AOBPMR PM&R flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

ASIA Impairment Scale A

Complete spinal cord injury with no sacral sparing: absent S4-5 sensation and absent deep anal pressure. No motor or sensory function preserved below the neurologic level.

Central cord syndrome

Incomplete SCI with greater upper extremity than lower extremity weakness, often after hyperextension in a stenotic cervical spine. Sacral sensation is typically spared.

Brown-Séquard syndrome

Hemisection of the spinal cord causing ipsilateral motor loss and proprioceptive loss, with contralateral pain and temperature loss below the lesion.

Anterior cord syndrome

Injury to anterior spinal cord affecting corticospinal and spinothalamic tracts. Causes bilateral motor loss and pain/temperature loss with preserved proprioception and vibration.

Upper motor neuron signs

Hyperreflexia, spasticity, Babinski sign, and clonus indicate a lesion above the anterior horn cell in the corticospinal tract.

Lower motor neuron signs

Flaccidity, muscle atrophy, fasciculations, and areflexia indicate a lesion at or distal to the anterior horn cell or peripheral nerve.

Spinal shock

Transient flaccid paralysis and areflexia after acute SCI lasting days to weeks. Return of bulbocavernosus reflex marks transition to upper motor neuron physiology.

Rule of Nines

Burn surface estimate: head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, perineum 1%. Adjust for pediatric proportions.

Glasgow Coma Scale

Eye 1–4, verbal 1–5, motor 1–6; total 3–15. Score of 8 or less indicates severe impairment and need for airway protection.

Demyelinating neuropathy

Nerve conduction shows slowed conduction velocity, prolonged distal latency, and conduction block. Amplitude is relatively preserved compared with axonal injury.

Axonal neuropathy

Nerve conduction shows reduced amplitude with relatively preserved conduction velocity and distal latency. Reflects loss of axons rather than myelin.

Rancho Los Amigos levels

Eight-level cognitive scale after TBI: I–III no/generalized/localized response; IV–VI confused-agitated to confused-appropriate; VII–VIII automatic and purposeful appropriate.

Parkinson disease triad

Resting tremor, rigidity, and bradykinesia. Postural instability appears later. Levodopa-carbidopa is first-line pharmacotherapy.

Stroke thrombolysis window

IV alteplase may be given within 3–4.5 hours of onset in eligible patients. Mechanical thrombectomy is possible up to 24 hours in selected large-vessel occlusion.

Neurogenic bladder management

Intermittent catheterization is preferred. Anticholinergics treat detrusor overactivity; alpha-blockers address sphincter dyssynergia. Monitor for urinary tract infection.

Spasticity treatment ladder

Progression: physical modalities, then oral agents (baclofen, tizanidine, dantrolene), then focal botulinum toxin, then intrathecal baclofen, then surgery.

Functional Independence Measure

18-item tool scoring motor and cognitive function on a 1–7 scale. Used for inpatient rehabilitation outcomes and program comparisons.

Barthel Index

Ten-item measure of basic ADLs and mobility scored 0–100. Higher scores indicate greater independence; useful for stroke and geriatric rehabilitation.

Berg Balance Scale

14-item balance assessment scored 0–56. Scores below 45 suggest increased fall risk in older adults and stroke survivors.

Six-minute walk test

Measures distance walked in six minutes as a submaximal endurance index. Used in cardiac and pulmonary rehabilitation and in amputee prosthetic training.

Pressure injury Stage 1

Intact skin with non-blanchable erythema. Indicates localized tissue damage before skin breakdown; reposition and offload the area.

Pressure injury Stage 4

Full-thickness loss with exposed bone, tendon, or muscle. Requires surgical debridement and often flap reconstruction; high infection risk.

DVT prophylaxis in rehab

Combine mechanical prophylaxis (intermittent pneumatic compression) with pharmacologic agents (LMWH or UFH). Hold anticoagulation if active bleeding or recent neuraxial procedure.

Cardiac rehab phases

Phase I inpatient, Phase II outpatient monitored, Phase III supervised, Phase IV maintenance. MET levels guide progression of activity.

Transfemoral prosthetic knee

Microprocessor knees suit variable-cadence community ambulators. Mechanical stance-control knees are simpler and more durable for limited ambulators.

Energy-storing foot

Prosthetic foot that stores and returns energy during stance. Best for active community ambulators with good balance and cardiovascular reserve.

Oral case presentation order

Chief complaint, history, exam, functional assessment, problem list, differential, plan, prognosis, disposition. Follow this sequence in Part II oral cases.

Home safety assessment

Evaluate bathroom (grab bars, shower chair), bedroom (bed height), stairs, and lighting. Match mobility device to weight-bearing status and endurance.

Amputee residual limb care

Maintain shrinker or rigid dressing, inspect skin daily, and manage edema. Fit prosthesis when limb volume stabilizes, often weeks after surgery.

Heterotopic ossification

Abnormal bone formation in soft tissue after TBI or SCI. Presents with swelling, warmth, and reduced range of motion; treat with NSAIDs or bisphosphonates.

Deep pressure relief

Reposition wheelchair users every 15–30 minutes with pressure-relief lifts. Use pressure-redistribution cushions and monitor skin at bony prominences.

Spinal cord injury prognosis

ASIA A injuries have limited motor recovery. Incomplete injuries, especially sacral-sparing patterns, have better functional outcomes.