Neuromuscular Part Eleven Flashcards
two gait patterns for spastic CP
scissoring
toe walking
when is APGAR tested
1, 5, 10, 15 minutes after birth
four main syndromes of CP
spastic
athetoid
ataxic
mixed (most often spasticity and athetosis)
onset and integration of moro reflex
onset: 28 weeks gestation
integration: 5-6 months
how should pressure on tendons in order to inhibit tone be applied
firm, constant pressure
what is plantar grasp stimulus and response
stimulus: maintain pressure under toes
response: maintain flexion of toes
what is tested on APGAR
heart rate
respiration
muscle tone
color
reflex irritability
Erb’s Palsy affects what nerve roots
C5-C6
ATNR stimulus and response
stimulus: rotation to the side of the head
response: flexion of the skull limbs, extension of the jaw limbs
what is the cognitive stage of motor learning
develop an overall understanding of the skill through trial and error practice
athetosis in CP results from involvement with what part of the brain
basal ganglia involvement
what does Klumpke’s Paralysis result in weakness of
hand and wrist flexors
onset and integration of crossed extension reflex
onset: 28 weeks gestation
integration: 1-2 months
Klumpke’s Paralysis affects what nerve roots
C8-T1
most common syndrome of CP
spastic
appropriate parameters for low-frequency vibration
5-50 Hz
what appearance of the hand is common with Klumpke’s Paralysis
claw hand
when does Klumpke’s Paralysis occur
when C8-T1 are stretched during the birthing process
plantar and palmar grasp onset and integration
onset: palmar at birth, plantar 28 weeks gestation
integrated: palmar 4-6 months, plantar 9 months
what is feedforward
sending of afferent signals in advance of movement to ready the system
normal score on APGAR
7 or higher
what is the autonomous stage of motor learning
after considerable practice the motor performance becomes automatic
what is palmar grasp stimulus and response
stimulus: maintain pressure to palm of hand
response: maintain flexion of fingers
protective extension reaction stimulus and response
stimulus: displace COG outside BOS
response: arms or legs extend and ABD to support and to protect the body against falling
an individual with strong flexor spasticity would have what reflex absent
Landau
for spastic CP, how are DTRs in affected limbs
increased
landau reflex onset and integration
onset: 3 months
integration: 2 years
what demonstration is there after premature birth with CP
spastic paraplegia
optical and labryrinthine righting reflex stimulus and response
stimulus: alter body position by tipping body in all directions (for labryinthine, vision is occluded)
response: head orients to vertical position and mouth horizontal
facilitation techniques examples
repetitive brushing
quick icing for muscles
quick stretch/tapping
high frequency vibration
prolonged influence of ATNR can result in
scoliosis
hip subluxation (if there is marked hypertonia)
onset of optical and labyrinthine righting reflex
onset: birth-2 months
integrated: persits
for CP, where could hemorrhage be present that initially caused it
below the lining of the ventricles
what Hz should high-frequency vibration be applied at
50-300 Hz
when does Erb’s Palsy occur
when C5-C6 nerve roots are stretched during birthing process
a score of ___ or less on APGAR requires immediate care
4 or less
inhibition technique examples
prolonged icing
neutral warmth
prolonged stretch
low-frequency vibration
pressure on tendons
what LE PNF helps rolling in any direction
D1 flexion
what does fast spinning do
facilitate postural tone and promotes head righting
what is the associate stage of motor learning
refinement of the motor strategy is achieved through continued practice; concentrate on how to do the movement rather than on what to do
moro reflex stimulus and response
stimulus: sudden change in position of the head in relation to the trunk (drop patient backward from sitting)
response: extension and abduction of UE with hand opening… arms move across the chest
arm deformity with Erb’s Palsy
shoulder ADD, IR
“waiter’s tip” deformity
for athetoid CP, what reflexes may be persistent
ATNR
STNR
tonic labyrinthine
what is neutral warmth
relaxation by wrapping patient in towels or blankets to decrease postural tone
positive supporting reaction stimulus and response
stimulus: contact to the ball of the foot in an upright standing position
response: rigid extension of LE with PF and IV, toes clawing and IR
Landau reflex stimulus and response
stimulus: lift the child under the thorax in a prone position
response: first the head and then the back and legs will exten
onset of ATNR and when is it integrated
onset: birth
integrated: 4-6 months
tonic labryinthine reflex stimulus and rsponse
stimulus: prone or supine position
response:
prone - increased flexor tone
supine - increased extensor tone
stimulus and response in crossed extension reflex
stimulus: noxious stimuli to ball of foot or extremity in fixed extension
response: a. LE flexes, then adducts, then extends
b. in patients with hemiplegia, lifting the uninvolved leg off the ground during ambulation results in increased extensor tone in the involved leg
three stages of motor learning in order from most basic to most advanced
cognitive
associative
autonomous
STNR stimulus and response
stimulus: flexion or extension of head
response:
with head flexion - flexion of arms and extension of legs
with head extension - extension of arms and flexion of legs
