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OCCTH554
Neuro Rehab
| Question | Answer |
|---|---|
| What does the timed-up-and-go test measure? | Fall risk, Ability to stand, and walk |
| What does the FIM measure? | Functional independence, level of service, physical and cognitive health |
| What does the FAM measure? | Function, physical, cognitive, affective health, community integration, employability |
| What does the Tinetti measure? | Balance sitting and standing |
| What does the Berg Balance test? | Degree of balance while performing activity |
| What does the Asworth measure? | Tone/Spacticity |
| What are the parts to a neurological exam? | 1. Client hx 2. Gait/Balance 3. Vision 4. sensation 5. motor control 6. Hearing |
| What are teh parts to the cranial nerve exam? | 1.Client interview and general inspection 2.Olfactory 3. Vision 4. Sensation 5. Motor control 6. Hearing 7. Feeding/swallow 8. Elevation |
| What cranial nerves are responsible for vision? | The second, third, fourth and sixth nerve |
| What cranial nerve controls facial sensation and mastication? | The 5th cranial nerve, trigeminal |
| What nerve is responsible motor control? | the 7th |
| What nerve controls hearing? | The 8th |
| What nerves are responsible for feeding/swallowing? | 9th, 10th, 12th |
| What nerve controls the trapezius? | The 11th |
| What does the Barthel Index measure? | Measure function, muscular control, mobility, ADLs( including bowel/bladder control) |
| What is a Traumatic Brain Injury (TBI)? What are the two types of TBI? | Non congenital, non degenerative injury Focal and Multi-focal |
| What two injuries to the covering of the brain can cause Traumatic Brain injury? | Epidural Hematoma-damage menigeal arteries in dura matter Subdural Hematoma-damage between arachnoid and duramater |
| What are the three types of multifocal brain injury? | Intercerebral hemorrage- Midbrain, btwn white and grey matter Subarachnoid/Intraventricular hemorrage-tearing of membrane Diffused axonal Injury-shearing of nerves, causes coma |
| What four assessments are used to determine the severity of a brain injury? | Glasgow Coma Scale (GCS) Disability Rating Scale (DRS) Rancho Los Amigos Level of Cognitive Functioning Scale (LCFS) Galveston Orientation and Amnesia Test (GOAT) |
| What does the Glasgow Coma Scale (GCS) measure? | Degree of conciousness |
| What does the Disability Rating Scale (DRS) measure? | Arousal Cognitive ability independence social skills |
| What is the Ranchos Los Amigos (LCFS) used for? | Arousal, Sensation, Emotion, Awareness and cognitive function |
| What is the Goat used for? | Orientation to self and enviroment |
| What is looked for in the motor assessment? | Spacticity/tone,Primitive reflexes, Ataxia, Muscle strength, ROM, Endurance, Sensation |
| What is a symptom of damage to the midbrain vs the basal ganglia? | Impairment of righting reactions vs. equalibrium reactions |
| Difficulty coordinating smooth movement is what? | Ataxia, due to cerebellar or ascending motor pathway damage |
| What are the most persistent and hard to treat result of TBI? | Cognitive and Behavioral deficits |
| What cognitive processes might be effected by a stroke? | Memory, Executive Function, Attention, perceptual function and vision problems |
| What psychosocial skills maybe effected by TBI? | Self concept, Social roles, Affect, Independence |
| What 3 processes make up cognition? | Attention processes, Executive processes, Memory processes |
| What two areas of the brain help form new memories? | The hippocampus and the medial temporal lobe |
| What kind of memory, helps remember to do future tasks? | Prospective memory |
| What is the awareness of your own memory and abilities called? | Metamemory |
| What parts of the brain are responsible for declarative memory? | Medial temporal lobe, Hippocampus, Frontal lobe, Parietal lobe |
| What parts of the brain is responsible for procedural, skills and habits memory? | Striatum |
| What part of the brain is responsible for emotion and emotional memory? | The amygdala |
| What part of the brain is responsible for skeletal/motor skill memory? | Cerebellum |
| What does the Rivermead assessment measure? | Memory skills related to everyday life |
| What are ways to compensate for memory impairment? | Compensatory devices(electronic reminder), Behavoral Remediation (simple tasks), Memory training (mnemonics) |
| What is exectutive function and where will damage be most noticable? | Intitation, Planning, preparation, organization(, Sequencing, proplem solving In AIDL task |
| What parts of the brain are responsible for executive function? | The Obitofrontal cortex, Dorsal lateral prefrontal cortex, Frontal lobe |
| Damage to the Orbitofrontal cortex would cause what kind of behavior? | Disinhibition, inapropriate behavior, |
| Damage to the Doralateral prefrontal cortex would cause what behavior? | Decreased planning, attention, self awarness |
| Damage to the medial frontal lobe will cause what symptoms? | Apathy, Blunt Affect |
| What does the Dysexecutive Questionaire? | Self report of Executive function impairment |
| What does the BRIEFA (Behavior Rating Invetory of Executive Funtion measure? | Test of Executive Function |
| What does the Multiple errands test measure? | Executive function- funtionally perform a series of tasks in the most efficient way |
| What are 4 interventions for Dysexecutive function? | Task specific training, Metacognition-self awareness of abilities, Processes training-work on mental skills,Compensatory-cuing devices Environmental adaptation |
| Damage two what 2 areas of the brain will cause attention deficits? | The frontal lobe, The reticular activating system` |
| What are the 5 types of attention? | Selective Attention (focus) Sustained Attention Alternating Attention (switch) Divided attention (more than 1 task) |
| What are 3 tests of attention? | Test of Every Day Attention -function Moss Attention rating scale-observed Cognitive failure Questionnaire-self report |
| What 3 interventions for attention? | Attention Process Training-focus with distractors Training specific functional skills Compensatory techniques incl. enviroment modification |
| What are the two visual streams responsible for? | Dorsal/parietal stream- spacial orientation and location Ventral-temporal stream-object recognition |
| What is the frontal eye field responsible for? | decision making, planning ahead, emotional tone |
| What is hemi-inattention/neglect? | Damage a hemisphere causes ignorance of the opposite visual field |
| What assessment is used to detect spacial neglect/hem-inattention? | Any task to recognize right and left or two sides. |
| What interventions can be used for hemi-innattention? | Searching games, Trained scanning left to right Opposite visual occlusion |
| A lesion to one optic nerve will cause what symptom? | Monocular (one eye) Blindness |
| A lesion to the optic chiasm will cause what symptom? | Bi temporal Hemianopia (peripheral blindness) |
| A lesion to one side of the occipital lobe will cause what? | Contralateral Homonymous hemianopia (loss of one side of vision) |
| What are the two types of Traumatic Spinal cord injury? | Tetraplegia- deficits in all four limbs Paraplegia- damage in thoracic or lower |
| What is spinal shock? | Acute symptoms of High BP and low reflexes below spinal injury |
| What is Neurological shock? | Low BP, Bradycardia, in spinal injury about t6 |
| What is autonomic dysreflexia? | Low BP, Impaired cardiac control, after spinal cord injury |
| What is central cord syndrome? | Weaker upper extremities than lower extremities |
| Damage to the middle of the spinal cord where interneurons cross will cause what? | Brown-Sequard syndrom ipsilateral (same side) motor and proprioception loss Contralateral (opposite side) sensory loss |
| Damage to the anterior spinal vs posterior spinal artery artery can cause what ? | anterior- Loss of motor function and pain posterior-just loss of proprioception |
| Injury to the sacral and lumbar spine may cause what? | May have bowel and bladder dysfunction but still have muscular reflexes |
| What are the cardinal features of Parkinsons? | TRAP tremor, rigidity, akinesia/bradykinesia, Postural instability |
| What is parkinsons tremor? | a resting tremor, |
| What is pakinsons rigidity? | resistance to passive stretch and flexion |
| What is parkinsons Bradykinesia? | Slow movement and swallowing, drooling |
| What is parkinsons Akinesia? | Lack of movement/trouble initiating Low affect Aminina-lack of blinking (dry eyes) |
| What is parkinsons micrographia? | Movements that get smaller |
| What 7 parkinsons posture or gait movements? | Short suffling gait, stooped posture, leg draging, low arm swing, hesitancy, freezing, wide turning |
| What are 3 common non TRAP parkinsons features? | Sialorrhea (excess salivation), Depression, Cognitive difficulties. |
| What are common OT assessments? | ADLs, Strength and ROM, Balance, Ambulation, Coordination |
| What assessments are common? | Fatigue, Sleep, Cognition, Depression, Quality of life |
| What are the general treatments for parkinsons? | Stretching, Use of non effected limbs Work on positioning and splinting Mental exercise Energy conservation Enviroment management Relaxation Adaptive equipment Pain managment |
| What part of the nervous system is implicated in parkinsons? | The dendritic spines in the basal ganglion, ALFA SYNUCLIEN aggregages, Lewy body formation, and dopamine accumulation (all associated with recycling cell) |
| Then side effects of parkinson medication are what? | Aggression, nausea, blurred vision |
| What adaptive equipment is useful for parkinsons feeding? | Built up handles, rocker knifes, weighted utensiles, scoop trays |
| What adaptive equipment is useful for dressing and bathing with parkinsons? | Long handled reachers and scrubs, Elastic/Velco, Sock aid |
| What adaptive equipment can be used for Housekeeping and meal prep? | Dycem to prevent slipping, trays |
| What adaptive equipment might help with electronics? | Handsfree Devices |
| What treatment for walking is common for parkinsons? | Visual or auditory cues, Reduce distraction, Large movements, Counting |
| What kind of foods may be benificial in parkinsons? | Moist, wet, soft foods to prevent dehydration |
| What kind of treatments may be useful for cognition? | Reminders, limit steps, allowing extra time, mnenomics. |
| What is MS? | autoimmune disorder, attack oligodendrocites/myelin, |
| What thermal modality may worsten symptoms? | Heat, beware of anything raising body temp. like exercise |
| What are the symptoms of MS? | They vary include include affect, effective and processing. Abnormal nerve reflex, Decreased ability to coordinate, Changes in sensation, Loss of neural function |
| What are the complications of MS | Difficulty thinking Swallowing Fatigue Depression -esp after medication Disuse problems Ulcers Immune problems |
| What is a stroke? | Interuption of the blood flow to the brain |
| What are the five main warning sighns of stroke? | Vision problems Weakness Trouble speaking Headaches Dizziness |
| What are the two types of stroke? | Ischemic blood clot Hemorragic rumpture of vessle |
| What are the features of an ischemic stroke? | Edema Core region death Peripheral Blockage temporary dysfunction |
| What are the three types of Ischemic stroke? | Thrombosis, Embolism, Lacunar |
| What is a Thrombotic stroke? | 2/3rd occlusion occlusion, |
| What are the symptoms of a thromosis? | At rest, numbness |
| What is an embolism stroke? | Blood clot traveling from another part of the body, greater danger with increase BP & HR |
| What is Lacunar stroke? | Deep brain structures, affects only muscular recruitment or sensation |
| What is a hemoragic stroke? | weakening of blood vessel causeing and aneurysm-out pouch. |
| What are two types of hemoragic stroke? | Intracerebral Hemorrhage- Bleeding into brain Danger of anticoagulants Subarachnoid hemorrhage into the CSF-pressure |
| What are the signs and symptoms of intracerebral hemmorage? | Headache Vomiting Convulsions Stupor |
| What are a sign of a subarachnoid hemorrhage? | Sever headache, vomiting, Stupor. |
| What are complications of stroke? | Seizures, Infections, clot formantion |
| What is the circle of Willis? | Arteries that rise arount the midbrain and brain stem |
| What artery most often has stroke? | The middle cerebral artery, Motor control |
| If the middle arterial artery is affected, what will be affected? | Visual field, Emotion, Aphasia |
| What is stroke of the anterior cerebral artery responsible for? | Speech problems |
| What is stroke of the posterior cerebral artery responsible for? | Memory impairment and agnosia |
| What assessment would be used to determine impariment from a stroke? | COPM, ADL (FIM, Barthel), Physical asessment |
| What is the Chedoke-McMaster used for? | Assessment of physical impairment, and function |
| What is the PASS Performance Assessment of Self Care used for? | ADL, and IADL function |
| What are the implications of a Right Hemisphere stroke? | Left sided neglect, Emotional Libility, Impulsivity |
| What is AMPS Assessment of Motor and Process Skills? | AIDL fuction |
| What impairments will a left hemisphere stroke suffer? | Language, voluntary movement |
| What are the three treatment approaches for dealing with stroke? | Adaptive appoach-compensatory devices Remedial approach-restorative/functional tasks Combination/ |
| What is Neurodevelopmental therapy (NDT)? | Relearn normal patterns, encourage both side use. |
| What are the 4 common motor symptoms of a stroke? | Hemiplegia, Hemiparesis, Primitive reflex, Loss of higher function |
| What affect will a Lacunar Infarct have? | Dysarthria-clumsiness, Dyphasia-difficulty swallowing |
| What are the 4 types of Neurodevelopment therapy? | Rood approach Brunnstrom Proprioceptive Neuromuscular Facilitation PNF Bobath |
| What to Rood, Brunnstrom and PNF have incommon? | Use of development posture progression and sensory activation |
| What is neuro inhibition? | decrease tone by deep pressure over the tendon |
| What is neuro facilitation? | tapping over the muscle belly to increase tone |
| What effect will a Brainstem infarct have? | Diverse, Paralysis, Vertigo, Nausea, Diverse |
| What theory is behind Brunnstrom? | There are stages of recovery from flaccticity to rigidity to normal through 7 stages |
| What theory is behind PNF? | Large gross movements |
| What is the theory behind Bobath technique? | Applying positioning and weightbearing, and use functional tasks. |
| What is the main symptom of ALS? | Amyotrophy-muscle wasting, fatal, progressive |
| What neurons are affected by ALS? | Upper and lower motor neuorns: coriticospinal tract, brainstem, anterior spinal cord, basal ganglian, cerebellum, |
| What are the components of the Upper motor track? | Basal ganglia, Cerebellum |
| What is the progressive path of ALS? | Loss of control small muscles of hands and feet, loss of large muscle movement, Difficulty speaking and swallowing, loss of emotional and temp. control. |
| Loss of the cranial spinal tract would cause what? | Loss of motor control, posture |
| Loss of the corticobulbar tract would cause? | loss of facial, jaw and swallowing |
| Loss of the colliculospinal tract would cause what? | involuntary head response to the visual information |
| Loss of the rubrospinal tract would cause what? | Involuntary body righting response |
| What are the three subtypes of ALS? | |
| What are generic signs and symptoms of ALS? | Weak hands, asymmetrical foot drop, cramping, proxression distal to proximal |
| What are functional presentations of ALS? | slurred speech, fatigue, emotions, dropping things |
| What is the expected lifespan of someone with ALS? | 3 years |
| What are the primary goals of OT with ALS? What is contra-indicated? | function, planning Muscle training, decreased respiration |
| What assessments would you use with ALS? | Strength, ROM, balance, function, psychosocial, Leisure, Roles, Productivity |
| What are the 3 phases of ALS? | 1. Independent, 2 partially independent 3 Dependent |
| In phase 1 what are the main goals? | Energy conservation, ROM, Safety, Adaptive Equiment, planning for the future |
| In phase 2 what are the main goals? | Homecare and support for the family, Electric control of devices |
| In phase 3 what are the main goal? | Comfort/pallative care, communication |
| What is the main characteristic of Muscular Dystophy? | Degeneration of the muscle |
| What is the historical difference in the perception of the neuro development? | People progress in a predicatable manner, vs. complex interaction with enviroment |
| What is the traditional neuro development belief for the motor system? | Gross to fine |
| What is the traditional neuro development belief for the sensory system? | Gross sensation to fine descrimination, increase in perceptual difficulties |
| What is the traditional neuro development belief for the cognitive development? | Simple concepts to complex ideas |
| What is the traditional neuro development belief for the socail? | Simple concepts of roles to complex flexible roles and empathy |
| What was Rood's contribution to OT? | Sensory to facilitate or inhibit motor control, Inhibit:deep pressure, rocking, heat, Facilitation: Brushing, icing, stretch, tap, vibration, joint compression, vestibular |
| What is the goal of Rood's therapy? | purposeful, goal directed movmenents |
| What was Bobath's contribution to OT? | Inhibitor approach using proprioception, refex patterns, reactions, use both sides, check muscle tone |
Created by:
swcherry
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