Neuro Flashcards
What gives taste to anterior 2/3 of tongue
facial n (CN 7)
What gives taste to posterior 1/3 of tongue
Glossopharyngeal n (CN 9)
If Oculomotor n (CN 3) is down then what will occur
- inability to elevate eye
- inability to depress eye
- inability to adduct eye
If Trochlear n (CN 4) is down then what will occur
inability to depress and adduct the eye
What muscle does the trochlear n (CN 4) innervate
superior oblique
What will occur if the Trigeminal n (CN 5) is down
- loss of facial sensation
- loss of jaw reflex
- jaw deviation toward side of lesion
- loss of corneal reflex
- loss of masseter and temporalis contraction with active jaw closing
What will occur if the Abducens n (CN 6) is down
adduction of the eye (due to loss of ability to abduct the eye)
What will occur if the Facial N (CN 7) is down
- loss of taste to ant 2/3 of tongue
- loss of facial expressions
Gag reflex will be impacted by what nerve being down
Glosspharyngeal (CN 9) or Vagus n (CN 10)
Uvular deviation AWAY from lesion will be seen by what CN being down
CN 10: Vagus N
Inability to protrude tongue and lateral deviation of tongue TOWARDS the lesion will be seen with what CN being down
CN 12: Hypoglossal
Which two cranial nerves will have CL deviation (away from side of lesion) when down
- Facial (CN 7)
- Vagus (CN 10)
Which two cranial nerves will have IL deviation (towards side of lesion) when down
- Trigeminal (CN 5)
- Hypoglossal (CN 12)
Lack of awareness of the body structure or relationship of body parts
Somatoagnosia
Severe condition lack of awareness of one’s paralyssi
Anosagnosia
Cannot recognize objects presented
Visual agnosia
No idea of how to perform an action (no concept of what to do)
Ideational apraxia
Can only perform a task automatically and cannot perform it on demand
Ideomotor apraxia
Clinical findings with Spinal Accessory nerve (CN 11) injury
- Decr cervical lordosis
- Downwardly rotated scap
- Lateral winging of scapula
- Neck, shoulder, medial scapular pain
What innervates the supraspinatus, infrapsinatus
Suprascapular N (C5-C6)
What nerve levels are impacted with Erb’s palsy
C5-C6
What will be seen with suprascapular nerve injury
- Dull ache in lateral shoulder
- Atrophy/weakness with supraspinatus and infraspinatus
- Incr scapular elevation with arm elevation
What does the Musculocuteaneous nerve (C5-C6) innervate
Coracobrachialis, Brachialis, and Biceps brachii
What provides sensory input to lateral forearm
Musculocutaneous n (C5-C6)
What will be seen with injury to Musculocutaneous n (C5-C6)
- Lateral arm sensory changes
- Weakness/atrophy with elbow flexors
- Diminished biceps reflex
What does tha axillary n (C5-C6) innervate
- Teres Minor
- Deltoid
What will be seen with axillary n injury
- Axillary pain
- Deltoid area paresthesia
- Atrophy of deltoid and teres minor
- Elevation weakness
- Abd weakness
- ER weakness
What innervates serratus
Long thoracic n (C5-C7)
What would cause medial winging of scapula nerve wise
Injury to the long thoracic n
Crutch use would cause issues with what nerve
Radial N (C6-T1)
Posterior interosseous nerve innervatees what and is a branch of what nerve
supintor
branch of radial n
Thenar wasting (ape hand) is seen with what nerve injury
Median n injury (C5-T1)
Inability to do the OK sign is weakness with what nerve
Anterior Interosseous n (branch of median)
What muscles and nerve does the OK sign (tip to tip) test
FPL and FDP
-Anterior Interosseous n
What nerve is injured if you attempt to make a fist and the first 3 fingers do not flex but the last 2 do flex
Median n
What neve is injured if at rest the last 2 fingers are flexed and the others are extended
Ulnar n
Froment’s sign tests what
Ulnar n
Adductor Pollicis
What innervates the adductor pollicis
Ulnar N
Inability to extend the PIP/DIP will be seen with a lesion to what nerve
Ulnar N
Hypothenar wasting seen with what nerve injury
Ulnar
Loss of key pinch grip is called what and means what muscle and nerve is down
Froment’s sign
Loss of Adductor Pollicis
Loss of ulnar n
What neerve levels of affected with Klumpke’s Palsy
C7-T1
What is Klumpke’s palsy also known as
claw hand
What is impacted in Klumpke’s palsy
loss of intrinsics of the hand
What is the differentiating factor between lateral epicondylitis and posterior interosseous nerve lesion
- No sensory for posterior interosseous nerve lesion
- Lateral epicondylitis will have true sensory issues due to pain
What muscle will subsittue in the loss of musculocutaneous nerve
brachioradialis
What nerve innervates the supinator
radial
Ape hand = issue with what nerve
median
Weakness with elbow flex, wrist ext, and diminished brachioradialis reflex
C6 myotome
What nerve is the issue when there is weakness with shoulder abd and ER =
axillary n
No tip-to-tip piinch of 1st and 2nd fingers
anterior interosseous n syndrome
Weakness with elbow ext and diminished tricpes reflex
C7 or radial n
If the L4/L5 disk is herniated which nerve root is more likely to be impacted
L5
What is a compensation for weak quads
Forward trunk lean
What does the Femoral n (L2-L4) innervate
- Illiopsoas
- Sartorius
- Pectineus
- Quads
Sensory: to medial thigh, medial knee, proximal leg
What will be seen with injury to femoral n
- knee buckling
- knee ext weakness
- anterior knee pain
- sensory loss medial aspect of leg
- forward trunk lean (compensatory for weak quads)
Saphenous n is a branch of what nerve and where does it supply sensation to
Femoral n
sensory to medial calf
Sural n is a branch of what nerve and where does it supply sensation to
tibial n
sensory to lateral calf
What will be seen if obturator n is injured
- Loss of hip ER
- Loss of hip add
What innervates gluteus medius, glut min, and TFL (deep muscles)
Superior glueteal n (L4-S1)
What innervates glut max
-Inferior gluteal n (L5-S2)
What will be seen with inferior gluteal n (L5-S2) injury
posterior trunk lean at IC
What will be seen with superior gluteal (L4-S1) n injury
Trendelenburg
What innervates TA
deep peroneal n
What provides sensory input to first webspace of foot
deep peroneal n
foot slap will be seen with injury to what nerve
deep peroneal
What provides input to fibularis longus, fibularis brevis
superficial peroneal n
What provides input to gastroc/soleus, popliteus, tibilais posterior, flexor digitorum longus, and flexor hallucis longus
Tibial n (L4-S3)
What provides sensation to dorsum of foot
superficial peroneal n
what will be seen with tarsal tunnel syndrome
weak foot intrinsics
full active ROM but may have pain with foot pronation
Weak toe flex and lateral foot paresthesia
tibial n
What nerve is impacted if someone has weak eversion
superficial peroneal n
Weak DF and sensory loss over first webspace of foot
deep peroneal n
1+ patellar tendon reflex, weak hip flex, loss of sensation on medial malleolus
femoral n
Occurs during first trimester during utero; fibrosis of muscles; caused by poor movements in early development
Arthrogryposis Multiplex Congentia (AMC)
What is the cause of Bell’s palsy
autoimmune
Is full recovery likely for cauda equina syndrome
No
Caused by non-closure of neural tube by 28th day of gestation
Spina Bifida
What is TOS caused by
- Enlarged first rib
- Tight SCM, scalenes
- Tumor
- Pregnancy
SCIs above what level can lead to AD
T6 or higher can be prone to AD
What will be seen with Brown Sequard lesion
- CL pain and temp loss
- IL motor loss
- IL loss of fine touch/proprioception
What will be seen with central cord syndrome
UE more affected than LE
Distal more affected than proximal
MOI for central cord injury
forced hyperextension
MOI for anterior cord injury
flexion or vascular
What will be seen with anterior cord syndrome
BL loss of motor
BL loss of pain and temp
What type of bladder seen with a lesion to S2-S4 above conus medullaris (L1)
spastic/hyperreflexive
What type of bladder seen with a lesion to S2-S4 below the conus medullaris (L1)
flaccid/areflexive bladder
_____ or less on Glasgow coma scale = coma
8 or less
What are the 3 categories on the Glasgow coma scale
- ) Eye opening response
- ) Best verbal response
- ) Best motor response
UE Flexion Synergy pattern
- Scapular Retraction and elevation
- Shoulder abduction
- Shoulder ER
- Forearm supination
- Wrist flexion
- Finger flexion
UE Extension synergy pattern
- Scapular protraction
- Shoulder adduction
- Shoulder IR
- Elbow Ext
- Forearm pronation
- Wrist flexion
- Finger flexion
LE Flexion synergy pattern
- Hip flexion
- Hip ER
- Knee flexion
- Ankle DF
- Ankle Inv
- Toe DF
LE Extension synergy pattern
- Hip extension
- Hip adduction
- Hip IR
- Knee ext
- Ankle PF
- Ankle Inv
- Toe PF
When would be best for someone with MS to have PT
mornings…..due to fatigue in afternoons
What position will someone’s UE be in if they have Erb’s palsy (C5-C6 brachial plexus injury)
“Waiter’s tip”
- Scapular depression
- Shoulder ADD
- Shoulder IR
- Elbow extension
- Forearm pronation
Supplies the entire medial of the medulla, including the anterior part of the spinal cord
Anterior spinal artery
supplies the cerebellum
posterior inferior cerebellar artery
Reflex grade:
No response
0
Reflex grade:
Diminished response; may or may not be abnormal
1+
Reflex grade:
Normal
2+
Reflex grade:
Brisk/exagerrated; may or may not be normal
3+
Reflex grade:
hyperactivie; always abnormal
4+
What level does biceps tendon reflex test
C5-C6
What level does brachioradialis tendon reflex test
C5-C6
What level does Triceps tendon reflext test
C6-C7
What level does patellar tendon reflex test
L3-L4
What level does Achilles tendon reflex test
S1-S2
Dermatome/Myotome:
C1
Top of skull, N/a
Dermatome/Myotome:
C2
Forehead, N/a
Dermatome/Myotome:
C3
Neck, breathing
Dermatome/Myotome:
C4
Shoulder, shoulder shrug
Dermatome/Myotome:
C5
Radial styloid process, Deltoid
Dermatome/Myotome:
C6
Tip of thumb, Biceps or wrist ext
Dermatome/Myotome:
C7
Tip of middle finger, Triceps or wrist flex
Dermatome/Myotome:
C8
Tip of pinky, thumb ext
Dermatome/Myotome:
T1
Medial forearm, interossei
Dermatome/Myotome:
T2
Subclavicle/armpit area, n/a
Dermatome/Myotome:
T4
Nipple line
Dermatome/Myotome:
T10
Belly button, n/a
Dermatome/Myotome:
T12
ASIS
Dermatome/Myotome:
L1
Upper groin, n/a
Dermatome/Myotome:
L2
Anterior thigh, illiopsoas (h flex)
Dermatome/Myotome:
L3
Knees/medial thigh, quad (knee ext
Dermatome/Myotome:
L4
Medial lower leg, anterior tibilais
Dermatome/Myotome:
L5
Anterior tibial region, extensor hallucis longus (toe ext)
Dermatome/Myotome:
S1
Lateral foot, gastroc (plantar flex)
Dermatome/Myotome:
S2
Posterior thigh, hamstrings
Dermatome/Myotome:
S3
Buttocks, n/a
Dermatome/Myotome:
S4
rectum/anal area, bladder/ rectum
RLA level of cognitive functioning:
No response; unresponsive to any stimuli
1
RLA level of cognitive functioning:
Generatlized response; Inconsistent response, non-purposeful, non-specific, few response, and used the same response regardless of stimuli
2
RLA level of cognitive functioning:
Localized response; specific response, but inconsistent responses are directly related to the stimulus, may follow commands
3
RLA level of cognitive functioning:
Confused-agitated; heighted state of activity, behavior is bizzare, non-purposeful, uncoorperative, incoherent, lacks STM/LTM
4
RLA level of cognitive functioning:
Confused-inappropriate; responds to simple commands, unable to learn new info, gross attention but easily distracted, impaired memory
5
RLA level of cognitive functioning:
Confused-appropriate; behavior is goal-directed, but dependent on external input/direction, follows simple commands, responses are appropriate to the siutation, past memories have more depth and detail than recent memory, shows carryover for releared tasks
6
Are past or more recent memory better remmember from TBI ppl
past
RLA level of cognitive functioning:
Automatic; goes thru daily routine in automatic or robot like manner, able to integreate socail activities, shows carryover for new learning
7
RLA level of cognitive functioning:
Purposeful; able to recall and integrate past and recent events, is aware of and responsvie to environment, shows carrover for new learning, no supervision necessary once activities are learned
8
How old?
Decreased flexion, momentary head elevation with minimal forearm support, tracks a
moving object, head usually to one side, reciprocal and symmetrical kicking, positive support and
primary walking reflexes in supported standing, neonatal reaching, alter, brightening expression.
1 mo
How old?
Head elevation to 45° in prone, in prone on elbows with elbows behind shoulders, head
bobs in supported sitting, responses to friendly handling
2 mo
How old?
Prone on elbows, weight bearing on forearms, elbows in line with shoulders, head
elevated to 9o°, coos and chuckles, optical and labyrinthine head-righting present.
3 mo
How old?
Rolls prone to side, supine to side, sits with support, no head lag in pull to sit, ulnarpalmar grasp, laughs out loud
4 mo
How old?
Rolls from prone to supine, weight shifts from one forearm to the other in prone, head
control in supported sitting
5 mo
How old?
Prone on hands, with elbows extended, weight shifts from hand to hand, rolls supine to
prone, independent sitting, pulls to stand, bouncing.
6 mo
How old?
Can maintain quadruped, pivots on belly, moves body in circle while prone, trunk
rotation in sitting, recognizes tone of voices, may show fear of strangers.
7 mo
How old?
Belly crawls, quadruped creeping, side-sitting, pulls to stand through kneeling,
cruises sideways, can stand alone, radial palmar, can transfer objects from one hand to the other
8-9 mo
How old?
Begins to walk unassisted, begins self-feeding, neat pincer grasp, can release,
searches for hidden toys, suspicious of strangers, plays patty cake and peekaboo, imitates
10-15 mo
How old?
Ascends stairs step to pattern, running more coordinated, jumps off bottom step,
plays make believe
20 mo
How old?
Runs well, can go upstairs foot over foot, active, restless, tantrums.
2 years
How old?
Rides tricycle, stands on one foot briefly, jumps with 2 feet, understands sharing
3 years
How old?
Hops on 1 foot several times, stands on tiptoes, throws ball overhand, relates to friends
4 years
How old?
Skips, kicks ball well, dresses self
5 years
What cranial nerves are down if the Corneal reflex is impaired
CN 5 and CN 7
What cranial nerves are down if the Gag reflex is impaired
CN 9 and CN 10
practicing a single motor task over and over
Blocked practice
practice of varied motor skills in which the performer is required to make rapid
modifications of the skill in order to match the demands of the task
variable practice
practice of a group or class of motor skills in random order
random practice
What to do in cognitive stage of learning
Feedback after every trial, knowledge of
performance and results, practice in stresscontrolled environment, distributed practice or
blocked practice
What to do in the associated stage of learning
provide variable feedback
and after errors, assist self-evaluation, encourage
consistency, variable practice, progress towards
changing environment
What to do in the autonomous stage of learning
Decision making skills apparent, occasional
feedback when errors present, massed practice,
vary environment
relatively continuous practice in which the amount of rest time is small (rest time
less than practice time
massed practice
Practice in which the rest time is relatively large
Distributed practice
What nerve root innervates deltoid
C5
What nerve root innervates trapezius and leavtor scapulae
C4
What nerve root innervates biceps
C6
What nerve root innervates the tricpes
C7
What nerve root innervates the thumb extensors
C8
What nerve root innervates the intrinsics of the hand
T1
Total cut of the axon. Surgical intervention will be needed to get recovery
Neutotmesis
Tranient block caused by stretch or pressure. No wallerian degenration
Neuopraxia
Nerve preserved, but axons damaged. Wallerian degneration
Axontmesis
What innervates the SCM
CN 11
What nerve roots does the suprascapular nerve come from
C5-C6
What innervates the supraspinatus and infraspinatus
Suprascapular n (C5-C6
What will be seen with a suprascapular n (C5-C6) injury
Dull ache lateral shoulder
Atrophy/weakness supraspinatus & infraspinatus
Increased scapula elevation during arm elevation
What nerve roots does the musculocutaneous nerve come from
C5-C6
What innervates the biceps brachii, coracobrachialis, and the brachialis
Musculocutaneous n (C5-C6)
What will be seen with a musculocutaneous nerve (C5-C6) injury
Lateral arm sensory changes
Weakness/atrophy biceps, brachialis, coracobrachialis
Diminished biceps reflex
What provides sensation to the lateral arm
Musculocutaneous nerve (C5-C6)
What nerve roots does the axillary nerve come from
C5-C6
What innervates the teres minor and deltoid
Axillary n (C5-C6)
What will be seen with an axillary nerve (C5-C6) injury
Axillary pain
Deltoid area paresthesia
Atrophy deltoid & teres minor
Elevation weakness
What nerve roots does the long thoracic nerve come from
C5-C7
What innervates serratus anterior
Long thoracic nerve (C5-C7)
What will be seen with a long thoracic nerve injury (C5-C7)
Weak scapular protraction
Weak upward rotation of scapula
Winging of medial scapula
Where does the axillary nerve (C5-C6) provide sensory innervation
Proximal lateral arm
What will be seen with a radial nerve (C6-T1) injury
Triceps weakness Extensors of forearm weakness Webspace sensory loss, dorsal hand/forearm sensory loss Crutch Use (radial groove of humerus) Midshaft humeral fracture
Where does the Radial nerve (C6-T1) provide sensory innervation
Dorsal arm, dorsal forearm, dorsal hand, 1st interosseous space (webspace) thumb.
What provides innervation to pronoter teres
Median nerve (C5-T1)
What two muscles are used to make the OK sign
Flexor pollicis longus
Flexor digitorum profundus
What nerve is the issue if you are attempting to make a fist and the first three digits do not flex
Median nerve (C5-T1)
What will be seen with an ulnar n (C8-T1) injuryrve
Ulnar claw Inability to extend PIP & DIP (lumbricals) Inability to abduct fingers (interossei) Inability to adduct thumb (AP) Weakness with ulnar deviation (FCU) Hypothenar wasting Loss of sensation of 4-5th fingers
What nerve innervates the adductor pollicis
Ulnar N (C8-T1)
What will be seen if the last 2 finger and flexed at the PIP/DIP (due to loss of the 3rd and 4th lumbricals)
also hyperextneded at MCP
Ulnar nerve issue (ulnar claw)
Pronator teres entrapment is also known as what
anterior interosseous syndrome
What nerve injury is likely to present with incorrect use of the axillary bar on crutches
Radial nerve (C5-T1)
Saphenous nerve (sensory n) is a branch of what nerve
Femoral n
A forward trunk lean is a comepnsation for what
weak quads
Femoral n comes from what nerve root levels
L2-L4
Where does saphenous n provide sensation to
Medial leg
Where does the sural n provide sensation to
Lateral leg
What innervates the Iliopsoas, sartorius, pectineus, and quads
Femoral n (L2-L4)
What will be seen with a femoral n (L2-L4) injury
Knee buckling Knee extension weakness Anterior knee pain Sensory loss medial aspect of leg below knee Forward trunk lean during
What nerve root does the Obturator n come from
L2-L4
What will be seen with an obturator nerve injury
Loss of ER and adduction at the hip
What does the Obturator n (L2-L4) innervate
Addcutor longus
Gracilis
Adductor Magnus
Obturator externus
What nerve innervates the Glutues medius, gluteus minimus, and TFL
Superior gluteal n (L4-S1)
What nerve inneravtes the Glutues max
Inferior gluteal n (L5-S2)
What innervates the 1st webspace of foot
Deep peroneal n
What innervates Tibialis anterior, Extensor digitorum longus, Extensor hallucis longus
Deep peroneal n
What innervates Fibularis longus, fibularis brevis
Superficial peroneal n
What provides senation to lower leg and dorsum of foot
Superficial peroneal n
Foot slap will be seen with injury to what nerve
Deep peroneal
How long should rooting and sucking reflexes be present
Birth to 3 months
What is the Moro Reflex
Baby’s head is dropped suddenly backwards from a sititng position:
Response: Child abducts and extend
arms, then quickly adducts
arms and flexes
How long should the Moro Reflex be present
Birth to 6 months
What is traction response
when you take the wrist of baby and lift them into sitting from supine
baby should flex elbow and elevate shoulders
What is flexor withdrawal?
Pinprick or pinch sole of foot
Baby should withdrawl the leg
How long is palmar grasp present
4 months
What is palmar grasp
Place index finger into infant’s hand from the ulnar side
Infant should flex around examiner’s fingers
How long is plantar grasp present
8 months
What is plantar grasp
Examiner places pressure on plantar aspect of foot just below toes
Baby should flex toes
What is crossed extension
When one side is pinched the opposite leg extenends to compensate for the flexion of the leg that was pricked
How long is crossed extension present
4 mo
What is the Galant response
Stroking the paravertebrals from thoracic to lumbar region causes child to laterally flex trunk towards stimulus
How long is spontaneous stepping present
2 mo
What is Asymmetrical Tonic Neck Reflex (ATNR)
When head is turned to one side……child extends arm on the looking side and flexes arm on the back of the head side
“fencing” position
How long is ATNR present
4 mo
What is the Symmetrical Tonic Neck Reflex (STNR)
Passively flex and then extend infant’s head over your thigh while they are iin prone
- Infant’s head flexes: arm flex and legs extend
- Infant’s head extends: arm extend and legs flex
How long is STNR present
6 mo
What is labyrinthine head righting
Infant blind folded and their head is moved around in various directions
Baby’s head orients to vertical
What is Landau
Holding baby in the air
Should see baby extend the head, then trunk, then hip
“superman”
When does protective extension begin for a child
5 mo (forward) 7 mo (sideways) 9 mo (backwards)
1 cause of Autonomic dysreflexia
Catheter compression
Will full or part of the face be paralyzed with Bell’s palsy
full face
Is motor affected with Bell’s palsy
Yes
Are the lower or upper facial muscles more impacted by stroke palsy
lower facial muscles more affected by stroke
What is the cause of Bell’s palsy
Virus
Weakness/paralysis of the mms innervated by the motor nuclei of the lower brainstem, affecting the muscles of the face, tongue, larynx, and pharynx
Bulbar palsy
MOI for central cord syndrome
compression due to hyperexension of C-spine
What body structures are impacted with Huntington’s dz
Atrophy of basal ganglia and cerebral cortex
Will facial pain be seen with Bell’s palsy or Trigeminal Neuralgia or both
Trigeminal Neuralgia
Is the jaw and corneal reflexes are absent then what is the issue
Trigeminal Neuralgia
What muscle will be weak with Bell’s palsy
Frontalis
What muscles will be weak with Trigeminal Neuralgia
Temporalis and Masseter
What makes Trigeminal Neuralgia worse
Cold
What makes Bell’s Palsy worse
use of muscles
Loss of motor function & pain / temperature below level of the lesion,
caused by hyperflexion injuries or ischemic damage
Anterior cord syndrome
Multiple contractures, joint dislocation, muscle atrophy, cylinder-shaped
limbs with no definition/tone
Arthrogryposis Multiplex Congentia
Sweating, dilated pupils, bradycardia, hypertension, blurred vision, high
blood pressure
Autonomic Dyreflexia
Asymmetrical drooping of eyelid & mouth, drooling, dry eyes, can’t close
eyelid due to weakness
Bell’s palsy
Loss of ipsilateral vibratory/position sense & contralateral pain/temp
Brown Sequard Lesion
Dysphagia, nasal regurgitations, slurred speech, choking, dysphonia,
dysarthria, dysphasia
Bulbar Palsy
Area of brain affected by a lesion to the Anterior Cerebral Artery
Anterior frontal lobe,
Medial surface of frontal lobe
Medial surface of parietal lobe
Features of an Anterior Cerebral Artery stroke
Contralateral loss of LE motor and sensory, loss
of bowel and bladder, aphasia, apraxia,
agraphia, akinetic mutism
Will UE or LE be affected more by an ACA stroke
LE
Will UE or LE be affected more by an MCA stroke
UE
Area of brain affected by MCA
Cerebrum and Basal Ganglia
Features of MCA stroke
Upper extremity more affected, contralateral
weakness and sensory loss of face, Wernicke’s
aphasia, apraxia, anosognosia, homonymous
hemianopsia
Area of brain affected by PCA
Occpital lobe
Midbrain
Thalamus
Features of PCA stroke
Contralateral hemiplegia, contralateral loss of
pain and temperature, prosopagnosia
Features of Vertebral Basilar Artery stroke
Hemi-tetraplegia, dysphagia, dysarthria,
ataxia, loss of consciousness, Locked-In
syndrome
What areas of the brain does the Vertebral Basilar artery supply
Cerebellum, Medulla, Pons
Which side of the brain did the CVA occur on?
Speech, language impairments Slow, cautious behavior Difficulty expressing positive emotions Difficulty with verbal cues/ commands Difficulty planning a movement (apraxia)
Left
Which side of the brain did the CVA occur on:
Visual perceptual impairments Quick, impulsive behavior Poor judgment, can’t self-correct Difficulty with perception of emotions (mostly negative emotions) Difficulty with visual cues (non-verbal communication) Difficulty sustaining a movement
Right side
What drugs can Levodopa interact with
Drugs to treat depression
What type or orthotic is commonly used for Spina Bifida
RGO
Which canal is involved:
Torsional upbeating nystagmus in left ear down position
Left posterior canal BPPV
Which canal is involved:
Torsional upbeating nystagumus in the right ear down position
Right posterior canal BPPV
Upbeating torsional nystagmus =
posterior canal
Downbeating torsionnal nystagmus =
anterior canal
Right anterior canal is paried with ____posterior on the dix hallpike
left
Left anterior canal is paired with the _____posterior canal on the dix hallpike
right
Left dix hallpike will detect a _____posterior canal and a ______ anterior canal issue
Left posterior canal
Right anterior canal
Right dix hallpike will detect a ____posterior canal and ____anterior canal issue
right posterior
left anterior
Expose patient to non-painful stimuli
repeatedly to allow patient to adapt
to that stimuli so that it no longer
causes impairment
Habituation
What is the goal of habituation
Decr sensitive to noxious stimuli
Visual cues are needed if patient has a stroke on what side
Left
Verbal cues are needed if patient has a stroke on what side
right
Brunnstrom stage:
No spasticity , no synergy
1
Brunnstrom stage:
Begnning spasticity, weak associated synergy movements
2
Brunnstrom stage:
Peak spasticity
3
Brunnstrom stage:
Mass synergy movements
3
Brunnstrom stage:
Decreasing spasticity; begin out of synergy movements
4
Brunnstrom stage:
Decreasing spasticity; pretty much completely out of synergies
5
Brunnstrom stage:
Minimal spasticity except during rapid movements; free of synergy but may have awkward isolated movements with coordination
6
Brunnstrom stage:
Normal spastiicty and no synergy
7
What to use for strengthening muscles less than 1/5 MMT
HRAM
What is used to initiate mobility
HRAM or RI
Isometric contraction on 1 side of joint then the
other side; no rest
AI
Isometric contraction of all muscles around a joint
(rotational component); relax and move into new
range
Rhythmic stabilization
Proximal part is restricted until distal part initiates
movement
Normal timing (for skill)
Improve coordination
Strengthens weak components; isotonic &
isometric; overflow to weak muscles
Timing for emphasis
Improves control of movement and posture;
resisted concentric contraction of agonist and
antagonists without rest between reversals
Slow Reversal
Slow reversal with an isometric hold at end of each
movement to gain stability
Slow reversal hold
Used w/ hypertonia; “let me move you, help me,
resist me” (basically like AAROM)
RI
Used to decrease hypertonia; passively rotate
extremity to improve ROM
Rhythmic rotation
RI is often used with what
hypertonia
stronger parts of the body are used to stimulate and strengthen weaker parts of
the body. (PNF)
Kabat Knott Voss
introduced use of synergy stimulation to facilitate or inhibit responses, such as icing or
brushing, in order to elicit desired reflex motor response
Rood
Created and defined the term synergy and encouraged patient to immediately
practice synergy patterns and subsequently develop combinations of movement patters out of
synergy.
Brunnstrom
Patient learns to control
movement through normal activities that promote normal movement patterns
Bobath
What is Bobath very heavy on
Promoting normal movements (disadvantage is that it does not allow for much reps)
