Case Inquiry
What are contraindications of an MRI
Pacemaker, metal implants/screws, joint replacement, insulin pump, claustrophobic
What is the difference between visual agnosia and cortical visual impairment?
Visual Agnosia: occurs in association area = can't identify object
CVI: in V1/Broadmann's 17 (primary visual cortex)= "appears" blind but demonstrates otherwise
What is the result of lower motor neuron damage?
Skeletal muscle damage causing a decrease in tone and reflexes (flaccid, hypotonic)
How does the amygdala become activated?
The Thalamus receives a sensory signal, identifies it as a threat or danger and takes one of two paths to get the amygdala (thalamo-amygdala path=fast way) (thalamo-cortico-amygdala path= slow processing)
What is the difference between nociceptive and neuropathic pain?
Nociceptive pain: injury from tissue damage: somatic (from muscle/skin-easy to localize) & Visceral (from organs)
Neuropathic: injury to nerves (burning, pins/needles)
Describe an inpatient rehabilitation setting
24/7 care, 3 hours of therapy a day, LOS typically 2 weeks
What lobe is the dorsal pathway located in? Ventral pathway?
Dorsal= parietal ("where")
Ventral=temporal ("what")
What are two components of pregrasp/Anticipatory grip?
Thumb aperture (*extension)
Visual guidance
What happens when the hypothalamus receives a fear response signal from the amygdala?
It activates the sympathetic nervous system by sending a signal to the adrenal glands to produce epinephrine (adrenaline) keeping you on high alert
What path/tract do the A Delta fibers travel on?
Spinothalamic Tract (FAST, easy to localize)
State the signs vs symptoms of a concussion
Signs: negative imaging, uncoordinated/disoriented, vomiting, light sensitivity
Symptoms: dizzy, blurred vision, headache, ringing in ears, amnesia, can't focus/sleep
What types of lesions are seen in the dorsal pathway? (broadmans 7 & 8)
Simultanagnosia (inability to preceive more than 1 detail at a time)
Optic Ataxia (Inability to accurately reach & grasp for an object)
Hemi-spatial neglect (contralateral)
Is edema, joint subluxation and pain a primary or secondary effect
secondary
What happens if the stressor doesn't go away?
LongTerm stress= Negative feedback
The hypothalamus releases norepinephrine by secreting corticotropin releasing hormone, then goes to the pituitary gland to release ACTH, then goes to the adrenal gland causing the release of cortisol
CORTISOL (too much surpasses immune system and has negative psychological problems)
How does Icy Hot make you feel like the pain is going away
Gate control theory
Icy Hot= distractive stimuli blocks transmission of nociceptive info before it reaches second order
What is second impact syndrome?
getting a second concussion before the first is healed; rapid brain swelling
What 2 disorders describes the following scenarios:
1. On the table was a bunch of buttons and nickels. Billy's mom asked him to pick up a button. Billy looked really confused and picked up a nickel saying "is this it?"
2. Billy's favorite color is blue. He wanted to wear his blue socks that his mom layed out for him on his bed that had blue blankets on it but he could not find them.
1. Form Discrimination
2. Figure Ground Discrimination
What motions occur in someone with flexor synergy?
What is abnormal within individuals with PTSD?
-Hippocampus doesn't code details of past trauma correctly so the individual becomes overwhelmed
-Prefrontal cortex is hypoactive
What is Allodynia?
Hypersensitive to things that shouldn't hurt (central sensitization)
What will a person with an SCI at C6 have difficulty with?
Bladder/Bowel control (hyperreflexive, spastic)
Loss of trunk control/balance
Full sensory and motor loss in LE
no fx at C7 and below (elbow extension)
C6:
What monocular cue makes railroad tracks look like they are coming together in the distance?
Linear perspective
What disorder has a bilateral impact and causes a person to use their finger to stir their coffee
Ideomotor apraxia
What is autonomic dysreflexia
Sympathetic response to innocuous stimuli in individuals with an SCI at T6 and above
Stimuli cannot reach brain so SNS provides a reflexive response that can be life threatening until removed
What occurs in an individual with Complex Regional Pain Syndrome 2?
Initial nerve injury is present
extreme chronic pain affects limbs that is not proportional to severity of initial injury