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Term 3 > Neuromuscular Unit 13-14 > Flashcards

Neuromuscular Unit 13-14 Flashcards

1
Q

What are the 4 Key Elements of the UE to reach, grasp and manipulate?

A
  1. Locating the target
  2. Reaching involved transportation of the arm and hand
  3. Grasp, including grip formation, grasp and release
  4. Hand manipulation of the object

All 4 aspects must be examined when deficits in UE performance are suspected

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2
Q

Neuro Impairment: Effect on Reach/Grasp/Manupulation

With the Key Elements, which system is most necessary for Locating (a target)?

A

Vision and Cognition

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3
Q

Neuro Impairment: Effect on Reach/Grasp/Manupulation

With the Key Elements, which system is most necessary for Reaching?

A

Vision
Somatosensory
Motor Control (Most essential)
Cognition (not as essential)

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4
Q

Neuro Impairment: Effect on Reach/Grasp/Manupulation

With the Key Elements, which system is most necessary for Grasp/Release?

A

Vision (not as essential)
Somatosensory
Motor Control (Most essential)
Cognition (not as essential)

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5
Q

Neuro Impairment: Effect on Reach/Grasp/Manupulation

With the Key Elements, which system is most necessary for Hand Manipulation?

A

Vision (not as essential)
Somatosensory (Most Essentional)
Motor Control (Most essential)
Cognition (not as essential)

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6
Q

What is a common condition that we will see after stokes, sometimes after brain injuries/SCI and UMN lesions?

A

Shoulder Subluxation (A drop of the humeral head)

  • Due to the severe weakness at the proximal musculature of the shoulder girdle (lack of motor control)
aka Sulcus Sign

You measure the subluxation by how many fingertips you can fit between the acromian and humeral head

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7
Q

What are Intrinsic causes of Shoulder Subluxations?

A
  • Trunk/Joint malalignment (Most common cause)
  • Imbalance of muscle activation
  • Weakness
  • Abnormalities of tone (Specifically hyertonicity)
  • Soft Tissue Extensibility
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8
Q

What are Extrinsic causes of Shoulder Subluxations?

A
  • Positioning (ex. sitting in a w/c for a prolonged period of time with the arm unsupported)
  • Handling (dont pull the pt. at the arm, rather support at the scapula)
  • Assistive Devices
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9
Q

What are the effects of Subluxation of the Shoulder, acutely?

A

This is often not painful, however easily traumatized

  • What will cause pain with when there is lack of glenohumeral rhythem when doing overhead activities with a subluxed shoulder, creating impingement syndrome.
    (When the humerus elevates and the scap does not move, the humerus will impinge on the aromion causeing pain)
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10
Q

What are the effects of Subluxation of the Shoulder, chronically?

A

You will see pain because of the extensibility issue associated with the ligaments that are getting overly stretched

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11
Q

How can can you reduce subluxations?

A
  • Actively align trunk
  • Keep scapula in neutral position
  • Have good alignement of the humerus
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12
Q

Effects of shoulder subluxation

How can you prevent the shoulder pain associated with this?

A
  • By trying to prevent subluxations and trying to prevent moving the arm without moving the scapula
  • The scap and the humerus are married and are not allowed to get divorced, they have to move together. When moving the patients arm for any functional task, one hand must be on the scapula and the other on the humerus and they move at the same time
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13
Q

What are the UE Function/Impairments Outcome Measures?

A
  • 9 Hole Peg: This looks specifically at fine motor control, where the patient is timed to put 9 pegs into 9 different holes using different grips with their fingers
  • Action Research Arm Test: This Specifically looks at functionality of the UE specific to stroke
  • Fugl Meyer: This looks at motor recovery after stroke, takes into account abnormal synergy and reflexes. Also uses the Brunnstrom stages to assess motor control
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14
Q

A person that has had a TBI, CVA or SCI is this an example of Chronic Illness or Disability?

A

These are examples of Disabilites

Chronic Illness include: MS, ALS, PD, and cancer

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15
Q

What is the differene in onset between Chronic Illness and Disability?

A

Disability is sudden onset

Chronic Illness is Insidious Onset

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16
Q

Chronic Illness vs Disability

With Disability what are the adaptations with this?
(What is the patient respones)

A
  • Shock
  • Anxiety and Depression (Grief over loss of premorbid function)
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17
Q

Chronic Illness vs Disability

With Chronic Illness what are the adaptations with this?
(What is the patient respones)

A
  • Anxiety and Depression (Relete to future; fear of death and unknown)
  • Acknowledgement and adjustment phases more difficult to achieve
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18
Q

What is the difference between Cognition and Perception?

A

Cognition is the act or process of knowing, including awareness, reasoning, judgement, intuition and memory. Includes executive functions

Perception is the integration of sensory impression into information that is psychologically meaningful

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19
Q

Why do we need to understand cognitive and perceptual disorders?

A
  • Cheif cause of poor rehab process
  • Communication
  • Safety
  • Collaboration with OT
  • Referral
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20
Q

If a patient has difficulty or the inability to perform simple task indeopendently or safely, the patient may…?

A

Hesitate many times

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21
Q

If a patient has difficulty or the inability to initiate or complete a task, the patient may…?

A

Appear distracted and frustrated

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22
Q

If a patient has difficulty or the inability to switch from one task to another, the patient may…?

A

Exhibit poor planning

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23
Q

If a patient has difficulty or the inability to Visually locate or identify objects that are necessary for task completion, the patinet may…?

A

Be inattentive to 1 side of the body

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24
Q

If a patient has difficulty or the inability to Follow 1 step commands, the patient may…?

A

Complete task impulsively

25
Q

If a patient has difficulty or the inability to Complete tasks in a timely manner, the patient may…?

A

Deny presence or extent of disability

26
Q

What is Attention?

A

The ability to select and attend to a specific stimulus while simultaneously suppressing extraneous stimuli

27
Q

What is Sustained Attention?

A

Attend to relevant information

28
Q

What is Focused (Selected) Attention?

A

Attend to task despite visual or auditory stimuliu in enviornment

29
Q

What is Alternating Attention?

A

Move between tasks

30
Q

What is Divided Attention?

A

Respond simultaneouly to 2+ task

31
Q

What is Memory?

A

Ability to restore and retrieve information for recall at a later time

32
Q

With memory, what is Immediate Recall?

A

Retention of info stored for a few seconds

33
Q

What is short-term Memory?

A

Retention of events or learning within a few minutes, hours, or days

34
Q

What is Long-Term Memory?

A

Early experiences; info acquired over years

35
Q

What are Executive Functions?

A

Those capabilites that enable a person to engage in independent, purposeful, self-serving behavior

36
Q

Executive Function

What is Volition?

A

Capacity to determine what one needs and wants to do; creation of goals

37
Q

Executive Function

What is planning?

A

Organization of steps to accomplish task; weighing alternatives; decision making

38
Q

Executive Function

What is Purposive Action?

A

Productivity and self regulation to achieve goal

39
Q

Executive Action

What is Effective Performance?

A

Quality control and self-correction of behaviors

40
Q

What is the difference between Body Scheme and Body Image?

A

Body Image: Visual and metal image of body

Body Scheme: Sptial awareness of body parts and of the body within the environment

41
Q

Body Scheme and Body Image Impairment

What is Unilateral Neglect?

A

The inability to register and integrate stimuli and perceptions from one side of the body (Body neglect) or environment (Spatial neglect)

This leads to poor recovery as compared to those without neglect

42
Q

Body Scheme and Body Image Impairment

What is Anosognosia?

A

A severe form of neglect
- More common with R hemisphere injuries
- They deny body part is their own or deny the paresis/paralysis
- Confabulates stories as to what it is or why it is not working

Safety is a concern

43
Q

Body Scheme and Body Image Impairment

What is Somatoagnosia?

A

Impairment in body scheme
- Difficulty following instructions that require distinguishing body parts
- May be unable o initiate movements
- Pts will confuse name or body parts and how body parts in relation to enviornment

  • “Extned the knee” may be a comand that they find confusing
44
Q

Body Scheme and Body Image Impairment

What is Right-Left Discrimination?

A

Inability to identify R and L sides of one’s body or that of the examiner
- Unable to follow commands that include terms left and right
- Unable to imitate movements

45
Q

Body Scheme and Body Image Impairment

What is Finger Agnosia?

A
  • Inability to identify the fingers of one’s own hands or of the hands of the examiner
  • Difficulty naming fingers on command
  • Difficulty identifying which finger was touched
46
Q

What are Spatial Relation Disorder?

What are some examples

A
  • These look at complex perception
  • Difficulty in perceiving the relationship between the self and 2+ objects
  • Frequent in R parietal lobe lesions

Examples:
- Finger Ground Discrimination: Distinguish object from background
- Form Discrimination: Differentiating between shapes/forms
- Spatial Relations: Relationship between objects

47
Q

Spatial Relation Disorders

What is Position in Space Impairment?

A

The inability to perceive and interpret spatial concepts (i.e. up/down, under/over)

48
Q

Spatial Relation Disorders

What is Topographical Disorientation?

A

Difficulty understanding and remembering the relationship on 1 location to another

49
Q

Spatial Relation Disorders

What is Depth and Distance Perception?

A

Inaccurate judgement of direction, distance and depth

50
Q

Spatial Relation Disorders

What is Vertical Disorientation?

A

Distorted perception of vertical

51
Q

What is Agnosias?

A

The inability to recognize or make sense of incoming information despite intact sensory capacities (Visual, auditory, tactile)

52
Q

What is Visual Agnosia?

A

Inability to recognize familiar objects despite normal function of the eys

53
Q

What are 3 different Types of Visual Agnosia?

A
  • Simultanagnosia: Inability to perceive visual stimulus as a whole (will interpret in pieces)
  • Prosopagnosia: Inability to recognize familiar faces (can lead to significant frustration from family - education to family is necessary - compenstate with recognition of voice)
  • Color Agnoisa: Inability to recognize, identify or name colors (not color blindness)
54
Q

What is Auditory Agnosia?

A

Inability to recognize nonspeech or to discriminate them
- This is a Temporal Lesion

55
Q

What is Tactile Agnosia (or Astereognosia)?

A

Inability to recognize forms by handling them

  • Tactile, proprioceptive and thermal sensation may be intact
56
Q

What is Apraxia?

A

Impairment of voluntary movement
- Not a result of motor, sensory or intellectual deficit
- Inability to perform purposeful movement
- Occurs often with aphasia as a result from a lesion in the dominate hemisphere (usually left)

57
Q

What is Ideomotor Apraxia?

A

The patient understand what to do
- Habitual task can be done automatically but there is an inability to perform a task when commanded

58
Q

What is Ideational Apraxia?

A

Lost in the idea of what to do
- Cannot carry out the steps of the task
- Unable to conceptualize a task and cannot perform a purposeful motor act either on command or automatically

Term 3 (50 decks)

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