Flashcards in Chapters 18-25 Deck (81):
What are two types of Tumors?
How are gliomas classified?
Location of Glioma
Grade: 1 & 2 are low grade, slow growing, tend to be benign (better prognosis)
3 & 4 are high grade, fast growing, spreads to norm. brain tissue, tends to be malignant
What is the survival rate for someone with a high grade glioma?
What is the survival rate of grade 1 and 2 (low grade) gliomas?
What are some signs and symptoms of glioma?
Located in Brain: Headache, Seizure, Nausea, Vomiting
Located in Spine: Pain, Weakness, Numbness, Tingling
What is the definition of a Glioma?
Tumor of the glial tissue of the nervous system.
Tumor composed of neuroblasts (Most commonly found in the adrenal gland).
What are some signs and symptoms of Neuroblastoma?
Some of the 1st signs are: Fever, Malaise, Pain, Loss of Appetite, Weight Loss and Diarrhea.
As the disease progresses (Depending on where the tumor is located): Bone Pain, Diff. Breathing/ Chronic Cough, Enlarged Abdomen, Flushed/ Red Skin, Pale Skin with Blue Coloring Around the Eyes, Profuse Sweating and Tachycardia.
When is a neuroblastoma found?
It is found through an ultrasound while the baby is still in the womb. If it is not found before birth then the child is anywhere from 1-3 yrs. old before it is found.
What is Amyotrophic Lateral Sclerosis (ALS)?
A progressive degeneration of the motor neurons of the central nervous system, leading to wasting of the muscles and paralysis.
What age does ALS usually occur and who is apt to get it?
Usual age of onset is 35 yrs old. Men are 2-3x more likely to get it than women.
What are some signs and symptoms of ALS?
Muscle weakness in one or more of the following: hands, arms, legs or the muscles of speech, swallowing or breathing
Twitching (fasciculation) and cramping of muscles, especially those in the hands and feet
Impairment of the use of the arms and legs
"Thick speech" and difficulty in projecting the voice
In more advanced stages, shortness of breath, difficulty in breathing and swallowing
How is ALS diagnosed?
A neurologist will administer an electromyogram (EMG), which is used to detect nerve damage. Additional tests can rule out muscular dystrophy, multiple sclerosis, spinal cord tumors, or other diseases.
*Also the doctor may order a biopsy of a wasted away muscle.
What is Amyotrophic Lateral Sclerosis (ALS) also referred to as?
Lou Gehrig's Disease
What therapy is involved in caring for someone with ALS?
Therapy provided Equipment Needs
Provides Caregiver and Patient Education about the disease and how to care for themselves/ patient.
Define Alzheimer's Disease.
A progressive mental deterioration that can occur in middle or old age, due to generalized degeneration of the brain. It is the most common form of Dementia.
What are some signs and symptoms of Alzheimer's?
Short Term Memory Loss, Confusion, Irritability
As the disease progresses: Aggressive, Mood Swings, Forget Words, Long Term Memory Loss
What is the common age range of onset of Alzheimer's and who is more apt to get it?
Onset usually occurs after the age of 65 yrs. old. Affects men just as much as women.
What is the life expectancy of a patient with Alzheimer's?
What is the definition of Huntington's Disease?
A hereditary disease marked by degeneration of the brain cells and causing chorea (jerky involuntary movements affecting especially the shoulders, hips, and face) and progressive dementia.
In what age range does Huntington's usually appear?
35-44 years of age
Who is more apt to have Huntington's Disease?
Men are more apt to have this than women. Those of European decent are also more apt to have this.
What is the average life expectancy of someone who is diagnosed with Huntington's Disease?
What are some signs and symptoms of Huntington's Disease?
Slight uncontrollable movements.
Some slight signs of lack of emotion.
Lack of focus, slight concentration problems.
Lapses in short-term memory.
Mood changes - this may include antisocial behavior and aggression.
How is Huntington's Treated?
Medication is used to relieve symptoms.
Define Parkinson's Disease.
A disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination.
What age range does the onset of Parkinson's occur?
55-60 years old
What are the Cardinal Signs of Parkinson's Disease?
Tremors (Most Common), Rigidity (resistance to limb movements), and Movement Slowness (the person has difficulty planning and initiating their movements)
What kind of Medical Management is offered for one with Parkinson's?
Medicines that mimic dopamine that the body is missing.
Deep Brain Stimulator (Last resort when meds no longer work)
Physical Therapy that addresses ROM, Gait, Balance etc as well as education for the patient and pt. family.
Define Multiple Sclerosis (MS).
A chronic, typically progressive disease involving damage to the sheaths of nerve cells in the brain and spinal cord.
What are some common signs and symptoms of MS?
Symptoms may include numbness, impairment of speech and of muscular coordination, blurred vision, and severe fatigue.
What is the common age range of onset for MS?
30-60 yrs old but has been know to show up in people as young as 10.
How is MS diagnosed?
There is no diagnostic test for MS.
Patient's must show signs for at least a 24 hr period with each episode occurring 1 mo. apart. (Symptoms must progress over a 6 mo. period)
An MRI or CT Scan can be used to spot central nervous lesions
Also an exam of the optic nerves can be ran as well.
What is the treatment for MS?
Medications are given to control symptoms.
Physical Therapy is used to increase and maintain ROM, Control Spasticity, Improve Gait and Balance, Increase Motor Control and Address any Equipment Needs.
What is the definition of a stroke?
A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food.
What are the 2 types of strokes?
Ischemic 80% of all strokes
Hemorrhagic 20% of strokes
What ages are Ischemic Strokes prominent in?
Usually occur in people older than 66 yrs.
What ages are more common for Hemorrhagic Strokes more common in?
No definite age however these usually appear in younger people.
What are some signs and symptoms of a stroke?
Sudden Weakness/ Loss of Sensation, Double Vision, Slurred Speech, Facial Droop on one side, Weakness on one side, Loss of Cordination, Sudden Loss of Consciousness
What are the Risk Factors for a Stroke?
Non-Controllable: Age, Race, Gender, Family History, having had a previous Stroke
Controllable: Inactivity/Obesity, High BP, Diabetes, High Cholesterol, Poor Diet as well as not controlling other Artery, Heart and Sickle Cell Diseases.
How is a stroke diagnosed?
CT Scan, MRI and Brain Scans are used to find the clot.
Angiographies are also used to locate the clot.
Doctor may also check Blood Sugar Levels as well as a cholesterol check and a Lipid Panel
How are strokes classified?
By their location and hemisphere.
What are the locations of a stroke?
Anterior Cerebral Artery
Middle Cerebral Artery
Posterior Cerebral Artery
Vertebral Basilar Artery
Inferior Cerbellar Artery
What are the different hemispheres called?
Left and Right
What does left hemisphere stroke damage affect?
Deficits on the Right side of the body: weakness, loss of speech
What does right hemisphere damage affect?
Deficits on the Left side of the body: Weakness, Memory Issues, Neglect of Left side of body (Pt seems to forget that they have a Left side), altered vision perception, loss of concept of midline.
What treatments are available for stroke patients?
TPA can be given to a patient who is within the window of 3-4 hours since the stroke began. (This minimizes the affects that the stroke pt will endure)
Maintain Airway/ Breathing Function
Control Inter-cranial Function
Physical Therapy Helps: Restore function
Maximize independence with ADL's, Gait and Balance
Educates patient and caregiver
What is the number 1 cause of death in children and adults?
Traumatic Brain Injury
What are some common events that cause Traumatic Brain Injuries?
Car Accident, Falls, Contact Sports, Gun Shot Wound/ Domestic Violence or an Explosive Blast or other Combat Injuries.
Who is effected by a Traumatic Brain Injury and at what age?
A Brain Injury can affect anyone however men are affected more than women. The common age of occurrence is 15-24yrs. old.
What are the classifications of a Traumatic Brain Injury?
Open(Skull fracture or penetrating injury)
Closed(No External Damage)
How is a Traumatic Brain Injury Diagnosed?
A Glasgow Scale
Rancho Los Amigos Scale (Based on Cognition)
How is the Glasgow Scale used in diagnosing a Traumatic Brain Injury?
Evaluates Eye Opening/Motor Response/Verbal Response Activities from 1-5. All of the numbers are added up in order to discover the severity of the brain injury.
8 & Below SEVERE
What diagnostic procedures are used in diagnosing a Traumatic Brain Injury?
EEG looks at Brain Wave Activity
CT Scan & MRI looks for location as well as size of the injury.
What is involved in Low Level Management (LOCF I-III)
Maintain Skin Integrity (Prevent Bed Sores)
Provide Sensory Stimulation
Promote Early Return of Functional Mobility Skills
What is involved in Mid-Level Management (LOCF IV-VI)?
*Patient will be confused and agitated/ You will be unable to build on previous sessions.
Provide Structure/ Routine
Remain Calm/ Use Calm Voice
Provide Calm Atmosphere
Engage Patient in Task Specific training
Limit the number of activities
Provide Verbal and Physical Assistance
What is involved in High Level Management (LOCF VII-VIII)?
Patient will be confused but no longer gets agitated.
Assist patient with behavioral, cognitive, emotional reintegration
Promote independence in ADL's and Daily Living Skills.
Promote Posture/ Balance Control
Promote staying active
Provide Patient and Family with Education.
What is the definition of a Spinal Cord Injury?
Damage to any part of the spinal cord or nerves at the end of the spinal canal.
What are the two classifications of a Spinal Cord Injury? Give examples.
Traumatic: Car Accident, Gun Shot Wound, Stab Wound, Falls
Non-Traumatic: Tumors, Infections, Congenital Causes
List each of the Common Fractures.
*Jefferson Caused by axial loading (hit from the top of the head). No permanaent Neuro. problems if treated promptly.
*Hangman's (2nd Surgical Vertebrea) Caused by pressure from the top of the head towards the body.
*Wedge Compression Causes Loss of Height
*Burst Vertebrae literally burst into pieces. (Caused by a high impact force) Shards tend to enter surrounding tissue.
What are the classifications of Spinal Cord Injuries?
Levels of lesions
Frankel Scale Functional Classification
Upper vs. Lower Motor Neuron
Having all four limbs hindered to some degree.
Only two limbs are affected in somme way.
How is a Spinal Cord Injury Diagnosed?
What are some examples of acute management of a spinal cord injury?
*Stabilize injury with rods, screws,etc
*Bone Graph for a Bone Fusion
*Brace through traction (Gardener Wells Tongs Traction)
*Use of a halo for Cervical Fractures.
Define Cerebral Palsy.
Cerebral palsy is a group of disorders that can involve brain and nervous system functions, such as movement, learning, hearing, seeing, and thinking.
What Caused Cerebral Palsy?
It is caused by a lesion in 1 or more part of the brain. This usually happens in Utero but can also be caused by a traumatic birth.
What are the signs and symptoms of Cerebral Palsy?
Unusual Startle Reflex
Delayed Motor Skills
Delayed Accomplishment of Mile Stones for Patient's age.
What is the role of PT with a patient who suffers from Cerebral Palsy?
Improve Function, Increase Independence, Education of Patient.
Define Muscular Dystrophy
An inherited progressive musculoskeletal skeletal disease. (Group Muscle Disease)
When is the onset of Muscular Dystrophy and the life expectancy?
Onset: The age a child starts walking.
Life Expectancy: 15-51yrs
What are some sign and symptoms of Muscular Dystrophy?
Loss in muscle mass
Build up of fat and connective tissue
What are the options for medical management of Muscular Dystrophy?
There is no cure.
PT works with issues of immobility
PT offers low intensity exercise that slows the progression of MD
Define Bell's Palsy.
Facial Nerve Damage (There is a partial or total paralysis of some or all of the muscles of the face).
What are some signs and symptoms of of Bell's Palsy?
Unable to close affected eye, lack of tear production, corner mouth droop, excessive drooling/slurred speech, loss of tone in voice.
What are the treatments used for Bell's Palsy?
Massage of the affected area
Exercise of the face
When the body's immune system attacks the perephrial nervous system.
Define Myasthenia Gravis.
An autoimmune disease where the body attacks the receptors at the neuromuscular junction.
A very serious bacterial infection that can result in death if left untreated.
What are three types of meningitis?
Aseptic (Viral) Meningitis