i bc27f85be50b71b1 (100 page)

NERVOUS SYSTEM

329

2 1 . Gelh OJ. The Neurologic Examination. In OJ Ge1b (ed), Introducrion ro

Clinical Neurology (2nd cd). Boston: Butterworth-Heinemann, 2000;

43-90.

22. Bickley LS, Hockclman RA. The Nervous System. In LS Bickley, B Bares,

RA Hoekclman (cds), Bate's Guide ro Physical Examinacion and Hismry

Taking (7rh cd). PhIladelphIa: LIppincott, 1 999;585.

23. Shpritz OW. Nellrodiagnostic studies. Nurs Clin North Am 1 999;34:

593.

24. Kelley RE, Gregor)' T. CT versus MRI: Which is better for diagnosing

stroke? Patient Care. 1 999;33: 175- 1 78, 1 8 1-182.

25. Delapaz R, Chan S. Computed Tomography and Magnetic Resonance

Imaging. In LP Rowland (ed), Merritt's Neurology ( 1 0th ed). Philadelphia: LIPPJJ1COtt, W""ams & Wilkins, 2000;55-63.

26. MeN:lIf ND. Traumatic brain injury. Nurs eli" North Am

1999;34:637-659.

27. Wong E Prevenrion of secondary brain injury. eric Care Nurs

2000;20: 1 8-27.

28. Zank BJ. Traumatic brain injury ourcome: concepts for emergency care.

Ann Emerg Med 200 I ;37:31 8-332.

29. DlIhcndorf P. Spmal cord inJury pathophysiology. Crit Care Nurs Q

1 999;22:3 1-3.1.

30. MaUlcs A, Weinzierl MR, Donovan F, Noble LJ. Vascular evenrs after

spinal cord II1IUf)': conrributlon to secondary pathogenesis. Phys Ther

2000;80:673-687.

3 1 . Mitcho K, Yanko JR. Acute care managemenr of spinal cord injuries.

Cm Care Nurs Q 1 999;22:60-79.

32. Selzer ME, Tessler AR. Plasticiry and Regeneration in the Injured Spinal

Cord. In EG Gonzalez, SJ Myers (cds), Downey and Darling's Physiological Basis of Rehabilirarion Medicine (3rd ed). Boston: Butterworrh

Heinemann, 200 I ;629-632.

33. Buckley DA, Gu::mci MM. Spinal cord trauma. Nurs Clin North Am

1 999;34:661-687.

34. Bradle)' WG, Daroff RB, Fel1lchel GM, Marsden CD (eds). Pocket CompanIon ro Neurology in Clinical Practice (3rd ed). Boston: Burterworrh

Heinemann, 2000.

3.\. Ingall TJ. Preventing ischemic Stroke. Postgrad Med 2000;1 07:34-50.

36. Meschia JE Managemenr of acute ischemic stroke. Posrgrad Med

2000;1 07:85-93.

37. Blank .. � Keyes M. Thrombolytic therapy for patients with acute stroke

In rhe ED setting. J Emerg Nurs 2000;26:24-30.

38. Hock NH. Brain attack: rhe stroke continuum. Nurs Clin North Am

1999;34:689-724.

39. Fieml1llllg KD, Brown RD. Cerebral infarction and transient ischemic

attacks. Postgrad Med 2000; 1 07:55-83.

40. Mower-Wade D, Cavanaugh MC, Bush D. Protecting a patienr with

ruptured cerebral aneurysm. Nursing 100 1 ;3 1 :51-57.

4 I . Drury IJ, Gclb OJ. Seizures. In OJ Gelb (cd), Introduction to Clinical

Neurology (2nd cd). Boston: Butterworth-Heinemann, 2000; 129- 1 5 1 .

330 AClITE CARE HANDBOOK FOR PHYSICAL THERAPISTS

42. Aminoff MJ. Nervous System. In LM Tierney, SJ McPhee, MA

Papadakis (eds), Current Medical Diagnosis and Treatment 2001 (40th

ed). New York: Lange Medical Books/McGraw-Hili, 200 I ;979-980,

983-986.

43. Cox MM, Kaplan D. Uncovering the Cause of Syncope. Patient Care

2000;34:39-48, 59.

44. Fuller KS. Degenerative Diseases of the Ceorral Nervous Sysrem. in CC

Goodman, WG Boissonnaulr (cds). Pathology: Implications for rhe

Physical Therapist. Philadelphia: Saunders, ·1 998;723.

45. Worsham TL. Easing the course of Guillain-Barre syndrome. RN

2000;63:46-50.

46. King BS, Gupta R, Narayan RJ. The early assessmenr and intensive care

unit management of parienrs with severe traumatic brain and spinal

cord injuries. Surg elin North Am 2000;80:855-870.

5

Oncology

Susan Polich

Introduction

Callcer is a term that applies to a group of diseases characterized by

the abnormal growth of cells. The physical therapist requires an

understanding of underlying cancer pathology, as well as the side

cffects, considerations, and precautions related to cancer care to

enhance clinical decision making to safely and effectively trear the

patient with cancer. This knowledge will also assist the physical thetapist with the early detection of previously undiagnosed cancer. The objectives for this chapter are to provide the following:

I.

An understanding of the medical assessment and diagnosis

of a patienr with cancer, including staging and classification

2.

An understanding of the various medical and surgical

methods of cancer management

3.

A better understanding of a variery of the different body

system cancers

4.

Examination, evaluation, and intervention considerations

for the physical therapist

331

332 AClITE CARE HANDBOOK FOR PHYSICAL THERAPISTS

Definitions

The terms neoplasm, tumor, and cancer are currently used interchangeably. Neoplasm means "new growth" and applies to any abnormal mass of tissue which exceeds the growth of normal tissue,

grows at the expense of itS host, and persists even after the stimulus to

grow is removed. The term /1I1110r originally applied to the swelling

caused by inf1�mmation but now refers only to a new growth. Cancer

is the layperson's term for all malignant neoplasms.''''

Normal cells change in size, shape, and type, known collectively as

dysplasia, if the proper stimulus is provided. Hyperplasia refers to an

increase in cell number. Metaplasia is the change of one cell type to

another. Hyperplasia and metaplasia can be reversible and normalor persistent and abnormaI.1,2,4

Neoplasms, or persistent, abnormal dysplastic cell growth, are

classified by cell type, growth pattern, anatomic location, degree of

dysplasia, tissue of origin, and their ability to spread or remain in the

original location. Two general classifications for neoplasm are benign

and malignant. Bellign tumors are usually considered harmless and

slow growing and have cells that closely resemble normal cells of

adjacent cissue. However, chese benign tumors may occasionally

become large enough to encroach on surrounding tissues and impair

their function. Malignant neoplasms, or malignant tumors, grow

uncontrollably, invading normal tissues and causing destruction to

surrounding tissues and organs. Malignant neoplasms may spread, or

metastasize, to other areas of the body through the cardiovascular or

lymphatic system. '-5

Tumors may also be classified as primary or secondary. Primary

rumors are the original tumors in the original location. Secondary

tumors are those metaStases that have moved from the primary site.4

Nomenclature

Benign and malignant tumors are named by their cell of origin

(Table 5- J). Benign tumors are cusromarily named by attaching

-oma to the cell of origin. Malignant tumors are usually named by

adding carcinoma ro the cell of origin if they originate from epithelium and sarcoma if they originate in mesenchymal tissuc.I-J Variations to this naming exist, such as melanoma and leukemia.

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