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Flashcards in Comp Exam Deck (83):
1

Scapula Spasticity Pattern

retraction
downward rotation

2

Shoulder Spasticity Pattern

adduction and IR
depression

3

Elbow Spasticity Pattern

Flexion

4

Forearm spasticity pattern

pronation

5

Wrist spasticity pattern

flexion
adduction

6

Hand spasticity pattern

finger flexion
clenched fist
thumb adducted in palm

7

Pelvis spasticity pattern

retraction (hip hiking)

8

Hip spasticity pattern

adduction
IR
extension

9

Knee spasticity pattern

extension

10

Foot and ankle spasticity pattern:

plantarflexin
inversion
equinocarus
toe claw
toe curls

11

UE flexion synergy pattern:

scapular retraction/elevation, shoulder abduction, ER, elbow flexion, forearm supination, wrist and finger flexion

12

UE extension synergy pattern:

scapular protraction, shoulder adduction, IR, elbow extension, forearm pronation, wrist and finger flexion

13

LE flexion synergy pattern:

hip flexion, abduction, ER, knee flexion, ankle dorsiflexion and inversion

14

LE extension synergy pattern:

hip extension, adduction, IR, knee extension, ankle plantarflexion and inversion

15

BERG balance low fall risk

41-56

16

BERG balance moderate fall risk:

21-40

17

BERG balance high fall risk

0-20

18

ACA stroke:

contralateral hemiparesis of mainly LE
contralateral hemisensory loss mainly LE
urinary incontinence
problems with bimanual tasks. apraxia

19

MCA stroke:

contralateral spastic hemiparesis and sensory loss of face, UE and LE with face and UE more involved
broca's or nonfluent aphasia
wernicke's or fluent aphasia
global aphasia
neglect
contralateral homonymous hemianopsia

20

PCA stroke:

contralateral homonymous hemianopsia
visual agnosia
dylexia
memory defect
topographic disorientation

21

Stage 1 motor recovery:

initial flaccidity, no voluntary movement

22

Stage 2:

emergence of spasticity, hyperreflexia, syngeries

23

Stage 3:

voluntary movement possible, only in synergies, spasticity strong

24

Stage 4:

voluntary control in isolated joint movement emerging, decline of spasicity and syngergies

25

Stage 5:

increasing voluntary control out of syngery
coordination deficit present

26

Stage 6:

control and coordination near normal

27

Typical right sided CVA:

apraxia, impulsive, neglect

28

Typical left sided CVA:

aphasia, overly cautious

29

Synergy:

stereotyped set of movements that occur in response to a stimulus or voluntary movement

30

Associated reaction:

stereotyped movements in which effortful use of one extremity influences the posture and tone of another

31

CIMT criteria:

10 degrees active wrist extension
thumb abduction
finger extension

32

Mild TBI

LOC: 0-30 mins
alteration of consciousness: less than 24 hours
amnesia: less than 1 day
GCS 13-15
imagining: normal

33

Moderate TBI:

LOC: more than 30 mins, less than24 hours
Alteration of consciousness: > 24 hours
amnesia: >1 day < 7 days
GCS: 9-12
imaging: normal or abnormal

34

Severe TBI

LOC: > 24 hours
Alteration of consciousness: > 24 hours
Amnesia: > 7 days
GCS: < 9
Imaging: normal or abnormal

35

Stage progression following diffuse axonal injury?

coma
unresponsive vigilance/vegetative state
confusional state
emerging independence
intellectual/social competence

36

Common levels of injury to spinal cord:

C5, C7, T12, L1

37

Level A:

complete
no motor function below lesion

38

Level B;

incomplete
sensory but not motor function is preserved below the neurological level

39

Level C:

incomplete
motor function is preserved below neurological level and most key muscles have a muscle grade of less than 3

40

Level D:

incomplete
motor function is preserved below neurological level and most key muscles have a muscle grade of greater than 3

41

Level E:

normal

42

Central Cord Lesion

UMN
Loss of bilateral pain and temp
Loss of bilateral motor function; primarily UE
Preservation of proprioception and discriminatory sensation

43

Brown-Sequard Syndrome

UMN
hemisection of spinal cord
Ipsilateral loss of tactile discrimination, pressure, vibration and proprioception
Ispilateral loss of motor function and spastic paralysis below level of lesion
Contralateral loss of pain and temp below level of lesion; at level of lesion bilateral loss

44

Anterior cord syndrome:

UMN
loss of bilateral motor function, spastic paralysis below level of lesion
loss of bilateral pain and temp
preservation of proprioception kinesthesia and vibration

45

Posterior cord syndrome:

UMN
bilateral loss of proprioception, vibration pressure and stereognosis and 2 pt discrmination (DCML)
preservation of motor function, pain, and light touch

46

Stage 1 (PD)

minimal or absent disability
unilateral symptoms

47

Stage 2 PD

minimal bilateral or midline involvement
no balance involvement

48

Stage 3 PD

impaired balance
some restrictions in activity

49

Stage 4 PD

all symptoms present and severe
stands and walks only with assistance

50

Stage 5 PD

confined to bed or w/c

51

Loss of archicerebellum (flocculonodular)

central vestibular symptoms: ocular dysmetria, poor eye pursuits, dysfunctional VOR, impaired hand eye coordination
gait and trunk ataxia

52

Lesion of paleocerebellum (anterior)

hypotonia
truncal ataxia: poor posture, wide BOS
ataxic gait

53

Lesion of neocerebellum

intention temor
dysdiadochokineisa
dysmetria
dyssynergia
errors in timming

54

Additional impairments in cerebellar lesions:

asthenia
hypotonia
motor learning impairments
cognition
emotion dysregulation

55

Bulbar palsy:

LMN affecting CN VII-XII
flaccid paralysis of pharynx and larynx
CN IX and X

56

Pseudo-bulbar palsy:

UMN
spastic paralysis of pharynx and larynx

57

Bell's palsy:

loss of control of salivation and lacrimation
CN VII
drooping of corner of mouth, eyelids that don't close

58

Which cranial nerves should be examined in GBS?

VII, IX, X, XI, XII

59

Which cranial nerves should be examined in ALSS?

VII, IX, X, XI, XII

60

Stage I ALS:

early disease, mild focal weakness, asymmetrical distribution, symptoms of hand cramping and fasiculations

61

Stage II ALS:

moderate weakness in groups of muscles, some wasting of muscles
modified independent with AD

62

Stage III ALS

severe weakness of specific muscles, increasing fatigue, mild to moderate functional limitations
ambulatory

63

Stage IV ALS:

severe weakness and wasting of LEs, mild weakness if UEs, moderate assistance and AD required, wc

64

Stage V ALS:

progressive weakness with deterioration of mobility and endurance, increased fatigue, moderate to severe weakness of whole limbs and trunk; spasticity, hyperreflexia, loss of head control, max assist

65

Stage VI ALS:

bedridden, dependent in ADLs, FMS, progressive respiratory distress

66

C1-C4 w/c;

electric w/ tilt in space
puff and sip

67

C5 w/c

shoulder function and elbow flexion
manual w/c with propulsion
may choose electronic w/c for energy conservation

68

C6 w/c

radial wrist extensors
manual w/c with friction surface hand rims
independent

69

C7 w/c

triceps
same as C6 with increased propulsion

70

Gait for T6-T9:

bilateral KAFO
crutches, swing to
supervised ambulation for short periods

71

Gait for T12-L3:

independent in all ambulation on all surfaces and stairs
swing through or 4 pt pattern
bilateral KAFO and crutches
independent household ambulators
w/c community

72

Gait for L4-L5:

independent with bilateral AFOs and crutches or canes
independent community ambulators
may use w/c for high endurance

73

Peripheral vestibular symptoms:

sudden memorable onset
less than 24 hours
head movement provokes symptoms
more likely to have auditory involvement

74

Peripheral disorders:

vestibular neuritis
labyrninthitis
acoustic neuroma
meniere's disease
BBPV
toxicity

75

Vestibular neuritis

imbalance, nausea improving over 1-4 days
head movement sensitivity

76

Labryinthitis

similiar to vestibular neuritis except with hearing loss before onset of vertigo

77

Acoustic neuroma

tumors from Schwann cells
progressive unilateral hearing loss or tinnutus without vestibular symptoms
balance issues mild and intermittent

78

Meniere's disease

postural imbalance,nystagmus, nausea, vomitting, hearling loss and aural fullness
vertigo will persist 30-42 hours
vestibular exercises not appropriate

79

BPPV

most common
vertigo when head is turned

80

Central vestibular symptoms:

sudden onset of vertigo with one of D: diplopia, dysphagia, diaphoresis, dysarthria, drop attacks
vertigo lasts 24/7

81

Central vestibular disorders:

disequilibrium of aging
CVA
migraine
head trauma

82

Exam generalizations of peripheral symptoms:

direction fixed nystagmus-horizontal
abnormal VOR via head thrust
nystagmus more likely to be seen with fixation removed
nystagmus exacerbated when gazing in fast component (Alexander's law)
pursuit and saccade normal
nystagmus exacerbated post horizontal head shake (horizontal nystagmus)

83

Exam generalization of central symptoms:

direction change nystagmus
nystagmus seen with fixation
nystagmus to be pure vertical or torsional
nystagmus post shaking vertically
abnormal pursuit/ saccades
cannot walk or stand with assistance