CVA
Paralysis on one side of the body +100
Weakness of one half of the body +100
Hemiplegia
Hemiparesis
ALS causes muscle weakness and atrophy: how are muscles impacted?
•Progresses distal to proximal in UE and LE
•UE’s are affected more
•Extensors affected > flexors
Tetraplegia (Quadraplegia)
Injury in cervical area
Partial or complete paralysis of trunk & all 4 extremities
Includes respiratory muscles
Non-progressive lesion of cerebral cortex that occurs around birth
Cerebral Palsy
Another name for ALS.
What is Lou Gehrig's Disease?
Receptive vs Expressive
Receptive (Wernickes): decreased comprehension of written and spoken language. speak fluently but out of context
Expressive (Brocas): slowed speech, impaired vocab, difficulty expressing self, comprehension ok
What are the 4 classic signs of Parkinson's
Rigidity: Increased resistance to passive stretch in both directions
cogwheel: jerky, rachetlike movements
leadpipe: constant uniform resistance
Bradykinesia: Slowness of movement, difficulty initiating mvmt.
Resting tremor: Initial sign in 50% of pts
pill rolling: disappears with voluntary movement
Impaired postural reflexes
Decreased balance reactions
Difficulty maintaining upright
C1-C3 expected level of function
no phrenic nerve innervation (diaphragm)
dependent on ventilator
dependent on ADL’s
electric W/C: sip and puff, microswitch
Caused by abnormalities in the “wiring” of the brain or neurotransmitter imbalance or a combination of both
Epilepsy
Causes may include motor vehicle accident, assault, falls and sports injuries.
What is Traumatic Brain Injury?
Recovery of Hemiparesis
1: Initially: Flaccid paralysis, No voluntary mvmt
2: Delayed spasticity: Replaces flaccidity, Synergies: mass patterns of mvmt, difficult to isolate mvmts
3:Increased reflexes: May be primitive reflexes, ATNR
4: Associated reactions: Automatic response in involved limb with mvmt elsewhere in body
Pathology of MS and 1 rehab implication
Demyelination of CNS
Sensory changes: Protective sensation, balance
Motor changes: Weakness, function
Exercise guidelines: Avoid fatigue, AM may be better
Avoid extreme temperatures: Heat contraindicated
Can be a medical emergency
Noxious stimuli such as pressure, distended bladder
And which at which cervical level?
Autonomic dysreflexia
Injuries above T6
Acute onset
Ascending paralysis
1st symptom is often paresthesia in the toes
Name disease and what is ascending paralysis?
Guillain-Barre
Ascending paralysis
Distal to proximal, symmetrical
LE to UE to diaphragm and resp. ms
alteration of consciousness, usually transient (< 24 hrs): c/o vertigo, nausea, HA, weak pulse
damage to both side of the brain, bounces in rigid skull
state of consciousness from which cannot be aroused
post comatose awareness
concussion
coup-countercoup
coma
persistent vegetative state
What does FAST stand for?
•Face – ask the person to smile, do both side of the mouth elevate equally?
•Arms – ask the person to raise their arms, do both arms lift equally?
•Speech- ask the person to repeat a sentence, is the person able to? Are the words slurred?
•Time – if the person shows any of these symptoms, call 911
Progressive, hereditary disorder
Causes enlargement of the ventricles and atrophy of the basal ganglia
EXTRA CREDIT +200 each
Dysdiadochokinesia
Apraxia
Chorea
Huntington’s Disease
inability to make rapid alternating movements
inability to perform skilled or purposeful movements
brief, abrupt, irregular, unpredictable movements
Period of areflexia following SCI
several hours to weeks
can't tell involvement until resolved
Spinal shock
What is the Glascow Coma Scale?
Which disease is it associated with?
TBI
Determines level of consciousness and severity of injury
Areas assessed: eye opening, motor response, verbal response
< 8 = severe head injury
9-12 = moderate
13-15 = mild
3 treatments for Parkinson's
Dopaminergic: Levadopa
Anticholinergic: resting tremors
Nutrition: high calorie, low protein
Stereotaxic surgery: chemo or cryosurgery to destroy areas in BG
Deep brain stimulation: brain pacemaker
List 3 characteristics of L CVA and 3 of R CVA
R CVA
L CVA
Describe the pathology of Alzheimer’s Disease
Cell death and atrophy of cerebral cortex
Formation of amyloid: “senile plaques”
Neurofibrillary tangles: nerves and proteins tangled
Muscles impacted for injury at L2, L3, L4, L5 and S1
L2: hip flexors
L3: knee extensors
L4: ankle dorsiflexors
L5: big toe extensors/dorsiflexion
S1: ankle plantar flexors
Name the 3 types of CP and 1 defining characteristic of each
•
Spastic
most common, 70% (50%)
spasticity and increased reflexes
monoplegia, diplegia, hemiplegia, quadriplegia
develop tight muscle and contractures
Athetoid
dyskinetic
slow, twisting, involuntary contraction of face and extremities
UE more involved than LE
speech impairments
movements increase with stress
developmental abnormal reflexes
Ataxic
decreased reflexes, balance and coordination
tremors, unsteady gait, loss of coordination, abnormal movements
1. Never exercise to the point of fatigue, prevent overuse
2. abnormal bone growth around jt
3. most common inherited disease of the motor and sensory nerves, affects the peroneal nerve
4. 2 treatments for disease listed in number 3
1. post-polio
2. heterotopic ossification
3. Charcot Marie Tooth disease
4. orthotics for foot drop, hand splint, prevention of contractures, balance training and skin care