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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
What is the position of decerebrate posture?
- UE extend/ LE extend
26
What is the position of opisthotonic?
Extreme extension positioning
27
What are the involved structures in a patient with hypotonicity/ atonia?
UMN system, cerebellum, unknown sites
28
A patient with hypotonicity/atonia will present with: - (BLANK) muscle tone - (BLANK) tension with lengthened - (BLANK) DTR/MTR - (BLANK) change with rate/velocity & position
- Decreased - Decreased - Decreased - Possible change
29
A patient with hypotonicity/ atonia will present as (BLANK) on palpation?
Soft/ mushy
30
T/F: a patient with hypotonicity will have atrophy, weakness, decreased endurance & some tonic reflexes
True
31
What is flaccidity?
Motor & sensory loss, decreased DTR/MSR, atrophy, fasciculation & fibrillation, abnormal nerve conduction studies
32
In a patient presenting with dyskinetic (dystonia/torsion spasm) what structures are involved?
Basal Ganglia
33
34
A patient with Dystonia/ Torsion spasm will present - (BLANK) on palpation - (BLANK) DTR/MSR - (BLANK) PROM with (BLANK) end feel
- Tense/firm on palpation - Increased DTR/MSR - Decreased PROM with firm end feel
35
What is dystonia?
- 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
What are the involved structures in athetosis?
Basal ganglia Extrapyramidal system
37
Describe athetosis
Fluctuating/ changeable/ unfixed muscle tone
38
What is choreoathetoid?
Involuntary, unpredictable small movement of head & distal extremities, some say large, jerky movements
39
Athetosis presents as: - ROM? - Distribution? - (BLANK) co contraction & (BLANK) reciprocal inhibition - Reflexes? - Strength?
- ROM not affected - Asymmetrical distribution - Decreased co contraction & increased reciprocal inhibition - Primitive/ tonic reflexes - Decreased strength
40
What structures are involved in chorea?
Basal Ganglia
41
Chorea presents as in regards to: Muscles tone? Movements? PROM?
- 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
What structures are involved in ataxia?
Cerebellum, sensory tracts
43
How does Ataxia present in regards to: - Tone? - Movement?
- Low postural tone - Abnormal volitional movement (dyssynergia, asynergia, decompensation, dysmetria, dysdiadochokinesis, intention tremor, titration)
44
How does ataxia present in regard to mobility and reflexes?
- Hypermobile - Primitive reflexes modified in children
45
What are the involved structures in apraxia?
Cerebellum or other CNS
46
What is the presentation of Apraxia in regards to movement and tone?
- 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
What are the standardized outcome measures for Cerebral Palsy?
- Gross Motor Function Classification System for Cerebral Palsy - Functional Mobility Scale
48
What is the Gross Motor Functional Classification System?
Standardized gross motor classification for children with CP up to 18 y/o
49
What is examined in the GMFCS?
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
T/F: GMFCS includes a family report questionnaire
True
51
What is a body support walker?
- Mobility device that supports the pelvis & trunk - Child positioned in walked by another person
52
What is hand-held mobility device?
Do not support the trunk
53
What is physical assistance?
Another person manually assists child/youth to move
54
What is powered mobility?
Child or youth actively controls the electrical switch or joystick
55
What is self - propels manual wheelchair?
Child/youth actively used arm & hands to propel them
56
What is transported?
A manually pushes a mobility device
57
What does it mean if a child walks?
No physical assistance from another person or any use of hand held mobility device
58
Describe the general heading of level 1 of the GMFCS
Walks without limitations
59
What is the general heading for level 2 of GMFCS?
Walks with limitations
60
What is the general heading for level 3 of GMFCS?
Walks using a hand held mobility device
61
What is the general heading for level 4 of GMFCS?
Self mobility with limitation, may use powered mobility
62
What is the general heading for level 6 of GMFCS?
Transported in a manual wheelchair
63
What is the distinction between level 1 & 2 of the GMFCS?
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
What is the distinction between levels 2 & 3 of the GMFCS?
- 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
What is the distinction between levels 3 & 4?
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
What is the distinction between levels 4 & 5?
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
What is the functional mobility scale and what does it afford the child?
- Short standardized mobility assessment for children w/ CO ages 4-18 - Affords the child use of assistive device or orthoses
68
What are children scored on and how are they scored using the Functional Mobility Scale?
- 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
What does it mean if a child is rated a 1 using the Functional Mobility Scale?
- Uses wheelchair - May stand for transfers - May do some stepping support by another person or using a walker/frame
70
What does it mean if a child is rated a 2 using the Functional Mobility Scale?
- Uses walker or frame - Without help from another person
71
What does it mean if a child is rated a 3 using the Functional Mobility Scale?
- Uses forearm crutches without help from another person
72
What does it mean if a child is rated a 4 using the Functional Mobility Scale?
- Uses canes without help from another person
73
What does it mean if a child is rated a 5 using the Functional Mobility Scale?
- Independent on level surface - Does not use walking aids or need help from another person - Requires a rail for stairs
74
What does it mean if a child is rated a 6 using the Functional Mobility Scale?
- 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

Neuromuscular Rehab 1 (3 decks)

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