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The Nervous System: Pathology > Rehabilitation in neurology > Flashcards

Rehabilitation in neurology Flashcards

1
Q

Who needs rehabilitation

A

Those with

-Impairment

-Disability (activity limitation)
or

-Handicap (Participation restriction)

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2
Q

What is the definition of handicap

A

Problems individual may have in involvement in life situations

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3
Q

what is the definition of impairment

A

Problems in body function or structure such as a significant deviation or loss

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4
Q

What is the definition of disability

A

Difficulties an individual may have in executing activities

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5
Q

Define rehabilitation

A

The restoration of patients to their fullest physical, mental and social capability

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6
Q

What is the conceptual definition of rehabilitation

A

A process of active change by which a person who has become disabled acquires the knowledge and skills needed for optimal physical, psychological and social function

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7
Q

What is the service definition of rehabilitation

A

The use of all means to minimise the impact of disabling conditions and to assist people with activity limitation to achieve their desired level of autonomy and participation in society

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8
Q

What is the definition of rehabilitation medicine

A

The specialty of Medicine involved with the prevention and reduction of activity limitation and participation arising from impairments, and the management of disability from a physical, psychosocial and vocational point of view.

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9
Q

What is the definition of long term neurological condition

A

Disease of, injury or damage to the nervous system which will affect the individual and their family in one way or another for the rest of their life

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10
Q

What are sudden onset if long tern neurological conditions

A

Acquired brain injury
spinal cord injury
stroke

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11
Q

What are intermittent/ unpredictable long term neurological conditions

A

Epilepsy

Early multiple sclerosis

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12
Q

What are progressive long term neurological conditions

A

Motor Neurone Disease

Parkinson’s disease

Later stages of Multiple Sclerosis

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13
Q

What are stable long term neurological conditions

A

Post-polio syndrome

Cerebral palsy in adults

Spina bifida in adolescence/adults

{Changing needs due to development or ageing}

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14
Q

What are other long term neurological conditions

A

Guillain Barre Syndrome

Muscle diseases (e.g. myotonic dystrophy)

Hereditary spastic paraparesis

Huntington’s disease

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15
Q

What are physical problems experience from long term neurological conditions

A

Weakness (hemiparesis/paraparesis)

Loss of / abnormal sensation

Increased or decreased tone / spasticity

Visual disturbance, e.g. homonymous hemianopia

Loss of hearing

Loss of smell and taste

Swallowing and communication difficulties

Bladder and bowel difficulties

Pain Syndrome

Seizures / Epilepsy

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16
Q

What are cognitive problems after brain injury

A

Post-traumatic amnesia

Confusion / disorientation

Severe memory problems (especially with recent events / working memory)

Poor concentration/ attention

Slowed thinking

Poor “executive functioning”

17
Q

What is psychiatric / behavioural problems after brain injury

A

Depression

Anxiety

Personality change

Irritability

“Childishness, selfishness, laziness”

Behavioural problems, including aggression disinhibition, apathy

18
Q

What is assessed in rehabilitation

A

History and Examination

Mobility

Activities of Daily living

Mood and Cognition

Bladder and bowels

Communication and swallow

Skin, Vision and hearing

19
Q

What is the process of rehabilitation

A

Problem lists

Set Goals (SMART)

Identify barrier issues

Formulate management
plan

Draw upon all relevant disciplines

Involve patient (family/carers)

20
Q

When is rehabilitation most effect

A

When delivered by a coordinated multidisciplinary team

21
Q

What is spasticity

A

Motor disorder characterised by a velocity dependent increase in tonic stretch reflexes with exaggerated tendon jerks

22
Q

What is the pathology of spasticity

A

Disordered sensorimotor control due to an upper motor neurone syndrome (UMN) lesion, presenting as intermittent or sustained involuntary activation of muscles

eg stroke, spinal cord injury, traumatic brain injury

23
Q

What is the complications of spasticity

A

Poor seating and lying positions

Sleep difficulties and fatigue

Dressing and hygiene issues

Pain, spasms and associated reactions

Communication and feeding problems

Pressure sores and contracture

Poor self-image and relationship issues

24
Q

Define Contracture

A

a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints

25
Q

What is the management of spasticity

A

Multidisciplinary team approach

Physical therapy

Exclude exacerbating factors

Oral antispasticity agents

Focal treatment with Botulinum toxin

26
Q

Where does rehabilitation take place

A

Acute hospital

Rehabilitation ward

Outpatient centre

Community facilities, e.g. local sports hall

Vocational rehabilitation service

In the patient’s home

27
Q

What is the benefits of rehabilitation

A

Greater independence

Greater chance of getting home or remaining at home

Increased comfort and dignity

Increased chance of remaining in / returning to work

Improved quality of life

Reduced need for care / assistance

28
Q

What secondary complication can rehabilitation prevent

A

Pressure sores

Chest infections

Deep venous thrombosis

Malnutrition

Constipation

Musculoskeletal pain

Contractures

Low morale and depression

29
Q

What social complications can rehabilitation prevent

A

relationship and family breakdown,

childcare issues,

unemployment,

social isolation

30
Q

What is different classification of acquired brain injury

A

Head injury (traumatic brain injury)

Haemorrhagic (e.g. SAH)

Hypoxic / Anoxic (e.g. out of hospital cardiac arrest

Metabolic (e.g. hypoglycaemic)

Infective (meningitis, encephalitis)

31
Q

What are important predictors to the severity of head injury

A

GCS,

length of loss of consciousness

post-traumatic amnesia

32
Q

What is signs of a sever head injury

A

GCS 3-8

PTA 1-7 days

33
Q

What is signs of a moderate head injury

A

GCS 9-12

PTA 1-24 hours

34
Q

What is signs of mild head injury

A

GCS 13-15

PTA less than 1 hour

35
Q

What are other specialties that must be accessible in rehabilitation

A

Spasticity management services

Wheelchair and seating services

Continence service

Sexual / relationship counselling

Vocational rehabilitation

Orthotics

Driving assessment
service

Assessment service for people in low awareness states

Pain management

Neuro psychiatry / clinical psychology

National behavioural management service

National ABI service in Edinburgh

Carers centre

Brain injury group / Headway

The Nervous System: Pathology (25 decks)

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