Prac Viva 2 Flashcards
(28 cards)
Give the pathophysiology of Gullian-Barre Syndrome as well as key features.
Acute autoimmune demyelinating polyneuropathy resulting in flaccid paralysis
Often post-infectious (e.g. Campylobacter)- GI or UTI
Rapid progression of symmetrical weakness, often distal to proximal. LL to UL
What assessments would you use for Gullian Barre Syndrome
Hx- Illness, onset, prior episodes?
Motor- Strenght, reflexes, ROM, functional movements
Sensation- Chart pattern of loss
Respiratory function
Swallowing- IX glossopharageal, X vagus nerve
Fatigue- FSS
Gullian Barre Syndrome- What are some common symptoms and Red Flags? What are some risks and things to look out for?
Symmetrical ascending weakness
Bilateral facial paralysis present in 50%
Flaccid muscle weakness
Red Flags- Swallowing issues, respiratory decline.
Contraindictations- don’t use high resistance, use BP closely during mobility. Pain and hypersensivity. Pressure injury risk
List what you would do for every phase of Gulllian Barre Syndrome
Deterioration Phase- Chest care- suction, postural drainage.
Positioning for wound care
TENS
TEDS
Massage and heat for desensiitation.
Platuea Phase
- Positional change, encourage concentration when ROMing
- Reassurance
-Tilt table for orthostatic tolerance
Recovery Phase
- Hydrotherapy, strengthening, functional activities. Stretches, mobilising, balance reeducation
Avoid over fatiguing muscles, low reps, higher frequency and shorter durations.
Give the pathophysiology of MND as well as key features.
Progressive degenerative disease, demylenating the cortico, brain and spinal motor neurons. Atrophy of muscles. Extracellular gliutamate leans to excittotoxicity and calcium overload. Caused by free redicals and inflammatory cascade.
Survival of 2-5 years post diagnosis.
UMN= spasticity, widespread mm wasting. Hypertonia, hyperreflexia Primitive reflexes checked- globellar tap and babinski.
LMN= shoulder sublux, atrophy of specific muscles, fasiculations. Hypo tonia
Symptoms=Sensory loss, depression, contractures,
What assessments would you use for ALS/MND?
ALS Severity Scale
Functional- DGI, FRAT- Fall Risk Assessment Test, FIM (early stages)
MMT, oedema, pain, posture, Tardiu!
MND- What are some common symptoms and Red Flags? What are some risks and things to look out for?
Avoid letting patient overheat. Increased falls risk, fatigue flare ups.
What are your treatment options through all phases of MND?
Maintain independence
Muscles with < G3, will not improve. Avoid vigorous exercise
Phase 1
Stage 1- Increase activity and flexibility and strenght
Stage 2- Same as above but use of orthotics
Stage 3- Focus on pleasurable activities- Walking, Posture Drainage and Deep Breathing, wheelchair prescription.
Phase 2
Stage 4- Pain reduction, heat and massage
Oedema measures- AROM, Isometric contractions
Stage 5- Mechanical ventilation, family education on turning and transfers
Phase 3
Stage 6- Suctioning, positioning, comfort.
Give the pathophysiology of SCI as well as key features- What are each levels and classifications?
Damage to the spinal cord, and can be caused by trauma, tumours, infections.
A- No S4-S5 sensation (Incontinent)
b- Sensory incomplete- Sensory function below neuro level but not motor
C- Full sensory but 50% of motor less then 3
D- Full sensory and 50% gace greater then 3
What assessments would you use for SCI
ASIA scoriong
What are some common symptoms and red flags for SCI
Orthostatic hypotention, skin intergrity issues, low bone mass.
Autonomic dysreflexia (Above T6)
What are some important milestones for certain injuries to the spine?
C1-C3 needs life support
C6- Use tendonsis
C7- Triceps for moblising
T12-L1- Unsupported sitting
L2- Walking with aids
What are some goals for the training of someone with SCI
Prevent contractures.
Maintain ROM and length
Strengthen preserved muscle groups
Improved sitting tolerance and posture.
What is a central cord sign?
Damage to the coritcospinal and spinthemalic tract- Effects UL more, bladder control, pain and temp and will fade.
Falls- Whats the acronym for history
SPLATT
Symptoms, previous, location, activity, time and trauma
Falls- What assessments?
Neuro- tone, reflexes, proprioception, sensation
Vision- acuity,
Gait/balance- DGI, TUG, step test
LL joint- Strength, ROM
Fallscreen
TBI- What is it?
Road traffic incident, sports, assaults and falls. 3:1 Men to Women
What is Diffuse Axonal Injury (DAI)
Caused usually by rotational forces, high speed acc/dec, widespread shearing of axons. Difference in density between white and grey matter
List some Primary and Secondary Brain injuries
Primary- Skull fracture, contusion and bleeds. DAI
Secondary- Hypoxia, infection, metabolic cascade.
Assessments for TBI
Glasgow Coma Scale. Measures 3-15.
3-8 severe
9-12 moderate
13-15 nil
PTA (Duration of Post Trumatic Amnesia) Length of time to get 12/12 records outcomes 3 days in a row. 5mins very mild, 5-60mins mild, 1-24 hours moderate, 1-7 days severe
In later stages, DGI, HIMAT and CBM (Community Balance and Mobility Scale
TBI- What is Heterotopic Ossification? How does it present?
Formation of bone in soft tissues, usually adjacant to major joints. Common at the hips, shoulders and elbows post severe TBI.
Presents as hot, swollen joint with reduced ROM
TBI- Early management?
TBI- Late Management?
Tight muscles- Seriel casting, stretching
Truncual ataxia- Core stability tasks, alignment when reaching, reaching outside BOS. Swiss ball, kneeling, half kneeling.
PD- What is Dyskinesia?
A writhing movement and its caused by leva-dopa, a side effect of the medication.
