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Neuromuscular Rehab 1 > Movement Disorders > Flashcards

Movement Disorders Flashcards

1
Q

Quadriplegia/Tetraplegia

A

whole body involved in varying degrees

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2
Q

Diplegia

A
  • Whole body involved but LE> UE symmetrical or asymmetrical distribution
  • Good head control and min/mod involvement of UE
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3
Q

Hemiplegia

A

One side (face, UE, LE) involved

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4
Q

Monoplegia

A

one extremity involved

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5
Q

Paraplegia

A
  • Used more for spinal cord
  • Involvement of trunk & LE to varying degrees
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6
Q

Name some Objective Muscle Tone Grading Scales

A
  • Modified Ashworth Scale
  • Tardieu Scale
  • Wilson Howle Assessment of Motor Tone
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7
Q

What are the structures involved in spasticity?

A
  • Motor cortex or white matter projections to/from corticosensorimotor areas of brain, pyramidal system, corticospinal tracts
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8
Q

True or False: Spasticity would be characterized by an increase in muscle tone of muscle groups

A

True

Patients would present with hypertonicity

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9
Q

With spasticity when may tension increase?

A
  • Increased tension when lengthen (spastic catch/clasp-knife response)
  • Increased with rate/velocity & position change
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10
Q

True or False: A patient with spasticity will present with firm/tense on palpation, and increased DTR/MSR

A

True

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11
Q

In a patient with spasticity PROM will be?

A

Decreased with atypical firm end feel

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12
Q

A patient with spasticity will have (BLANK) co- contraction and (BLANK) reciprocal inhibition

A
  • Increased
  • Decreased
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13
Q

T/F: Spasticity presents with distribution of either more flexors or extensors and usually asymmetrical

A

True

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14
Q

Why may a patient with spasticity have disuse atrophy?

A

Because they are only working through a small range activity

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15
Q

What structures are involved when a patient has rigidity?

A

Basal ganglia

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16
Q

What is rigidity?

A
  • Increased muscle tone of muscle groups that is continuous or sometimes intermittent
  • Sustained muscle contraction even when relaxed
  • Increased tension uniformly & immediately as lengthens
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17
Q

What will occur in a patient with rigidity with a change of rate/velocity and position?

A
  • No change or increased DTR/MSR
  • No change
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18
Q

How will PROM present as with a patient with rigidity? And how is the is distributions of flexors & extensor?

A
  • Decreased PROM with atypical firm end feel
  • More equal distribution of flexors & extensors & symmetrical
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19
Q

A patient with rigidity will have (BLANK) co contraction & (BLANK) reciprocal inhibition

A
  • Increased
  • Decreased
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20
Q

T/F: A patient with rigidity can present with disuse atrophy

A

True

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21
Q

What is lead pipe rigidity?

A

Constant resistance to movement throughout ROM

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22
Q

What is cogwheel rigidity?

A

Alternative episodes of resistance & relaxation through ROM

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23
Q

What is the broad definition of akinesia/hypokinesia/bradykinesia grouped together?

A

Disinclination of patient to use affected body part or do natural movement of those parts, no/slow imitation & execution of movement

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24
Q

What is the position of decorticate posture?

A
  • UE flex/ LE extend
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25
Q

What is the position of decerebrate posture?

A
  • UE extend/ LE extend
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26
Q

What is the position of opisthotonic?

A

Extreme extension positioning

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27
Q

What are the involved structures in a patient with hypotonicity/ atonia?

A

UMN system, cerebellum, unknown sites

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28
Q

A patient with hypotonicity/atonia will present with:
- (BLANK) muscle tone
- (BLANK) tension with lengthened
- (BLANK) DTR/MTR
- (BLANK) change with rate/velocity & position

A
  • Decreased
  • Decreased
  • Decreased
  • Possible change
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29
Q

A patient with hypotonicity/ atonia will present as (BLANK) on palpation?

A

Soft/ mushy

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30
Q

T/F: a patient with hypotonicity will have atrophy, weakness, decreased endurance & some tonic reflexes

A

True

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31
Q

What is flaccidity?

A

Motor & sensory loss, decreased DTR/MSR, atrophy, fasciculation & fibrillation, abnormal nerve conduction studies

32
Q

In a patient presenting with dyskinetic (dystonia/torsion spasm) what structures are involved?

A

Basal Ganglia

33
Q
A
34
Q

A patient with Dystonia/ Torsion spasm will present
- (BLANK) on palpation
- (BLANK) DTR/MSR
- (BLANK) PROM with (BLANK) end feel

A
  • Tense/firm on palpation
  • Increased DTR/MSR
  • Decreased PROM with firm end feel
35
Q

What is dystonia?

A
  • Persistent attitude or posture in one or other extremes of athetoid movement (flx,ext head, inverted foot, torsion of spine, grimace, forced eye closure)
    -Tends to be in large axial muscles (trunk & limb girdle)
36
Q

What are the involved structures in athetosis?

A

Basal ganglia
Extrapyramidal system

37
Q

Describe athetosis

A

Fluctuating/ changeable/ unfixed muscle tone

38
Q

What is choreoathetoid?

A

Involuntary, unpredictable small movement of head & distal extremities, some say large, jerky movements

39
Q

Athetosis presents as:
- ROM?
- Distribution?
- (BLANK) co contraction & (BLANK) reciprocal inhibition
- Reflexes?
- Strength?

A
  • ROM not affected
  • Asymmetrical distribution
  • Decreased co contraction & increased reciprocal inhibition
  • Primitive/ tonic reflexes
  • Decreased strength
40
Q

What structures are involved in chorea?

A

Basal Ganglia

41
Q

Chorea presents as in regards to:
Muscles tone?
Movements?
PROM?

A
  • Decreased muscle tone to fluctuating muscle tone
  • Dance of involuntary arrhythmic movements of a forceful, rapid, jerky type, simple or complex patterns of movement
  • PROM not as affected
42
Q

What structures are involved in ataxia?

A

Cerebellum, sensory tracts

43
Q

How does Ataxia present in regards to:
- Tone?
- Movement?

A
  • Low postural tone
  • Abnormal volitional movement (dyssynergia, asynergia, decompensation, dysmetria, dysdiadochokinesis, intention tremor, titration)
44
Q

How does ataxia present in regard to mobility and reflexes?

A
  • Hypermobile
  • Primitive reflexes modified in children
45
Q

What are the involved structures in apraxia?

A

Cerebellum or other CNS

46
Q

What is the presentation of Apraxia in regards to movement and tone?

A
  • Impaired voluntary learned movement, unable to perform purposeful movement not accounted for by cognitive impairments or major motor diagnosis
  • Challenges with timing/sequences of movement
  • Mild hypotonicity
47
Q

What are the standardized outcome measures for Cerebral Palsy?

A
  • Gross Motor Function Classification System for Cerebral Palsy
  • Functional Mobility Scale
48
Q

What is the Gross Motor Functional Classification System?

A

Standardized gross motor classification for children with CP up to 18 y/o

49
Q

What is examined in the GMFCS?

A

5 levels based on child’s self-initiated movement (abilities) in consideration of:
- Sitting
- Walking
- Wheeled Mobility

Distinction between levels made on ability & need for AT to participate across home, school & community

50
Q

T/F: GMFCS includes a family report questionnaire

A

True

51
Q

What is a body support walker?

A
  • Mobility device that supports the pelvis & trunk
  • Child positioned in walked by another person
52
Q

What is hand-held mobility device?

A

Do not support the trunk

53
Q

What is physical assistance?

A

Another person manually assists child/youth to move

54
Q

What is powered mobility?

A

Child or youth actively controls the electrical switch or joystick

55
Q

What is self - propels manual wheelchair?

A

Child/youth actively used arm & hands to propel them

56
Q

What is transported?

A

A manually pushes a mobility device

57
Q

What does it mean if a child walks?

A

No physical assistance from another person or any use of hand held mobility device

58
Q

Describe the general heading of level 1 of the GMFCS

A

Walks without limitations

59
Q

What is the general heading for level 2 of GMFCS?

A

Walks with limitations

60
Q

What is the general heading for level 3 of GMFCS?

A

Walks using a hand held mobility device

61
Q

What is the general heading for level 4 of GMFCS?

A

Self mobility with limitation, may use powered mobility

62
Q

What is the general heading for level 6 of GMFCS?

A

Transported in a manual wheelchair

63
Q

What is the distinction between level 1 & 2 of the GMFCS?

A

Compared to children in Level 1, children in level 2 have limitations:
- Walking long distances & balancing
- May need hand held mobility device when first learning to walk
- May use wheeled mobility when traveling long distances outdoors or in community
- Require use of railing to walk up and down stairs
- Not capable of running & jumping

64
Q

What is the distinction between levels 2 & 3 of the GMFCS?

A
  • Children in LEVEL 2 are able to walk without hand held device after age of 4 (may choose too at times)
  • Children in LEVEL 3 need a hand held mobility device to walk indoors & use wheeled mobility outdoors & in community
65
Q

What is the distinction between levels 3 & 4?

A

Children in level 3:
- Sit on their own or require limited external suport
- independent in standing transfers
- Walk with hand held device

Children in LEVEL 4:
- sit supported but self mobility is limited
- More likely to be transported in manual wheelchair or powered mobility

66
Q

What is the distinction between levels 4 & 5?

A

Children in Level 5:
- Have severe limitation in head & trunk control
- Require extensive assisted technology & physical assistance
- Self mobility is achieved only if they can learn to operate a powered wheel chair

67
Q

What is the functional mobility scale and what does it afford the child?

A
  • Short standardized mobility assessment for children w/ CO ages 4-18
  • Affords the child use of assistive device or orthoses
68
Q

What are children scored on and how are they scored using the Functional Mobility Scale?

A
  • Parent reports on child’s ability to ambulate at 3 distance to represent natural environment
  • Scale rating 1 to 6 with higher scored indicating improved functional ambulation skills
69
Q

What does it mean if a child is rated a 1 using the Functional Mobility Scale?

A
  • Uses wheelchair
  • May stand for transfers
  • May do some stepping support by another person or using a walker/frame
70
Q

What does it mean if a child is rated a 2 using the Functional Mobility Scale?

A
  • Uses walker or frame
  • Without help from another person
71
Q

What does it mean if a child is rated a 3 using the Functional Mobility Scale?

A
  • Uses forearm crutches without help from another person
72
Q

What does it mean if a child is rated a 4 using the Functional Mobility Scale?

A
  • Uses canes without help from another person
73
Q

What does it mean if a child is rated a 5 using the Functional Mobility Scale?

A
  • Independent on level surface
  • Does not use walking aids or need help from another person
  • Requires a rail for stairs
74
Q

What does it mean if a child is rated a 6 using the Functional Mobility Scale?

A
  • Independent on all surfaces
  • Does not use any walking aids or needs help from another person when walking over surfaces including uneven ground, curbs ets
75
Q
A

Neuromuscular Rehab 1 (3 decks)

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