Chapters 31, 32, & 36 Flashcards

1
Q

Your next client has sustained a right cerebral vascular accident (RCVA) with resultant left-sided hemiplegia and limited isolated control of the left upper extremity. Which SPECIFIC PNF diagonal pattern would you use to help your client regain the ability to comb her hair on the right side of her head using her left hand?

A

D1 flexion

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2
Q

You are planning your daily intervention for a client who sustained an RCVA and now has left hemiparesis. You are considering using PNF to increase the client’s left upper extremity strength and range of motion. Your client’s past medical history also includes a transient ischemic attack, hypertension, and active rheumatoid arthritis with substantial inflammation and pain in both shoulders and wrists. You choose __.

a.
forceful use of PNF diagonal 1 flexion with resistance to increase strength of left shoulder flexion, adduction, external rotation, supination, and finger flexion

b.
forceful use of PNF diagonal 1 extension with resistance to increase strength of left shoulder extension, abduction, internal rotation, pronation, and finger extension

c.
forceful use of PNF diagonal 2 extension with substantial resistance to increase range of motion for dressing activities of daily living.

d.
resistive use of PNF patterns is not an appropriate intervention for this client at this time.

A

d.

resistive use of PNF patterns is not an appropriate intervention for this client at this time.

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3
Q

Which statement about relaxation techniques is inaccurate?

a.
Contract-relax is used when no active range of motion in the agonist pattern is present.

b.
Hold-relax involves an isometric contraction of the antagonist, followed by relaxation and then active movement in the agonistic pattern.

c.
Rhythmic rotation is ineffective in decreasing spasticity and increasing range of motion.

d.
Slow-reversal-hold relax is preferred when the client has the ability to move the agonist actively.

A

c.

Rhythmic rotation is ineffective in decreasing spasticity and increasing range of motion.

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4
Q

Which of the following is not a contraindication for use of PNF techniques or procedures?

a.
Traction for persons with fractures

b.
Traction for persons who have had recent surgery

c.
Multiple repetitions of rhythmic stabilization with maximal exertion for persons with cardiac involvement

d.
Hold-relax techniques for persons with RSD/CRPS

A

d.

Hold-relax techniques for persons with RSD/CRPS

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5
Q

Your client, who sustained an RCVA with resultant left hemiplegia, wants to regain the motor control to use the left hand to hold a glass while the uninvolved right-hand pours from a pitcher. Which PNF pattern would be the closest approximation to this desired movement for the left upper extremity?

A

D1 flexion

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6
Q

Which of the following statements accurately describes PNF reversal of antagonist’s techniques?

a.
Slow reversals are characterized by alternating isotonic contractions of both the agonist and antagonists opposed by enough resistance to prevent motion.

b.
Stabilizing reversals are isotonic contractions of the antagonists followed by an isotonic contraction of the agonist.

c.
Rhythmic stabilization increases stability through contractions of only the antagonistic muscle groups.

d.
All of the above.

A

b.

Stabilizing reversals are isotonic contractions of the antagonists followed by an isotonic contraction of the agonist.

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7
Q

You are working with a client who has had a recent RCVA with left hemiparesis. The client has difficulty maintaining trunk control while standing and has difficulty holding objects. Using Rood’s approach to motor control, you decide to work with the client in a standing table while the client completes a jigsaw puzzle. This activity would involve which of Rood’s components of motor control?

a.
Reciprocal inhibition

b.
Co-contraction

c.
Heavy work

d.
Skill

A

d.

Skill

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8
Q

Which of the following statements accurately describes techniques directed to the agonist?

a.
Rhythmic initiation is ineffective for improving the ability to initiate movement.

b.
Rhythmic initiation involves voluntary relaxation, passive movement, and repeated isotonic contractions of the agonistic pattern.

c.
Repeated contraction techniques assume that the number of repetitions of an activity is not necessary for motor learning.

d.
Resistance should never be used during rhythmic initiation to reinforce a movement pattern.

A

b.
Rhythmic initiation involves voluntary relaxation, passive movement, and repeated isotonic contractions of the agonistic pattern.

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9
Q

Which of the following statements best describes the procedure of maximal resistance?

a.
If resistance breaks the client’s hold, apply additional resistance.

b.
Strength is increased by movement against resistance that requires maximal effort by the client.

c.
For clients with neurological impairment, very light resistance is usually ineffective and may not meet the client’s needs.

d.
If a client has spasticity, resistance cannot increase existing muscle imbalance.

A

b.

Strength is increased by movement against resistance that requires maximal effort by the client.

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10
Q

Which of the following techniques, using the Rood approach, is not an inhibitory technique?

a.
Neutral warmth

b.
Slow stroking

c.
Light joint compression

d.
Fast rocking/vestibular stimulation

A

d.

Fast rocking/vestibular stimulation

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11
Q

Which of the following describes a technique involving behavioral techniques to encourage small, successive gains that build toward a desired outcome?

a.
Shaping

b.
Biofeedback

c.
Neuromuscular re-education

d.
Constraint-induced movement therapy (CIMT)

e. 
Neurodevelopmental technique (NDT)
A

a.

Shaping

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12
Q

Which of the following concepts reflect the dynamic systems theory and heterarchical model of motor control?

a.
Dynamic interaction between client factors, context, and occupations

b.
Higher motor systems in CNS control the subordinate lower centers

c. 
Each subsystem (component) is critical to support engagement in occupation

d.
All answers are correct

e.
A and C only

A

e.

A and C only

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13
Q

__ is a treatment technique involving the forced use of a hemiparetic extremity post-neurological injury.

A

Constraint-induced movement therapy (CIMT)

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14
Q

For the person with C6 quadriplegia, it is desirable to develop some tightness in the long finger flexors because __.

A

the tightness of the finger flexors, combined with active wrist extension, can produce some functional grasp through tenodesis action

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15
Q

The person with C6 quadriplegia may be able to assist in transfers by locking the elbows in extension and performing shoulder __.

A

depression, external rotation, and adduction

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16
Q

The patient has a C6 quadriplegia. We can anticipate that he or she has innervation of which of the following?

a.
Deltoids, latissimus, biceps, radial wrist extensors

b.
Latissimus, serratus, biceps, triceps

c.
Deltoids, biceps, triceps, hand intrinsics

d.
All of the above.

A

Deltoids, latissimus, biceps, radial wrist extensors

17
Q

The occupational therapist can help achieve the desired flexor tightness necessary for tenodesis grasp by doing which of the following?

a.
Ranging finger flexion with the wrist extended and finger extension with the wrist flexed

b.
Ranging finger flexion with wrist flexed and finger extension with wrist extended

c.
Ranging finger flexion with wrist at neutral and extension with wrist extended

d.
Ranging finger extension with wrist at neutral and extension with wrist extended

A

Ranging finger flexion with the wrist extended and finger extension with the wrist flexed

18
Q

The patient has a C5 quadriplegia. We can anticipate that he or she has innervation of which of the following?

a.
Upper trapezius, deltoids, biceps, levator scapulae, wrist flexors

b.
Latissimus, deltoids, biceps, supinators, pronators

c.
Upper trapezius, diaphragm, levator scapulae, biceps, and supinators

d.
Both A and B

A

c.

Upper trapezius, diaphragm, levator scapulae, biceps, and supinators