smile for me?
Describe the ischemic penumbra
area surrounding ischemic event that may be viable via collateral arteries.
Besides tenodesis grip, what is another significant ability that people with a C6 SCI have?
independent pressure relief maneuvers in w/c
most common complaints of pain with GBS
low back and leg throbbing, deep pain
ALS is a ____ motor neuron disease (upper or lower)
both
What is the most common trigger of autonomic dysreflexia
bladder or bowel distension/irritation
What is signficant about ICA syndrome?
significant edema, leading to increased ICP,
can lead to uncle herniation, coma, death
What develops autonomic dysreflexia?
noxious stimuli = increased SNS = increased BP/HR = increased vagal output reponse
How is post polio believed to occur?
neural fatigue where rate of deineneration is faster than reinnervation
What is the cardinal sign of ALS?
weakness (UE, LE, bulbar, and mix)
Most susceptible pressure sores to occur when lying supine (2)
coccyx and heels
other secondary: occiput, scapulae, vertebrae, elbows, sacrum
difficulty motor planning and performing, purposeful WITHOUT physical motor impairements
left hemisphere
Describe the phases of spinal shock
0-24 hrs: total arreflexia
1-3days: some reflexes
1-4 weeks: increasing hyperreflexia
4+weeks: final hyperreflexia
GBS presentation is typically ___ (a/symmetrical), and symptoms begin ____ and move ____ (proximal or distal)
symetrical,
distal move proximal
Why do ALS symptoms progress slowly at first, then become a rapid decline?
due to axon regeneration/sprouting/re-innervation that occurs to try and preserve function.
As disease progresses, rate of re-innervation is too slow for rate of degeneration
Loss of sense of smell is an early sign of what condition?
PD
Differentiate between receptive, expressive, and global aphasia
receptive: difficulty comprehending (wernicke's)
expressive: difficulty producing (Brooke's)
global: extensive damage to both, simple instructions,
A patient was diagnosed with an SCI after a traumatic MVA due to some loss of function in their lower extremities. The patient has sensory preserved, hip flexion is 5/5 MMT, hip abduction 2+/5, ankle dorsiflexion 2/5, hamstrings 1/5 MMT. What is the level of their lesion and ASIA impairment scale?
Incomplete C, lesion at L4.
Explanation: they have full hip flexion (L3)-preserved, and less than 3/5 MMT on L4 and below muscles.
Compare and constrast GBS and post polio in context of: onset, type of MN presentation, recovery period
onset: GBS is acute, post polio is gradual multiple years after initial polio infection
both LMN
both up to 2 year recovery
What areas are generally spared in ALS?
sensory system, spinocerebellar tracts, vision,
interestingly some pelvic floor muscles
What is the difference between MS and post polio with intolerance?
MS has heat intolerance
post polio has cold intolerance
What are the benefits of side lying on the affected shoulder? Where should they actually be placed?
on affected: increases awareness of sh, WB on weaker side will regulate abnormal muscle tone, inhbits abnormal postures
on their scapular vs humeral head
Upon examination, a patient with a C7 SCI is seen to have tight lower trunk muscles and hamstrings. Describe what exercises you would prescribe for this?
1. nothing for tight lower trunk muscles as it may increase trunk stability and sitting posture (I'm sorry)
2. stretching hamstrings via SLR to for long sitting, avoiding contractures, and functional tasks such as dressing LE
What is the KEY factor to consider with rehabilitation with either GBS or post polio
the f'in fatigue guys. Gotta balance the gains vs the overdoing it delay healing
take your time bb's
Patients with ALS can have motor weakness in their facial muscles. List functional and respiratory applications of this.
difficulty swallowing, cannot project voice/enunciate, cannot clear excess saliva, increased risk of aspiration
resp: secretion retention, pneumonia risk, atelectasis due to rep. muscle weakness
What are major risk factors of stroke specific to women
early menopause
estrogen supplementation
pregnancy, birth, and first 6 weeks PP
preeclampsia