Conditions week 13 and 14

Week 13 Terms

Stroke (CVA)

  • Ischemic (Most Common):

    • Embolic: Clot from elsewhere travels to brain.

    • Thrombotic: Clot forms in brain vessel.

  • Hemorrhagic: Blood vessel ruptures in brain.

  • TIA (Transient Ischemic Attack):

    • Mini-stroke; temporary blockage; no permanent damage.

Risk Factors:

  • Mutable: Hypertension, smoking, obesity, diet, diabetes, alcohol, stress, inactivity, cardiac conditions.

  • Non-mutable: Ethnicity (African American ↑ risk), age (>65), gender (women), heredity.

Symptoms: Walking/balance issues, speech trouble, numbness (one side), vision changes, sudden headache.

FAST: Face droop, Arm drift, Speech slurred, Time to call 911.

Left CVA: Right side weakness, aphasia, emotional, aware of deficits, depression.

Right CVA: Left side weakness, impulsive, spatial/perception issues, neglect.

  • Hemiplegia: Total paralysis.

  • Hemiparesis: Weakness.

  • Ataxia: Poor coordination.

  • Neglect: Unawareness of one side.

Treatment:

  • tPA: Only for ischemic strokes, within 3 hours.

Multiple Sclerosis (MS)

  • Autoimmune attack on CNS myelin.

  • Types:

    • Remitting MS: Flare-ups and recovery.

    • Secondary Progressive MS: Steady decline after RMS.

    • Primary Progressive MS: Continuous progression.

  • Symptoms: Numbness, fatigue, pain, vision/memory/mood changes, paralysis.

  • Therapy: Energy conservation, adaptive equipment, low-impact strengthening.


Parkinson’s Disease (PD)

  • Loss of dopamine in the substantia nigra.

  • Symptoms: Bradykinesia, tremors, stiffness, micrographia.

  • Treatment:

    • Medications: Sinemet (Levodopa/Carbidopa).

    • Deep Brain Stimulation.

  • Therapy: Aerobic exercise, visual cues, music (metronome beat), full-body movements (dance, tai chi, boxing).

Amyotrophic Lateral Sclerosis (ALS)

  • Types: Sporadic (90%), Familial (genetic link).

  • Symptoms: Muscle weakness, cramps, walking and speech difficulty.

  • Diagnosis: No specific test; rule out other diseases.

  • Therapy: Primarily compensatory (adapt to progressive decline).

Week 14 Terms:

Acquired Brain Injury (ABI)

  • Definition: Brain damage from injury causing functional change.
    Classification:

    • Post-concussion syndrome

    • Closed (non-penetrating) vs. Open (penetrating)

    • Mild, Moderate, Severe

  • Complications: Coma, seizures, hydrocephalus, dysautonomia, DVT.

Assessment Scales

  • Glasgow Coma Scale: Eye, verbal, motor response.

    • Mild (13–15), Moderate (9–12), Severe (3–8)

  • Rancho Los Amigos Scale: Measures cognitive function post-TBI.

OT and TBI

  • Affects all occupations.

  • Cognitive/vision assessments and retraining, physical rehab, adaptive equipment.

Brain Regions and Functions

  • Frontal Lobe: Attention, executive function, speech, motor planning, behavior control.

  • Temporal Lobe: Memory, language, hearing, communication.

  • Parietal Lobe: Sensory integration, perception, math, body awareness.

  • Occipital Lobe: Vision processing.

  • Cerebellum: Balance, coordination, motor skills.

  • Brain Stem: Vital functions (breathing, heart rate), consciousness.

Spina Bifida

  • Definition: Birth defect—spinal cord fails to form properly.

  • OT Role: Adaptive equipment/techniques, home mods, handwriting, seating/positioning, strengthening.

Spinal Stenosis

  • Definition: Narrowed spinal spaces causing nerve pressure (lower back, neck).

  • Symptoms: Pain, weakness, numbness, immobility.

Spinal Epidural Abscess

  • Definition: Infection between spine and spinal cord lining; causes swelling.

  • Treatment: Antibiotics; can follow surgery or infection.

Spinal Cord Injury (SCI)

  • ASIA Scale:

    • A: Complete (no sensory/motor)

    • B: Sensory preserved, no motor

    • C: Motor preserved; less than half can lift against gravity

    • D: Motor preserved; more than half can lift against gravity

    • E: Normal

  • Syndromes:

    • Anterior Cord Syndrome: Loss of motor, pain, temp sensation below injury.

    • Brown-Sequard Syndrome: Motor/sensory loss on same side; pain/temp loss on opposite side.

  • Dermatome: Skin areas served by spinal nerves.

  • Myotome: Muscle groups served by spinal nerves.

  • C1–C4: Most severe. Paralysis in limbs/trunk, breathing/speech problems, full ADL dependence.

  • C5: Arm/shoulder movement; needs help for ADLs; uses power wheelchair.
    C6: Wrist extension; better mobility, may drive adapted car.

  • C7: Elbow and finger extension; mostly independent with ADLs.

  • C8: Hand movement; good independence but bowel/bladder issues persist.

SCI Complications

  • Spinal shock, flaccid paralysis, respiratory issues, autonomic dysreflexia, postural hypotension, DVT, thermal regulation issues.

SCI Interventions

  • Physical rehab, adaptive tech (wheelchairs, driving), aquatic therapy, harness training.