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NBCOT Study > Neuro > Flashcards

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
Q

Describe diagonal 2 PNF pattern

A
  • start straight up same side and pull down to opposite side
  • putting on seat belt passenger side
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25
Q

goals of NDT

A

improve postural control and movement

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26
Q

Techniques of NDT

A
  • handling techniques
  • weight bearing
  • guide normal movement and discourage compensation
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27
Q

what is dystonia

A

abnormal tone

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28
Q

describe flaccidity

A
  • no tone
  • no voluntary muscle activation
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29
Q

describe hypotonicity

A

muscle feels soft and offers little movement

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30
Q

describe hypertonicity

A

increased muscle tone

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31
Q

what causes hypertonicity

A

damage to UMN increases stimulation of LMN

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32
Q

what is the job of UMN

A

inhibits LMN

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33
Q

what is the job of LMN

A

increases motor activity

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34
Q

describe spasticity

A

increased tone with rapid movements

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35
Q

what is clonus

A

involuntary contraction and relaxation of spastic muscles

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36
Q

describe rigidity

A

increase of muscle tone of agonist and antagonist simultaneously

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37
Q

lead pipe rigidity

A

constant resistance

38
Q

cogwheel rigidity

A

rhythmic give in resistance

39
Q

Modified Ashworth Scale gradings

A
  • 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
Q

dysmetria

A

inabiltiy to judge distances leading to over or under shooting targets

41
Q

dysdiadochokinesia

A

impaired abilty to complete rapid alternating movements

42
Q

intention tremor

A

tremor that occurs during voluntary movement

43
Q

apraxia vs ataxia

A

-both affect coordination
- ataxia is motor control impairment
- apraxia is perceptual impairment

44
Q

dressing apraxia

A

inability to plan movements for dressing

45
Q

ideomotor apraxia

A

inability to create plan and carry out

46
Q

ideational apraxia

A

inability to use real objects appropriately, may use objects for something unintended for

47
Q

agnosia

A

inabilty to interpret senses

48
Q

anosognosia

A

limited awareness or insight to self

49
Q

ischemic stroke

A

clot blocks blood flow to area of the brain

50
Q

hemorrhagic stroke

A

bleeding occurs inside or around brain tissue

51
Q

ischemic embolic stroke

A

blood clot travels arteries and then lodges in vessel

52
Q

ischemic thrombotic stroke

A

plaque builds up inside wall

53
Q

NIH Stroke Scale grading

A

0- no stroke; 21-42 severe stroke

54
Q

what is a SAFE Score

A
  • 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
Q

Interventions for Brunstrom stage 1-2

A
  • 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
Q

interventions for brunnstrom stage 3

A
  • task oriented strategies to facilitate functional use
  • orthotics to increase hand use
  • manage tone with orthotics and neuroinhibition
57
Q

Interventions for Brunnstrom stage 4-5

A

CIMT, Mirror therapy, action observation, mental imagery, e-stim

58
Q

ASIA Grade A

A

Complete, no motor or sensory function

59
Q

ASIA Grade B

A

incomplete, sensory but no motor function

60
Q

ASIA grade C

A

incomplete, motor function but majority of key muscles are less than 3 MMT

61
Q

ASIA grade D

A

incomplete, motor function with muscle grades above 3

62
Q

ASIA Grade E

63
Q

describe central cord syndrome

A
  • more damage to central grey matter of cord
  • paralasys and sensory loss greater in UE
64
Q

Describe cauda equina syndrome

A

-Central disc herniation or disc burst fracture below L2 level
- LMN paralysis and partial or complete loss of sensation

65
Q

describe Anterior cord syndrome

A
  • vascular injury or burst injury to anterior spinal artery
  • loss of motor, pain and temperature
66
Q

brown-sequard syndrome

A
  • hemisection of cord
  • same side deficits in motor control, proprioception and vibration sensation
  • opposite side deficits in pain and temperature sensations
67
Q

when does autonomic dysreflexia occur

A

with injury at T6 or higher

68
Q

what causes autonomic dysreflexia

A

irritation below level of injury

69
Q

symptoms of autonomic dysreflexia

A
  • high BP
  • pounding headache, flushed face
  • sweating above level of injury
  • slow pulse
  • goose bumps above injury
70
Q

how to resolve autonomic dysreflexia

A
  • Raise patient head
  • locate irritant
  • loosen clothing
  • check catheter
  • check skin
71
Q

splinting goals for C1-C4 SCI

A

positioning for joint protection

72
Q

splinting goals for C5 SCI

A

positioning and enable participation

73
Q

Splinting goals for C6 SCI

A

preserve tenodesis and enable particiapation

74
Q

C7-8 SCI splinting goals

A

prevent deformity

75
Q

describe tenodesis

A

fingers come together with wrist extension

76
Q

how to facilitate tenodesis

A
  • never stretch hand into full wrist and finger extension
  • tenodesis training splint
77
Q

what are the 2 different weight shifting schedules

A
  • 1-2 minutes q30 minutes
  • 15 seconds q15 minutes
78
Q

Glasgow Cona scale grading

A
  • 15 best response
  • 8-4 comatose client
  • 3 totally unresponsive
79
Q

what does the glasgow coma scale measure

A
  • eye opening response
  • verbal response
  • motor response
80
Q

Intervention for Rancho level 1-3

A
  • sensory stimulation
    -prevention of skin break down and loss in ROM
  • support and educate family
  • restore alertness and facilitate goal directed behaviors
81
Q

Intervention for Rancho level 4

A
  • manage agitation
  • short directions and no questions
  • short treatment sessions
82
Q

intervention for Rancho level 5

A
  • address performance skills
  • participate in activities with direction
83
Q

describe Rancho level 1

A

-no response to stimuli
- total assistance

84
Q

describe Rancho level 2

A
  • generalized response (may be the same regardless of type or location of stimulation)
  • Total Assistance
  • will follow one-step commands with 50% accuracy
85
Q

describe rancho level 3

A
  • 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
Q

describe rancho level 4

A
  • confused, agitated
  • Maximal assistance
  • begin to use too appropriately
87
Q

describe rancho level 5

A
  • confused, inappropriate
  • non agitated
  • maximal Assistance
  • beginning to follow 2 step commands
88
Q

describe rancho level 6

A
  • 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
Q

describe rancho level 7

A
  • automatic- appropriate
  • Min assist for routine ADLs
  • consistently oriented
90
Q

describe rancho level 8

A
  • purposeful and appropriate
  • SBA for ADLs
91
Q

Describe rancho level 9

A
  • Purposeful and appropriate
  • SBA on request for ADLs
  • can begin medicaiton management with pillbox
92
Q

describe Rancho level 10

A
  • Purposeful and appropriate
  • independent
  • can multitask

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