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NM PT > (1) Principles of NM PT > Flashcards

(1) Principles of NM PT Flashcards

1
Q

What are the 5 benefits to using the ICF framework?

A
  • non-discipline specific
  • all inclusive
  • incorporates contextual factors
  • used with any health condition
  • broaden our perspective
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2
Q

“to determine the significance, worth or condition of, usually by careful appraisal and study”

A

evaluate

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3
Q

“a label encompassing a cluster of signs and symptoms, syndromes or categories”

A

diagnosis

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4
Q

“the determination of the optimal level of improvement that might be attained and the amt of time required to reach that level”

A

prognosis

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5
Q

what does alert and oriented x 4 mean

A

person, place, date, and reason for being admitted

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6
Q

what 4 things might you check when determining pts level of communication and language

A
  • command following
  • gesturing
  • identifying objects
  • yes/no accuracy
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7
Q

what are 2 important questions to ask the pt during the exam

A
  1. what is their perception of their biggest problem
  2. goals
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8
Q

describe the tone scale

A

hypotonicity < normal < hypertonicity < rigidity

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9
Q

shoulder subluxation occurs as a result of what type of tone

A

hypotonicity

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10
Q

serial casting and meds, such as baclofen, are used to treat what level of tone?

A

hypertonia

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11
Q

what treatment methods are often used for rigidity

A

surgery - tendon lengthening

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12
Q

what is “and increased, velocity dependent resistance to passive stretch”

A

spasticity

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13
Q

spasticity is an indication of what type of injury

A

CNS

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14
Q

what type of reflexes do you see with spasticity

A

hyperactive

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15
Q

what does the modified ashworth scale measure

A

spasticity

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16
Q

Modified Ashworth Scale: 0

A

no increase in tone - no spasticity

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17
Q

modified Ashworth scale: 1

A
  • slight increase in tone
  • manifested by a catch AND release OR
  • minimal resistance at end of ROM
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18
Q

Modified Ashworth scale: 1+

A

-slight increase in tone
- manifested by a catch
- followed by minimal resistance throughout remainder (< 1/2) ROM

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19
Q

Modified Ashworth Scale: 2

A
  • more marked increase in tone thru most ROM
  • BUT affected parts easily moved
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20
Q

Modified Ashworth score: 3

A
  • considerable increase in m tone
  • passive mvmt is difficult
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21
Q

Modified ashworth scale: 4

A
  • affected parts rigid in flex/ext
  • possible clonus
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22
Q

how is ashworth and mod ashworth scale different?

A

regular one does not have 1+ category

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23
Q

what do you document for clonus

A
  • strength and # of beats
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24
Q

what is a positive babinski result

A
  • up mvmt of great toe
  • flair of toes 2-4
  • flexor withdrawal (if severe)
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25
Q

what is the reflex scale?

A

0 = none
1+ = hypo
2+ = normal
3+ = hyper reflexive
4+ = marked reflex/clonus

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26
Q

what is a positive Hoffman’s sign

A
  • flexion/approximation of thumb and 2nd finger
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27
Q

describe the UE flexion synergy

A
  • scapular retraction and elevation
  • shoulder ABD/ER
  • elbow flexion
  • forearm supination
  • wrist and finger flexion
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28
Q

describe the UE extension synergy

A
  • scapular protraction
  • shoulder ADD/IR
  • elbow extension
  • forearm pronation
  • wrist and finger flexion
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29
Q

what is the main mvmt seen in UE flexion synergy

A
  • elbow flexion
30
Q

what is the hallmark of the UE ext synergy

A
  • shoulder ADD
  • forearm pronation
31
Q

escribe the LE flexion synergy

A
  • hip flexion/ER/ABD
  • knee flexion
  • ankle DF/IV
  • toe DF
32
Q

what is the hallmark of the LE flexion synergy

A

hip flexion

33
Q

escribe the LE extension synergy

A
  • hip ext/IR/ADD
  • knee ext
  • ankle PF/IV
  • toe PF
34
Q

what is the hallmark of LE ext synergy

A

hip ADD
knee ext
ankle PF

35
Q

when does synergy mvmt show up?

A

when a pt tries to perform voluntary mvmts

36
Q

What are the 6 stages of recovery according to Brunnstrom

A
  1. flaccidity
  2. spasticity/associated mvmt
  3. synergy
  4. mvmt deviating from basic synergies
  5. relative independence of basic synergies
  6. indep, isolated mvmt
37
Q

which 2 stages of recovery have no voluntary mvmt?

A

stage 1 - flaccidity
stage 2 - associated reactions/spasticity

38
Q

what is a key characteristic of stage 3 recovery

A
  • spasticity becomes pronounced
  • pt gains voluntary control thru synergy pattern but limited range
39
Q

describe 4 UE mvmts to demonstrate that a pt is in stage 4 recovery (mvmts deviating from synergy)

A
  • hand to sacrum
  • raise arm horizontal
  • pronation/supination with elbow flexed
40
Q

Describe 4 LE mvmts to demonstrate that a pt is moving into stage 4 (mvmts deviating from synergy)

A
  • supine unilateral hip ABD
  • sitting hip flexion or knee flexion
  • ankle DF
  • knee ext
41
Q

describe 4 UE mvmts that indicate a pt is in stage 5 recovery (relative indep of basic synergy)

A
  • raise arm to side - horizontal
  • supination (shoulder 90 deg flex/elbow ext)
  • forward reach from horizontal (serratus)
  • raise arm overhead
42
Q

escribe 3 LE mvmts to indicate a pt is in stage 5 recovery

A
  • ankle DF/PF with knee extended
  • ankle IV/EV (heel on floor)
  • standing isolated knee flexion w/o hip flexion
43
Q

what 3 things indicate a pt has reached stage 6 - indep, isolated mvmt

A
  • fractionated mvmt
  • spasticity is no longer apparent
  • normal to near normal mvmt
44
Q

you notice a pt is demonstrating pronator drift. What does this look like and what does it indicate

A
  • slow downward drift of arm from shoulder flexion, elbow ext, forearm supination –> forearm pronation and elbow ext
  • sign of UMN involvement –> mild hemiparetic weakness
45
Q

what term is used to describe rapid alternating mvmts when testing for coordination

A

dysdiadochokinesia

46
Q

what term is used to describe impaired distance judgement when testing for coordination

A

dysmetria

47
Q

what is hypermetria

A

overshooting a distance

48
Q

what is hypometria

A

undershooting a distance

49
Q

give some examples of how you might test for dysdiadochokinesia

A
  • pronation/supination
  • hand to knee to opposite shoulder
  • knee flex/ext
  • hand or toe tapping
50
Q

give some examples of how you would test for dysmetria

A
  • finger to nose
  • finger to therapist finger
  • heel on shin
  • indiv finger touch
51
Q

anytime you see perceptual or sensory issues, what part of the brain is most likely affected

A

parietal lobe

52
Q

you notice a pt is demonstrating neglect/inattention to the L side, what area of the brain is affected?

where will you see physical symptoms?

A
  • R hemisphere lesion in the inferior-posterior parietal lobe
  • L hemi symptoms
53
Q

what is denial or lack of awareness of a paretic limb

A

anosognosia

54
Q

you notice a pt demonstrating signs of anosognosia, where is the most likely location of the lesion

A

R (non-dominant) parietal lobe

55
Q

you notice a pt is demonstrating issues with R/L discrimination, where is the lesion

A

parietal lobe of either side

56
Q

if a pt has spatial relations deficit, what might you see?

A
  • inability to perceive relationship in space of one object to another or oneself
  • may have issues with layout of numbers
57
Q

inability to perform purposeful mvmts not attributable to loss of strength, coordination, sensation, tone or poor comprehension

A

apraxia - a perceptual disorder

58
Q

when is the ability to motor plan worse for pts with apraxia?

A

when they have to motor plan on command

ex: when someone askes them to do something such as pick up a cup

59
Q

you notice a pt with apraxia, and your CI asks you to tell them where the lesion is

A

L hemisphere (dominant) of the frontal/parietal lobe

60
Q

what are the 2 types of apraxia

A

ideomotor and ideational

61
Q

what is the breakdown b/w concept and performance

A

ideomotor apraxia

62
Q

you notice a pt is unable to imitate gestures or follow commands when you ask them to do something although they have full strength and control. what condition do you suspect?

A

ideomotor apraxia

63
Q

what is the inability to grasp the concept of a task

A

ideational apraxia

64
Q

you give your pt a button up shirt without any instruction and they are:
- unable to describe the process or function of the shirt
- unable to use it appropriately

A

ideational apraxia

65
Q

where is the lesion of a pt with ideational apraxia

A

L parietal lobe

66
Q

you give a pt a toothbrush and toothpaste and they do not use it correctly. What condition might they have?

A

ideational apraxia

67
Q

what is a resistance to upright vertical correction by active pushing with non-paretic extremities to the side C/L to the brain lesion

A

contraversive pushing

68
Q

what are 2 other names for contraversive pushing

A

lateropulsion or pusher syndrome

69
Q

where is the lesion if the pt demonstrates contraversive pushing

A
  • inferior parietal lobe at junction of post central gyrus
  • L or R posterolateral thalamus
70
Q

what scale is used to assess contraversive pushing

A

Burke LAteropulsion scale

71
Q

what is the cutoff score for BLS

A

> / = 3 means a pt has CP

72
Q

what is the max score/range for severe lateropulsion

A

13-17

NM PT (16 decks)

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