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neuropt 1 > Sensory and Postural Deficits: Exam 1 > Flashcards

Sensory and Postural Deficits: Exam 1 Flashcards

1
Q

Somato-sensory impairments

Pt may exp. LOSS of what?

A
  • Sensation
    • tactile
    • proprio
    • pain/temp
    • vis. field
  • Perception
  • Cognition

**MAJOR cause of disability

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2
Q

Somatosensory impairs are often neglected in therapy

Implications?

A
  • fork slips out of hand
  • not knowing if knee will buckle
  • lack of confidence
  • Pt may adapt to one-handed function OR give up attemping tasks (stairs for ex.)
    • NOT GOOD !!!
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3
Q

Tactile Impairments include…

A
  • Localization and discrimination of stimuli
  • Stereognosis
    • recognizing obj. in your hand
  • 2-pt discrim
    • 2.83, 3.22
    • <5mm-5mm===normal
  • correlation b/w recovery in hand and touch sensibility
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4
Q

Stereognosis

A
  • Tactile ID of common objects
    • recognition phys objects
    • recognition nature of objs
  • NOT innate ability
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5
Q

What is the ABSENCE of Stereognosis ?

A

Astereognosis

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6
Q

2-pt. Discrim.

Ability to recognize what?

A

2 points when simultaneously applied

VISION OCCLUDED!!!

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7
Q

2-PT Discrim.

when can 2 poins be felt as 1?

A

IF they are in close proximity

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8
Q

W/ ANY Sensation test OTHER THAN VISION

A

EYES CLOSED!!!

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9
Q

Proprio. Impairments

impairment in recognition of……

A

Direction

Pos. in space

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10
Q

Proprio impairments are most obvious where?

A

DISTALLY

ankle, wrist

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11
Q

Often involved in proprio impairments

A

kinesthesia

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12
Q

Proprio. is crucial for what ?

A

Balance

Manipulative actions

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13
Q

Central Pain or….

A

Thalamic Pain

Awful!!!

  • 2% pts following CVA
  • More common in L. Hemiplegia
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14
Q

Peripheral pain often comes from….

A

2* complications

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15
Q

Explain Central Pain aka Thalamic Pain

A
  • burning (dysesthesia), unpleasant tingling, pins, needles, numbness
  • Exaggerated by:
    • ​mvmt
    • stress
    • lt. touch
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16
Q

Some ways that we can examine Sensory Impairs

A
  • Lt touch (DCML)/Sharp-Dull Discrim (spinothalamic)
  • Heat/Cold
  • Sense of passive mvmt and pos.
  • Vibration
  • Tactile
    • stereognosis
    • 2-pt discrim
  • PAIN
    • ​Quant/Qual
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17
Q

Visual Impairments can involve 2 things:

A
  • Reception of input to the eye due to retinal dysf.
  • Perceptual-cognitive
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18
Q

Remembe w/ visual impairs that…..

A

pre-existing cond. may exist

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19
Q

W/ visual impairments make sure you consider…..

A

glare

lighting

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20
Q

Crucial that you distinguish visual impairments from….

A

NEGLECT

  • lack of awareness 1/2 of body and proprio representation
  • They Completely ignore it
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21
Q

Ex. of Visual Field Defs

A
  • Homonymous Hemianopsia
    • ​”same side 1/2 no eye”
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22
Q

Homonymous hemianopsia is NOT

A

Neglect

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23
Q

In Homonymous Hemianopsia

what is lost?

temporal field vs. nasal field

A

Lose temporal field on LEFT

Lose nasal field on RIGHT

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24
Q

Loss of vision in same side of ea. eye

A

Homonymous Hemianopsia

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25
Q

Visual Pathway

COME BACK TO THIS AND RE-WATCH WHAT HE SAYS !!!

A

SEE PICS

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26
Q

Disruptions in the visual pathway

MAKE MORE CARDS ON THIS!!!!!!!!

A

see pics

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27
Q

Visual Field Testing

What does that look like?

A

See pics!!!

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28
Q

perceptual-cognitive defs are defs in the interaction b/w…..

A

perception and cognition

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29
Q

Perception is the ability to ______ and ______ sensory info.

A

process and interpret sensory info.

30
Q

Cognition is the ability to ______ and ______ INFORMATION

JUST information***

A

process and interpret INFORMATION

just INFORMATION

31
Q

Perceptual-Cognitive Impairs

4 disorders/impairments

A
  • Body Scheme Disorders
  • Spatial Relations Disorders
  • Agnosia
  • Apraxia
32
Q

Perceptual-Cog Impairs

Body Scheme Disorders

A

Unilateral Neglect

R and L Discrimination

33
Q

Agnosia or…

A

inability to recognize familiar objects

ex. toothbrush, hairbrush

34
Q

Apraxia

A

Inability to perform purposeful, skilled motion, in the presence of adequate strength, sensation, coordination

  • NOTE: often shows when CHALLENGED to do activity
    • ​ex. “get up and walk”
      • ​cannot do it
35
Q

Ex’s of test results w/ unilateral neglect

they often cannot “finish” things on the side neglected

A

see pics

36
Q

Tx of Somatosensory impairments

somatosensory impairs CAN improve…..

b/w R and L what side usually can improve more?

A

L. Hemiplegia < R. Hemiplegia

37
Q

Somatosensory Impairments

Principles of Tx:

A
  • Session starts and ends w/ tasks the pt CAN do
  • Tasks should be interesting to the pt
  • Vision and use of UNAFFECTED hand to teach perception
  • Freq. rests utilized!!!!!!!!!
38
Q

What would be some suggestions for Tx. w/ Somatosensory Impairs?

A
  • ID # of touches or lines——read article!!!
  • ID letters and #’s drawn on arm or hand
  • Find your thumb when blindfolded
  • Discrim. of shape, wt, texture of obj’s OR materials placed in hand
  • Passive drawing
39
Q

Somatosensory Impairment Tx’s

Specific UE tasks

A
  • Discrim. common objs thru tactile sense only
  • Hand-eye coord.
40
Q

Somatosensory impairments Tx:

Activities to address Neglect

A
  • FORCING USE OF LIMB
    • Wt. bear
    • Standing
41
Q

Somatosensory impairments Tx

Visual tasks

A
  • Reading
  • Scanning
42
Q

Postural orientation is the orientation of body to….

A

body to environment

43
Q

Postural stability===Balance

2 components:

A

Static and Dynamic EQUILIBRIUM

44
Q

Postural Control=====>

A

Orientation + Stability

45
Q

Postural Control

what 2 systems are involved?

A

MSK system

NMSK system

46
Q

The Neuromuscular system specifically is ability to coordinate what ?

A

muscle synergies

47
Q

Postural deficits can include what?

4 things

A
  1. Sequencing prolems—activate @ right time
  2. Activation of postural responses
  3. Scaling of mm activity
  4. Adaptation of motor responses
48
Q

Postural orientation:

Static is…

A

Maintain vertical orientation

49
Q

Postural Orientation:

Motor Mechanisms

A
  • spontaneous postural sway
  • alignment
  • Postural tone

​

50
Q

Postural Orientation:

Sensory Mechanisms:

3

A
  • visual
  • vestibular
  • somatosensory
51
Q

Postural orientation

Explain the Typical Development

A
  • Righting rxns
    • keeps you in vertical
  • Protective Extension
  • Equilib rxns
52
Q

Postural orientation

what kind of progression should there be?

A

Cephalocaudal progression

“head to tail” progression

53
Q

In terms of Postural Orientation

Adult-like mvmt patterns @ when?

A

7-10yrs

54
Q

Postural orientation

Normal aging process that certain things are lost/affected

Systems affected?

A
  • MM strength
    • disproportionate loss of fast-twitch fibers
      • ​LESS amp, SLOWER rxn times
  • ROM
  • Sensory
    • ​impaired, less info for change in pos’s
55
Q

Postural orientation

Aging process and Postural sway

A

INC’d sway

56
Q

Abnormal Posture

Many pot. variations ….

A
  • lean towards INVOLVED
  • lean towards UNINVOLVED
  • Dependent on patho.
    • ​PD
    • CP
    • CVA
      • knee hyperext, Pusher syndrome
57
Q

Pusher Syndrome aka…

A

Contraversive Pushing

58
Q

Pusher syndrome

A

Pt pushes forcefully w/ the non-paretic extremities TOWARDS paretic side

59
Q

Pusher syndrome is likely due to damage where?

A

Ventral Posterolateral Nucleus of Thalamus

60
Q

When Pusher Syndrome is on the RIGHT

assoc’d w/….

A

Neglect

61
Q

When Pusher Syndrome on LEFT

assoc’d w/

A

Aphasia

62
Q

In Pusher Syndrome….

person feels that their upright is shifted by __________ from midline, thus they pushing to restore their perceived midline BACK to vertical

A

18-20 degrees

63
Q

Posture: Examination

Alignment should be in what?

A

Sitting or standing use a plumb line/grid

64
Q

Posture Exam:

Consider these things (balance support)

A

Foot position

BOS

65
Q

Posture exam:

wt. scales under ea. foot

why would you do this?

A

See if there is even distribution of wt b/w both sides or if they are leaning/overusing one side

66
Q

Posture Exam:

we want to attempt to standardize measurement

meaning?

A

Make sure that whatever we use is REPRODUCABLE

67
Q

Posture: Tx

We want to develop an initial position that will allow…..

3 goals of Tx

A
  • Develop initial position
    • that is appropriate for functional task
    • is efficient
    • is stable
68
Q

In Symmetrical/Vertical Posture

What kind of feedback would you give?

A

verbal cues

manual cues

visual cues

69
Q

Symmetrical/vertical posture

practice this way!

A
  • eyes open/closed
  • consider effect of AD’s
70
Q
A

neuropt 1 (7 decks)

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