final Flashcards
flexion of head towards affected side
depression of shoulder
scapula retracted
IR & adduction of GH
elbow flexed
forearm pronated
wrist and fingers flexed
thumb adduction
=
flexor patter of upper body
adduction, ER, flexion of hip
knee flexed
dorsiflexion and inversion of ankle
toes flexed
flexor pattern of lower extremity
teeth clenched together w extreme force
bite reflex
ROM is interrupted by tremors stopping and starting through the movement
= what type of rigidity
cogwheel
what condition is “shoulder hand syndrome” associated w
hemiplegia
decreased ROM of the shoulder and hand followed w throbbing P and edema
elbow is symptom free
=
shoulder hand syndrome
poor coordination (damage to cerebellum) =
ataxic
A client with Multiple Sclerosis describes increasing symptoms following attacks, periods of
remission becoming less frequent =
chronic progressive attack remitting MS
anterior cord syndrome will present
bilateral motor pain and temperature losses
Pt w ms describes: between attacks symptoms either completely resolve or only mild disability remains
benign / mild attack remitting MS
When assessing a client w hemiplegia what might the pt present w around their shoulder
hemiplegic shoulder
pain in adduction and IR w retraction of scapula resulting in anterior sublux of GH
triggered by stimulation or pressure to the back of the head or trunk, person vigorously extends limbs/arches back
extensor thrust pattern
slight ext of pt’s neck and head w trunk bent away from the affected side, scapula retraction, IR of GH, elbow ext forearm pronation, hand/fingers in flexion
extensor pattern of upper body
adduction, IR and ext of hip, ext of knee, PF and inversion of ankle
extensor pattern of lower body
What type of rigidity - a uniform resistance through the ROM (palpated)
lead pipe
Seizure presents- blank stare, change in postural tone, short in time
petit mal
A central cord spinal injury involves what pattern of injury
mostly motor and sensory affected in the UPEXT w less effect to LEXT
Describe the onset of resting tremors in parkinsons
starts in one hand then in the foot/limb of same side
after time, the tremor presents on other side
pin rolling tremor
uncontrolled movement (injury to basal ganglia)
athetoid or dyskineisia
acute phase of hemiplegia after a stroke
mm on affected side will be flaccid, last for a few days → weeks, no spasticity or reflex patterns present
gait present with hemiplegia or MS
circumduction
occurs when loss of inhibition of alpha motor neuron firing
resistance of limb to passive movement
spasticity
stiffening of legs in ext or tight flexion
can occur in response to pressure on ball of foot or stretching of plantar surface by dorsiflexing toes
positive supporting reaction
ratchet-like movement of an affected limb, limb can be moved a short distance through ROM but movement is interrupted by a tremor, movement stops for a moment & then resumed again – cycle repeated throughout ROM
coghweel rigidity
decreased ROM of SH & hand, followed by throbbing P & edema – elbow remains symptom free – syndrome usually occurs with a lesion of the premotor cortex
shoulder hand syndrome
mild form, few exacerbations followed by complete recovery & client remains asymptomatic
benign MS
repeated cycles of exacerbation & remission, symptoms such as double vision, slurred speech, numbness & tingling anywhere in body can occur during these attacks
attack - remitting MS
results in increased symptoms following attacks, in some cases, remission periods become less & less frequent, disability increases continuously
chronic progressive attack remitting MS
rapid progression of symptoms & disability, can be fatal within a few years, more severe form of MS, least common
acute progressive MS
spinal cord begins from medulla oblongata, just superior to foramen magnum and ends at ___ where it becomes the ___ and then cauda equina
L2
conus medullaris
most vulnerable segments of spinal cord
C4-C6
T12-L1
difference between complete and incomplete spinal cord injury
complete - lesion results in total loss of function below level of lesion
incomplete - lesion results in some function below level of lesion
damage in the centre of the cord w the periphery of the cord unaffected
central cord syndrome
cause = hyperextension, usually C-spine, affects elderly w arthritic changes to spine
central cord syndrome impairement
motor and sensory abilities of upper limbs affected, mm weak or flaccid, LL spared or less affected
damage to one side of the cord
brown sequard syndrome
cause - stabbing and gunshot wounds
brown sequard syndrome impairement
on same side of lesion, decreased or absent motor function, proprioception, vibration and two point discrimination but normal P and temp perception
damage to the anterior spinal artery or anterior aspect of the cord, resulting in corticospinal & spinothalamic tract injury
anterior cord syndrome
cause - direct trauma, often hyperflexion injury
anterior cord syndrome impairement
variable bilateral loss of motor function & P, temp and crude touch perception, proprioception
3 main causes of cerebral palsy
- hypoxia and ischemia
- trauma to, rupture of, cerebral blood vessels
- toxicity and infection
most common type of polio
spinal poliomyelitis - inflammation & destruction of anterior horn cells may occur at any level of spinal cord
most serious type of polio
bulbar poliomyelitis
- involves cranial nerves and sometimes cardiorespiratory centre
poor prognosis
where are lesions most commonly found w MS
brain stem
cerebellum
spinal cord
what cranial nerves are most often involved in MS
optic
trigeminal
causes only mild disability when the attack subsides (MS)
benign or mild attack remitting
acute episode of exaggerated sympathetic response
evoked by painful stimuli in the abdomen/pelvic area
autonomic dysreflexia
occurs w lesion at T6 or above
- severe hypertension 300/160
- bradycardia
- sudden pounding headache
- considered an emergency
what do you do if autonomic dysreflexia occurs
place the client in upright position w the head raised up to 45 degrees
supportive or tight clothing is loosened
noxious stimuli is removed
medical attention is sought
resistance to movement in flexion, extension, rotation
rigidity
after a stroke , mms on affected side are flaccid & no spasticity/reflex pattern are present yet
acute phase hemiplegia
painful condition of shoulder - adduction, internal rotation, retraction of scapula
hemiplegic shoulder
often results in subluxation of humerus
decrease in ROM of sh and hand followed by throbbing pain and edema - elbow remains symptom free
shoulder-hand syndrome
One side of body involved. Usually rigidity or tremors are present. If symptoms are mild, no treatment is given. If they are moderate, massage and physio are helpful.
stage 1 parkinsons
Both sides of the body are involved. Moderate tremors, rigidity and bradykinesia are present. Balance is not affected. Levodopa drug therapy begins
stage 2 parkinsons
Significant tremors, rigidity and bradykinesia are present. Balance and walking are now impaired. Other symptoms include unsteadiness, dystonia and freezing.
stage 3 parkinsons
Increasingly severe disability results because of severe bradykinesia. While walking is still possible, there is marked impairment. Some assistance is required with ADL’s.
stage 4 parkinsons
There is a loss of ability to function independently. Person is immobile.
stage 5
anterior horns of the grey matter contain
lower motor neurons whos axons terminate in skeletal muscle
what horns contain sympathetic fibres from the ANS
lateral horns
what horns contain sensory fibers
posterior horns
what are the most vulnerable segments of the spinal cord
C4-C6 and T12-L1
results in total loss of function below the level of the lesion. There may be nerve breakage because the spinal cord is stretched, ischemia or total transection of the spinal cord
complete lesion
results in some function below the level of the lesion
incomplete lesion
lack of movement control
palsy
main causes of cerebral palsy
-hypoxia and ischemia
-trauma to or rupture of cerebral blood vessels
-toxicity and infection
least common form of cerebral palsy
ataxic
joints with least restriction are moved first followed by
those that are most restricted
if a pt with parkinsons is having a benign /essential tremors what does it look like
trembling in both hands, can spread to head and voice
progresses slowly w long periods of remission
occurs when hand is held in a particular position, like holding a cup
it does NOT occur at rest and will cease when limb Is supported
what is the cardinal sign to diagnose for parkinsons
bradykinesia
others are resting tremor or rigidity
what does polio attack
motor neurons in the brain stem and spinal cord
Ulcer stages:
full thickness damage, skin loss to subcutaneous
cavity is created
crust is eschar, thick, leathery necrotic tissue
stage 3
ulcer stages:
full thickness damage, necrosis to bone and mm
deep cavity w crust and leads to sepsis
stage 4
stiff mms (spasticity) associated w damage to or developmental differences in the ______
cerebral cortex
uncontrollable movements (dyskinesia) assciated w damage to ____
basal ganglia
athetoid
poor balance and coordination associated w damage to ___
cerebellum
ataxia
