Neurology - Day 3

On Thursday, we went to NCV/EMG lab but there wasn't any study so the doctors in Physical Therapy dept. showed us around their facility. Again, the head of physical therapy told us that some patients do come in more than they should. So we asked how they determined who get tx if the patient # becomes more than the facility could accomodate for each session, and he told us that they prioritize patients (who will get the most of out this, who could really improve from the tx's, severity, etc).

We went to meet with the superintendent at 11. That was pretty cool. He's so nice. He is a busy man and he took time to meet with us students.

In the afternoon, we went on ward run. I saw the same patients I did on Monday. They all seemed to be doing better. They were more alert this time.

In the ICU, an old female patient suffered ischemic stroke, most likely due to her A.Fib. She was being monitored carefully to prevent edema which develops 4 days, and she had been in the hospital for 2 days. I learned about neurological index: eyes are rated 1-4; best verbal respponse 1-5; best motor response 1-6; arms 1-5 (There are more categories but I didn't get them all down).

I also learned about:

Cogwheel rigidity (def from medical dictionary): muscle response with cogwheel- like jerks to the use of force in bending the limb (e.g. Parkinson)

Lead pipe ridigity: a state of inflexibility and stiffness that remains uniform throughout the range of passive motion --> associated with disease of basal ganglia

I would go on youtube to watch how the techniques are performed

On brain CT, old stroke appears as dark as CSF while new stroke is darker than brain matter but lighter than CSF

Plasticity develops 1-2 weeks after stroke

Later that day, we went to EMG lab

Indications for NCV include: CTS; ulnar neuropathy; peripheral neuropathy; brachial plexopathy; radiculopathy; myasthenia gravis; muscle disease

Indications for EMG include: radiculopathy; neuropathy; muscle diseases; motor neuron diseases