0
Q
Neuron regeneration (PNS)
A
- Regeneration does occur.
2. Schwann cells support cell regeneration and new axonal connections.
1
Q
What is synaptic strengthening?
A
- Changes underlying strengthening
- presynaptic action potential -> increases release of neurotransmitter.
- larger current induced in post synaptic cell.
- Presynaptic activity must be consistently followed by post synaptic activity (Hebb’s rule).
- Induced by repetitive stimulation.
2
Q
Effects of brain damage
A
Cell death Neural degeneration Diaschisis Altered cortical excitability Hypoperfusion
3
Q
Neuron regeneration (CNS)
A
- Oligodendrocytes do NOT support cell regeneration.
- Damage more extensive than in PNS.
- Glial cells from scar tissue -> barrier to new axonal growth.
- Limited regeneration occurs, but not sufficient to make up for large cell loses.
4
Q
Recovery of function
A
- learning reorganizes the damaged brain even w/o therapy.
- person develops compensatory behaviors that alter brain structure and function.
5
Q
compensatory behaviors that alter brain structure and function
A
- ex. reliance on less affected limb in hemipelegia.
- can be adaptive and improve function.
- can be maladaptive and interfere with improvements that could be made with therapy.
6
Q
Experience dependent plasticity relies on what?
A
- use it or lose it. 6. time matters.
- use it and improve it. 7. salience matters.
- specificity. 8. Age matters.
- repetition. 9. Transference.
- intensity. 10. interference.
7
Q
Transcranial Magnetic Stimulation (TMS)
-adjunct to behavioral therapy-
A
- coil placed on skill induces current in the cerebral cortex.
- current suppresses or enhances cortical excitability.
8
Q
Transcranial direct current stimulation (tDCS)
-adjunct to behavioral therapy-
A
- surface electrodes placed on skull.
- electrodes induce current in the brain.
- Influences neuronal excitability.
9
Q
Neurological examination
A
- examine the cranial nerves, motor system, sensory system.
- examine reflexes.
- Higher cortical function.
* *Informs of structure and function.
10
Q
EEG
A
Electroencephalogram
- studies electrical activity in brain.
- uses surface electrodes.
- used most often to diagnose seizures.
- informs of functon.
11
Q
EMG/nerve conduction studies
A
EMG=Electromyography.
- used to diagnose neuromuscular disease.
- EMG: measure electrical activity of muscles at rest and during movement. Used to diagnose ALS, myasthenia gravis. Function.
- Nerve conduction study: Measures nerve impulse propagation in LMNs. Used to diagnose Guillain-Barre Charcot-Marie-Tooth. Structure and function
12
Q
fMRI
A
functional magnetic resonance imaging.
- done in a MR scanner.
- indirect measure of neuronal function.
- Used for pre-surgical planning.
- resting state fMRI.
- *Funtion**
13
Q
PET
A
Positron emission computed tomography.
- Measures metabolic rates for oxygen, glucose or blood flow (rCBF).
- radioactive tracer injected into vein -> tracer collects in organs/tissues.
- “GOLD STANDARD” for tumor detection.
- Aid in differential diagnosis of movement disorders.
- *Function**
14
Q
Spinal tap
A
- CSF drawn from lumbar cistern.
- examined for: White blood cells (infection, tumor, demyelinating disease.
- Red blood cells (bleeding).
- Excess protein (tumor, infection, diabetes.)
- Glucose (elevated or decreased)
- *Structure**
15
Q
cerebral angiography
A
visualize arteries.
- incision made in an artery.
- catheter passed through arterial system, then in to the carotid artery.
- contrast medium forced through catheter and thus into the cerebral circulation.
- x-rays are taken.
* *Structure**
16
Q
plasticity
A
ability of the brain to change its structure and function over the course of the lifetime.
17
Q
conditions where neuroplasticity occurs
A
- normal childhood brain development.
- Learning/memory throughout lifetime.
- Reorganization after brain injury.
18
Q
developmental plasticity
-synaptogenesis and synaptic pruning-
A
synaptogenesis- new synapses created as a result of experiences.
synaptic pruning- the number of synapses are reduced, the stronger ones stay and the weaker ones are pruned.
19
Q
in which order do the systems develop?
A
1st-> sensory system develops
2nd-> language system develops
3rd-> cognition develops
20
Q
metaplasticity
A
Regulates plasticity so it occurs at the proper time and to the proper extent.
May be impaired in certain populations (eg. Autism)
21
Q
Normal adult plasticity
A
The brain never stops learning/changing.
Changes in plasticity appear to underlie expertise..
22
Q
physiological bases of plasticity in the normal adult.
A
- dendritic spines expand, allowing more interaction with other neurons.
- axons develop new connections (in passing or through sprouting).
- Glial cells affect the synaptic transmission, coordinate neural activity, and affect the excitability.
- unmasking
- synaptic strengthening
23
Q
unmasking
A
- many brain networks are chronically inactive due to inhabition.
- These networks are released from inhabition and begin to function.
24
MRA
| -magnetic resonance angiography
- visualize arteries.
- performed in MR scanner.
- with or w/o contrast.
- less invasive than traditional angiography.
* *structure**
25
CT/CAT scan
| - computerized axial tomography -
- 3D images.
- with or w/o contrast.
- often used in the ER.
- CT w/o contrast is less sensitive to acute stroke the MRI.
* *Structure**
26
MRI
| - magnetic resonance imaging -
- types: T1-weighted, T2-weighted, Diffusion (dwi)/Perfusion (pwi)-weighted, diffusion tractography imaging and FLAIR.
- with or w/o contrast.
- greater resolution than CT.
- patient must not move and must pass a safety screen.
* *structure**
27
doppler ultrasound
- extracranial or transcranial.
- sound waves transmitted into the body and reflected back to provide info about blood pressure and flow.
* *Structure**
28
Brain Biopsy
- brain tissue removed, usually through a needle.
- usually performed to sample a brain tumor but may be performed as a last resort for unexpected neurological problems.
- Tissue is studied.
* *Structure**
29
ionizing radiation
- from natural sources like soil and water.
- used in some imaging techniques:
1. xrays 3. PET
2. CT 4. flouroscopy
30
Higher cortical function
| -assesses what/for in a neuro exam?-
- Apraxia
- orientation and memory
- speech and language
31
Reflex examination looks for..
| - neuro exam -
- superficial and deep reflexes.
| - exaggerated or diminution of reflex.
32
Sensory system
| - neuro exam, looks for...?-
- anesthesia (without feeling)
- hypoesthesia (reduced feeling)
- hyperesthesia (increased feeling)
- deep and superficial sensation
33
Motor system
| - neuro exam completed how? and looks for what?
- visual examination.
- palpation of muscles to determine tone.
- passive movement (with clinician moving the body part)
- active movement
34
Examination of cranial nerves
| - neuro exam checks what? -
- nerves subserving the eyes (acuity, visual fields , movements, pupillary reflex)
- facial nerves (facial expression, whistling, etc.)
- facial sensation - through light touch, pin prick.
35
imaging the body, what does it tell us? what do we see?
resolution- detail that can be seen differs by technique.
contrast- exogenous (something introduced for better visability), endogenous (uses internal, natural things for better visability).
- Ionizing radiation -> natural sources.
36
what is ICD
International classification of diseases.
| Part of the ICF family
37
Stucki and Sangha (1998) developed - Rehab CYCLE
| what is it?
1. designed to improve health status and QOL.
2. helps to develop rehab goals.
3. forms the basis for their RPS form
- > data sheet based on the ICF.
- > designed to be used by a multidisciplinary team
38
ICF coding
```
alphanumeric
describes health and health related domains.
b= body functions
s= body structures
d= activities and participation
e= environmental
```
39
ICF number coding
0=no impairment .0=no barrier +0=no facilitator
1= mild impairment .1= mild bar. +1=mild fac.
2= moderate imp. .2= moderate bar. +2=mod. fac.
3= severe imp. .3= severe bar. +3=severe fac.
4= complete imp. .4= complete bar. +4=complete fac.
8= not specified .8= barrier not specified +8=fac. not spec.
9= not applicable .9= not applicable +9=not applicable
40
ICF activities and participation
```
performance qualifier (what a person does in his/her current environment.
Capacity qualifier (ability to execute a task or action in a standardized environment
```
41
personal factors
- individual's particular background.
- features not part of health condition/state.
- may include gender, race, fitness level, education, life experiences and personality.
- NOT coded in ICF due to cultural differences.
42
Definition of environmental factors
- physical, social and attitudinal environments in which people live and conduct their lives.
43
Definition of participation
Involvement in a life situation
44
definition of participation restrictions
problems being involved in life situations
45
definition of activity
execution of a task or action by an individual
46
definition of activity limitation
difficulty in executing tasks.
47
definition of impairment
problem in body function or structure
| eg. significant deviation or loss.
48
models of disability
- Medical model: disability is a problem to be fixed.
- Social model: disability is a society-created problem.
- ICF: biopsychosocial model that integrates social and medical. -Biology, individual, and societal
49
What is ICF?
International Classification of Functioning Disability and Health.
- Created by WHO to describe standard language and framework for describing health.
- list of body functions and structure.
- list of domains of activity and participation
- Child and youth version (ICF-CY)
50
Tests used to diagnose neurological impairment
- Neurological examination.
- Electroencephalogram (EEG).
- Electromyography (EMG)/nerve conduction studies.
- Spinal tap.
- Imaging the body.
- brain biopsy.
51
Types of imaging
- cerebral angiography
- computerized axial tomography (CT/CAT)
- Magnetic Resonance Imaging (MRI)
- Magnetic Resonance Angiography (MRA)
- Functional Magnetic Resonance Imaging (fMRI)
- Positron Emission Computed Tomography (PET)
- Doppler Ultrasound.
Cognitive Communication
flashcards
Decks in class (4)
# Cards
