Neuro PM&R
List 2 types of pathologies for upper and motor neuron lesions?
UMN possible answers - CP, CVA, Spinal cord injury (maybe), TBI, MS, ALS
LMN possible answers - Post-polio, charcot-marie-tooth, guillian-barre, peripheral neuropathy, ALS, Spinal cord injury (maybe)
Difference between primary injury and secondary injury and give an example of each.
primary examples - focal cortical contusion, coup-contrecoup, penetration, skull fracture, axonal shear injury
Secondary examples - brain swelling, hemorrhage, hypotension, ischemia, hypoxia.
Difference - secondary are complications of primary and may be preventable
Ways to diagnose MS.
What is magnetic resonance imaging (MRI), cerebrospinal fluid (CSF), and backup use of evoked potentials (EP)
The two symptoms required for diagnosis of guillan-barre syndrome.
What is progressive weakness in more than one extremity and loss of deep tendon reflexes?
The model that recognizes the relationship between psychological, social, and physiological on disease and health.
What is the biopsychosocial model?
The most common form of Cerebral Vascular Accident and what is it.
What is Ischemic stroke? Blood supply to the brain is blocked
Do you want a high or low number with the Glasgow Coma Scale for Head Injury?
High
The pathology that is an inflammation of the spinal cord and causes a change in sensation.
What is Transverse Myelitis?
The pathology that has a clinical presentation of lower leg weakness and foot deformities (ex. cavus foot) with a slow progression.
What is Charcot-Marie-Tooth Disease
The 7 stages of grief and when some of the stages do not apply.
What is shock, denial, anger, bargaining, depression, testing, and acceptance? Shock and testing occur after traumatic injury.
Methods of CVA diagnosis.
What is physical exam (FAST), CT, MRI, Cerebral angiogram?
Posture that is a sign of a brainstem injury
What is decerebrate posture?
The musculoskeletal symptoms from neurofibromatosis are a result of what.
The musculoskeletal symptoms from neurofibromatosis are a result of what.
What is pressure of enlarging neurofibroma on normal nervous tissue?
The type of peripheral nerve injury that we are focusing on and the types of symptoms.
Mononeuropathy: motor, sensory, and autonomic nerve damage
Give an example of a variation in lifestyle that could create a barrier to care.
Cultural differences, generational differences, ethnic differences, socioeconomic
Explain recovery for CVA
Early phase - (immediately after acute stroke), limbs are flaccid and paralyzed; prone to subluxation, positioning important
During recovery - (when we start to see them), prone to contractures, controlling tone needs to balance functional needs for recovery
general patterns - varies significantly, synergistic movements, LE recovers earliest and most completely, then upper extremity and hand, volitional control over proximal limb occurs before distal
Hallmark characteristic of Amyotrophic Lateral Sclerosis
What is Amyotrophic Lateral Sclerosis will eventually affect both upper motor neurons and lower motor neurons?
The infection that everyone with post-polio syndrome had.
What is poliomyelitis?
Give an example of median, radial, and common peroneal nerve injuries.
What is Median: carpal tunnel syndrome, radial: compression in axilla (improper crutch use), upper arm, forearm, peroneal: trauma or continuous compression to knee
Earlier prosthetic fitting after a disabling event provides the patient with...
what is less psychological distress
Difference between complete and incomplete spinal cord injury.
What is complete spinal cord injury is a total loss of sensory and motor function below the level of injury and incomplete spinal cord injury has some function.
Difference between relapsing-remitting MS and progressive-relapsing MS.
What is progressive-relapsing MS continues to get worse between spikes of worse neurologic dysfunction?
The pathology that is most commonly the cause of acutely evolving motor and sensory deficit.
What is guillan barre syndrome?
Explain the difference in muscle bulk, weakness, fasciculation, tone, reflex for UMN and LMN involvement.
UMN involvement | LMN involvement | |
Muscle bulk | Grossly normal | Atrophic |
Weakness | Mild to moderate | Severe |
Fasciculation | Absent | Present |
Tone | Hypertonia (spasticity) | Hypotonia |
Reflex | Brisk | Reduced or Absent |
List 1 resources for patients concerning prosthetic rehabilitation
Amputee coalition of America, National rehabilitation Information Center, Association of Children’s Prosthetic/Orthotic Clinics