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NPTE > Neuromuscular > Flashcards

Neuromuscular Flashcards

1
Q

Thrombus

A

Atherosclerotic plaque build up in artery causing occlusion

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2
Q

Embolus

A

Tissue (typically atherosclerotic plaque) travels through bloodstream until it reaches a vessel it cannot pass through, causing occlusion

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3
Q

L hemisphere CVA symptoms

A

R sided weakness
Frustration
Decreased processing
Aphasia
Dysphagia
Motor apraxia
Decreased R/L discrimination
R hemianopsia

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4
Q

R hemisphere CVA Symptoms

A

L sided weakness
Decreased attention span
L hemianopsia
Decreased awareness and judgment
Memory deficits
L inattention
Decreased abstract reasoning
Emotional lability
Impulsivity
Decreased spatial orientation

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5
Q

Brainstem CVA Symptoms

A

Unstable vitals
Decreased consciousness
Decreased ability to swallow
Bilateral weakness/paralysis

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6
Q

Cerebellum CVA Symptoms

A

Decreased balance
Ataxia
Decreased coordination
Nausea
Nystagmus
Decreased ability to perform postural adjustment

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7
Q

Flexor synergy pattern (UE)

A

Scapular elevation + retraction
GH abduction + ER
Elbow flexion
Wrist flexion
Forearm supination
Finger flexion and adduction
Thumb flexion and adduction

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8
Q

Extensor synergy pattern (UE)

A

Scapular depression + protraction
GH adduction + IR
Elbow extension
Wrist extension
Forearm pronation
Finger flexion and adduction
Thumb flexion and adduction

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9
Q

Flexor synergy pattern (LE)

A

Hip abduction + ER
Knee flexion
Ankle DF + supination
Toe extension

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10
Q

Extensor synergy pattern (LE)

A

Hip extension, adduction, IR
Knee extension
Ankle PF + pronation
Toe flexion + adduction

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11
Q

Motor control

A

Ability to regulate and direct movement

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12
Q

Motor learning

A

Acquisition or modification of movement

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13
Q

Motor learning principles

A

Learning vs performance
Use of feedback
Impact of practice on skill
Transfer of learning across tasks and environments

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14
Q

Adam’s closed loop theory of motor learning

A

Use of sensory feedback (compare current movement with stored information) and practice

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15
Q

Schmidt’s schema theory of motor learning

A

High emphasis on the value of feedback and variation with practice, open loop

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16
Q

Three stage model: cognitive phase

A

Controlled environment preferred
High rate of errors
Inconsistent attempts and performance
Increased cognitive work (listening, observing and processing feedback)

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17
Q

Three stage model: associative phase

A

Controlled or open environment okay
Decreased errors
More independently able to distinguish correct vs incorrect performance
Should avoid excessive external feedback (use of internal/proprioceptive feedback)
Decreased need for concentration and cognition
Skill refinement
Improved coordination

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18
Q

Three stage model: autonomous phase

A

Improved efficiency
Variable environment
Automatic response, non-cognitive
Error-free regardless of environment or distractions
Can perform more than one task simultaneously
Intrinsic feedback > extrinsic (should not be used)

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19
Q

Intrinsic feedback

A

Feedback received through sensory systems as a result of movement

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20
Q

Extrinsic feedback

A

Feedback provided during or after a movement, typically verbal or manual/tactile

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21
Q

Knowledge of results

A

Extrinsic, terminal feedback, regarding the outcome in relation to the goal

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22
Q

Knowledge of performance

A

Extrinsic, relating to the actual movement pattern

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23
Q

Massed practice

A

Practice time > rest time

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24
Q

Distributed practice

A

Practice time < (or equal to) rest time

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25
Q

Constant practice

A

Uniform practice conditions

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26
Q

Variable practice

A

Differing practice conditions

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27
Q

Random practice

A

Varying practice amongst different tasks

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28
Q

Blocked practice

A

Consistent practice of single task

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29
Q

Whole training

A

Practicing entire task

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30
Q

Part training

A

Practicing individual component of task

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31
Q

Closed system model

A

Transfer of information that incorporates multiple feedback loops and larger distribution of control. Nervous system is an active participant

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32
Q

Compensation

A

Ability to utilize alternate strategies due to impairment that limits normal completion of task

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33
Q

Habituation

A

Decreased response due to consistent exposure to stimuli

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34
Q

Learning (non-associative)

A

Single repeated stimulus (habituation, desensitization)

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35
Q

Learning (associative)

A

Gaining understanding of the relationship between multiple stimuli (classic or operant conditioning)

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36
Q

Learning (procedural)

A

Learning of tasks that can be performed automatically without attention or concentration

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37
Q

Learning (declarative)

A

Learning of tasks that require attention, awareness, and reflection to attain knowledge

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38
Q

Open system model

A

Single transfer of information within any feedback loop, nervous system in “awaiting stimuli” to react

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39
Q

Sensitization

A

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

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40
Q

Closed motor skill

A

Skill performed under a stable and unchanging environment

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41
Q

Open motor skill

A

Skill performed under a consistently changing environment

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42
Q

Carr and shepherd motor relearning approach

A

Emphasizes that the factors involved with learning are also involved with re-learning (setting goal, inhibition of unnecessary movement, adjusting to balance/gravity, proper alignment, internal and external practice, feedback, knowledge of results)

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43
Q

Bobath NDT

A

-Train postural control by decreasing BOS and increasing distance between COM and BOS
-Avoid compensation
-Include rotation in treatment
-Move in and out of midline to facilitate midline orientation/control
-Facilitate and inhibit tone
-Reflex inhibiting postures
-Proximal control

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44
Q

Brunnstrom 7 stages of recovery (hemiplegia)

A

1 - no volitional movement
2 - basic synergies, spasticity beginning to form
3 - synergies performed volitionally, increasing spasticity
4 - decrease in spasticity, movement patterns exist outside of synergies
5 - decrease in spasticity, independence from synergy patterns
6 - isolated joint movements performed with coordination
7 - normal motor function

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45
Q

Associated reaction definition

A

Involuntary and automatic movement of a body part as a result of an intentional active or resistive movement in another body part

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46
Q

Homolateral synkinesis definition

A

Flexion pattern of the involved upper extremity facilitates flexion of the involved lower extremity

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47
Q

Raimiste’s Phenomenon

A

The involved LE will abduct/adduct with applied resistance to the uninvolved LE in the same direction

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48
Q

Souques’ Phenomenon

A

Raising the involved UE above 100 deg with elbow extension will produce abduction and extension of the fingers

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49
Q

UE PNF: D1 Flexion

A

Scapular elevation, abduction, upward rotation
GH flexion, adduction, ER
Elbow flexion or extension
Radioulnar supination
Wrist flexion, radial deviation
Thumb adduction

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50
Q

UE PNF: D1 Extension

A

Scapular depression, adduction, downward rotation
GH extension, abduction, IR
Elbow flexion or extension
Radioulnar pronation
Wrist extension, ulnar deviation
Thumb abduction

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51
Q

UE PNF: D2 Flexion

A

Scapular elevation, adduction, upward rotation
GH flexion, abduction, ER
Elbow flexion or extension
Radioulnar supination
Wrist extension, radial deviation
Thumb extension

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52
Q

UE PNF: D2 Extension

A

Scapular depression, abduction, downward rotation
GH extension, adduction, IR
Elbow flexion or extension
Radioulnar pronation
Wrist flexion, ulnar deviation
Thumb opposition

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53
Q

LE PNF: D1 Flexion

A

Pelvic protraction
Hip flexion, adduction, ER
Knee flexion or extension
Ankle and toe DF, inversion

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54
Q

LE PNF: D1 Extension

A

Pelvic retraction
Hip extension, abduction, IR
Knee flexion or extension
Ankle and foot PF, eversion

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55
Q

LE PNF: D2 Flexion

A

Pelvic elevation
Hip flexion, abduction, IR
Knee flexion or extension
Ankle and foot DF, eversion

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56
Q

LE PNF: D2 Extension

A

Pelvic depression
Hip extension, adduction, ER
Knee flexion or extension
Ankle and foot PF, inversion

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57
Q

Agonist reversals

A

Targets: controlled mobility, skill
Isometric contraction, followed by alternating concentric and eccentric contractions with resistance

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58
Q

Alternating isometrics

A

Targets: stability (endurance and strength)
Isometric contractions performed alternating from one side of joint to the other (without rest)

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59
Q

Contract relax

A

Targets: mobility
End range of motion –> maximal isotonic contraction of antagonist muscle (5 s) while moving limb through ROM –> relax into range

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60
Q

Hold relax

A

Targets: mobility
End range of motion –> maximal isometric contraction of antagonist muscle (5 s) –> relax into range

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61
Q

Hold relax active movement

A

Targets: mobility (used to initiate movement in muscle testing 1/5 of less)
Muscle taken to shortened range –> contracted isometrically –> relaxed and taken to lengthened position + quick stretch –> isotonic contraction attempted to return limb to shortened position

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62
Q

Normal timing

A

Targets: skill (coordination)
Performed distal to proximal, proximal components are limited until distal components activate and initiate movement - promotes appropriate muscle contraction timing (distal – proximal)

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63
Q

Repeated contractions

A

Targets: mobility
Used to initiate movement and sustain contraction through ROM
Provide quick stretch followed by isometric/tonic contractions through ROM

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64
Q

Resisted progression

A

Targets: skill (coordination)
Resistance applied during the gait cycle to enhance coordination, strength, endurance

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65
Q

Rhythmic initiation

A

Targets: mobility (initiating movement with hypertonia)
passive –> active assisted –> active –> slightly resisted
Slow and rhythmic through full ROM

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66
Q

Rhythmic stabilization

A

Targets: mobility, stability
Used as a progression from alternating isometrics
Isometric contractions of all muscles around a joint against progressive resistence

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67
Q

Rhythmical rotation

A

Target: mobility (decrease hypertonia)
Passively rotating an extremity around longitudinal axis

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68
Q

Slow reversal

A

Target: stability, controlled mobility, skill (movement control and posture)
Slow resisted concentric contractions of agonists and antagonists without rest

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69
Q

Slow reversal hold

A

Target: stability, controlled mobility, skill
Slow reversal with the addition of isometric contraction at the end of each movement

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70
Q

NM Junction injury signs

A

Sensory intact, motor fatigue, normal DTR (Myesthenia gravia)

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71
Q

Chorea

A

Sudden, rapid, jerky, purposeless movement involving limbs, trunk, face

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72
Q

Asthenia

A

Weakness due to cerebellar pathology

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73
Q

Dysmetria

A

Inability to control the range of a movement or force of muscle activity

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74
Q

Evoke potentials purpose

A

Non-invasive, used to rule out MS, brain tumor, acoustic neuroma

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75
Q

Myelography purpose

A

Invasive, used to rule out abnormalities in subarachnoid space, spinal n injury, herniated disc, fracture, back/hip pathology, spinal tumors

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76
Q

ALS UMN signs

A

Incoordination
Spasticity
+ babinski
Clonus
Fatigue
Oral motor impairment
Motor paralysis
Respiratory paralysis

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77
Q

ALS LMN signs

A

Asymmetric muscle weakness
Fasciculations
Cramping
Hand atrophy
Distal > proximal weakness

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78
Q

Friedrich’s ataxia signs

A

Gait unsteadiness
UE ataxia
Dysarthria
Paresis
Tremors
Impaired reflexes, vibration and position sense
Caused by impaired mitochondria function (autosomal recessive)

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79
Q

Huntington’s disease signs

A

Involuntary choric movement
Mild personality alteration
Tongue protrusion
Grimacing
Ataxia

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80
Q

Multiple sclerosis signs

A

Visual impairment
Paresthesias/sensory changes
Clumsiness
Weakness
Ataxia
Balance dysfunction
Fatigue
Periods of exaceration and remission

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81
Q

Myasthenia gravis signs

A

Extreme fatiguability
Muscle weakness
Ocular muscles impacted first
Dysphagia
CN weakness

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82
Q

Parkinson’s disease signs

A

Resting tremor
Impaired balance
Bed mobility
Fine motor tasks

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83
Q

PD progression

A

Hypokinesia
Akinesia
Rigidity
Freezing
Mask like appearance
Festinating and shuffling gait
Bradykinesia
Poor posture
Dysphagia

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84
Q

Post-polio syndrome signs

A

Slow and progressive weakness
Fatigue
Atrophy
Pain
Swallowing issues

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85
Q

Anti-spasticity drug names

A

Baclofen
Valium (diazepam)

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86
Q

Cholinergic drug indications

A

Glaucoma
Dementia
Myesthenia gravis

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87
Q

Cholinergic drug names

A

Duroid
Pilocar
Aricept
Tensilon

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88
Q

Dopamine replacement drug names

A

Levodopa
Amantadine

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89
Q

Muscle relaxant drug names

A

Valium (diazepam)
Flexeril
Paraflex

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90
Q

Anti-epileptic drug side effects

A

Ataxia
Skin changes
HA
Weight gain
Behavior changes
GI
Blurred vision

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91
Q

Anti-spasticity drug side effects

A

Drowsiness
Dizziness
Confusion
Weakness
HA

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92
Q

Dopamine replacement drug side effects

A

Arrhythmias
GI
Orthostatic hypotension
Mood
Dyskinesia
Tolerance

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93
Q

Muscle relaxant drug side effects

A

Sedation
Drowsiness
Dizziness
N/V
HA
Tolerance
Dependence

94
Q

Allodynia

A

Pain due to non-pain provoking stimulus

95
Q

Causalgia

A

Persistent, severe, burning pain due to peripheral n injury

96
Q

Paresthesia

A

Abnormal sensation of numbness and tingling without objective cause

97
Q

Peripheral n injury

A

Sensory loss, motor weakness, atrophy in nerve distribution
Fasciculations
Ex. trauma

98
Q

Peripheral neuropathy injury

A

Stocking glove sensory impairments
Distal > proximal weakness
Fasciculations
Decreased DTRs
Ex. DB

99
Q

Spinal root n injury

A

Dermatomal sensory loss and motor weakness
Fasciculations
Decreased DTRs
Ex. herniated disc

100
Q

Athetosis

A

Slow, writhing, involuntary movements

101
Q

Dystonia

A

Abnormal muscle tone causing twisting, abnormal posture and repetitive movements
Ex. PD, CP, encephalitis

102
Q

Akinesia

A

Inability to initiate movement

103
Q

Ataxia

A

Lack of muscle coordination

104
Q

Dysdiadochokinesia

A

Inability to perform rapid alternating movements

105
Q

Clasp knife response

A

Tone with greatest resistance at beginning of ROM

106
Q

Cerebral angiography purpose

A

Invasive, used to diagnose CVA, brain tumor, aneurysm, vascular malformation

107
Q

CT scan purpose

A

Non-invasive, used to rule out vascular malformation, tumor, cyst, herniated disc, hemorrhage, epilepsy, encephalitis, spinal stenosis, intracranial bleeding, head injury

108
Q

Discography purpose

A

Invasive, CT scan + contract, used to assess integrity and pathology of spinal disc

109
Q

EMG purpose

A

Invasive, used to rule out muscle pathology, nerve pathology, spinal cord disease, denervated muscle, LMN injury

110
Q

MRI purpose

A

Non-invasive, used to rule out MS, brain tumor, head trauma

111
Q

PET scan purpose

A

Non-invasive, used to rule out cerebral circulatory pathology, metabolism dysfunction, tumor, blood flow, brain changes

112
Q

Spinal puncture purpose

A

Invasive, used to rule out hemorrhage, inflammation, infection, meningitis, tumor

113
Q

Alzheimers signs

A

Changes in higher cortical functions (learning, memory, concentration)
Loss of orientation
Word finding difficulty
Depression
Poor judgement
Rigidity
Bradykinesia
Shuffling gait

114
Q

Bell’s palsy signs

A

Asymmetrical facial appearance, full 1/2 face

115
Q

Carpal tunnel syndrome signs

A

Sensory and motor changes to median n distribution
Radiating pain
Night pain
Hand weakness
Decreased grip strength
Clumsiness
Decreased wrist mobility

116
Q

Spinocerebellar ataxia signs

A

Neuropathy
Ataxia
Restless leg syndrome
Autosomal dominant

117
Q

Acquired ataxias cause

A

Toxin exposure (alcohol, carbon monoxide, etc)
Idiopathic (hypothydroidism)

118
Q

Epilepsy signs

A

Loss of awareness
Loss of consciousness
Movement disturbances
Sensation
Mood
Mental function

119
Q

Myoclonic seizures

A

Muscle contractions involving one or multiple body parts

120
Q

Atonic seizures

A

Loss of tone, LOC, drop attack

121
Q

Bilateral convulsive seizure (tonic and clonic)

A

Sudden LOC
Rigidity - tonic
Jerking - clonic

122
Q

Absence seizure

A

Sudden cessation of ongoing conscious activity (ie petit mal seizure)

123
Q

Guillain barre syndrome signs

A

Motor weakness (distal to proximal)
Sensory impairment
Respiratory paralysis
Peak disability @ 2-4 wk
Decreased DTRs

124
Q

Anti-epileptic drug names

A

Clonazepam
Gabapentin
Carbamezepine

125
Q

Cholinergic drug side effects

A

GI
Bradycardia
Bronchoconstriction
Parasympathetic response

126
Q

Dorsal column (fasiculis gracilis) function

A

LE proprioception
Vibration
Two point discrimination

127
Q

Dorsal column (fasiculis cuneatus) function

A

UE proprioception
Vibration
Two point discrimination

128
Q

Anterior spinothalamic tract function

A

Crude touch
Deep pressure

129
Q

Lateral spinothalamic tract function

A

Pain
Temperature

130
Q

Anterior corticospinal tract function

A

Ipsilateral voluntary, discrete movement

131
Q

Lateral corticospinal tract function

A

Contralateral voluntary, fine movement

132
Q

Analgesia

A

Inability to feel pain

133
Q

Anesthesia

A

Loss of sensation

134
Q

Dysesthesia

A

Distortion of any sense (specifically touch)

135
Q

Hyperesthesia

A

Increased sensitivity to stimulation

136
Q

Hyperpathia

A

Extreme exaggerated response to pain

137
Q

Hypesthesia

A

Decreased sensitivity to touch

138
Q

Neuralgia

A

Nerve pain

139
Q

Pallanesthesia

A

Loss of vibration sensation

140
Q

Anterior horn cell injury

A

Sensory intact
Motor weakness
Normal or decreased DTRs
Ex. polio, ALS

141
Q

Muscle injury

A

Sensory intact
Motor weakness
Normal or decreased DTRs
Ex. muscular dystrophy

142
Q

Nerve conduction velocity purpose

A

Non-invasive, used to rule out peripheral neuropathy, carpal tunnel, demyelination injury, peripheral n compression

143
Q

Rood theory to neuromuscular treatment

A

Motor output is the result of past and present sensory input
Goal: obtain homeostasis by using key patterns to enhance motor control
Sensory stimulation is used to facilitate or inhibit a response

144
Q

Sensory facilitation techniques

A

Approximation
Joint compression
Icing
Light touch
Quick stretch
Resistance
Tapping
Traction

145
Q

Sensory inhibition techniques

A

Deep pressure
Prolonged stretch
Warmth
Prolonged cold

146
Q

Agnosia

A

Inability to interpret information

147
Q

Agraphesthesia

A

Inability to recognize symbols, letters, or numbers traced on the skin

148
Q

Agraphia

A

Inability to write due to lesion

149
Q

Alexia

A

Inability to read or comprehend written language due to lesion

150
Q

Anosognosia

A

Denial or unawareness of one’s illness

151
Q

Apraxia

A

Inability to perform purposeful learned movements (with no impairment that would hinder)

152
Q

Astereognosis

A

Inability to recognize objects by touch

153
Q

Constructional apraxia

A

Inability to reproduce geometric figures and designs. Unable to visually analyze how to perform a task.

154
Q

Decerebrate rigidity

A

Characteristic of corticospinal lesion at the level of the brainstem
Extension of trunk and all extremities

155
Q

Decorticate rigidity

A

Characteristic of corticospinal lesion at the level of the diencephalone
Trunk and LE in extension, UE in flexion

156
Q

Dysprosody

A

Impairment in rhythm and inflection of speech

157
Q

Ideational apraxia

A

Inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for movement is impaired

158
Q

Ideomotor apraxia

A

Able to plan a movement but cannot volitionally perform it

159
Q

Neologism

A

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

160
Q

Anterior cord syndrome impairments and MOI

A

MOI flexion
Loss of motor, pain, temperature (CST and STT)

161
Q

Brown sequard syndrome impairments and MOI

A

MOI stab
Loss of ipsilateral motor, vibration, proprioception (DCML and CST)
Loss of contralateral pain and temperature (STT)

162
Q

Cauda equina syndrome impairments

A

Lesion below L1, peripheral n injury
Flaccidity, areflexia, bowel and bladder dysfunction

163
Q

Central cord syndrome impairments and MOI

A

MOI hyperextension
STT, DCML, CST
UE > LE injury
Motor > sensory impairments

164
Q

Posterior cord syndrome impairments and MOI

A

MOI (rare) posterior spinal a compression
Loss of proprioception, two point discrimination, stereogensis
Motor preserved

165
Q

ASIA A

A

Complete: no sensory or motor function in S4-5

166
Q

ASIA B

A

Sensory incomplete
Sensory preserved below the level of lesion, including S4-5.
No motor function in more than 3 levels below motor level

167
Q

ASIA C

A

Motor incomplete
Motor function preserved for voluntary anal contraction OR sensory incomplete + motor function of more than 3 levels below motor level
Less than half of the muscle below injury have a grade of > 3

168
Q

ASIA D

A

Motor incomplete
At least half of muscles below injury have a grade > 3

169
Q

ASIA E

A

Normal function

170
Q

ASIA Key muscles

A

C5 elbow flexors
C6 wrist extensors
C7 elbow extensors
C8 finger flexors
T1 small finger abductors
L2 hip flexors
L3 knee extensors
L4 ankle DFs
L5 great toe extensors
S1 ankle PFs

171
Q

DVT symptoms

A

LE swelling
Pain
Sensitivity over clot
Warmth

172
Q

Autonomic dysreflexia

A

Can occur with any lesion above T6
Symptoms: high BP
Severe HA
Blurred vision
Stuff nose
Profuse sweating
Goose bumps
Flushing

173
Q

Heterotopic Ossification symptoms

A

Edema
Decreased ROM
Increased temperature of involved joint

174
Q

Myelotomy

A

Surgical procedure that severs certain tracts in spinal cord to decrease spasticity and improve function

175
Q

Neurectomy

A

Surgical removal of a segment of a nerve to decrease spasticity and improve function

176
Q

Neurogenic non-reflexive bladder

A

Flaccid bladder (underactive muscles), injuries below T12

177
Q

Neurogenic reflexive bladder

A

Reflexive bladder, empties reflexively, injury above T12

178
Q

Paradoxical breathing

A

Abnormal breathing where abdomen rises and chest is pulled inward during inspiration, upon expiration the abdomen falls and chest expands (common in tetraplegia)

179
Q

Rhizotomy

A

Surgical resection of sensory component of spinal n to decrease spasticity and improve function

180
Q

Tenotomy

A

Surgical release of a tendon in order to decrease spasticity and improve function

181
Q

Coup lesion (TBI)

A

A direct lesion of the brain under the point of impact. Local brain damage sustained
Primary injury

182
Q

Contrecoup lesion (TBI)

A

An injury that results on the opposite side of the brain, due to rebound effect of brain after impact
Primary injury

183
Q

Epidural hematoma (TBI)

A

Hemorrhage that forms between skull and dura mater
Secondary injury

184
Q

Subdural hematoma (TBI)

A

Hemorrhage that forms between dura mater and arachnoid mater (due to venous rupture)
Secondary injury

185
Q

Secondary injury types (TBI)

A

Hematoma
Hypoxia
Ischemia
Increased ICP
Post traumatic epilepsy

186
Q

Primary injury types (TBI)

A

Skull penetration
Skull fracture
Contusions

187
Q

Coma

A

Unconscious and unresponsible to external and internal stimuli

188
Q

Stupor

A

State of general unresponsiveness with arousal from repeated stimuli

189
Q

Obtundity

A

State of sleep, reduced alertness, delayed responses to stimuli

190
Q

Grade 1 concussion

A

Head injury without LOC
Transient confusion, resolves in less than 15 min
Removed from game and return after 1 week of no symptoms

191
Q

Grade 2 concussion

A

Moderate head injury
Transient confusion for > 15 min
Poor concentration, retrograde/anterograde amnesia
Removed from game and medical eval
Return to play after 2 weeks of no symptoms

192
Q

Grade 3 concussion

A

Head injury with LOC
Transport to ER for full neuro evaluation
Minimum of 1 month symptom free for return to play

193
Q

Rancho level I

A

No response
Deep sleep, completely unresponsive

194
Q

Rancho level II

A

Generalized response
Inconsistent, non-purposeful, non-specific response to stimuli
Responses include physiological changes, gross body movements, vocalization

195
Q

Rancho level III

A

Localized response
Inconsistent, specific response to stimuli
May follow simple commands (EC, hand squeeze) inconsistently

196
Q

Rancho level IV

A

Confused agitated
Heightened state of activity
Bizarre, non-purposeful activity
Unable to cooperate with treatment efforts
Frequent incoherent, inappropriate verbalization
Brief attention to environment
Lacks short and long term recall

197
Q

Rancho level V

A

Confused in-appropriate
Responds to simple commands fairly consistently
Gross attention to the environment, but is highly distractible and cannot focus on task
Inappropriate vocalization
Severely impaired memory
May perform learned tasks with structure, unable to learn new tasks

198
Q

Rancho level VI

A

Confused appropriate
Goal-directed behavior, dependent on external input/direction
Follows simple directions consistently, shows carryover
May respond incorrectly due to memory difficulty
More depth and detail to past memory than present

199
Q

Rancho level VII

A

Automatic appropriate
Appropriate and oriented to hospital and home setting
Goes through daily routine automatically
Carryover in new learning
Able to initiate social or recreational activities with structure

200
Q

Rancho level VIII

A

Purposeful appropriate
Able to recall and integrate past and present events and is aware of and responsive to environmental stimuli
Shows carryover in new learning and no longer needs supervision

201
Q

Glasgow coma scale

A

< 8 severe brain injury
9-12 moderate brain injury
13-15 mild brain injury
Assesses: eye opening, motor response, verbal response

202
Q

Autonomic nervous system: sympathetic division function

A

Stimulating response
‘fight or flight’
Involved with norepinephrine

203
Q

Somatic nervous system function

A

Regulates body movement through sensory and motor neurons that transmit information from the brain to muscle fibers throughout the body.
Controls: voluntary movement, 5 senses, reflex arcs (DTRs)

204
Q

Autonomic nervous system: parasympathetic division function

A

Conserving and restoring
‘rest and digest’
Involved with acetylcholine

205
Q

Limbic system function

A

Mood
Emotion
Recent memory
Olfaction
Appetite
Drastic behavior change with lesion

206
Q

Frontal lobe functions

A

Personality
Voluntary movement
Orientation
Executive function
Brocas area (L)

207
Q

Parietal lobe functions

A

Sensation, kinesthesia, vibration, temperature
Memory
Language interpretation
Receives sensory info (hearing, vision, etc)
Spatial perception

208
Q

Temporal lobe functions

A

Auditory
Olfactory
Wernickes area (L)
Interpretations of emotions and reactions

209
Q

Occipital lobe functions

A

Visual processing
Distance perception
Color, light, shape

210
Q

Hippocampus

A

L temporal lobe
Forms and stores declarative memories

211
Q

Basal ganglia

A

Responsible for voluntary movement, regulation of autonomic movement, posture, tone, control of motor responses
Impairments may cause: PD, HD, ADHD, Tourette’s OCD

212
Q

Amygdala

A

Located in bilateral temporal lobes
Emotion and social processing
Fear, pleasure, arousal
Memory processing

213
Q

Thalamus

A

Relay/processing for info in cerebral cortex. Receives information from cerebellum, basal ganglia and sensory pathways and transmits to cerebrum

Impairment may cause thalamic pain syndrome

214
Q

Hypothalamus

A

Receives and integrate info from the ANS, regulates hormones, controls hunger, thirst, sexual behavior, sleep, body temp, glands

215
Q

Subthalamus

A

Regulates skeletal muscle movement

216
Q

Epithalamus

A

Pineal gland (secretes melatonin and controls circadian rhythm)

217
Q

Midbrain function

A

Relay center
Reflex center

218
Q

Cerebellum function

A

Movement fine tuning, posture, tone, rapid alternating movements, location of extremities in space

219
Q

Pons function

A

Part of hindbrain and brainstem
RR regulation, head orientation in regard to visual/auditory stimuli

220
Q

Medulla function

A

Part of hindbrain
ANS activity, HR/RR regulation
Vomiting, coughing, sneezing
Relays somatic sensory info

221
Q

Brainstem

A

Made up of midbrain, pons, medulla
Relays info from body to cerebral cortex
Primitive functions
Reticular activating system

222
Q

ACA blood supply

A

Anterior frontal lobe, medial frontal and parietal lobes

223
Q

MCA blood supply

A

Frontal lobe, parietal lobe, outer surfaces of temporal lobe

224
Q

PCA blood supply

A

Medial and inferior temporal lobes, medial occipital lobe, thalamus, hypothalamus, visual receptive area

225
Q

Vertebrobasilar a. blood supply

A

Cerebellum, medulla, pons, midbrain, occipital cortex, brainstem

226
Q

ACA lesion impairments

A

Personality
Hemiparesis/plegia
Neglect
Aphasia
Perseveration

227
Q

MCA lesion impairments

A

Aphasia (communication & language interpretation)
Spatial relations
Cognition
Sensation
Voluntary movement (face and arm > leg)

228
Q

PCA lesion impairments

A

Contralateral hemiplegia (face and arm > leg)
Ataxia/tremor
Homonymous hemianopsia
Blindness
Receptive aphasia
Memory deficits

229
Q

Vertebral basilar a lesion impairments

A

Unilateral or bilateral extremity weakness
Loss of vibration sense, two point discrimination, and proprioception
Diplopia
Homonymous hemianopsia
Dysphagia
Dysarthria
Nausea
Confusion

230
Q

L hemisphere function

A

Ability to understand language
Producing written and spoken language
Expression of positive emotions
Ability to be analytical, controlled, logical
Math

231
Q

R hemisphere function

A

Nonverbal processing
Artistic expression
Spatial relationships
Kinesthetic awareness
Body image awareness

232
Q
A

NPTE (6 decks)

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