Fine motor (week 4) Flashcards
The function of the hand: Prehensile
(grasp/capture)
- Shape itself around objects
- Shape itself on top of surfaces
- Accommodation (Erhardt)
Function of hand: Non-prehensile
Pushing, lifting with whole hand
Function of hand: Perceptual
Haptic sense
Active touch
Stereognosis
Motor requirements for hand function
- Dynamic palmar arches
- Combined movements of wrist and forearm
- Reach
- Weight bearing and proximal stability
Motor tracks: Brainstem
posture and proximal control
Motor tracks: reticulospinal tract
Pontine, reticulospinal connections. Exert generalized inhibition of muscles in body.
Motor tracks: Vestibulospinal tract
Muscle tone, postural control, adjustment, stability and balance, extensors
Motor tracks: Rubrospinal tract
(Red nucleus)
-Spinal flexors
Motor tracks list
Brainstem, reticulospinal tract, vestibulospinal tract, rubrospinal tract
Cortex
Related to precision, speed, and isolated distal movements (Corticospinal/pyramidal)
Sensory tract: Dorsal column medial lemniscus (DCML)
Touch, vibration, 2-point discrimination and proprioception
Sensory tract: Anterolateral/Spinothalamic tract
Pain and temperature
Bones in hand
27
Extrinsic muscle feature
Muscle bellies are in forearm
Intrinsic muscle features
Distal to wrist joint, originate in hand, form arches of hand
Palmar arches types
Transverse
Longitudinal (proximal and distal)
Oblique
Grasp types with no thumb opposition
Hook
Power/palmar
Lateral pinch
Grasp type with thumb opposition
Fine pincer/tip pincer Pincer Tripod Cylindrical Spherical
Development of grasp
Grasp of dowel
Grasp of cube
Grasp of pellet
Development of release
Release of dowel or cube
Release of pellet
In-hand manipulation definition
The process of using one hand to adjust an object for more effective object placement in that hand prior to release
In-hand manipulation categories
Translation
Shift
Rotation
Translation in-hand manipulation
Finger to palm
Palm to finger
Shift in–hand manipulation
Occurs at the fingers and thumb pads with alternation of thumb and finger movements
Rotation in-hand manipulation
Simple rotation
Complex rotation
In-hand manipulation begins when?
Around 18 months
In-hand manipulation fully developed?
by 7 years
When do the greatest number of manipulation skills emerge?
Between 2 and 2.5 years old
Treatment NDT three steps
Inhibit (spasticity and primitive reflexes)
Facilitate (Normal movement patterns, postural alignment)
Sensory input (Deep pressure. Weight bearing)
Development of scissor use
- Shows interest
- Learns to hold open and close.
- Single snips at edge of paper
- Snips with forward motion (may not have force modulatioN)
- Lines, simple shapes
(2. 5-3 years)
Hand development in down syndrome
Hands 10-30% shorter
Only 23 bones
Bones slender and short and have poor calcification
Middle phalanx of 5the digit is small or absent (curved inward)
Crease 2 and 3 merged as one
Weak intrinsic muscles.
Hand development in CP
Spasticity: prolonged grasp reflexes, fisted hands, abnormal flexor pattern.
Flaccidity: Weak extrinsic and intrinsic muscles
Joint protection strategies
Scar management
Edema
ROM
