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547 > (A) Neuromotor Impairment (Ax & Tx) > Flashcards

(A) Neuromotor Impairment (Ax & Tx) Flashcards

1
Q

What assessments can be done to assess body functions and structures or what could be assessed

A
  • posture, balance
  • AROM, PROM (ROM)
  • strength (grip, pinch strength, MMT)
  • m tone, sensation, edema, pain
  • coordination
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2
Q

What is paresis?

A

partial paralysis or weakness (loss of strength) of body part

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3
Q

what is plegia

A

complete paralysis of body part

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4
Q

what is hemiparesis

A

partial paralysis or weakness on half side of body => can be mild, moderate, or severe & can be Upper or LE

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5
Q

what is hemiplegia

A

complete paralysis of half of body (could be UE or LE)

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6
Q

Describe a scapular assessment (3)

A
  1. positioning: winging (shoulder blade sticking out), has it moved
  2. movement/strength (palate spine and follow its movement into shoulder flex/ext)
  3. tone surrounding scapular (palpate)
    * compare w unaffected side*
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7
Q

what is a shoulder subluxation

A

change in glenohumeral joint w palpable gap between acormion and humeral head

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8
Q

what can cause a shoulder subluxation?

A

w stroke, can occue in hemiplegic arm due to flaccid supporting musculature

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9
Q

How do you assess a shoulder subluxation?

A
  • may or may not have pain associated with it (if dont have pain, its most probable a neurological proble not subluxation which tend to be very painful)
  • palpate gap between acromion and humeral head: feels very stiff

wrist and elbow should be included in splint for shoulder subluxation

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10
Q

What construct the box and block test assess?

A

unilateral gross manual dexterity

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11
Q

what construct does the 9 hole peg test assess

A

finger dexterity

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12
Q

what construct does the fugl (FMA) assess?

A

motor functioning, balance, sensation, joint functioning

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13
Q

what construct does the chedoke mcmaster assess

A

physical impairement
level of disability
Upper and lower limb

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14
Q

what are the treatment (prevention, pain modalities, exercises) used for shoulder subluxation/apin?

A
  1. prevention:
    - early ROM exercises
    - positioning w pillows, splint, slings
  2. exercise
    - tx contracture
    - arom shoulder
    - frequent prom shoulder
  3. prom modalities
    - thermal, hand desensitization, electric n stimulation
  4. medication
  5. injections
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15
Q

what positioning should be done for shoulder subluxation in a seated position (4)

A
  • back supported chair
  • feet flat on floor
  • equal weights thru buttocks
  • affected arm suppoted on adjustable base
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16
Q

what positioning techniques should be used for shoulder subluxation when lying on unaffected side? (3)

A
  • head and trunk straight using pillows behind back
  • shoulder and pelvic forward using pillow
  • arm and leg raised forward onto pillow
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17
Q

what positioning techniques should be used for shoulder subluxation when lying on affected side? (3)

A
  • ease affected shoulder forward
  • affected arm resting on bed, pal upwards
  • affected leg flexed forward
18
Q

what positioning techniques should be used for shoulder subluxation when lying on in bed (on back)?

A

affected arm supported by pillow

19
Q

what are the 10 principles of experience dependent plasticity

A
  1. use it or lose it (activate brain areas)
  2. use it and improve it
  3. specificity (specific training leads to increased function)
  4. repetition matters
  5. intensity matters (frequency)
  6. time matters (different forms of plasticity occur at different times => acute vs chronic)
  7. salience matters (training relevant to client)
  8. age matters (> younger brain plasticity)
  9. transference (plasticity in one function can enhance aquisition of similar functions)
  10. interference
20
Q

what is muscle tone

A

tension of muscle at rest

21
Q

what is hypotonia? (3)

A
  • muscle slower react to stretch
  • unable to sustain prolong m contraction
  • feels soft, floppy
22
Q

what is hypertonia?

A
  • overreactive muscle to stretch

- may maintain prolonged contraction (risk of contracture)

23
Q

what is a clonus?

A

repetitive contraction in antagonist m in response to rapid stretch

24
Q

what is the clinical presentation of hyperspasticity in UE?

A
  • flexed elbow
  • bent wrist
  • pronated foreaem
  • clenched fist
  • thumb in palm
25
Q

what assessment can be to assess spasticity

A

Ashworth scale => testing resistance to passive stretch

26
Q

what are the tx for hypotonia? (5)

A
  1. education
  2. positioning (wc, sling, laptable)
  3. conservatice tx (NDT principles): weight bearing activities, facilitation
  4. physical agen modalities (cold, heat, ultrasound, electrical stimulation)
  5. cast, splint, passive stretching to prevent contracture
27
Q

what are the tx for hypertonia? (5)

A
  1. early on (to avoid contracture): want to maintain rom (bc joint not moved in 24h can stiffen w permanent shortening of m if persist)
  2. ROM excersices
  3. streching
  4. splinting
  5. botox
28
Q

what does trunk control/posture influence?

A

tone, balance, arom

29
Q

how do you assess trunk control/posure

A

observation: trunk stability, alignment, mobility, tone in ALL situations (in bed, transfer…)

30
Q

what is the trunk control test?

A

for neurological conditions => scoring based on 4 items that you observe them do and ability to perform task

31
Q

what are different tx for trunk control/posture?

A
  • visual/verbal cues (use mirror to fix posture)
  • positioning aides (beds, chairs, pillows)
  • selection of surfaces of chair, bed
32
Q

what can cause balance impairement?

A

motor, sensory and cognitive impairements

33
Q

what are different balance tx?

A
  • assistive devices (cane, walker) ie compensatory
  • functional reaching during ADL/IADLs
  • yoga, tai chi
34
Q

what is motor apraxia?

A

inability to plan mvm => cannot get body to do what you want it to do (cogntiive impariment NOT motor)

35
Q

what is ideomotor apraxia?

A

inability to carry out motor act on verbal command or initiation
=> able to explain how to perform action but not imagine or act it out

36
Q

what is ideational apraxia?

A

inability to use real objects, conceptualize task, complete multistep actions

(may complete actions but in incorrect order)

37
Q

what are the tx for motor apraxia (remedial)

A
  1. remedial: provide repetitive routine that is consistent, hand over hand guidance, proprioceptive/tactile/kinesthetic input
38
Q

what are tx for motor apraxia (compensatory)

A
  • provide short, concise, verbal cuering
  • use familiar and spontaneous task in natural environment
  • alter the environment
39
Q

how do you walk with a cane?

A

hold cane w unaffected hand (so opposing side of affected side)

  • advance cane and affected limb together => lean on arm w cane as neede
  • advance w unaffected limb
40
Q

why would you suggest a sling for someone using a cane w hemiparesis or hemiparalysis during ambulation?

A

affected arm is likely heavy and not supported

547 (22 decks)

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