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.