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Motor Control > Exam 5: Parts 1 and 2 > Flashcards

Exam 5: Parts 1 and 2 Flashcards

1
Q

Is this the order of academics or clinical practice

systems -> normal function -> Dysfunction -> patient problem -> signs and symptoms

A

academics

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2
Q

Is this the order of academics or clinical practice

signs and symptoms -> patient problems -> dysfunction -> normal function -> systems

A

clinical practice

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3
Q

What does ICF stand for

A

International classification of function

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4
Q

Based on the ICF model, what category does a medical diagnosis or movement disorder belong to

A

health condition

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5
Q

What is another term for impairments

A

body structure/function

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6
Q

What is another work for task

A

activity

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7
Q

What are some examples of impairments that belong under the body structure/function category according to the ICF model

A 
ROM
Strength
Sensation/cognition
Proprioception
Muscle tone
Balance/Composite impairment
Postural control
Coordination
Endurance/fatigue
Pain
Body alignment
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8
Q

What are the two sub categories of the activity category according to the ICF model

A

abilities and limitations

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9
Q

What are some examples of abilities and limitations that belong under the activity category according to the ICF model

A 
Bed mobility
Sitting Balance
Standing Balance
Ambulation
Functional mobility/transfers
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10
Q

What are the two sub categories of the participation category according to the ICF model

A

abilities and restrictions

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11
Q

What are some examples of abilities or restrictions that belong under the participation category of the ICF model

A 
parent
care provider
family member/friend
employee/student
recreation participant (sewing, chess playing, swimming, jogging, rock climbing)
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12
Q

What are the two sub categories under the environmental category of the ICF model

A

internal +/- and external +/-

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13
Q

What are some examples of +/- internal environmental factors according to the ICF model

A 
motivation
stress management
comorbidities
attention/focus
intact body structure/function
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14
Q

What are some +/- external environmental factors according to the ICF model

A 
Home environment/accessibility
access to healthcare (financial or physical)
Family/societal support
Demands of job
Demands of family role
Demands or societal role
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15
Q

What is a composite impairment

A

When multiple systems are affecting a specific tasks like balance

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16
Q

____ is being able to perform a task without assistance

A

an ability

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17
Q

____ is performing a task with the help of outside assistance

A

a limitation

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18
Q

True or False:

Attention can either be an internal or external environmental factor

A

True

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19
Q

What is the definition of a sign

A

an objection findings of pathology that can be measured with a physical examination

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20
Q

Are signs objective or subjective

A

objective

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21
Q

What is the definition of a symptom

A

subjective report of experiences associated with the pathology but may not be measured objectively on examination

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22
Q

Are symptoms objective or subjective

A

subjective

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23
Q

In the following example:

“Many patients have decreased endurance following a stroke.”

The ___ is measured and confirmed as a decreased distance walking during a 6 minute walk test

and

The ___ would be reported by the patient as fatigue

A

sign

symptom

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24
Q

(negative/positive) signs and symptoms are the presence of new abnormal behaviors

A

positive

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25
Q

(negative/positive) signs and symptoms is the loss of normal behaviors

A

negative

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26
Q

What are some examples of positive signs and symptoms

A

babinski and clonus

spasticity

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27
Q

What are some examples of negative signs and symptoms

A

paresis and decreased balance

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28
Q

What is a positive babinski’s sign and what age should we expect to see this in

A

a positive sign is when the big toe dorsiflexes and the other toes flare out. This is normal is children under 6 months, and becomes abnormal after 6 months of age

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29
Q

What is a primary impairment

A

a direct result of a CNS lesion

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30
Q

What is a secondary impairement

A

the result of the primary impairment

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31
Q

If there is a lesion in the descending motor pathways, give an example of what primary impairment could happen and what secondary impairment could happen

A

primary: paresis, spasticity
secondary: structural and functional changes in muscles and joints

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32
Q

Are primary or secondary impairments preventable?

A

secondary

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33
Q

What will occur to the body if there is damage to the motor cortex?

A

Weakness

34
Q

Why does weakness occur to the body if there is damage to the motor cortex

A

Because the primary motor area is located in the motor cortex

35
Q

____ is the ability to generate sufficient muscle tension to sustain a position or move a body segment

A

strength

36
Q

What is the definition of strength

A

The ability to generate sufficient muscle tension to sustain a position or move a body segment

37
Q

Strength is influenced by both ____ properties and _____ activation

A

muscle; neural

38
Q

What is the term used to describe a total or severe loss of muscle activity

A

paralysis or plegia

39
Q

What is the term used to describe mild or partial loss of muscle activity

A

paresis

40
Q

What is hemiplegia

A

weakness or muscle loss on one side of the body

41
Q

What is paraplegia

A

weakness or muscle loss in the lower extremities

42
Q

What is tetraplegia or quadriplegia

A

Weakness or muscle loss in all four extremities

43
Q

What type of patient will the term “diplegia” and what does it mean?

A

CP patients are considered diplegic because they have weakness or muscle loss in both lower limbs due to damage of the 3rd or 4th ventricle

44
Q

In general, children with CP have greater weakness in their lower extremities than normal developing children. In some cases, a hemiplegic patient might show more strength than a normal child, what is the rational behind this?

A

A hemiplegic patient might show more strength and less weakness than a normal developing child because they are over compensating for the other leg and might even vault to clear to nondominant side.

45
Q

Hemiplegic patients have more weakness (distally/proximally)

A

distally

46
Q

In hemiplegic patients, there is a clear difference in strength/weakness between the patients dominant vs nondominant side. Explain why diplegic patients show little to no difference between their dominant or nondominant side

A

Diplegic patients show no difference between sides because both lower limbs are affected so they both have weakness or paresis

47
Q

Regarding children with CP, are their hip extensors or hip flexors stronger?

A

Hip flexors

48
Q

Regarding children with CP, there will usually always be noticeable weakness in which muscles?

A

Glutes

49
Q

In the EMG of isometric testing of quadriceps in typical developing and children with CP, the child with CP showed activation of both the hamstrings and the quadriceps when asked to extend the leg from a flexed position… explain what this is indicative of.

A

The EMG of children with CP the co-contraction occurring between the hamstring and quadricep. The quadricep has to fight against the activation of hamstring which also demonstrates poor selective control.

50
Q

What term is defined as a muscle’s resistance to passive stretch

A

muscle tone

51
Q

What are the two types of muscle tone

A

hypertonicity and hypotonicity

52
Q

Spasticity and rigidity are related to (hypertonicity/hypotonicity)

A

hypertonicity

53
Q

flaccidity is related to (hypertonicity/hyptonicity)

A

hypotonicity

54
Q

Spasticity is described as velocity ______ resistance to passive stretch

A

dependent

55
Q

Rigidity is described as velocity _____ resistance to passive stretch

A

independent

56
Q

What is the term used to describe a muscle that has absolutely no resistance to stretch

A

flaccidity

57
Q

What is the definition of hypertonicity

A

increased resistance to passive stretch

58
Q

What is the definition of hypotonicity

A

decreased resistance to passive stretch

59
Q

What does the term velocity dependent mean

A

Speed influences the resistance. The faster you move a muscle, the more resistance you feel

60
Q

What does the term velocity independent

A

Speed does not influence the resistance, you can move fast or slow and the resistance will be the same

61
Q

Is flaccidity velocity dependent or velocity independent

A

velocity independent

62
Q

Is spasticity velocity dependent or velocity independent

A

velocity dependent

63
Q

Is rigidity velocity dependent or velocity independent

A

velocity independent

64
Q

What is the spasticity “trash can” referring to?

A

Hypotonicity

65
Q

What is the term that is used to refer to a single diagnosis that is commonly used but actually encompasses multiple separate impairments

A

trash can

66
Q

True or False:

Spasticity is a term that gets thrown in the “trash can”

A

true

67
Q

What type of patients usually present with mild to moderate spasticity

A

down syndrome patients

68
Q

Spasticity is often used in the clinic to refer to what what 6 terms

A
  1. Hyperactive stretch reflex
  2. Abnormal limb posture
  3. Excessive co-activation
  4. Associated movements
  5. Clonus
  6. Stereotypical synergy patterns
69
Q

Regarding spasticity hypothesis, the primary hypothesis is that changes in the _____ activity produces _____ responses of the segmental stretch reflex

A

descending; abnormal

70
Q

Describe the differences between Rymer et al. and Thilmann et al. hypotheses about spasticity

A

Rymer suggested that when you provide a passive stretch, the body provides resistance to protect itself, so with spasticity there is a decreased threshold.

Thilmann suggested that spasticity is actually an early and prolonged activation that is just proactive more than it is active

71
Q

What is the impact of spasticity on function

A

During a concentric contraction of the agonist, the antagonist has an excessive activation of the stretch reflex and does not lengthen normally, so the concentric contraction of the agonist is more difficult to complete

72
Q

What seems to be the biggest problem on function in patients with spasticity

A

poor selective control

73
Q

What other problems usually accompany spasticity?

A

paresis, abnormal reciprocal inhibition, impaired coordination of muscle synergies

74
Q

____ ____ are coupling of muscle firing into classic patterns of movement that are not ideal

A

abnormal synergies

75
Q

True or False:

Patient with abnormal synergies can often change the coupling of muscles depending on the task

A

False, the coupling of motion cannot be changed

76
Q

What type of abnormal synergy is usually presented in patients after a stroke

A

an upper flexor synergy

77
Q

What is the movement being made in an upper flexor syngery

A

when the elbow flexes, the shoulder will abduct along with some scapular retraction

78
Q

What is the term used to describe why patients cannot change the coupling of motion with abnormal synergies

A

Disassociation or a lack of fractionalization

79
Q

______ is the inability to produce movement in one joint without simultaneously producing movement in another

A

disassociation

80
Q

What is the definition of coactivation?

A

The simultaneous contraction of the agonist and antagonist during functional movement

81
Q

____ is commonly seen in early learning of skilled movements in neurologically intact children and adults, but diminishes as the skill is learned

A

coactivation

82
Q

True or False:

Following neurological injury, coactivation is seen again and again or may not diminish with recovery

A

true

Motor Control (11 decks)

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