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What percent of the US has a visual impairment?
17% (14 million)
How many individuals are "totally blind"?
130,000 people
What disability do people say is "the worst thing that can ever happen"?
visual impairment
How many visually impaired are also hearing impaired and wheelchair users?
What are the 7 components of vison?
visual acuity, visual field, contrast sensitivity, lighting/glare, binocular vision, color vision, night vision
What is visual acuity?
ability to resolve detail; testing distance/letter size; unlike most animals
Which component of vision includes the Snellen Measurement System?
visual acuity
What does letter size represent?
distance needed for letter to create visual angle of 5 minutes; "I see at X feet what everyone else sees at Y feet."
What is the visual field?
scope of vision, normal is 105 degrees,
How is visual acuity measured?
perimetry-testing the visual angle
T/F You lose acuity with increased field is evolution at work.
What is contrast sensibility?
ability to determine foreground and background
Can individuals have completely different states of acuity and contrast sensitivity?
Is the world typically in high contrast?
What is lighting/glare?
the sensitivity threshold to light and glare can compound visual impairment; more of visual comfort concept-effects acuity
What is binocular vision?
ability of both eyes fixating on one object resulting in single image
What two things result due to poor binocular vision?
double vision or loss of visual field
What is color vision?
ability to distinguish hues and shades
T/F Color vision impairment affects women more.
False. Men, typically involves only certain hues.
T/F Lou Gehrig's disease may cause color vision impairment.
What is night vision?
ability to utilize lesser amounts of light to maintain acuity, field, and contrast
Are color vision and night vision symptomatic of certain diseases?
T/F Night vision is disabling and dangerous.
To be legally blind one out of what two things must be true?
1-best corrected acuity is 20/200 or worse in better eye
2-peripheral visual field is restricted to 20 degrees or less
T/F If you are legally blind you are totally blind.
What are 5 specific visual diseases?
cataract, corneal disease, macular degeneration, glaucoma, retinitis pigmentosa
What is a cataract?
clouding of the lens, resulting in acuity and contrast deficiencies; in middle normally no outer lens
T/F Cataracts are a normal part of aging.
True-50% of those 65-70y/o and 70% of 75+y/o
T/F Caucasians are 3x more likely to have cataracts.
T/F Smokers have a 60% increase for cataracts.
What are some causes of cataracts?
eye trauma, genetics, or systemic conditions
T/F Cataracts progressively worsen.
How are cataracts diagnosed?
ocular examination
What is done about cataracts?
surgically removed and replaced with intraocular lens (IOL)
What is corneal disease?
disease manifestation that directly affects cornea, resulting in acuity loss-contrast can remain intact; also known as myopia(can't see detail)
Are there demographic variables indicated in prevalence?
What are the leading causes of corneal disease?
keratonous, viral infections, trauma, and dystrophies
What is done to diagnose corneal disease?
ocular examination
What treatment is there for corneal disease?
keratoplasty, which requires a compatible donor
What is the leading cause of visual impairment in the elderly?
macular degeneration
What is macular degeneration the result of?
blood vessel damage near macula
What are some causes of macular degeneration?
age-related atrophy of macula, development of fibrovascular scarring, cyst formation, trauma, and hypertension
T/F Macular degeneration has prevalence towards caucasians and there has been a genetic component found.
What two types of macular degeneration are there?
dry and wet
Which type of macular degeneration is more disabling: wet or dry?
Why is wet macular degeneration more disabling than dry?
results in greater visual impairment(acuity/contrast) and vision is lost more rapidly
T/F Dry macular degeneration's vision is lost more rapidly than wet.
False, it remains the same.
How is macular degeneration diagnosed?
ocular examination
What is treatment for macular degeneration?
laser photocoagulation for wet MD; you can utilize radiation therapy, retinal cell transplantation, and the use of Vascular Endothelial Growth Factor (VEGF)-reduces risk of further blood vessel damage
What is glaucoma?
an increase in ocular pressure, resulting in atrophy and death of the optic nerve; loss of field, have acuity til nerve goes
What are some causes of glaucoma?
congenital, hereditary, systemic, traumatic, and drug- and surgery-induced
What are the three types of glaucoma?
chronic, acute, and low-tension
What is chronic glaucoma?
progessive elevation in pressure to optic nerve
What is acute glaucoma?
rapid increase typically accompanied by intense ocular pain; due to trauma or surgery; repairable;
What type of glaucoma is repairable chronic, acute, or low-tension?
What is low-tension glaucoma?
pressure that decreases blood flow to optic nerve
How is glaucoma diagnosed?
ocular examination
What is treatment for glaucoma?
options are based on visual impairment issue-carbachol(eye drop) is taken by everyone; pressure release surgery to alleviate field, contrast, and glare problems; laser therapy to alleviate field problems; glaucoma can be recurrent-medication compliance(why use medicine if I can see);
What is the number one cause of blindness?
retinitis pigmentosa
What is retinitis pigmentosa?
progressive genetic eye disease that is most common for inherited blindness
T/F 30% of those with retinitis pigmentosa have congenital hearing impairment.
T/F There is an unresponsible gene for retinitis pigmentosa.
What visual impairment causes a major visual field impairment "island of vision"?
retinitis pigmentosas
T/F Loss of night vision, and acuity in later stages, also can present with retinitis pigmentosas.
How is retinitis pigmentosas diagnosed?
electroretinogram and ocular examination
What treatment options are there for retinitis pigmentosas?
None, periodic vision exams are needed to determine appropriate assistive technology and accomodations.
T/F Conductive hearing loss has to do with the inner ear.
False, outer and middle.
What is conductive hearing loss?
impairment of hearing due to a disruption of the transmission of sound through the OUTER and MIDDLE ear
What are the 4 causes of conductive hearing loss?
1-ear canal blockage; 2-eustachian tube blockage; 3-eardrum damage; 4-hereditary factors;
What is ear canal blockage?
conductive hearing loss; perceived reduced volume
What causes ear canal blockage?
caused by wax build-up or foreign objects (tumor, items, jelly bean)
What is treatment for ear canal blockage?
removal of blockage, including physical/surgical removal
What is eustachian tube blockage?
conductive hearing loss; results in distorted sounds, typically reported as muffled
What causes eustachian tube blockage?
infection or allergic reaction
How is eustachian tube blockage treated?
antibiotic (Otimar) or antihistamine treatment to reduce blockage
What is eardrum damage?
conductive hearing loss; results in ear/temporal pain and reduction in sound volume
What causes eardrum damage?
viral infection, but can also occur from trauma
What is the treatment for eardrum damage?
medication, eardrum lancing, tube insertion, or surgical repair of eardrum
What are the two hereditary causes for hearing loss?
otosclerosis and atresia
What is otosclerosis?
hereditary cause of conductive hearing loss; chronic condition or ossicle(middle ear); major volume reduction;
What is atresia?
hereditary cause of conductive hearing loss; progressive atrophy of ear drum; major volume reduction;
What are the treatments for otosclerosis and atresia?
otosclerosis-implantation of prosthetic ossicles and hearing aid usage; atresia-no treatment
What is sensorinerual hearing loss?
hearing impairment due to sensory or nerve damage in the INNER ear, auditory nerve, or auditory cortex of the brain; all causes result in severe reduction of sound volume(can be complete), sound distortion, loss of some speech sounds, and language interpretation difficulties;
What are the 3 classes of sensorineural hearing loss?
prenatal, postnatal, and other
What causes prenatal sensorineural hearing loss?
causes include genetic hearing loss and viral infection
What causes postnatal sensorineural hearing loss?
premature birth, anoxia, viral infections, bacterial infections
What can be a cause for both prenatal and postnatal sensorineural hearing loss?
toxic exposure(fetal alcohol syndrome)
What causes "other" sensorineural hearing loss?
aging(inner), ototoxic drugs(mycin), head injuries, auditory nerve tumor, excessive noise exposure, and Meniere's Disease
What is mycin?
an ototoxic drug that has an associated risk with causing sensorineural hearing loss
What is Meniere's Disease?
a chronic condition-increase fluid pressure on auditory nerve NOT very common; causes sensorineural hearing loss; antihistamine usage alleviates symptoms
What are treatments for sensorineural hearing loss?
hearing aid usage and cochlear implants for all; surgery is available for auditory nerve tumors, but only somewhat successful; antihistamine usage for Meniere's Disease, but only alleviates symptoms
What is the decibel measurement for a normal conversation?
What is hard of hearing?
difficulty hearing items that range between 35-69dB; unable of hearing conversational speech without hearing aid usage
What is deafness?
incapable of hearing anything below 75dB; speech is nearly impossible to hear even with hearing aid usage
What are the 2 most common speech disorders?
aphasia and apraxia
What is aphasia?
inability to express and/or comprehend language as a result of organic brain damage; typically left cortex; 2/3 or those who have CVA(stroke) report aphasia; demonstrated language content, meaning, structure, and usage dysfunction; cognitive processes (memory) may also be affected; dysnomia(unable to name objects) and dysgraphia(can't write down word); intelligence remains intact;
What is dysnomia?
unable to name objects
What is dysgraphia?
can't write down word
What is aphasia a result of?
brain tumor, head trauma, and viral/bacterial infections
What are the 2 classes of aphasia?
fluent and nonfluent
What is fluent aphasia?
effortless speech, but may be completely void of content, anomic(can't describe 1 thing but beat around bush), or palilative(keep repeating something over); comprehension & read/write difficulties; Wernicke's Aphasia-could only say w/ speech therapy
Which type of aphasia is more difficult to work with fluent or nonfluent?
What is non-fluent aphasia?
speech is dramatically impaired; intact comprehension w/ limited expression; Broca's Aphasia-easily tell you??(you tell them?); "Global Aphasia"
How is aphasia diagnosed?
symptoms and CT
What is treatment for aphasia?
speech-language therapy-no efficacious medications or surgical options available; use melody to regain speaking;
What is apraxia?
impairment of the capacity to utilize muscles required for speech; "voice paralysis"-neurologically cuased; can be subtle to profound; comprehension no compromised; slow, deliberate, and full of errors; cognitively intact and aware;
How is apraxia diagnosed?
symptoms and EMG-electromyogram
What is the treatment for apraxia?
speech-language therapy and experimental Transcranial Magnetic Stimulation (TMS)-wave on head
What are the 3 things for the TBI Model system definition of TBI?
1-documented loss of consciousness(length of time not indicated); 2-person has amnesia for event. This means they can't recall the actual traumatic event; 3-Glasgow Coma Scale(GCS) score of less than 15 during first 24 hours;
What is the Brain Injury Association definition of TBI?
Insult to the brain, not of a degenerative or congenital nature but caused by an external physical force, that may produce a diminished or altered state of consciousness which results in an impairment cognitive abilities or physical functioning. It may be either temporary or permanent and cause partial or total functional disability or psychosocial maladjustment.
After how many seconds does one person in the US sustain a TBI?
21 seconds
How many times more likely are you to sustain a TBI than alzheimer's?
Do males or females get TBI's more?
men 78.8 vs. 21.2
What age range has the most TBIs 15-25 or 26-35?
What are the 2 types of TBI?
open head injury and closed head injury
What is open head injury?
TBI where skull is penetrated and exposed to air
What is a closed head injury?
TBI where cranial contents have not been penetrated and there is no air inside the protective layer os the skull
Which type of TBI is better to have open or closed?
open, pressure has somewhere to go
What are the 5 stages on the Glasgow Coma Scale?
1-Dead; 2-Vegetative state:unable to interact w/ environment; unresponsive; 3-Severe disability:able to follow commands/unable to live independently; 4-Moderately disability:able to live independently, unable to return to work or school; 5-Good recovery-able to return to work or school
T/F the GCS range is determined within the first 24 hours.
T/F Can have more deficits even if mild TBI or severe TBI that doesn't show deficits.
T/F The higher the GCS range the more mild of a TBI.
True. (3-8-severe) (9-12-moderate) (13-15-mild)
What are the two distinct stages of the development of brain damage?
primary damage and secondary damage
What is primary damage in regards to TBI?
occurs at moment of impact; clinically untreatable; skull fracture, contusions, lacerations, diffuse axonal injury, intracranial hemorrhage, etc. (coup contra coup); seatbelts and airbags will help prevent; blood touches brain tissue and then kills it (brain is made of water & salt-good conductors)
What is secondary damage in regards to TBI?
complicating events initiated at the moment of injury; do not present clinically for a period of time after the injury; includes elevated intracranial pressure, hypoxia/ischemia, swelling, inflammation, infection, vasospasms, chemical changes at the cellular level;
What does the hypocampus deal with?
memory-short term
Which type of TBI is the best for rehab outcome?
What is the frontal lobe responsible for?
how we know what we are doing w/in enviro.(consciousness); how we initiate activity in response to enviro.; controls emotional response & expressive language; involves word meaning; memory for habits & motor activities;
What are some observed problems with damage to frontal lobe?
loss of simple movement of various body parts(paralysis); inability to complete multi-stepped tasks; persistence of single thought; inability to focus on task; Broca's aphasia(inability to express language)
What is the parietal lob responsible for?
near the back & top of head; visual attention; touch perceptions; goal directed voluntary movements; manipulation of objects; integration of different senses that allows for understanding a single concept;
What are some observed problems with damage to parietal lobe?
inability to attend to more than one object at a time; inability to name an object(anomia); inability to locate words for writing(agraphia); problems with reading(alexia); difficulty drawing objects; difficulty in distinguishing left from right; diff. doing math(dyscalculia); lack of awareness of certain body parts; inabilty to focus visual attention; difficulties w/ hand eye coordination;
What is the occipital lobe responsible for?
most posterior, at the back of head; vision
What are some problems observed with damage to occipital lobe?
defects in vision; difficulty locating objects in enviro; difficulty w/ identifying colors; production of hallucinations; visual illusions; word blindness; difficulties w/ reading & writing;
What functions are associated w/ the temporal lobe?
side of head above ears; hearing ability, memory acquisition, some visual perceptions, and categorization of objects
What are some problems observed with damage to temporal lobe?
difficulty recognizing faces(prosopagnosia); diff. understanding spoken word (Wernicke's Aphasia); short-term memory loss; interference w/ long-term memory; increased or decreased sex drive; inability to categorize objects; right lobe can cause persistant talking; increased aggressive behavior
What functions are associated with the brain stem?
breathing, heart rate, swallowing, reflexes to seeing & hearing; sweating, blood pressure, digestion, temperature(autonomic nervous system); affects level of alertness; ability to sleep; sense of balance(vestibular function)
What are some observed problems of brain stem damage?
dizziness & nausea; sleeping difficulites; swallowing food & water;
What functions are associated with the cerebellum?
located at base of skull; balance and equilibrium; some memory for reflex motor acts; coordination of voluntary movement;
What are some observed problems with damage to cerebellum?
loss of ability to walk; inability to reach & grab objects; tremors; dizziness; slurred speech; inability to make rapid movements;
What is a spinal cord injury?
any causation of disruption between neurological communication between the brain and the body; completely/incompletely severed cord, compression, bruising, loss of blood supply;
T/F The higher up the spinal cord, the greater the injury.
T/F If the spinal cord is completely severed it results in paralysis.
Is there a small population of spinal cord injured people in the US?
Yes, 200,000
What is the average age of a spinal cord injury patient?
What are the top 3 causes for spinal cord injuries?
MVA-starting to decline; Falls/Other accidents; violence-rising;
What are the 2 types of spinal cord injuries?
complete and incomplete
What is central cord syndrome?
loss of blood supply to the spinal nerve; walk, run, no use of arms; diaplagia;
What is Brown-Sequard Syndrome?
hemisectional lesion on spinal nerve; bruising; partial tear; ipsilateral sensory loss, contralateral motor functioning;
What is Cauda Equina Syndrome?
damage to the Cauda Equina; horsetail bottom, bicycle butt sensation all the time, or emergencty situation-tell brain legs fine, poor circulation;
Know these numbers about the spine:
7 cervical vertebrae; 12 thoracic vertebrae; 5 lumbar vertebrae; 5 fused sacral vertebrae; the injury to the spinal cord nerve root is either directly at or below the specified vertebrae(T-3, b/w 3rd and 4th thoracic vertebrae)
How are spinal cord injuries diagnosed?
radiographic equipment for location; pinprick test for neurological damage; 29 dermatomes;
What is the ASIA scale?
ASIA impairment scale is for one of 5 classifications for neurological functioning; A-complete, no sense or motor function in sacral segments S4-S5; B-Incomplete, motor funtion preserved below neurological level extends thru S4-S5; C-Incomplete, same above and muscles have grade less than 3; D-incomplete, above and muscle grade 3 or greater; E-Normal
What is autonomic hyperreflexia?
blood pressure imbalance caused by stimuli in spinal cord injuries
What is spasticity?
signal reflexes from motor neurons may arc from PNS to spinal cord; valium is used to control spasticity however leads to mental clarity probs.
What are decubitus ulcers?
"pressure sores" frequent and costly problem
What is the most frequent cause of death for long-term SCI?
cardiac problems
In the movie the Toughest Break how did Martin Shay obtain a spinal cord injury?
car crash
What are researchers using to help restore myelin sheath from spinal cord injuries?
HIV-to enter 2nd door but use + load
What are neurological disorders?
movement and functioning disorders attributed to deficiencies found in the neurological systems
What are neuromuscular disorders?
movement and functioning disorders attributed to deficiencies found in neurological systems THAT PROMOTE MUSCULAR ATROPHY
What is the central nervous system made up of?
brain and spinal cord; cerebrum, cerebellum, brain stem
What is the peripheral nervous system made up of?
initiates at spinal nerves, going to all areas of body and allowing sensation and muscle control
What is the autonomic nervous system?
initiates at spinal nerves, going to involuntary organ systems; sweating; don't have to think about it;
What are 5 specific neurological disorders?
epilepsy, reflex sympathetic dystrophy, spina bifida, carpal tunnel syndrome, hand-arm vibratory syndrome
What is epilepsy?
a neurological disorder; "epilepse"-derived from Greek "to be seized"; a catch-all for seizure conditions; disruption of brain activity due to neuron instability; can be partial or generalized seizure; depends on which part of the brain experiences neuron instability; slight disturbance almost unnoticeable to complete cessation of bodily activity;
What are the 6 causes of epilepsy?
birth trauma(anoxia); TBI; brain tumors; infections; vascular disorders; genetics;
What are the 2 most common causes of epilepsy?
birth trauma(anoxia) and TBI
What are 4 risk factors for epilepsy?
hypertension; depression; substance abuse; Low SES
T/F A seizure is a discrete event-recurrent needed for diagnosis.
T/F Individuals with epilepsy typically experience one type of seizure.
What are the 6 types of seizures?
tonic, clonic, tonic-clonic, atonic, myoclonic, absent
What is a tonic seizure?
What is a clonic seizure?
What is a tonic-clonic seizure?
a comob of rigid and convulsive
What is an atonic seizure?
"drop attack" motor function stops
What is a myoclonic seizure?
painful seizures-electic
What is an absent seizure?
petit mal, lose consciousness for few seconds
How is epilepsy diagnosed?
factitious disorder-don't believe true; hospitilization for 24/7 monitoring; electroencephalogram(EEG) monitoring-unless experiencing disorder everything will be fine; CT/MRI/PET may show brain disruption;
What are the medications for epilepsy?
depends on type of seizure; medications attempt to maintain neuron stability: tonic, clonic, atonic-tegretol, neurontin, topamax; tonic-clonic-valproic acid; myoclonic-tridione; absent-zarontin;
What are some treatments for epilepsy?
medications; vagus nerve stimulator-1st created for seizures no helps depression; surgical intervention IF: 1-medication can't help; 2-clear evidence of location involved; 3-lesion removal; we don't know what exactly we are messing with in the brain;
What are the 4 parental responses to epilepsy?
Created by Epilepsy Foundation of America: 1-reality-oriented; 2-over-protective(social isolation, won't let them do normal stuff) 3-spartan(suck it up and do it); 4-rejecting(unattached to child)
What is Reflex Sympathetic Dystrophy?
chronic, progressive, neurological conditions that affects skin, muscles, joints, and bones; typically in extremities, but can be located to torso; also known as CRPS-complex regional pain syndrome;
What causes Reflex Sympathetic Dystrophy?
unknown-complex interaction of the sensory, motor, autonomic nervous, and immune systems; Trauma-induced-don't know cause just that it occurs after trauma; Extreme variablity;
T/F 5% of PNS injury and 12% of hemiplegia patients develop Reflex Sympathetic Dystrophy as a complication.
T/F approximately 2% of population develops Reflex Sympathetic Dystrophy after a bone fracture.
What are the 3 stages of pain in RSD?
acute, dystrophic, and atrophic
What is acute pain in RSD?
burning pain, swelling, increased sensitivity to touch, increased hair & nail growth in affected area, joint pain, color & temp changes; first 1-3 months;
What is dystrophic pain in RSD?
constant pain and swelling, limb feels cool and looks bluish, muscle stiffness and atrophy(wasting of muscles), early osteoporosis(bone loss) 3-6 months;
What is atrophic pain in RSD?
continuous pain, cool and shiny skin, increased muscle stiffness and weakness, symptoms may spread to another limb
How do you diagnose Reflex Sympathetic Dystropy?
difficult to differentiate-neurological, neuromuscular, rheumatic; physical examination; MRI; Nerve conduction test; thermogram;
What are medications for Reflex Sympathetic Dystrophy?
anti-inflammatories; prescription pain-meds(Ultram); localized pain creams(capsacin); muscle relaxants(skelaxin);
What are some treatments for RSD?
nerve block injections-cervical for UE, lumbar for LE; TENS unit-electric shock, distraction not therapy; PT/OT; Counseling;
What is Spina Bifida?
aka myelomeningocele; congenital abnormalities of the vertebral elements, resulting in numerous motor, sensory, and cognitive dysfunctions; growth in lumbar region; gradually progress into worsen neurological states;
What are symptoms of spina bifida?
anatomical-large growth on lumbar spine, occasionally with hairy tuft, sometimes visually scoliosis-like, and extremely high-arches in feet; physiological-bladder/bowel management, sexual function, renal disease(63%); functional-LE paresis/paralysis and rigidity/contractures, usually resulting in bracing or use of wheelchair; high frequency of falls; manual fine motor skills may also be impaired; visual acuity problems may be present; cognitive-speech/language impairment commonly found, executive functioning may be impaired, not common;
T/F Caucasion females are more prone to spina bifida.
T/F The number of births with spina bifida is rising.
False, going down.
What is the causation for spina bifida?
neural tube defect-during gestation, neural tube that will become CNS doesn't fully develop resulting in: 1-failure to fuse properly, 2-disruption in tissue growth, 3-abnormal cerebrospinal fluid pressure; most frequent causes for neural tube defect includes: 1-malnutrition-folic acid and other vitamin/mineral deficiencies, 2-obesity, 3-alcohol, 4-valproic acid-prescribed for epilepsy
How can you be diagnosed for spina bifida?
prenatal diagnosis can be made via ultrasound; amniotic fluid for elevated alpha-fetoprotein analysis-second trimester so termination is available; false positives can occure if mother has gastrointestional problems at time of test; cesarean deliveries;
What is treatment for spina bifida?
comprehensive therapy; medications for symptoms alleviation; surgery for recurrent hip dislocation common;
What is carpal tunnel syndrome?
occupational injury; compression of the median nerve within wrist; clinically known as Median Nerve Dysfunction; numerous debilitating symptoms, including pain, tingling, and numbness; thumb-side of palm;
What causes carpal tunnel syndrome?
repetitive movement/action with the wrist, resulting in compression; ie-typing, sewing, playing musical instruments, sports;
How many Americans experience Carpal Tunnel Syndrome?
8 million; probably more
What age range has the highest frequency for Carpal Tunnel Syndrome?
30-50 y/o
How many times more likely is Carpal Tunnel Sydrome for women than men?
4-5x more for women than men
What are the risk factors for CTS and 4 highest frequency occupations?
computer users and demographics; 1-computer operators 2-dentists 3-construction workers 4-assembly line workers
Is carpal tunnel syndrome the most frequent surgery?
second, but WILL BE the most
What is the best treatment for CTS?
T/F 6/10 CTS cases are work related.
What are C-1 thru C-8 functions?
neck and shoulders and elbows and wrists
What are T1-T7 functions?
trunk above waist
What are the functions for L1-L5?
abdominal muscles, thighs, leg at hip;
What are the functions for L4-Ssomething?
toes leg at knee
Is ultrasound a treatment for CTS?
What is hand-arm vibratory syndrome?
occupational; damage to nerves and blood vessels located in the hands, wrists, and forearms due to continuous use of vibratory tools; breakdown of blood vessels, resulting in "blanching" of the digits and in severe cases the hands;
Do the symptoms for Hand arm vibratory syndrome take more or less time to develop than CTS?
more time to develop
What are symptoms for HAVS?
on & off tingling; slow development numbness; slow developmental pain, blanching, gangrene;
What causes HAVS?
continuous vibration to hands, wrists, arms; using power tools including pneumatic, electic, hydraulic, and gas powered;
T/F The severity of the vibration is arbitrary to HAVS.
Is there an age or sex difference for HAVS?
T/F There is a huge risk factor if you don't use proper protection and form for HAVS.
T/F Cold environmental conditions increase risk for HAVS.
T/F Air powered (pneumatic) tools are 4x greater in risk.
What are treatments for HAVS?
medical treatment is quickly necessary; if caughte before blanching, treatment consists of Education, Rest, Hand Therapy; If blanching has occured, treatment consists of calcium channel blockers, pain meds, and hand therapy; if gangrene is present amputation is required;
What are 5 neuromuscular disorders?
multiple sclerosis, muscular dystrophy, amytrophic lateral sclerosis, charcot-marie-tooth syndrome, parkinson's disease
What is multiple sclerosis?
chronic neuromuscular disease; characterized by exacerbations and remissions of CNS symptoms; clinical course of MS can last for entire lifespan;
The main difference between neuromuscular and neurological disorders is...
atrophy is caused by the neuromuscular disorder
What are causes of multiple sclerosis?
unknown; genetic predisposistion; demyelination occurs; susceptible to infection and plaque formation;
What are some risk factors for multiple sclerosis?
onset b/w 20-40 y/o; geographic tendencies-increase w/ latitude from equator; hereditary factor;
What are the 4 courses of MS?
1-relapsing-remitting: acute exacerbations w/ periods of complete remission(most common); 2-primary-progressive: continuous disease progression w/ no acute exacerbations; 3-secondary-progressive: initial relapsing-remitting course, then transforms into primary-progressive course; 4-Progressive-relapsing: continuous disease progression w/ acute exacerbations
What is the treatment for MS?
no cure; medications to treat symptoms during exacerbations; interferon-beta to promote remyelinization;
What is the average life expectancy post diagnosis of MS?
35 years
What is muscular dystrophy?
progressive genetically-linked disease; characterized by muscle weakness, muscle wasting, joint contractures, and deformities; differ in cuasation, age of onset, and clinical features; some examples: Duchenne, Facioscapulohumeral (FSH), and Myotonic;
What is Duchenne Muscular Dystrophy?
X-linked disorder-nearly males only; symptoms first appear in early childhood, include waddling gait, difficulties in rising from floor or chair, and using items for support; progressive scoliosis occurs MR may also accompany Duchenne MD
What is Facioscapulohumeral(FSH) MD?
dominant trait, equal gender; onset in adolescence, affects muscle control and development; affects shoulders, UE, facial muscles, eye mobility, and lip control; later affects pelvic muscle; footdroop may occur; no intellectual deficits;
What is myotonic MD?
dominant trait, found in more males; onset in late 20s to early 30s; facial,hand,and foot weakness noted first, then neck stability and swallowing difficulties; depression highly comorbid;
What do all 3 Duchenne, FSH, Myotonic forms for muscular dystropy share?
systemic muscle wasting, impaired arm functioning, impaired ambulation, difficulties w/ performing ADLs; will need assistance for mobility
What are treatments for MD?
no cure and no specific drug treatments; Duchenne-administer prednisone; PT/OT/Orthotics; SLP for myotonic MD
What is ALS Amytrophic Lateral Sclerosis?
chronic disease that affects CNS and PNS; Lou Gehrig's disease; muscle weakness and fasciculations; NOT type of MS-QUICK muscle atrophy
What are 4 types of ALS?
familial-case from having parent w/ ALS; guamaniam-unexplained phenomenon, ie ALS occurs in Guam at rates of 65x greater; secondary-associated w/ having syphillis and other plasma-cell disorders; sporadic-no known cause; research suggests diathesis-stress theory;
What are symptoms of ALS?
degeneration of CNS nerve cells, specifically along nerve endings; NO cognitive deficits; gait, motor, speech, and respiratory disturbances; spasticity;
What is the treatment for ALS?
no cure or drug regimen; branched amino acid therapy to slow disease; gastric feeding tube; PT/OT/Orthotics/SLP
What is the life expectancy post diagnosis for ALS?
5 years
What is Charcot-Marie-Tooth Syndrome?
progressive PNS disease characterized by muscle weakness and deformity to the hands and feet; high accompaniment by Roussy-Levy Syndrome(tremors-misdiagnosed for Parkinson's); PNS loses myelin, scarring; onset in mid-20s; no cognitive deficits
Is CMT a dominant or recessive trait?
Are there medical or surgical options for CMT?
What is the number 1 cause of neuromuscular disability in those over 60y/o? neurological?
Parkinson's; Alzheimer's
What is Parkinson's?
nonhereditary chronic disease characterized by movement and posture abnormalities; tremors;
What are the causes for Parkinson's?
unknown loss of dopamine; results in destruction of substantia nigra, then symptoms;
What are the symptoms of Parkinson's?
"pill rolling"; "cog wheeling"-rigidity in UE; "Freezing"-contractors; delayed motor response; postural changes; ANS problems; cognitive distrubances;
What are treatments for Parkinson's?
medicine to replinish dopamine; life expectancy 9 years post-onset; neurosurgery-last case scenario;

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