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NPTE Neuro > Balance > Flashcards

Balance Flashcards

1
Q

somatosensory receptors location

A

in joints, muscles, ligaments and skin

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2
Q

What information do somatosensory receptors provide?

A

length, tension, pressure, pain and joint position

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3
Q

How do you challenge the somatosensory system?

A

examine vibration and pressure

observe a pt when changing the surface they are standing on (slopes, uneven surfaces, standing on foam)

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4
Q

What are the purpose of visual receptors?

A

allow for perceptual acuity regarding verticality, motion of objects and self, environmental orientation, postural sway and movements of the head/neck

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5
Q

Who rely heavily on the visual system for maintenance of balance?

A

children

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6
Q

how do you challenge the visual system?

A

examine quiet standing w/ eyes open
observe balance strategies to maintain COG w/ and w/o visual input

assessment of potential visual field cuts, hemianopsia, pursuits, saccades, double vision, gaze control and acuity is necessary

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7
Q

What does the vestibule system provide»

A

the CNS w/ feedback regarding the position and movement of the head w/ relation to gravity

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8
Q

what does the labyrinth consist of?

A

3 semicircular canals filled w/ endolymph and 2 otolith organs

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9
Q

what do semicircular canals respond to?

A

movement of fluid w/ head motion

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10
Q

what do otoliths measure?

A

effects of gravity and movements w/ regard to acceleration/decceleration

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11
Q

How do you challenge the vestibular system?

A

examine balance w/ head movement

testing such as Dix hall pike test, bithermal caloric testing, assessment for nystagmus, head thrust sign, testing the VOR reflex

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12
Q

What does the vestibuloocular reflex (VOR) allow for?

A

head/eye movement coordination

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13
Q

what does VOR support and how?

A

gaze stabilization through eye movement that counters movements of the head

This maintains a stable image on the retina during movement

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14
Q

vestibulospinal reflex (VSR)

A

attempts to stabilize the body and control movement

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15
Q

what does the VSR assist with/.

A

stability while the head is moving as well as coordination of the trunk during upright postures

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16
Q

ankle strategry

A

elicited by a small range and slow velocity perturbation when the feet are on the ground

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17
Q

Which automatic postural strategy is activated first by a small range and slow velocity perturbation?

A

ankle

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18
Q

Pattern of muscle group contraction w/ ankle strategy

A

distal to proximal fashion

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19
Q

hip strategy

A

elicited by a greater force, challenge or perturbation through the pelvis and hips

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20
Q

which way do the hips move w/ hip strategy?

A

opposite direction from the head

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21
Q

Pattern of muscle group contraction w/ hip strategy

A

proximal to distal fashion

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22
Q

suspensatory strategy

A

used to lower the COG during standing or ambulation in order to better control the COG

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23
Q

examples of suspensatory strategy

A

knee flexion, crouching or squatting

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24
Q

when is the suspensatory strategy normally used?

A

when both mobility ands stability are required during a task (think surfing)

25
Q

stepping strategy

A

elicited through unexpected challenges or perturbations during static standing or when the perturbation produces such a movement that the COG is beyond the base of support

LE step and/or UE reach

26
Q

What does Berg balance scale assess?

A

pt’s risk for falling

27
Q

tasks in berg balance scale

A

static activities, transitional movements, and dynamic activities in sitting and standing positions

28
Q

Berg Balance Scale score for risk for falling

A

< 45 = increased risk for falls

29
Q

What does the Fregly-Graybiel Ataxia Test Battery asses?

A

balance dysfunction for pt’s w/ high level motor skills

30
Q

Test conditions w/ Fregly-Graybiel Ataxia Test Battery

A 
stand on beam EO and EC
walk on beam w/ EO
sharpened Romberg
standing w/ EO and EC
standing on one leg EC
walking on the floor w/ EC
31
Q

What does Fugl Meyer asses

A

balance specifically for pt’s w/ hemiplegia

32
Q

What does the functional reach test asses?

A

standing balance and risk for falling

33
Q

What score correlated w/ an increased risk for falling on the functional reach test?

A

20-40 y/o= < 14.5in
41-69 t/o= < 13.5in
70-87y/o = <10.5in

34
Q

what does the Romberg test assess?

A

balance and sensory ataxia

35
Q

What does the timed up and go (TUG) asses?

A

mobility and balance

36
Q

What times correlate with an increased risk of falling on the TUG?

A

> 20 sec

>30 sec high risk

37
Q

What does the Tinetti Performance Oriented Mobility Assessment assess>

A

increased risk for falling

balance and gait

38
Q

What score on the Tinetti POMA correlates to increased risk for falling?

A

<19 = high risk for falls

39
Q

Romberg test w/ BPPV

A

negative

40
Q

Romberg test w. Unilateral vestibular hypofunction

A

acute: (+)

chronic (-)

41
Q

Romberg test w/ bilateral vestibular hypofunction

A

acute: (+)
chronic: (-)

42
Q

Romberg test w/ central lesion

A

often (-)

43
Q

Tandem Romberg w/ BPPV

A

(-)

44
Q

SLS w/ BPPV

A

(-)

45
Q

gait w/ BPPV

A

normal

46
Q

turn head while walking w/ BPPV

A

may produce slight unsteadiness

47
Q

Tandem Romber w/ Unilateral vestibular hypofunction

A

(+), eyes closed

48
Q

SLS w/ Unilateral vestibular hypofunction

A

may be (+)

49
Q

gait w/ Unilateral vestibular hypofunction

A

acute: wide BOS, slow, decreased arm swing and trunk rotation
compensated: normal

50
Q

turn head while walking w/ Unilateral vestibular hypofunction

A

acute: may not keep balance
compensated: normal

51
Q

Tandem Romberg w/ bilateral vestibular hypofunction

A

(+)

52
Q

SLS w/ bilateral vestibular hypofunction

A

acute: (+)
chronic: (-)

53
Q

gait w/ bilateral vestibular hypofunction

A

acute: wide BOS, slow, decreased arm swing and trunk rotation
compensated: mild gait deviation

54
Q

turn head while walking w/ bilateral vestibular hypofunction

A

may not keep balance or slows cadence

55
Q

Tandem Romberg w/ central lesion

A

(+)

56
Q

SLS w/ central lesion

A

may be unable to perform

57
Q

Gait w/ central lesion

A

may have pronounced ataxia

58
Q

turn head while walking w/ central lesion

A

may not keep balance, increased ataxia

NPTE Neuro (4 decks)

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