MSPD
pathophys of MS
damage to myelin sheath and myelin producing cells in CNS
What is the general difference between UMN lesions and LMN lesions?
UMN = hyper response
LMN = hypo response
describe the 2 common etiologies of stroke including names, occurrence rate, and define
ischemic (80%) = blood clot to the brain!!!
hemorrhagic (20%) = bleed in the brain
3 domains (+%) of sensory input for balance
visual = 10
vestibular = 20
somatosensory = 70
normal ICP is?
5-20, anything over 20 is elevated and has contraindications to some tx/positions
4 cardinal features of PD
TRAP (tremor at rest, rigidity, akinesa/bradykinesia, postural instability)
describe ataxic gait
wide BOS, high guard, irreg stepping pattern, unsteady, high falls risk
Describe the anatomical areas affected from ACA vs MCA
ACA = frontal parental lobes, basal ganglia, broca's area
MCA= lateral of frontal, temporal, parietal, wernicke's and Broca's area
Get up and Go test VS timed up and go test
GUG = same test, walking at normal speed (graded on amount of abn and not timed)
TUG = timed, at normal pace, grading on time
list types of memory impairements with tbi
anomia, intergrade amnesia, retrograde amnesia, post traumatic amnesia
what does having heart intolerance with MS change your pt tx
morning, cool enviro, well hydrated, empty bladder, ensure cool temp, not hot baths, more rest intervals, no max exericse
cerebellar vs sensory ataxia
cerebellar : rombers + with eyes open/closed, all other motor imapriements, ataxic gait
sensory: + comb with eyes closed, normal motor control, impaired proprioception/sensory
left vs right hemispheric lesions and behaviour differences
left = slow, cautious, hesitant, aware of deficits
right = quick, impulsive, safety risk, unaware of deficits
1+ of MAS?
slight increase in muscle tone, catch, followed by minimal resistance throughout remainder (less than half) of ROM
What GSC is considered an mtbi, what is typical recover?
GCS of 13-15 (pretty normal)
recovery 7-10 days
what is the first s/s of PD
loss of sense of smell
what is the goal of restoring physiotherapy treatment (generally)
for the patient to be able to move ACCURATELY not fast/efficiently
happens with right hemisphere lesions bc you lose your left side vision. (right brain looks at both fields of vision, left brain only looks at right side)
- very dangerous, only eats half plate of food, only is aware of left side
What is the Performance oriented mobility assessment (POMA) used for?
reliable/brief measure of static and dynamic balance (measures balance and some gait tests)
List 3 special considered for confused and agitated patients
consistencty, expect no carryover, model calm behaviour, expect egocentricity, flexibility/options, safety
Describe festinating gait vs freezing gait
short strides, fast speed, stopped posture, forward or backward leaning
freezing = sudden stop in movement/inability to initiate movement
what are the 5 D's related to ataxia (one we didn't learn in school)
dysmetria, dysdiodochokinesia, dyssynergia, dysarthria, dysrrthmia
what are the 3 characteritics of the clinical assessment scale for contraversive pushing and why is it used?
1. tilt towards paretic side often, abd/ext of unaffected limb, restate to passive correction
- pusher syndrome, postural disorder pushing from strong side to weak, falls risk
Name all the combined cortical sensation tests
sterogensis, tactile localization, two point discrimination, double simultaneous stem, graphesthesia, texture recognition, barognosis
List the moderate Glasgow coma scale findings (9-12) with time of loss of consciousness, time of altered consciousness, post traumatic amnesia, and neuro imaging
AC = >24 hours
post traumatic stress disorder amn = 1-7 days
neuroimaging = normal or abn