Neuromuscular Part Eleven

Question 1

two gait patterns for spastic CP

Answer 1

scissoring

toe walking

Question 2

when is APGAR tested

Answer 2

1, 5, 10, 15 minutes after birth

Question 3

four main syndromes of CP

Answer 3

spastic

athetoid

ataxic

mixed (most often spasticity and athetosis)

Question 4

onset and integration of moro reflex

Answer 4

onset: 28 weeks gestation
integration: 5-6 months

Question 5

how should pressure on tendons in order to inhibit tone be applied

Answer 5

firm, constant pressure

Question 6

what is plantar grasp stimulus and response

Answer 6

stimulus: maintain pressure under toes
response: maintain flexion of toes

Question 7

what is tested on APGAR

Answer 7

heart rate

respiration

muscle tone

color

reflex irritability

Question 8

Erb’s Palsy affects what nerve roots

Answer 8

C5-C6

Question 9

ATNR stimulus and response

Answer 9

stimulus: rotation to the side of the head
response: flexion of the skull limbs, extension of the jaw limbs

Question 10

what is the cognitive stage of motor learning

Answer 10

develop an overall understanding of the skill through trial and error practice

Question 11

athetosis in CP results from involvement with what part of the brain

Answer 11

basal ganglia involvement

Question 12

what does Klumpke’s Paralysis result in weakness of

Answer 12

hand and wrist flexors

Question 13

onset and integration of crossed extension reflex

Answer 13

onset: 28 weeks gestation
integration: 1-2 months

Question 14

Klumpke’s Paralysis affects what nerve roots

Answer 14

C8-T1

Question 15

most common syndrome of CP

Answer 15

spastic

Question 16

appropriate parameters for low-frequency vibration

Answer 16

5-50 Hz

Question 17

what appearance of the hand is common with Klumpke’s Paralysis

Answer 17

claw hand

Question 18

when does Klumpke’s Paralysis occur

Answer 18

when C8-T1 are stretched during the birthing process

Question 19

plantar and palmar grasp onset and integration

Answer 19

onset: palmar at birth, plantar 28 weeks gestation
integrated: palmar 4-6 months, plantar 9 months

Question 20

what is feedforward

Answer 20

sending of afferent signals in advance of movement to ready the system

Question 21

normal score on APGAR

Answer 21

7 or higher

Question 22

what is the autonomous stage of motor learning

Answer 22

after considerable practice the motor performance becomes automatic

Question 23

what is palmar grasp stimulus and response

Answer 23

stimulus: maintain pressure to palm of hand
response: maintain flexion of fingers

Question 24

protective extension reaction stimulus and response

Answer 24

stimulus: displace COG outside BOS
response: arms or legs extend and ABD to support and to protect the body against falling

Question 25

an individual with strong flexor spasticity would have what reflex absent

Answer 25

Landau

Question 26

for spastic CP, how are DTRs in affected limbs

Answer 26

increased

Question 27

landau reflex onset and integration

Answer 27

onset: 3 months integration: 2 years

Question 28

what demonstration is there after premature birth with CP

Answer 28

spastic paraplegia

Question 29

optical and labryrinthine righting reflex stimulus and response

Answer 29

stimulus: alter body position by tipping body in all directions (for labryinthine, vision is occluded) response: head orients to vertical position and mouth horizontal

Question 30

facilitation techniques examples

Answer 30

repetitive brushing quick icing for muscles quick stretch/tapping high frequency vibration

Question 31

prolonged influence of ATNR can result in

Answer 31

scoliosis hip subluxation (if there is marked hypertonia)

Question 32

onset of optical and labyrinthine righting reflex

Answer 32

onset: birth-2 months integrated: persits

Question 33

for CP, where could hemorrhage be present that initially caused it

Answer 33

below the lining of the ventricles

Question 34

what Hz should high-frequency vibration be applied at

Answer 34

50-300 Hz

Question 35

when does Erb's Palsy occur

Answer 35

when C5-C6 nerve roots are stretched during birthing process

Question 36

a score of ___ or less on APGAR requires immediate care

Answer 36

4 or less

Question 37

inhibition technique examples

Answer 37

prolonged icing neutral warmth prolonged stretch low-frequency vibration pressure on tendons

Question 38

what LE PNF helps rolling in any direction

Answer 38

D1 flexion

Question 39

what does fast spinning do

Answer 39

facilitate postural tone and promotes head righting

Question 40

what is the associate stage of motor learning

Answer 40

refinement of the motor strategy is achieved through continued practice; concentrate on how to do the movement rather than on what to do

Question 41

moro reflex stimulus and response

Answer 41

stimulus: sudden change in position of the head in relation to the trunk (drop patient backward from sitting) response: extension and abduction of UE with hand opening... arms move across the chest

Question 42

arm deformity with Erb's Palsy

Answer 42

shoulder ADD, IR "waiter's tip" deformity

Question 43

for athetoid CP, what reflexes may be persistent

Answer 43

ATNR STNR tonic labyrinthine

Question 44

what is neutral warmth

Answer 44

relaxation by wrapping patient in towels or blankets to decrease postural tone

Question 45

positive supporting reaction stimulus and response

Answer 45

stimulus: contact to the ball of the foot in an upright standing position response: rigid extension of LE with PF and IV, toes clawing and IR

Question 46

Landau reflex stimulus and response

Answer 46

stimulus: lift the child under the thorax in a prone position response: first the head and then the back and legs will exten

Question 47

onset of ATNR and when is it integrated

Answer 47

onset: birth integrated: 4-6 months

Question 48

tonic labryinthine reflex stimulus and rsponse

Answer 48

stimulus: prone or supine position response: prone - increased flexor tone supine - increased extensor tone

Question 49

stimulus and response in crossed extension reflex

Answer 49

stimulus: noxious stimuli to ball of foot or extremity in fixed extension response: a. LE flexes, then adducts, then extends b. in patients with hemiplegia, lifting the uninvolved leg off the ground during ambulation results in increased extensor tone in the involved leg

Question 50

three stages of motor learning in order from most basic to most advanced

Answer 50

cognitive associative autonomous

Question 51

STNR stimulus and response

Answer 51

stimulus: flexion or extension of head response: with head flexion - flexion of arms and extension of legs with head extension - extension of arms and flexion of legs