16 Chapter 06 – Lecture Unit 6: Neurological System

Neurological Conditions

For this chapter, we will be introducing you to the pathophysiology textbook you will be using next year if the form of a scavenger huntYou will need the following link to work through this chapter:  Your neuro-text link

You will be working through just five conditions but will be using Chapters 9 and 10 of this Pathophysiology text to do so.  These chapters contain both text and Kahn Academy Videos.  I will guide your search through the information, questions and prompts below.

PATHOPHYSIOLOGY OER TEXT Chapter 9:  ALS, MS,  and Parkinson’s Disease

PATHOPHYSIOLOGY OER TEXT Chapter 10:  CVA and Traumatic Brain Injury

As a clinician, you will treat many patients with neurological conditions.  Some, because it is the primary reason, they are receiving PT services. Others, because they have a neurological condition as part of their PMH. Regardless, you will need to be aware of the pathophysiology and precautions, treatments and challenges of these diagnoses to be an effective clinician.

Your Mission:

  • Review the questions below and then use your link to find the answers in your pathophysiology resource. Some of the answers are going to be very obvious; others will require some thinking.   Have FUN!!

PATHOPHYSIOLOGY Text Chapter 9ALS, MS,  and Parkinson’s Disease.

(multiple choice – There are 17 questions, click next to go to the next question.)

Review:

  • Amyotrophic lateral sclerosis: A progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord.
    A-myo-trophic:
    “A” …No.
    “Myo” …Muscle
    “Trophic” …nourishment / growth
    “No muscle nourishment / growth.”
  • Motor learning: The process of skill or movement acquisition
  • Motor development: The age-related processes of changes in motor behavior seen over the life span
  • Motor control: Refers to neural control of posture and movement
  • The Task-Oriented approach uses the neuroplasticity of the CNS to facilitate recovery of function by using the involved extremity to accomplish everyday skills/activities/tasks.
  • Big and Loud treatment for patients with Parkinson’s Disease:
  • Big and Loud Treatment Video

A spinal cord injury (SCI) is the result of damage to the spinal cord which causes paresis or plegia of the trunk and / or extremities.

GENERAL CONSIDERATIONS FOR SCI:

Etiology:  Typically result of trauma: MVA, Fall, Sports-related.

Age of onset:  More common for those between the ages of 16 – 30.

Gender bias:  Men > Women

Quadriplegia (all 4 extremities) versus paraplegia (2 extremities) or diplegia (both LEs)

Incomplete vs complete

Paresis vs plegia

Prevention of complications:  Spasticity, contractures, skin breakdown and autonomic dysreflexia (AD).

AD is a potentially life-threatening medical emergency that affects people with spinal cord injuries: At the level of T6 or above.

 

PATHOPHYSIOLOGY Text Chapter 10: CVA and Traumatic Brain Injury

CVA and Traumatic Brain Injury

(multiple choice – There are 7 questions, click next to go to the next question.)

Review:

REVIEW:

  • A CVA may be referred to as White or Red.
    White:  Blockage from a clot that results in ischemia.
    Red:   Impaired blood flow d/t hemorrhage.
  • Statistics for a CVA may include:

For every 100:

  • 22 – 25: Die within one year.

Of the remaining 75:

  • 30 – 40: Severe disability.

Of that 40:

  • Recovery: 6 – 24 months (most during the first 3 months)

 

  • Warning Signs of a CVA you need to know: FAST

 

FAST
Spot a Stroke: Warning Signs and Symptoms
https://www.stroke.org/en/about-stroke/stroke-symptomsFacial Drooping
AArm Weakness
SSpeech Difficulty
TTime to call 911
  • A short video regarding PT treatment for those with a CVA. Stroke Rehab Video
  • The two types of hemorrhagic strokes are intracerebral hemorrhage subarachnoid hemorrhage.
  • The assessment tool used in the emergency room to assess a patient’s level of consciousness following a head injury: The Glasgow Coma Scale

Glasgow Coma Scale

Response: Eye Opening Responses

Scale Score
Eyes open spontaneously 4 points
Eyes open to verbal command, speech, or shout 3 points
Eyes open to pain (not applied to face) 2 points
No eye opening 1 point

Response: Verbal Responses

Scale Score
Oriented 5 points
Confused conversation, but able to answer questions 4 points
Inappropriate responses, words discernible 3 points
Incomprehensible sounds or speech 3 points
No Verbal response 1 point

Response: Motor Response

Scale Score
Obeys commands for movement 6 points
Purposeful movement to painful stimulus 5 points
Withdraws from pain 4 points
Abnormal (spastic) flexion, decorticate posture 3 points
Extensor (rigid) response, descerebrate posture 2 points
No motor response 1 point

Minor Brain Injury = 13 – 15 points; Moderate Brain Injury = 9 – 12 points; Severe Brain Injury = 3 – 8 points

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Introduction to the Practice and Policies of the Physical Therapist Assistant Copyright © by Dan Dandy PT, DPT, ACCE is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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