Chapter 2: Cranial and Peripheral Disorders = Bulbar Palsy

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Author:
dmshaw9
ID:
298147
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Chapter 2: Cranial and Peripheral Disorders = Bulbar Palsy
Updated:
2015-03-13 14:30:38
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Bulbar Palsy
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NPTE,Chapter2
Description:
NPTE: Chapter 2
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  1. Defintion
    • A.k.a. bulbar paralysis
    • Weakness or paralysis of muscles innervated by motor nuclei of lower brainstem
    • Affects muscles of face, tongue, larynx, and pharynx
  2. Etiology
    Result of tumors, vascular or degenerative diseases of lower cranial nerve motor nuclei (i.e. ALS)
  3. Examine/Determine
    • Glossopharyngeal and vagal paralysis: phonation, articulation, palatal action, gag, swallowing 
    • Changes in voice quality: dysphonia (hoarseness or nasal quality) 
    • Bilateral involvement: severe airway restriction with dyspnea, difficulty with coughing 
    • Possible complications: aspiration pneumonia
  4. Pseudobulbar Palsy
    • Bilateral dysfunction of corticobulbar innervation of brainstem nuclei
    • Central or UMN lesion analogous to corticospinal lesions disrupting function of anterior horn cells 
    • Produces similar symptoms as bulbar palsy
    • Examine for hyperactive reflexes (increased jaw jerk and snout reflex (tapping on lips produces pouting)
  5. PT Goals, Outcomes, and Interventions
    • Suctioning, oral care
    • Maintenance of respiratory function, open airway
    • Elevate head of bead
    • Dietary changes = soft foods, liquids

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