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Neurodegenerative
| Question | Answer |
|---|---|
| Multiple sclerosis | body attacks myelin sheath resulting in scar tissue and plaque further resulting in impaired nerve conduction and inflammation |
| Multiple sclerosis symptoms | motor ataxia, spasticity, weakness, intention tremors sensory paresthesia, vertigo, pain visual deficits diplopa, scotoma, nystagmus slurred and scanned speech cognition, sexual deficits, emotional deficits |
| Phases/Types of MS | Relapse-remitting secondary progressive-- cessation of fluctuations primary progressive--deterioration from beginning progressive relapsing Benign vs malignant |
| MS intervention | goals are compensatory c/i: heat, alcohol, increased emotional or physical stress, overexertion therapy: rest and avoid fatigue, stretch proximal before distal |
| Parkinson's | basal ganglia, substantia nigra depigments with decreased production of dopamine |
| Primary symptoms of Parkinsons | tremor: resting, pill rolling muscuel rigidity/stiffness: cogwheel bradykinesia: slow movements postural instability: stooped psoture, decreasd arm swing |
| Secondary symptoms of Parkinsons | gait, fine motor, freezing, cognition, sensory loss, dysphagia, communication, mood |
| Stages of PD | 1: unilat, resting tremor, no fxl deficit 2: bilat, no balance deficits, trunk mob affected 3: impaired balance 2nd to postural instab, mild/mod dec in fxn 4: decrease in function, impaired mobility, A with ADL poor FMC 5: w/c bed, max A ADL & mob |
| PD intervention | active music therapy Voiding schedule large tip pens heat, stretch, ROM for rigidity antispasticity or progressive splint for contractures Sedentary job with min verbal communication |
| ALS | motor neurons destoryed and replaced with scar tissue--> progressive muscle atrophy DISTAL TO PROXIMAL and asymmetrical, starts with muscle weakness in hands |
| ALS symptoms | dysphagia, spasticity, cramping, fasciculations cognition, sensation, vision, hearing, bowel, bladder intact |
| Stages of ALS | 1: walk, independent, some weakness 2: walk, mod weakness 3: walk, severe weakness 4: w/c, some assist with ADL, weakness in LE 5: w/c, dep for ADL, weakness UE and LE 6: bed, dep for ADL |
| Wheelchair for ALS | high backed, reclining, lightweight, support for head, trunk, extremities |
| Guillian Barre | inflammatory, demyelination of axons in peripheral nerves, symmetrical ascending pattern of flaccid paralysis begins in feet |
| GBS symptoms | pain, fatigue, edema, sensory loss in hands and feet dysfunction of CN, ANS |
| GBS stages | 1: onset and acute inflammatory: 2-4 weeks 2: plateau: most debilitating up to 2 years 3: recovery: remyelination and axonal regeneration, fatigue residual sx |
| Huntingtons | hereditary, progressive loss of nerve cells in the brain |
| HD symptoms | motor: chorea, akathisia, dystonia, bradykinesia, akinesia, ataxia cognitive, dyshpagia, slow eye movements Later stages unable to walk, talk, BADL |
| Alzheimer's | cortical atrophy, accumulation of amyloid tau protein |
| Alzheimers symptoms | progressive impairment of memory, executive function, attention, language, praxis, visual process |
| Vascular dementia | TIA's, less memory involvement than AD, abrupt decline |
| Frontotemporal dementia | progressive aphasia, corticalbasal syndrome, symptoms similar to AD or PD immediate distinct onset, progressive |
| Lewy Body dementia | protein in limbic or neocortical, decrease in ach and dopamine ex fxn, attention, memory, visuospatial --> aphasia, apraxia, spatial disorientation |
| Stages of dementia | early: IADL affected middle: no longer live alone, neglect ADL/IADL later: dep in ADL, no longer ambulate safely, communication lost |
| paratonia | involuntary resistance to passive movement of extremity |
| hyperflexia | overflexion of limb |
| agnosia | inability to interpret sensations or recognize them |
| chorea | rapid, involuntary, irregular movements |
| akathisia | motor restlessness |
| dystonia | abnormal, sustained posturing |
| akinesia | delayed initiation of movement, impaired voluntary and spontaneous movement initiation resulting in freezing, during walking esp. |
| dysmetria | decreased coordination |
| fasciculation | involuntary muscle contraction and relaxation, muscle twitch |
| festinating gait | small rapid steps resulting from a forward tiled head and trunk posture |
| paresthesia | numbness and tingling because of sensory nerve changes |
| Allen Level 6 | Planned actions, independent, no disability |
| Allen Level 5 | Exploratory actions, supervision for cognitive assist visible, concrete, meaningful stimuli w/ external cuing trial & error problem solving follow 4-5 step process & learn new concrete ideas diff with jdugment, reasoning, planning, semantic & episodic |
| Allen Level 4 | Goal directed activity, min cognitive assist attention directed to visual/ tactile cues understands cause& effect, cant problem solve 2-3 step activities, labels/pics task set up for bathing and grooming eat I, assist for amt wandering, 24 hr sup |
| Allen Level 3 | manual actions, mod cog assist attention to tactile cues 1-step familiar and action oriented activity cannot learn new behaviors routine, avoid sensory overload during grooming/bathing, items presented 1 at a time |
| Allen Level 2 | postural actions, max cog assist highly disorganized thinking, internal cues one step, imitated, reflexive, familiar and gross motor ADL by imitating caregiver spontaneous behaviors, eat finger foods, paces, wanders, clock void |
| Allen Level 1 | automatic, total cog assist attention subliminal internal cues 1 word, near reflexive directions monitoring for nutrition assist with ambulation and transfers, dep for ADL |
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10212468994420890
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