Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurologic PT > Tone, Mobility, Selective Capacity and Force Generation > Flashcards

Tone, Mobility, Selective Capacity and Force Generation Flashcards

1
Q

List 3 positive signs of UMN lesions.

A
  1. Hyperreflexia
  2. Spasticity
  3. Pathological reflexes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List 6 negative signs of UMN lesions.

A
  1. Paresis (decreased force generation)
  2. Loss of fractionation
  3. Abnormal motor unit recruitment
  4. Obligatory synergies
  5. Decreased coordination and dexterity
  6. Spatial and temporal movement abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What occurs with the loss of fractionation?

A

Patient loses the ability to move single joints or aspects of the extremities in isolation from the others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Obligatory synergies result in decreased ______.

A

Selective Capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is resting muscle tone?

A

Light tension in the muscle when it is at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the position of the shoulder, elbow, forearm wrist, hips and ankles in decorticate rigidity.

A 
Shoulder adduction
Elbow flexion
Forearm supination
Wrist Flexion
Hip IR
Ankle PF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the position of the shoulder, elbow, forearm, wrist, and ankles in decerebrate rigidity.

A 
Shoulder adduction
Elbow extension
Forearm Pronation
Wrist Flexion
Ankle PF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List 3 interventions used to treat hypertonia. Why are they effective in treating this condition?

A
  1. Air casting
  2. Serial casting
  3. Splinting

Provide low load, long duration stretch to high tone muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What typically occurs immediately after a CVA?

A

Flaccidity/Hypotonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is flaccidity/hypotonia?

A

Complete absence of muscle tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or False: Flaccidity/hypotonia most commonly affects the LE.

A

FALSE

Most common in the UE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Length of time the period of flaccidity lasts is related to ____.

A

Prognosis

Longer the flaccidity lasts, the poorer the prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are 2 effects of hypotonia on the musculoskeletal system?

A
  1. Knee laxity (genu recurvatum)

2. Shoulder subluxation (weight of arm pulls humeral head down)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List 5 interventions used to treat hypotonia.

A
  1. Neurofacilitation
  2. E-stim to improve active movement (takes long time)
  3. E-stim of supraspinatus to prevent subluxation
  4. Scaled active movement / mirror training
  5. Positioning to prevent subluxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is scaled active movement or mirror training?

A

Patient begins to convert trace movements into meaningful movements

Affected limb is perceived as moving as the patient observes the non-affected limb moving in the mirror

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What should be avoided when positioning the arm to prevent subluxation?

A

Avoid using arm sling to position the UE to prevent formation of contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is spasticity?

A

Velocity dependent response of muscle to passive stretching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Spasticity: Resistance ____ as speed and rhythm of movement increases.

A

INCREASES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Spasticity: Resistance to passive movements could be ____ or ____.

A

unidirectional or bi-directional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is clonus? (2)

A
  1. A series of involuntary, rhythmic, muscular contractions and relaxations.
  2. Self re-excitation of hyperactive stretch reflex
21
Q

What are 2 causes of clonus?

A
  1. Increase in motor neuron excitability (decrease descending inhibition)
  2. Nerve signal delay (increased nerve conduction time and long reflex pathways)
22
Q

What are 2 causes of spasticity?

A
  1. Decreased supra-spinal pre-synaptic inhibition of alpha motor efferents
  2. Stimulation by a hypersensitive fusimotor system
23
Q

What position must the patient be in when performing the Modified Ashworth Scale? How many times is it performed?

A
  1. Supine
  2. Performed twice

V1: move through entire ROM slowly
V2: move through entire ROM < 1 sec

24
Q

List and describe all 6 grades on the Modified Ashworth Scale.

A

0 – no increase in tone / normal tone
1 – slight increase in tone manifested by catch and release or by minimal resistance at End ROM
1+ - slight increase in muscle tone, manifested by catch followed by minimal resistance throughout the reminder (less than ½) of the ROM
2 – marked increase in muscle tone throughout most of the ROM but affected parts easily moved
3 – considerable increase in muscle tone, passive movement difficult
4 – rigidity in flexion or extension

25
Q

What is the inter-rater/intra-rater reliability, validity and convergent validity of the Modified Ashworth Scale?

A
  1. Adequate to good intra-rater reliability
  2. Poor to adequate inter-rater reliability
  3. Poor criterion validity
  4. Adequate convergent validity
26
Q

List 5 things than can influence spasticity.

A
  1. Tonic Labyrinthine changes in different positions
  2. Postural exertion / Mental exertion
  3. Pain or discomfort (INCREASES SPASTICITY)
  4. Infections, decubiti, inflammations (INCREASES SPASTICITY)
  5. Handling (INCREASES SPASTICITY)
27
Q

List 6 complications associated with spasticity.

A
  1. Reduced strength and function (intact muscles trying to resist spastic muscles, which weakens them)
  2. Inactivity / Immobility
  3. Tissue adaptation, contracture/deformity
  4. Tissue breakdown, mechanical damage and necrosis
  5. Discomfort
  6. Impaired posture (respiratory distress/infections)
28
Q

List 4 things that are associated with inactivity/immobility secondary to spasticity.

A
  1. Cardiovascular problems
  2. Social isolation
  3. Osteoporosis
  4. DVTs
29
Q

List 4 effects of spasticity on the musculoskeletal system.

A
  1. Trunk asymmetries
  2. Ankles and feet (i.e. equino varus, very severe)
  3. Finger deformities (contractures develop)
  4. Heterotrophic ossifications: abnormal bone growth in muscle
30
Q

What is a possible advantage of spasticity? Provide 2 examples.

A
  1. May assist with posture control and ADLs

Example: Spastic gastrocs stabilize knees
Example: Spastic hams stabilize trunk

31
Q

List 6 inhibiting techniques used to treat spasticity.

A
  1. Slow rocking (vestibular input)
  2. Counter rotation
  3. Deep tendon pressure
  4. Prolonged stretching
  5. Reflex inhibition position (closed chain, approximation)
  6. Positioning
32
Q

List 4 PT interventions used to treat spasticity.

A
  1. Joint mobilization
  2. STM
  3. Muscle stretching programs
  4. Casting
33
Q

List 2 types of casting that can be used to treat spasticity.

A
  1. Inhibitive: restore normal anatomical & biomechanical relationships
  2. Serial: long duration, low load stretch
34
Q

List 5 oral medications used to treat spasticity.

A 
Baclofen (Lioresal)
Diazepam (Valuium)
Dantrolene (Dantrium)
Tizanidine (Zanaflex)
Clonidine (Catapres)
35
Q

List 2 injectable medications/ nerve blocks used to treat spasticity.

A
  1. Phenol

2. Botulinum toxin type A or B (Botox)

36
Q

List 3 surgical interventions used to treat spasticity.

A
  1. Selective Dorsal Rhizotomy (knocks out sensory information from muscle spindle)
  2. Intrathecal Baclofen therapy
  3. Tendon lengthening (Z-plasty: cut the tendon and reattach it to make it longer)
37
Q

What is intrathecal Baclofen therapy? Highest level it can be placed?

A
  1. Baclofen is delivered directly to the spinal cord via indwelling pump
  2. Highest level = T8 so diaphragm remains unaffected allowing the patient to breathe
38
Q

What is the typical presentation of the joints in an UE flexion synergy? (7)

A 
Elevation
Retraction
Abduction
**Elbow Flexion**
Supination
Radial Deviation
Wrist and Finger Flexion
39
Q

What is the typical presentation of the joints in an LE extension synergy? (7)

A 
**Hip Extension** 
Adduction
IR
**Knee Extension**
**Plantar Flexion**
Inversion
Toe Flexion
40
Q

List 5 interventions used to treat synergies.

A
  1. Grade tasks to avoid synergy – (NDT)
  2. AAROM out of synergy
    (lots of GE (gravity eliminated) work)
  3. Strengthen out of synergy
  4. Facilitate opposite synergy (Brunnstrom)
  5. Loading with isometrics out of synergy
41
Q

List 9 impairments associated with impaired force generation after stroke.

A
  1. Decrease in # of motor units
  2. Decrease rate of firing of motor units
  3. Abnormal recruitment of motor units
  4. Learned non-use
  5. Atrophy of muscle
  6. Loss of type II/fast twitch fibers (become smaller and do not fire as efficiently)
  7. Disordered patterns of agonist-antagonist muscle activity (can be caused by spasticity)
  8. Passive restraints due to changes in viscoelastic properties of muscle and connective tissue
  9. Increased fatigability (lack sufficient strength needed to sustain level of activity)
42
Q

What were Bobath’s vs Guliani’s beliefs regarding the use of strength training to treat patients with synergies?

A
  1. Bobath “synergies will increase”: if muscles responsible for synergies were strengthened (don’t strengthen)
  2. Guliani “weakness will decrease function and increase synergies”: so argument was to strengthen the synergistic muscles
43
Q

What is the current consensus regarding the use of strength training to treat patients with synergies?

A

Strengthen regardless of the presence of a synergy

44
Q

How many stages make up Brunnstrom’s stages of recovery?

A

7

45
Q

Define stages I, II, III of Brunstrom’s stages of recovery.

A

Stage I : Flaccidity

Stage II Spasticity and Synergies Emerge

Stage III: Voluntary control of synergies and spasticity increases

46
Q

Define stage IV of Brunstrom’s stages of recovery. (3)

A
  1. Movement in Synergy still dominates
  2. Movements out of synergy emerges
  3. Spasticity decreases
47
Q

Define stage V of Brunstrom’s stages of recovery. (3)

A
  1. Dominance of synergies decreases
  2. Isolated Movement Increases
  3. Spasticity Decreases
48
Q

Define stage VI of Brunstrom’s stages of recovery. (3)

A
  1. No spasticity
  2. Isolated movement dominates
  3. Coordination emerges
49
Q

Define stage VII of Brunstrom’s stages of recovery.

A

Normal function restored

Neurologic PT (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions