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Neuro Terminology Flashcards

1
Q

Athetosis

A

slow, twisting, and writhing movements that are large in amplitude.

Seen in face, tongue, trunk, and extremiteis

common finding in several forms of CP secondary to basal ganglia pathology

Peripheral movements occur without central stability

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2
Q

Chorea

A

hyperkinesia with brief, irregular contractions that are rapid

secondary to damage to caudate nucleus (basal ganglia)

“fidgeting”

Huntington’s

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3
Q

Ballismus

A

form of chorea. flailing movements of limbs secondary to damage of the subthalamic nucleus

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4
Q

Dystonia

A

sustained m contractions
causes twisting, abnormal postures, and repetitive movements

Common diagnosis: Parkinson’s disease, CP, encephalitis

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5
Q

Tics

A

sudden, brief, repetitive coordinated movements. Tourette syndrome

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6
Q

Tremors

A

involuntary, rhythmic, oscillaotry movements

3 types:
- Resting (pill rolling - Parkinson’s)
- Postural (hyperthyroidism, fatigue or anxiety, or beneign essential tremor)
- Intentional aka kinetic (MS) likely indicated lesion in cerebellum

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7
Q

Akinesia

A

The inability to initiate movement; commonly seen in patients with Parkinson’s disease.

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8
Q

Ataxia

A

The inability to perform coordinated movements.

Typically seen with damage from cerebellum 

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9
Q

Asthenia

A

Generalized weakness, typically secondary to cerebellum pathology

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10
Q

Bradykinesia

A

Movement that is very slow.

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11
Q

Clasp-knife response:

A

A form of resistance seen during range of motion of a hypertonic joint where there is greatest resistance at the initiation of range that lessens with movement through the range of motion.

Seen is UMN lesion

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12
Q

Clonus

A

involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex.

A characteristic of an upper motor neuron lesion;

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13
Q

Cogwheel rigidity

A

A form of rigidity where resistance to movement has a phasic quality to it; often seen with Parkinson’s disease.

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14
Q

Dysdiadochokinesia

A

The inability to perform rapidly alternating movements.

inappropriate timing of muscle firing and difficulty with cessation of ongoing movement. Common tests for dysdiadochokinesia include rapid supination and pronation of the forearms, alternating finger to nose, and altering the speed and direction of walking

From cerebellar pathology I believe

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15
Q

Dysmetria

A

The inability to control the range of a movement and the force of muscular activity.

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16
Q

Fasciculation

A

A muscular twitch that is caused by random discharge of a lower motor neuron and its muscle fibers;

lower motor neuron disease,
But… can be benign.

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17
Q

Hemiballism

A

An involuntary and violent movement of a large body part.

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18
Q

Kinesthesia

A

The ability to perceive the direction and extent of movement of a joint or body part.

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19
Q

Lead pipe rigidity

A

A form of rigidity where there is uniform and constant resistance to range of motion; often associated with lesions of the basal ganglia.

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20
Q

Rigidity

A

A state of severe hypertonicity where a sustained muscle contraction does not allow for any movement at a specified joint.

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21
Q

Adam’s closed loop theory

A

So using old movement patterns to compare to current movements

Giles - The first attempt at the creation of a comprehensive motor learning theory with the premise of sensory feedback as an ongoing process for the nervous system to compare current movement with stored information on memory of past movement;

high emphasis on the concept of practice.

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22
Q

Schmidt’s schema theory

A

This theory was created in response to the limitations of the closed loop theory. Its main construct relies on open loop control processes and a motor program concept; promotes clinical value of feedback and importance of variation with practice.

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23
Q

Cognitive Stage of motor learning

A

This is the initial stage of learning where there is a high concentration of conscious processing of information.

The person will acquire information regarding the goal of the activity and begin to problem solve as to how to attain the goal. A controlled environment is ideal for learning during this stage and participation is a must for the person to progress.

Characterized by:
* large amount of errors
* inconsistent attempts
* repetition of effort allows for improvement in strategies
* inconsistent performance
* high degree of cognitive work: listening, observing, and processing feedback

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24
Q

Associative Stage of motor learning

A

This is the intermediate stage of learning where a person is able to more independently distinguish correct versus incorrect performance.

The person is linking the feedback that has been received with the movement that has been performed and the ultimate goal.

A controlled environment is helpful but at this stage, the person can progress to a less structured or more open environment.

Avoid excessive external feedback as the person should have improved internal or proprioceptive feedback for the task at hand.

Characterized by:
* decreased errors with new skill performance
* decreased need for concentration and cognition regarding the activity
* skill refinement
* increased coordination of movement
* large amount of practice yields refinement of the motor program surrounding the activity

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25
Q

Autonomous Stage

A

This is the final stage of learning or skilled learning where a person improves the efficiency of the activity without a great need for cognitive control.

The person can also perform the task with interference from a variable environment

Characterized by:
* automatic response
* mainly error-free regardless of environment
* patterns of movement are non-cognitive and automatic
* distraction does not impact the activity
* the person can simultaneously perform more than one task if needed
* extrinsic feedback should be very limited or should not be provided
* internal feedback or self-assessment should be dominant

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26
Q

Purpose of feedback with motor learning

A
  • feedback is imperative for the progression of motor learning.
  • A patient will rely on both intrinsic and extrinsic feedback as it relates to movement.
  • Feedback allows for correction and adaptation within the environment.
  • Current research supports reducing the extrinsic feedback (fading of feedback) in order to ultimately enhance learning.
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27
Q

Intrinsic Feedback

A

feedback from themselves

represents all feedback that comes to the person through sensory systems as a result of the movement including visual, vestibular, proprioceptive, and somatosensory inputs.

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28
Q

Extrinsic (augmented) feedback

A

feedback from others

represents the information that can be provided while a task or movement is in progress or subsequent to the movement. This is typically in the form of verbal feedback or manual contacts.

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29
Q

Knowledge of results

A

is an important form of extrinsic feedback and includes terminal feedback regarding the outcome of a movement that has been performed in relation to the movement’s goals.

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30
Q

Knowledge of performance

A

is extrinsic feedback that relates to the actual movement pattern that someone used to achieve their goal of movement.

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31
Q

Practice

A

Practice refers to repeated performance of an activity in order to learn or perfect a skill. Physical practice allows for direct physical experience and kinesthetic stimulation to assist with acquisition of the skill. Mental practice is the cognitive rehearsal of a task or experience without any physical movement.

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32
Q

Massed practice

A

The practice time in a trial is greater than the amount of rest between trials.

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33
Q

Distributed practice

A

The amount of rest time between trials is equal to or is greater than the amount of practice time for each trial.

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34
Q

Constant practice

A

Practice of a given task under a uniform condition.

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35
Q

Variable practice:

A

Practice of a given task under differing conditions.

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36
Q

Random practice

A

Varying practice amongst different tasks.

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37
Q

Blocked practice

A

Consistent practice of a single task.

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38
Q

Whole training

A

Practice of an entire task.

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39
Q

Part training

A

Practice of an individual component or selected components of a task.

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40
Q

Closed system model

A

Nervous system is constantly responding to the information around it.

This is characterized by transfer of information that incorporates multiple feedback loops and larger distribution of control. In this model, the nervous system is seen as an active “participant with the ability to enable the initiation of movement as opposed to solely “reacting” to stimuli.

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41
Q

Compensation

A

The ability to utilize alternate motor and sensory strategies due to an impairment that limits the normal completion of a task.

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42
Q

Habituation

A

The decrease in response that will occur as a result of consistent exposure to non-painful stimuli.

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43
Q

What is learning?

A

The process of acquiring knowledge about the world that leads to a relatively permanent change in a person’s capability to perform a skilled action.

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44
Q

Different types of learning

A
  • Non-associative: a single repeated stimulus (habituation, sensitization)
  • Associative: gaining understanding of the relationship between two stimuli, causal relationships or stimulus and consequence (classical conditioning, operant conditioning)
  • Procedural: learning tasks that can be performed without attention or concentration to the task; a task is learned by forming movement habits (developing a habit through repetitive practice)
  • Declarative: requires attention, awareness, and reflection in order to attain knowledge that can be consciously recalled (mental practice)
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45
Q

Motor learning

A

The ability to perform a movement as a result of internal processes that interact with the environment and produce a consistent strategy to generate the correct movement. It is the acquisition of, or modification of movement.

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46
Q

Motor program

A

A concept of a central motor pattern that can be activated by sensory stimuli or central processes. Motor programs are seen as containing the rules for creating spatial and temporal patterns of motor activity needed to carry out a given motor task.

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47
Q

Open system model

A

This is characterized by a single transfer of information without any feedback loop (reflexive hierarchical theory). In this theory, the nervous system is seen as awaiting stimuli in order to react.

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48
Q

Performance

A

A temporary change in motor behavior seen during a particular session of practice that is a result of many variables, however, only one variable is focusing on the act of learning.

Performance is not an absolute measure of learning since there are multiple variables that potentially affect performance.

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49
Q

Plasticity

A

The ability to modify or change at the synapse level either temporarily or permanently in order to perform a particular function

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50
Q

Postural control

A

The ability of the motor and sensory systems to stabilize position and control movement.

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51
Q

Recovery

A

The ability to utilize previous strategies to return to the same level of functioning.

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52
Q

Sensitization

A

The increase in response that will occur as a result of a noxious stimulus.

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53
Q

Strategy

A

A plan used to produce a specific result or outcome that will influence the structure or system.

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54
Q

Agnosia

A
  • The inability to recognize and interpret incoming sensory information when the sensory pathways are intact.
  • Typically, when one form of agnosia exists and does not allow the patient to identify an object, alternate sensory modalities function to compensate and allow the patient to identify the object.
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55
Q

Agraphesthesia

A

The inability to recognize symbols, letters or numbers traced on the skin.

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56
Q

Agraphia

A

The inability to write due to a lesion within the brain and is typically found in combination with aphasia.

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57
Q

Alexia

A

The inability to read or comprehend written language secondary to a lesion within the dominant lobe of the brain.

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58
Q

Anosognosia

A

The denial or unawareness of one’s illness; often associated with unilateral neglect.

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59
Q

Aphasia

A

The inability to communicate or comprehend due to damage to specific areas of the brain.
Acquired neurological impairment of the processing of receptive and/or expressive language.

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60
Q

Apraxia

A
  • The inability to perform purposeful learned movements or activities even though there is no sensory or motor impairment that would hinder completion of the task.
  • Damage to the prelateral forntal cortex and somatosensory association cortex.
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61
Q

Astereognosis

A

The inability to recognize objects by sense of touch.

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62
Q

Body schema

A

Having an understanding of the body as a whole and the relationship of its parts to the whole.

63
Q

Constructional apraxia

A

The inability to reproduce geometric figures and designs. A person is often unable to visually analyze how to perform a task.

64
Q

Decerebrate rigidity

A
  • A characteristic of a corticospinal lesion at the level of the brainstem that results in extension of the trunk and all extremities (Fig. 5-54).
  • Brainstem lesion between superior colliculus and vestibular nucleus.
65
Q

Decorticate rigidity

A
  • A characteristic of a corticospinal lesion at the level of the diencephalon where the trunk and lower extremities are positioned in extension and the upper extremities are positioned in flexion (Fig. 5-55).
  • Lesion above the superior colliculus (above brainstem)
66
Q

Diplopia

A

Double vision.

67
Q

Dysarthria

A
  • Slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech.
  • Motor impairment of speech
  • motor disorder of speech (UMN lesion) that affects the m that articulate words and sounds.
  • could also have some issues respiratory or phonatory systems due to the weakness
68
Q

Dysphagia

A

The inability to properly swallow.

69
Q

Dysprosody

A

Impairment in the rhythm and inflection of speech.

70
Q

Emotional lability

A

A characteristic of a right hemisphere infarct where there is an inability to control emotions and outbursts of laughing or crying that are inconsistent with the situation.

71
Q

Fluent aphasia

A
  • Characteristic of receptive aphasia where speech produces functional output regarding articulation, but lacks content and is typically dysprosodic using neologistic jargon.
  • Empty speech that lacks substance, though work output and speech production are still functional

From lesion in the temporal lobe

72
Q

Hemiparesis

A

A condition of weakness on one side of the body.

73
Q

Hemiplegia

A

A condition of paralysis on one side of the body.

74
Q

Homonymous hemianopsia

A

The loss of the right or left half of the field of vision in both eyes.

lesions of the optic tract, the lateral geniculate nucleus, the optic radiations, and the cerebral visual (occipital) cortex

75
Q

Bitemporal hemianopsia

A

loss of outer half of both R and L visual field resulting in loss of peripheral vision.

Damage occurs at the optic chiasm.

76
Q

Ideational apraxia

A
  • The inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for movement is impaired.
  • pt cannot perform task at all, either on command or on own (wrong sequencing)
77
Q

Ideomotor apraxia

A
  • A condition where a person plans a movement or task, but cannot volitionally perform it. Automatic movement may occur, however, a person cannot impose additional movement on command.
  • pt cannot perform task on command but can do task when left on on. Can perform it automatically
78
Q

Neologism

A

Substitution within a word that is so severe that it makes the word unrecognizable.

79
Q

Non-fluent aphasia

A
  • Characteristic of expressive aphasia
  • where speech is non-functional, effortful, and contains paraphasias
  • speech, speech is awkward, restricted, interrupted, and produced with effort 
  • poor word output, dysprosodic speech, poor articulation, and increased effort for speech.

Writing is also impaired.

Broca’s area (L frontal lobe)

80
Q

Perseveration

A

The state of repeatedly performing the same segment of a task or repeatedly saying the same word/phrase without purpose.

81
Q

Prosopagnosia

A
  • Inability to recognize faces in person or in photos.
  • The person may be identified by the patient, however, by voice or other mannerisms
82
Q

Synergy

A

Mass movement patterns that are primitive in nature and coupled with spasticity due to brain damage.

83
Q

Unilateral neglect

A

The inability to interpret stimuli and events on the contralateral side of a hemispheric lesion. Left-sided neglect is most common with a lesion to the R inferior parietal or superior temporal lobes

84
Q

Cauda equina injury

A

A term used to describe injuries that occur below the L1 level of the spine. A cauda equina injury is considered to be a lower motor neuron lesion

85
Q

Dermatome

A

Designated sensory areas based on spinal segment innervation.

86
Q

Head-hips relationship

A

A principle of mechanics used during mobility training with upper extremity weight bearing used as a fulcrum for activity. This technique requires the head to move in the opposite direction from the hips.

87
Q

Myelotomy

A

A surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function.

88
Q

Myotome

A

Designated motor areas based on spinal segment innervation.

89
Q

Neurectomy

A

A surgical removal of a segment of a nerve in order to decrease spasticity and improve function.

90
Q

Neurogenic nonreflexive bladder

A

The bladder is flaccid as a result of a cauda equina or conus medullaris lesion. The sacral reflex arc is damaged.

91
Q

Neurogenic reflexive bladder

A

The bladder empties reflexively for a patient with an injury above the level of T12.
The sacral reflex are remains intact.

92
Q

Neurologic level

A

The lowest segment (most caudal) of the spinal cord with intact strength and sensation. Muscle groups at this lever must receive a grade of fair.

93
Q

Paradoxical breathing:

A

A form of abnormal breathing that is common in tetraplegia

Inspiration abdomen rises and the chest is pulled inward

On expiration the abdomen falls and the chest expands

94
Q

Paraplegia

A

A term used to describe injuries that occur at the level of the thoracic, lumbar or sacral spine.

95
Q

Rhizotomy

A

A surgical resection of the sensory component of a spinal nerve in order to decrease spasticity and improve function.

96
Q

Sacral sparing

A

An incomplete lesion where some of the innermost tracts remain innervated. Characteristics include sensation of the saddle area, movement of the toe flexors, and rectal sphincter contraction.

97
Q

Tenodesis

A

Patients with tetraplegia that do not possess motor control for grasp can utilize the tight finger flexors in combination with wrist extension to produce a form of grasp.

98
Q

Tenotomy

A

A surgical release of a tendon in order to decrease spasticity and improve function.

99
Q

Tetraplegia (quadriplegia)

A

A term adopted by the American Spinal Injury Association to describe injuries that occur at the level of the cervical spine.

100
Q

Zone of partial preservation

A

A term used to describe the area below the neurologic level of injury that contains partial sensory or motor innervation.

101
Q

Modified Ashworth Scale

A

0 - no increase in muscle tone

1 - slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected parts) is moved in flexion or extension

1+ - slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM

2 - more marked increase in muscle tone through most of the ROM, but affected part(s) easily moved

3 - considerable increase in muscle tone, passive movement difficult.

4 - affected parts rigid in flexion or extension

102
Q

Which two diagnoses would be least likely to warrant the use of the Modified Ashworth Scale?

SCI
DS
Muscular dystrophy
MS

A

down syndrome and muscular dystrophy

this is saying you wouldn’t see spasticity with these

103
Q

When testing the biceps brachii spasticity, a pts elbow should initially be placed in ________ to begin the assessment procedure

A

Flexion

104
Q

When administering the modified ashworth scale, a joint should be through entire range how quickly?

A

in 1 sec

105
Q

Which entry in the medical record would be a potential indicator for the use of the Modified Ashworth Scale?

  • increased evidence of fasciculations
  • presence of an abnormal primitive reflex
  • presence of a peripheral nerve injury
  • increased resistance to passive stretch
A

increased resistance to passive stretch

106
Q

Allodynia

A

the sensation of pain in response to a stimulus that would not typically produce pain

107
Q

Analgesia

A

the absence of pain while remaining conscious

108
Q

Anesthesia

A

the absence of touch sensation

109
Q

Causalgia

A

constant, relentless, burning hyperesthesia and hyperalgesia that develops after a peripheral nerve injury

110
Q

Dysesthesia

A

distortion of any of the senses, especially the sense of touch

111
Q

Hyperesthesia

A

heightened sensation

112
Q

Hyperpathia

A

an extreme exaggerated response to pain

113
Q

Hypesthesia

A

a diminished sensation of touch

114
Q

Neuralgia

A

severe and multiple shock-like pains that radiate from a specific nerve distribution

115
Q

Pallanesthesia

A

loss of vibration sensation

116
Q

Paresthesia

A

abnormal sensations such as tingling. pins and needles or burning sensations

117
Q

Double crush syndrome

A

Existence of two separate lesions along the same nerve that create more severe symptoms than if only one lesion existed

Type of peripheral nerve lesion

118
Q

Mononeuropathy

A

an isolated nerve lesion; associated conditions include trauma and entrapment

Type of peripheral nerve lesion

119
Q

Neuroma

A

abnormal growth of nerve cells; associated conditions include vasculitis, AIDS, and amyloidosis

120
Q

Peripheral neuropathy

A

impairment or dysfunction of the peripheral nerves; associated conditions include diabetic peripheral neuropathy, trauma, alcoholism

121
Q

Peripheral Nerve Lesion process

A

voluntary m first exhibit an altered response to acetylcholine, with wasting of the sarcoplasm and loss of fibrils. This results in total loss of muscle over time with replacement by fibrous tissue.

122
Q

Polyneuropathy

A

diffuse nerve dysfunction that is symmetrical and typically secondary to pathology and not trauma;

Guillain Barre syndrome, peripheral neuropathy, use of neurotoxic drugs, and HIV

123
Q

Neuropraxia

A
  • MILDEST form of injury
  • Conduction block usually due to myelin dysfunction
  • Axonal continuity preserved
  • Axons, epineurium, perineurium, and endoneurium intact
  • Nerve conduction is preserved proximal and distal to the lesion
  • Nerve fibers are not damaged, no evidence of nerve degeneration is noted
  • Symptoms include pain, minimal muscle atrophy, numbness or greater loss of motor and sensory function, diminished proprioception
  • Recovery is rapid and complete and will occur within 4-6
    weeks
  • Pressure injuries are the most common
124
Q

Axontmesis

A
  • A more severe grade of injury to a peripheral nerve (the MIDDLE ONE)
    REVERSIBLE injury to damaged fibers since they maintain an anatomical relationship to each other
    Damage occurs to the axons with preservation of the endoneurium (neural connective tissue sheath), epineurium,
    Schwann cells, and supporting structures
  • Distal Wallerian degeneration can occur
    The nerve can regenerate distal to the site of the lesion at a rate of one millimeter per day
  • Recovery is spontaneous and varies from spotty to no recovery; surgery may be required for repair Traction, compression, and crush injuries are the most
    common
125
Q

Neurotmesis

A

The MOST SEVERE grade of injury to a peripheral nerve
* Axon, myelin, connective tissue components are all damaged or transected
* IRREVERSIBLE injury; no possibility of regeneration
* FLACCID paralysis and wasting of muscles occur; total loss of sensation to area supplied by the nerve
* All motor and sensory loss distal to the lesion becomes permanently impaired
* No spontaneous recovery; with surgical reattachment, potential regenerating axons may grow at one millimeter per day with proximal recovery first; sensory recovery occurs sooner than motor fibers
*Complete transection of the nerve trunk

126
Q

Upper Motor Neuron Disease (what is it and what do you see)

A
  • lesion found in descending motor tracts within the cerebral motor cortex, internal capsule, brainstem, or spinal cord (lateral white column of the SC)
  • Characteristics of upper motor neuron:
  • weakness of involved m
  • hypertonicity
  • hyperreflexia
  • mild disuse atrophy
  • abnormal reflexes
127
Q

What are classified as Upper Motor Neuron Disease (give examples)

A

cerebral palsy
• hydrocephalus
• ALS (both upper and lower)
• CVA
• birth injuries
• multiple sclerosis
• Huntington’s chorea
• traumatic brain injury
• pseudobulbar palsy
• brain tumors

128
Q

Lower Motor Neuron Disease (what is it and what do you see)

A
  • lesion that affects nerves or their axons at or below the level of the brainstem, usually within the “final common pathway”. (vertical gray column of SC)
  • Characteristics of the lower motor neuron:
  • flaccidity or weakness of involved m
  • decreased tone
  • Fasciculations
  • m. atrophy
  • decreased or absent reflexes
129
Q

What are classified as lower motor neuron diseases? (give examples)

A

poliomyelitis
• ALS (both upper and lower)
• Guillain-Barre syndrome
• tumors involving the spinal cord
• trauma
•progressive muscular atrophy
• infection
•Bell’s palsy
• carpal tunnel syndrome
• muscular dystrophy
• spinal muscular atrophy

130
Q

Equilibrium vs non-equilibrium testing

A

Equilibrium testing
- static and dynamic components of POSTURE AND BALANCE when the patient is an upright STANDING position.
- These tests look at STABILITY and FUNCTION as it relates to BALANCE and MOTOR control.
- Examples of equilibrium coordination testing may include standing on one foot or tandem walking

Non-equilibrium testing
- Static and dynamic components of movement when the patient is SITTING.
- These tests incorporate both GROSS and FINE motor activities and are typically used to screen for pathology within the CEREBELLUM.
- Other examples of non-equilibrium coordination testing may include drawing a circle in the air or tapping of the foot on the ground.

131
Q

Finger-to-nose testing as well as sliding the heel back and forth on the opposite shin are examples of which type of testing?

A

Non-equilibrium testings

132
Q

Examples of somatosensory testing?

A
  • discriminative touch, proprioception, pain, and temperature.
  • Examples of somatosensory testing may include two-point discrimination, vibration or stereognosis.
133
Q

Examples of vestibular testing?

A
  • Gaze stabilization, posture, balance, control, and dizziness (vertigo).
  • These tests incorporate activities that may reproduce a patient’s symptoms of dizziness.
  • Examples of vestibular testing include Dix-Hallpike maneuver or the Vertigo Positions and Movement Test.
134
Q

Operant conditioning

A

is learning that takes place when the learner recognizes the connection between the behavior (participating in therapy) and its consequences (receiving identified rewards).

This is a form of associative learning that can be very effective with this age group. (from a question about a 7 y/o that doesn’t want to participate in therapy anymore)

135
Q

Barogenesis

A

Perceive the weight of different objects in the hand

136
Q

Stereognosis

A

Ability to perceive and recognize the form of an object in the absence of visual and auditory information, by using tactile information to provide cues from texture, size, spatial properties, and temperature, etc (from wiki)

137
Q

Raimiste’s phenomenon

A
  • facilitating hip abduction or hip adduction of the involved lower extremity with applied resistance to the uninvolved lower extremity in the same direction.
138
Q

Souque’s phenomenon

A
  • raising the involved upper extremity above 100 degrees with elbow extension in order to produce extension and abduction of the fingers.
139
Q

Homolateral synkinesis

A
  • flexion pattern of the involved upper extremity facilitates flexion of the involved lower extremity.
140
Q

What is superficial sensation and how is it tested?

A
  • Superficial: temperature, light touch, and pain
  • Typically evaluated first. If impairment with this can expect impairment in the other two
  • Temperature: perceive warm vs cold test tubes
  • Light touch: perceive through light pressure or use of a cotton ball
  • Superficial Pain: perceive noxious stimulus using a pen cap, paper clip end or pin
141
Q

What is deep sensation and how is it tested?

A
  • Deep: proprioception, kinesthesia, vibration
  • Need to be tested separately though they are all similar.
  • Proprioception: identify a static position of an extremity or body part
  • Kinesthesia: identify direction and extent of movement of joint or body part
  • Vibration: perceive vibration or pain through tuning fork.
142
Q

What is cortical sensation and how is it tested?

A
  • Cortical: B simultaneous stimulation, stereognosis, two-point discrimination, barognosis, localization of touch
  • Combined cortical sensation are interpretive sensory functions that require superficial and deep sensations to be intact in order to reliably measure.
  • 2-point discrimination: use a 2-point caliper on the skin, identify 1 or 2 points without visual input.
  • Barognosis: perceive the weight of different objects in the hand
  • Localization of touch: ability to identify exact location of light touch on body using verbal response or gesturing.
143
Q

What two factors most likely affect the outcome of nerve conduction velocity testing (if they have no neurological damage?)

A

Age and temperature – most influential factors

  • at birth NCV is 1/2 of the adult value; decreases after age 35; significantly decreases after age 70
  • Skin temp should be at least 25C (95F) for UE or 32C (90F) for the LE for NCV to be considered valid
144
Q

Figure ground discrimination dysfunction

A
  • lesion of the parieto-occipital lesion of the R hemisphere
  • difficulty distinguishing the foreground from the background in a complex visual array.
  • difficulty ignoring irrelevant visual stimuli and can’t select the appropriate cue to respond
  • can lead to distractibility, resulting in shortened attention span, frustration, and decreased independent and safe functioning.
  • How to test: picking out forks out of a drawer of disorganized silverware, locate buttons on shirt, distinguish arm hole on shirt, not able to tells steps apart on stairs.
145
Q

Which hemisphere is most responsible for language?

A

LEFT

146
Q

Wernicke’s Aphasia

A

Type of fluent aphasia (aka receptive aphasia).

  • Impaired reading and auditory comprehension of speech. (have to use non-verbal cuing!)
147
Q

Conduction aphasia

A
  • Type of fluent aphasia
  • Severe impairment with word repetition and word finding difficulty.
148
Q

Broca’s Aphasia

A
  • Non-fluent (aka expressive aphasia)
  • Difficulty with naming and repetition skills and frustration with language skill errors. (they know they are wrong)
149
Q

Global Aphasia

A
  • Non-fluent
  • Both comprehension impairments and impairments in naming, writing, and reptition skills
150
Q

Verebal Apraxia

A
  • impairment of prosody and articulation of speech.
  • verbal expression is impaired due to motor planning issues.
151
Q

Which area of the brain serves as the motor area for speech?

A

Broca’s area is found in the frontal lobe and is responsible for expression of language.

152
Q

Dysphonia

A

changes in vocal quality such as harshness, hoarseness or breathiness

153
Q

Which artery affected is likely to impact the speech?

A

L MCA

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