Rehab II: MS
About this set
Created by:
skyliele on March 5, 2009
Subjects:
rehabilitation, rehab 2, Physical Therapy
Classes:
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66 terms
Terms | Definitions |
|---|---|
 Lhermette's sign | Electric shock-like sensations down the back and back of legs when flexing neck |
| Hyperpathia | Extreme sensitivity to touch |
| 2 types of spasticity | Hypertonicity and hyperreflexia |
| Most common complaint of MS patients | Fatigue, particularly after noon |
| Charcot's Triad is these three things | intention tremor, scanning speech/cerebellar dysarthria, nystagmus |
| Parasthesia | weird feelings such as pins and needles |
| Dysmetria | overshooting, poor judgment of distance |
| The name of the lesions caused by MS | plaques |
| MS plaques are located throughout ... | the CNS white matter. They do not affect peripheral nerves |
| Primary age range affected by MS | 15-45 |
| Theories of the etiology of MS | infectious origin, autoimmune system origin or a combo of the two (those who have had mono are more likely to get MS) |
| Risk of MS diagnosis in the general population | 1 in 1000 |
| Supportive lab/diagnostic tests for MS include | lumbar puncture, CSF evaluation, MRI, Electrophysiological testing (ex: Visual Evoked Potentials or VEP) |
| VEP -- Visual Evoked Potentials look for | impaired transmission of the optic nerve |
| CSF evaluation for MS looks for | elevated levels of IgG antibodies and oligoclonal bands (proteins) and protein byproducts of breakdown of the myelin sheath |
| cerebellar dysarthria | a disorder that results in jerky, uncoordinated movements of the speech musculature; caused by lesions in the cerebellum; Slow, slurred prolonged syllables with inappropriate pauses |
| Dysdiadochokinesia | inability to perform rapid, alternating movements. |
| Uthoff's sign | the worsening of neurologic symptoms in multiple sclerosis after periods of exercise and increased body heat. |
| Dysphagia | difficulty swallowing |
| MRIs show abnormalities in this percentage of people who have MS | 95% |
| Criteria for MS diagnosis includes time factors and multiple signs of | neurologic dysfunction involving two or more parts of the CNS, predominantly involving the white matter |
| The two time factors for diagnosis of MS | 1. two or more episodes of exacerbation each lasting more than 24 hours and separated by no less than one month or 2. slow progression extending over at least 6 months. |
| Slow progression of neurological dysfunction must extend over at least this time period to be criteria for MS diagnosis | 6 months |
| To meet criteria for MS diagnosis, "episodes of exacerbation/worsening" must last more than ___ hours and be separated by no less than ___ | 24 hours, one month |
| Like Rheumatoid Arthritis, MS is characterized by ... | exacerbations and remissions |
| MS prognosis can be estimated by... | the number of exacerbations per year for the first 1-2 years. 1 or 2 episodes indicates good prognosis. 5, not so good. |
| Typically, MS patients live __ years post-diagnosis | 35 |
| Four types of MS | Relapsing remitting, Secondary progressive (follows relapsing remitting), Primary Progressive, Progressive Relapsing |
| The most common form of MS is | Relapsing Remitting |
| Relapsing Remitting is characterized by | partial or total recovery after exacerbations |
| Approximately 85 % of MS patients begin with this form of MS | Relapsing Remitting |
| More than 50% of those with RRMS (relapsing remitting) will develop... | SPMS (Secondary progressive) within 10 years |
| More than 90% of those with RRMS with develop SPMS within... | 25 years |
| The type of MS in which symptoms do not remit | Primary Progressive MS (PPMS) |
| Approximately 10% of MS patients are diagnosed with... | PPMS (Primary Progressive) |
| The most rare form of MS, about 5% of cases | Progressive Relapsing MS |
| This form of MS is slowly progressive with obvious acute attacks along the way and no remission | Progressive Relapsing MS (PRMS) |
| Female patients with onset before age 35 are associated with | a more favorable course of MS |
| Sensory symptoms, like numbness, rather than motor symptoms indicate | a more favorable prognosis |
| 5 factors associated with less favorable MS course | Male, onset after age 35, cerebellar symptoms, poor remissions, frequent attacks |
| 2 forms of spasticity | Hypertonicity and hyperreflexia |
| A movement/perception disorder that can be due to MS lesions in the Brain Stem | vertigo |
| When working with an MS patient, aim for the most energy intensive tasks at this time of day | the morning |
| Mild paresis or total paralysis in MS patients is secondary to lesions here | in the motor cortex |
| Poor coordination can be due to lesions in the | "upper motor" neurons |
| Visual disturbances occur in this percentage of MS patients at some point | 80% |
| Often the initial symptom of MS is | visual disturbance |
| Sexual dysfunction with MS can be due to direct demyelination or indirect via | depression, spasticity, contractures, bladder and bowel disturbances |
| Most common behavioral disturbance with MS | Euphoria |
| Mild to moderate problems with this kind of reasoning are common | abstract reasoning |
| Heat, emotional stress, cold or humidity, trauma and strenuous exercise are | exacerbating factors |
| Initial interval between exacerbations is usually | 5 years |
| Menstruation can | exacerbate symptoms for those with MS |
| Medical management of MS has these two routes | 1. Treatment of the acute attacks and 2. Symptom management |
| Treatment of acute MS attacks includes | high dose intravenous corticosteroids. 3 day course as an outpatient followed by oral steroids if possible |
| Treatment of spasticity includes these medications | Baclofen, Zanaflex, Dantrium, Valium or Neurotin |
| Injectable medications for spasticity management | botox, phenol and ethanol (which act as nerve blocks) |
| UTIs are treated with | antibiotics |
| Death from MS is usually secondary to... | a respiratory infection or UTI |
| immunomodulators reduce... | the frequency and severity of exacerbations and new or active lesions on MRI |
| Immunosuppressants like Novantrone are used in.. | worsening relapse remitting MS and secondary progressive and progressive relapsing MS. Can only be used for 2 to 3 years |
| Novantrone doses occur ___ | once every 3 months |
| The goal of PT with MS patients is to ... | maintain independence for as long as possible |
| Good coordination exercises to use with MS | Frenkel's |
| relaxation exercises, prolonged icing, slow rocking and stroking, as well as pressure at tendon insertion help to.. | decrease spasticity |
| A large part of patient education is teaching... | energy conservation techniques AND precautions with sensory loss |
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