hemiplegia, CNS, MS, CP Flashcards
Progressive CNS disorders
Parkinson’s
MS
non progressive CNS
hemiplegia
spinal cord injuries
cerebral palsy
vigorously extend limbs while arching back
triggered by stimulation or pressure to the back of the head or trunk
extensor thrust pattern
teeth clenched w extreme force
can accompany extensor thrust
bite reflex
stiffening of legs in ext or tight flexion
occurs in response to pressure on ball of foot or stretching of plantar surface by dorsiflexing toes
positive supporting reaction
stimulus to palmar surface of hand can elicit grasp reflex which results in withdrawal of entire arm into tightly flexed position
grasp reflex
flexion of head and trunk toward affected side
shoulder depressed
scap retracted
internal rotation and adduction of GH
elbow flexed
forearm pronated
wrist flexed
fingers w thumb adduction
flexor pattern of upper body
slight ext of neck and head w trunk bent away from affected
scap retracted
IR of GH
elbow rigidly extended
forearm pronated
hand in flexion forming tight fist, flexion at DIP/PIP
palm faces backwards
extensor pattern of upper body
abduction, external rotation, flexion of hip
flexion of knee
dorsiflexion and inversion of ankle
flexion of toes
flexor pattern of lower body
adduction, internal rotation, ext of hip
extension of knee
PF and inversion of ankle
extensor pattern of lower body
gait pattern w hemiplegia and MS
circumduction
gait pattern w parkinsons
festinating
resistance of a limb to passive movement, espec outside of the clients normal pattern of spasticity
spasticity
ratchet like movement on affected limb, interuppted by a tremor
movement stops, then resumes
cycle is repeated throughout ROM
cogwheel rigidity
(parkinsons)
palpate as a uniform resistance throughout the ROM of affected joint
lead pipe rigidity
resistance to movement, generally equal resistance from agonist and antagonist mm’s - leads to painful cramping, pain, numbness, achiness
rigidity
Non progressive condition of paralysis on one side of the body as a result of brain lesion
Occurs on one side of the body, opposite to the side on which the lesion has occurred
hemiplegia
head trauma, brain tumor, cerebral thrombus due to aneurysm and cerebral embolism can all result in…
hemiplegia
painful condition w shoulder in adduction and internal rotation combined w retracted scapula due to reflex patterns and spasticity
flaccidity in sh girdle mms and poor positioning of the persons body often resulting in an inferior subluxation of humerus
hemiplegic shoulder
decreased ROM of shoulder and hand, followed by throbbing pain and edema
(elbow remains symptom free)
shoulder hand syndrome
usually occurs w a lesion of premotor cortex
what is the most common pattern in hemiplegia
flexor pattern in upper limbs combined w extensor pattern in lower limbs
passive and active movement are performed on the affected and unaffected side simultaneously
whole body integration
damage to immature brain from hypoxia, ischemia, trauma or rupture of of cerebral blood vessels, toxicity and infection
cerebral palsy
4 main types of movement disorders
- spastic - most common, increased tone, increases w pain, stress (internal rotation of hip is commonly seen)
- athetoid - slow movements, increase w voluntary movement and stop w sleep
- ataxic - poor coordination/balance
- mixed - spastic and athetoid
what does an injury to the cerebellum result in
poor coordination and balance
quick movements, uncontrolled and w/o purpose, does not stop w sleep
choreiform
what does an injury to the cerebral cortex look like
spasticity , stiff muscles
one arm or leg affected
monoplegia
usually both legs affected
diplegia
3 limbs affected
triplegia
one arm and leg affected on same side of body
hemiplegia
shortening of Achilles tendon resulting in reduced dorsiflexion, leading to bony changes the foot
equinus deformity
seen in cerebral palsy
demyelination resulting in scar tissue formation that affects nerve transmission
sclerotic plaques develop at sites of demyelination
multiple sclerosis
mild form of MS, few exasperations followed by complete recovery, asymptomatic
benign MS
repeated cyles of exasperation and remission, causes only mild disability
benign or mild attack remitting MS
repeated cycles of exasperation and remission, results in increased sx following attacks
chronic progressive attack remitting
rapid progression of sx and disability, can be fatal in a few years
acute progressive MS
where are intention tumors seen
MS
sensory and autonomic changes in MS
proprioception impairment, paresthesia, cold extremities, sweating abnormalities, edema
MS CI’s
painful or fatiguing techniques
extreme heat / large applications of heat
uncontrollable movements (dyskinesia) is associated w damage to what part of the brain
basal ganglia
poor balance and coordination (ataxia), is associated w damage to what part of the brain
cerebellum
assessment observation in cerebral palsy
AROM & PROM will reveal a decrease in ROM if spasticity present
if athetoid present = ROM testing may not yield useful results
assessment observations seen in hemiplegia
AROM / PROM will show decreased ROM if spasticity present
mm testing will not be useful testing if spasticity present
