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TRI 3 - NM > Exam 2 content > Flashcards

Exam 2 content Flashcards

1
Q

What is sensory integration

A

The ability of the body to intake and interpret sensations

Ability to do two tasks

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2
Q

What are the levels of alertness and how are they defined

A

Alert - awake, responds appropriately
Lethargic - drowsy, difficult to maintain attention
Obtunded - Dull reaction, confused when awake
Stupor - dazed, reacts to painful stimulus
Coma - completely unresponsive

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3
Q

What is an exteroreceptor sensitive to

A

Pain
Temperature
Light touch
Pressure

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4
Q

Where do proprioceptors receive inputs from

A

Muscle
Tendons
Ligaments
Joints and fascia

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5
Q

What do proprioceptors sense

A

Position sense and awareness of joints at rest or during movement

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6
Q

Define combined cortical sensation

A

Exteroceptors and proprioceptors working together

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7
Q

What are examples of combined cortical sensation (6)

A 
Barognosis - weight
Graphesthesia - letters and numbers
Stereognosis - objects 
2-pt discrimination
Texture recognition
Tactile localization - locate site of tactile sensation
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8
Q

What sensations does the ALS transmit (what test is used to assess)

A

Pain
Temperature
Crude touch
(Sharp dull test)

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9
Q

What sensations does the DCML transmit (what test is used to assess)

A 
Light touch
Proprioception
Vibration
Pressure
(Cotton swab test)
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10
Q

What is the name and test for CN ll

A

Optic

Visual field testing

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11
Q

What is the name test and function of CN 3, 4, 6

A

H test

Oculomotor - Up down adduct
Trochlear - down
Abducens - Abduct

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12
Q

What is visual fixation

A

The patient focuses on an object brought near and far from them

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13
Q

What is Saccade

A

How well the eyes move rapidly between two objects

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14
Q

What is Vestibular ocular reflex (vor)

A

Gaze stabilization

The eyes move in conjunction with the head

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15
Q

Describe homonymous hemianopsia

A

Cannot see one side of their visual field
Named for side they cannot see
Side they cannot see is contralateral the optic tract lesion

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16
Q

What is a blind spot in the affected eye

A

lesion to the retina

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17
Q

What causes blindness in the ipsilateral eye

A

Lesion to optic nerve

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18
Q

What is strabismus

A

Malalignment of the eye

Makes depth perception difficult

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19
Q

Describe the components of primary muscle weakness

A

Reduced motor unit recruitment
Impaired motor unit firing rates and rate coding
Contraction and relaxation times are both slow
Co-contraction of agonist and antagonist

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20
Q

Describe secondary muscle weakness

A

Disuse atrophy

Changes in viscoelastic properties

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21
Q

Describe “Functional testing” regarding clinical examination of strength

A

Observed during functional mobility activities

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22
Q

Describe “Examination of movement strategies” in the context of clinical examination of strength

A

Observing and assessing how a patient moves can provide valuable information

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23
Q

Describe hypertonia

A

Hight muscle tone

Spasticity and rigidity

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24
Q

Describe spasticity

A

Associated with UMN lesions
Overactive stretch reflex
Velocity dependent

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25
Q

Describe rigidity

A

Associated with basil ganglia lesions
Relative to the joint
Cog wheel and lead pipe

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26
Q

Describe hypotonia

A

Low muscle tone
Flaccidity
LMN lesions

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27
Q

What are the most common synergy patterns for the upper and lower body

A

UE - Flexion

LE - Extension

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28
Q

What is the extension synergy pattern for the LE

A

Hip - EXT, ADD, IR
Knee - EXT
Ankle - PF, INV
Toe - PF

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29
Q

What causes Abnormal synergy patterns

A

Damage to the CNS

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30
Q

What are the stages of motor recovery according to brunnstrom

A

1 - Flaccidity
2 - Spasticity begins, involuntary reactions, no voluntary movement
3 - Spasticity worsens, voluntary movement occurs in synergy pattern
4 - Spasticity declines, some voluntary movement out of synergy
5 - Spasticity continues to decline, relative independence from synergistic movement
6 - Spasticity disappears

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31
Q

What are the scores used on the modified Ashworth scale

A

0 - normal
1 - slight increase in tone, may catch and release
1+ - slight increase in tone in less than half range, catch with min resistance
2 - marked increase in most of the range, limb still easily moved
3 - passive movement difficult, may not have full range
4 - no movement at all

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32
Q

Describe the Tardieu scale scoring system

A

V1 - as slow as possible
V2 - speed of limb falling under gravity
V3 - as fast as possible

0 - no resistance
1 - slight resistance
2 - catch and release at precise angle
3 - fatigable clonus, less than 10 seconds
4 - non fatigable clonus
5 - Joint is immovable
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33
Q

Describe Decorticate posture

A

UE Flexion
LE extension
lesion in mesencephalic region, cervical spinal tract or cerebral hemispheres
arms like Cs

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34
Q

Describe Decerebrate posture

A

UE and LE extension pattern
Upper brainstem damage, midbrain or pons
Arms like e’s

35
Q

What is equilibrium coordination

A

Ability to maintain balance in upright posture

36
Q

What is nonequilibrium coordination

A

single limb and interlimb movement

Gross and fine movement together

37
Q

What are some nonequilibrium defecits resulting from issues with the cerebellum

A 
Dysmetria
Dysdiadochinesia
Tremor
Movement decomposition
Rebound phenomenon
Gait ataxia
38
Q

What are some nonequilibrium deficits resulting from issues with the basal ganglia

A 
Akinesia/ bradykinesia
Rigidity
Tremor
Dystonia
Involuntary movements
39
Q

What are some nonequilibrium deficits resulting from issues with the DCML

A

Dysmetria

Slowness of movement

40
Q

Define orientation

A

Ability to maintain a relationship between the body and the environment

41
Q

Define stability

A

ability to maintain one’s COM within our limits of stability

42
Q

Define adaptive postural control

A

React and respond

Feed back control

43
Q

Define Anticipatory postural control

A

Past experiences

Feed foreword control

44
Q

Describe an ankle strategy

A

Light perturbations
Distal to proximal engagement
Pushed forewords - Gastroc, Hamstring, paraspinals
Pushed backwards - tib anterior, quads, abdominals

45
Q

Describe a hip strategy

A

Medium Perturbations
Proximal to distal activation
Pushed forewords - Abdominals, quads
Pushed backwards - paraspinals, hamstrings

46
Q

What is muscle sequencing regarding direct balance impairments

A

Postural muscles activate in the wrong order

47
Q

What is hypermetria

A

excessive sway compensation opposite direction of perturbation

48
Q

Describe Coactivation

A

agonist and antagonist muscles contract simultaneously

Common in Parkinson’s

49
Q

Describe Visual, somatosensory and Vestibular balance

A

Visual - What we see, will assume greatest role if somato is impaired
Somatosensory - what we feel, most efficient in adults
Vestibular - position and movement of the head

50
Q

Which part of the inner ear is sensitive to what

A

Angular forces - Semicircular canal

Linear forces - Utricle/ otoliths

51
Q

Describe the PASS

A 
Postural Assessment Scale for Stroke patients
Tests balance - non-vestibular
Acute stroke patients
No assistive device 
12.5/36 predicts ambulation at d/c
52
Q

Describe the foam and dome

A

AKA: Sensory organization test
Tests which sensory system is relied upon
Parkinson’s, vestibular disorders
Inability to maintain balance indicates impairments

53
Q

Describe the Romberg test

A

Static standing balance
Vestibular disorders, balance disorders
Standing arms crossed heels together, eyes open and closed
If they cant balance with their eyes closed indicates proprioceptive or somatosensory loss

54
Q

Describe the functional reach test

A

Measures patient limits of stability
6 inches is no risk of falling
3rd MTP
no AD

55
Q

Describe the berg balance test

A 
Demonstrate tasks for balance
MCID 6.5
Standing dynamic balance
> 45 is normal
< 45 is increased fall risk
56
Q

Timed up and go test

A

reliable test of mobility
Stand from a chair and walk 3 meters and back and sit
can use AD
longer than 13.5 seconds = fall risk
longer or equal to 15 seconds = have fallen in the past

57
Q

Describe the MINI BESTest

A

14 tasks

scored out of 28

58
Q

Describe the dynamic gait index

A

Walking activities

< 19/24 = fall risk

59
Q

Describe 5x sit to stand

A

> 15 seconds = fall risk

60
Q

Describe stability

A

Maintaining upright posture against any perturbations

61
Q

Describe step length

A

Initial contact of one foot to initial contact of the other

62
Q

Describe Stride length

A

Initial contact to initial contact on the same foot

63
Q

Describe step width

A

Horizontal distance from heels of both feet

64
Q

Describe cadence

A

steps per minute

  1. 5 per minute
  2. 9 per second
65
Q

Describe gait velocity

A

meters per second

1.46 is average

66
Q

Describe vertical displacement during gait

A

5cm total
Highest - midstance / midswing
lowest - double limb support

67
Q

Describe lateral displacement during gait

A

4cm is average

max displacement is during mid-stance

68
Q

How does the body minimize vertical displacement of the COM

A

Horizontal pelvic rotation
Lateral pelvic tilt
Knee flexion
Ankle rotation

70
Q

Describe the cognitive exam

A

below 26 suggests dementia

71
Q

Describe the plantar flexion spasticity impairment as it relates to gait

A

Result: Toe drag - swing phase
Compensation: Vaulting, circumduction, contralateral lean, hip hike

72
Q

Describe the quadriceps spasticity impairment as it relates to gait

A

Result: Knee hyperextension in loading response
Compensation: foreword trunk lean

73
Q

Describe the hamstring spasticity impairment as it relates to gait

A

Result: crouch gait, buckling of knee in stance
Compensation: shortened step length

74
Q

Describe the adductor spasticity impairment as it relates to gait

A

Result: contralateral pelvic drop in stance, medial displacement of leg in swing
Compensation: scissoring gait

75
Q

Describe the hip flexor stiffness impairment as it relates to gait

A

Result: reduced hip extension in mid and terminal stance
Compensation: foreword trunk lean

76
Q

Describe the plantar flexor weakness impairment as it relates to gait

A

Result: excessive knee flexion in stance, decrease heel rise in terminal stance
Compensation: Walking like gum on shoe, bent knee walking

77
Q

Describe the dorsiflexor weakness impairment as it relates to gait

A

Result: foot slap, foot flat or forefoot contact, toe drag in swing
Compensation: N/A

78
Q

Describe the quadricep weakness impairment as it relates to gait

A

Result: knee buckle in loading, mid stance knee destabilization
Compensation: Locks knee for stability, trunk lean

79
Q

Describe the hip flexor weakness impairment it relates to gait

A

result: limb advancement issues in swing phase, decreased knee flexion
Compensation: Shortened step length

80
Q

Describe the hip extensor weakness impairment as it relates to gait

A

Result: foreword trunk lean in stance
Compensation: posterior trunk lean during initial contact on weak side

81
Q

Describe the hip abductor weakness impairment as it relates to gait

A

Result: contralateral pelvic drop in stance
Compensation: trunk lean toward affected side, circumduction of contralateral leg

82
Q

Describe the Tinetti outcome measures

A

Tests fall risk
< 18 is high fall risk
> 24 is low fall risk

83
Q

Describe the 10 meter walk test outcome measures

A 
2 - 6 - 2
6 / walking time = score in M/S
> .8 M/S = community ambulation
.4-.8 M/S = limited community ambulation
< .4 household ambulation only
84
Q

Describe the dynamic gait index outcome measure

A

Gait in during different activities

< 19 = fall risk

85
Q

Describe the Functional gait assessment outcome measure

A

Decreases the ceiling effect

TRI 3 - NM (5 decks)

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