PTA 230 Nero Chapters 3-4

an area of damage of dysfunction

lesion

understanding the effects of lesions enables the therapist to

1. select appropriate therapy

2. predict therapeutic outcomes

3. recognize signs and symptoms that indicate the need to refer the patient to another health professional.

true or false.

where the lesion is located is more important than what caused it.

evidence a disease or an impairment that can be observed by someone other than the patient

sign

subjective experience of a patient

symptoms

limited to a single location

focal

limited to several nonsymmetric locations

multifocal

affects bilaterally symmetric structures but does not cross the midline as a single lesion

diffuse

the proportion of population that develops a new case of the disorder within in a defined time period. Exp. ( cavities in last 5 years)

incidence

current proportion of the population with the condition, including both old and new cases. Exp. (total number in room, ever had a cavity)

prevalence

is reported per 1000 people or as a % of people.

prevalence

tumor in spinal cord is an example of

focal lesion

tumor that has metastasized to several locations

multifocal

Alzheimer disease, a memory and cognitive disorder is

diffuse

Events that may affect the nervous system

. Trauma

. Vascular disorders

. Inflammation

. Degenerative disorders

. Developmental disorders

. Tumors

. Immunological disorders

. Toxic or metabolic disorders

Acute onset usually indicates a

vascular problem, trauma

subacute onset indicates an

inflammatory process, infection

chronic onset often suggests a

tumor or degenerative disease

indicating minutes or hours to maximal signs and symptoms

acute

progressing to maximal signs and symptoms over a few days

subacute

"Gradual worsening of signs and symptoms continuing for weeks or years"

chronic

questions used to obtain neurologic history

. What problems are you having

. when did the problem begin

. Did the problem start abruptly, over a few hours or days or gradually.

. How severe is the problem.

. Are symptoms constant or intermittent

. Have you had previous episodes

. Do you have any other symptoms

. Do you take medications or supplements

stroke, traumatic spinal cord injury is diagnostic example of

acute

improving or stable is a pattern of progression of

acute

multiple sclerosis, bacterial meningitis are diagnostic examples of

subacute

fluctuating and gradual improvement are pattern progressions of

subacute

meningioma, parkinson disease are diagnostic examples of

chronic

progressive and worsening are pattern progressions of

chronic

. x-rays pass through the body to the detector, to measure relative densities of tissue.

. used to see acute hemorrhage, abnormalities or bone fractures, calcified lesion, sinus disease

. scan time 5 minutes

. radiation exposure

Computed Tomography (CT)

. measures changes in oxygenated blood flow

. used to detect neural activity in the brain by evaluating changes in blood flow

. scan time 60 minutes

. no radiation

Functional Magnetic Resonance Imaging (fMRI)

. magnetic fields and radio waves detect hydrogen ions

. used to detect: stroke, tumors, infection, multiple sclerosis

. scan time 30-120 minutes

. no radiation

Magnetic Resonance Imaging (MRI)

. magnetic fields and radio waves detect water diffusion along axons

. used for: detailed images of white matter tracts, surgical planning

. scan time 30 minutes

. no radiation

Diffusion Tensor Imaging (DTI)

. detects radioactive isotopes as they travel through the blood

. use to: measure blood flow, glucose metabolism, and oxygen consumption

. scan time 30 minutes

. radiation exposure

Positron Emission Tomography (PET)

axial images are oriented

as if you are standing at the feet and looking toward the head of an inclined person

coronal images are oriented

as if you are standing in front of the person looking at him or her

what are the results in viewing axial and coronal images

the right side of the person body is on the left image, and the left side of the body is on the right side of the image

sagittal image is a

vertical slice that divides the body into right and left sides

horizontal slice that divides the body into caudal and rostral positions

axial cut

vertical slice that divides the body into posterior and anterior portions

coronal cut

tissues with higher water content appear____ on CT images

dark gray

metal and bone appear _____ on CT images, because they have increased density

white

substances with a high protein concentration will be_____ on CT images

light gray

air and cerebrospinal fluid appear ____ on CT images, because they are less dense structures

black

structures with similar intensity to the brain are called

isodense

CT should be avoided in

children and pregnant women

brain tissue has what color

light gray

term used to describe structures that are light gray

hyperdense

term used to describe structure that are dark gray

hypodense

the densest structure in the body

bone

indications for for contrast-enhanced CT

to detect increased angiogenesis ( sign of tumor), inflammation, infection

the intensity of MR images depends on

the presence of hydrogen protons

MRI is contraindicated for patients with

. metal fragments in the body

. pacemaker

. cochlear implants

since air and calcified bone lack water, they appear _________to brain tissue on MRIs

hypointense

fMRI is safer and noninvasive than _____ , as there is no need for injection of radioactive isotopes

PET

. scans useful when evaluating for ischemia

. helpful in differentiating various lesions

. highlights areas of reduced water movement

diffusion-weighted imaging (DWI)

. creates an image of the white matter tracts

. used to measure how water diffuses around bundles of axons

Diffusion tensor imaging (DTI)

. type of T2 image in which CSF and vitreous fluid signal is suppressed.

. useful when looking for plaques associated with multiple sclerosis, near ventricles

. useful look for areas of edema of neural tissue

(FLAIR) fluid-attenuated inversion recovery magnetic resonance imaging

what is helpful in screening for carotid stenosis, aneurysm, and abnormal connections between arteries and veins?

CT angiography or MRA

what is the difference between CTA and MRA?

CTA injects a contrast agent and MRA can be done with or without a contrast agent

CT venography

MRV

MRI

T1, T2

which picture shows a Diffusion weighted imaging

which image shows a fMRI

which image shows a PET

which image shows an axial MRI

which image shows a Diffusion tensor imaging

which image shows a Sagittal MRI

which image shows a CTA computed tomography angiography

which image shows a Coronal MRI

which image shows an Axial CT

which image shows a MRA

which images shows a MRV