Neurorehabilitation- Sensory And Motor Function Flashcards

1
Q

Spinal cord involvement

A

Bilateral typically
Below level of lesion with diffuse sensory involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Brain stem involvement

A

Ipsilateral facial impairments
Contra lateral trunk and limb impairments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Brain involvement

A

Cortical lesion- impairment is dependent on area of somatosesory cortex affect
Deeper lesions involving thalamus and adjacent structures can lead to diffuse unilateral dysfunction
Contra lateral side affected (crossing of tracts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Feedback control

A

Sensory info is received during mvmt to adject motor output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Feedforward conril

A

Sensory info from past experience are used for anticipatory adjustments (postural control, mvmt)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Sensation testing

A

Vision should be occluded
Provide a normal
Test stimuli in a random and unpredictable manner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Order of testing sensory

A

Superficial (pain, tem, touch)
Deep (proprio)
Combine cortical sensations (stereognosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do you record for sensory testing

A

Modality tested
Surface area affected
Degreee or severity of involvement
Subjective feelings about altered sensation
Potential impact of sensory impairment on function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Superficial sensations

A

Pain perception (sharp dull)
Temperature awareness (distinguish b/w hot and cold)
Touch awareness (tactile touch input)
Pressure perception (assess by pressing enough to leave an imprint)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Deep sensations testing

A

Proprioception awareness (up or down or mirroring) *hold sides to keep it controlled
Kinesthesia awareness (awareness of movement, going up or going down)
Vibration perception (assesses the ability to perceive vibratory stimuli with a tuning fork on a bony landmark)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Coritcal sensations

A

Stereognosis perception (assess tactile object recognition- objects they old know)
Tactile localizations (assess the ability to localize touch sensation- touch patient then patient point where they were touched)
Two-point discrimination (assesses the ability to perceive two separate points on the skin simultaneously and measure the minimal detectable distance between points)
Double simultaneous stimulation (assesses the ability to perceive simulaneous touch stimulus)
Graphesthesia (tracing number, letters, designs that are known)
Texture Recognition (assess the ability to differentiate among various textures)
Barognosis (assesses recognition of weight)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Allodynia

A

Non-noxious stimulus produces pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Analgesia

A

Loss of pain sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causalgia

A

Burning painful sensation, often along nerve distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dysesthesia

A

Touch sensation produces pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hyperalgesia

A

Heightened sensitivity to pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hyperasthesia

A

Heightened sensitivity to sensory stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hypoalgesia

A

Decreased sensitivity to pain

19
Q

Paresthesia

A

Abnormal sensation with no apparent cause (numbness, tingling)

20
Q

Interventions to impaired sensation- compensatory approach

A

How to accommodate with having sensory impairments
Developing alternate stratgies and environmental adaptions

21
Q

Interventions to impaired sensation- sensory integration approach

A

Functional skills through guided practice with controllers sensory intake
Activates sensory receptors and higher brain centers
Stimuli are presented in the context of meaningful activities
Enhance sensory integrations is the goal- will have an effect on motor performance

22
Q

Upper motor neurons

A

Originate in the brain, brainstorm,, or spinal cord
Before the anterior horn cells of the spinal cord

23
Q

Lower motor neuron

A

Originate in the cranial nerve nuclei and motor neurons distal to the anterior horn cells of the spinal cord (receive info from the upper and carry to the muscles)

24
Q

Weakness

A

UMN (spastic) and LMN (flaccid)

25
Q

Atrophy

A

LMN

26
Q

Fasciculations

A

LMN

27
Q

Reflexes

A

UMN- hyperreflexive LMN- hyporeflexia/ areflexia

28
Q

Tone

A

UMN- increased
LMN- decreased

29
Q

UMN S&S

A

Hyperactive stretch reflexes
Involuntary flexor and extensor spasms
Clonus
Babinskis sign
Exaggerated cutaneous reflexes
Loss of precise autonmic control
Dyssynergic mvmt patterns

30
Q

LMN S&S

A

Decrease or absent tone and reflexes
Paresis
Muscle fasciculations and fibrillations with enervation
Neurogenic atrophy

31
Q

UMN lesions

A

Amyotrophic lateral sclerosis (ALS)
Brain injury
Cerebral palsy
Multiple sclerosis
Spinal cord injury
Stroke
Tumor in brain or spinal cord

32
Q

LMN Lesions

A

Amyotrophic lateral sclerosis (ALS)
Bell’s palsy
Cauda equine syndrome
Gillian-barre syndrome
Peripheral nerve injurie s
Poliomyelitis
Post-polio syndrome

33
Q

Tone

A

Resistance of muscle to passive elongation
Hypertonia (spacitisty, rigidity)
Hypotonia (below normal at resting level)
Dystonia (disordered tonicity)

34
Q

Spasticity

A

Velocity dependent resistance to passive elongation
- increase speed of stretch= increase resistance
- clasp knife response- catch and let go
- associated with UMN syndrome

35
Q

Rigidity

A

Velocity independent hypertonic state of muscle
Leadpipe- constant rigidity throughout entire ROM (Parkinson’s disease)
Cogwheel- jerky type of rigidity (Parkinson’s disease)

36
Q

Decorticate rigidity

A

For those in a coma (unconscious, corticospinal tract lesion usually)
UE in flexion (shoulder in adduction)
LE in extension (INTERNAL ROTATED, ankle plantarflexion)

37
Q

Decerebrate rigidity

A

Brain stem lesion
Sustained trunk and limbs in full extension
UE- elbow extended, forearmpronated
LE- no internal rotation

38
Q

Hypotonia (flaccidity)

A

Muscles feel soft and squishy upon palpating
Poor postural control
Floppy limbs
W sitting

39
Q

Dystonia

A

Normal birth history- starts in the legs and move up if it is generalized
Involuntary twisting and repetitive mvmts, abnormal fixed postures and disordered tone
Dry tonic posturing- cocontraction of muscles causing weird posture

40
Q

How do you grade spasticity?

A

Modified Ashworth scale
0
1
1+
2
3
4

41
Q

Interventions for abnormal tone

A

Stretching casting splinting orthoses sensory stimulation techniques

42
Q

Interventions for hypotonia

A

Decrease support
Increase resistance
Joint compression (no pain)
Manual facilitation techniques

43
Q

Interventions for hypertonic may include

A

Increase support
Modify tasks
Positioning in lengthen positions
Heat

44
Q

UMN reflexes

A

Clonus
Babinski
Hoffman