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DPT 830 Neuromuscular Rehab > Neuromuscular Unit 1 Exam > Flashcards

Neuromuscular Unit 1 Exam Flashcards

1
Q

used to screen patients presenting to therapy to determine if further neurologic evaluation is appropriate + determine body regions with deficits

A

neurological screen

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2
Q

4 orientation questions

A

person, place, time, situation

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3
Q

quick memory screen

A

3 words to remember

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4
Q

normal level of arousal

A

conscious

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5
Q

decreased level of arousal

A

hypoarousal

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6
Q

increased level of arousal

A

hyperarousal

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7
Q

mildly depressed level of consciousness

A

lethargic

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8
Q

significantly diminished arousal, will respond to noxious stimuli but may be confused

A

obtund

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9
Q

minimal arousal and requires vigorous noxious stimuli

A

stupor

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10
Q

no arousal, unable to make purposeful response

A

coma

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11
Q

conscious but unaware of their environment and no purposeful attention

A

minimally conscious vegetative state

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12
Q

in a vegetative state for longer than 1 year following a traumatic brain injury

A

persistent vegetative state

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13
Q

gold standard scale in acute brain injury

A

Glasgow coma scale (GCS)

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14
Q

outcome measure for stroke severity

A

national institutes of health stroke scale (NIHSS)

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15
Q

mild GCS score

A

12-15

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16
Q

moderate GCS score

A

9-11

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17
Q

severe GCS score

A

3-8

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18
Q

2 noxious stimuli

A

sternal rub and nail bed pressure

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19
Q

direction of awareness, necessary to perform a conscious task

A

attention

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20
Q

5 categories of attention

A

focused
sustained
selective
alternating
divided

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21
Q

category of attention when the patient can process specific information

A

focused

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22
Q

category of attention when the patient is attentive continuously over time

A

sustained

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23
Q

category of attention when the patient can perform with distractions

A

selective

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24
Q

category of the attention when the patient shifts attention back and forth

A

alternating

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25
Q

category of the attention when the patient responds to multiple stimuli simultaneously

A

divided

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26
Q

outcome measure for attention that characterizes behavioral responses after brain injury

A

moss attention rating scale (MARS)

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27
Q

behaviors that describe mood or emotional state

A

affect

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28
Q

emotional dysregulation, uncontrolled and exaggerated laughing or crying

A

psuedobulbar affect

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29
Q

shallow or blunted emotional response

A

apathy

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30
Q

exaggerated feelings of well being

A

euphoria

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31
Q

poor perception of self and environment

A

depression

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32
Q

sorting, retrieving, and manipulating information

A

cognition

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33
Q

________ and fall risk are directly related

A

cognition

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34
Q

3 things to assess patient’s alertness

A

arousal
attention
cognition

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35
Q

patients with dementia and cognitive impairments are at an increased risk of experiencing a _____

A

fall

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36
Q

giving a patient one minute to name as many animals as possible

A

animal fluency test

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37
Q

> 65 years old = ___ animals

A

12

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38
Q

< 65 years old = ___ animals

A

18

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39
Q

having a patient draw clock on a blank piece of paper with numbers 1-12 and then drawing hands to indicate a time

A

clock drawing

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40
Q

asking the patient to interpret a phrase

A

reasoning

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41
Q

giving a patient a list of words for them to remember and repeat back to you

A

retention

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42
Q

asking later in the screen for the patient to repeat the 3 words back to you

A

recall

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43
Q

exam used if issue is expected but not diagnosed; measures orientation, recall, short term verbal memory, calculation, language and construct ability

A

mini mental state exam (MMSE)

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44
Q

max score of a mini mental state exam

A

30

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45
Q

< ___ indicates cognitive impairment on the mini mental state exam

A

24

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46
Q

what does MOCA stand for?

A

montreal cognitive assessment

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47
Q

< ___ on the MOCA is indicative of dementia and further testing needed

A

26

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48
Q

outcome measure that is similar to the MOCA and mini mental exam but is used for lower level cognitive patients

A

SLUMS

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49
Q

what does SLUMS stand for?

A

St. Louis university mental status exam

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50
Q

outcome measure that is more sensitive to identifying dementia

A

SLUMS

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51
Q

why is it important to perform interventions even if patients cannot remember?

A

they can develop habits (learn by doing rather than remembering)

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52
Q

what form of practice is better to use as an intervention for this patient population?

A

blocked practice

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53
Q

less explicit information = better ability to ______ the task

A

learn

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54
Q

3 Ds

A

delirium
depression
dementia

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55
Q

disrupted consciousness, cognition, or perception that develops in a short period of time usually postoperatively

A

delirium

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56
Q

most common mental health disorder in adults 65 years of age and older

A

depression

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57
Q

medical diagnosis that are highly correlated with depression

A

stroke
cancer
chronic pain
multiple sclerosis

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58
Q

a good tool to catch depression and patients that are at risk

A

geriatric depression scale

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59
Q

as as PT, what should your interventions look like for a patient that is depressed?

A

activities that are engaging and interesting to the patient

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60
Q

clinical syndrome of cognitive and functional decline that is chronic and progressive in nature

A

dementia

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61
Q

true or false: physical therapists can diagnose dementia

A

false

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62
Q

4 types of dementia

A

Alzheimer’s disease
vascular dementia
dementia with Lewy bodies
frontotemporal dementia

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63
Q

altered cognition that fills the gap between normal and dementia

A

mild cognitive impairment

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64
Q

what are signs of a patient that has a mild cognitive impairment?

A

losing things
forgetting appointments
trouble finding words
increased forgetfulness of recent events

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65
Q

most common form of dementia that is associated with advanced age

A

Alzheimer’s disease

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66
Q

predominant symptom of Alzheimer’s

A

memory decline

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67
Q

pathological changes in the brain that cause Alzheimer’s disease

A

amyloid plaques, neurofibrillary tangles, atrophy in the inferior prefrontal cortex, and inadequate levels of acetylcholine

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68
Q

mental disorder with the main feature of cardiovascular disease

A

vascular dementia

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69
Q

with vascular dementia, brain damage results from what type of stroke?

A

vascular strokes

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70
Q

result of multiple large or small infarcts that causes brain loss (mini strokes)

A

multi infarct dementia

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71
Q

rate of cognitive decline is similar to AD but the life expectancy is shorter for patients with what type of dementia?

A

multi infarct dementia

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72
Q

first noted symptoms of vascular dementia

A

slow processing speed
impaired judgement
impaired ability to make decisions + plan

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73
Q

slow gait and poor balance are associated with _______ dementia depending on where the ischemia is occurring

A

vascular

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74
Q

form of dementia characterized by early sleep disturbance and hallucinations

A

Lewy body dementia

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75
Q

pathological changes in the brain that cause Lewy body dementia

A

build up of Lewy bodies inside the neurons in the cortex that control memory and motor control

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76
Q

Parkinson’s disease is marked by ____ systems and Lewy body dementia is marked by ____ impairments

A

motor, cognitive

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77
Q

______ _______ (Lewy bodies) linked to Parkinson’s disease and multi system atrophy

A

alpha synuclein

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78
Q

progressive nerve cell loss in the brain’s frontal and temporal lobes that causes deterioration in behavior, personality, language, and alterations in motor and muscle function

A

frontotemporal lobe dementia

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79
Q

2nd most common cause of dementia after Alzheimer’s disease

A

frontotemporal lobe dementia

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80
Q

patients with what form of dementia are less oriented than AD but have more difficulty with executive function and problem solving

A

frontotemporal lobe dementia

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81
Q

sudden loss of neurologic function caused by interruption of blood flow to the brain

A

stroke

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82
Q

2 types of stroke

A

ischemic and hemorrhagic

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83
Q

type of stroke that occurs secondarily to thrombosis, embolism, or hypoperfusion

A

ischemic stroke

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84
Q

type of stroke that affects 80% of individuals who have strokes

A

ischemic

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85
Q

type of stroke that occurs when blood vessels rupture, causing leakage of blood in or around brain

A

hemorrhagic

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86
Q

which type of stroke has more severe complications?

A

hemorrhagic

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87
Q

deficits of a stroke must remain for at least how many hours?

A

24

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88
Q

spontaneous improvement that occurs as swelling in the brain goes down

A

reversible ischemic neurological deficit

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89
Q

3 etiologies of a stroke

A

thrombosis
embolus
hemorrhage

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90
Q

5th leading cause of death

A

stroke

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91
Q

leading cause of long term disability in the US

A

stroke

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92
Q

stroke incidence increases with ____

A

age

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93
Q

largest number of deaths come from what type of stroke?

A

hemorrhagic

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94
Q

what are some general risk factors for strokes?

A

hypertension
diabetes
high cholesterol
heart disease

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95
Q

what are some modifiable risk factors for strokes?

A

smoking
physical inactivity
obesity
diet

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96
Q

what does the BE FAST acronym stand for?

A

balance
eyes
face
arms
speech
time

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97
Q

what are some S&S of ACA stroke?

A

contralateral LE hemiparesis and hemisensory loss, urinary incontinence, apraxia, contralateral grasp and suck reflex, akinetic mutism, slowness, lack of spontaneity, and motor inaction

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98
Q

what are some S&S of MCA stroke?

A

contralateral UE + face hemiparesis and hemisensory loss, motor and receptive speech impairments, global aphasia, perceptual deficits, limb kinetic apraxia, contralateral homonymous hemianopsia, loss of conjugate gaze to the opposite side, and contralateral limb sensory ataxia

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99
Q

difficulty with planning and sequencing movements

A

apraxia

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100
Q

2 types of apraxia

A

ideational and ideamotor

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101
Q

inability of the patient to produce movement either on command or automatically and represents a complete breakdown in the conceptualization of the task

A

ideational apraxia

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102
Q

example of ideational apraxia

A

you tell the patient to brush their teeth and they don’t know to pick up the tooth brush

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103
Q

when the patient is unable to produce a movement on command, but is able to move automatically

A

ideamotor apraxia

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104
Q

example of ideamotor apraxia

A

you hand the patient the tooth brush, and they know to start brushing their teeth

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105
Q

apraxia is more evident with what side hemisphere damage?

A

L hemisphere

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106
Q

loss of language

A

aphasia

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107
Q

type of aphasia characterized by broken speech, limited vocabulary, and slow + hesitant speech

A

Broca’s/non fluent aphasia

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108
Q

type of aphasia characterized by impaired auditory comprehension, fluent speech, and normal rate and melody

A

Wernicke’s/fluent aphasia

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109
Q

type of aphasia characterized by nonfluent speech with poor comprehension

A

global aphasia

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110
Q

type of stroke caused by small vessel disease in the cerebral white matter that can be motor or sensory

A

lacunar strokes

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111
Q

why are there are deficits in consciousness, language, or visual fields NOT seen with lacunar strokes?

A

high cortical areas are preserved

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112
Q

occlusions of this artery can produce a wide variety of symptoms with both ipsilateral and contralateral signs + cerebellar and cranial nerve abnormalities are present

A

vertebrobasilar artery

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113
Q

why are there both ipsilateral and contralateral signs associated with vertebrobasilar artery syndrome?

A

some brainstem tracks have crossed over and some have not

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114
Q

syndrome where damage caused at PICA

A

lateral medullary syndrome

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115
Q

what is the other name for lateral medullary syndrome?

A

wallenburg’s syndrome

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116
Q

what are some signs and symptoms of lateral medullary syndrome/wallenburg’s syndrome?

A

ipsilateral face and contralateral body loss of pain and temperature, dizziness/vertigo, ataxia, diplopia, dysphagia, dysarthria, Horner’s syndrome

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117
Q

syndrome where damage is caused at the sympathetic trunk

A

Horner’s syndrome

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118
Q

3 characterizations of Horner’s syndrome
ipsilateral or contralateral side?

A

miosis, ptosis, anhidrosis
ON THE IPSILATERAL SIDE

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119
Q

drooping eyelid

A

ptosis

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120
Q

constricting pupil

A

miosis

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121
Q

loss of sweating on the face

A

anhidrosis

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122
Q

what are S&S of Horner’s syndrome?

A

miosis, ptosis, anhidrosis, dysphagia, dysphonia, sensory impariment of the trunk and extremities, impaired pain and thermal sense

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123
Q

syndrome where damage is caused at the basilar artery affecting the ventral pons and S&S include bilateral cranial nerve palsy, coma, and leads to tetraplegia or quadriplegia

A

locked in syndrome

124
Q

what two things are spared in locked in syndrome?

A

cognition and upward gaze

125
Q

what are S&S of peripheral territory PCA stroke?

A

bilateral or contralateral homonymous hemianopsia (some degree of macular sparing), visual agnosia, prosopagnosia, dyslexia, memory deficit, and topographic disorientation

126
Q

what are some S&S of central territory PCA stroke?

A

central post stroke thalamic syndrome, spontaneous pain and dysesthesias sensory impairments, involuntary movements, contralateral hemiplegia, and occulomotor nerve palsy

127
Q

what syndrome is a result of a central territory PCA stroke?

A

central post stroke (thalamic) pain syndrome = LOTS of pain

128
Q

neurological condition characterized by an inability to recognize or interpret visual stimuli (can see objects clearly but cannot identify them) but normal vision

A

visual agnosia

129
Q

neurological condition known as face blindness that impairs the ability to recognize faces but normal vision

A

prosopagnosia

130
Q

type of hemiplegia that results from a central territory PCA stroke? ipsilateral or contralateral

A

contralateral

131
Q

sensory impairments can contribute to unilateral neglect and learned _______ of limbs

A

nonuse

132
Q

located in the distal end of an afferent nerve fiber that give rise to perception of a specific sensation once stimulated

A

sensory receptors

133
Q

3 divisions of sensory receptors

A

superficial, deep, and combined cortical

134
Q

systems that mediate to higher centers

A

spinal pathways

135
Q

sensory receptor that responds to mechanical deformation of the receptor or surrounding areas

A

mechanoreceptors

136
Q

sensory receptor that responds to change in temperature

A

thermoreceptors

137
Q

sensory receptor that responds to noxious stimuli and result in the perception of pain

A

nociceptors

138
Q

sensory receptor that responds to chemical substances

A

chemoreceptors

139
Q

sensory receptor that is electromagnetic and responds to light within visible spectrum

A

photic receptors

140
Q

sensory receptors located at the terminal portion of the afferent fiber

A

cutaneous receptors

141
Q

sensory receptors located in muscles, tendons, and joints

A

deep sensory receptors

142
Q

information enters the spinal cord through the ______ ______, and sensory signals are carried to higher centers via ______ pathways

A

dorsal roots, ascending

143
Q

2 ascending pathways

A

anterolateral spinothalamic system and dorsal column medial lemniscal system

144
Q

spinal pathway of slow conducting fibers that initiates self protective reactions and responds to stimuli that are potentially harmful

A

anterolateral spinothalamic system

145
Q

the ALS system is transmission of….

A

thermal and nociceptive information, pain mediation, temperature, crudely localized touch, tickle, itch, sexual sensations

146
Q

spinal pathway of fast conducting fibers that is involved with responses to more discriminative sensations

A

dorsal column medial lemniscus system

147
Q

the DCMLS mediates the sensations of…

A

discriminative touch and pressure sensations, vibration, movement, position sense, and awareness of joints at rest

148
Q

projections to the sensory association areas allow for the perception and interpretation of what type of sensations?

A

combined cortical

149
Q

the DCML tract carries discriminative sensations such as ____ and ______

A

kinesthesia and touch

150
Q

the ALS tract carries _____ and _______

A

pain and temperature

151
Q

the most complex processing of sensory information occurs where?

A

somatosensory cortex

152
Q

3 main divisions of somatosensory cortex

A

primary (post central gyrus)
secondary
posterior parietal cortex

153
Q

somatotopic map that represents either motor or sensory input and identifies the relative size of the cortex devoted to specific body parts as it relates to function

A

homunculus

154
Q

information received from the external environment via the skin and subcutaneous tissue

A

superficial sensation

155
Q

______ are responsible for superficial sensations

A

exteroceptors

156
Q

4 superficial sensations

A

pain perception
temperature awareness
touch awareness
pressure perception

157
Q

information received from muscles, tendons, ligaments, joints, and fascia

A

deep sensations

158
Q

________ are responsible for deep sensations and position sense

A

proprioceptors

159
Q

3 deep sensations

A

kinesthesia awareness
proprioceptive awareness
vibration perception

160
Q

combination of both the superficial and deep sensory mechanisms

A

combined cortical sensations

161
Q

combined cortical sensation information comes from both ________ and ________ receptors as well as intact function of cortical sensors association areas in the brain

A

exteroceptive and proprioceptive receptors

162
Q

what 3 things does the Glasgow coma scale measure?

A

eye opening, verbal response, and motor response

163
Q

combined cortical sensations

A

stereognosis perception
tactile localization
two point discrimination
double simultaneous stimulation
graphesthesia
recognition of texture
barognosis

164
Q

route of the anterolateral spinothalamic tract

A

dorsal roots > immediate crossing to ascend the spinal cord through the medulla, pons, and midbrain > VPL of the thalamus > projections sent to the somatosensory cortex via the internal capsule

165
Q

route of the dorsal column medial lemniscus tract

A

dorsal column > ascend to the medulla and synapse with dorsal column nuclei > cross to the opposite side and pass up to the thalamus via medial lemniscus to the VPL > somatosensory cortex

166
Q

the ability of sharp vs dull discrimination, indicates function of protective sensation

A

pain perception

167
Q

the ability to distinguish between warm and cool stimuli

A

temperature awareness

168
Q

determines perception of tactile input

A

touch awareness

169
Q

awareness of movement + direction through ROM

A

kinesthesia awareness

170
Q

awareness of joint position sense at rest

A

proprioceptive awareness

171
Q

the ability to recognize the form of objects by touch

A

stereognosis perception

172
Q

the ability to localize touch sensation on the skin (topognosis)

A

tactile localization

173
Q

the ability to perceive two points applied to the skin simultaneously

A

two point discrimination

174
Q

the ability to perceive simultaneous touch stimuli

A

double simultaneous stimulation

175
Q

term used to describe a situation in which only the proximal stimulus is perceived with “extinction” of the distal

A

extinction phenomenon

176
Q

the ability to recognize letters, numbers, or designs “written” on the skin

A

graphesthesia

177
Q

the ability to differentiate various textures

A

recognition of texture

178
Q

the ability to recognize different weights of two objects that are the same size and shape

A

barognosis

179
Q

normal adult respiratory rate

A

12-20 breaths per minute

180
Q

normal adult blood pressure

A

120/80 mmHg

181
Q

normal adult heart rate

A

60-100 bpm

182
Q

normal adult O2 sats

A

100%

183
Q

control center location for blood pressure

A

pons and upper medulla

184
Q

hypertension

A

> 140/90

185
Q

prehypertension

A

120-139/80-90

186
Q

hypotension

A

systolic < 100

187
Q

medical emergency blood pressure

A

> 180/110

188
Q

slow heart rate < 60 bpm

A

bradycardia

189
Q

fast heart rate > 100 bpm

A

tachycardia

190
Q

pressure exerted by CSF inside the skull on the brain tissue

A

intracranial pressure (ICP)

191
Q

normal ICP value

A

4-15 mmHg

192
Q

if ICP is too high, the brain can _______

A

herniate

193
Q

signs of high ICP

A

vomiting and headache

194
Q

mild ICP hypertension value

A

20-30 mmHg

195
Q

severe ICP hypertension

A

> 39 mmHg

196
Q

in RBCs, transports O2 throughout the body

A

hemoglobin (Hb)

197
Q

male hemoglobin value

A

14-17 g/dL

198
Q

female hemoglobin value

A

12-16 g/dL

199
Q

PT exercise indication for hemoglobin value of < 8 g/dL

A

no exercise

200
Q

PT exercise indication for hemoglobin value of 8-10 g/dL

A

light exercise

201
Q

PT exercise indication for hemoglobin value of > 10 g/dL

A

resistive exercise

202
Q

percentage of RBCs throughout the body

A

hematocrit

203
Q

male hematocrit percentage

A

40-51%

204
Q

female hematocrit percentage

A

36-47%

205
Q

PT exercise indication for hematocrit percentage of < 25%

A

no exercise

206
Q

PT exercise indication for hematocrit percentage of > 25%

A

light exercise

207
Q

PT exercise indication for hematocrit percentage of > 35%

A

resistive exercise

208
Q

ratio of how well your blood clots

A

international normalizing ratio (INR)

209
Q

normal INR value

A

.8-1.2

210
Q

PT indication of 4 INR value

A

no increase in intensity

211
Q

PT indication of 4-5 INR value

A

no resistance exercise

212
Q

PT indication of 5-6 INR value

A

no exercise

213
Q

PT indication of > 6 INR value

A

bed rest

214
Q

the lower the INR value…

A

the faster blood will clot

215
Q

the higher the INR value…

A

the slower blood will clot + greater risk for excessive bleeding

216
Q

red flag O2 sat value

A

< 90%

217
Q

condition of hemoglobin value < 8 g/dL

A

anemia

218
Q

line that is inserted directly into the artery at hip or wrist and measures arterial blood pressure in real time

A

arterial line/catheter

219
Q

line that measures ICP + drains CSF

A

external ventricular drain

220
Q

line that measures ICP in real time through hole drilled into the skull

A

bolt

221
Q

usually patients with these two lines have a low GCS score and are unable to participate in movement

A

EVD and bolt

222
Q

line inserted into the neck and goes down large vein through the vena cava into the right atrium

A

Swan-ganz catheter

223
Q

line that delivers medication directly into the circulatory system

A

central line (central venous catheter)

224
Q

line that is peripherally inserted into the vein and goes directly into the heart, used with longer course antibiotics

A

PICC line (peripherally inserted central catheter)

225
Q

patients usually get a ________ if on the vent for more than how many days?

A

tracheostomy, > 14-21 days

226
Q

line that gives high amounts of oxygen to a patient without having to intubate

A

high flow nasal cannula

227
Q

why is it important not to mobilize or push nasal cannula patients?

A

patient can desat and have to be intubated

228
Q

collects fecal matter into a bag, often used with c-diff

A

fecal management system

229
Q

urine collection that is gravity dependent

A

foley catheter

230
Q

feeding tube through the nose to stomach, short term solution

A

NG tube (nasogastric tube)

231
Q

feeding tube directly into the abdomen, long term solute common in patients with more severe brain injuries

A

PEG tube (percutaneous endoscopic gastrostomy)

232
Q

if a patient has a feeding tube and are NPO, what can the therapist not do?

A

give the patient food and water

233
Q

helps determine if motor deficits are neurological (tone or paresis) or MSK (past or present injury)

A

motor screen

234
Q

muscles, joints, and their sensory and motor nerve innervations

A

peripheral motor system

235
Q

association areas (cortex and basal ganglia), motor cortex, cerebellum,
brain stem, and spinal cord

A

central motor system

236
Q

additional positioning that may be required to fully assess a neurological patient during a motor screen

A

gravity minimized position

237
Q

association areas are responsible for….

A

movement strategy to best achieve goal (cortex and basal ganglia)

238
Q

motor cortex and cerebellum are responsible for…

A

sequence of contractions, arranged in space and time, smoothness to achieve goal

239
Q

brain stem and spinal cord are responsible for…

A

execution and activation of the motor neurons to generate the movement

240
Q

what 2 structures do not have direct output to the spinal cord?

A

cerebellum and basal ganglion

241
Q

information comes directly from what three areas of the brain?

A

motor cortex
spinal cord
premotor areas

242
Q

integration of the sensory input informs and guides the motor ______

A

response

243
Q

main area of the brain that involves motor function

A

motor cortex

244
Q

has the largest concentration of corticospinal neurons and requires a stimuli of low response to elicit a motor response

A

primary motor cortex

245
Q

the primary motor cortex is anterior to the central sulcus and controls contralateral ________ movements

A

voluntary

246
Q

anterior to the primary motor cortex, requires a higher intensity stimuli for motor response

A

supplementary and premotor areas (SMA and PMA)

247
Q

axons from this area directly innervate motor units involved in initiation of movement, timing, sequential tasks, and action monitoring

A

SMA

248
Q

area that innervates motor units that control trunk and proximal limb movements, plan and prepare the body for movement

A

PMA

249
Q

the motor cortex receives information from what three things?

A

somatosensory cortex
cerebellum
basal ganglia

250
Q

somatosensory information is relayed directly to the primary motor cortex from the __________

A

thalamus

251
Q

relays information to the cerebellum and basal ganglia which allow integration and appropriate course of action

A

thalamus

252
Q

regulates movement, postural control, and muscle tone

A

cerebellum

253
Q

if input from the feedback system does not compare appropriately, the ______ gives a counteractive influence

A

cerebellum

254
Q

what does it mean that the cerebellum is error correcting?

A

the cerebellum sends signals to the cortex to modify the movement

255
Q

where are basal ganglia located?

A

cerebral cortex

256
Q

main basal ganglia nuclei

A

caudate
putamen
globus pallidus

257
Q

subcortical basal ganglia

A

subthalamic nucleus
substancia nigra

258
Q

why do Parkinson’s patients get rigid?

A

because basal ganglia maintains normal background muscle tone and is disrupted/diseased in Parkinson’s patients

259
Q

maintains normal background muscle tone

A

basal ganglia

260
Q

what are some functions of basal ganglia?

A

initiation and regulation of intentional movement, planning and executing motor responses, postural adjustments

261
Q

the ability to generate sufficient tension in a muscle for posture and movement

A

strength

262
Q

_______ results from musculoskeletal properties of the muscle and neural activation

A

strength

263
Q

inability to generate normal levels of force

A

weakness

264
Q

very common impairment in those with UMN lesions

A

weakness

265
Q

decreased voluntary motor unit recruitment or difficulty recruiting motor units to generate movement (still SOME recruitment)

A

paresis

266
Q

absence of muscle recruitment and inability to generate movement

A

paralysis

267
Q

what is the order of ROM when the patient cannot move through the full range?

A

AROM > AAROM > PROM

268
Q

muscle grade for no contraction

A

0

269
Q

muscle grade for a visible muscle twitch but no movement of the joint

A

1

270
Q

muscle grade for a weak contraction that is unable to overcome gravity

A

2

271
Q

muscle grade for a weak contraction that is able to overcome gravity but not able to take additional resistance

A

3

272
Q

muscle grade for a weak contraction that is able to overcome gravity and take some resistance

A

4

273
Q

muscle grade for a strong contraction that is able to overcome gravity and full resistance

A

5

274
Q

muscle’s resistance to passive stretch

A

muscle tone

275
Q

is muscle tone velocity dependent?

A

no

276
Q

muscle tone is causes by output from what two types of motor neurons?

A

alpha and gamma

277
Q

velocity dependent increase in tonic stretch reflex (exaggerated tendon jerk from hyperexcitability)

A

spasticity

278
Q

spasticity is a dysfunction of what tract?

A

corticospinal

279
Q

spasticity is common in UMN or LMN?

A

UMN lesions

280
Q

increased resistance to passive movement but is not velocity dependent

A

rigidity

281
Q

disruption or disease of ______ ________ causes rigidity

A

basal ganglia

282
Q

type of rigidity, consistent resistance to movement through entire range

A

lead pipe rigidity

283
Q

type of rigidity, alternating episodes of resistance to movement throughout the range (catching)

A

cogwheel rigidity

284
Q

reduced stiffness of the muscle when lengthened or moved through the range (loose and floppy)

A

hypotonia

285
Q

_______ beating is a type of spasticity

A

clonus

286
Q

scale used to assess alterations in muscle tone

A

modified ash worth scale

287
Q

muscle bulk can be ______ (too much) or _________ (wasting)

A

hypertrophic or atrophic

288
Q

small wavelike movements under the skin that indicate denervation of the muscle

A

fasciculations

289
Q

rhythmic movements common in patients with Parkinson’s disease

A

tremors

290
Q

quick, large, piano like playing movement

A

chorea

291
Q

slower, writhing like movement that is a medication side effect of Parkinson’s

A

dystonia

292
Q

quick, jerky moving of a joint or limb

A

myoclonus

293
Q

multiple joints and muscles are activated at the appropriate time and force

A

coordination

294
Q

coordination deficits are commonly seen with lesions in what 3 areas?

A

motor cortex
basal ganglia
cerebellum

295
Q

abnormal patterns of movement secondary to lack of ability to move a single joint without simultaneously generating movement in other joints

A

synergy

296
Q

MOST common synergy pattern

A

flexion of the UE

297
Q

UE flexion synergy pattern

A

scapular retraction + elevation
shoulder abduction + ER
elbow flexion
forearm supination
wrist and finger flexion

298
Q

LE extension synergy pattern

A

hip extension, adduction, and IR
knee extension
ankle plantarflexion + inversion
toe plantarflexion

299
Q

problems judging distance or range of movement, therefore an inability to scale forces to meet certain tasks

A

dysmetria

300
Q

dismetria is a ________ problem

A

coordination

301
Q

coordination deficits are common in patients with what type of dysfunction?

A

cerebellar

302
Q

overestimation of the force or range of movement needed for a specific task

A

hypermetria

303
Q

underestimation of the required force of range to complete a task

A

hypometria

304
Q

inability to perform rapid alternating movements (random)

A

dysdiadochokinesia

305
Q

common coordination tests

A

finger to nose
alternating finger to nose
pronation/supination
rebound test
heel to shin

306
Q

how do therapists treat coordination deficits?

A

repetition of functional task specific movements and WB activities

307
Q

therapist applies manual resistance for an isometric elbow flexion contraction, resistance is sudden released and the triceps should contract to keep from having rebound

A

rebound test

DPT 830 Neuromuscular Rehab (3 decks)

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