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Exam 1 Flashcards

1
Q

What is the fasciculus cuneatus (posterior or dorsal column) tract?

A
  • Sensory
  • For trunk, neck, and UE proprioception, vibration, two-point discrimination, and graphesthesia
  • Cross in brainstem
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2
Q

What is the fasciculus gracilis (posterior or dorsal column) tract?

A
  • Sensory
  • For trunk and LE proprioception, two-point discrimination, vibration, and graphesthesia
  • Cross in brainstem
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3
Q

What is the spinocerebellar tract (dorsal)?

A
  • Sensory
  • Tract ascends to cerebellum
  • Ipsilateral subconscious proprioception, tension in muscles, joint sense, and posture of trunk and LE
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4
Q

What is the spinocerebellar tract (ventral)?

A
  • Sensory
  • Ascends up to cerebellum with crossing and recrossing at the pons
  • Ipsilateral subconscious proprioception, muscle tension, joint sense, and posture of trunk, UE, and LE
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5
Q

What is the spino-olivary tract?

A
  • Ascend to cerebellum

- Relay info from cutaneous and proprioceptive organs

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6
Q

What is the spinoreticular tract?

A
  • Afferent pathway for reticular info that influences levels of consciousness
  • Located next to lateral spinothalamic tract
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7
Q

What is the spinotectal tract?

A
  • Sensory

- Provides afferent info for spinovisual reflexes and assists with the movement of the eyes and head towards a stimulus

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8
Q

What is the anterior spinothalamic tract?

A
  • Sensory
  • Light touch and pressure
  • Cross at level of entry to SC or 1-3 levels above
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9
Q

What is the lateral spinothalamic tract?

A
  • Sensory

- Pain and temp sensation

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10
Q

Where do sensory tracts originate from?

A
  • Cells of spinal ganglia

- Intrinsic neurons within gray matter

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11
Q

What are descending tracts responsible for?

A
  • Motor function
  • Mm tone
  • Reflexes
  • Equilibrium
  • Visceral innervation
  • Modulation of ascending sensory signals
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12
Q

Where do smaller descending tracts originate from?

A
  • Nuclei in the midbrain, pons and medulla
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13
Q

What is the lateral corticospinal tract?

A
  • Pyramidal motor
  • Voluntary fine motor movement
  • Thought that it controls more distal parts
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14
Q

What happens if there is damage to the lateral corticospinal tract?

A
  • Positive Babinski
  • Absent superficial ab reflex
  • Cremasteric reflex
  • Loss of fine motor or skilled voluntary movement
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15
Q

What is the anterior corticospinal tract?

A
  • Pyramidal motor
  • Ipsilateral voluntary, discrete, and skilled movements
  • Thoughts that it controls the more proximal parts
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16
Q

What is the reticulospinal tract?

A
  • Extrapyramidal motor tract

- Facilitation or inhibition of voluntary and reflex activity through influence of alpha and gamma motor neurons

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17
Q

What is the rubrospinal tract?

A
  • Extrapyramidal motor tract
  • Motor input of gross postural tone, facilitate activity of flexor muscles, and inhibit extensor muscles
  • Originate in red nucleus (midbrain) and crosses immediately
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18
Q

What is the tectospinal tract?

A
  • Extrapyramidal motor tract
  • Contralateral postural muscle tone associated with auditory/visual stimuli
  • Cross in midbrain
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19
Q

What is the vestibulospinal tract?

A
  • Extrapyramidal motor tract
  • Ipsilateral gross postural adjustments subsequent to head movements
  • Facilitate extensor muscles and inhibit flexors
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20
Q

What happens if there is damage to the extrapyramidal tracts?

A
  • Significant paralysis
  • Exaggerated DTR
  • Clasp-knife reaction
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21
Q

What is the interhemispheric fissure?

A
  • AKA medial longitudinal

- Separate two hemispheres

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22
Q

What is the Sylvian fissure?

A
  • Anterior

- Separates temporal and frontal lobes and temporal from parietal

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23
Q

What is the central sulcus?

A
  • Sulcus of Rolando

- Separate frontal and parietal lobes laterally

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24
Q

What is the calcarine sulcus?

A
  • Separate occipital lobe into superior and inferior halves
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25
Q

What is the function of the frontal lobe?

A
  • Voluntary movement, intellect, and orientation
  • Contains Broca’s area = speech and concentration
  • Personality, temper, judgement, reasoning, behavior, self-awareness, executive function
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26
Q

What happens if there is an impairment to the frontal lobe?

A
  • Contralateral weakness
  • Preservation, inattention
  • Personality changes, antisocial behavior
  • Impaired concentration, apathy
  • Broca’s aphasia
  • Delayed or poor initiation
  • Emotional lability
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27
Q

What is the function of the parietal lobe?

A
  • Sensation of touch, kinesthesia, perception of vibration, and temp
  • Receive info from other areas of the brain regarding hearing, vision, motor, sensory, and memory
  • Provide meaning to objects
  • Interpret language and words
  • Spatial and visual perception
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28
Q

What happens if there is an impairment to the parietal lobe?

A
  • Dominant hemisphere = agraphia, alexia, agnosia
  • Non-dominant hemisphere = dressing apraxia, constructional apraxia, and anosognosia
  • Contralateral sensory deficit
  • Impaired language comprehesion
  • Impaired taste
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29
Q

What is the function of the temporal lobe?

A
  • Primary auditory processor and olfaction
  • Wernicke’s area location (typically left side) = ability to speak, verbal and general memory, and assist with understanding language
  • Rear portion enables humans to interprets others emotions and reactions
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30
Q

What happens if there is an impairment to the temporal lobe?

A
  • Learning deficits
  • Wernicke’s aphasia
  • Antisocial, aggressive behavior
  • Difficulty with facial recognition and memory
  • Inability to categorize objects
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31
Q

What is the function of the occipital lobe?

A
  • Visual information processor (colors, shapes, light, etc)

- Judgement of distance and seeing in 3D

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32
Q

What happens if there is an impairment to the occipital lobe?

A
  • Homonymous hemianopsia
  • Impaired extraocular Mm movement and visual deficits
  • Impaired color recognition
  • Reading and writing impairments
  • Cortical blindness with B lobe involvement
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33
Q

What is the L hemisphere responsible for?

A
  • Language
  • Sequencing and performing movement
  • Understand language
  • Produce written and spoken language
  • Analytical
  • Controlled
  • Logical
  • Rational
  • Math calc
  • Express positive emotions
  • Process verbally coded info in an organized and logical manner
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34
Q

What is the R hemisphere responsible for?

A
  • Nonverbal processing
  • Process info in holistic manner
  • Artistic abilities
  • General concept comprehension
  • Hand-eye coordination
  • Spatial relationships
  • Kinesthetic awareness
  • Understand music
  • Understand nonverbal communication
  • Math reasoning
  • Express negative emotions
  • Body image awareness
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35
Q

What makes up the CNS?

A

Brain and SC

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36
Q

Where does the spinal cord truly end?

A

~ L1-L2

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37
Q

What is the importance of the brainstem?

A

Regulate HR and RR

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38
Q

What constitutes the brainstem?

A
  • Midbrain
  • Pons
  • Medulla oblongata
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39
Q

What is the function of the hippocampus?

A
  • Form and store memories of personal history or declarative info
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40
Q

What is the function of basal ganglia?

A
  • Voluntary movement

- Regulation of autonomic movement, posture, tone, and control of motor responses

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41
Q

What is the amygdala?

A
  • Emotional and social processing
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42
Q

What is the function of the thalamus?

A
  • Relay station for info going to cerebral cortex
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43
Q

What is the function of the hypothalamus?

A
  • Receive and integrate info from ANS and assist in hormone regulation
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44
Q

What is the function of the subthalamus?

A
  • Regulate movements produced by skeletal Mm
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45
Q

What is the function of the epithalamus?

A
  • Pineal gland

- Secrete melatonin and involved in Circadian rhythm

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46
Q

What is the function of the midbrain?

A
  • Large relay center for info passing through to the cerebrum, cerebellum, and SC
  • Reflex center for visual, auditory, and tactile responses
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47
Q

What is the function of the cerebellum?

A
  • Fine tuning of movement
  • Assist in maintaining posture and balance
  • Control ability to perform rapid movements
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48
Q

What is the function of the pons?

A
  • Assist in regulation of RR and orientation of the head in relation to visual or auditory stimuli
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49
Q

What CN run through the pons?

A

CN V - VII

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50
Q

What is the function of the medulla oblongata?

A
  • Influence autonomic nervous activity and regulation of RR and HR
  • Reflex center for vomiting, coughing, and sneezing
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51
Q

What is the function of the brainstem?

A
  • Relay station, sends messages between parts of the body and cerebral cortex.
  • Primitive functions for survival
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52
Q

Where are most CN located?

A

Brainstem

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53
Q

What is the function of the meninges?

A

Protection from contusion and infection

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54
Q

What are the layers of meninges from deep to superficial?

A
  • PAD –> pia, arachnoid, and dura
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55
Q

What is the function of the ventricular system?

A

Protect and nourish the brain

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56
Q

What is the function of CSF?

A
  • Nutrition to CNS
  • Removal of metabolites
  • Provide support and buoyancy
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57
Q

What is the function of the BBB?

A

Exchange of nutrients from CNS and vascular system

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58
Q

What makes up the BBB?

A
  • Meninges
  • Protective glial cells
  • Capillary beds
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59
Q

What is Broca’s aphasia?

A
  • Can comprehend conversation

- Have difficulty getting thoughts across and words out

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60
Q

What is Weirnikes aphasia?

A
  • Cannot process conversation

- Can talk and talk in circles

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61
Q

What is the function of dopamine?

A

Needed for motor patterns

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62
Q

Where is dopamine produced?

A

Substantia nigra

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63
Q

What is Horner’s syndrome?

A
  • Descending sympathetic tract

- Sx/Sx: miosis (small pupil), ptosis (droopy eye), and decrease sweating

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64
Q

What is POTS?

A
  • Postural orthostatic tachycardic syndrome
  • HR increases significantly when changing positions
  • ANS disorder
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65
Q

How is sensory info processed?

A

Moves up the brain and into dorsal root

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66
Q

How is motor information processed?

A

Through a descending tract through the anterior horn of SC to initiate muscle contraction

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67
Q

What is RAS?

A
  • Reticular Activating System

- Sleep/wake cycles

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68
Q

What is communicating hydrocephalus?

A

No blockage

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69
Q

What is non-communicating hydrocephalus?

A

Blockage

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70
Q

What is the function of the spinal cord?

A
  • Send signals to the brain

- Send motor neurons down the efferent pathway

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71
Q

Is gray matter myelinated or unmyelinated?

A

Gray hair is UN-wanted = unmyelinated

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72
Q

What is an extrapyramidal system?

A
  • Motor system
  • Involuntary reflex and movement
  • Modulation of movement
  • Found in reticular formation of pons and medulla
  • Target neurons in SC involved in reflexes, locomotion, complex movement, and postural control
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73
Q

What is the pyramidal system?

A
  • Include corticospinal tracts

- Directly innervate anterior horn

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74
Q

What is the Babinski test?

A
  • Stroking sole of foot and toes should curl
  • Reflex takes place until about 2 years old
  • Abnormal = toes splay
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75
Q

Where do sensory nerves originate?

A

Dorsal root ganglion

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76
Q

Where do motor nerves originate?

A

Ventral horn

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77
Q

Which receptors are cutaneous sensory end-organ receptors?

A
  • Thermoreceptors
  • Nociceptors
  • Mechanoreceptors
  • Chemoreceptors
  • Photoreceptors
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78
Q

What are the different types of mechanoreceptors?

A
  • Merkel’s disc
  • Ruffini’s corpuscle
  • Pacinian corpuscle
  • Meissner’s corpuscle
  • Muscle spindle
  • Golgi tendon organ
  • Free nerve ending
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79
Q

What is the function of Merkel’s disc?

A

Sustained touch and pressure

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80
Q

What is the function of Ruffini’s corpuscle?

A

Slow adaptation to pressure - IE. stretch of skin

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81
Q

What is the function of Pacinian corpuscle?

A

Deep pressure and fast vibrations

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82
Q

What is the function of Meissner’s corpuscle?

A

Light touch

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83
Q

What is the function of muscle spindle?

A

Prevent overstretching by Mm contraction
AKA stretch reflex
Contract
- Only has to go to the SC and back

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84
Q

What is Golgi tendon organ function?

A

Inhibit Mm activation
Detects Mm tension
Relax

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85
Q

What is the function of free nerve endings?

A

Unspecialized, sends signal to sensory neuron

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86
Q

What is the function of chemoreceptors?

A
  • Detect change and send to CNS

- Response for homeostasis

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87
Q

What are the A Fibers?

A
  • Large and myelinated (FAST)
  • Carry proprioceptive info from Mm spindles, GTOs, and joints
  • Think of freeway
88
Q

What are B fibers?

A
  • Medium and myelinated (MEDIUM SPEED)
  • ANS
  • Think of highway
89
Q

What are C fibers?

A
  • Small with little to no myelination (SLOW)
  • Sympathetic
  • Free Nn endings carry pain, temp, and touch
  • Think of country road
90
Q

What is the purpose of superficial sensation test? What is it and how does it work?

A
  • Cortical
  • Temp, light touch, and pain
  • Test with two tubes of hot and cold water
91
Q

What is the purpose of the deep sensation test? What is it and how does it work?

A
  • Proprioception, kinesthesia, and vibration
92
Q

What is the definition of proprioception?

A

Awareness of movement in space

93
Q

What is the definition of kinesthesia?

A
  • Extent of movement

- Moving continuously and grading the arc of motion

94
Q

What is the monofilament sensation test and how is it used?

A
  • Small plastic rods of different sizes
  • Used to see if pt can feel the size
  • Protective sensation - if they detect a certain size they are safer to walk barefoot (IE. peripheral neuropathy)
95
Q

Which peripheral nerve arises from C5-6?

96
Q

Which peripheral nerve arises from C5-7?

A

Musculocutaneous

97
Q

Which peripheral nerve arises from C5-T1?

98
Q

Which peripheral nerve arises from C6-T1?

99
Q

Which peripheral nerve arises from C8-T1?

100
Q

What is polyneuropathy?

A
  • PNS lesion
  • Difficult to make improvements
  • Symmetrical and not usually caused by trauma
101
Q

What is neurapraxia?

A
  • Acute PNS injury
  • Pressure injury
  • Conduction block usually due to myelin dysfunction
  • Recovery is rapid and complete within 4-6 weeks
102
Q

What is axonotmesis?

A
  • Acute PNS injury
  • Caused from traction, compression, and crush injury
  • Nn regenerates (~ 1 mm/day)
  • Spontaneous recover or spotty to none
103
Q

What is neurotmesis?

A
  • Acute PNS injury
  • Complete transection of Nn in trunk
  • Irreversible
  • See flaccidity and atrophy
  • Absence of sensation
104
Q

What is UMN lesion?

A
  • Lesion of descending tracts (cerebral motor cortex), internal capsule, brainstem, or SC
  • IE. CP, hydrocephalus, ALS, CVA, MS, Huntington’s, etc
105
Q

What is a LMN lesion?

A
  • Lesion of affecting nerves or axons at or below brainstem

- IE. ALS, GBS, SC tumors, trauma, Bell’s palsy, progressive MA, etc

106
Q

Where does UMN refer to?

A

Brain/spinal cord

107
Q

What does LMN refer to?

A

At or below brainstem

108
Q

What signs/symptoms do you see in an UMN lesion?

A
  • Increased reflex
  • Mild atrophy
  • Absent fasciculations
  • Increased tone
109
Q

What signs/symptoms do you see with a LMN lesion?

A
  • Decreased or absent reflex
  • Atrophy
  • Fasciculations are present
  • Decreased or flaccid tone
110
Q

What are signs/symptoms of hypokinesia?

A
  • Apraxia
  • Rigidity
  • Bradykinesia
111
Q

What are signs/symptoms of hyperkinesia?

A
  • Ataxia
  • Athetosis
  • Chorea
  • Tics
  • Tremors
  • Dysmetria
  • Dystonia
112
Q

What is athetosis?

A

Involuntary movements combined with instability of posture

113
Q

What is chorea?

A

Sudden, random, and involuntary movement

114
Q

What is ataxia?

A

Inability to coordinate movements

115
Q

What is dysmetria?

A

Inability to control the range of movement and the force of muscular activity

116
Q

What is dysdiadochokinesia?

A

Inability to perform rapidly alternating movements

117
Q

What is a fasciculation?

A

Muscle twitch

118
Q

What is hemiballism?

A

Involuntary and violent movement of a large body part

119
Q

What is lead pipe rigidity?

A

Uniform and constant resistance to ROM. Associated with basal ganglia lesions

120
Q

What is cogwheel rigidity?

A

Resistance to movement. Seen in PD

121
Q

What is clasp-knife rigidity?

A

Great resistance to the initiation of ROM that lessens with movement

122
Q

What is the circulation pattern for the Circle of Willis?

A

Aorta –> Internal/External carotid

  • Internal carotid enters into brain - splits into anterior and middle cerebral Aa
  • Middle cerebral Aa supplies outer cerebrum (UE, basal ganglia, post/ant capsule, and putamen)
  • Anterior cerebral Aa supplies outer cerebrum (LE)

Subclavian Aa and vertebral Aa unite = Basilar Aa

  • Basilar splits into posterior cerebral Aa
  • Posterior cerebral Aa supplies brainstem, portion of midbrain, cerebellum, medial temporal lobe, and occipital lobes
  • Veretrobasilar Aa supplies the medulla, cerebellum, pons, and middle occipital cortex

Anterior and posterior systems connect at the base of brain

123
Q

What is the function of fluid in the ear?

A

Tell where your head is in space

124
Q

What is the vestibuloocular reflex (VOR)?

A

Keep same image while the head is moving

125
Q

What is the vestibulospinal reflex (VSR)?

A

Assist with stability while head is moving

126
Q

What is a positive VOR?

A

Patient cannot keep eye on object/image

127
Q

What is suspensory reflex?

A

Crouching down

128
Q

What are automatic postural strategies?

A
  • Automatic motor response to maintain COG over BOS

- Ankle strategy - hip strategy - suspensory - stepping strategy

129
Q

What is the BERG balance scale?

A
  • 14 tasks (static, transitional, and dynamic sitting and standing)
  • Less than 45 is fall risk
130
Q

What is the Fugl-Meyer Sensorimotor Assessment of Balance Performance Battery?

A
  • Specific to hemiplegics

- 7 items

131
Q

What is the functional reach test?

A
  • 3 trials and take average
  • Less than 7 inches = increase fall risk
  • Age related norms
  • SB states to use middle finger or head of 3rd metacarpal as landmark
132
Q

What is the Romberg Test?

A
  • If positive with e/c = somatosensory or vestibular deficit (not cerebellar)
  • Feet together with arms crossed - e/o and e/c. Hold 30 sec
133
Q

What is the Sharpened Romberg?

A
  • Same as Romberg, but in tandem
134
Q

What is the Timed Get Up and Go test?

A
  • Can use AD
  • 10 sec is norm
  • Cut-offs based on population
135
Q

What is the Tinetti Performance Oriented Mobility Assessment?

A
  • Balance and gait assessment
136
Q

What can cause vestibular disorders?

A
  • Disease, injury, genetic, environmental, and idiopathic
137
Q

What is the VOR assessment with Dix-Hallpike?

A
  • AKA Epley maneuver
  • Keep eyes open
  • If positive will see nystagmus - direction determines which semicircular canal is involved
138
Q

How can PT assist in vestibular disorders?

A
  • Maneuvers for BPPV
  • Habituation
  • Retrain balance reactions, proprioception, and vestibuloocular reflex (VOR 1 and VOR 2)
  • SLS on variable surfaces
  • Gait with head movement
  • Balance with e/c
139
Q

What is habituation in terms of PT for vestibular disorders?

A

Become less sensitive through adaptation, substitution, cognitive, and symptom prediction

140
Q

What is the definition of aphasia?

A

Impairment of processing for receptive and/or expressive language

141
Q

What is fluent aphasia?

A
  • Word output and speech production are functional
  • Empty speech
  • Neologisms
142
Q

What is the definition of neologism?

A

Substitution within a word that makes it unrecognizable

143
Q

What is non-fluent aphasia?

A
  • Poor word output with impairment to rhythm and inflection

- Poor articulation and increased effort

144
Q

What are characteristics of Wernicke’s (fluent) Aphasia?

A
  • Impaired comprehension and writing
  • Good articulation
  • Poor naming ability
  • Receptive
145
Q

What are characteristics of Broca’s (fluent) Aphasia?

A
  • Expressive
  • Intact auditory and reading comprehension
  • Impaired repetition and naming skills
  • Frustration with errors
  • Paraphasias are common
  • Motor impairment depending on area
146
Q

What is global (fluent) aphasia?

A
  • Comprehension severely impaired
  • Impaired naming, writing, and repetitions skills
  • May involuntarily verbalize
  • Many use nonverbal skills for communication
147
Q

What is dysarthria?

A
  • Motor disorder of speech (UMN lesion) affecting muscles that help articulate words and sounds
  • Slurred with possible effect on respiration and phonation
148
Q

What is an antiepileptic? What are the side effects, implications, and examples?

A
  • Tx epilepsy/seizures
  • Side effects - ataxia, skin issues, behavioral changes, GI distress, HA, blurred vision, and wt gain
  • Implications - greater sensitivity to light or noise
  • IE. Tegretol and Dilantin
149
Q

What is an antispastic drug? What are the side effects, implications, and examples?

A
  • Treat tone disorder
  • Side effects: drowsiness, confusion, HA, dizziness, generalized Mm weakness, hepatotoxicity, tolerance, and dependnence
  • PT implications: Focus to promote mobility and scheduling (sedation)
  • IE. Baclofen and Dantrium
150
Q

What is a dopamine replacement drug? What are the side effects, implications, and examples?

A
  • Replaces dopamine
  • Side effects: arrhythmias, GI distress, OH, dyskinesias, mood/behavior change, and tolerance
  • PT implications: Schedule 1 hour after levadopa dose and monitor BP
  • IE. Levadopa, Sinemet, Madopar
151
Q

What is a muscle relaxant? What are the side effects, implications, and examples?

A
  • Relax muscle
  • Side effects: sedation, drowsiness, dizziness, nausea, vomiting, HA, tolerance, and dependence
  • PT implications: Scheduling and pt education (posture)
  • IE. Valium and Flexeril
152
Q

What are the 3 motor stages of learning

A
  • Cognitive
  • Associative
  • Autonomous
153
Q

What happens in the cognitive stage of learning?

A
  • Initial stage
  • Frequent errors
  • Repetition
  • Listen, observe, and process feedback
154
Q

What happens in the associative stage of learning?

A
  • Able to independently detect errors
  • Decrease errors and need for concentration during tasks
  • Improved coordination
  • Practice yields skill refinement of motor program
155
Q

What happens in the autonomous stage of learning?

A
  • Final stage
  • No feedback
  • Distraction doesn’t impact activity
  • Self correct
156
Q

What is knowledge of results?

A
  • Terminal

- Outcome of movement has been performed in relation to movement goals

157
Q

What is knowledge of performance?

A
  • Relates to movement pattern that someone uses to achieve their goal
158
Q

What is massed motor learning?

A

Practice time in trial is greater than amount of rest between trials

159
Q

What is distributed motor learning?

A

Amount of rest time between intervals is greater than or equal to amount of practice time for each trial

160
Q

What is constant motor learning?

A

Uniform condition

161
Q

What is variable motor learning?

A

Differing conditions

162
Q

What is random motor learning?

A

Varying practice amongst different tasks

163
Q

What is blocked motor learning?

A

Constant practice of single task

164
Q

What is whole motor training?

A

Practice entire task

165
Q

What is part motor training?

A

Practice specific component of task

166
Q

What is pivot prone?

A
  • Infant has strength to lift head and legs against gravity
  • Swimming motion
  • Turn body using hands and weight shifts
167
Q

What is protective extension?

A
  • Being able to use UE to prevent falling
  • Child feels the limits of falling without actually falling
  • First learn to catch themselves going forward
  • Second learn to catch themselves going to the side
  • Finally, protect themselves from going backwards
168
Q

What is modified plantigrade?

A
  • Upright WB through LE and have WB in UE
  • IE. standing and pushing into table
  • Progression to static stand
169
Q

What is the Apgar score?

A
  • Infant is scored 1 minute and 5 minutes after birth
  • Assess skin color, pulse, grimace, activity, and respiration
  • Score of 7-10 is good
  • Score of 3 or below = medical attention
  • In between is up to discretion of medical staff
170
Q

How do we develop?

A
  • Cephalic to caudal
  • Gross to fine
  • Mass to specific: simple movement acquisition with progression to more complex
  • Proximal to distal
171
Q

When is the normal response of asymmetrical tonic neck reflex (ATNR) occur?

A

Birth to 6 months

172
Q

When does symmetrical tonic neck reflex (STNR) occur?

A

6 to 8 months

173
Q

When does tonic labyrinthine reflex (TLR) occur?

A

Birth to 6 months

174
Q

When does galant reflex occur?

A

30 weeks gestation to 2 months

175
Q

When does palmar grasp reflex occur?

A

Birth to 4 months

176
Q

When does plantar grasp reflex occur?

A

28 week gestation to 9 months

177
Q

When does rooting reflex occur?

A

28 weeks gestation to 3 months

178
Q

When does moro reflex occur?

A

28 weeks gestation to 5 months

179
Q

When does startle reflex occur?

A

28 week gestation to 5 months

180
Q

When does positive support reflex occur?

A

25 weeks gestation to 2 months

181
Q

When does walking (stepping) reflex occur?

A

38 weeks gestation to 2 months

182
Q

What is the normal response of TLR?

A

Supine = extremities and body in ext

Prone = extremities and body in flexion

183
Q

What does TLR interfere with if the reflex is not integrated?

A
  • Ability to initiate rolling
  • Ability to prop on elbows with extended hips in prone
  • Ability to flex trunk and hips to come into sitting from supine
  • Causes full body ext, which interferes with sitting and standing
184
Q

What is the normal response for the rooting reflex?

A
  • Turning head in the same direction as stimulus with open mouth
185
Q

What does rooting reflex interfere with if it does not integrate?

A
  • Oral-motor development
  • Development of midline head control
  • Poor visual tracking
186
Q

What is the normal response to Moro reflex?

A
  • Arms ABd with fingers open, then cross into ADd and cry
187
Q

What does the Moro reflex interfere with if it does not integrate?

A
  • Balance reactions in sitting
  • Protective response in sitting
  • Eye-hand coordination
  • Visual tracking
188
Q

What is the normal response in the startle reflex?

A
  • Similar to Moro, but elbows remain flexed and hands closed
189
Q

What happens if startle reflex does not integrate?

A
  • Sitting balance
  • Protective sitting response
  • Eye-hand coordination
  • Visual tracking
  • Social interaction
  • Attention
190
Q

What is the normal response for positive support reflex?

A
  • When standing up infant and their knees lock out, but cannot support their weight
191
Q

What happens if positive support reflex does not integrate?

A
  • Standing and walking
  • Balance and WB
  • Contractures in ankles into PF
192
Q

What is arthrogryposis multiplex congenita (AMC?

A
  • Occurs in utero
  • Non-progressive
  • Unknown etiology
  • S/S: cylindrical like extremities with atrophy, significant and multiple contractures, and joint dislocations
  • Tx: Positioning, stretching, strengthening, splinting, and use of AD. Possible surgery. Education
193
Q

What is Autism Spectrum Disorder?

A
  • Umbrella term
  • Etiology: environment and genetics
  • S/S: 2-3 years w/o speech, diminished facial expressions, awkward social interactions, lack empathy, defensive toward sensory stim, repetitive self-stimulation behaviors, perseverations, routines/rituals, and decreased coordination
  • Tx: Improve social interactions and decrease non-purposeful movements and vocalizations, sensory integration
194
Q

What is CP?

A
  • Umbrella term
  • Non-progressive
  • Impaired ability to monitor and control nerve/voluntary Mm activity
  • Etiology: lack of O2 in utero, maternal infection, drug/alcohol abuse, placental abnormalities, toxemia, prolonged labor, premature, and Rh incompatibility
  • S/S: Abnormal Mm tone, impaired modulation of movement, abnormal reflexes, and impaired mobility
  • Tx: pt/cargiver education, normalize tone, stretching, strengthening, motor learning, positioning, WB, and mobility skills
195
Q

What are the motor patterns of CP?

A
  • Spastic: UMN lesion
  • Athetoid: Basal ganglia lesion
  • Mixed
196
Q

What is diplegia CP?

A
  • Usually affects B LE

- Can affect UE, but less likely

197
Q

What is hemiplegia CP?

A
  • Affects one side of the body
198
Q

What is Down Syndrome?

A
  • Genetic abnormality - extra 21st chromosome
  • S/S: intellectual disability, hypotonia, jt hypermobilty, flat nasal bridge, narrow eyelids, small mouth, flat feet, scoliosis, congenital heart disease, and visual/hearing loss
  • Tx: Exercise and fitness, stability, max resp function, and pt/caregiver education. Surgery for cardiac abnormalities
199
Q

What is DMD?

A
  • Progressive disorder
  • Fat and CT replace muscle
  • Death by CP failure by 25 y/o
  • In males
  • Etiology: Absence of gene that produces dystrophin and nebulin. Mother is silent carrier
  • S/S: Occurs around 2-5 y/o with progressive weakening, disinterest in running, falling, toe walking, excessive lordosis, and pseudohypertrophy
  • Tx: Pt/caregiver education, resp function, submax exercise, mobility skills, splinting, orthotics, and adaptive equipment.
200
Q

What is Prader-Willi Syndrome?

A
  • Etiology: partial deletion of chromosome 15
  • S/S: small hands, feet and sex organs, hypotonia, almond-shaped eyes, obesity, constant desire for food, and coordination. Could literally eat themselves to death.
  • Tx: Postural control, exercise and fitness, gross and fine motor skills
201
Q

What is spina bifida?

A
  • Insufficient closure of neural tube by day 28 gestation
  • Etiology: genetics, environment, low folic acid, maternal hyperthermia, and certain drug classes
  • S/S: motor and sensory loss below level of defect, hydrocephalus, Arnold Chirari Type II malformation, osteoporosis, clubfoot, scoliosis, tethered cord syndrome, latex allergy, bowel and bladder dysfunction, and learning disabilities
  • Tx: Positioning, handling, ROM, strengthening, balance, facilitating milestones, and skin care
202
Q

What are the classifications of spina bifida?

A
  • Occulta
  • Meningocele
  • Myelomeningocele
203
Q

What is occulta spina bifida?

A
  • SC and meninges remain intact
  • Usually no disability
  • Tuft of hair
  • Spinous process doesn’t fully develop
204
Q

What is meningocele?

A
  • Herniation of meninges and CSF into sac that protrudes

- Remains within canal

205
Q

What is myelomenigocele?

A
  • Severe herniation of meninges, CSF, and SC extending through defect in vertebrae
206
Q

What is spinal muscle atrophy (SMA)?

A
  • Progresive degeneration of anterior horn
  • Etiology: Autosomal recessive inheritance (chromosome 5)
  • S/S: progressive Mm weakness and atrophy, diminished or absent DTR, normal intelligence, intact sensation, and end-stage resp compromize
  • Tx: vestibular and visual stim, mobility training and use of AD
207
Q

What are the IDEA amendements?

A
  • Enacted in 1997
  • Schools responsible for finding free, appropriate education for those with disabilities
  • IEP
  • Most common services include all 3 rehab disciplines
208
Q

What is the No Child Left Behind Act

A
  • Enacted in 2002
  • Redefined federal role in K-12 education
  • Require accountability for all
  • Aims to close achievement gaps
209
Q

What gross motor skills develop from birth to 1 month?

A
  • Prone: flexion, lift head briefly, and head to side
  • Supine: Flexion and rolls partly to side
  • Sitting: head lag to pull to sit
  • Standing: reflex standing and walking
210
Q

What gross motor skills occur from 2-3 months?

A
  • Prone: lift head to 90 degrees, chest up with some weight in UE, and rolls prone to supine
  • Supine: ATNR, legs kick reciprocally, and prefers head to side
  • Sitting: head upright with bob, variable head lag, and needs full support
  • Standing: poor WB and hips in flexion behind shoulders
211
Q

What gross motor skills occur from 4-5 months?

A
  • Prone: WB on ext arms and pivot in prone to reach
  • Supine: rolls from supine to side and plays with feet in mouth
  • Sitting: Head steady in supported position, turn head in sitting, and sits alone for brief periods
  • Standing: WB through legs in supported standing
212
Q

What gross motor skills occur from 6-7 months?

A
  • Prone: Rolls from supine to prone and hold wt on one hand to reach
  • Supine: lift head
  • Sitting: Lift head when pulling into seated position, gets into seated position w/o assist, and sits independently
  • Mobility: crawl backward
213
Q

What gross motor skills occur from 8-9 months?

A
  • Prone: Get into quadraped
  • Supine: does not tolerate
  • Sitting: move from sitting to prone, sits without hand support for longer periods, and pivots in seated position
  • Standing: stands at furniture, pulls up to stand, and lowers to sitting position from supported position
  • Mobility: crawls forward and cruises
214
Q

What gross motor skills occur between 10-11 months?

A
  • Standing: stand w/o support briefly, pulls to stand using half-knee, and picks up object from floor with standing support
  • Mobility: walks with both hands held, walk with one hand held, and creeps on hands and feet (bear walk)
215
Q

What gross motor skills occur between 12-15 months?

A
  • Walk w/o support
  • Fast walk
  • Walk sideways
  • Bends over to look b/t legs
  • Creeps or hitches upstairs
  • Throw ball in sitting
  • Mark paper with crayons
  • Build tower with 2 cubes
  • Turn over small container of objects
216
Q

What gross motor skills occur between 16-24 months?

A
  • Squat in play
  • Walk backward
  • Walk upstairs and downstairs one foot at a time
  • Propel ride-on toys
  • Kick balls
  • Throw ball
  • P/u toy from floor w/o fall
  • Fold paper
  • String beads
  • Stack 6 cubes
  • Imitates vertical and horizontal stroke with crayon
  • Hold cray with thumb and fingers

Neuro PTA (3 decks)

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