Neuro: lecture 2

Question 1

The basis of movement is provided by what?

Answer 1

Normal Postural tone

Question 2

What does BEFAST stand for?

Answer 2

Balance- look for LOB/coordination

Eyes - vision changes

Face- ask them to smile

Arm- ask them to raise both arms

Speech - dysarthria/slurring

Time- 3 hour window to administer clot buster

Question 3

dysarthria vs dysphagia

Answer 3

slurring and slowing of speech pattern –> speech motor production impairment

dysphagia: eating/swallowing activity limitation

Question 4

muscles too weak cant

Answer 4

stablize joints

Question 5

muscles too stiff cant allow

Answer 5

functional movement

Question 6

impaired joint alignment will result in?

Answer 6

abnormal efforts for movement

Question 7

if the stroke is being caused by a blood clot, there is a ____ window to adminster some tPA to help dissolve the clot and minimize the resulting sequellae of an ishemic brain lesion

Answer 7

3 hours

Question 8

What is normal postural tone?

Answer 8

Amount of tone sufficient to hold us upright against gravity

Question 9

What are primitive reflexes?

Answer 9

Primitive reflexes provide the basis of movement patterns that progressively show more selective coordination and less stereotpying with time and maturation

Question 10

primitive reflexes are sometimes called?

Answer 10

reflexes

Question 11

What are righting reactions?

Answer 11

Serve to provide orientation to the head and align body parts w/ gravity

Question 12

What are protective extension reactions?

Answer 12

Allow us 1 line of defense against changes in our postural balance. Also called parachute reactions in UE and protective stepping in LE.

Question 13

What are equilibrium reactions?

Answer 13

Extension of protective reactions they allow us to balance by adjusting the location of our CoG over our BoS

Question 14

reemergence of tonic reflexes occur with motor impairments such as

Answer 14

ATNR
positive support

Question 15

What are atypical synergies

Answer 15

Atypical movements related to altered biomechanical alighment due to tone or caused by neurological disorganization or motor neuron recruitment

Question 16

What are tonic reflexes?

Answer 16

example: Assymetric tonic neck reflex

They should go away when you grow up but they might re-emerge with CNS damage

Question 17

motion components associated with hemiparetic synergies examples:

Answer 17

flexion synergy
extension synergy

Question 18

predictive movement patterns occurring during volitional attempts at movement OR as associated reactions. Thus movements become sterotypical and restrictive of normal activity

Answer 18

atypical synergies

Question 19

Flexion synergies have Scapular ____________

Answer 19

Elevation and retraction

Question 20

Flexion Synergies have shoulder _____________

Answer 20

abduction and external rotation

Question 21

Flexion synergies have elbow ________ and forearm ______________

Answer 21

Flexion

Supination

Question 22

Flexion synergies have Wrist ________ and finger ____________

Answer 22

flexion

Question 23

Extension synergies have scapular ___________ and ____________

Answer 23

depression and protraction

Question 24

Extension synergies have shoulder _________ and ___________ and ____________

Answer 24

Extension and adduction and internal rotation

Question 25

Extension synergies have elbow ________ and forearm ___________

Answer 25

Elbow extension Forearm pronation

Question 26

Extension synergies have wrist ______ and finger ________

Answer 26

Extension Flexion

Question 27

What are the strongest components of UE synergies that you will see at rest (Resting UE synergies) Scapula _____ Shoulder _______ Elbow _____ Forearm __________ Wrist/finger __________

Answer 27

Scapular depression/retraction Shoulder extension, adduction, internal rotation Elbow: flexion Forearm : Pronation Wrist/finger : Flexion

Question 28

What is an associated reaction?

Answer 28

Example: arm comes up while coughing but you can't lift it independently

Question 29

In the flexion synergy you have pelvis _____ and _____

Answer 29

Elevation and retraction

Question 30

In the flexion synergy you have hip ______ , ________ , __________

Answer 30

Hip flexion, abduction, external rotation

Question 31

In the flexion synergy you have knee _____

Answer 31

flexion

Question 32

In the flexion synergy you have ankle ________ with foot __________

Answer 32

Dorsiflexion Inversion

Question 33

In the extension synergy you have pelvic _______ and ____________

Answer 33

Depression and protraction

Question 34

In the extension synergy you have hip _______ and __________ and __________

Answer 34

Extension and adduction and Internal rotation

Question 35

In the extension synergy you have knee _______

Answer 35

extension

Question 36

In the extension synergy you have ankle _______ with foot _____________

Answer 36

ankle plantarflexion with foot inversion

Question 37

What are the strongest components of synergies (resting synergy) in the LE Pelvis: Hip: Knee: Ankle/foot:

Answer 37

Pelvis: Elevation and retraction Hip Flexion, adduction, internal rotation (note it is a mix of Flexion and extension synergies) Knee Extension ankle/foot : Plantarflexion and inversion

Question 38

expressive aphasia

Answer 38

brocas area cant produce speech well

Question 39

receptive aphasia

Answer 39

wernickes cant understand speech well

Question 40

clock circle

Answer 40

tell pt draw clock

Question 41

double letter cancellation test

Answer 41

cross out E and R

Question 42

fugl meyer test UE and LE

Answer 42

looks at reflex activity order has a lot of position changes

Question 43

line bisection test

Answer 43

tell pt to draw line in each line middle

Question 44

Modified Ashworth Scale MAS

Answer 44

measure of spasticity 0: no increase in tone 1: slight increase in tone; catch and release or by min resistance at end of ROM when affected moved into flexion or extension 1+: slight increase in tone, catch followed by min resistance 2:more marked increase in muscle tone through most of ROM but affected part move easily 3: considerable increase in muscle tone, passive movement difficult 4:affected parts is ridgid in flexion or extension

Question 45

National Institutes of Health Stroke Scale

Answer 45

done in ER,ICU,Disuse Care research Score pt gets linked to prognosis mid/mod stroke

Question 46

Orpington Prognostic Score

Answer 46

quick seen in research year of WWII

Question 47

scale of the assessment and rating of ataxia SARA

Answer 47

score ataxia

Question 48

stroke rehabilitation assessment of movement STREAM

Answer 48

can use total score,voluntary movement limb score UE/Le together or separate and or basic mobility scale -measures impairment and activity levels

Question 49

Tardieu Scale

Answer 49

grading performed at same time of day, body positions, etc for each muscle group, reaction to stretch is scored at particular stretch velocity

Question 50

Tardieu Scale angle of muscle reaction Y:

Answer 50

angle of muscle reaction Y: measured from 0 position R1: PROM till catch point R2: full PROM

Question 51

action reach arm test

Answer 51

activity/participation

Question 52

FIM/FAM

Answer 52

activity/participation

Question 53

PASS Postural Assessment Scale Stroke

Answer 53

activity/participation

Question 54

STREAM

Answer 54

activity/participation note: also impairment

Question 55

SIS stroke impact scale

Answer 55

activity/participation

Question 56

what is one of the most important things to screen?

Answer 56

depression

Question 57

what are predictors of poor rehab outcome in stroke

Answer 57

-dementia -global aphasia -previous stroke -older age -prolonged urinary and bowel incontinence -severe visuospatial deficits -persistent sensory deficits

Question 58

with the exception of incontinence, _____ are not on te list of poor predictors of poor outcome or poor prognosis.

Answer 58

motor sequellae

Question 59

what is more devastating to someones recovery and QOL than most movement disorders

Answer 59

sensory and cognitive disturbances

Question 60

ability to handle one's needs w/o the assistance of a caregiver. providing adaptive equipment may help max functional independence

Answer 60

functional independence

Question 61

what are the general goals of rehab?

Answer 61

-max functional independence -return to the most optimal living environment feasible (home vs other environments) -improve QOL -dont forget the caregivers