DH Chapter 59: The Patient with a Physical Impairment

Orthopedic appliance or apparatus used to support, align, prevent, or correct deformities or to improve the function of a movable part of the body.

Orthosis

Surgical excision or destruction of part of the globus pallidus in the basal ganglia to prevent symptoms of Parkinsonism, including tremor, muscular rigidity, and bradykinesia.

Pallidotomy

Impaired ability to control movement.

Palsy

A symptom of the loss or impairment of motor function in a body part caused by a lesion of the neural or muscular mechanism.

Paralysis

Which of the following is true regarding Bell's palsy?

Paralysis of the facial muscles is innervated by the facial or seventh cranial nerve Majority of patients experience spontaneous recovery and a return to normal within a month

Paralysis of the legs and in some cases the lower part of the body is known as:

Paraplegia

Paralysis of the legs and in some cases the lower part of the body.

Paraplegia

Slight or incomplete paralysis.

Paresis

Abnormal sensation, such as burning, prickling, tingling.

Paresthesia

Which of the following diseases is known for a severe deficiency of dopamine, one of the substances that participates in nerve transmission?

Parkinson's Disease

A symptom complex comprising any combination of tremor, akinesia or bradykinesia, rigidity, loss of postural reflexes, and flexed posture. There are many causes of parkinsonism, one of which is Parkinson's disease.

Parkinsonism

Transient ischemic attack; brief episode of cerebral ischemia that results in no permanent neurologic damage; symptoms are warning signals of impending CVA (stroke).

TIA

A resting tremor of one or both hands is common in Parkinson's disease, which of the following is true regarding this tremor?

can be reduced or stopped when the person engages in purposeful action

Which of the following best describes the pathology of Multiple sclerosis:

destruction or removal of the myelin sheath

A complete transection or compression of the spinal cord results in which of the following?

no sensation or motor function below the level of the lesion

Emergency care for autonomic dysreflexia includes all but one of the following. Which is the exception? position chair upright recline chair and monitor blood pressure check bladder distention and straighten catheter if clamped manually relieve bowel impaction if necessary monitor vitals

recline chair and monitor blood pressure

How many vertebrae are in the sacral section of the spinal column?

5

How many vertebrae are in the cervical region of the spinal column?

7

T or F: The incidence of malocclusion is high with cerebral palsy and is often due to musculoskeletal abnormality rather than only misaligned teeth.

Both statements are true.

A clinical feature of Parkinson's disease is :

Bradykinesia

Abnormal slowness of movements.

Bradykinesia

Union of bone with bone or bone with tissue resulting in complete immobility; the periodontal ligament of an ankylosed tooth is completely obliterated.

Bony Ankylosis

Rheumatoid arthritis can involve significant complication with the temporomandibular joint causing pain, difficulty chewing, and possibly a condition of bone to bone union resulting in immobility. This condition or term is called:

Bony ankylosis

T or F: More than 50% of individuals with cerebral palsy have significant cognitive impairment, and many lack ability to comprehend or communicate.

Both statements are false

Absence or loss of power of voluntary motion.

Akinesia

Parkinson's disease is an example of degenerative, neurological condition involving:

Akinesia

CVA can influence which of the following factors related to dental hygiene? Decreased self-cleansing action of the tongue and lips Decreased control of saliva Impaired motor ability Impaired cognitive ability A and B A and C All of the above

All of the above

Immobility due to direct union between parts.

Ankylosis

Defect in, or loss of power of, expression by speech, writing, or signs, or of comprehension of spoken or written language.

Aphasia

Cell death activated by a biochemical reaction; sometimes referred to as "programmed cell death."

Apoptosis

Failure of muscular coordination; irregularity of muscle action.

Ataxia

Wasting; decrease in size; occurs when muscle fibers are not used or are deprived of their blood supply, or when the nerve connection is interrupted.

Atrophy

A focal neurologic disorder caused by destruction of brain substance because of intracerebral hemorrhage, thrombosis, embolism, or vascular insufficiency; also called stroke.

Cerebrovascular Accident (CVA)

____________________ is a focal neurological disorder caused by destruction of brain substance because of intracerebral hemorrhage, thrombosis, embolism, or vascular insufficiency.

Cerebrovascular accident

Ulcer that usually occurs over a bony prominence as a result of prolonged, excessive pressure from body weight; also called pressure sore or bed sore.

Decubitus Ulcer

Destruction/removal of the myelin sheath of a nerve.

Demyelinate

Paralysis of like parts on either side of the body.

Diplegia

Double vision; perception of two images of a single object.

Diplopia

Which type of muscular dystrophy primarily affects males and is apparent before age 10, with a lifespan not much longer than two decades?

Duchenne

Although all muscular dystrophies are considered rare, which two types are more common?

Duchenne and Fascioscapulohumeral muscular dystrophy

Impairment of oral, lingual, or pharyngeal muscles that causes verbal clumsiness or impairment.

Dysarthria

Difficulty in swallowing.

Dysphagia

Slight or incomplete paralysis of one side of the body.

Hemiparesis

Paralysis of one side of the body; usually caused by CVA or a brain lesion.

Hemiplegia

Excess of cholesterol in the blood.

Hypercholesterolemia

Raised triglyceride blood level.

Hypertriglyceridema

Deficiency of blood caused by functional constriction or actual obstruction of a blood vessel.

Ischemia

Abnormally increased convexity in the curvature of the thoracic spine (viewed from the side).

Kyphosis

Head that is small in relation to the rest of the body; contrast with macrocephaly, head that is large in relation to the rest of the body.

Microcephaly

_______________ is a genetic myopathy characterized by progressive severe weakness and loss of use of groups of muscles.

Muscular dystrophy

Weakness of eye movements with diplopia and drooping eyelids may be the initial indicator of which disease?

Myasthenia gravis

Any disease of muscle.

Myopathy

Immediately after the injury, spinal shock causes a complete loss of reflex activity. The rest is a flaccid paralysis below the level of injury that may last from several hours to several months.

Spinal Shock

Cerebral palsy is known for several accompanying conditions. Which of the following is NOT a condition related to cerebral palsy? Sensory disorders Dysarthria Cognitive impairment Seizures Primitive Reflexes Quadriplegia

Quadriplegia

Paralysis of all four limbs from the neck down; tetraplegia.

Quadriplegia

Induration or hardening; especially hardening from inflammation and in disease of the interstitial substance.

Sclerosis

Passage between two natural channels; to bypass or drain an area.

Shunt

Excessive secretion of saliva.

Sialorrhea

The use of folic acid prior to conception can prevent which of the following?

Spina bifida

Paralysis of three limbs; hemiplegia with additional paralysis of one limb on the opposite side.

Triplegia

Surgical creation of a communication between a cerebral ventricle and a cardiac atrium by means of a plastic tube; for relief of hydrocephalus.

Ventriculoatrial Shunt

Communication between a cerebral ventricle and the peritoneum by means of a plastic tube; for relief of hydrocephalus.

Ventriculoperitoneal Shunt

Pertaining to internal organs (digestive, respiratory, urogenital, endocrine, spleen, heart, and great vessels).

Visceral

Post-Polio Syndrome (PPS) is best described as which of the following?

a condition that affects adults years after recovery from the poliomyelitis virus

Autonomic dysreflexia is best described as

a severe complication related to dysfunctions in emptying bladder and bowel.

Symptoms of a transient ischemic attack (TIA) are considered:

a warning signal of impending CVA (stroke)

Your 1 pm patient is accompanied by her daughter and lacks ability to communicate by writing or speech. Her daughter explains her mother had a stroke 8 months ago. Your patient has a condition called:

aphasia

Myasthenic crisis may result when muscles used to control breathing become severely compromised. Which of the following are NOT considered precipitating factors to this crisis? excess sleep oral infection emotional excitement loss of sleep alcoholic intake under medication

excess sleep

A high percentage of children with myelomeningocele have a condition called _______________. This condition is characterized by an excessive accumulation of fluid in the ________________.

hydrocephalus/brain