Neuromuscular and Nervous Systems Flashcards
What is Somatosensory Input.
It is the proprioceptive input you receive from your joints. muscles, ligaments, and skin regarding length, tension, pressure, pain, and joint position in order to keep you balanced.
How do you challenge the Somatosensory System?
You change the surface the patient is standing on: slopes, uneven surfaces, standing on foam…
How do you challenge the Visual System in terms of balance?
Examine the patient balancing with eyes open and closed.
What is Vestibular Input?
Input regarding the position and movement of the head in relation to gravity.
In regards to the vestibular system, what do the Semicircular Canals do?
They respond to the movement of fluid with head motion.
In regards to the vestibular system, what do the Otoliths do?
They measure the affects of gravity and movement with regard to acceleration and deceleration.
How do you challenge the Vestibular System?
By examining balance with different head movements.
What are some examples of Vestibular Tests?
-Dix-Hallpike Test: The patient is quickly lowered to supine with their neck extended to approximately 30 degrees, then their eye movements are examined
-Bithermal Caloric Testing: The patients ear canals are irrigated with water at different temperatures, then their eye movements are examined.
-Nystagmus Assessment: Different tests to analyze the type of nystagmus the patient has.
-Head Thrust Sign: The patent’s head is quickly thrusted in multiple directions while they try to maintain their gaze on a fixed object; the patient should be able to maintain a fixed gaze.
What is the Vestibuloocular Reflex (VOR)?
A reflex that supports gaze stabilization through eye movement that counters movements of the head. E.g. a dancer spotting while she spins.
What is the Vestibulospinal Reflex (VSR)?
A reflex that assists with stability while the head is moving as coordination of the trunk during upright postures.
What is the Suspensory Strategy?
It is used in conjunction with the ankle, hip, and stepping strategies. It is when you lower your center of gravity to maintain balance. This strategy is often used when both mobility and stability are required during a task (such as surfing).
Describe the Berg Balance Scale
It is a test to access the patient’s risk for falling. It includes 14 tasks with a maximum score of 56. A score less than 45 indicates an increased risk for falling.
Describe the Fugl-Meyer Sensorimotor Assessment of Balance Performance Battery
It is designed to assess balance specifically for patients with hemiplegia. It includes 7 items to be assessed and the highest score you can get is a 14.
Describe the Functional Reach Test
It is just like the reaching portion of the Berg, but it utilizes age related reaching norms (20-40, 41-69, 70-87). If the patient falls below the age appropriate range for functional reach, they are at an increased risk of falling.
Describe the Romberg/Sharpened Romberg Tests
-Romberg: the patient stands with their arms across their chest and their feet together and holds for 30 seconds with eyes open and then again with eyes closed
-Sharpened Romberg: same as the Romberg, but with feet in tandem stance
What does it mean if a patient has a positive Romberg test?
Either the somatosensory or vestibular system is affected.
What does it mean if a patient exhibits Ataxia and also receives a positive Romberg test?
The patient is affected by Sensory Ataxia and not Cerebellar Ataxia
Describe the Timed Up and Go Test
It test the patients balance by having them quickly stand up from a chair, walk approximately 10 feet, turn around, walk back, and sit back down. A patient who can do it in 10 seconds or less is considered independent, over 20 seconds is considered increased risk for falling, and over 30 seconds is considered high risk for falling.
Describe the Tinetti Performance Oriented Mobility Assessment.
It assesses balance through a STS section and a gait section. The first section has a maximum score of 16 and the second section has a maximum score of 12, with a total max score of 28. A total score less than 19 indicates a high risk for falls.
What is Aphasia?
Impairment of processing for receptive and/or expressive language.
What is Paraphasia?
When someone makes an unintentional sound(s) when saying a word or phrase.
What are the type(s) of Fluent Aphasia?
Wernicke’s Aphasia
What is Wernicke’s Aphasia?
A lesion in the temporal lobe which affects the patient’s comprehension of language, writing, and naming ability.
What are the type(s) of Non-fluent Aphasia?
-Broca’s Aphasia
-Global Aphasia