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Lecture I
Impairments and Limitations, Stroke, MS, Neuroanatomy
80
Medical
Graduate
07/03/2015

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Term
Impairments or Limitation: weakness/paralysis
Definition
impairment
Term
Impairments or Limitation: tone changes-spasticity, flaccidity, rigidity
Definition
impairment
Term
Impairments or Limitation: sensory loss/perceptual deficits
Definition
impairment
Term
Impairments or Limitation: coordination deficits
Definition
impairments
Term
Impairments or Limitation: balance dysfunction
Definition
impairment
Term
Impairments or Limitation: akinesia, bradykinesia, motor planning deficits
Definition
impairment
Term
Impairments or Limitation: cognitive limitations
Definition
impairment
Term
Impairments or Limitation: aphasia
Definition
impairment
Term
Impairments or Limitation: bed mobility
Definition
limitations
Term
Impairments or Limitation: transfers
Definition
limitations
Term
Impairments or Limitation: walking
Definition
limitations
Term
Impairments or Limitation: hygiene, dressing
Definition
limitation
Term
Impairments or Limitation: eating
Definition
limitation
Term
Impairments or Limitation: stair climbing
Definition
limitation
Term
Impairments or Limitation: inability to leave the home
Definition
limitation
Term
chronic neuroimmunologic disease of the CNS, characterized by random inflammatory episodes with myelin damage and scarring
Definition
multiple sclerosis
Term
MS is a hereditary disease. T/F?
Definition
False. Exposure to environmental trigger msut also occur
Term
Who is more likely to develop MS men or women
Definition
women
Term
4 patterns of MS
Definition
relapsing-remitting, secondary progressive, primary progressive, progressive relapsing
Term
MS patterns: clearly defined acute attacks with full recovery or a residual deficit upon recovery. Periosd between attacks characterized by lack of disease progression
Definition
relapsing remitting MS
Term
MS Patterns: with relapsing remitting MS what happens as more relapses occur
Definition
greater disability
Term
MS Patterns: 70-75% of people are intially diagnosed with this pattern
Definition
RRMS
Term
MS Patterns: begins with initial relapsing remitting course followed by progression at variable rate that may include occasional relapses and plateus
Definition
secondary progressive MS
Term
MS Patterns: of the 70-75 who begin RRMS more than 50% will develop this pattern within 10 years, and 90% within 25 years
Definition
secondary progressive MS
Term
As MS progresses, what happens to Brain volume?
Definition
decreases
Term
MS Patterns: characterized by progression of disability from onsent with or without plateaus or minor improvements
Definition
primary progressive MS
Term
MS Patterns: only 10% of MS patients are diagnosed with this pattern
Definition
primary progressive MS
Term
MS Diagnosis: requires these two pieces of evidence
Definition
evidence of lesions on MRI in at least two distinct areas (space) and that the lesions occured at discrete points in time
Term
MS diagnosis: supporting evidence from what two tests
Definition
CSF, VEP (Visual Evoked Potential)
Term
Prognosis of MS for a favorable course (4)
Definition
female, onset before 35, monoregional vs polyregional lesions, complete recovery after exacerbation
Term
Prognosis in MS: factors associated with less favorable course (5)
Definition
male, onset after 35, cerebellar symptoms (tremor, nystagmus, dysarthria, ataxia), poor recovery following exacerbations, frequent attacks
Term
MS: Treatment of acute attacks involves what? for how long?
Definition
high dose intravenous corticosteriods for 3-5 days
Term
MS: Use of corticosteriods has what long term use side effects (5)
Definition
hypertension, diabetes, osteoporosis, cataracts, ulcers
Term
How may steroids improve function during an acute attack?
Definition
improve nerve conduction by reducing inflammation, thus leading to reduction in symptoms
Term
etiology of a stroke (2)
Definition
risk factors, congenital aneurysm
Term
types of stroke 3
Definition
embolic (cardiac primary), thrombotic, hemorrhagic (aneurysm rupture/HTN)
Term
pathophysiology of a stroke (6)
Definition
ischemia, infarction of neurons, with bleed compression of underlying neural tissue, development of prenumbra, learned nonuse
Term
the prenumbra is a secondary zone of damage composed of what
Definition
lacte and glutamate accumulation
Term
Nagi Model: Pathology leads to
Definition
impairment
Term
Nagi Model: Impairment leads to
Definition
functional limitation
Term
Nagi model: funcitonal limtation leads to
Definition
disability
Term
Who model: disease leads to
Definition
impairment
Term
Who model: impairment leads to
Definition
disability
Term
WHO model: disability leads to
Definition
handicap
Term
NCMRR Model: Pathology leads to
Definition
impairment
Term
NCMRR Model: impairment leads to
Definition
functional limitation
Term
NCMRR Model: functional limitaiton lead sto
Definition
disability
Term
NCMRR Model: disability leads to
Definition
social limitation
Term
WHO II model: pathology leads to
Definition
body structures/functions
Term
WHO II model: body structures/functions leads to
Definition
activities
Term
WHO II model: activities leads to
Definition
participation
Term
WHO II Terminology: impairment
Definition
loss or abnormality of body structure of a psychological or physiological function
Term
WHO II Terminology: activity limitations
Definition
performance decrements in funcitonal activities of the person
Term
WHO II Terminology: participation restriction
Definition
person's restrictions in involvment in life situations in the context they live (societal Level)
Term
3 cortical descending pathways
Definition
corticospinal, corticobulbar, cortical inhibiting axons to subcortical nuclei
Term
3 subcortical nuclei and associated descending pathways
Definition
red nucleus (rubrospinal tract), vestibular nucleus (vestibulospinal tract), reticular formation (reticulospinal tract)
Term
tracts of brainstem (2)
Definition
desending corticobulbar, ascending sensory
Term
3 tracts of spinal cord
Definition
descending corticospinal, descending pathways from subcortical nuclei, ascends sensory pathways
Term
4 ascending sensory pathways of the spinal cord
Definition
dorsal column/medial lemniscus system, ant spinothalamic, lat spinothalamic, spinocerebellar
Term
motor components of peripheral nervous system
Definition
alpha motor neurons, gamma motor neurons
Term
sensory afferents of peripheral nervous system
Definition
muscle spindles, GTOs, joint proprioception, mechanoreceptors
Term
aa of Circle of willis (8)
Definition
vertebral, basilar, posterior communicating, internal carotid, middle cerebral, anterior cerebral, anterior communicating
Term
anterior cerebral aa supplies what
Definition
LE portion of the motor homunculus
Term
middle cerebral aa supplies what (8)
Definition
arm, face, and trunk of motor homunculus, broca's area, wernicke's area, visual radiations, basal ganglia, genu of internal capsule
Term
5 impairments from lesions of motor pathways
Definition
weakness, spasticity, balance deficit, coordination deficits, sensory and perceptual deficits
Term
3 types of balance deficits associated with impairments from lesions of motor pathways
Definition
somatosensory, visual, vestibular
Term
upper motor neuron palsy name
Definition
supranuclear palsy
Term
signs of supranuclear palsy (7)
Definition
mm affected in groups, slight atrophy due to disuse, spasticity with increased DTRs, + Babinski, - fascicular twitches, normal NCV, - denervation in EMG
Term
Lower motor neuron palsy name
Definition
infranuclear palsy
Term
infranuclear palsy signs and symptoms (7)
Definition
individual mm may be affected, atrophy pronounced 70-80%, decrease tone with decreased or 0 DTRs, -Babinski, +fasicular twitches, abnormal NCV, +EMG with fibrillation
Term
Upper motor neuron lesion examples (4)
Definition
CVA, MS, huntington's chorea, parkinson's, head injury
Term
lower motor neuron lesion examples (5)
Definition
bell's palsy, carpal tunnel, trauma/lesion to peripheral nn, guillian barre, herpes zoster
Term
CSF disturbance lead sto...
Definition
hydrocephalus
Term
examples of intracranial neoplams
Definition
gliomas, meningiomas, astrocytomas, meduloblastomas
Term
examples of nonviral infections
Definition
bacterial meningitis, bacterial encephalitis, brain abcess
Term
examples of viral infection
Definition
poliomyelitis, herpes zoster, acute encephalitis
Term
examples of CVA
Definition
thrombotic, embolic, hemorrhagic
Term
disease of the spinal cord examples
Definition
trauma, myelitis, vascular lesions
Term
examples of demyelinating disease
Definition
MS, guillian barre
Term
examples of degenerative disease
Definition
Alzheimer's disease, Huntington chorea, parkinson's disease
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