Exam 2 Flashcards
1
Q
Disability
A
inability to perform activities usually expected in specific social roles that are customary for the individual or expected for the person’s status or role
2
Q
Three components of physical therapy intervention
A
Coordination, communication, documentation
Patient/client related instruction
Procedural interventions
3
Q
Restorative
A
Treat involved areas to remediate/improve function
4
Q
Compensatory
A
Promote optimal function using residual abilities
5
Q
Preventitive
A
Avoid potential future damage
6
Q
Phase Models of Psycholsocial Adaptation
A
Shock, Anxiety, Denial, Depression, Internalized anger, externalized hostility, acknowledgement, adjustment
7
Q
Strategies for Type A (high achievers)
A
Give good HEP
8
Q
Strategies for perfectionists
A
Help patient find pleasure in accomplishing simple things
9
Q
Strategies for authoritative personality
A
Engage in problem solving
10
Q
Strategies for a passive-aggressive
A
Place responsibility for progress on patient, have patient make decisions about treatment, summarize progress
11
Q
Positive coping strategies
A
Seeking control and information
Express emotion
Seeking social interactions
12
Q
Negative coping strategies
A
Avoid control and information
Repress emotions
Withdrawal from social interactions
13
Q
External locus of control
A
Other people or outside factors have control over outcomes
Have stress and anxiety in rehab
14
Q
Internal locus of control
A
Person can affect his/her own circumstances
Quicker recovery, better motivation, more hope, more energy
15
Q
Acute stress disorder
A
Symptoms that range in duration from 2 days to 4 weeks
16
Q
Posttraumatic stress disorder
A
Acute: symptoms less than 3 mos
Chronic: symptoms beyond 3 mos
17
Q
Motor control
A
Ability to regulate or direct the mechanisms essential to movement
18
Q
Motor skills
A
Learned through interaction and exploration of the environment
19
Q
Motor program
A
Abstract representation of movement that results in production of coordinated movement sequence
20
Q
Motor plan
A
Idea or plan for purposeful movement that is made up of several motor programs
21
Q
Short term change in neuroplasticity
A
Efficiency or strength of synaptic connections
22
Q
Long term change in neuroplasticity
A
Organization and numbers of neural connections
23
Q
Motor learning
A
Internal processes associated with practice or experience leading to relatively permanent changes in capacity for skilled behavior
24
Q
Feedback
A
Response produced information received during or after the movement; monitor output for corrective actions
25
Feedforward
Sending signals in advance of movement to ready the system; allows for anticipatory adjustments in postural activity
26
Validity
Test accurately measures the parameter of performance being examined
27
Reliability
Consistency of results in test/retest situations
28
Ascending reticular activating system
Exerts an excitatory influence on the cerebral cortex to maintain the alert state
29
Levels of consciousness
Alert
Lethargic - slow to respond, drowsy
Obtunded - dull, blunted response, difficult to arouse, appears confused
Stupor - semiconscious, aroused only with intense stimuli
Coma - no response to stimuli
30
4 parts of orientation
Time
Place
Person
Circumstance
31
What indicates attention problems
Inability to repeat six items (short lists of numbers or objects)
32
Declarative memory
Recall of facts/events
33
Immediate memory
Recall after a few seconds
34
Short term memory
Recall in minutes to days
35
Long term memory
Recall in years (general knowledge)
36
Anterograde amnesia
Poor new learning
37
Retrograde amnesia
Unable to remember previous learning
38
Factors of articulation
```
Timing
Vocal quality
Pitch
Volume
Breath control
```
39
Neologisms
Creating new words
40
Circumlocutions
Talk around what it really is
41
Anomia
No language or stuck on word or two
42
Ideomotor apraxia
Have automatic movement, but not on demand
43
Ideational apraxia
Purposeful movement is not possible
44
Closed loop system of motor control
Uses feedback, somatosensation
45
Open loop system of motor control
Does not use feeback or error detection
| Rapid movements or well learned movements so don't have time to process
46
Tone
Resistance of muscle to passive stretch while attempting to maintain muscle relaxation
47
Spasticity
Velocity dependent resistance to passive stretch
48
Clasp knife response
Meet a lot of resistance, then reach a point where it is easier to move
49
Decorticate rigidity
UE flexion, LE extension
| Disruption above superior colliculus
50
Decerebrate rigidity
Sustained posturing of UE & LE extension
| Lesion between superior colliculus and vestibular nucleus
51
Opisthotonus
Sustained contraction of neck and trunk extensors
52
Tone grading
```
0 - no response
1 + decreased response (hypotonia)
2+ normal response
3+ exaggerated response
4+sustained response (rigidity)
```
53
Gold standard for spasticity
Modified Ashworth Scale
54
LE extensor tone actions
Hip Ext, add, IR,
Knee ext
Ankle PF and inv
55
Reflex grading
```
0 - no response
1+ decreased response (abnormal)
2+ normal response
3+ brisk response (hyperreflexia)
4+ very brisk, hyperactive, 1-3 beat clonus
5+ >3 beat clonus or sustained response
```
56
Flexor withdrawal LE
Hip flexion, ER, and abduction
57
Closed motor skill
Performed in a stable, nonchanging environment
58
Open motor skill
Performed in a variable, changing environment
59
Fixed support balance strategies
Ankle strategy
Hip strategy
Suspensory strategy
60
Change in support balance strategies
Stepping strategy
| Protective extension
61
FIM Scores
5 and lower = need another person
6 = need AD but independent
7 = independent in a timely and safe fashion
62
Generalizability
Extent to which practice on one task contributes to the performance of other, related skills
63
Reflex theory
Sherrington
| A stimulus causes a response
64
Hierarchial theory
Jackson
| CNS organized in 3 layers: high, medial, and low and motor control proceeds in a top down direction
65
Highest level of hierarchy
Association cortex; elaborates perceptions and planning strategies
66
Middle level of hierarcy
Sensorimotor cortex along with basal ganglia, brainstem, cerebellum
67
Lowest level of hierarchy
Spinal cord, resulting in execution of movement
68
Systems theory
Bernstein
| Cooperative actions of many systems
69
Systems model
Vereijken
| Novice, Advanced, and Expert levels
70
Closed Loop Theory
Adams
| Sensory feedback compared to stored memories
71
Schema Theory
Schmidt
Relationship formed on the basis of experience
Slow movement: feedback based
Fast movement: program based
72
Recall schema
Selects initial movement conditions
73
Recognition schema
Evaluate movement responses based on expected sensory outcomes
74
3 stages of motor learning
Fitts and Posner
| Cognitive, Associative, and Autonomous
75
Two stage theory of motor skill acquisition
Gentile
Getting the idea of the movement
Fixation/diversification
76
Concurrent feedback
Given during the performance of the task
77
Terminal feedback
Given at the end of performance of the task
78
Knowledge of performance
Feedback about the quality of the movement pattern
79
Knowledge of results
Feedback about the end results or outcome
80
Summed feedback
Given after a set number of trials
81
Faded feedback
Given after every trial initially, then progressively less frequently
82
Bandwidth feedback
Given only when performance outside given error range
83
Delayed feedback
Given after a brief delay
84
Massed practice
Rest time is less than practice time
| Good for high motivation, good concentration, and good endurance/energy level
85
Distributed practice
Rest time equal or longer than practice time
| Most learning per training time
86
Blocked practice order
Repeated practice in a predictable order
111222333
Good for early acquisition of skills
87
Serial practice order
Predictable but nonrepeating order
123123123
Good for retention and generalizability
88
Random practice order
Nonrepeating and unpredictable order
123321231
Good for retention and generalizability
89
Transfer of learning
The gain (or loss) of task performance as a result of practice or experience on some other task
90
Parts to whole transfer
Practicing component parts of a motor activity in order to learn the whole activity
91
Bilateral transfer
The patient practices movement on the unaffected side first, then progresses to practice with the affected side
92
Regenerative synaptogenesis
Sprouting of injured axons to innervate previously innervated synapses
93
Reactive synaptogenesis
Collateral sprouting
| Reclaiming of synaptic sites of injured axon by dendritic fibers from neighboring axons
94
Vicariance
Experiencing from experience from others
95
Neurodevelopmental Treatment
Karl and Berta Bobath
| Postural control is foundation for all skill learning
96
Motor Relearning Programme for Stroke
Carr and Shephard
97
Recovery stage in patients with stroke
Signe Brunnstrom
98
Stage 1
Presence of flaccidity
99
Stage 2
Emergency of basic limb synergies
100
Stage 3
Voluntary performance of all or part of basic limb synergies
101
Stage 4
Beginning of collateral movement outside of synergistic pattern
102
Stage 5
Relative independence of basic limb synergies
103
Stage 6
Isolated, coordinated joint movement
104
PNF Patterns
Kabat, Knott, Voss
105
Neuromuscular/Sensory stimulation techniques
Maragret Rood
106
Reciprocal Innervation
Reflex activation for movement patterns in developmental sequence
107
Coinnervation
Cocontraction of agonist and antagonist to stabilize body from head to feet
108
Heavy work
Movement superimposed on cocontraction
109
What artery is most commonly infarcted in stroke? Why?
Middle cerebral artery because of its direct continuation from the internal carotid artery
110
Intracranial Hemorrhage
Rupture of cerebral vessel (weakened by atherosclerosis and having formed an aneurysm)
111
Subarachnoid Hemorrhage
Bleeding into subarachnoid space from saccular or berry aneurysm
112
Top risk factors for stroke
Atherosclerosis
Hypertension
Heart disease
Diabetes
113
Ischemic umbra
Core area of focal infarction
| Irreversible cellular damage
114
Ischemic penumbra
Area between normally perfused tissue and ischemic tissue
| Viable, but metabolically lethargic
115
Subclavian steal syndrome
A narrowing of the proximal subclavian artery causes blood to be shunted to the extremity instead of the full amount going to brain
Symptoms include dizziness, arm claudication, and BP difference between arms greater than 20 mmHg
116
Anterior cerebral artery syndrome
Artery supplies the medial aspect of the cerebral hemisphere
CL hemiparesis in LE
117
Middle cerebral artery syndrome
```
Supplies the entire lateral aspect of the cortex and sub cortical structures
CL hemiparesis of UE and face
CL sensory loss
Aphasia
Homonymous hemianopsia
```
118
Internal carotid artery syndrome
ICA supplies ACA and MCA
| If circle of willis is impaired, extensive cerebral infarcction, cerebral edema, uncal herniation, and death
119
Lacunar syndromes
Small vessel (penetrating arteries) disease deep in cerebral white matter
120
Pure motor lacunar stroke
Involvement of posterior limb of internal capsule, pons, and pyramids
121
Purse sensory lacunar stroke
Ventrolateral thalamus or thalamocortical projections
122
Locked in syndrome
Complete basilar artery thrombosis and bilateral infarction of pons
Paralysis (tetraplegia) and lower bulbar paralysis (CN V-XII)
Mutism (anarthria) - unable to speak
123
What is preserved in locked in syndrome
Consciousness
Sensation
Vertical eye movements
Blinking
124
Ideational apraxia
Unable on command OR automatically
125
Ideomotor apraxia
Unable on command
126
Inpatient rehab rules? Who accredits them?
CARF
| Patient must tolerate 3 hours a day for 5 days a week by 2 or more disciplines (PT, OT, SLP)
