Exam 1 Flashcards
(216 cards)
1
Q
What is the fasciculus cuneatus (posterior or dorsal column) tract?
A
- Sensory
- For trunk, neck, and UE proprioception, vibration, two-point discrimination, and graphesthesia
- Cross in brainstem
2
Q
What is the fasciculus gracilis (posterior or dorsal column) tract?
A
- Sensory
- For trunk and LE proprioception, two-point discrimination, vibration, and graphesthesia
- Cross in brainstem
3
Q
What is the spinocerebellar tract (dorsal)?
A
- Sensory
- Tract ascends to cerebellum
- Ipsilateral subconscious proprioception, tension in muscles, joint sense, and posture of trunk and LE
4
Q
What is the spinocerebellar tract (ventral)?
A
- Sensory
- Ascends up to cerebellum with crossing and recrossing at the pons
- Ipsilateral subconscious proprioception, muscle tension, joint sense, and posture of trunk, UE, and LE
5
Q
What is the spino-olivary tract?
A
- Ascend to cerebellum
- Relay info from cutaneous and proprioceptive organs
6
Q
What is the spinoreticular tract?
A
- Afferent pathway for reticular info that influences levels of consciousness
- Located next to lateral spinothalamic tract
7
Q
What is the spinotectal tract?
A
- Sensory
- Provides afferent info for spinovisual reflexes and assists with the movement of the eyes and head towards a stimulus
8
Q
What is the anterior spinothalamic tract?
A
- Sensory
- Light touch and pressure
- Cross at level of entry to SC or 1-3 levels above
9
Q
What is the lateral spinothalamic tract?
A
- Sensory
- Pain and temp sensation
10
Q
Where do sensory tracts originate from?
A
- Cells of spinal ganglia
- Intrinsic neurons within gray matter
11
Q
What are descending tracts responsible for?
A
- Motor function
- Mm tone
- Reflexes
- Equilibrium
- Visceral innervation
- Modulation of ascending sensory signals
12
Q
Where do smaller descending tracts originate from?
A
- Nuclei in the midbrain, pons and medulla
13
Q
What is the lateral corticospinal tract?
A
- Pyramidal motor
- Voluntary fine motor movement
- Thought that it controls more distal parts
14
Q
What happens if there is damage to the lateral corticospinal tract?
A
- Positive Babinski
- Absent superficial ab reflex
- Cremasteric reflex
- Loss of fine motor or skilled voluntary movement
15
Q
What is the anterior corticospinal tract?
A
- Pyramidal motor
- Ipsilateral voluntary, discrete, and skilled movements
- Thoughts that it controls the more proximal parts
16
Q
What is the reticulospinal tract?
A
- Extrapyramidal motor tract
- Facilitation or inhibition of voluntary and reflex activity through influence of alpha and gamma motor neurons
17
Q
What is the rubrospinal tract?
A
- Extrapyramidal motor tract
- Motor input of gross postural tone, facilitate activity of flexor muscles, and inhibit extensor muscles
- Originate in red nucleus (midbrain) and crosses immediately
18
Q
What is the tectospinal tract?
A
- Extrapyramidal motor tract
- Contralateral postural muscle tone associated with auditory/visual stimuli
- Cross in midbrain
19
Q
What is the vestibulospinal tract?
A
- Extrapyramidal motor tract
- Ipsilateral gross postural adjustments subsequent to head movements
- Facilitate extensor muscles and inhibit flexors
20
Q
What happens if there is damage to the extrapyramidal tracts?
A
- Significant paralysis
- Exaggerated DTR
- Clasp-knife reaction
21
Q
What is the interhemispheric fissure?
A
- AKA medial longitudinal
- Separate two hemispheres
22
Q
What is the Sylvian fissure?
A
- Anterior
- Separates temporal and frontal lobes and temporal from parietal
23
Q
What is the central sulcus?
A
- Sulcus of Rolando
- Separate frontal and parietal lobes laterally
24
Q
What is the calcarine sulcus?
A
- Separate occipital lobe into superior and inferior halves
25
What is the function of the frontal lobe?
- Voluntary movement, intellect, and orientation
- Contains Broca's area = speech and concentration
- Personality, temper, judgement, reasoning, behavior, self-awareness, executive function
26
What happens if there is an impairment to the frontal lobe?
- Contralateral weakness
- Preservation, inattention
- Personality changes, antisocial behavior
- Impaired concentration, apathy
- Broca's aphasia
- Delayed or poor initiation
- Emotional lability
27
What is the function of the parietal lobe?
- Sensation of touch, kinesthesia, perception of vibration, and temp
- Receive info from other areas of the brain regarding hearing, vision, motor, sensory, and memory
- Provide meaning to objects
- Interpret language and words
- Spatial and visual perception
28
What happens if there is an impairment to the parietal lobe?
- Dominant hemisphere = agraphia, alexia, agnosia
- Non-dominant hemisphere = dressing apraxia, constructional apraxia, and anosognosia
- Contralateral sensory deficit
- Impaired language comprehesion
- Impaired taste
29
What is the function of the temporal lobe?
- Primary auditory processor and olfaction
- Wernicke's area location (typically left side) = ability to speak, verbal and general memory, and assist with understanding language
- Rear portion enables humans to interprets others emotions and reactions
30
What happens if there is an impairment to the temporal lobe?
- Learning deficits
- Wernicke's aphasia
- Antisocial, aggressive behavior
- Difficulty with facial recognition and memory
- Inability to categorize objects
31
What is the function of the occipital lobe?
- Visual information processor (colors, shapes, light, etc)
| - Judgement of distance and seeing in 3D
32
What happens if there is an impairment to the occipital lobe?
- Homonymous hemianopsia
- Impaired extraocular Mm movement and visual deficits
- Impaired color recognition
- Reading and writing impairments
- Cortical blindness with B lobe involvement
33
What is the L hemisphere responsible for?
- Language
- Sequencing and performing movement
- Understand language
- Produce written and spoken language
- Analytical
- Controlled
- Logical
- Rational
- Math calc
- Express positive emotions
- Process verbally coded info in an organized and logical manner
34
What is the R hemisphere responsible for?
- Nonverbal processing
- Process info in holistic manner
- Artistic abilities
- General concept comprehension
- Hand-eye coordination
- Spatial relationships
- Kinesthetic awareness
- Understand music
- Understand nonverbal communication
- Math reasoning
- Express negative emotions
- Body image awareness
35
What makes up the CNS?
Brain and SC
36
Where does the spinal cord truly end?
~ L1-L2
37
What is the importance of the brainstem?
Regulate HR and RR
38
What constitutes the brainstem?
- Midbrain
- Pons
- Medulla oblongata
39
What is the function of the hippocampus?
- Form and store memories of personal history or declarative info
40
What is the function of basal ganglia?
- Voluntary movement
| - Regulation of autonomic movement, posture, tone, and control of motor responses
41
What is the amygdala?
- Emotional and social processing
42
What is the function of the thalamus?
- Relay station for info going to cerebral cortex
43
What is the function of the hypothalamus?
- Receive and integrate info from ANS and assist in hormone regulation
44
What is the function of the subthalamus?
- Regulate movements produced by skeletal Mm
45
What is the function of the epithalamus?
- Pineal gland
| - Secrete melatonin and involved in Circadian rhythm
46
What is the function of the midbrain?
- Large relay center for info passing through to the cerebrum, cerebellum, and SC
- Reflex center for visual, auditory, and tactile responses
47
What is the function of the cerebellum?
- Fine tuning of movement
- Assist in maintaining posture and balance
- Control ability to perform rapid movements
48
What is the function of the pons?
- Assist in regulation of RR and orientation of the head in relation to visual or auditory stimuli
49
What CN run through the pons?
CN V - VII
50
What is the function of the medulla oblongata?
- Influence autonomic nervous activity and regulation of RR and HR
- Reflex center for vomiting, coughing, and sneezing
51
What is the function of the brainstem?
- Relay station, sends messages between parts of the body and cerebral cortex.
- Primitive functions for survival
52
Where are most CN located?
Brainstem
53
What is the function of the meninges?
Protection from contusion and infection
54
What are the layers of meninges from deep to superficial?
- PAD --> pia, arachnoid, and dura
55
What is the function of the ventricular system?
Protect and nourish the brain
56
What is the function of CSF?
- Nutrition to CNS
- Removal of metabolites
- Provide support and buoyancy
57
What is the function of the BBB?
Exchange of nutrients from CNS and vascular system
58
What makes up the BBB?
- Meninges
- Protective glial cells
- Capillary beds
59
What is Broca's aphasia?
- Can comprehend conversation
| - Have difficulty getting thoughts across and words out
60
What is Weirnikes aphasia?
- Cannot process conversation
| - Can talk and talk in circles
61
What is the function of dopamine?
Needed for motor patterns
62
Where is dopamine produced?
Substantia nigra
63
What is Horner's syndrome?
- Descending sympathetic tract
| - Sx/Sx: miosis (small pupil), ptosis (droopy eye), and decrease sweating
64
What is POTS?
- Postural orthostatic tachycardic syndrome
- HR increases significantly when changing positions
- ANS disorder
65
How is sensory info processed?
Moves up the brain and into dorsal root
66
How is motor information processed?
Through a descending tract through the anterior horn of SC to initiate muscle contraction
67
What is RAS?
- Reticular Activating System
| - Sleep/wake cycles
68
What is communicating hydrocephalus?
No blockage
69
What is non-communicating hydrocephalus?
Blockage
70
What is the function of the spinal cord?
- Send signals to the brain
| - Send motor neurons down the efferent pathway
71
Is gray matter myelinated or unmyelinated?
Gray hair is UN-wanted = unmyelinated
72
What is an extrapyramidal system?
- Motor system
- Involuntary reflex and movement
- Modulation of movement
- Found in reticular formation of pons and medulla
- Target neurons in SC involved in reflexes, locomotion, complex movement, and postural control
73
What is the pyramidal system?
- Include corticospinal tracts
| - Directly innervate anterior horn
74
What is the Babinski test?
- Stroking sole of foot and toes should curl
- Reflex takes place until about 2 years old
- Abnormal = toes splay
75
Where do sensory nerves originate?
Dorsal root ganglion
76
Where do motor nerves originate?
Ventral horn
77
Which receptors are cutaneous sensory end-organ receptors?
- Thermoreceptors
- Nociceptors
- Mechanoreceptors
- Chemoreceptors
- Photoreceptors
78
What are the different types of mechanoreceptors?
- Merkel's disc
- Ruffini's corpuscle
- Pacinian corpuscle
- Meissner's corpuscle
- Muscle spindle
- Golgi tendon organ
- Free nerve ending
79
What is the function of Merkel's disc?
Sustained touch and pressure
80
What is the function of Ruffini's corpuscle?
Slow adaptation to pressure - IE. stretch of skin
81
What is the function of Pacinian corpuscle?
Deep pressure and fast vibrations
82
What is the function of Meissner's corpuscle?
Light touch
83
What is the function of muscle spindle?
Prevent overstretching by Mm contraction
AKA stretch reflex
Contract
- Only has to go to the SC and back
84
What is Golgi tendon organ function?
Inhibit Mm activation
Detects Mm tension
Relax
85
What is the function of free nerve endings?
Unspecialized, sends signal to sensory neuron
86
What is the function of chemoreceptors?
- Detect change and send to CNS
| - Response for homeostasis
87
What are the A Fibers?
- Large and myelinated (FAST)
- Carry proprioceptive info from Mm spindles, GTOs, and joints
- Think of freeway
88
What are B fibers?
- Medium and myelinated (MEDIUM SPEED)
- ANS
- Think of highway
89
What are C fibers?
- Small with little to no myelination (SLOW)
- Sympathetic
- Free Nn endings carry pain, temp, and touch
- Think of country road
90
What is the purpose of superficial sensation test? What is it and how does it work?
- Cortical
- Temp, light touch, and pain
- Test with two tubes of hot and cold water
91
What is the purpose of the deep sensation test? What is it and how does it work?
- Proprioception, kinesthesia, and vibration
92
What is the definition of proprioception?
Awareness of movement in space
93
What is the definition of kinesthesia?
- Extent of movement
| - Moving continuously and grading the arc of motion
94
What is the monofilament sensation test and how is it used?
- Small plastic rods of different sizes
- Used to see if pt can feel the size
- Protective sensation - if they detect a certain size they are safer to walk barefoot (IE. peripheral neuropathy)
95
Which peripheral nerve arises from C5-6?
Axillary
96
Which peripheral nerve arises from C5-7?
Musculocutaneous
97
Which peripheral nerve arises from C5-T1?
Radial
98
Which peripheral nerve arises from C6-T1?
Median
99
Which peripheral nerve arises from C8-T1?
Ulnar
100
What is polyneuropathy?
- PNS lesion
- Difficult to make improvements
- Symmetrical and not usually caused by trauma
101
What is neurapraxia?
- Acute PNS injury
- Pressure injury
- Conduction block usually due to myelin dysfunction
- Recovery is rapid and complete within 4-6 weeks
102
What is axonotmesis?
- Acute PNS injury
- Caused from traction, compression, and crush injury
- Nn regenerates (~ 1 mm/day)
- Spontaneous recover or spotty to none
103
What is neurotmesis?
- Acute PNS injury
- Complete transection of Nn in trunk
- Irreversible
- See flaccidity and atrophy
- Absence of sensation
104
What is UMN lesion?
- Lesion of descending tracts (cerebral motor cortex), internal capsule, brainstem, or SC
- IE. CP, hydrocephalus, ALS, CVA, MS, Huntington's, etc
105
What is a LMN lesion?
- Lesion of affecting nerves or axons at or below brainstem
| - IE. ALS, GBS, SC tumors, trauma, Bell's palsy, progressive MA, etc
106
Where does UMN refer to?
Brain/spinal cord
107
What does LMN refer to?
At or below brainstem
108
What signs/symptoms do you see in an UMN lesion?
- Increased reflex
- Mild atrophy
- Absent fasciculations
- Increased tone
109
What signs/symptoms do you see with a LMN lesion?
- Decreased or absent reflex
- Atrophy
- Fasciculations are present
- Decreased or flaccid tone
110
What are signs/symptoms of hypokinesia?
- Apraxia
- Rigidity
- Bradykinesia
111
What are signs/symptoms of hyperkinesia?
- Ataxia
- Athetosis
- Chorea
- Tics
- Tremors
- Dysmetria
- Dystonia
112
What is athetosis?
Involuntary movements combined with instability of posture
113
What is chorea?
Sudden, random, and involuntary movement
114
What is ataxia?
Inability to coordinate movements
115
What is dysmetria?
Inability to control the range of movement and the force of muscular activity
116
What is dysdiadochokinesia?
Inability to perform rapidly alternating movements
117
What is a fasciculation?
Muscle twitch
118
What is hemiballism?
Involuntary and violent movement of a large body part
119
What is lead pipe rigidity?
Uniform and constant resistance to ROM. Associated with basal ganglia lesions
120
What is cogwheel rigidity?
Resistance to movement. Seen in PD
121
What is clasp-knife rigidity?
Great resistance to the initiation of ROM that lessens with movement
122
What is the circulation pattern for the Circle of Willis?
Aorta --> Internal/External carotid
- Internal carotid enters into brain - splits into anterior and middle cerebral Aa
- Middle cerebral Aa supplies outer cerebrum (UE, basal ganglia, post/ant capsule, and putamen)
- Anterior cerebral Aa supplies outer cerebrum (LE)
Subclavian Aa and vertebral Aa unite = Basilar Aa
- Basilar splits into posterior cerebral Aa
- Posterior cerebral Aa supplies brainstem, portion of midbrain, cerebellum, medial temporal lobe, and occipital lobes
- Veretrobasilar Aa supplies the medulla, cerebellum, pons, and middle occipital cortex
Anterior and posterior systems connect at the base of brain
123
What is the function of fluid in the ear?
Tell where your head is in space
124
What is the vestibuloocular reflex (VOR)?
Keep same image while the head is moving
125
What is the vestibulospinal reflex (VSR)?
Assist with stability while head is moving
126
What is a positive VOR?
Patient cannot keep eye on object/image
127
What is suspensory reflex?
Crouching down
128
What are automatic postural strategies?
- Automatic motor response to maintain COG over BOS
| - Ankle strategy - hip strategy - suspensory - stepping strategy
129
What is the BERG balance scale?
- 14 tasks (static, transitional, and dynamic sitting and standing)
- Less than 45 is fall risk
130
What is the Fugl-Meyer Sensorimotor Assessment of Balance Performance Battery?
- Specific to hemiplegics
| - 7 items
131
What is the functional reach test?
- 3 trials and take average
- Less than 7 inches = increase fall risk
- Age related norms
- SB states to use middle finger or head of 3rd metacarpal as landmark
132
What is the Romberg Test?
- If positive with e/c = somatosensory or vestibular deficit (not cerebellar)
- Feet together with arms crossed - e/o and e/c. Hold 30 sec
133
What is the Sharpened Romberg?
- Same as Romberg, but in tandem
134
What is the Timed Get Up and Go test?
- Can use AD
- 10 sec is norm
- Cut-offs based on population
135
What is the Tinetti Performance Oriented Mobility Assessment?
- Balance and gait assessment
136
What can cause vestibular disorders?
- Disease, injury, genetic, environmental, and idiopathic
137
What is the VOR assessment with Dix-Hallpike?
- AKA Epley maneuver
- Keep eyes open
- If positive will see nystagmus - direction determines which semicircular canal is involved
138
How can PT assist in vestibular disorders?
- Maneuvers for BPPV
- Habituation
- Retrain balance reactions, proprioception, and vestibuloocular reflex (VOR 1 and VOR 2)
- SLS on variable surfaces
- Gait with head movement
- Balance with e/c
139
What is habituation in terms of PT for vestibular disorders?
Become less sensitive through adaptation, substitution, cognitive, and symptom prediction
140
What is the definition of aphasia?
Impairment of processing for receptive and/or expressive language
141
What is fluent aphasia?
- Word output and speech production are functional
- Empty speech
- Neologisms
142
What is the definition of neologism?
Substitution within a word that makes it unrecognizable
143
What is non-fluent aphasia?
- Poor word output with impairment to rhythm and inflection
| - Poor articulation and increased effort
144
What are characteristics of Wernicke's (fluent) Aphasia?
- Impaired comprehension and writing
- Good articulation
- Poor naming ability
- Receptive
145
What are characteristics of Broca's (fluent) Aphasia?
- Expressive
- Intact auditory and reading comprehension
- Impaired repetition and naming skills
- Frustration with errors
- Paraphasias are common
- Motor impairment depending on area
146
What is global (fluent) aphasia?
- Comprehension severely impaired
- Impaired naming, writing, and repetitions skills
- May involuntarily verbalize
- Many use nonverbal skills for communication
147
What is dysarthria?
- Motor disorder of speech (UMN lesion) affecting muscles that help articulate words and sounds
- Slurred with possible effect on respiration and phonation
148
What is an antiepileptic? What are the side effects, implications, and examples?
- Tx epilepsy/seizures
- Side effects - ataxia, skin issues, behavioral changes, GI distress, HA, blurred vision, and wt gain
- Implications - greater sensitivity to light or noise
- IE. Tegretol and Dilantin
149
What is an antispastic drug? What are the side effects, implications, and examples?
- Treat tone disorder
- Side effects: drowsiness, confusion, HA, dizziness, generalized Mm weakness, hepatotoxicity, tolerance, and dependnence
- PT implications: Focus to promote mobility and scheduling (sedation)
- IE. Baclofen and Dantrium
150
What is a dopamine replacement drug? What are the side effects, implications, and examples?
- Replaces dopamine
- Side effects: arrhythmias, GI distress, OH, dyskinesias, mood/behavior change, and tolerance
- PT implications: Schedule 1 hour after levadopa dose and monitor BP
- IE. Levadopa, Sinemet, Madopar
151
What is a muscle relaxant? What are the side effects, implications, and examples?
- Relax muscle
- Side effects: sedation, drowsiness, dizziness, nausea, vomiting, HA, tolerance, and dependence
- PT implications: Scheduling and pt education (posture)
- IE. Valium and Flexeril
152
What are the 3 motor stages of learning
- Cognitive
- Associative
- Autonomous
153
What happens in the cognitive stage of learning?
- Initial stage
- Frequent errors
- Repetition
- Listen, observe, and process feedback
154
What happens in the associative stage of learning?
- Able to independently detect errors
- Decrease errors and need for concentration during tasks
- Improved coordination
- Practice yields skill refinement of motor program
155
What happens in the autonomous stage of learning?
- Final stage
- No feedback
- Distraction doesn't impact activity
- Self correct
156
What is knowledge of results?
- Terminal
| - Outcome of movement has been performed in relation to movement goals
157
What is knowledge of performance?
- Relates to movement pattern that someone uses to achieve their goal
158
What is massed motor learning?
Practice time in trial is greater than amount of rest between trials
159
What is distributed motor learning?
Amount of rest time between intervals is greater than or equal to amount of practice time for each trial
160
What is constant motor learning?
Uniform condition
161
What is variable motor learning?
Differing conditions
162
What is random motor learning?
Varying practice amongst different tasks
163
What is blocked motor learning?
Constant practice of single task
164
What is whole motor training?
Practice entire task
165
What is part motor training?
Practice specific component of task
166
What is pivot prone?
- Infant has strength to lift head and legs against gravity
- Swimming motion
- Turn body using hands and weight shifts
167
What is protective extension?
- Being able to use UE to prevent falling
- Child feels the limits of falling without actually falling
- First learn to catch themselves going forward
- Second learn to catch themselves going to the side
- Finally, protect themselves from going backwards
168
What is modified plantigrade?
- Upright WB through LE and have WB in UE
- IE. standing and pushing into table
- Progression to static stand
169
What is the Apgar score?
- Infant is scored 1 minute and 5 minutes after birth
- Assess skin color, pulse, grimace, activity, and respiration
- Score of 7-10 is good
- Score of 3 or below = medical attention
- In between is up to discretion of medical staff
170
How do we develop?
- Cephalic to caudal
- Gross to fine
- Mass to specific: simple movement acquisition with progression to more complex
- Proximal to distal
171
When is the normal response of asymmetrical tonic neck reflex (ATNR) occur?
Birth to 6 months
172
When does symmetrical tonic neck reflex (STNR) occur?
6 to 8 months
173
When does tonic labyrinthine reflex (TLR) occur?
Birth to 6 months
174
When does galant reflex occur?
30 weeks gestation to 2 months
175
When does palmar grasp reflex occur?
Birth to 4 months
176
When does plantar grasp reflex occur?
28 week gestation to 9 months
177
When does rooting reflex occur?
28 weeks gestation to 3 months
178
When does moro reflex occur?
28 weeks gestation to 5 months
179
When does startle reflex occur?
28 week gestation to 5 months
180
When does positive support reflex occur?
25 weeks gestation to 2 months
181
When does walking (stepping) reflex occur?
38 weeks gestation to 2 months
182
What is the normal response of TLR?
Supine = extremities and body in ext
Prone = extremities and body in flexion
183
What does TLR interfere with if the reflex is not integrated?
- Ability to initiate rolling
- Ability to prop on elbows with extended hips in prone
- Ability to flex trunk and hips to come into sitting from supine
- Causes full body ext, which interferes with sitting and standing
184
What is the normal response for the rooting reflex?
- Turning head in the same direction as stimulus with open mouth
185
What does rooting reflex interfere with if it does not integrate?
- Oral-motor development
- Development of midline head control
- Poor visual tracking
186
What is the normal response to Moro reflex?
- Arms ABd with fingers open, then cross into ADd and cry
187
What does the Moro reflex interfere with if it does not integrate?
- Balance reactions in sitting
- Protective response in sitting
- Eye-hand coordination
- Visual tracking
188
What is the normal response in the startle reflex?
- Similar to Moro, but elbows remain flexed and hands closed
189
What happens if startle reflex does not integrate?
- Sitting balance
- Protective sitting response
- Eye-hand coordination
- Visual tracking
- Social interaction
- Attention
190
What is the normal response for positive support reflex?
- When standing up infant and their knees lock out, but cannot support their weight
191
What happens if positive support reflex does not integrate?
- Standing and walking
- Balance and WB
- Contractures in ankles into PF
192
What is arthrogryposis multiplex congenita (AMC?
- Occurs in utero
- Non-progressive
- Unknown etiology
- S/S: cylindrical like extremities with atrophy, significant and multiple contractures, and joint dislocations
- Tx: Positioning, stretching, strengthening, splinting, and use of AD. Possible surgery. Education
193
What is Autism Spectrum Disorder?
- Umbrella term
- Etiology: environment and genetics
- S/S: 2-3 years w/o speech, diminished facial expressions, awkward social interactions, lack empathy, defensive toward sensory stim, repetitive self-stimulation behaviors, perseverations, routines/rituals, and decreased coordination
- Tx: Improve social interactions and decrease non-purposeful movements and vocalizations, sensory integration
194
What is CP?
- Umbrella term
- Non-progressive
- Impaired ability to monitor and control nerve/voluntary Mm activity
- Etiology: lack of O2 in utero, maternal infection, drug/alcohol abuse, placental abnormalities, toxemia, prolonged labor, premature, and Rh incompatibility
- S/S: Abnormal Mm tone, impaired modulation of movement, abnormal reflexes, and impaired mobility
- Tx: pt/cargiver education, normalize tone, stretching, strengthening, motor learning, positioning, WB, and mobility skills
195
What are the motor patterns of CP?
- Spastic: UMN lesion
- Athetoid: Basal ganglia lesion
- Mixed
196
What is diplegia CP?
- Usually affects B LE
| - Can affect UE, but less likely
197
What is hemiplegia CP?
- Affects one side of the body
198
What is Down Syndrome?
- Genetic abnormality - extra 21st chromosome
- S/S: intellectual disability, hypotonia, jt hypermobilty, flat nasal bridge, narrow eyelids, small mouth, flat feet, scoliosis, congenital heart disease, and visual/hearing loss
- Tx: Exercise and fitness, stability, max resp function, and pt/caregiver education. Surgery for cardiac abnormalities
199
What is DMD?
- Progressive disorder
- Fat and CT replace muscle
- Death by CP failure by 25 y/o
- In males
- Etiology: Absence of gene that produces dystrophin and nebulin. Mother is silent carrier
- S/S: Occurs around 2-5 y/o with progressive weakening, disinterest in running, falling, toe walking, excessive lordosis, and pseudohypertrophy
- Tx: Pt/caregiver education, resp function, submax exercise, mobility skills, splinting, orthotics, and adaptive equipment.
200
What is Prader-Willi Syndrome?
- Etiology: partial deletion of chromosome 15
- S/S: small hands, feet and sex organs, hypotonia, almond-shaped eyes, obesity, constant desire for food, and coordination. Could literally eat themselves to death.
- Tx: Postural control, exercise and fitness, gross and fine motor skills
201
What is spina bifida?
- Insufficient closure of neural tube by day 28 gestation
- Etiology: genetics, environment, low folic acid, maternal hyperthermia, and certain drug classes
- S/S: motor and sensory loss below level of defect, hydrocephalus, Arnold Chirari Type II malformation, osteoporosis, clubfoot, scoliosis, tethered cord syndrome, latex allergy, bowel and bladder dysfunction, and learning disabilities
- Tx: Positioning, handling, ROM, strengthening, balance, facilitating milestones, and skin care
202
What are the classifications of spina bifida?
- Occulta
- Meningocele
- Myelomeningocele
203
What is occulta spina bifida?
- SC and meninges remain intact
- Usually no disability
- Tuft of hair
- Spinous process doesn't fully develop
204
What is meningocele?
- Herniation of meninges and CSF into sac that protrudes
| - Remains within canal
205
What is myelomenigocele?
- Severe herniation of meninges, CSF, and SC extending through defect in vertebrae
206
What is spinal muscle atrophy (SMA)?
- Progresive degeneration of anterior horn
- Etiology: Autosomal recessive inheritance (chromosome 5)
- S/S: progressive Mm weakness and atrophy, diminished or absent DTR, normal intelligence, intact sensation, and end-stage resp compromize
- Tx: vestibular and visual stim, mobility training and use of AD
207
What are the IDEA amendements?
- Enacted in 1997
- Schools responsible for finding free, appropriate education for those with disabilities
- IEP
- Most common services include all 3 rehab disciplines
208
What is the No Child Left Behind Act
- Enacted in 2002
- Redefined federal role in K-12 education
- Require accountability for all
- Aims to close achievement gaps
209
What gross motor skills develop from birth to 1 month?
- Prone: flexion, lift head briefly, and head to side
- Supine: Flexion and rolls partly to side
- Sitting: head lag to pull to sit
- Standing: reflex standing and walking
210
What gross motor skills occur from 2-3 months?
- Prone: lift head to 90 degrees, chest up with some weight in UE, and rolls prone to supine
- Supine: ATNR, legs kick reciprocally, and prefers head to side
- Sitting: head upright with bob, variable head lag, and needs full support
- Standing: poor WB and hips in flexion behind shoulders
211
What gross motor skills occur from 4-5 months?
- Prone: WB on ext arms and pivot in prone to reach
- Supine: rolls from supine to side and plays with feet in mouth
- Sitting: Head steady in supported position, turn head in sitting, and sits alone for brief periods
- Standing: WB through legs in supported standing
212
What gross motor skills occur from 6-7 months?
- Prone: Rolls from supine to prone and hold wt on one hand to reach
- Supine: lift head
- Sitting: Lift head when pulling into seated position, gets into seated position w/o assist, and sits independently
- Mobility: crawl backward
213
What gross motor skills occur from 8-9 months?
- Prone: Get into quadraped
- Supine: does not tolerate
- Sitting: move from sitting to prone, sits without hand support for longer periods, and pivots in seated position
- Standing: stands at furniture, pulls up to stand, and lowers to sitting position from supported position
- Mobility: crawls forward and cruises
214
What gross motor skills occur between 10-11 months?
- Standing: stand w/o support briefly, pulls to stand using half-knee, and picks up object from floor with standing support
- Mobility: walks with both hands held, walk with one hand held, and creeps on hands and feet (bear walk)
215
What gross motor skills occur between 12-15 months?
- Walk w/o support
- Fast walk
- Walk sideways
- Bends over to look b/t legs
- Creeps or hitches upstairs
- Throw ball in sitting
- Mark paper with crayons
- Build tower with 2 cubes
- Turn over small container of objects
216
What gross motor skills occur between 16-24 months?
- Squat in play
- Walk backward
- Walk upstairs and downstairs one foot at a time
- Propel ride-on toys
- Kick balls
- Throw ball
- P/u toy from floor w/o fall
- Fold paper
- String beads
- Stack 6 cubes
- Imitates vertical and horizontal stroke with crayon
- Hold cray with thumb and fingers
