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MS Test 3

Ind Study, Case studies

migraine S&S before pn: flashing lights, intolerance to light (photophobia), ringing or buzzing in ears (tinnitus),unusual thirst, craving for sweet foods, unusual energy peaks, and alterations in mood and mental clarity. once pn begins, usually w/nausea, vomiting
migraine etiology foods: chocolate, aged cheese, red wine, caffeine & monosodium glutamate. hormonal changes in women, sensory stimuli, odors, changes in wx & medications
migraines are... changes in the cerebral blood flow, presumable due to vasoconstriction & subsequent vasodilation of cerebrocranial arterioles
most common type of HA tension
tension headache triggered by stress, resulting in mm tension, esp suboccipital mm's. contributing factors: fwd head posture, work @ desk
PT rx includes: modalities, posture training, stretch pecs, strengthen back ext, massage, deep breathing, work ergonomics
enchephalitis is... a viral infection of gray matter of the brain (often transmitted by vector mode, ticks)
symptoms of encephalitis are similar to... meningitis
enchephalitis dx CT, MRI
enchephalitis rx is primarily... supportive & preventative
enchephalitis prognosis residual neurological problems are most likely with infants
PPS is... PostPolio syndrome, loss of ant horn cells of giant motor units due to normal aging (its faster with PPS)
S&S of PPS fatigue, new weakness, overuse & high energy cost, decreased function & deconditioning
if there is infantile paralysis w/ PPS may have collateral sprouting w/recovery of giant motor units
PPS rx lifestyle change, maybe AD or orthotics, jt protection, work modification, energy conservation, power WC, ex @ submax level, aerobics w/ decreased RPE
seizure finite event, the result of paroxymal excess discharge of cerebral neurons resulting in temp impairment or LOC
epilepsy chronic disorder of various causes characterized by recurrent sz
types of seizures generalized absence (aka Petit Mal), tonic-clonic (aka Grand Mal), infantile spasms, febrile convulsions
generalized absence (aka Petit Mal) sudden cessation of ongoing consciousness, staring into space
tonic-clonic (aka Grand Mal) 2 phases: a rigidity phase (tonic) followed by rapid jerking (tonic) of the whole body. often followed by LOC, falls/injuries w/ onset possible
infantile spasms non-specific rx on the part of the brain, associated with cessation of psychological development
febrile convulsions seizures resulting from high fever, between ages 6 mos-5 yrs
seizure dx EEG
seizure rx meds: phenobarbatol, dilantinin... and clear the area
etiology of meningitis mainly bacterial & viral
bacterial meningitis includes... inflammation & infection
rx for viral meningitis treat symptoms
rx for bacterial meningitis antibiotics- on isolation
some results of meningitis neuro damage, hearing loss, retardation & sz
Guillain-Barre Syndrome most frequent cause of acute generalized weakness due to a lower motor lesion
3 forms of Guillain-Barre Syndrome acquired inflammatory demyelinating polyradiculoneuropathy (AIDP), acute axonal neuropathy (AMAN) & Miller Fisher syndrom
acute phase of Guillain-Barre Syndrome symmetrical ascending progressive loss of motor function beginning distally and progresses proximally, 80% experience paresthesia, 70% areflexia, 60% wkness in all limbs, lasts 4 weeks
plateau phase of Guillain-Barre Syndrome stabilization of symptoms, 4 wks
recovery phase of Guillain-Barre Syndrome begins to improve, can last up to a year
initial/chief complaint of Guillain-Barre Syndrome respiratory or gastrointestinal illness, followed by weakness & sensory changes
dx tests for Guillain-Barre Syndrome electromyogram (EMG), NCV, spinal tap (lumbar puncture)
mental status w/Guillain-Barre Syndrome fearful, anxious
pain w/Guillain-Barre Syndrome muscular in nature, sore to touch
appearance w/Guillain-Barre Syndrome flaccid paralysis, bilateral facial wkness
sensation w/Guillain-Barre Syndrome paresthesias (burning/tingling) or hypesthesia (abnormal sensitivity to touch)
jt mob/ROM w/Guillain-Barre Syndrome decreased
strength w/Guillain-Barre Syndrome acute generalized wkness, diplopia (double vision) from eye mm wkness, facial wkness, diaphragm wkness
mm tone/reflexes w/Guillain-Barre Syndrome absent, areflexia is a core feature
cardiopulmonary w/Guillain-Barre Syndrome fluctuating BP, poor venous return, (causes blood pooling), tachycardia, arrythmias, ventilator
balance/coordination w/Guillain-Barre Syndrome fall risk due to decreased strength & eventual paralysis
functional mob w/Guillain-Barre Syndrome acclamation to upright
gait w/Guillain-Barre Syndrome ataxia, paralysis, none
ADL/Functional Assessment w/Guillain-Barre Syndrome oral motor wkness, dysphasia, dysarthria
rx for Guillain-Barre Syndrome pain meds aren't always effective, plasmaphersis (blood removed & only blood celss removed, no plasma), infusion of immunoglobins
prognosis for Guillain-Barre Syndrome good, over 80% recover in a year- safeguard the musculoskeletal and cardiopulmonary systems and improve function without causing overuse damage
problem list for Guillain-Barre Syndrome skin, breakdown, contractures, pulmonary function, intolerance to upright, decreased strength
precautions/contras Guillain-Barre Syndrome avoid overwork wkness, extra care when performing ROM because of damaged mm
how does osteomyelitis get to the bone directly thru wound or blood carries to bone
pn w/osteomyelitis doesn't develop until infection has gotten to periosteum, is deep, trobbing, constant ache, even @ rest & @ night, worse w/ mvmt & WB
dx osteomyelitis MRI & bone scan
meds osteomyelitis IV antibiotics for 3-4 wks
dx test osteoporosis DXA (dual x-ray absorptioniometry- measure bone mineral density before fx), QUS (quantitative US), CT, RA, bone density test, biochemical markers for bone turnover
osteoporosis meds Biophosphanates (fosamax, actonel, boniva
osteoporosis precautions/contras flexion ex & eval or rx w/pressure techniques on thorax
PMH septic knee HIV, DM, preexisting arthritis, IV drug abuse, trauma to jt
septic knee dx arthrocentesis (aspiration of jt fluid), WBC, PE, MRI, ESR (erythrocyte sedimentation rate)
septic knee posture increased varus or valgus in knee (common in children)
septic knee med rx IV antibiotics in hospital, oral antibiotics 2-3 wks after hospital stay, tidal irrigation, arthroscopy, or arthrotomy
septic knee precautions/contras modalities that can't be used during infection phase, overuse of jt in early stages
septic knee PT course in acute phase-rest & splint to prevent infection from getting worse. once infection has cleared use more vigorous ex to restore functional mob, strength & stability
2 routes infection can enter the hip 1)hematogenous: bacterium may occur from dentogingival infections, pyogenic skin processes & genitourinary or GI infections. 2) direct implantation during sx 60%
infected THA PMH DM, RA, previous sx @ hip, poor nutritional status, obese, low albumin, comorbities, suppressed immune system
infected THA dx arthrocentesis (aspiration of jt fluid) main one
infected THA medical rx 6 wk IV antibiotic after new jt replacement (or lifelong antibiotics if no add't sx), sx drainage, prosthesis removal followed by surgical debridement of surrounding tissue & replacement of new prosthesis impregnated w/antibiotics
infected THA precautions/contras US, HP, compression, massage, AROM w/pn. also keep universal hip replacement precautions in mind
fibromyalgia chronic mm pn syndrome; not a dx; auspice of rheumatology; possibly associated w/neurohormonal dysfunction of the ANS; most common musculoskeletal disorder in US
fibromyalgia PMH prolonged anxiety, emotional stress, trauma, hypothyroidism, viral or nonviral infections, ruptured silicone breast implants
fibromyalgia dx no definitive test. if pn is widespread in 4 quadrants above & below the waist for at least 3 months & 2 reports of pn when pressure applied to 11-18 common tender pts on body sometimes using dolorimeter, r/o other conditions
fibromyalgia medical rx analgesics, antidepressants, metabolic rehab (triodothyroine, T3)
fibromyalgia precautions/contras intense ex, overuse of mm relaxers, heavy lifting, stress
fibromyalgia is associated w/ decreased mob in AM, Reynauld's phenomenon
ALS (amyotrophic lateral sclerosis) or Lou Gehrig disease most common form of adult-onset progressive motor neuron dx affecting the ant horn cells & corticospinal tracts. characterized by degeneration & scarring of upper &/or lower motor neurons in lat aspect of spinal cord, brain stem, & cerebral cortex
initial/chief complaint ALS or Lou Gehrig disease involuntary mm contr & mm atrophy, wkness, twitching (esp in extremities), probs w/speech, chewing, swallowing, breathing
PMH ALS or Lou Gehrig disease 90% idiopathic. 10% autosomal inherited traits
dx tests ALS or Lou Gehrig disease combination of clinical presentation & electromyogram (EMG), nerve conduction test, mm biopsy, MRI to r/o other dx
ALS or Lou Gehrig disease is associated w/ drooping head, decreased strength of ext mm in UE & flex mm in LE, asymmetric wk in distal aspect of 1 limb progressing to wk of contiguous mm, dorsiflex lost before plantarflex, + Babinski, Clonus & Hoffman
ALS or Lou Gehrig disease medical rx no effective rx, just rx symptoms. Riluzole (Rilutek)slows dx by 10-15%. myotrophin promotes survival of motor neurons & regenration of motor nerves. Vit E controls free rads. anticholinergic drugs for drooling. baclofen or diazepam for spasticity
ALS or Lou Gehrig disease prognosis death usually occurs 2-10 yrs after onset, resulting mainly from pneumonia or respiratory failure. relentlessly progressive
ALS or Lou Gehrig disease precautions/contras don't overwork or fatigue, rotate shd during ABD & accessory motions (subluxation of shd), watch for feeding tube w/gt belt
multiple sclerosis chronic, autoimmune, progressive & irreversible dx characterized by destruction of the lipid & protein layer, the myelin sheath, that insulates & protects the axons of certain nerve cells. the demyelination process occurs at scattered sites
multiple sclerosis initial/chief complaint varies due to the scattered sites of dymyelination thru-out the CNS may include sudden & transient motor & sensory disturbances, impaired or total loss of vision, mm wkness, paralysis, incontinence, fatigue, balance probs, numbness & mood swings
multiple sclerosis PMH genetics have been linked to MS, along w/acute infection, trauma, serum injections, pregnancy, stress & fever
multiple sclerosis dx tests no definitive test, MRI(MOST USED) r/o other possibilities w/ neurological exam, CSF analysis & cranial CT scan
multiple sclerosis is associated w/ exacerbations, cognitive deficit, pn, tremors, poor tolerance to heat, ataxia, spastic mm, overshooting targets, ataxic & antalgic gt, eventual loss of bowel & bladder, ability to speak & swallow,
multiple sclerosis meds interferon-beta products are injected to reduce # of exacerbations & slow progress of physical disability. avonex (taken wkly), betaseron (every other day),rebif (3x wk), copaxone (daily orally) to decrease inflammation, corticosteroids
multiple sclerosis precautions/contras no HP, only low to mod intensity ex, avoid overwork, avoid overheating
alzheimer's disease most common form of dementia, type of progressive, chronic, ultimately fatal organic brain syndrome characterized by the death of neurons in the cerebral cortex w/resultant neurofibrillary tangles, a tangled mass of nonfunctioning neurons & plaques
alzheimer's disease dx comprehensive hx & PE that includes mental & functional health status, cranial CT & MRI, PET scan, depression scale & cognitive functioning test, lab tests of urine & blood, EEG, SPECT (single proton emission tomography)
alzheimer's disease is associated w/ sundowner's, agression, rigidity, decreased ability to do ADL's
alzheimer's disease med rx 1)cholinesterase inhibitors 2)memantine, regulates glutamate 3)tacrine & donepezil to control symptoms 4) anti-inflammatories
Created by: jessigirrl4



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