neuro 4

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neuro 4
2014-06-18 19:02:59
license exam

license exam
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  1. Glasgow Coma scale - scoring ranges
    • 3-8: severe brain injury
    • 9-12: moderate
    • 13-15: mild
  2. 3 categories in the Glasgow coma scale
    • eye opening
    • motor response (to command, to pain, posture)
    • verbal response
  3. decorticate vs decerebrate
    • decorticate: UE flex, LE ext
    • decerebrate: UE ext, LE ext

    in the Glasgow coma scale, you get a higher score for being decort than decerebrate
  4. dysarthria vs dysphagia
    • dysarthria: difficulty speaking caused by lack of muscle control
    • dysphagia: difficulty swallowing
  5. amyotrophic lateral sclerosis / Lou Gehrig's disease -- basic description?
    • UMNs and LMNsĀ degenerate or die and stop sending messages to muscles
    • muscles gradually weaken, atrophy, and fasciulate
    • eventually, the ability of the brain to start and control voluntary movement is lost.
  6. where will ALS first present?
    weakness in hands
  7. sensory changes in ALS
    usually none
  8. sings and symptoms of ALS
    • progressive muscle weakness, starting in hands, going to resp muscles
    • dysarthria and dysphagia
    • muscle atrophy, cramping, fascis
    • spasticy and hyperreflexia
  9. treatment for ALS
    • resp exercises
    • PROM
    • positioning
    • skin care
    • prevent further deconditioning / disuse atrophy
    • avoid overworking muscles / teach energy conservation
    • symptomatic treatment of pain, spasms, spasticity
    • psych support
  10. Bell's palsy - basic description
    inflam response affecting CN VII (facial) --> unilat paralysis
  11. signs and symptoms of Bell's palsy
    • depends on which branch/es of CN VII are involved, but can be ...
    • weakness or paralysis of wrinkling forehead, closing eye tight, smiling
    • loss of control of salivation
    • mouth droops
    • decreased taste sensation on ant 2/3 of tongue
  12. treatment for Bell's palsy
    • hydrate or patch eye to protect cornea
    • e-stim to maintain tone of facial muscles
    • facial muscle exercises
    • functional retraining (chew on opp side)
  13. Guillain-Barre syndrome (GBS) - basic description
    • LMN polyneuropathy of viral origin --> weakness, paralysis, sensation loss
    • presents LE to UE, distal to proximal
    • recovery is slow, takes up to 1 year
  14. GBS signs and symptoms
    • affects cranial and periph nerves
    • sensory loss (stocking/glove)
    • paresthesias (tingling, burning)
    • can produce tetraplegia w resp failure
    • tachycardia, abnormalities in cardiac rhythm, BP changes
  15. treatment for GBS in ascending, stabilized, and descending phases
    • asc: resp therapy, PROM, positioning to reduce contractures, skin care
    • stab: prevent injury to denervated muscles, avoid overuse and fatigue, do gentle stretching, initiate mvmnt in controlled env
    • desc: muscle re-edu, mod exercise, teach energy conservation
  16. postpolio symptoms
    • myalgia
    • joint paoin
    • asymmetrical atrophy
    • excessive fatigue and decreased endurance --> loss of function
  17. treatment for postpolio
    • low intensity exercise NEVER to point of fatigue
    • orthotics
    • work on endurance and energy conservation
  18. thalamic pain syndrome aka dejerine-roussy syndrome
    what is it?
    stroke involving which artery?
    • continuous intense pain on hemiplegic side
    • posterior cerebral artery
  19. myofascial pain syndrome (MPS)
    • persistent deep aching muscle pain
    • nonarticular in origin
    • characterized by trigger points

    fibromyalgia also affects soft tissues and other symptoms, sleep disturbances, b&b, numbness and tingling, cognitive...
  20. nonarticular def
    affecting or involving soft tissues (as muscles and connective tissues) rather than joints
  21. referred pain in heart attack
    medial L arm and jaw pain
  22. referred pain from gall bladder
    right subscapular
  23. referred pain from kidney
    thoracic or flank pain
  24. referred pain from spleen
    L upper quadrant or shoulder pain
  25. D1 UE flexion (ext is the reverse sequence)
    • start: GH IR, abd, ext
    • goes to: ER, add, flexion

  26. D2 UE flexion (ext is the reverse sequence)
    • starts with: GH IR, add, ext
    • goes to: ER, abd, flex
  27. D1 flex LE (ext is the reverse sequence)
    • start: hip IR, abd, ext
    • goes to : ER, add, flex

    hacky sac
  28. D2 LE flex (ext is the reverse sequence)
    • start: hip ER, add, ext
    • got to: IR, abd, flex
  29. which PNF sequence helps rolling in any dir?
    LE D1
  30. agonist reversals (AR) pnf technique
    when to use
    • concentric followed by eccentric contraction (so the resisting hand is the same place as pt goes both ways)
    • weak postural muscles, inability to eccentrically control body during transfers
  31. indication for approximations (per PNF)
    • stimulate afferent nerve endings and facil postural extensors, promoting stability
    • (useful if there's joint laxity/flaccidity)
  32. contract-relax
    limited ROM 2/2 muscle tightness or spasticity

    (push push push)
  33. hold-relax
    limitations in ROM 2/2 muscle tightness, spasm, pain

    hold hold hold
  34. repeated contractions (PNF)
    • isotonic contractions against resistanceĀ induced by quick stretch
    • performed thru range or at point of weakness
    • indications: weakness, incoordination, muscle imbalances, lack of indurance
  35. rhythmic initiation
    • PROM, then AAROM, then AROM against resistance
    • spasticity, rigidity, hypertonicity, apraxia, motor learning deficits, aphasia
  36. rhythmic rotation is for what?
  37. slow reversal w/wo hold
    • alternating concentric contractions, can have a hold at point of weakness
    • inability to revers dir, muscle weakness or imbalance, incoordination, lack of endurance
  38. PNF rational for traction
    facilitates flexor muscles

    (approximation facilitates extensors)