Final Exam Flashcards
(175 cards)
1
Q
Motor skills
A
observable, goal directed actions during daily life tasks during interaction with objects and the environment
2
Q
motor learning
A
development of a skill and modification of movement patterns over time
3
Q
motor control
A
ability to produce movement in response to activity and environmental demands
4
Q
motor control theory involves what
A
multisensory approach
learning as a result of neuroplasticity
cortical reorganization
5
Q
movement information flow
A
motivation- limbic system
ideation- brain lobes
programming- premotor areas, basal ganglia
execution- motor cortex, spinal cord
6
Q
Traditional Sensorimotor Approaches
A
Rood
Brunnstrom Movement Therapy
PNF
NDT
7
Q
Rood Approach assumptions
A
normal muscle tone is a prerequisite to movement
motivation and repetition are necessary
sensory stimulation can be inhibitory or faciliatory
developmental sequences
8
Q
Faciliatory Rood Treatments
A
quick stretch
maintained stretch
vibration
approximation
light touch
brushing
manual contact
9
Q
inhibitory Rood treatment
A
prolonged, firm stretch
firm pressure on tendon
icing for long period
neutral warmth
maintained touch
slow stroking
10
Q
Brunnstrom assumptomes
A
use for patients with CVA and stroke recovery
regression to older pattern of movements
stages of motor recovery
change in muscle tone and reflexive movements are normal in recovery
requires muscles to work synergistically
intervention focuses on progressing client through stages
11
Q
Brunnstrom Stages of recovery
A
1- tone is flaccid, no voluntary movement
2- synergies can be elicited reflexively, spasticity developing
3- begin voluntary movements, spasticity may be significant
4-spasticity decreases, movement starting to deviate from synergy patterns
5- further decreased tone, increased ability to perform complex movement patterns
6- tone nearly normal with ability to do complex combinations of isolated movement
7-normal speed and coordination
12
Q
treatment goals of brunnstrom stages 1-2
A
facilitate increased tone
13
Q
treatment goals of brunnstrom stages 2-3
A
assist client in achieving full voluntary control of limb synergies and use these in functional activities
14
Q
treatment goals of brunstrom stages 4-5
A
break away from limb synergies and begin more isolated complex patterns of movement. tone should be decreasing
15
Q
treatment goals of brunstrom stages 5-6
A
develop more complex isolated movements and increase speed of movement
16
Q
treatment goals of brunnstrom stages 7
A
client demonstrates normal isolated complex movements
17
Q
PNF
A
awareness of body position
includes diagonal movement patterns and crossing midline
creates balance between agonists and antagonists
alternates between flexion and extension
18
Q
PNF diagonal 1
A
start across up, then straight down
brushing hair on opposite side of head
19
Q
PNF diagonal 2
A
start straight up, the across down
putting on a seatbelt
20
Q
NDT
A
improve postural control and movement
handling techniques, weight bearing, avoidance of negative sensory input
handling occurs at key points of proximal control
21
Q
Task Oriented Approach ideas
A
learning process requires practice, feedback, understanding goals, motivation
cognition is important
practiced tasks rather than exercises
22
Q
Task oriented approach principles
A
use real objects
whole task practice
practice functional tasks
constrain degrees of freedom
23
Q
dystonia
A
abnormal tone
24
Q
flaccidity
A
absence of tone
no voluntary movement
25
hypotonicity
low tone
muscle feels soft, little resistance to movement
26
hypertonicity
increased muscle tone
27
hypertonicity vs spasticity
hypertonicity-- elastic properties of connective tissue; response to passive stretch
spasticity-- neural change due to stretch reflex; velocity dependent
28
clonus
involuntary contraction and relaxation of spastic muscles
29
rigidity
increase of muscle tone of agonist AND antagonist
30
lead pipe (parkinson's) rigidity
constant resistance
31
cogwheel (parkinsons) resistance
rhythmic "give" in resistance
tremor and rigidity
32
Decerebrate regidity
extensor posturing of limbs and neck
33
decorticate rigidity
flexor posturing of UE and extensor posturing of LE
34
Motor return after stroke
proximal to distal
flexion then extension
35
Dysmetria
inability to judge distance leading to over or under shooting target
36
Dysdiadochokinesia
impaired ability to complete rapid alternating movements
37
Ataxia
incoordination or clumsiness of movement
tremor, shakiness, balance
38
tremor
shakiness
39
4 general categories of motor performance
balance
standing up/sitting down
walking
reach and manipulation
40
ways of initiating functional mobility
positioning
bridging
supine to sit
scooting in sitting
41
which way should you roll towards when getting out of bed
the weak side
42
what is the biomechanical approach to splinting
maintain and increase length of soft tissues
position hand to assist in functional activities
43
What is the neurophysiological approach to splinting
reflex inhibition
44
splint wearing schedule
start with 30-60 min and check for redness/pressure areas
goal of 6-8 hours alternating 2 hours on/2 hours off
night time as tolerated
during day for functional splints
45
Basic vision screen includes what
acuity testing
visual fields testing
oculomotor testing
46
what is acuity testing
ability of the eye to distinguish detailed info
size and contrast
47
what is visual field testing
the total area of vision
48
what is oculomotor testing
ability of eyes to work together, eye muscles
49
what are the two types of acuity
distance acuity-- ability to see at a distance
near acuity-- distance to see things close to eye
50
how is visual acuity measured
eye chart with letters getting progressively smaller
assess both eyes together then one at a time
51
which vision acuity is required for driving
20/40
52
which vision acuity is considered low vision
20/60
53
which vision acuity is considered legal blindness
20/200
54
signs of a visual field deficit
narrow scope of scanning
slow scanning toward deficit
hesitant with functional mobility
holds head to one side
55
strabismus
eye is unable to move in direction of paretic muscles or cannot maintain central position of
56
what is diplopia
double vision
57
ptosis
droopy eyelid
58
what is visual pursuits
ability to follow a moving object smoothly
59
visual fixation
ability to maintain vision on a stationary object
60
saccades
ability to adjust from one stationary object to another
61
convergence
ability to attend to objects moving towards the eyes
62
signs of unilateral spatial neglect
failure to respond or orient to stimuli on one side of the body
head turned away from one side
when asked to look that way does not
collides with or ignores objects on one side
63
visual neglect
inability to see things on one side of the
64
personal neglect
impaired ability to attend to body
65
spatial neglect
impaired ability to attend to space around the body
66
peripersonal neglect
space within reaching distance
67
extrapersonal neglect
space beyond reaching distance
68
ways to test visual neglect
line bisection, albert's test, clock draw
69
Apraxia
perception impairment causing dysfunction of purposeful movement
70
dressing apraxia
inability to plan effective motor action during dressing
71
ideomotor apraxia
inability to create plan and carry out but can perform gestures or pretend to use the tool
72
ideational apraxia
inability to use real objects appropriately
73
constructional apraxia
inability to copy shapes accurately
74
agnosia
inability to interpret senses and therefore recognize objects, people and sounds
75
Cognition relies on the integration of what
sensory systems
language
visual systems
perceptual systems
76
methods of arousal
noxious stimuli
cold wash cloth
change position
tactile and verbal stimulation
77
screening for orientation
self
place
time
why are they here
78
orientation memory usually returns in what progression
person, place, time
79
Hierarchy of Attentional processes
Arousal
sustained
selective
alternating
divided
80
stages of memory
attention
encoding
storage
retrieval
81
working memory
keep track of current conversation
82
declarative memory
event based. recalling past facts and events
83
procedural memory
ability to remember how to perform an activity
84
prospective memory
ability to remember intention of activities required for future
85
grading of cues
indirect general cues
gestural guidance
specific cue
tactile cues
86
executive function impairments
working memory
initiation
inhibition
flexibility
organization
87
ischemic stroke
a clot blocks blood flow to an area of the brain
88
hemorrhagic stroke
bleeding occurs inside or around brain tissue as a result of a broken blood vessel
89
ischemic embolic stroke
when a blood clot travels from somewhere else and ends in the brain
90
ischemic thrombotic stroke
clot forms inside the wall of an artery forming the brain
91
common causes of hemorrhagic stroke
high BP
aneurysm
AVM
92
transischemic attack (TIA)
temporarily restricted blood flow to the brain
93
difference between a TIA and CVA
TIA symptoms last less than 24 hours
CVA symptoms last longer than 24 hours
94
What is Tissue plasminogen activase (TPA)
clot buster than can be used within 3 hours of the oncet of symptoms for an ischemic stroke
95
global aphasia
loss of all language skills
96
brocas aphasia
expressive aphasia. can understand well but has trouble expressing words
97
wernicke's aphasia
receptive aphasia. do not understand what words mean
98
Long term Care hospital
acute care hospital with anticipated longer length of stay
99
Sub-acute/transitional Care
requires more intensive nursing care than SNF but not quite acute care
30-90 min of therapy
stay is 7-35 days
100
inpatient rehab facility
intense multidisciplinary therapy
tolerate 3 hours of therapy 5-7 days a week
101
SNF
24 hr care available
therapy as needed
medically stable
102
home health care
patient discharges home with skilled care from health services
must be homebound
103
outpatient
discharge home but would benefit form continued therapy services
104
hospice
end of life care
life expectancy is less than 6 months
105
What is ALS
progressive disease affecting the UMN and LMN
106
Signs and symptoms of ALS
speech/swallowing difficulties
asymmetrical
may begin in hands
motor dysfunction
107
Guillian- Barre' Syndrome
axonal demyelination of peripheral nerves
108
phases of guillan barre syndrome
acute inflammatory progressive phase
plateau phase
progressive recovery phase
109
acute inflammatory progressive phase of GBS
weakness in 2 limbs
reaches peak 2-4 weaks
ventilation required for 20-30-%
can be life threatening
110
plateau phase of GBS
no significant change which can last for days or weeks
greatest disability present at this phase
111
Progressive recovery
remyelination and axonal regeneration
recovery starts at head then proceeds distally
50% expereince return of normal funciton
112
Symptoms of GBS
quickly progressing
symmetrical weakness
starts with feet
sensory loss or hypersensitivity
cognition remains intact
113
Huntington's Disease
Progressive breakdown of brain nerve cells due to genetic gene
114
Classic symptoms of PD
tremor
Bradykinesia
Decreased Balance
Rigidity
115
What are Hoehn and Yahr Scale stages
Stages of Parkinson's disease
116
Hoehn and Yahr Scale stage 1
Unilateral involvment only with minimal functional disability
117
Hoehn and Yahr Scale stage 1.5
unilateral and axial involvement
118
Hoehn and Yahr Scale stage 2
Bilateral or midline involvement without balance issues
119
Hoehn and Yahr Scale stage 2.5
mild bilateral disease with recovery on the pull test
120
Hoehn and Yahr Scale stage 3
Bilateral disease with mild to moderate disability with impaired postural reflexes
physically independent
121
Hoehn and Yahr Scale stage 4
severely disabling but still able to walk or stand unassisted
122
Hoehn and Yahr Scale stage 5
confinement to bed or wheelchair unless aided
123
Early stages of PD on Hoehn and Yahr Scale
stages 0-2.5
124
Complicated stages of PD on Hoehn and Yahr Scale
stages 3-4
125
Late stages of PD on Hoehn and Yahr Scale
stage 5
126
What is LSVT
PD program to increase mobility and communication
127
LSVT program protocol
4 consecutive days a week for 4 weeks
60 minute sessions
high intesnsity and frequency
128
3 key features of LSVT
Target-- hypo- and brady kinesia with sensory disorder, internal cueing, neuropsychological
Mode-- intensive and high effort
calibration-- address mismatch between perception of movement and how others perceive it
129
What is MS
inflammation damages myelin of nerves of CNS
130
Relapsing-remitting MS
relapses of worsening function followed by partial or complete improvement
131
when does most recovery occur after a CVA
95% occurs within 13-15 weeks
132
when is there slower recovery following a CVA
6 months to 3 years
133
Most effective treatment for CVA
task specific
repetitive
intense
active
evidence based
function based
134
what is a SAFE score
shoulder abduction and finger extension are used to predict UE function
if greater than 8 w/in 72 hrs then good return in 3 months
135
Goals for Motor recovery brunnstrom stage 1-2
preserve soft tissue integrity and joint alignment
facilitate muscle activity
incorporate into activity-- prevent disuse
136
Task specific training protocol
4 days a week
one repetition= reaching, grasping, manipulation, releasing
300 reps in 60 min OR 3 activities 20 min each
137
when is task specfic training too easy or too hard
less than 50 reps in 15 min is too difficult
more than 100 in 15 min is too easy
138
what is the most common complication after a stroke
shoulder pain
139
what is shoulder pain after a stroke caused by
CRPS
decreased sensation
subluxation
muscle spasticity
soft tissue injury
140
what is winging
occurs when the muscles holding the scapula against the abdominal wall are weakened or paralyzed
141
what is subluxation
when 2-3 fingers can fit between the acromion process and humeral head
142
when does edema occur following a stroke
between 2 weeks and 2 months post CVA
143
what does edema following a stroke result from
loss of muscle activity
venous congestion
dependent positioning
144
Causes of traumatic SCI
MVA, gunshot wounds, falls, sports
145
causes of Non-traumatic SCI
tumors, MS, cancer
146
tetraplegia
all 4 limbs and trunk involved in SCI
147
Paraplegia
paralysis or weakness affect only the LE, trunk, hips
148
How are SCI classified
the last fully functioning neurologic segment of the psinal cord
149
complete SCI
total paralysis and loss of sensation in tracts below the lesion
150
incomplete SCI
some degree of preservation of sensory or motor nerve pathways below the lesion
151
ASIA grade A
Complete injury
no motor or sensory function
152
ASIA grade B
incomplete injury
sensory but not motor function is preserved
153
ASIA grade C
incomplete injury
motor function is preserved but most muscles are below MMT 3
154
ASIA grade D
incomplete injury
motor function is preserved and most muscles are about MMT 3
155
ASIA grade E
all motor and sensory functions are normal
156
central cord syndrome
LMN weakness at level of injury
UMN spasticity below level of injury
157
Managing BP in SCI
raise head to decrease BP
Lower head to increase BP
OR use abdominal or leg wraps
158
symptoms of Autonomic dysreflexia
high BP
pounding headache, flushed face
sweating above injury level
slow pulse
goose bumps below level of injury
159
What causes autonomic dysreflexia
irritant below the level of injury
wrinkles, tight pants, bowel or bladder distension, pressure
160
at what spinal level does autonomic dysreflexia occurr
T6 and higher
161
What to do for autonomic dysreflexia
raise patient head
attempt to locate irritant
loosen clothing
check catheter
162
Splinting goal for C1-C4
positioning splints to protect joints
163
splinting goal for C5
positioing and enable participation
164
C6 splinting goals
preserve tenodesis and enable participation
165
splinting goals for C7-8
prevent deformity
166
at what level can tenodesis be performed
C6
167
how to facilitate tenodesis
never stretch fingers all the way
extend wrist with fingers flexed
flex wrist with fingers extended
168
how is intermittent catheterization performed
done every 3-4 hours
169
how often should weight shifts occur
1-2 minutes every 30 min OR 15 sec every 15 min
170
How to score ASIA scale
NOOON is complete injury
last level of 3+ motor or all 2 for sensory
171
Glasgow Coma Scale coma classifications
13-15 = mild concussion
9-12=moderate
less than 8= severe
172
diffuse injury TBI
occurs follwing rapid movement of the head
173
focal injury TBI
brain contusion or laceration when the brain hits the skill and scrapes against irregular bony structures
174
open focal injury
object enters the cranial cavity causing penetration
175
closed focal injury
crush injury or rapid acceleration/develeration
