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Phys Dys 2 > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Motor skills

A

observable, goal directed actions during daily life tasks during interaction with objects and the environment

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2
Q

motor learning

A

development of a skill and modification of movement patterns over time

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3
Q

motor control

A

ability to produce movement in response to activity and environmental demands

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4
Q

motor control theory involves what

A

multisensory approach

learning as a result of neuroplasticity

cortical reorganization

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5
Q

movement information flow

A

motivation- limbic system
ideation- brain lobes
programming- premotor areas, basal ganglia
execution- motor cortex, spinal cord

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6
Q

Traditional Sensorimotor Approaches

A

Rood
Brunnstrom Movement Therapy
PNF
NDT

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7
Q

Rood Approach assumptions

A

normal muscle tone is a prerequisite to movement

motivation and repetition are necessary

sensory stimulation can be inhibitory or faciliatory

developmental sequences

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8
Q

Faciliatory Rood Treatments

A

quick stretch
maintained stretch
vibration
approximation
light touch
brushing
manual contact

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9
Q

inhibitory Rood treatment

A

prolonged, firm stretch
firm pressure on tendon
icing for long period
neutral warmth
maintained touch
slow stroking

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10
Q

Brunnstrom assumptomes

A

use for patients with CVA and stroke recovery

regression to older pattern of movements

stages of motor recovery

change in muscle tone and reflexive movements are normal in recovery

requires muscles to work synergistically

intervention focuses on progressing client through stages

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11
Q

Brunnstrom Stages of recovery

A

1- tone is flaccid, no voluntary movement
2- synergies can be elicited reflexively, spasticity developing
3- begin voluntary movements, spasticity may be significant
4-spasticity decreases, movement starting to deviate from synergy patterns
5- further decreased tone, increased ability to perform complex movement patterns
6- tone nearly normal with ability to do complex combinations of isolated movement
7-normal speed and coordination

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12
Q

treatment goals of brunnstrom stages 1-2

A

facilitate increased tone

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13
Q

treatment goals of brunnstrom stages 2-3

A

assist client in achieving full voluntary control of limb synergies and use these in functional activities

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14
Q

treatment goals of brunstrom stages 4-5

A

break away from limb synergies and begin more isolated complex patterns of movement. tone should be decreasing

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15
Q

treatment goals of brunstrom stages 5-6

A

develop more complex isolated movements and increase speed of movement

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16
Q

treatment goals of brunnstrom stages 7

A

client demonstrates normal isolated complex movements

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17
Q

PNF

A

awareness of body position

includes diagonal movement patterns and crossing midline

creates balance between agonists and antagonists

alternates between flexion and extension

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18
Q

PNF diagonal 1

A

start across up, then straight down

brushing hair on opposite side of head

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19
Q

PNF diagonal 2

A

start straight up, the across down

putting on a seatbelt

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20
Q

NDT

A

improve postural control and movement

handling techniques, weight bearing, avoidance of negative sensory input

handling occurs at key points of proximal control

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21
Q

Task Oriented Approach ideas

A

learning process requires practice, feedback, understanding goals, motivation

cognition is important

practiced tasks rather than exercises

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22
Q

Task oriented approach principles

A

use real objects
whole task practice
practice functional tasks
constrain degrees of freedom

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23
Q

dystonia

A

abnormal tone

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24
Q

flaccidity

A

absence of tone

no voluntary movement

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25
Q

hypotonicity

A

low tone
muscle feels soft, little resistance to movement

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26
Q

hypertonicity

A

increased muscle tone

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27
Q

hypertonicity vs spasticity

A

hypertonicity– elastic properties of connective tissue; response to passive stretch

spasticity– neural change due to stretch reflex; velocity dependent

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28
Q

clonus

A

involuntary contraction and relaxation of spastic muscles

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29
Q

rigidity

A

increase of muscle tone of agonist AND antagonist

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30
Q

lead pipe (parkinson’s) rigidity

A

constant resistance

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31
Q

cogwheel (parkinsons) resistance

A

rhythmic “give” in resistance

tremor and rigidity

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32
Q

Decerebrate regidity

A

extensor posturing of limbs and neck

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33
Q

decorticate rigidity

A

flexor posturing of UE and extensor posturing of LE

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34
Q

Motor return after stroke

A

proximal to distal

flexion then extension

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35
Q

Dysmetria

A

inability to judge distance leading to over or under shooting target

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36
Q

Dysdiadochokinesia

A

impaired ability to complete rapid alternating movements

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37
Q

Ataxia

A

incoordination or clumsiness of movement

tremor, shakiness, balance

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38
Q

tremor

A

shakiness

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39
Q

4 general categories of motor performance

A

balance

standing up/sitting down

walking

reach and manipulation

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40
Q

ways of initiating functional mobility

A

positioning
bridging
supine to sit
scooting in sitting

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41
Q

which way should you roll towards when getting out of bed

A

the weak side

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42
Q

what is the biomechanical approach to splinting

A

maintain and increase length of soft tissues

position hand to assist in functional activities

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43
Q

What is the neurophysiological approach to splinting

A

reflex inhibition

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44
Q

splint wearing schedule

A

start with 30-60 min and check for redness/pressure areas

goal of 6-8 hours alternating 2 hours on/2 hours off

night time as tolerated

during day for functional splints

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45
Q

Basic vision screen includes what

A

acuity testing

visual fields testing

oculomotor testing

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46
Q

what is acuity testing

A

ability of the eye to distinguish detailed info

size and contrast

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47
Q

what is visual field testing

A

the total area of vision

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48
Q

what is oculomotor testing

A

ability of eyes to work together, eye muscles

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49
Q

what are the two types of acuity

A

distance acuity– ability to see at a distance

near acuity– distance to see things close to eye

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50
Q

how is visual acuity measured

A

eye chart with letters getting progressively smaller

assess both eyes together then one at a time

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51
Q

which vision acuity is required for driving

A

20/40

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52
Q

which vision acuity is considered low vision

A

20/60

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53
Q

which vision acuity is considered legal blindness

A

20/200

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54
Q

signs of a visual field deficit

A

narrow scope of scanning

slow scanning toward deficit

hesitant with functional mobility

holds head to one side

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55
Q

strabismus

A

eye is unable to move in direction of paretic muscles or cannot maintain central position of

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56
Q

what is diplopia

A

double vision

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57
Q

ptosis

A

droopy eyelid

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58
Q

what is visual pursuits

A

ability to follow a moving object smoothly

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59
Q

visual fixation

A

ability to maintain vision on a stationary object

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60
Q

saccades

A

ability to adjust from one stationary object to another

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61
Q

convergence

A

ability to attend to objects moving towards the eyes

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62
Q

signs of unilateral spatial neglect

A

failure to respond or orient to stimuli on one side of the body

head turned away from one side

when asked to look that way does not

collides with or ignores objects on one side

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63
Q

visual neglect

A

inability to see things on one side of the

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64
Q

personal neglect

A

impaired ability to attend to body

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65
Q

spatial neglect

A

impaired ability to attend to space around the body

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66
Q

peripersonal neglect

A

space within reaching distance

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67
Q

extrapersonal neglect

A

space beyond reaching distance

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68
Q

ways to test visual neglect

A

line bisection, albert’s test, clock draw

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69
Q

Apraxia

A

perception impairment causing dysfunction of purposeful movement

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70
Q

dressing apraxia

A

inability to plan effective motor action during dressing

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71
Q

ideomotor apraxia

A

inability to create plan and carry out but can perform gestures or pretend to use the tool

72
Q

ideational apraxia

A

inability to use real objects appropriately

73
Q

constructional apraxia

A

inability to copy shapes accurately

74
Q

agnosia

A

inability to interpret senses and therefore recognize objects, people and sounds

75
Q

Cognition relies on the integration of what

A

sensory systems
language
visual systems
perceptual systems

76
Q

methods of arousal

A

noxious stimuli
cold wash cloth
change position
tactile and verbal stimulation

77
Q

screening for orientation

A

self
place
time
why are they here

78
Q

orientation memory usually returns in what progression

A

person, place, time

79
Q

Hierarchy of Attentional processes

A

Arousal
sustained
selective
alternating
divided

80
Q

stages of memory

A

attention
encoding
storage
retrieval

81
Q

working memory

A

keep track of current conversation

82
Q

declarative memory

A

event based. recalling past facts and events

83
Q

procedural memory

A

ability to remember how to perform an activity

84
Q

prospective memory

A

ability to remember intention of activities required for future

85
Q

grading of cues

A

indirect general cues
gestural guidance
specific cue
tactile cues

86
Q

executive function impairments

A

working memory
initiation
inhibition
flexibility
organization

87
Q

ischemic stroke

A

a clot blocks blood flow to an area of the brain

88
Q

hemorrhagic stroke

A

bleeding occurs inside or around brain tissue as a result of a broken blood vessel

89
Q

ischemic embolic stroke

A

when a blood clot travels from somewhere else and ends in the brain

90
Q

ischemic thrombotic stroke

A

clot forms inside the wall of an artery forming the brain

91
Q

common causes of hemorrhagic stroke

A

high BP
aneurysm
AVM

92
Q

transischemic attack (TIA)

A

temporarily restricted blood flow to the brain

93
Q

difference between a TIA and CVA

A

TIA symptoms last less than 24 hours

CVA symptoms last longer than 24 hours

94
Q

What is Tissue plasminogen activase (TPA)

A

clot buster than can be used within 3 hours of the oncet of symptoms for an ischemic stroke

95
Q

global aphasia

A

loss of all language skills

96
Q

brocas aphasia

A

expressive aphasia. can understand well but has trouble expressing words

97
Q

wernicke’s aphasia

A

receptive aphasia. do not understand what words mean

98
Q

Long term Care hospital

A

acute care hospital with anticipated longer length of stay

99
Q

Sub-acute/transitional Care

A

requires more intensive nursing care than SNF but not quite acute care

30-90 min of therapy

stay is 7-35 days

100
Q

inpatient rehab facility

A

intense multidisciplinary therapy

tolerate 3 hours of therapy 5-7 days a week

101
Q

SNF

A

24 hr care available
therapy as needed
medically stable

102
Q

home health care

A

patient discharges home with skilled care from health services

must be homebound

103
Q

outpatient

A

discharge home but would benefit form continued therapy services

104
Q

hospice

A

end of life care
life expectancy is less than 6 months

105
Q

What is ALS

A

progressive disease affecting the UMN and LMN

106
Q

Signs and symptoms of ALS

A

speech/swallowing difficulties

asymmetrical

may begin in hands

motor dysfunction

107
Q

Guillian- Barre’ Syndrome

A

axonal demyelination of peripheral nerves

108
Q

phases of guillan barre syndrome

A

acute inflammatory progressive phase

plateau phase

progressive recovery phase

109
Q

acute inflammatory progressive phase of GBS

A

weakness in 2 limbs

reaches peak 2-4 weaks

ventilation required for 20-30-%

can be life threatening

110
Q

plateau phase of GBS

A

no significant change which can last for days or weeks

greatest disability present at this phase

111
Q

Progressive recovery

A

remyelination and axonal regeneration

recovery starts at head then proceeds distally

50% expereince return of normal funciton

112
Q

Symptoms of GBS

A

quickly progressing

symmetrical weakness

starts with feet

sensory loss or hypersensitivity

cognition remains intact

113
Q

Huntington’s Disease

A

Progressive breakdown of brain nerve cells due to genetic gene

114
Q

Classic symptoms of PD

A

tremor
Bradykinesia
Decreased Balance
Rigidity

115
Q

What are Hoehn and Yahr Scale stages

A

Stages of Parkinson’s disease

116
Q

Hoehn and Yahr Scale stage 1

A

Unilateral involvment only with minimal functional disability

117
Q

Hoehn and Yahr Scale stage 1.5

A

unilateral and axial involvement

118
Q

Hoehn and Yahr Scale stage 2

A

Bilateral or midline involvement without balance issues

119
Q

Hoehn and Yahr Scale stage 2.5

A

mild bilateral disease with recovery on the pull test

120
Q

Hoehn and Yahr Scale stage 3

A

Bilateral disease with mild to moderate disability with impaired postural reflexes

physically independent

121
Q

Hoehn and Yahr Scale stage 4

A

severely disabling but still able to walk or stand unassisted

122
Q

Hoehn and Yahr Scale stage 5

A

confinement to bed or wheelchair unless aided

123
Q

Early stages of PD on Hoehn and Yahr Scale

A

stages 0-2.5

124
Q

Complicated stages of PD on Hoehn and Yahr Scale

A

stages 3-4

125
Q

Late stages of PD on Hoehn and Yahr Scale

A

stage 5

126
Q

What is LSVT

A

PD program to increase mobility and communication

127
Q

LSVT program protocol

A

4 consecutive days a week for 4 weeks

60 minute sessions

high intesnsity and frequency

128
Q

3 key features of LSVT

A

Target– hypo- and brady kinesia with sensory disorder, internal cueing, neuropsychological

Mode– intensive and high effort

calibration– address mismatch between perception of movement and how others perceive it

129
Q

What is MS

A

inflammation damages myelin of nerves of CNS

130
Q

Relapsing-remitting MS

A

relapses of worsening function followed by partial or complete improvement

131
Q

when does most recovery occur after a CVA

A

95% occurs within 13-15 weeks

132
Q

when is there slower recovery following a CVA

A

6 months to 3 years

133
Q

Most effective treatment for CVA

A

task specific
repetitive
intense
active
evidence based
function based

134
Q

what is a SAFE score

A

shoulder abduction and finger extension are used to predict UE function

if greater than 8 w/in 72 hrs then good return in 3 months

135
Q

Goals for Motor recovery brunnstrom stage 1-2

A

preserve soft tissue integrity and joint alignment

facilitate muscle activity

incorporate into activity– prevent disuse

136
Q

Task specific training protocol

A

4 days a week

one repetition= reaching, grasping, manipulation, releasing

300 reps in 60 min OR 3 activities 20 min each

137
Q

when is task specfic training too easy or too hard

A

less than 50 reps in 15 min is too difficult

more than 100 in 15 min is too easy

138
Q

what is the most common complication after a stroke

A

shoulder pain

139
Q

what is shoulder pain after a stroke caused by

A

CRPS
decreased sensation
subluxation
muscle spasticity
soft tissue injury

140
Q

what is winging

A

occurs when the muscles holding the scapula against the abdominal wall are weakened or paralyzed

141
Q

what is subluxation

A

when 2-3 fingers can fit between the acromion process and humeral head

142
Q

when does edema occur following a stroke

A

between 2 weeks and 2 months post CVA

143
Q

what does edema following a stroke result from

A

loss of muscle activity
venous congestion
dependent positioning

144
Q

Causes of traumatic SCI

A

MVA, gunshot wounds, falls, sports

145
Q

causes of Non-traumatic SCI

A

tumors, MS, cancer

146
Q

tetraplegia

A

all 4 limbs and trunk involved in SCI

147
Q

Paraplegia

A

paralysis or weakness affect only the LE, trunk, hips

148
Q

How are SCI classified

A

the last fully functioning neurologic segment of the psinal cord

149
Q

complete SCI

A

total paralysis and loss of sensation in tracts below the lesion

150
Q

incomplete SCI

A

some degree of preservation of sensory or motor nerve pathways below the lesion

151
Q

ASIA grade A

A

Complete injury

no motor or sensory function

152
Q

ASIA grade B

A

incomplete injury

sensory but not motor function is preserved

153
Q

ASIA grade C

A

incomplete injury

motor function is preserved but most muscles are below MMT 3

154
Q

ASIA grade D

A

incomplete injury

motor function is preserved and most muscles are about MMT 3

155
Q

ASIA grade E

A

all motor and sensory functions are normal

156
Q

central cord syndrome

A

LMN weakness at level of injury

UMN spasticity below level of injury

157
Q

Managing BP in SCI

A

raise head to decrease BP

Lower head to increase BP
OR use abdominal or leg wraps

158
Q

symptoms of Autonomic dysreflexia

A

high BP
pounding headache, flushed face
sweating above injury level
slow pulse
goose bumps below level of injury

159
Q

What causes autonomic dysreflexia

A

irritant below the level of injury

wrinkles, tight pants, bowel or bladder distension, pressure

160
Q

at what spinal level does autonomic dysreflexia occurr

A

T6 and higher

161
Q

What to do for autonomic dysreflexia

A

raise patient head
attempt to locate irritant
loosen clothing
check catheter

162
Q

Splinting goal for C1-C4

A

positioning splints to protect joints

163
Q

splinting goal for C5

A

positioing and enable participation

164
Q

C6 splinting goals

A

preserve tenodesis and enable participation

165
Q

splinting goals for C7-8

A

prevent deformity

166
Q

at what level can tenodesis be performed

A

C6

167
Q

how to facilitate tenodesis

A

never stretch fingers all the way
extend wrist with fingers flexed
flex wrist with fingers extended

168
Q

how is intermittent catheterization performed

A

done every 3-4 hours

169
Q

how often should weight shifts occur

A

1-2 minutes every 30 min OR 15 sec every 15 min

170
Q

How to score ASIA scale

A

NOOON is complete injury

last level of 3+ motor or all 2 for sensory

171
Q

Glasgow Coma Scale coma classifications

A

13-15 = mild concussion
9-12=moderate
less than 8= severe

172
Q

diffuse injury TBI

A

occurs follwing rapid movement of the head

173
Q

focal injury TBI

A

brain contusion or laceration when the brain hits the skill and scrapes against irregular bony structures

174
Q

open focal injury

A

object enters the cranial cavity causing penetration

175
Q

closed focal injury

A

crush injury or rapid acceleration/develeration

Phys Dys 2 (1 decks)

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