Neuromuscular Flashcards
when you stand on foam or pillow with eyes open, what systems are you relying on and which are you not relying on? Why?
eyes open, the visual system is relied on.
You are also relying on the vestibular system because it is not compromised.
You are NOT relying on proprioceptive because the pillow is allowing too much movement in the ankles and you cannot rely solely on this system.
common impairments left vs right side of the brain CVA
left sided: speech issues, language issues, difficulty planning and sequencing, cautious behavior.
right sided: spatial awareness problems, difficulty sustaining movement and impulsive behavior.
when learning a new skill… do you want massed or distributed? do you want frequent feedback
distributed, and no, NO frequent feedback.
differentiate between spastic and athetoid CP
spastic CP will have increased tone due to the involvement of the cerebrum motor cortex. There will be couched gait (hip flexion, ADD, IR and knee flexion). There will also be contractures and deformities
Athetoid will be a mixed tone condition. There is an issue int he basal ganglion, and there will be slow integrating reflexes and issues with posture. This is known as “floppy baby” or “worm” due to the mixed tones.
sustained contractions is indicative of
dystonia
chorea is described as
rapid/jerky movements
moving the eyeball lateral tests the ___ CN
abducens, 6.
how do you test the VOR
rapid, movements of the head with high velocity and high acceleration so the eyes can stay fixed on a target in those conditions.
Cremasteric reflex.
For the cremasteric reflex text, the patient lies in supine position while the examiner strokes the inner side of the upper thigh with a pointed object. The test result is negative if the scrotal sac on the tested side pulls up. Unilateral absence of this response indicates a lower motor neuron lesion between L1 and L2.
anal sphincter contraction comes from what nerve roots
S2-4
Gluteal sensation comes from what nerve roots
L4-5 and S1-3
superficial abdominal reflex
Movement of the umbilicus down and toward the area being stroked is due to the superficial abdominal reflex. The examiner uses a pointed object to stroke each quadrant of the abdomen of the supine patient in a triangular fashion around the umbilicus. Absence of the reflex (movement of the skin) indicates an upper motor neuron lesion; unilateral absence indicates a lower motor neuron lesion from T7–L2, depending on where the absence in noted, as a result of segmental innervation.
flexion synergy of the UE looks like…
scapular elevation/retraction and hyperextension, shoulder ABD, ER, elbow flexion, forearm supination and finger and wrist flexion.
if you nee to mobilize a scapula that is in a flexor synergy, how would you do it
upward rotation and protraction. we want to preserve the subacromial space in there and not cause more damage.
difference between decorticate and decerebrate
decorticate is a comatose patient with a lesion above the superior colliculi that will result in UE flexion and LE extension
Decerebrate is a lesion between the superior colliculi and the vestibular nucleus resulting in all extension at the Extremities and trunk and neck.
jaw reflex tests tests the integrity of which CN
5- trigeminal
what causes central cord syndrome
hyperextension of the neck
lump in the throat is indicative of
transverse ligament tear
bowel function with the following two conditions:
above S2-4
Below S2-4
above S2-4 spastic bowel with spinal dedication reflexes intact
below flaccid bowel (loss of spinal defecation reflexes)
what is the Tinel sign
this is a sign for CTS, where you tap the anterior surface of the wrist from primal to distal.
describe the Spurling test
compression of the spine with ipsilateral rotation and extension
direct pressure at the base of the thumb with test for
bowlers thumb.
do you transfer to the stronger or weaker side
stronger side. example, if you are s/p hip arthroplasty, you will want to transfer to the stronger side and not onto the weaker surgical side.
what factor best predicts upper extremity function following a CVA
having active wrist and finger extension
Phalen test is for
carpal tunnel, this is when the wrists are together and the fingers are pointing down to the ground.
Allen test is for
TOS
Froment test is for
ulnar nerve. pinch the paper. A positive test is if the thumb cannot stay flat and straight when gripping the paper, and when there is abnormal flexion in the thumb.
piano key test is for
distal radioulnar injury.
upbeating vs downbeating nystagmus and determining which canal. then what about right and left torsion.
the upbeating indicates a posterior canal whereas the downbeating indicated an superior canal. right torsion means its the right side, and left is with left.
what is the beginning stage of motor learning and what should you do here
cognitive stage, this is where cues, instruction, guidance and demonstration should be used here.
Performing a task with little cognitive attention at variable speeds is characteristic of the ___ stage of learning.
autonomous
Problem-solving independent from the therapist’s feedback is characteristic of the ___ stage of learning.
associative
Exploration of different strategies with little or no input from the therapist is characteristic of the ___ stage of learning.
associative
what CN palsy can lead to torticollis in a child
CN 4, trochlear due to a visual deficit in which the eyes cannot move. can cause diplopia, so kids will tilt their head anteriorly and laterally towards the good side.
name some contraindications for postural drainage
head trauma
spinal fusions
eye surgeries
precautions for postural drainage
pleural effusion
PE
chorea is an issue in what structure of the brain
basal ganglia
list some components of the DCML
proprioception, discrimination light touch, vibration.
what is on the anterolateral tract
distinction between hot and cold and light touch
___ ___ grade is an important predictor of motor recovery
Initial paresis
cubital tunnel entrapment is the ___ nerve
ulnar nerve
what runs through the pronator teres
median nerve
FCR, FDS, FPL, FPB are all innervated by
median nerve
Bakody sign
TOS
agonist reversals will help with what kind of contraction
eccentric (also concentric and isometric too)
rhythmic stabilizations help with
isometric contractions
rhythmic initiations help with
concentric contractions
dynamic reversals only focus on
concentric
musculocutaneous nerve innervates the
biceps and brachialis.
brachioradialis is innervated by the
radial nerve
pronator teres innervated by
median nerve
feedback should occur after every __- reps for hard and simple tasks
simple, after 15
hard after 5
Which of the following interventions is MOST appropriate to improve stability in long sitting for an individual with a complete T4 spinal cord injury?
stretch hamstrings to 110 degrees SLR to stretch the naturally tight low back.
how can you test figure ground discrimination
you can look at the white button on the white shirt. they cannot tell the difference between the object and the background in which it is embedded.
Which of the following exercises promotes context-dependent responses in a patient who has Parkinson disease? swimming treadmill walking outside stationary bike.
Exercises such as karate and other martial arts, dancing, and walking outdoors promote context-dependent responses and are important to incorporate in treatment of patients who have movement disorders because these exercises require patients to adjust the response to a specific task
retention is tested after
a period of no practice.
APGAR score looks at
appearance (A), pulse (P), grimace (G), activity (A), and respiration (R)
scored on a scale of 10. because each one is scored out of 2
tests at 1 or 5 minutes. over 7 means the baby is ok.
how will reflexes look in MS
hyperreflexive
cranial nerves responsible for eye movements
CN III oculomotor: ADD, ELEVATION AND DEPRESSION OF EYE
CN IV: trochlear, depression of an adducted eye
CN VI: abducens: lateral abduction movements of the eye
A physical therapist is conducting an initial examination with a patient who has a history of an ASIA Impairment Scale A cervical spinal cord injury. The patient has 5/5 muscle strength in the elbow flexors, elbow extensors, finger flexors, and wrist extensors but 0/5 muscle strength in the finger abductors. What is the patient’s motor level?
C8 because the T1 would be the finger abductors, so the next likely with the 5/5 strength is the finger flexors which is C8.
spinothalamic tract relays ___ and ___ information in the spinal cord.
pain and temperature
The spinocerebellar tract relays unconscious ___ in the spinal cord.
proprioception
the ___ are the key muscle group to facilitate independence in lateral transfers
triceps
