Card Set Information

2011-09-19 21:13:50

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  1. ________: a medical doctor who specializes in physical medicine and rehabilitation whose primary responsibility is for the medical care of the patient.
  2. ______ ______: concerned with teaching patients to do as much for themselves as possible. This involves evaluating patient's needs and then initiating exercises to increase muscle strength and joint movement.
    Physical Therapist
  3. ______ _____: through evaluation and treatment, provides patients with an opportunity to reach their maximum level of physical and psychosocial funciton so that they can live independently.
    occupational therapist
  4. ______ and _______ _______:evaluates patients for communicationproblems and intitates therapy as needed.
    speech and language pathologist
  5. ________: evaluates intellect, personality functions, and emotional adjustment, as needed.
  6. _____ ______: through involvement and participation in therapeutic recreational programs, the patient will become more socially involved with others, develop and use physical and intellectual abilities, learn new skills, and or modify old ones.
    recreational therapist
  7. _______ therapist: available to assess the breathing status of patients. Treatment is provided as deemed necessary by the physician.
    respiratory therapist
  8. ______ ______: patient and family advocate to ensure family input into the patent's treatment program, and also keeps the family informed of the patient's progres and sets up family conferences and teaching sessions.
    social worker
  9. ______ ______: provides 24 hour care to persons with spinal cord injury.
    Rehabilitation nurse
  10. _______: plays an integral role in the care of the patient with spinal cord injury. A thorough nutritional assessment is conducted upon admission ot determine each patient's unique needs.
  11. _____ ____: may be assigned to each patient on admission. He or she provides clinical coordination for all services provided to the patient.
    case manager
  12. FIM:
    Independent: another person is not required for activity.
    ______ _____: all of the tasks describes as making up the activity are typically performed safely, without modification, assistive devises, or aids, and witing reasonable time.
    ______ _____: activity requires any one or more than one of the following: assistive device, more than reasonable time, or there are safety considerations.
    • complete independence
    • modified independence
  13. FIM:
    modified dependence: subject expends half or more of the efort. The levels of assistance required are:
    _____ or _____: subject requires no more help than standby, cuing or coaxing without physical contact. Or, helper sets up needed items or applies orthoses.
    _____ _____ _____: wit hphysical contact the subject requires no more help than touching, and subject expends 75% or more of the effort.
    ______ _____: subject requires more help than touching, or expends half or more of the effort.
    • supervision or setup
    • minimal contact assistance
    • moderate assistance
  14. FIM:
    complet dependence: the subject expends less than half or the effort. Maximal or total assistance is required, or the activity is not performed.
    _____ ______: subject expends less than 50% of the effort, but at least 25%.
    ______ _____: subject expends less than 25% of the effort.
    • maximal assistance
    • total assistance
  15. _____: disruption of blood supply to an area of the brain resulting in neurologic impairment.
  16. Warning signs of a stroke: 5 total
    • 1. sudden onset of weakness or numbness of face, arm, leg or side of body
    • 2. sudden loss of vision, especially in one eye
    • 3. loss of speech or difficulty understanding speech
    • 4. sudden severe headaches
    • 5. unexplained dizziness, unsteadiness, or falls without previous symptoms
  17. Clinical Manifestations of Stroke:
    ____ and ___ of lesion is more critical to production of deficits/clinical signst than type of CVA
    site and size
  18. ______ CVA:
    * right hemiparesis
    * difficulty understanding what is being said by others and or self
    * difficulty speaking (word finding, nonsense words, telegraphic speech)
    * dificulty understanding written language (reading)
    * difficulty with writing
    * right neglect/visual field deficits
    * difficulty wit hmath
    * perservation
    * fatigue
    * emotional lability
    Left CVA
  19. _____ CVA:
    * short attention span
    * denial of impairments
    * distractibility
    * difficulty with abstract
    * difficulty ordering of events
    * difficulty wit hmath
    * left neglect or visual field deficits
    * confabulation
    * absence of facial expression
    * impaired sense of humor
    * agnosia
    * difficulty swallowing
    * fatigue
    * emotional lability
    Right CVA
  20. Common impairments of L and R CVA: 5
    • 1.difficulty with speaking
    • 2. difficulty with math
    • 3. emotional lability
    • 4. fatigue
    • 5. visual field deficits
  21. Speech/Language Disorders:
    Typically with lesions of the ______ cortexof dominant hemisphere (usually _____ hemisphere)
    • parietooccipital cortex
    • Left
  22. _____: communication disorder caused by brain damage. Impaired language comprehension, formulation, and use. Can include writing.
  23. ______ aphasia: (damage areais called Wernicke's area) speech flows smoothly and is spontaneous. Impaired comprehension, naming, reading and writing with word substitutions.
    Fluent aphasia
  24. _____ aphasia: (damage to Broca's area) speech is slow, poorly articulated, and hesitant with limited vocab. Good comprehension for spoken word with good reading and writing ability.
    Non-fluent aphasia
  25. _______ aphasia: all aspects of language affected, unable to speak or ocmprehend, and poor reading and writing.
    Global aphasia
  26. ________: impaired speech production due to damage to PNS or CNS that causes weakness, paralysi, or incoordination of motor speech system.
  27. Orophacial dysfunction:
    ______: swallowing dysfunction.
  28. _____ CVA: negative, anxious, hesitant, and depressed; cautious, insecure and uncertain.

    ____ CVA: impulsive, poor awareness of deficits, poorjudge of own abilities, misjudged as uncooperative, unmotivated, overly dependent, and confused.
    • Left CVA
    • Right CVA
  29. ________: lose emotional control, go from lauging to crying for no apparent reason. Important to redirect or distract.
  30. ______ ______: emotional responses following decreasedsensory input due to visual impairments, decreased hearing, decreased touch. Worse at night ="sundowning"
    Sensory Deprivation
  31. ______: results from multiple infarcts, faulty judgements, poor memory, and mood alterations.
  32. ______: active process that determines which sensations and experiences are relevant to the individual.

    ______: stories or words that are used to fill in gaps in memory; pt believes these to be true
    ______: common (1/3 cases with stroke) due to psychological reaction to loss; also due to physiological changes.
    • attention
    • confabulation
    • depression
  33. ______: postural model of body including relationship of parts to each other
    Body Scheme
  34. _____: Mental image of one's body (body image)
  35. _____: inability to recognize sensory stimuli; can be visual, tactile, or auditory
  36. ______: when asked to lock R brake on w/c, patient cannot find it despite repeated attempts and looking in that direction
    figure-ground discrimination
  37. _____: When asked to lock L brake on w/c, patient initally makes no attempt. Does not look left without visual AND spatial cues.
    Visuo-spatial neglect
  38. ____: inability to percieve one side of body or environment; usually with R CVA
    Unilateral neglect
  39. _____: unpleasant abnormal sensation produced by normal stimuli
  40. ____: altered strength

    (UE/LE) more affected; (Distal/Proximal) muscles more affected

    Atrophy of type ___ ____ twitch fibers

    UE; Distal

    II fast
  41. ____: lack of resistance to movement

    ____: no tone at all; right after a stroke

    ____: increased above normal resting levels of resistance


  42. _____: disordered tone; basal ganglia lesions
  43. ______: increased resistance to passive stretch; emerges in 90% of the cases and may lead to contractures
  44. _____: dominate synergy of UE with:
    -retraction, abd and ER of shoulder
    -flex elbow
    -supination of forearm
    -wrist/finger flex
    flexion synergy
  45. _____: weaker UE synergy
    -protraction of shoulder
    -add of UE
    -IR of shoulder
    -ext of elbow
    -pronation of forearm
    -ext wrist with flex fingers
    Extension synergy
  46. _____: combo of two UE synergies
    typical UE posture
  47. ______: weakest LE synergy
    -flex, abd & ER of hip
    -flex knee
    -DF and inversion of ankle
    -ext of toes
    Flexion synergy
  48. _____: dominate LE synergy
    -add, IR and ext of hip
    -ext of knee
    -PF and inversion of ankle
    -PF of toes, maybe ext of great toe
    Extension synergy
  49. ___ ____ ____ ____: ATNR
    asymmetric tonic neck reflex
  50. ____ _____: reflex stimulation due to yawn, cough, sneeze or stretch; involuntary limb movement due to voluntary movement of another extremity

    Flexion of uninvolved UE evokes ____ of involved UE; same with extension

    Flexion of uninvolved side evokes ____ of involved side; opposit for extension
    associated reactions


  51. _____ ______: resistance of abd in uninvolved side elicits abd of involved limb
    Raimiste's Phenomena
  52. ____ ____ _____: flexion of hemiplegic UE elicits flexion of hemiplegic LE
    Homolateral Limb Synkinesis
  53. _____: inability to carry out purposeful movements despite lack of motor, sensory, cognitive or behavioral deficits - can't initiate, but understand!

    Rx for this: proprioceptive/tactile input throughout, ____ verbal commands, and support

  54. ______: complication due to bed rest, paralysis or decreased activity; includes edema, "tight" feeling in calf, positive Homan's sign (pain with passive ankle ____)
    DVT (Deep vein thrombosis)

  55. ____: flexibility of connective tissue is lost
  56. _____: common impairment of shoulder after stroke

    ____ stage: decreased support and action of RC muscles

    ____ stage: adnormal tone of shoulder muscles
    Shoulder Subluxation

    Flaccid stage

    Spastic stage
  57. _____: effect after cerebellar stroke; due to loss of proprioception & weakness causing decreased coordination

    Rx: postural stability with joint approximations, PNF, slow weight shifts
  58. A condition seen after a CVA in which the patient pushes strongly towards his hemiplegic side in all positions and resists any attempt at passive correction
    of this posture?
    Pusher syndrome
  59. Condition with symptoms like:
    –Unable to sit up/ fall to hemiplegic side
    –Fail to use axial or trunk muscles
    –do not resist correction
    Thalamic Antasia
  60. The tendency to fall sideways
    –Cerebellar and Brain Stem lesions: (Wallenberg’s Syndrome)
    –Tilt of visual vertical = vision aligns improperly with environment
    –Deviate ipsilaterally = toward brain lesion
    –do not resist correction or push with nonparetic side
  61. Lose balance due to hemiparesis and fall
    to hemi side but:
    •Recognize loss of balance
    •do not resist correction
    •Cling onto something with non-paretic hand to prevent fall
    Listing phenomenon
  62. Tilt of visual vertical without pushing behavior
    Vestibular cortex lesion
  63. 40-50% of all Pushers are ____ CVAs
  64. Pushing: High correlations are due to close anatomical relationships of _______ to those causing Neglect or Aphasia
    posterior thalamus
  65. •Karnath (2000) et al investigated
    pushing patients ability to align themselves to earth vertical = subjective
    postural vertical (SPV)
    •Sitting in tilting chair with eyes open: patients ____
    •Eyes closed: patients aligned themselves ~20 degrees towards the ______ side
    (against hypothesis that would align 20 degrees to _____ side)
    aligned themselves

    ipsilateral side

    contralateral side
  66. Pushers can visually identify objects that are vertically aligned.

    True or False?
  67. A diagnosis of “pusher syndrome”
    does not necessarily mean a _____ prognosis.

    -brain compensates for the mechanism/
  68. Intervention for pushing includes: (8)
    • visual input that corresponds to reality!
    • Midline orientation/ weight shift
    • Strength
    • Balance
    • Gait
    • Transfers
    • Bed Mobility
    • Endurance
  69. 1st step in treating pushing
    Draw patient's attention to problem: use mirrors and controlled falling
  70. 2nd step in treating pushing
    Encourage patient to actively correct posture: weight shift and reach to nonparietic side
  71. 3rd step in treating pushing
    Internalize newly learned compensation: perform all tasks maintaining correct alignment
  72. Pusher's unlike usual stroke patients must weight bear on ____ side and use ____ side to control pushing.
    strong side

    weak side
  73. Weak point in blood vessel in brain can bulge and rupture causing a _____.

    Can be caused by trauma, infection, hardening of arteries or be congenital

    enlarged pupil in one eye, drooping eyelid, pain behind one eye are common symptoms
    Cerebral aneurysm
  74. Common place for berry aneurysms to form
    Circle of Willis
  75. Abnormal collection of blood vessels; lack of tiny capilllaries

    Cause: congenital
    Arterio-venous malformation (AVM)
  76. _____: Symptoms include headache, seizures, dizziness

    Can be diagnosed by ___, ____, or _____

    Treatment includes: ____, radiation or surgery

    CT, MRI, Arteriogram

  77. Cerebral aneurysms can be located by ____; if negative, a _____ can be performed to check for blood in CSF

    lumbar puncture
  78. plugging the blood vessels of the AVM:_____

    small tube is inserted into _____ artery then threaded to the area needed where glue or wire is used to block off area

  79. Risk of bleeding from an AVM (increases/decreases) over time.