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COTA Neurological Disorders and Intervention Approaches > Neurological System Disorders > Flashcards

Neurological System Disorders Flashcards

(75 cards)

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1
Q

Precentral Gyrus Frontal Lobe

A

primary motor cortex for voluntary muscle control

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2
Q

Prefrontal Cortex Frontal Lobe

A

controls emotions, judgments, higher-order cognitive functions such as ideation and abstraction

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3
Q

Premotor Cortex Frontal Lobe

A

related to planning movements includes Broca’s area, which controls motor aspects of speech

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4
Q

Postcentral Gyrus Parietal Lobe

A

Receives fibers conveying touch, proprioceptive, pain, and temp sensations

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5
Q

Temporal Lobe

A

receives/processes auditory stimuli Wernicke’s area- language comprehension

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6
Q

Occipital Lobe

A

receives/processes visual stimuli

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7
Q

Limbic System

A

concerned with instincts and emotions contributing to preservation of the individual

basic functions include feeding, aggression, emotions, endocrine aspects of sexual response, and long-term memory

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8
Q

Controllable CVA Risk Factors

A

Hypertension

Cardiac Disease

Diabetes Mellitus

Obesity

Diet; High Cholesterol

Use of oral contraceptives with high dose of estrogen

Cigarette smoking; Alcohol abuse

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9
Q

Uncontrollable CVA Risk Factors

A

Age

Gender (male)

Race (African American and Hispanic)

Genetic predisposition

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10
Q

CVA Warning Signs

A

Numbness or weakness of the face, arm, or leg, especially on one side of the body

Confusion

Difficulty speaking or understanding, slurred speech

Blurred vision

Difficulty walking, dizziness, loss of balance or coordination

Severe headache with no known cause

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11
Q

Transient Ischemic Attack (TIA)

A

Temporary interruptions in blood supply to the brain Mini-Strokes Symptoms generally last 24 hours

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12
Q

Cerebral Infarction

A

due to either embolism or thrombosis of intra or extracranial arteries

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13
Q

Cerebral Hemorrhage

A

bleed secondary to hypertension or aneurysm

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14
Q

Cerebral Arteriovenous Malformation AVM

A

abnormal, tangled collections of dilated blood vessels that result from congenitally malformed vascular structures

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15
Q

Right CVA

A

Left sided weakness and sensory loss

Visual-spatial and perceptual deficits

Left sided neglect

Swallowing deficits, slurred speech

Difficulty with abstract thinking

Short attention span

Behavior: impulsivity, denial of deficits, inappropriate comments, excessive talking

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16
Q

Left CVA

A

Right sided hemiplegia and sensory loss

Global Aphasia

Difficulty reading and writing

Decreased analytical thinking, impaired time concepts, impaired memory

Difficulties in learning new info

Apraxia, left/right confusion

Behavior: slow, cautious, easily frustrated, decreased motivation

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17
Q

Flexion Synergy Patterns

A

Scapular adduction and elevation; Humeral abduction and external rotation; Elbow flexion; Forearm supination; Wrist flexion; Digit flexion

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18
Q

Extension Synergy Patterns

A

Scapular abduction and depression; Humeral adduction and internal rotation; Elbow extension; Forearm pronation and wrist and finger flexion or extension

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19
Q

Open vs Close Head Injury TBI

A

Open Injury Injury results from an object penetrating the skull

Closed Injury Injury tends to be more diffuse Injury can be due to compression, expansion, acceleration, deceleration, or rotation of the brain inside of the skull

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20
Q

Glasgow Coma Scale Eye Opening

A

1- Never

2- To Pain

3- To Sound

4- Spnotaneous

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21
Q

Glasgow Coma Scale Motor Response

A

1- No Movement

2- Extension

3- Flexion Abnormal

4- Flexion Normal

5- Localizes Stimulus

6- Obeys Commands

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22
Q

Glasgow Coma Scale Verbal Response

A

1- None

2- Incomprehensible

3- Inappropriate

4- Confused

5- Oriented

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23
Q

Rancho Los Amigos Scale

A

I. No Response

II. Generalized Response

III. Localized Response

IV. Confused-Agitated

V. Confused-Inappropriate, Non-Agitated

VI. Confused-Appropriate

VII. Automatic-Appropriate

VIII. Purposeful-Appropriate

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24
Q

Generalized Response RLAS 2

A

inconsistent, non-purposeful. delayed response

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25
Localized Response RLAS 3
specific but inconsistent
26
Confused-Agitated RLAS 4
respond to internal stimulant, maybe combative because of confusion
27
Confused-Inappropriate, Non-Aggitated RLAS 5
appears alert.responds to very simple commands. reacts to external stimuli but out of proportion
28
Confused-Appropriate RLAS 6
Goal directed behavior, needs a lot of guidance
29
Automatic-Appropriate RLAS 7
increased awareness. follow simple directions consistently. can relearn old task
30
Purposeful-Appropriate RLAS 8
Appropriate and oriented. complete ADLs. requires supervision for decreased insight
31
Spinal Cord Etiology
Trauma to the spinal cord as a result of compression, shearing force, contusion secondary to motor vehicle accident, diving accident, gunshot/knife wound, sports injury, or fall Non-traumatic cord injuries may be a result of tumor, progressive degenerative disease
32
ASIA Impairment Scale
A= complete, no sensory or motor func in the sacral segments S4-S5 B= incomplete, sensory but no moter func below neurological lvl and extends thru sacral segments C= incomplete, motor func below neurological lvl and majority of key muscle groups muscle grade 3/5 D= incomplete, motor func below neurological lvl and majority of key muscle groups muscle grade \>/= 3/5 E= normal, sensory and motor func are normal
33
SCI Symptoms
Spinal shock- 4-8wks Cessation of all reflex activity below the level of injury Sensory deficits- partial or complete Loss of bladder/bowel control Loss of temp control below lesion Decreased respiratory func Sexual dysfunction Changes in muscle tone- spasticity/flacciidty Loss of motor func- quadraplegia/paraplegia complete/incomplete
34
SCI Complications
Respiratory Decubitus ulcer Orthostatic Hypotension DVT Autonomic Dysreflexia UTI Heterotopic Ossification
35
Heterotopic Ossification
Abnormal bone development in soft tissue in or around a joint Symptoms: Swelling Painful extremity Decreased range of motion with boney end feel
36
Autonomic Dysreflexia
A syndrome occuring in patients with spinal cord lesions above T6. Sudden and significant increase in blood pressure above their usual levels in response to a noxious stimuli
37
C1-C3 Spinal Injury
FO: Neck flx/ext, and rot; shrug shoulders (C3 only) ROM is WFL and painfree. Patient is able to direct PROM program RE: Mechanical ventilator, commun mouth sticks or env. control units, w/c sip/puff tech
38
C4 Spinal Injury
FO: Neck flexion, ext, rot; scap. elevation (shoulder shrug) and inspiration May breathe w/o ventilator RE: Power W/C, keyboard, mounted smartphone,commun mouth sticks or env. control units
39
C5 Spinal Injury
FO: Shoulder flx/ext, abd; elbow flx and sup; scap. add/abd Bed mobility w/assist. UED/UEB: Min-ModA. Feed s/u and Indp w/ae. RE: Power W/C, suspension sling, dorsal wrist w/universal cuff, wash mitt, scoop dish, angled utensils
40
C6 Spinal Injury
FO: Scap. protractor, some horiz. Add, forearm pron, wrist ext., tenodesis Bed mobility w/assist, indp eating, indp LED (maxA w/shoes and socks),assist grooming (Indp w/tenodesis grasp or splint), Trns w/assist-indp, MinA bathing w/handheld shower, tub bench RE: Power or manual W/C, move from universal cuff to built-up utensils, adapted cups/mugs, AE for dressing and eating, hydraulic standing frame, transfer board
41
C7-C8 Spinal Injury
FO: Elbow ext, wrist flex/ext, finger flex/ext, thumb use. Ind-assist bladder and bed mob, ind transfers and press relief, ind eating and UED/UEB, ind-assist LED/LEB RE: Manual W/C, padded tub bench or shower commode chair, handheld shower,button hook, modified vehicle
42
T1-T9 Spinal Injury
FO: UEs fully intact, ltd. upper trunk stability, endur. Independent all self-care, ind stand w/frame, ind homemaking, driving RE: Manual W/C, standing frame, hand controls (vehicle), elevated padded toilet seat or padded tub bench, shower/commode chair, handheld shower
43
T10-L1 Spinal Injury
FO: Good trunk stability. Paralysis of LEs Independent all self-care, assit-ind walk w crutches, ind homemaking, driving RE: Manual W/C, standing frame, forearm crutches or walker, KAFO, hand controls (vehicle), padded std or raised padded toilet seat, padded tub transfer bench, hand-held shower
44
L2-S5 Spinal Injury
FO: Good trunk stability, partial to full control of LEs. Partial paralysis of LEs, hips, knees, ankle, foot Independent all self-care, assit-ind walk w crutches, ind stand w frame, ind homemaking, driving RE: Padded toilet seat, padded tub bench, handheld shower, forearm crutches or cane, KAFO or AFO
45
Cerebral Palsy
Caused by an injury and/or disease prior to, during, or shortly after birth resulting in brain damage and secondary neurological and muscular deficits Types include Spastic CP, Dyskinetc CP, and Ataxic CP Classifications are Monoplegia, Hemiplegia, Paraplegia, Quadriplegia, Diplegia Complications include language and intellectual deficits, seizures, visual impairments, and feeding disturbances
46
Spastic CP
Lesion of the motor cortex resulting in spasticity with flexor and extensor imbalance. Spasticity can express itself as: 1. Hypertonia- increased tone 2. Hyperreflexia- increased intensity of reflexes
47
Dyskinetic CP
Lesion in the basal ganglia results in fluctuations in muscle tone. The lesion expresses itself as: 1. Dystonia- excessive or inadequate muscle tone 2. Athetosis- writhing involuntary movements 3. Chorea- spasdomic involuntary movements
48
Ataxia CP
Lesion in the cerebellum results in hypotonia and ataxic movements; characterized by lack of stability resulting in more primitive total patterns of movement. Classified according to ability by the GMFCS and MACS
49
Gross Motor Function Classification System (GMFCS) for Children w/CP
1- Walks w/o restrictions 2- Walks w/o ae 3- Walks w/ae 4- Self-mobility w/limitations (manual/power w/c) 5- Self-mobility severely limited, even w/ae
50
Manual Ability Classification System (MACS) for Children w/CP
1- Handles objects easily and sucessfully 2- Handles most objects but with somewhat reduced quality/speed 3- Handles objects with difficulty, needs help to prepare and/or modify activities 4- Handles a limited selection of easily managed objects in adapted situations 5- Does not handle objects and has severely limited ability to perform even simple actions
51
Dyskinesias
involuntary, non-repetitive movements affecting distal, proximal, and axial musculature
52
Myoclonus
brief and rapid, involuntary contractions of a muscle or muscle group
53
Chorea
brief, purposeless, involuntary movements of the distal extremities and face
54
Dystonia
Involuntary muscle contractions that cause repetitive or twisting movements
55
Ataxia
lack of coordination while performing voluntary movements
56
Hemiballismus
involuntary flinging motions of the extremities. continuous and random
57
CP Treatment Focus for Infants
Positioning Feeding orally Play positions Handling during feeding, holding, dressing, play
58
CP Treatment Focus for Toddler/Pre-School Age
Positioning Handling Fine motor skills/pre-K skills Self feeding and dressing Visual motor/visual perceptual skills mobility
59
CP Treatment Focus for School Aged
Positioning Fine motor activities to support performance in the classroom Handwriting Visual motor/visual perceptual skills Classroom adaptations Adaptive PE
60
CP Treatment Focus for Young Adult
Monitor positioning equipment, splints Pre-vocational activities and skills Readiness for a group home
61
Hypertonic Abnormal Muscle Development
hyper-ext of neck; retraction of shoulder; pelvis extended; legs add, maybe crossed Positioning On tummy, elbows underneath them; highly motivating toy in front for neck ext Side-lying Sitting; bolster (car seat if small); have child straddle for abd of legs; support hips; slowly rotate shoulders forward. Slow rocking motions to help break up tone
62
Hypotonic Abnormal Muscle Development
Needs lots of flx Positioning Facilitate tone prone in a platform swing Side-lying to bring head, legs, and arms into midline Sitting with lots of support in hips and trunk "W" sit for core strength Prone with pillow underneath (so face not on flr)
63
Multiple Sclerosis MS
chronic, inflammatory disease of the CNS in which most patients incur disability over time Pain Sensorimotor Changes- spasticity, ataxia, weakness, gait instability, hemi/quadriplegia Balance Disturbance- dizziness/vertigo Visual Changes Bowel and Bladder Disturbance Cognitive Changes- apathy, memory loss, lack of judgement, inattention Dysarthria and Dysphagia Tremor Sexual Dysfunction Depression Treatment- assist w/managing symptoms, maintain func, optimize QOL declining- adaptive approach; recovery- remedial approach
64
Types of MS
Relapsing Remitting- acute attack, recovery. another attack may or may not happen Secondary Progressive- relapse/remit, then progressive decline Primary Progressive- progressive w/o remitting Progressive Relapsing- progressive w/acute decline
65
Parkinson's Disease
Slow progressive disease of the nervous system Symptoms Bradykinesia; Muscle Rigidity; Resting Tremor; Cog-wheel Rigidity; Micrographia; Dementia; Memory Deficits; Voice softens-becomes monotone; Reduced facial expression; Shuffling Gait; Freezing
66
Parkinson's Disease Stages
I- Unilateral symptoms, no or minimal functional implications, usually a resting tremor II- Bilateral symptom involvement, no balance difficulty, mild problems with trunk mobility and postural reflexes III- Postural instability, mild to moderate functional disability IV- Postural instability increasing, though able to walk; functional disability increases, interfering with ADL; decreased manipulation and dexterity V- Confined to wheelchair or bed
67
Shunt Precautions
Blockage- headache, vomiting, irritability Infection- vomiting, lethargy, fever; seizures and deterioration of physical/cognitive functioning
68
Muscular Dystrophies/Atrophies
a group of degenerative disorders due to a hereditary disease process; can begin in infancy, childhood, or adulthood Includes Duchenne's MD, arthrogryposis multiplex congenita, limb-girdle MD, spinal muscular atrophy, congenital myasthenia gravis, and myopathies Symptoms: Low muscle tone and weakness Difficulty w/oral feeding Breathing difficulties
69
Amyotrophic Lateral Sclerosis ALS
Degenerative motor neuron disease of unknown etiology; more prevalent in men; avg onset 57yrs; life expectancy 2-5yrs Symptoms Affects Voluntary Muscles Spasticity and Stiffness Weakness, low tone and atrophy Speech deficits, swallowing and respiratory involvement Eye Muscles; external sphincters controlling bowel and bladder management; five senses; heart, liver, and kidneys are spared.
70
Stages of ALS
I: Independent in walking and ADLs, some weakness II: Can walk; mod weakness III: Can walk; severe weakness IV: Req w/c for mobility; some assist w/ADLs; severe weakness in legs V: Req w/c for mob; dependent for ADLs; severe weakness in arms and legs VI: Confinded to bed; req assist for ADLs and most self-care
71
Peripheral Neuropathies
Result of trauma, pressure paralysis, forcible over-ext of a joint, hemorrhage into a nerve, exposure to cold or radiation, or ischemic paralysis. Symptoms include pain, weakness, and paresthesias in the distribution of the affected nerve
72
Guillain-Barre Syndrome
a disorder in which the body's immune system attacks part of the peripheral nervous system. Inflammatory disease that causes demyelination of axons in peripheral nerves Etiology unknown; may occur after an infectious disorder, surgery, or immunization Three Phases Onset and Acute: acute weakness occurs in at least two extremeties and advances (20-30% req mechanical ventilation) Plateau: sypmtoms most disabling with little/no change for days-weeks Recovery: starts head/neck moves distally; sig-complete return of func, may have residual fatigue
73
Guillain-Barre Syndrome Symptoms
Rapid progression Pain, fatigue, edema Prickling, "pins and needles" sensations in your fingers, toes, ankles or wrists LE weakness that spreads to UE, can evolve into paralysis Unsteady walking Difficulty with eye or facial movements, including speaking, chewing or swallowing Severe pain that may feel achy or cramp-like and may be worse at night Difficulty with bladder/bowel function Rapid heart rate Low or high blood pressure Difficulty breathing
74
OT TBI Acute Treatment Focus
Sensory stimulation ROM Positioning Splinting
75
OT TBI Rehab Treatment Focus
Regaining func in ADLs, IADLs, executive func skills, and community reintegration

COTA Neurological Disorders and Intervention Approaches (3 decks)

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