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Cerebral Vascular Accident (CVA)
- -AKA Stroke, most common CNS Disorder
- -Damage to the brain from oxygen deprivation caused by blocked blood vessel or internal hemorrhage in the brain.
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Symptoms of a stroke
- weakness, numbness or paralysis of the face, arm or leg on one side of the body.
- Blurred or diminished vision or asymmetrical pupils
- Difficulty speaking or understanding simple sentences
- Dizziness or clumsiness
- sudden very extreme headache
- loss of consciousness
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Flaccid Paralysis
- Lesion in the lower motor neuron
- Tissue that lose innervation become fragile, dystrophic & are easily injured.
- Injuries take longer to heal
- Edema, pain and paresthesia will be present.
- muscle tone and tendon reflexes will be diminished or absent.
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Parkinson's Diseases
- Reduced Dopamine in the basal ganglia
- Slowly progressing disease
- More common in men, 50-60 year age group
- slowly spreading tremor, fatigue, muscular weakness, rigidity & festinating gait
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Parkinson's Treatment Triangle
- If able to position prone, bolster under shoulders
- Gentle Kneading
- Passive movement -Gentle prolonged stretching of flexors
- Active movement - concentric and eccentric muscle work
- Abdominal massage for constipation
- @ home, make faces in the mirror.
- Avoid nerve commpression
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Multiple Sclerosis (MS)
-Etiology
- Idiopathic
- Causes inflammation the degeneration of myelin sheath in CNS
- More common in women, 20-40 year age group
- Heat exacerbates symptoms
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Multiple Sclerosis (MS)
Symptoms
- Double vision (diplopia)
- Involuntary movement of eyes, reduced vision or color blindness
- Vertigo, loss of balance, lack of coordination
- bladder or bowel dysfunction
- Fatigue, mood swings
- Paresthesia, spasticity
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4 Shoulder Articulations
- Scapulothoracic
- Sternoclavicular
- Acromioclavicular
- Glenohumeral
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ROM of Glenohumeral Joint
- Flexion
- Extension
- Medial and lateral rotation
- Abduction and adduction
*Most motion occurs at this joint
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ROM of the Scapulothoracic Articulation
- Elevation
- Depression
- Upward and downward rotation
- Protraction and retraction of the scapula
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The Rotator Cuff consists of what 4 muscles?
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
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What 4 muscles are affected with Protracted Shoulders?
- Pec major
- Lat dorsi
- Teres major
- anterior deltoid
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What 2 muscles are affected with Elevated Shoulders?
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Tendinitis
- Acute onset
- current or past trauma
- Tear from overwhelming force
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Tendinosis
- Chronic Onset
- Weakened by microtears
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Apley Scratch Test
- Client attempts to reach behind back with one hand reaching over and behind the shoulder (testing abduction and external rotation), the other hand reaching behind the lower ribs (testing internal rotation and adduction). Both arms get tested in both postions and results compared.
- Frozen shoulder
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Frozen Shoulder
Glenohumeral stiffness and lost range of motion
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Adhesive Capsulitis
Loss of active and passive motion due to adhesions in the glenohumeral joint capsule
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Tennis Elbow Test
- Compress common extensor tendons (2 finger widths below lateral epicondyle) and perform MRT for wrist extension. Pain is positive test.
- Lateral Epicondylitis
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