neuro Flashcards
(157 cards)
1
Q
Eval for Neuro
A
OP, Performance in areas of occupation, determine sensory and motor dys, cog and perceptual dys, eval how specific deficits affect occupation, home eval, psychosocial dysfunction and strengths
2
Q
intervention for neuro
A
positioning, postural training, motor learning and motor control, ADLs, assistive devices, splinting, education, visual/cognitive, skin care, safety, sexual dysfunction
3
Q
Risk factors for stroke/cva
A
HTN, cardiac disease, atrial fib, diabetes, alcohol abuse, hyperlipidima
4
Q
TIA
A
last a few minutes, occurs when blood supply obstructed for short period
symptoms occur suddently and similiar to CVA,war
5
Q
cerebral infarction
A
embolism of thrombosis
6
Q
cerebral hemmorhage
A
bleed 2/2 hupertension or aneurysm
7
Q
cerebral arteriovenous malformation
A
abnormal dilated blood vessels that result from congentially malformed vascualr structures
8
Q
MCA
A
- Contralateral: hemiplegia, hemianesthesia, homonymous hemianopsia.
- LMCA: aphasia, apraxia
- RMCA: unilateral neglect, spatial dysfunction
9
Q
ICA
A
similair to MCA
10
Q
ACA
A
- contralateral hemiplegia
* grasp reflex, incontinence, confusion, apathy
11
Q
PCA
A
*homonymous hemianopsia, hemisensory loss, alexia, & thalamic pain.
12
Q
vetrobrobasilar
A
*dysarthria, dysphasia, emotional instability, tetraplegia
13
Q
Eval stroke/CVA
A
Self Care: barthel index,
FIM, COPM, Assessment of motor & process skills, stroke impact scale.
14
Q
Performance skills client factors
A
*postural support: berg balance, functional reach. Best to observe functionally.
*UE function: functional test for the hemiplegic/paretic UE, arm motor ability test, wolf motor function test
*Motor learning ability: includes visual function, speech &
language, motor planning,
cognition & psychological function
15
Q
Ot intervention
A
*focus on ADLs through training using compensatory & remedial approaches
*activity should be realistic as possible
* adapt environment
*psychosocial
*community transition
Postural adaptation
*establish alignment
*perform reaching activities while maintaining alignment
*perform activity to maintain trunk in midline
Communication
*communicate in quiet area
*allow time for response
*yes or no questions
*be concise
Motor Learning
*spatial relations & positioning, spatial neglect, body neglect, motor apraxia, ideational apraxia, organization/sequencing,
attention, figure/ground, initiation, visual agnosia, problem solving UE function
*include affected UE in task *constraint induced movement therapy
*e-stim, imagery, robot assisted, virtual reality, mirror therapy, orthotics
*prevent subluxatio
16
Q
age range for TBI
A
15-29 males
17
Q
open TBI/focal
A
penetration of skull
18
Q
Coma
A
absence of response to stimuli * no sleep-wake cycles * no intentional movement * eyes do not open to stimuli or spontaneously
19
Q
vegetative state
A
- no awareness/ability to interact * no sustained, reproducible, voluntary or behavioral response to stimuli * no language
comprehension/expression - CAN self-regulate temp, breathing, circulation for survival
- bladder/bowel incontinence
- onset within 1 mo of TBI
20
Q
TBI
A
- concussion characterized by post-traumatic loss of consciousness
- cerebral contusion/laceration/edema
- surface wounds/skull fx
- hemiplegia/monoplegia/abnormal reflexes * decorticate/decerebrate rigidity
- Decorticate: UE in spastic flexion with IR and add. LE in spastic ext, IR, abducted. - Decerebrate: UE and LE are in spastic ext, add, IR. Wrist and fingers flexed,
plantar portions of feet flexed + inverted,
trunk extends, head retracted. - fixed pupils
- coma
- changes in vitals
- muscle weakness
- ↓ endurance
- ↓ ROM
- changes in sensation
21
Q
- Decorticate:
A
: UE in spastic flexion with IR and add. LE in spastic ext, IR, abducted. -
22
Q
decerebrate
A
UE and LE are in spastic ext, add, IR. Wrist and fingers flexed,
plantar portions of feet flexed + inverted,
trunk extends, head retracted.
23
Q
Glasgow Coma scale
A
eye, verbal, motor responses
- Severe: < 8
- Moderate = 9-12
- Mild = >13
- Highest = 15 conscious; lowest = 3 coma
24
Q
ranchos los amigos
A
Level 1-10 assessing response to stimuli and assistance needed
25
acute initial intervention TBI
```
- Positioning (w/c, bed) to
prevent skin breakdown,
stabilize BOS *side lying is preferred for pt with
abnormal tone*
- PROM
- Splinting/casting → resting splint every 2hours, cone
splints to prevent fingers
from digging into palm,
antispasticity splints to
position in functional pos +
abduct fingers, elbow casts for loss of PROM in elbow flexors
-sensory stim
-agitation mgmt
-family and caregiver edu
```
26
minimally conscious state
* awareness of self + environment * CAN follow commands, gesture or verbal yes/no, intelligible verbalization, purposeful movement
27
inpatient rehab intervention
- ↑ motor function (begin with GM);
- ↑ vision
- ↑ visual-perceptual
- ↑ cognition
- ↑ voice/speech function
- Bed mobility
- w/c mgmt/proper alignment - Functional ambulation
- Community mobility
- Transfers
- Home mgmt
- Community reintegration
- behavioral/emotional
adaptations
- ↑ motor function (begin with GM);
- ↑ vision
- ↑ visual-perceptual
- ↑ cognition
- ↑ voice/speech function
- Bed mobility
- w/c mgmt/proper alignment - Functional ambulation
- Community mobility
- Transfers
- Home mgmt
- Community reintegration
- behavioral/emotional
adaptations
28
post acute rehab
transfer to home care, residential program, day treatment program or outpt community re-entry
- ↑ cognition (memory,
executive function)
- ↑ vision + visual-perceptual (compensation/adaptation)
- Self-maintenance role
competence: self-care and
IADLs
- leisure/social participation - work/vocational rehab
- behavioral/emotional
adaptation → self-awareness and coping
- Family education
29
SCI complications
Complications: respiratory, possible ulcer, orthostatic hypotension, DVT, autonomic dysreflexia, UTI, heterotopic ossification
30
A
complete- no sensory or motor
31
B
incomplete, sensory but no moto
32
C
incomplete, motor function
| preserved below neurological level. Major muscle groups have grade below ¾ MMG
33
D
incomplete, motor function
| preserved below neurological level. Major muscle groups have grade above ¾ MMG
34
specific symptoms of TBI
spinal shock (no reflexes & flaccid paralysis), sensory deficits, loss of bowel/bladder control, loss of temperature below lesion, decreased respiratory function, sexual dysfunction, changes in muscle tone (spasticity in upper motor neuron lesions & flaccidity in lesions below L1), loss of motor function.
35
central cord syndrome
more UE deficits then LE
36
brown sequard
(hemisection of cord)
Ipsilateral: paralysis, loss of position sense, discriminative touch
Contralateral: pain & thermal sense.
37
anterior cord
Bilateral: motor function, pain, pinprick,
| temperature
38
posterior cord
less frequent
* Proprioceptive loss
* Pain, temp, touch are preserved
* motor function preserved at varying degrees
39
conus medullaris
sacral cord & lumbar nerve roots
* LE motor/ sensory loss
* areflexic bladder/bowel
40
cauda equina
injury at L1
* flaccid paralysis
* no spinal reflex
* areflexic bladder/bowel
41
c1-c4
* respiratory assistance & complete assistance for personal care
* tetraplegia
* SNS possible autonomic dysreflexia *sip n puff WC
42
c5
* complete assistance personal care *low stamina, breathing on own
* can raise arms/flex elbows
* SNS compromised (autonomic dys) *electric WC hand controls
43
c6
* mod A personal care
* some wrist extension
* some bowel control
* may drive vehicle
44
c7
* little assistance personal care
* partial finger movement
* independent transfers
* MWC
45
C8
*independent in personal care
*assistance w/ heavy duty domestic care
*partial finger movement
MWC
46
T1-T12
* normal UE strength & ROM
* may stand in standing frame/walk with braces
* little bowel/bladder control
47
L1-5
*partial assistance w/ heavy duty domestic care
48
S1-S5
* some loss of function in hips/legs *may walk with assistance/aids
* may load WC into vehicle
49
TBiI eval
*physical eval w/ MMT, pinch/grip, observation, etc.
*COPM, FIM, quadriplegia index of function, spinal cord
independence measure.
*be sure to determine what
motion/sensation is present
without compromising SC
50
Acute recovery phase
limited to 15 minutes in acute care
* client/family education
*maintain normal UE ROM
(positioning, PROM, splinting) *position UE at 80 degrees
shoulder abduction external rotation & scapular depression *tenodesis
*sitting tolerance
*swallow eval
51
acute rehab phase
meaningful activities for self efficacy
* education
* ADLs
* pressure relief, sitting tolerance *AE
* strengthening
* c5: mobile arm support
* c6-7: radial wrist extensors *c8:MCP joint extenders
52
transitions rehab phase
*outpatient
*first year post injury
*support groups & enhance
community integration
53
cerebral palsy
* 2/2 brain damage during or shortly after birth
* commonly caused by: lack of O2, intracranial hemorrhage, meningitis, chronic alcohol abuse, toxicosis, infections, genetic factors, endocrine + metabolic factors
* may be accompanied by seizures, ID, visual impairment, +/or behavioral disorders
* characterized by monoplegia, hemiplegia, paraplegia, quadriplegia, diplegia (greater LE impairment)
54
spastic CP
a lesion of motor cortex- spasticity with flexor and extensor imbalance
55
dyskinetic CP
lesion in basal ganlia, fluctation in muscle tone
56
ataxic CP
lesion in cerelbellum, hypotinia and ataix movements can be mild mod or severe
57
hypertonia
increased tone
58
hyperrelfexia
increased reflex responses
59
dystonia
excessive or inadequate muscle tone
60
athethosiss
writhing involuntary movements more distal than proximal
61
chorea
spasmodic involuntary movemeents more proximal than distal- lack of co contractions
62
hypotina
decrease tone
63
tremor
*Rhythmic alternating, oscillatory movements
*contraction/relaxation of muscles
Classified as resting or during activity
64
dyskinesias
non repeptivie, BG disorders
65
myoclonus
brief and rapid contraction of muscle groups
66
tics
repeitive but not rhymic, often resemlbing fragments of normal motor movements
67
chorea
BG issue, brief, purposeful, movements in distal extremities and face
68
dystonia
sustained abnormal postures
69
ataxia
lack of coordination while completing voluntary movements,, jerky movements
70
heballismmus
involuntary flinging motions, violent and wide amplitudes of movement
71
stage 1 pD
unilateral tremor, rigidity, akinesia, min or no functional
| impairment
72
stage 2 PD
b/l tremor, rigidity or akinesia, with or without axial signs, Indep w/ ADL, no balance
73
stage 3 PD
worsening of symptoms, postural instability, onset of disability in ADL, can still lead indep life
74
stage 4 PD
requires help with some/all ADL, unable to live alone, able to walk + stand unaided
75
stage 5 PD
confined to w/c or bed, max A
76
symptoms of PD
* begins with “pill-rolling” tremor of one hand * tremor
* bradykinesia (slowed movement)
* rigidity
* resistance to passive motion that is not velocity dependent
* akinesia
* postural instability
* festinating gait
* falling backwards (retropulsion)
* falling forwards (propulsion)
* mask face
* micrographia
* FM deficits
* communication impairment
77
Meds
* side effects are common especially when disease progresses → pt may experience involuntary movement (dyskinesia), length of time the dosage is effective will shorten which may cause movement problems to happen
suddenly/unpredictably
* other side effects → hallucinations, orthostatic hypotension, nausea
78
eval PD
* FM coordination/dexterity
* mobility impairments in home or community
* ADL/IADL deficits
* swallowing/feeding issues
* sexual dysfunction
* disrupted sleep patterns
* social isolation
79
intervention PD
energy conservation
* caregiver edu/training
* support/advocacy groups
* HEP (walking certain distances or AROM)
* sit-to-stand txfers and bed mobility
* instruction in managing
“freezing” → avoid crowds, tight spaces, turns or corners
* instruct in assistive devices; eval for proper positioning in w/c * use of auditory cues to help w/smoother movements (e.g., rhythm of counting out loud or singing)
* feeding/ADL adaptations
* communication adaptations * sexual routine
* bowel/bladder
* cognition
* group therapy
* stress reduction/relaxation techniques
* home assessment/env adaptations for safety
-address rigiity, and pain
-work employmenet mods
80
spina bifida
failure of spinal columns veretebrae to protect neural tube learning to protrusion of neural tube
81
spina bifida oculta
*Bony malformation w/ separation of vertebral arches w/ no external
malformations
*OSD: when an external marker is present
82
spina bifida cystica
* an exposed pouch comprised of the spinal cord & meninges
* w/ meningocele: protrusion of CSF & meninges but not SC
* w/ myelomeningocele: protrusion including spinal nerve roots, often in Lumbar spine
83
SXs of SB oculta
no symptoms
84
SXs of sb meningocele
no symptoms impacting function
85
Sxs of SB myelomeningocele
* sensory/motor deficits below lesion
* deformities
* incontinence
86
tethered cord syndrome
difficulties with bowel and bladder, fair
| may go undiagnosed
87
muscle dystropy/atrophy
* degenerative disorders → muscle weakness and ↓ muscle mass due to absent dystrophin, ↑ levels of creatine kinase
88
general sxs
- ↓ muscle tone and weakness → abnormal movement patterns and delayed developmental milestones - Difficulty with oral motor feeding → nasogastric or gastrostomy tube
- Weakness → deformities of extremities and spine
- Difficulty with breathing → tracheostomies, mechanical ventilators, frequently results in death
89
Duchenne’s Muscular Dystrophy *MOST COMMON*
* weakness of all voluntary muscles including heart + diaphragm
* behavioral/learning difficulties may occur * rarely survive past early 20s
90
Becker Muscular Dystrophy
* slower to progress, less severe, less predictable than DMD
* loss of motor fx of hips, thighs, pelvic area, shoulders; involvement of cardiac, enlarged calves * survival into late adulthood
91
Arhrogryposis Multiplex Congenita
* loss of anterior horn cells
* weakness, deformities, contractures
* UE tends to be in shoulder IR, elbow ext, wrist flex
* LE tends to be in hip IR and hip flex, clubfeet
92
Fascioscapulohumeral Muscular Dystrophy
* occurs early adolescence
* involves face, upper arms, scapular region → masking, weakness, decreased mobility of face, inability to lift arms above shoulders
* progresses to weakness to abdominal and hip musc.
* slow progression; rarely affects cardiopulm systems → lifespan can be normal
93
Spinal Muscular Atrophy
Type 1: birth or infancy; life expectancy is 2 years
Type 2: children; progresses rapidly; life expectancy early childhood
Type 3: older children; later onset, less severe
Type 4: adolescent/adult; later onset, less severe
Types of muscular atrophy
94
Sxs of spinal muscular atrophy
* decrease of motor neuron protein → weakness of voluntary muscles of shoulders, hips, thighs, upper back
* affected muscles for breathing + swallowing
95
progressive spranuclear palsy
onset in later mid life
* loss of voluntary but preservation of reflexive eye movements
* bradykinesia
* rigidity
* axial dystonia
* pseudobulbar palsy
* dementia
96
Huntingtons chorea
* choreiform movements & progressive intellectual deterioration
* psychiatric disturbances usually precede movement disorder
97
involuntary moveemnts
chorea- rapid involuntary irregular movement,
akathsia- motor restlesness
dystonia- abnormal sustained posture
98
voluntary moveemnts
bradykinesa, akineas, incoordination
99
huntingonts eval
*Unified huntington's disease rating scale
100
huntingtons chorea intervention
* cognitive & emotional disability *motor disability using HEP & modifications
* safety at home
* energy conservation
* use of AE
* positioning
* ADLs
101
spinocerebellar degenerations
Group of degenerative disorders characterized by progressive ataxia 2/2 degeneration of cerebellum, brain stem, SC, PNS, & basal ganglia.
102
Fredrichs Ataxia
* autosomal recessive inheritance
* onset in childhood
* gait unsteadiness, UE ataxia, dysarthria, tremor is minor, areflexia
* progression can lead to scoliosis & cardiac issues.
103
cerebellar cortical degeneration
cerebellum and inferior olives
onset age of 30-50
cerebellar symptoms
104
multiple systems degeneration
spasticity, extrapyramidal, sensory, LMN, autonomic dysrfrefelexia
onset young midddle life
105
ALS
Progressive degeneration of corticospinal tracts & anterior horns- replaced by scar tissue.
106
symptoms of ALS
* Muscle weakness, atrophy
* begins distally & symmetrically
* cramps precede weakness
* signs usually begin in the hands
* LMN signs: spasticity, hyperactive tendon reflexes, corticospinal tract involvement *dysarthria/dysphagia
* sensory systems, eye movements, & urinary sphincters often spared
107
stage 1 als
can walk, independent with adls, some weakness
108
stage 2 als
can walk, mod weakness
109
stage 3 als
can walk severe weakness
110
stage 4 als
Wc some assistance with ADLs, severe weakness in legs
111
stage 5 als
Wc mobility, depends on ADLS, severe weakness in arms and legs
112
Stage 6 ALS
bed bound, dependent on ADLS and self care
113
eval ALS
*pt goals & priorities to follow through progresion
*ALS functional rating scale, purdue pegboard,
multidimensional fatigue
inventory, dysphagia screening *complete re-evaluations regularly as disease progresses
114
ALS intervention
* tx should be compensatory *adapt & conserve energy
* home eval
* positioning txrs & skin integrity * communication
* dysphagia management
* social participation
115
Braxial plexus disorder
* 2/2 traction during birth, invasion of metastatic cancer, radiation tx for fibrosis, or traction injury
116
erbs palsy
* paralysis of upper brachial plexus including C5-6 nerves; C7 sometimes involved
* arm cannot be raised; elbow flex is weakened; weakened scapular
retraction/protraction
* presents as arm straight and wrist fully bent
* contractures develop after 6 mo. → adduction and IR; supination deformity of forearm
117
Sxs of braxial plexus
* mixed motor and sensory disorders of
corresponding limb
* rostral injuries → shoulder dysfunction
* caudal injuries → hand dysfunction
118
intervention BP
Positioning and ROM exercises to retain shoulder ER, abduction + flexion; maintain distal flexibility
119
* paralysis of lower brachial plexus Including C7-8, T1 nerves
* rare compared to erb’s palsy
* results in paralysis of hand and wrist; hand is limp + fingers do not move
klumpkes palsy
120
Guillan Barre syndrome
Unknown cause; inflammatory disease causes demyelinization of peripheral nerves → acute, rapidly progressive form of polyneuropathy
121
onset and acute inflammatory phase GB
acute weakness occurs in at least 2 extremities → advances and reaches max at 2-4 weeks
122
plateu phase GB
* Symptoms are at their most disabling; little to no change over few days to wks
123
recovery phase GB
* Remyelination and axonal
regeneration occur over period (up to 2 years); recovery starts at head/neck and then distally. Most people can regain function but have fatigue
124
long term prognosis GB
* 50% mild neurological deficits; full recovery
* 15% residual functional deficits * 80% ambulatory in 6 months
* 5% die of complications
125
symptoms of GB
symmetric muscular weakness
* mild distal sensory loss/paresthesias
* weakness > sensory deficits
* respiratory failure and dysphasia seen sometimes * pain, mostly in LE
* fatigue
* edema
* absence of deep tendon reflexes
* dysfunction of cranial nerves, including facial palsy
* ANS involvement → may result in postural hypotension (decrease in BP when rising from horizontal position), arrhythmias, facial flushing, diarrhea, impotence, urinary retention, increased sweating
* bladder dysfunction
* cognitive difficulties (impaired executive functioning, ST memory, decision making)
126
Eval GB
* Plateau phase (usually in ICU/Acute) → communication, control of physical environment, comfort+positioning, anxiety mgmt * Recovery Phase (usually in inpt rehab, outpt rehab, home or work settings)→ mobility, self-care, ADLs, communication, leisure, workplace/community reintegration
127
intervention GB in plateu phase
- Use of communication tools - Environmental modifications to access call button, remote,
phone
- Adjust supine + sitting position to optimize function/comfort
and ↓ skin breakdown
- Position trunk, head, UE
stability
- client /fam edu on condition and anxiety
128
intervention GB in recovery phase
- Splinting to maintain ROM - Safe mobility, assistive device training
- Transfer safety
- Modified techniques for ADL - Communication adaptation - Client edu on adaptive
equipment and behavior mod - Energy conservation/fatigue mgmt
- FM coordination, strength, sensation
- Home assessment
129
Multiple Sclerosis (MS)
Immune system causing myelin damage.
130
symptoms of MS
* usually w/ remission & exacerbations
* paresthesias of one or more extremities on the trunk or the face
* visual disturbances
* emotional disturbances
* LOB or vertigo
* bladder dysfunction
* Cognitive: memory loss ,apathy, poor judgement, & inattention
* sensorimotor: spasticity, increased reflexes, fatigue, ataxia, weakness, gait instability, hemiplegia, quadriplegia
131
eval of MS
*occupational profile
*FIM, modified fatigue impact scale, beck depression inventory, nine hole or purdue pegboard, semmes weinstein, modified ashworth scale for spasticity *eval should occur when person feels most energized
*goals should address
exacerbation & remission stages *should be compensatory
because of the progressive nature of MS
132
MS intervention
*DO NOT: use heat modalities or go into hot temperature areas, cause emotional stress, no
alcohol
*vision: home safety & AE
*sensory disturbances: safety *urinary incontinence
*muscle weakness: body
mechanics, stretching, ther-ex, use AD
*pain management
*energy conservation
*proximal stabilization for ataxia *swallow safety
133
sensory processing disorder
* fluctuating or extreme responsiveness while engaging in daily activities
* difficulties interacting with environment in play, learning, social situations
* poor initiation of activities
* difficulty with goal-directed actions
134
Dunns models
neurological threshold (high/low) * behavioral response (passive/active)
135
sensory modulation disorder
* Sensory overresponsivity (SOR)
136
eval of sensory processing disorder
parent/caregiver interview * teacher interview re: school performance
* formal assessment of sensory processing → Sensory Profile * informal observation of
performance/behavior in multiple settings
* formal assessment of clinical observations (reflexes, crossing body midline, b/l coordination, muscle tone)
137
sensory underresponsibity
sensory seeking/craving (SS)
138
sensory based motor disorder
* Dyspraxia → motor planning deficit * Sensory-based postural disorders
139
* visual, auditory, tactile, vestibular, proprioceptive, taste/smell
sensory discrimination disorder
140
vestibular
gravitational insecurity, low muscle tone, postural-ocular deficits, deficits in b/l coordination, low endurance, deficient motor planning and sequencing, difficulty w/attention, organization of behavior, communication.
141
tonic clonic seizsure
* most common type in children
* numbness of sensations are warning sign
* loss of consciousness, stiff body, heavy breathing, drooling, incontinence *clonic phase: alternating rigidity & relaxation of muscles
* postictal state is a period of drowsiness & disorientation
142
myoclonic -akinetic seizsure
* brief involuntary jerking of extremities w/o loss of consciousness
* loss of tone
* difficult to control
143
pertit mal sezisures
* 4-12 years
* loss of consciousness w/o loss of muscle tone
* rapid blinking/ staring into space *does not fall down but no recall of episode
144
first aid seizure
*calm
*remove dangerous objects
*protect individual w/o interfering w/ their movements
*nothing in mouth
*if in bed raise bed rails
*individual on side if risk for
aspiration
*allow seizure to happen, protect head
*for tonic clonic place person in side lying position following tonic *monitor state following
*call for medical attention if it is first seizure, occurs in water, if there is a second seizure, no consciousness in 5-10 minutes, seizure lasts 5 mins,
diabetic/pregnant
145
dementia memory sx
recent memory,personal episodic memory, semantic memory, procedural memory in tact *
146
dementia cog deficits
aphasia, apraxia, agnosia, executive functioning deficits, topographical orientation, spatial tasks, poor judgment, anxiety/defensiveness, disinhibited behavior, psychotic symptoms
147
dementia motor deficits
gait disturbances, hyperflexia (overflexion of limb), paratonia (involuntary resistance to passive movement),
148
early stage dementia
adls in tact, decrease in IADL perform, decrease social and work and leeisure decreased
149
middle stafe dementia
impariment in all occs, cannot live alone, ADL impacted, eating issues, IADl neglected, deependent on comm mobility, fanical mgmt, shoppping, cleaning and cooking wiht supervision, decreased leisure and social partcipation and orientation to date
150
late stage dementia
all occ lost, dependent in ADL, cannot ambulate safely, communicatino lost
151
Alzheimers disease
cortical atrophy of frontal, parietal, and temporal lobes, hippocampus caused by plaques * Early Stage
* Middle Stage
* Late Stage
152
AD symptoms
Progressive impairment of:
* memory
* executive function
* attention
* language
* visual processing and praxis
* often behavioral disturbances
153
vascular dementia
```
cerebrovascular disease (small mini-strokes)
gait issues
abrupt delcine
```
154
frontotemporal dementia
neuronal, intranuclear inclusions
* progressive aphasia
* corticobasal syndrome
* similar to AD or parkinson’s
155
lewy body demetnia
usually in limbic areas; ↓acetylcholine and dopamine
Progressive deficits in:
* executive function deficits
* visuospatial abilities
* attention
* memory
* aphasia, apraxia, spatial disorientation
156
dementia eval
* clinical observation
* Functional Cognitive screens: - ACLS
- Assessment of Motor and Process Skills
- Cognitive Performance Test - Executive Function
Performance Test
- Independent Living Scales - Kitchen Task Assessment - Aradottir OT-ADL
Neurobehavioral Evaluation * Memory assessments
- Contextual Memory Test
- Hopkins Verbal Learning Test Revised
- Prospective Memory
Screening
- Rivermead Behavioral Memory Test
157
dementia interventions
Based on Claudia Allen’s
Cognitive Disability Levels
- Level 6: planned actions
- Level 5: exploratory actions - Level 4: goal-directed activity - Level 3: Manual actions
- Level 2: Postural actions
- Level 1: automatic actions * behavior mgmt →
communication, sundowning, anger, wandering,
pillaging/rummaging
* environmental modifications → ensuring safety and addressing sensory components of
environment
