NEURO

________: a medical doctor who specializes in physical medicine and rehabilitation whose primary responsibility is for the medical care of the patient.

______ ______: concerned with teaching patients to do as much for themselves as possible. This involves evaluating patient's needs and then initiating exercises to increase muscle strength and joint movement.

______ _____: through evaluation and treatment, provides patients with an opportunity to reach their maximum level of physical and psychosocial funciton so that they can live independently.

______ and _______ _______:evaluates patients for communicationproblems and intitates therapy as needed.

________: evaluates intellect, personality functions, and emotional adjustment, as needed.

_____ ______: through involvement and participation in therapeutic recreational programs, the patient will become more socially involved with others, develop and use physical and intellectual abilities, learn new skills, and or modify old ones.

_______ therapist: available to assess the breathing status of patients. Treatment is provided as deemed necessary by the physician.

______ ______: patient and family advocate to ensure family input into the patent's treatment program, and also keeps the family informed of the patient's progres and sets up family conferences and teaching sessions.

______ ______: provides 24 hour care to persons with spinal cord injury.

_______: plays an integral role in the care of the patient with spinal cord injury. A thorough nutritional assessment is conducted upon admission ot determine each patient's unique needs.

_____ ____: may be assigned to each patient on admission. He or she provides clinical coordination for all services provided to the patient.

FIM:
Independent: another person is not required for activity.
______ _____: all of the tasks describes as making up the activity are typically performed safely, without modification, assistive devises, or aids, and witing reasonable time.
______ _____: activity requires any one or more than one of the following: assistive device, more than reasonable time, or there are safety considerations.

FIM:
modified dependence: subject expends half or more of the efort. The levels of assistance required are:
_____ or _____: subject requires no more help than standby, cuing or coaxing without physical contact. Or, helper sets up needed items or applies orthoses.
_____ _____ _____: wit hphysical contact the subject requires no more help than touching, and subject expends 75% or more of the effort.
______ _____: subject requires more help than touching, or expends half or more of the effort.

FIM:
complet dependence: the subject expends less than half or the effort. Maximal or total assistance is required, or the activity is not performed.
_____ ______: subject expends less than 50% of the effort, but at least 25%.
______ _____: subject expends less than 25% of the effort.

_____: disruption of blood supply to an area of the brain resulting in neurologic impairment.

Warning signs of a stroke: 5 total

Clinical Manifestations of Stroke:
____ and ___ of lesion is more critical to production of deficits/clinical signst than type of CVA

______ CVA:
* right hemiparesis
* difficulty understanding what is being said by others and or self
* difficulty speaking (word finding, nonsense words, telegraphic speech)
* dificulty understanding written language (reading)
* difficulty with writing
* right neglect/visual field deficits
* difficulty wit hmath
* perservation
* fatigue
* emotional lability

_____ CVA:
* short attention span
* denial of impairments
* distractibility
* difficulty with abstract
* difficulty ordering of events
* difficulty wit hmath
* left neglect or visual field deficits
* confabulation
* absence of facial expression
* impaired sense of humor
* agnosia
* difficulty swallowing
* fatigue
* emotional lability

Common impairments of L and R CVA: 5

Speech/Language Disorders:
Typically with lesions of the ______ cortexof dominant hemisphere (usually _____ hemisphere)

_____: communication disorder caused by brain damage. Impaired language comprehension, formulation, and use. Can include writing.

______ aphasia: (damage areais called Wernicke's area) speech flows smoothly and is spontaneous. Impaired comprehension, naming, reading and writing with word substitutions.

_____ aphasia: (damage to Broca's area) speech is slow, poorly articulated, and hesitant with limited vocab. Good comprehension for spoken word with good reading and writing ability.

_______ aphasia: all aspects of language affected, unable to speak or ocmprehend, and poor reading and writing.

________: impaired speech production due to damage to PNS or CNS that causes weakness, paralysi, or incoordination of motor speech system.

Orophacial dysfunction:
______: swallowing dysfunction.

_____ CVA: negative, anxious, hesitant, and depressed; cautious, insecure and uncertain.

____ CVA: impulsive, poor awareness of deficits, poorjudge of own abilities, misjudged as uncooperative, unmotivated, overly dependent, and confused.

________: lose emotional control, go from lauging to crying for no apparent reason. Important to redirect or distract.

______ ______: emotional responses following decreasedsensory input due to visual impairments, decreased hearing, decreased touch. Worse at night ="sundowning"

______: results from multiple infarcts, faulty judgements, poor memory, and mood alterations.

______: active process that determines which sensations and experiences are relevant to the individual.

______: stories or words that are used to fill in gaps in memory; pt believes these to be true
______: common (1/3 cases with stroke) due to psychological reaction to loss; also due to physiological changes.

______: postural model of body including relationship of parts to each other

_____: Mental image of one's body (body image)

_____: inability to recognize sensory stimuli; can be visual, tactile, or auditory

______: when asked to lock R brake on w/c, patient cannot find it despite repeated attempts and looking in that direction

_____: When asked to lock L brake on w/c, patient initally makes no attempt. Does not look left without visual AND spatial cues.

____: inability to percieve one side of body or environment; usually with R CVA

_____: unpleasant abnormal sensation produced by normal stimuli

____: altered strength

(UE/LE) more affected; (Distal/Proximal) muscles more affected

Atrophy of type ___ ____ twitch fibers

____: lack of resistance to movement

____: no tone at all; right after a stroke

____: increased above normal resting levels of resistance

_____: disordered tone; basal ganglia lesions

______: increased resistance to passive stretch; emerges in 90% of the cases and may lead to contractures

_____: dominate synergy of UE with:
-retraction, abd and ER of shoulder
-flex elbow
-supination of forearm
-wrist/finger flex

_____: weaker UE synergy
-protraction of shoulder
-add of UE
-IR of shoulder
-ext of elbow
-pronation of forearm
-ext wrist with flex fingers

_____: combo of two UE synergies

______: weakest LE synergy
-flex, abd & ER of hip
-flex knee
-DF and inversion of ankle
-ext of toes

_____: dominate LE synergy
-add, IR and ext of hip
-ext of knee
-PF and inversion of ankle
-PF of toes, maybe ext of great toe

___ ____ ____ ____: ATNR

____ _____: reflex stimulation due to yawn, cough, sneeze or stretch; involuntary limb movement due to voluntary movement of another extremity

Flexion of uninvolved UE evokes ____ of involved UE; same with extension

Flexion of uninvolved side evokes ____ of involved side; opposit for extension

_____ ______: resistance of abd in uninvolved side elicits abd of involved limb

____ ____ _____: flexion of hemiplegic UE elicits flexion of hemiplegic LE

_____: inability to carry out purposeful movements despite lack of motor, sensory, cognitive or behavioral deficits - can't initiate, but understand!

Rx for this: proprioceptive/tactile input throughout, ____ verbal commands, and support

______: complication due to bed rest, paralysis or decreased activity; includes edema, "tight" feeling in calf, positive Homan's sign (pain with passive ankle ____)

____: flexibility of connective tissue is lost

_____: common impairment of shoulder after stroke

____ stage: decreased support and action of RC muscles

____ stage: adnormal tone of shoulder muscles

_____: effect after cerebellar stroke; due to loss of proprioception & weakness causing decreased coordination

Rx: postural stability with joint approximations, PNF, slow weight shifts

A condition seen after a CVA in which the patient pushes strongly towards his hemiplegic side in all positions and resists any attempt at passive correction
of this posture?

Condition with symptoms like:
–Unable to sit up/ fall to hemiplegic side
–Fail to use axial or trunk muscles
–do not resist correction

The tendency to fall sideways
–Cerebellar and Brain Stem lesions: (Wallenberg’s Syndrome)
–Tilt of visual vertical = vision aligns improperly with environment
–Deviate ipsilaterally = toward brain lesion
–do not resist correction or push with nonparetic side

Lose balance due to hemiparesis and fall
to hemi side but:
•Recognize loss of balance
•do not resist correction
•Cling onto something with non-paretic hand to prevent fall

Tilt of visual vertical without pushing behavior

40-50% of all Pushers are ____ CVAs

Pushing: High correlations are due to close anatomical relationships of _______ to those causing Neglect or Aphasia

•Karnath (2000) et al investigated
pushing patients ability to align themselves to earth vertical = subjective
postural vertical (SPV)
•Sitting in tilting chair with eyes open: patients ____
•Eyes closed: patients aligned themselves ~20 degrees towards the ______ side
(against hypothesis that would align 20 degrees to _____ side)

Pushers can visually identify objects that are vertically aligned.

True or False?
True False

A diagnosis of “pusher syndrome”
does not necessarily mean a _____ prognosis.

-brain compensates for the mechanism/
cause

Intervention for pushing includes: (8)

1st step in treating pushing

2nd step in treating pushing

3rd step in treating pushing

Pusher's unlike usual stroke patients must weight bear on ____ side and use ____ side to control pushing.

Weak point in blood vessel in brain can bulge and rupture causing a _____.

Can be caused by trauma, infection, hardening of arteries or be congenital

enlarged pupil in one eye, drooping eyelid, pain behind one eye are common symptoms

Common place for berry aneurysms to form

Abnormal collection of blood vessels; lack of tiny capilllaries

Cause: congenital

_____: Symptoms include headache, seizures, dizziness

Can be diagnosed by ___, ____, or _____

Treatment includes: ____, radiation or surgery

Cerebral aneurysms can be located by ____; if negative, a _____ can be performed to check for blood in CSF

plugging the blood vessels of the AVM:_____

small tube is inserted into _____ artery then threaded to the area needed where glue or wire is used to block off area

Risk of bleeding from an AVM (increases/decreases) over time.