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Developing Physiotherapy Practice 3 > P4 - Advanced Neuro Assessment > Flashcards

P4 - Advanced Neuro Assessment Flashcards

1
Q

What should be noted about a patient’s position during general observation?

A

Observe the patient’s position, for example, whether they are in bed, sitting out, leaning to one side, or pushing themselves up.

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2
Q

What should be observed regarding a patient’s appearance?

A

Pay attention to signs of discomfort or pain in the patient’s appearance.

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3
Q

Why is it important to observe a patient’s general position during assessment?

A

The patient’s position can provide clues about their comfort, physical limitations, or distress.

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4
Q

What might a patient leaning to one side indicate during general observation?

A

Leaning to one side could indicate discomfort, weakness, or pain in a specific area of the body.

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5
Q

What is the first step in assessing a patient’s muscle activity?

A

Facilitate the limb to counteract gravity and check for signs of activity, such as flicker at fingers or toes.

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6
Q

What should you do if a patient shows no signs of muscle activity?

A

What should you do if a patient shows no signs of muscle activity?

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7
Q

What is the next step if the patient can demonstrate AROM?

A

Provide resistance throughout the range of motion (ROM) and check if the patient can move against you.

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8
Q

What does Grade 0 indicate in muscle strength grading?

A

Grade 0 indicates no muscle contraction.

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9
Q

What does Grade 1 indicate in muscle strength grading?

A

Grade 1 indicates visible or palpable muscle contraction but no movement.

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10
Q

What does Grade 2 indicate in muscle strength grading?

A

Grade 2 indicates movement with gravity eliminated.

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11
Q

What does Grade 3 indicate in muscle strength grading?

A

Grade 3 indicates movement against gravity only.

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12
Q

What does Grade 4 indicate in muscle strength grading?

A

Grade 4 indicates movement against gravity with some resistance.

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13
Q

What does Grade 5 indicate in muscle strength grading?

A

Grade 5 indicates movement against gravity with full resistance.

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14
Q

What are the key components to assess during “Lying to Sitting” transition?

A

Ability to process the task
Ability to perform the task (e.g., level of independence)
Movement analysis

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15
Q

What aspects of balance are evaluated in “Sitting Balance”?

A

Static balance
Posture/alignment
Dynamic balance
Movement outside base of support (BoS)
Consideration of seating

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16
Q

What are the key considerations for assessing “Sit to Stand”?

A

Ability to process the task
Ability to perform the task (e.g., level of independence)
Movement analysis
Consideration of equipment

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17
Q

What are the components of “Standing Balance” assessment?

A

Static balance
Posture/alignment
Dynamic balance
Movement outside BoS
Consideration of equipment

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18
Q

What are the key points to assess in “Gait”?

A

Ability to process the task
Ability to perform the task (e.g., level of independence)
Movement analysis
Consideration of equipment

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19
Q

What are the elements of “Dynamic Balance” assessment?

A

Combination of movements
Higher-level functional activities (e.g., stairs)

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20
Q

What types of touch are evaluated in a sensation assessment?

A

The ability to detect light or crude touch, and sharp or blunt sensations.

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21
Q

What does pressure sensation assessment evaluate?

A

The ability to detect and respond to pressure applied to the skin.

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22
Q

How is temperature sensation assessed?

A

By determining the patient’s ability to differentiate between hot and cold stimuli.

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23
Q

What is “one and two-point discrimination”?

A

It is the ability to distinguish between one point and two points of touch on the skin.

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24
Q

What does proprioception assess in a sensation evaluation?

A

Proprioception assesses the awareness of body positioning, either of the whole limb or specific joints.

25
Q

How do we assess coordination formally or informally?

A

Coordination can be assessed using tasks that evaluate control of upper and lower limb movements through specific tests and observations.

26
Q

What is the “Finger-Nose” test used for in coordination assessment?

A

The Finger-Nose test evaluates upper limb coordination by having the patient touch their nose and then extend their finger to touch the examiner’s finger.

27
Q

What is the “Finger Chase” test used for?

A

The Finger Chase test assesses upper limb coordination by requiring the patient to follow and touch the examiner’s moving finger.

28
Q

What does the “Pronation/Supination” (DDK) test evaluate?

A

It assesses rapid alternating movements (dysdiadochokinesia or DDK) by having the patient repeatedly alternate between palm-up (supination) and palm-down (pronation) positions.

29
Q

How are reach, grasp, and ADLs used in upper limb coordination assessment?

A

Reach, grasp, and activities of daily living (ADLs) tests evaluate the patient’s ability to control and coordinate movements for functional tasks like picking up objects or performing self-care activities.

30
Q

What is the “Heel-Shin” test used for in lower limb coordination assessment?

A

The Heel-Shin test assesses lower limb coordination by asking the patient to slide the heel of one foot down the shin of the opposite leg.

31
Q

What do “Toe Taps” evaluate in lower limb coordination?

A

Toe Taps assess the ability to perform rapid, repetitive movements with the feet, indicating lower limb coordination.

32
Q

How are step and gait used to assess lower limb coordination?

A

Step and gait observation evaluates the coordination of the lower limbs during walking or stepping tasks, if appropriate for the patient.

33
Q

What is muscle tone?

A

Muscle tone is the degree of contraction of a muscle and the proportion of motor units that are active at any one time.

34
Q

How is muscle tone assessed through palpation?

A

Muscle tone is evaluated by the compliance of a muscle on palpation and its resistance to passive stretch or movement.

35
Q

What are the two main types of factors that influence muscle tone?

A

Muscle tone can be influenced by neural or non-neural (biomechanical) factors.

36
Q

How is muscle tone assessed during passive movement?

A

Muscle tone is assessed by applying variable speed to the passive range of motion and observing the muscle’s resistance.

37
Q

What is the purpose of the Modified Ashworth Scale?

A

The Modified Ashworth Scale is used to grade muscle spasticity.

38
Q

What does a score of 0 on the Modified Ashworth Scale indicate?

A

A score of 0 indicates no increase in muscle tone.

39
Q

What does a score of 1 on the Modified Ashworth Scale indicate?

A

A score of 1 indicates a slight increase in muscle tone, with a catch and release or minimal resistance at the end of the range of motion.

40
Q

What does a score of 1+ on the Modified Ashworth Scale indicate?

A

A score of 1+ indicates a slight increase in muscle tone, with a catch followed by minimal resistance through less than half of the range of motion.

41
Q

What does a score of 2 on the Modified Ashworth Scale indicate?

A

A score of 2 indicates a marked increase in muscle tone throughout most of the range of motion, but the affected part is still easily moved.

42
Q

What does a score of 3 on the Modified Ashworth Scale indicate?

A

A score of 3 indicates a considerable increase in muscle tone, making passive movement difficult.

43
Q

What does a score of 4 on the Modified Ashworth Scale indicate?

A

A score of 4 indicates that the affected part is rigid in flexion or extension.

44
Q

What causes spasticity?

A

Spasticity results from neuroplasticity and neuronal reorganization.

45
Q

What is the role of the α motor neurone in spasticity?

A

Loss of inhibition and hyperexcitability of the α motor neurone contribute to spasticity due to impaired supraspinal control.

46
Q

What is axonal sprouting and how does it relate to spasticity?

A

Axonal sprouting is the growth of new nerve fibers which can increase the excitability of motor pathways, contributing to spasticity.

47
Q

What reflex is involved in spasticity?

A

Spasticity involves excitation of the cutaneous stretch reflex.

48
Q

How does rigidity differ from spasticity?

A

Rigidity does not depend on the velocity of movement, unlike spasticity.

49
Q

In which neurological condition is rigidity a cardinal sign?

A

Rigidity is a cardinal sign in Parkinson’s disease.

50
Q

What is the “lead pipe” phenomenon in rigidity?

A

The lead pipe phenomenon refers to uniform resistance to passive stretching in all directions, affecting both flexors and extensors.

51
Q

What is the “cogwheel” phenomenon?

A

The cogwheel phenomenon is an intermittent increase in tone during passive movement, with a ratchet-like release due to a combination of lead pipe rigidity and tremor.

52
Q

What aspects of vision are typically assessed?

A

Visual fields, acuity, tracking (smooth pursuit, saccades), nystagmus, and neglect/inattention.

53
Q

What is smooth pursuit in vision assessment?

A

Smooth pursuit refers to the ability to follow a moving object smoothly with the eyes.

54
Q

What are saccades in vision assessment?

A

Saccades are rapid eye movements between two points of focus.

55
Q

What is nystagmus?

A

Nystagmus is an involuntary, rhythmic eye movement that can affect balance and vision.

56
Q

What does neglect or inattention refer to in vision assessment?

A

It refers to the inability to attend to or recognize one side of the visual field, often seen in stroke patients.

57
Q

What are the two main stages of the gait cycle?

A

The two main stages of the gait cycle are the Stance Phase (60%) and the Swing Phase (40%).

58
Q

What are the sub-stages of the Stance Phase in the gait cycle?

A

The sub-stages of the Stance Phase are:

Initial Contact (Heel Strike)
Load Response (Foot Flat)
Mid-Stance (Single Leg)
Terminal Stance (Heel Off)
Pre-Swing (Toe-Off)

59
Q

What are the sub-stages of the Swing Phase in the gait cycle?

A

The sub-stages of the Swing Phase are:

Initial Swing
Mid-Swing
Terminal Swing

Developing Physiotherapy Practice 3 (23 decks)

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