15 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 hunt. You 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 9: ALS, 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 the other 60:
- Recovery: 6 – 24 months (most during the first 3 months)
- Warning Signs of a CVA you need to know: FAST
Spot a Stroke: Warning Signs and Symptoms
https://www.stroke.org/en/about-stroke/stroke-symptoms
A – Arm Weakness
S – Speech Difficulty
T – Time 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