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Neuro Flashcards

1
Q

where does motivation for movement come from

A

limbic system

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2
Q

where does ideation for movement come from

A

frontal, partietal, temporal and occipital lobes

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3
Q

where does programming for movment come from

A

premotor areas, basal ganglia, cerebellum

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4
Q

where does execution of movemtn come from

A

motor cortex, cerebellum, spinal cord

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5
Q

what are the four traditional intervention approaches to motor control dysfunction

A
  • Rood
  • Brunnstrom Movement Therapy
  • Proprioceptive Neuromuscular Facilitation (PNF)
  • Neurodevelopmental Treatment (NDT)
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6
Q

Assumptions of Rood approach

A
  • normal muscle tone is required for movememnt
  • movement occurs in developmental sequence
  • repetition is necessary for re-education of muscular responses
  • sensory stimulation can be inhibitory or facilitory
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7
Q

facilitory techniques within Rood treatment

A
  • quick or maintained stretch
  • vibration
  • light touch
  • brushing
  • manual contact
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8
Q

inhibitory techniques for Rood treatment

A
  • prolonged, firm stretch
  • firm pressure on tendon
  • icing or neutral warmth
  • slow stroking
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9
Q

What is Brunstrum techniques used for

A

used to understand stroke recovery

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10
Q

assumptions of Brunnstrom

A
  • regerssion of older pattern of movements
  • stages of motor recovery categorize arm funciton
  • normal movement requires muscles to work synergistically
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11
Q

Describe Brunnstrom stage 1

A
  • flaccid tone
  • no voluntary movement
  • reflexive responses
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12
Q

describe brunstrom stage 2

A
  • synergies are eliceted reflexively
  • spasticity developing
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13
Q

describe brunnstrom stage 3

A
  • begin voluntary movment but only in synergy
  • significant spasticity
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14
Q

describe brunnstrom stage 4

A
  • spasticity begines to decrease
  • movement starting to deviate from synergy patterns
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15
Q

describe brunnstrom stage 5

A
  • further decreases in tone
  • increased abilty to perform complex movements
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16
Q

describe brunnstrom stage 6

A
  • tone nearly normal
  • able to do complex movements
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17
Q

describe brunnstrom stage 7

A

normal speed and coordination of movements

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18
Q

treatment goals of brunnstrom stage 1-2

A
  • facilitate increased muscle tone
  • promote development of synergies
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19
Q

treatment goals of brunstrom stage 4-5

A
  • break away from limb synergies and decrease tone
  • moving in isolated and complex movement patterns
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19
Q

treatment goals of brunnstrom stages 2-3

A
  • assist in achieving full voluntary control of limb synergies for funcitonal use
  • tone peaking at end of stage 3
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20
Q

treatment goals of brunnstrom stage 5-6

A

develop more complex isolated movements and increase speed

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21
Q

treatment goals of brunnstrom stage 7

A

demonstrate normal isolated complex movements

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22
Q

describe PNF treatments

A
  • use awareness of body position, verbal commands and visual cues by therapist
  • Diagonal movements crossing midline
  • create balance between agonists and antagonists
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23
Q

Describe Diagonal 1 in PNF patterns

A
  • start by opposite ear, pull down to same side hip
  • like putting on seat belt driver side
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24
Describe diagonal 2 PNF pattern
- start straight up same side and pull down to opposite side - putting on seat belt passenger side
25
goals of NDT
improve postural control and movement
26
Techniques of NDT
- handling techniques - weight bearing - guide normal movement and discourage compensation
27
what is dystonia
abnormal tone
28
describe flaccidity
- no tone - no voluntary muscle activation
29
describe hypotonicity
muscle feels soft and offers little movement
30
describe hypertonicity
increased muscle tone
31
what causes hypertonicity
damage to UMN increases stimulation of LMN
32
what is the job of UMN
inhibits LMN
33
what is the job of LMN
increases motor activity
34
describe spasticity
increased tone with rapid movements
35
what is clonus
involuntary contraction and relaxation of spastic muscles
36
describe rigidity
increase of muscle tone of agonist and antagonist simultaneously
37
lead pipe rigidity
constant resistance
38
cogwheel rigidity
rhythmic give in resistance
39
Modified Ashworth Scale gradings
- 0 no increase in muscle tone - 1 slight increase in tone, catch and release - 1+ slight increase in tone, catch nad minimal resistance through remainder of ROM - 2 increased tone through ROM but easily moved - 3 considerable increase in tone making passive movement difficult - 4 rigid
40
dysmetria
inabiltiy to judge distances leading to over or under shooting targets
41
dysdiadochokinesia
impaired abilty to complete rapid alternating movements
42
intention tremor
tremor that occurs during voluntary movement
43
apraxia vs ataxia
-both affect coordination - ataxia is motor control impairment - apraxia is perceptual impairment
44
dressing apraxia
inability to plan movements for dressing
45
ideomotor apraxia
inability to create plan and carry out
46
ideational apraxia
inability to use real objects appropriately, may use objects for something unintended for
47
agnosia
inabilty to interpret senses
48
anosognosia
limited awareness or insight to self
49
ischemic stroke
clot blocks blood flow to area of the brain
50
hemorrhagic stroke
bleeding occurs inside or around brain tissue
51
ischemic embolic stroke
blood clot travels arteries and then lodges in vessel
52
ischemic thrombotic stroke
plaque builds up inside wall
53
NIH Stroke Scale grading
0- no stroke; 21-42 severe stroke
54
what is a SAFE Score
- MMT grades of Shoulder Abduction and Finger Extension - if score is 8 or greater within 72 hrs predicts excellent UE function in 3 months
55
Interventions for Brunstrom stage 1-2
- preserve soft-tissues with positioning, orthotics, ROM - facilitate msucle activity with e-stim, stimulation, weight bearing - incorporate into activity with mental practice, mirror therapy, task oriented approach
56
interventions for brunnstrom stage 3
- task oriented strategies to facilitate functional use - orthotics to increase hand use - manage tone with orthotics and neuroinhibition
57
Interventions for Brunnstrom stage 4-5
CIMT, Mirror therapy, action observation, mental imagery, e-stim
58
ASIA Grade A
Complete, no motor or sensory function
59
ASIA Grade B
incomplete, sensory but no motor function
60
ASIA grade C
incomplete, motor function but majority of key muscles are less than 3 MMT
61
ASIA grade D
incomplete, motor function with muscle grades above 3
62
ASIA Grade E
Normal
63
describe central cord syndrome
- more damage to central grey matter of cord - paralasys and sensory loss greater in UE
64
Describe cauda equina syndrome
-Central disc herniation or disc burst fracture below L2 level - LMN paralysis and partial or complete loss of sensation
65
describe Anterior cord syndrome
- vascular injury or burst injury to anterior spinal artery - loss of motor, pain and temperature
66
brown-sequard syndrome
- hemisection of cord - same side deficits in motor control, proprioception and vibration sensation - opposite side deficits in pain and temperature sensations
67
when does autonomic dysreflexia occur
with injury at T6 or higher
68
what causes autonomic dysreflexia
irritation below level of injury
69
symptoms of autonomic dysreflexia
- high BP - pounding headache, flushed face - sweating above level of injury - slow pulse - goose bumps above injury
70
how to resolve autonomic dysreflexia
- Raise patient head - locate irritant - loosen clothing - check catheter - check skin
71
splinting goals for C1-C4 SCI
positioning for joint protection
72
splinting goals for C5 SCI
positioning and enable participation
73
Splinting goals for C6 SCI
preserve tenodesis and enable particiapation
74
C7-8 SCI splinting goals
prevent deformity
75
describe tenodesis
fingers come together with wrist extension
76
how to facilitate tenodesis
- never stretch hand into full wrist and finger extension - tenodesis training splint
77
what are the 2 different weight shifting schedules
- 1-2 minutes q30 minutes - 15 seconds q15 minutes
78
Glasgow Cona scale grading
- 15 best response - 8-4 comatose client - 3 totally unresponsive
79
what does the glasgow coma scale measure
- eye opening response - verbal response - motor response
80
Intervention for Rancho level 1-3
- sensory stimulation -prevention of skin break down and loss in ROM - support and educate family - restore alertness and facilitate goal directed behaviors
81
Intervention for Rancho level 4
- manage agitation - short directions and no questions - short treatment sessions
82
intervention for Rancho level 5
- address performance skills - participate in activities with direction
83
describe Rancho level 1
-no response to stimuli - total assistance
84
describe Rancho level 2
- generalized response (may be the same regardless of type or location of stimulation) - Total Assistance - will follow one-step commands with 50% accuracy
85
describe rancho level 3
- Localized response - reponse changes to stimuli and may respond to some people and not others - Total Assistance - will remain alert for 15 minute treatment sessions and attend to grooming tasks for 1 minute
86
describe rancho level 4
- confused, agitated - Maximal assistance - begin to use too appropriately
87
describe rancho level 5
- confused, inappropriate - non agitated - maximal Assistance - beginning to follow 2 step commands
88
describe rancho level 6
- Appropriate - moderate assistance - inconsistent orientation but able to attend to highly familar tasks - will refer to memory book and follow daily schedule with cueing
89
describe rancho level 7
- automatic- appropriate - Min assist for routine ADLs - consistently oriented
90
describe rancho level 8
- purposeful and appropriate - SBA for ADLs
91
Describe rancho level 9
- Purposeful and appropriate - SBA on request for ADLs - can begin medicaiton management with pillbox
92
describe Rancho level 10
- Purposeful and appropriate - independent - can multitask

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