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211 exam 1
Other Neuropathic Disorders
| Question | Answer |
|---|---|
| how many types of GBS are there? | 4 |
| 4 types of GBS | AIDP Miller Fischer syndrome Acute motor axonal syndrome Acute motor-sensory axonal syndrome |
| what is the best know acute neuropathy | Guillain Barre Syndrome |
| what is GBS commonly preceded by? | viral or bacterial infection (not always) |
| GBS causes elevated levels of ____ fluid protein | cerebrospinal |
| GBS is Due to an Autoimmune attack on the ____ nerves (demylination) | peripheral |
| ___ nerves may be affected by GBS | cranial (facial and occulomotor most common) |
| Usually follow ____ infections or occur w/o previous illness | respiratory |
| when was GBS first discovered? | 1976 followed vaccination against the swine flu, also other flu shots may trigger it. |
| mild vs severe GBS | Mild ->severe (ventilator) ->Death due to respiratory complications |
| May be life threatening, some improvement occurs in almost all, may be left with some disability. Maximum recovery is ___ years | 2 |
| meds for GBS | plasmaphoresis, immunoglobulin therapy, corticosteroids |
| Permanent weakness has usually resulted from prolonged periods of ____ during the acute phase | hypoxia |
| what 6 things should evaluation for GBS include? | strength tests -proximal weakness most common sensation-paresthesias ROM, balance, coordination, endurance pain -tenderness on pressure over affected muscles mobility tests reflex testing -may also be useful (deep reflexes are usually lost) |
| overwork weakness | overworking a pt with GBS in the early phases can lead to permanent damage to the axons, proceed with exercise carefully |
| GBS precautions | Vigorous strengthening exercises may aggravate the weakness or cause a relapse ***Avoid Overwork weakness!!!! Exhaustive endurance exercises may also cause a relapse Pressure ulcerations Autonomic Dysfunction |
| behavioral issues with GBS | not usually a problem there may be depression secondary to the pts disability, however, they usually get better unlike MS |
| how long does weakness from GBS last? | usually reversible over a period of two months to Two years. |
| If GBS onset is ___, the recovery is quicker. | acute |
| ____ onset recovery is 1-2 yrs and may not fully recover | insidious |
| PT tx for GBS | Temporary Amb. aids- wrap ankle for dflex support. May need knee support Ambulation- Parallel bars->cane/no assistive device Neural Flossing/Nerve Gliding May need UE aids (reacher and hand splints |
| Tightness is prevented/corrected by ___ and ____ | positioning and stretching |
| ____ ____ may be essential during early phases of GB syndrome | Family training |
| home program considerations for GBS | make sure you do not give the patient too much, emphasize pacing and frequent rests |
| why does nerve gliding help decrease pain with movement for GBS pts? | helps the nerve move more freely within the myelin sheath |
| most common and fatal motor neuron disease for adults | ALS |
| ALS involves ___ and ____ motor neurons | upper, lower |
| manifestations of ALS | Flaccidity (LMN) and spasticity (UMN). As the disease progresses UMN signs may decrease |
| bulbar palsy | common with ALS Dysartheria, Dysphagia, drooling |
| onset of ALS | insidious |
| ALS is characterized by | degeneration and scarring of motor neurons |
| what SC cells are lost with ALS? | anterior horn |
| early sign of ALS | tongue and eye fasciculations |
| respiratory impairments from ALS | Fatigue, dyspnea with activity, sighing, morning headache |
| what % of ALS pts have significant cognitive impairments | 40% |
| ____ impairments are rare with ALS | sensory |
| diagnostics for ALS | Genetic Testing EMG Nerve Conduction Velocity testing Nerve and muscle biopsy Presence of LMN and UMN clinical signs |
| prognosis for ALS | Depending onset date but typically 5 year survival rate once diagnosed. Individuals with Bulbar lesions have worse prognosis |
| is there a cure for ALS? | no cure |
| ___ can extend life of ALS pts by three months but many side effects | Rilutek |
| PT evaluation components for ALS | Cognition Psychosocial Pain – Visual analog scale ROM, joint integrity, muscle length Motor performance (MMT, endurance of muscle, Coordination, dexterity) Tone – Modified Ashworth Cranial Nerve assessment – See PTA 105 notes |
| ___ weakness is common with ALS | cervical |
| respiratory assessment for ALS | Cough assessment Forced Vital Capacity – spirometer Aerobic capacity Chest excursions (will need ventilator eventually) |
| PT for ALS in early stages | improving impairment |
| PT for ALS in late stages | preventing contractures, edema, adhesive capsulitis |
| compensatory interventions for ALS | orthoses, w/c, assistive device, etc. |
| early preventative PT for ALS | preventing loss of ROM, slowing progression of decrease aerobic capacity, strength, etc. |
| later preventative PT for ALS | difficult – minimize complications |
| shoulder pain from ALS | adhesive capsulitis and muscle imbalances |
| PT for respiratory weakness from ALS | Caregiver training – quad cough, inspiratory muscle training |
| what can PT provide to help with LE weakness with ALS | AFO's, AD |
| how can PT help with decreased mobility with ALS | Functional training with AD Equip - Easy Pivot, Uplift seat |
| treatment for spasticity and cramps from ALS | Cryotherapy, stretches, positioning |
| is exercise safe for ALS? | Overuse atrophy does not occur with a MMT of 3/5 or greater Moderate exercise can increase grades of 3/5 or greater No heavy eccentric exercise |
| benefits of exercise for ALS | Exercise may produce psych and functional benefits |
Created by:
bdavis53102
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