spina bifida myomeningocele

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24
Q

Describe spina bifida occulta

A

Mildest form - around 10%
Not always noticed
No protrusion of spinal cord
Outer part of some vertebra not completely closed

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25
Q

Describe spina bifida meningocele

A

Least common form
Vertebrae develop normally
Meninges forced into gaps between vertebrae
Nervous system undamaged

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26
Q

Describe spina bifida myomeningocele

A

Most common form
Most severe complications
Damage to nervous system - paralysis/loss of sensation below level of defect
Unfused portion of spinal column and spinal cord protrude through opening

27
Q

Describe the presentation of spina bifida

A

Lower limb weakness/paralysis
Low muscle tone
Bladder and bowel problems
Pressure areas

28
Q

Describe multiple sclerosis

A

Inflammatory disease affecting fatty, myelin sheaths surrounding axons of brain and spinal cord- nerve damage due to demyelination and scarring of nerves
Usually occurs in young adults and more common in women
Nerves in spinal cord and brain can no longer send signals effectively to muscles

29
Q

What neurological symptoms can ms cause?

A 
Loss of sensation and sensitivity 
Poor balance
Numbness
Tingling
Muscle weakness and spasm
Clonus
Poor co-ordination
30
Q

What different classifications are there of ms?

A 
Relapsing remitting (rpms) 
Secondary progressive (spms) 
Primary progressive (ppms)
Progressive relapsing (prms)
31
Q

Describe relapsing remitting ms

A 
Most common type- around 85%
Symptoms appear (over months/years) then either partially/completely fade away(remission) before relapsing
32
Q

Describe secondary progressive ms

A

Stage which follows rpms
Progression of disability, independent of any relapse
65% of those with RPMS will develop SPMS in around 15yrs after diagnosis

33
Q

Describe Primary Progressive MS

A

Affects about 10-15% with ms
First symptoms are progressive and appear in relapse
Subtle problems with walking which develop over time
Later diagnosis (around age 40-50)

34
Q

Describe progressive relapsing MS

A

Least common

Steady neurological condition.

35
Q

Describe motor neurone disease

A

Gradual, progressive degeneration of motor neurones leading to muscle atrophy and weakness
100,000 people in UK develop MND each year
2:1 male: female
Age 50-70 affected most

36
Q

What can mnd affect

A 
How a person:
Walks
Talks
Breathes
Eats
Drinks
37
Q

What are the symptoms of mnd?

A 
Pain and discomfort
Muscle cramps and spasms
Stiff joints
Bowl and bladder problems
Cognitive changes
38
Q

What types of mnd are there?

A 
Amniotrophic lateral sclerosis (als) 
Progressive bulbar palsy (pbp) 
Progressive muscular atrophy (pma)
Progressive lateral sclerosis (pls) 
Kennedy's disease (not classed as mnd but similar)
39
Q

Describe amniotrophic lateral sclerosis mnd

A

Most common form
Upper and lower motor neurone involvement
Muscle weakness and stiffness
Life expectancy 2-5 yrs after symptom onset

40
Q

Describe progressive bulbar palsy mnd

A

Affects around 25% of those with mnd
Upper and lower motor neurone involvement
Speaking and swallowing difficulty
Life expectancy 6months- 3 years after symptom onset

41
Q

Describe progressive muscular atrophy mnd

A

Least common
Damage to lower motor neurones
Weakness and clumsiness of hands first noticed
Life expectancy around 5yrs from symptom onset

42
Q

Describe primary lateral sclerosis mnd

A 
Rare form of mnd 
Involving upper motor neurones
Mainly weakness in lower limbs - some may have hand and speech problems
Life span essentially normal
Can develop into als
43
Q

Describe kennedy’s disease

A

Similar to mnd
Slow progressive disorder of the motor neurones caused by genetic mutation
Leads to muscle weakness
Only affects men, but women may carry the mutation
Life span is normal

44
Q

Describe cerebral vascular accident (cva/stroke)

A

Blood supply to brain is blocked causing lack of o2 and nutrients to the brain
Brain cells are damaged/destroyed

45
Q

What could lack of blood in a cva be due to?

A

Ischaemia
Embolism
Thrombosis
Haemorrhage

46
Q

What are the symptoms of a cva?

A

Muscle weakness on one side
Speech problems
Sight problems on one side

47
Q

What are the risk factors for a cva?

A 
Increased age
High blood pressure/cholesterol
Previous stroke/ transient ischaemic attack
Diabetes 
Smoking
48
Q

What can be used to prevent a stroke?

A

Asprin/ statin used to thin blood

49
Q

What types of stroke are there?

A

Ischaemic

Haemorraghic

50
Q

Describe an ischaemic stroke

A

Lack of blood to brain

51
Q

Describe a haemorragic stroke

A

Blood vessel rupture in brain or inside skull

52
Q

Describe poliomyelitis

A

Virus infection of motor nerve cells in anterior grey matter of spinal cord

  • can lead to temporary/permanent paralysis
  • No sensory impairment
53
Q

What are the symptoms of poliomyelitis?

A

Initial flu like symptoms, headache, joint ache
Rapid development of paralysis
Paralysis lasting more than 2yrs is permanent

54
Q

Describe duchenne muscular dystrophy

A

Aka pseudohypertrophic md
Rare and only effects males and symptoms appear before age 6
Progressive weakness of legs and pelvis(can also appear in arms, neck and other areas)
Calf muscles initially enlarge then muscle tissue is replaced by fat and connective tissue (pseudohypertrophy) -muscle contractures
Life expectancy 15-20yrs old due to muscle contractures and skeletal problems which effects respiratory system

55
Q

Describe becker muscular dystrophy

A

Aka benign pseudohypertrophic MD

Slower progressive muscle weakness of legs and pelvis than dmd

56
Q

What are common gait deviations in spina bifida?

A

Weak hip extensors
Weak hip abductors
Weak dorsiflexors
Weak plantarflexors

57
Q

Describe the gait deviation weak hip extensors with spina bifida

A

Hip extensors are active in:
-mid stance
-terminal stance
-loading
Compensate by leaning backwards so grf is posterior to hip
Rotation of pelvis used to propel body forward

58
Q

Describe the gait deviation weak hip abductors related to spina bifida

A 
Hip abductors active in:
-loading
-mid stance
-terminal stance
Lateral trunk bending towards stance side redirects grf laterally therefore abductor moment controlled by strong adductors
59
Q

Describe the gait deviation weak dorsiflexors with spina bifida

A

Active in:
-loading
-swing
Increased hip and knee flexion/circumduction/vaulting/hip hitching a swing phase compensation
No control of rate of plantarflexion in loading therefore foot slap

60
Q

Describe the gait deviation weak plantarflexors with spina bifida

A 
Active in:
-mid stance
-terminal stance
No control of tibial inclination
Greater demand placed on quads to control knee therefore drop off
61
Q

What medications are there?

A

Diazepan
Baclofen
Dantrolene
Botulinum Toxin

62
Q

Describe diazepan

A

Relaxant

63
Q

Describe baclofen

A

Blocks signals sent from spinal cord to relax muscles

64
Q

Describe dantrolene

A

Interferes with process of muscle contraction

65
Q

Describe botulinum toxin

A

Reduces muscle spasticity

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