Neuro Flashcards
upper extremities in spastic flexed position with internal rotation and adduction with lower extremities in spastic extended position, internally rotated, and adducted
decorticate rigidity
upper and lower extremities in spastic extension, adduction, and internal rotation with wrist and fingers flexed, plantar portions of the feet flexed and inverted, trunk extended, and head retracted
decerebrate rigidity
what reflexes will be impaired with midbrain damage
righting reflexes
what reflexes will be impaired with basal ganglia damage
equilibrium reactions and protective extension
what is a common feature of cerebellar damage
ataxia
what is a critical difference between a coma and vegetative state
sleep-wake cycle
3 behavioral areas of the Glasgow coma scale
motor responses
verbal responses
eye opening
describe the levels of eye opening for the Glasgow coma scale and their related point values
no response (1)
response to pain not applied to face (2)
response to commands/verbal stimuli (3)
spontaneous eye opening (4)
describe the levels of verbal responses for the Glasgow coma scale and their related point values
no response (1) incomprehensible speech (2) inappropriate words (3) confused but able to answer questions (4) oriented to person, place, time (5)
describe the levels of motor responses for the Glasgow coma scale and their related point values
no response (1)
extension response to pain (decerebrate) (2)
flexion response to pain (decorticate) (3)
withdrawals from pain (4)
purposeful movement to pain (5)
obeys commands for movement (6)
describe the scoring for the Glasgow coma scale
below 8: severe brain injury
9-12: moderate brain injury
> 14: minor brain injury
Describe level I of the Rancho Los Amigos Scale of Cognitive Functioning
no response
Describe level II of the Rancho Los Amigos Scale of Cognitive Functioning
generalized response; inconsistent and non-purposeful reactions to stimuli
Describe level III of the Rancho Los Amigos Scale of Cognitive Functioning
localized response; reacts specifically to stimuli, though inconsistently
Describe level IV of the Rancho Los Amigos Scale of Cognitive Functioning
confused/agitated
Describe level V of the Rancho Los Amigos Scale of Cognitive Functioning
confused, inappropriate, non agitated
Describe level VI of the Rancho Los Amigos Scale of Cognitive Functioning
confused and appropriate
Describe level VII of the Rancho Los Amigos Scale of Cognitive Functioning
automatic and appropriate
Describe level VIII of the Rancho Los Amigos Scale of Cognitive Functioning
purposeful and appropriate
What Ranchos Los Amigo Score would an individual with heightened activity state and severe decreased ability to process information; max A with brief attention
Ranchos Los Amigos Scale IV
What Ranchos Los Amigo Score would an individual with alert with fairly consistent reactions; complex commands cause random responses; max A no goal directed behavior and ataxia
Ranchos Los Amigos Scale V
What Ranchos Los Amigo Score would an individual with goal-directed behavior but dependent on external output for direction; mod A for 30 minutes of attention; NEW LEARNING
Ranchos Los Amigos Scale VI
What Ranchos Los Amigo Score would an individual that behaves appropriately and is oriented to place and routine but displays shallow recall; min A for ADLs; carryover of new learning
Ranchos Los Amigos Scale VII
What Ranchos Los Amigo Score would an individual that is alert and oriented and able to recall and integrate past and recent events; SBA for 1 hour of attention; increased rate of depression due to awareness
Ranchos Los Amigos Scale VIII
what is the top priority in the acute phase of a TBI
positioning and PROM
what is the preferred position for clients with abnormal tone following a TBI
side lying or semi-prone
provides sensory input
if spasticity is present following a TBI what splint would be prescribed as well as the wear schedule
resting hand splint when not involved in activity (alternating 2 hour periods)
anti-spasticity splint- abduct the fingers
what system should be used to track arousal and alertness to establish a method of communication initially
yes-no system (can be done through eye blinks)
what may be treated through interventions that focus on compensatory strategies for control such as weighting of body parts and use of weighted utensils/cups
ataxia
what may be treated through hand-over-hand exercises to repair damaged neural pathways; pictures or written steps may also work
apraxia
at what stage of rehabilitation would you most likely be able to use errorless learning, fading cues, and positive encouragement to restore competence in self-maintenance roles for TBI
post acute rehabilitation
birth defect caused when the backbone and spinal canal do not close before birth
myelomeningocele
growth of a cyst in the spinal cord
syringomyelia
complete injuries that have some innervation of dermatomes below the level of the injury; strengthening these muscles may dramatically improve functional performance
zone of partial preservation
initial stage of SCI that may last between 24 hours and 6 weeks where reflex activity ceases below the level of the injury, eventually resulting in spasticity
spinal shock
what level of SCI would indicate the need for respiratory assistance and an electric WC with sip and puff capabilities
C1-C4
what level of SCI would indicate the ability to breathe on one’s one, ability to raise the arms and flex the elbow and use an electric WC with hand controls
C5
what level of SCI would indicate moderate assistance for personal care, some wrist extension, and possibility of driving a vehicle with hand controls
C6
what level of SCI would indicate limited assistance for personal care; elbow extension, wrist flexion/extension, and partial finger movement; independent transfers
C7
what level of SCI would indicate partial assistance for heavy duty domestic care
C8
what level of SCI would indicate normal UE ROM and strength
T1-T5
what level of SCI would indicate the possibility of standing in a standing frame or walking with braces
T6-T12
what level of SCI would indicate partial paralysis in the hips and legs and possibility of walking with braces
L1-L5
what level of SCI would indicate the likelihood of walking with assistance and ability to load a WC into a car independently
S1-S5
if sensation or return of motor function does not occur in _________ after the injury, motor function is less likely to return
24-48 hours
most recovery for a SCI occurs in the first ________ post injury and continues for ___________ or longer with a slower rate of recovery
3 months
18 months
positioning for orthostatic hypotension
supine with feet elevated above the heart
positioning for autonomic dysreflexia
standing, loosening restrictive clothing/devices, and checking catheter for obstruction
visual inspection for asymmetry of LE color, size, and temperature is essential for identifying a
deep vein thrombosis
type of pain that occurs with muscle over use
nociceptive
type of paint that occurs with nerve damage
neuropathic
the initial physical evaluation for a SCI should start with
identification of precautions to identify how much movement and load is allowed without jeopardizing spinal integrity
assessment completed by the health care team and includes measures of ADL performance, sphincter control, respiration, and mobility for spinal cord injuries
the spinal cord independence measure
assessment specific for clients with tetraplegia
The quadriplegia index of function
phase of SCI recovery focused on environmental control, positioning, and ROM
acute recovery phase
what should be the position of the UEs in the acute phase of recovery for SCI
80° shoulder abduction external rotation scapular depression elbow extension forearm pronation
how often should weight shifts occur
every 30-60 minutes
important physical interventions for C5 SCI
mobile arm support and universal cuff for activity and grasp
important physical interventions for C6-C7 SCI
wrist-drive wrist-hand (tenodesis) splint for functional activity and pinch strength
important physical interventions for C8 SCI
grasping objects with MCP extension and PIP/DIP flexion
communication impairment is most commonly caused by damage to the
left hemisphere of the brain
loss of all language ability
global aphasia
broken speech, slow, labored speech with frequent mispronunciations
Broca’s aphasia
impaired auditory reception; speech may be fluent but is often meaningless of nonsensical
Wernicke’s aphasia
difficulty finding words
anomic aphasia
articulation disorder resulting from paralysis of the organs of speech
dysarthria
difficulty completing planned movements
motor apraxia
difficulty conceptualizing planned, multistep movements
ideational apraxia
difficulty recognizing objects
visual agnosia
common psychosocial disorder as a result of a stroke
depression
the barthel index, FIM, COPM, assessment of motor and process skills, stroke impact scale, and Arnadottir OT-ADL scale are common assessments for what type of injury
stroke
multidisciplinary team assessment that addresses several client factors for a stroke
National Institutes of Health Stroke Scale
functional test for the hemiplegic/paretic UE, arm mobility test, and wolf motor function test are all assessments specific to what
UE with hemiparesis
assessment not within the context of functional task performance used to assess postural adaptation
Berg Balance Scale
Functional Reach Test
approach to address environmental and activity considerations which has shown significant effectiveness in stroke rehabilitation compared with traditional therapy approaches; see’s person and environment as heterarchical organized
task-oriented approach
useful activities to address postural adaptation in standing for stroke recovery
kitchen tasks
allow for sturdy support with use of countertop if postural correction is needed
impairment of voluntary and spontaneous movement initiation resulting in freezing, especially during gait for PD, also present in Huntington’s disease
akinesia
slowed motor movement
bradykinesia
decreased coordination of movement
dysmetria
muscle stiffness that impairs movement
rigidity
involuntary muscle contraction and relaxation observed as a muscle twitch
fasciculation
small rapid steps resulting from a forward-tilted head and trunk posture
festinating gait
numbness and tingling because of sensory nerve changes
paresthesia
typical initial symptoms of MS
vision, dizziness, weakness
impaired balance and coordination while performing voluntary movement
ataxia
a sudden loss of vision with pain in or behind the eye, with symptoms possibly subsiding after 3-6 weeks without residual impairments. common with MS
optic neuritis
slow enunciation with frequent hesitations at the beginning of words or syllables. common with MS
scanning speech
lability is generally attributed to damage of which area of the brain
frontal lobe; right side
MS that has a fluctuating course of relapses with associated neurologic deficits, followed by periods of relative quiet
relapse-remitting
MS characterized by cessation of fluctuations with slow deterioration
secondary progressive
MS characterized by fluctuation with relapses and deterioration between relapses
secondary progressive with relapses
MS characterized by deterioration from the beginning
primary progressive
MS characterized by progression with relapses
progressive relapsing
medication used for functional skills
methylprednisolone
gabapentin is used for
pain
oxybutynin is used for
urinary problems
assessment of short distance walking, hand function, and cognition for MS
MS functional composite
one of the most important assessments for MS that measures endurance
Modified Fatigue Impact Scale
goals for MS should be
compensatory
contraindications to intervention for MS
hot temperature modalities (moist heat or fluidotherapy) and over exertion
therapeutic exercise for MS should be done
at submaximal resistance with frequent repetition to avoid overuse
encouraging proximal stabilization and hand-over-hand techniques for fine motor tasks can be useful in the presence of what symptom
ataxia
primary brain areas affected in parkinsons and the neurotransmitter that is diminished
basal ganglia/substantia nigra
dopamine
speed and accuracy of motor skills, postural stability, cognition, affect, and expression are mediated by what neurotransmitter
dopamine
condition in which people experience symptoms similar to those of parkinsons but the cause is related to the ingestion of drugs or other toxic chemicals (drugs to treat mental illness)
secondary parkinsonism
jerky sometimes painful movement with joint mobility most commonly in the UEs
cogwheel motions
smaller handwriting
micropraphia
reduced volume of speech
hypophonia
clinical stage of PD with unilateral symptoms, resting tremor, and none or minimal loss of function
stage 1
clinical stage of PD with bilateral symptoms, balance unaffected, problems with trunk mobility and postural reflexes
stage 2
