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OCCTH554

Neuro Rehab

QuestionAnswer
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