OTA week 3

Question 1

normal muscle tone

Answer 1

state of readiness when it is called upon to move

Question 2

abnormal muscle tone

Answer 2

*Flaccidity and Hypotonicity
* Spasticity and Hypertonicity
* Rigidity

Question 3

what is flaccidity?

Answer 3

• loss of muscle tone
• absence of active movement
• in UMN injury and a SCI, flaccidity can arise after shock, then transition to hypertonicity after a few weeks or months

Question 4

what is hypertonicity?

Answer 4

• high muscle tone
• movement can be uncoordinated
• hard to initiate movement

Question 5

what is hypotonicity?

Answer 5

• decreased muscle tone

Question 6

what is clonus?

Answer 6

type of spasticity - mod-severe

often seen in the finger flexors and ankle plantar flexors

Question 7

hypertonia vs spasticity

Answer 7

1. Hypertonia is not velocity
   dependent.
2. During passive movement, no
   cactch is felt with hypertonia.
3. Spasticity can’t be objectively
   measured with EMG like
   hypertonia.

Question 8

what are the 4 types of rigidity?

Answer 8

1. lead pipe rigidity
2. cog wheel
3. decorticate
4. decerebrate

Question 9

what is decorticate?

Answer 9

abnormal types of posturing and are associated with a brain injury

• flexed posturing is damage to cerebral hemispheres
• adduction and flexion of arms and hands with be closed shut
• legs will be rotated internally and feet flexed

TIP for decorticate posturing: Remember the letters COR in the word decorticate for the word “core”. The patient will bring their ARMS to the core of the body (middle).

Question 10

what is decerebrate?

Answer 10

abnormal types of posturing that is associated with a brain injury

• damage to brain stem
  -worst type between the two
• adduction and extension of arms and pronated hands and fingers will be flexed
• legs are extended and feet and plantar flexed

TIP for decerebrate posturing: Look at all the E’s in the word. There are a lot of them, so remember the word EXTENDED. The arms are going to be extended rather than flexed.

Question 11

modified ashworth scale

Answer 11

it assess muscle tone

0 = no increase in muscle tone
1 = slight increase in muscle tone
1+ = slight increase in muscle resistance throughout the range
2 = moderate increase in muscle tone throughout ROM, PROM is easy
3 = marked increase in muscle tone throughout ROM, PROM is difficult
4 = marked increase in muscle tone, affected part is rigid

Question 12

treatment for spasticity

Answer 12

• meds/injections
• motor learning
• weight bearing
• casting/splinting

Question 13

coordination

Answer 13

production of accurate, controlled movement

requires:
- proprioception
- body scheme
- ability to judge space accurately

Question 14

ataxia

Answer 14

cerebellum and pons are affected
- delayed movement
-jerky and poorly controlled movement
- falls, poor postural stability

Question 15

what is dysmetria?

Answer 15

• faulty distance between two points
• missing the target, with difficult movement precision

Question 16

what is a tremor

Answer 16

involuntary shaking or tremble
- intention tremor: occurs during voluntary movement - seen in MS - most important functional impact
-resting tremor: when no movement (subsides if voluntary movement)
- pill rolling: type of resting tremor in parkinsons

Question 17

what are complications with coordination?

Answer 17

• tendonitis
  -subluxation

Question 18

mal - aligned shoulder - impingement risk

Answer 18

arom/prom to avoid
- certain degrees of shoulder external rotation and abduction
- the arm should not be
moved beyond 90 degrees of
shoulder flexion or abduction,
unless the scapula is
upwardly rotated and the
humerus is laterally rotated

Question 19

what is frozen shoulder?

Answer 19

adhesive capsulitis
- bones, ligaments and tendons are encased in capsule in shoulder girdle
- capsule can thicken during immobilization, that causes restricted movement and pain
- managed with meds and therapy, and other procedures

Question 20

FIM and levels of assistance

Answer 20

FIM: Functional Independence Measure

Question 21

Level 1-4

Answer 21

1 - dependent transfer activities

assisted transfers
2- max assist
3 - mod assist
4- min assist

Question 22

level 5

Answer 22

5 - supervision
- no touching pt
- cueing, standing close

Question 23

level 6

Answer 23

6 - modified independence
- includes devices and increased time or safety risk

Question 24

level 7

Answer 24

7- independent

Question 25

name 3 things to keep in mind before doing a transfer from a manual wheelchair…

Answer 25

• be aware of surroundings and environment
  -try to have both surfaces transfer the same height. or if not possible go from high level to lower.
• remove foot plates and armrests to avoid any danger to the pt, and yourself, put brakes on

Question 26

what is pusher syndrome?

Answer 26

clinical disorder where that causes individuals to push away from their non paralyzed side

Question 27

what is the difference between hypotonicity and hypertonicity?

Answer 27

hypo: too little muscle tone
hyper: too much muscle tone

Question 28

what are three specific coordination disorders that we often see with neuro conditions?

Answer 28

• ataxia
• tremor
• dysmetria

Question 29

what are the 6 prehension patterns?

Answer 29

• fingertops
• palmar
• laterla
• cylindrical
• spherical
• hook

Question 30

what prehension pattern do you think you use more often on a daily basis?

Answer 30

palmar could be used often for eating and writing

hook could used often as well for opening doors