CVA
Pt presents to the emergency room with L sided weakness. Brain MRI confirms the pt had an right acute CVA. When walking into the room for your PT evaluation you notice the patient only ate the food on the right side of his plate. What does this patient have and what test would you use to confirm your suspicion?
Unilateral Neglect
line bisection test; visual tracking test; figure copying tests; functional task
The Glasgow Coma Scale measures what? A score of 8 or below is categorized as what (mild, moderate, severe).
classifies the severity of the injury; 8 or below is a severe injury
A patient who was recently in a MVA was left with a T1 SCI,a patient's goal is to work on independence with transfers. What principle would help a patient achieve a wheelchair to chair transfer without the use of the slide board?
Head-hips principle
What are the 3 cardinal signs for diagnosing Parkinson’s Disease
Rigidity OR
Bradykinesia AND
Tremor
What communication disorder presents with difficulty producing speech and/or writing even with understanding of language relatively intact?
Broca’s aphasia (expressive aphasia or non-fluent aphasia)
Pt who recently had a right sided CVA is in an acute rehab working with the OT in the kitchen. Pt reports that he has a glass of orange juice everyday. The OT tasks the patient with pouring himself a cup of orange juice. The pt goes to reach for a glass out of the cabinet and misses due to not reaching far enough. After getting the cup the patient pours himself orange juice and overfills his cup causing the orange juice to go everywhere. What type of spatial relation impairment does this patient have?
Depth and distance perception
Pt is having a slow increase in arousal, normal sleep/wake cycles, eyes open, no awareness of self/environment, reflexive behaviors (ie crying yet have no meaning attached to it). What state of consciousness does this patient have?
vegetative state
A patient had cervical hyperextension causing an incomplete spinal cord injury. Pt has more pronounced motor loss in the upper extremities compared to lower extremities. What incomplete spinal cord injury does this patient have? Where are the most common sensory deficits present in this syndrome?
Central cord syndrome; cape-like pattern in their upper back and posterior upper extremities
Describe the pathophysiology for Parkinson’s Disease
Decrease in dopamine production to substantia nigra therefore degenerates and affects effectiveness of “go” and “no go” pathways from the basal ganglia
What type of MS presents with periods of worsening symptoms that are reversible with periods of partial or complete recovery?
Relapsing-Remitting MS (RRMS)
Post stroke the pt had spasticity of the left arm resulting in internal rotation/adduction of the shoulder, flexion at the elbow, forearm pronation, and flexion of the wrist. Most recently the patient's spasticity has started to decrease yet still does not have selective control of movements. What Brunnstrom stage of motor recovery is this patient in?
Stage 4: out of synergy and less spasticity
How many stages are there in the Ranchos Los Amigos Level of Cognitive Function (LOCF)? A patient who has a TBI has bizarre behavior, is disoriented to the environment, non-compliant, and lacks short-term and long-term memory. Overall, the pt is confused and agitated. What Ranchos Los Amigos Level of Cognitive Function is this pt?
8 total stages; stage 4 confused/agitated
A patient with a SCI is having difficulty with stability and balance when sitting at the edge of their bed. What muscle group should be selectively tight to assist with the patient’s sitting ability?
Low back muscles
How would one describe Parkinsonian gait?
Anterior trunk lean
Shuffling - small stride length
Freezing of gait
Festination of gait
Reduced arm swing
Trouble initiating or stopping movements as well as trouble turning
A patient tests positive for right horizontal canalithiasis via the Roll Test. What canalith repositioning maneuver is indicated to treat this finding?
BBQ (Also Gufoni and Kim maneuvers)
Pt had a left CVA and is having difficulty understanding spoken and written areas of speech. The pt can speak fluently but is nonsensical (word salad). What type of aphasia does this pt have? What area of the brain was affected to cause this aphasia?
Receptive or fluent aphasia; damage to Wernicke’s area
Is elevated intracranial pressure a primary or secondary brain injury? Name 4 symptoms of elevated intracranial pressure? Bonus: what is the normal range for ICP.
secondary brain injury; headache, nausea, vomiting, papilledema, visual loss, diplopia, HTN, bradycardia, irregular respirations; normal range 5-20 mmHg
Name two exercises that would be beneficial to include in treatment sessions for a SCI patient to improve respiratory management
Any answers including two of the following: Eccentric control of exhalation, coughing techniques, Chest wall mobility, Abdominal support (binder or corset), Clearing secretions
What is the tissue test and how is this effective with people with Parkinson’s Disease
The tissue test is dropping a tissue near the patient in order to provide an external cue to rely on to initiate movement again. People with Parkinson's have an error with their internal feedback systems therefore external cues are more effective in their treatment plans and for initiating movements.
What hereditary disease is characterized by atrophy of basal ganglia and cerebral cortex and is fatal 15-20 years after symptoms start
Huntington’s disease
Pt post stroke has contralateral paresis LE > UE. Pt also has contralateral sensory impairment LE > UE. Pt has a cognitive impairment with a mini mental state exam (MMSE) score of 16. Pt also has urinary incontinence, apraxia, and akinetic mutism (slowness, delay, motor inaction).What syndrome/cerebral artery was affected? What is the cut off score for the MMSE?
anterior cerebral artery syndrome; <24 = cognitive impairment
Pt is a 22 y.o female who has a mild TBI. Pt symptoms are not lessening in the usual window of ~ 3 months. This is the pt’s 3rd concussion. In the past 4 weeks she has had impaired concentration, headaches, impaired sleep and dizziness. What syndrome is this patient exemplifying?
post concussion syndrome
A patient with an ASIA D T11 SCI asks their physical therapist if they can expect to be able to walk around their household in their future or if they can expect to rely on a wheelchair for all mobility. What should the physical therapist tell the patient regarding their walking expectations?
The patient should expect to be able to ambulate in the household with use of forearm crutches and KAFOs
What is the most common medication used for treating Parkinson’s disease?
Levodopa
What diagnosis is an autoimmune disease that is typically caused by a GI infection, or respiratory infection and has decreased DTR’s
Guillain barre syndrome