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Physiotherapy Practice C > PPC AT1 MID SEM EXAM > Flashcards

PPC AT1 MID SEM EXAM Flashcards

1
Q

STROKE: Primary motor impairments

A
  • Muscle weakness
  • Loss of coordination
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2
Q

STROKE: Primary non-motor impairments

A
  • Altered sensation
  • Altered proprioception
  • Altered perception
  • Altered cognition
  • Altered communication
  • Altered behaviour
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3
Q

STROKE: Secondary motor impairments

A
  • Loss of CV fitness
  • Reduced muscle length
  • Spasticity
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4
Q

STROKE: Secondary non-motor impairments

A
  • Fatigue
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5
Q

STROKE: Early motor activity limitations

A

Decreased walking, standing, standing up, sitting, bed mobility, reaching and manipulation, speaking and swallowing

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6
Q

STROKE: Early non-motor activity limitations

A

Decreased speech and cognition

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7
Q

STROKE: Late motor activity limitations

A
  • 80% can walk by end of rehab
  • 65% non-walkers achieve walking by 6 months
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8
Q

STROKE: Late non-motor activity limitations

A

50% with aphasia have recovered by 6 months

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9
Q

STROKE: Early participation restrictions

A

Decreased domestic tasks, self care, work, study and sport

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10
Q

STROKE: Late participation restrictions

A

40-80% dead or dependent on others at 6 months

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11
Q

TBI: Primary motor impairments

A
  • Muscle weakness
  • Ataxia
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12
Q

TBI: Primary non-motor impairments

A
  • Altered perception
  • Altered cognition
  • Altered behaviour
  • Altered proprioception
  • Altered sensation
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13
Q

TBI: Secondary motor impairments

A
  • Loss of CV fitness
  • Reduced muscle length
  • Spasticity
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14
Q

TBI: Secondary non-motor impairments

A
  • Fatigue
  • Depression
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15
Q

TBI: Early motor activity limitations

A

Decreased walking, standing, standing up, sitting, bed mobility, reaching and manipulation, and swallowing

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16
Q

TBI: Early non-motor activity limitations

A

Decreased speech and cognitive ability

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17
Q

TBI: Late motor and non-motor activity limitations

A

70% with severe TBI will have ongoing limitations

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18
Q

TBI: Early participation restrictions

A

Decreased domestic tasks, self care, work, study and sport

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19
Q

TBI: Late participation restrictions

A
  • 63% socially isolated
  • 60% higher support needs
  • Approx. 40% will return to work after TBI
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20
Q

PD: Primary motor impairments

A
  • Tremor
  • Bradykinesia
  • Hypokinesia
  • Freezing
  • Rigidity
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21
Q

PD: Primary non-motor impairments

A
  • Altered cognition
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22
Q

PD: Secondary motor impairments

A
  • Dyskinesia
  • Dystonia
  • Muscle weakness
  • Loss of CV fitness
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23
Q

PD: Secondary non-motor impairments

A
  • Depression
  • Anxiety
  • Apathy
  • Psychosis
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24
Q

PD: Early motor activity limitations

A

Decreased walking, standing, standing up, bed mobility, reaching and manipulation

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25
Q

PD: Early non-motor activity limitations

A

Decreased cognitive ability in 40% of cases

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26
Q

PD: Late motor activity limitations

A

Degenerative condition where performance will deteriorate over time

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27
Q

PD: Late non-motor activity limitations

A

Decreased language and cognition

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28
Q

PD: Early participation restrictions

A

Mild upon diagnosis, increasing over time

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29
Q

PD: Late participation restrictions

A

Normal life expectancy in most cases, with decreasing domestic tasks, self care, work, study and sport, with increased need for support over time

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30
Q

STANDING: Main important components

A
  • Feet few inches apart and pointing forwards
  • Hips in front of ankles
  • Shoulders over hips
  • Head balanced on level shoulders
  • Erect trunk
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31
Q

STANDING: Adaptive strategies

A
  • Wide base of support (feet far apart or legs externally rotated)
  • Shifts weight to intact foot
  • Flexes at hips/protracts at shoulder instead of dorsiflexing at ankles, moves trunk instead of hips/ankles (for reaching)
  • Takes premature step
  • Shuffles feet
  • Uses arms for balance
  • Avoids balance threats by hypo/bradykinesia, holding breath or stiffly
32
Q

SIT TO STAND: Main important components

A
  • Initial alignment reduces thigh support and increases ankle DF
  • Feet placement (knee flexion, ankles back into dorsiflexion)
  • Inclination of trunk forward by flexion at hips with extended trunk
  • Movement of knees forward
  • Extension of hips and knees for final standing alignment
33
Q

SIT TO STAND: Adaptive strategies

A

PRE-EXTENSION PHASE:
- Weight borne through intact side
- Wide base of support
EXTENSION PHASE:
- Falls backwards
- Pushes through arms
- Weight borne through intact side
- Final alignment flexed

34
Q

REACHING AND MANIPULATION: Main important components of REACHING

A
  • Protraction and elevation of shoulder girdle
  • Shoulder flexion (fwd), abduction (side), and extension (bwd)
  • Shoulder external rotation
  • Elbow flex/ext
  • Wrist extension w/ radial deviation
  • Opening of hand aperture btw fingers and thumb
  • Pronation/supination appropriate to object
35
Q

REACHING AND MANIPULATION: Main important components of GRASPING

A
  • Extension of wrist/fingers
  • Conjunct rotation (flex+abd) of CMCJ thumb
  • Conjunct rotation of MCPJ of ulna fingers
  • Closure of thumb/fingers around object w/ MCPJ flex while some IPJ in some ext
36
Q

REACHING AND MANIPULATION: Main important components of HOLDING

A
  • Flex/ext of wrist holding object
  • Lifting, placing and rotating objects of different sizes and weights
37
Q

REACHING AND MANIPULATION: Main important components of MANIPULATING

A
  • Flex/ext of fingers
  • Cupping of the hand
  • Independent finger flex/ext (e.g. tapping)
38
Q

REACHING AND MANIPULATION: Adaptive strategies

A
  • Uses intact arm only
  • Excessive hip flexion, shoulder elevation, abd+IR at GHJ, trunk side flexion to intact side
  • Excessive elbow flex + forearm pronation
  • Grasps/releases objects w/ wrist in excessive flexion
  • Excessive aperture btw thumb & fingers for grasp/release
  • Extension of CMCJ thumb & pronation of forearm for grasp/release
  • Flat hand/lack of cupping
  • Inability to move objects within hand
39
Q

WALKING STANCE: Main important components for HIP

A
  • Extension of hip throughout
  • Lateral horizontal shift of pelvis and trunk
40
Q

WALKING STANCE: Main important components for KNEE

A
  • Flexion of knee (10 degree knee yield) on heel strike
  • Knee extension through midstance
  • Knee flexion prior to toe-off
41
Q

WALKING STANCE: Main important components for ANKLE

A
  • Dorsiflexion of ankle at heel strike and throughout stance
  • Fast concentric plantarflexion
42
Q

WALKING SWING: Main important components for HIP

A
  • Hip extension at toe-off
  • Hip flexion throughout mid-swing and at end swing
  • Pelvic rotation forward
  • Slight lateral pelvic tilt downwards
43
Q

WALKING SWING: Main important components for KNEE

A
  • Flexion of knee at toe-off
  • Continued knee flexion through mid swing
  • Knee extension prior to heel strike
44
Q

WALKING SWING: Main important components for ANKLE

A
  • Initial plantarflexion at toe-off, dorsiflexion throughout swing
  • Eccentric dorsiflexion at heel strike
45
Q

WALKING: Adaptive strategies

A
  • Slow speed/cadence
  • Increased time in double support
  • Short step length
  • Trunk inclined forward in stance
  • Wide base of support
  • Elevation of pelvis and abduction of leg
  • Toes not clearing ground during swing (or circumduction)
  • Trunk inclined backwards at end of swing
46
Q

COMMUNICATION: What is needed in an introduction for an exercise?

A

My name and what I do

47
Q

COMMUNICATION: What is needed in an explanation of an exercise?

A

The exercise needs to be meaningfully related to patient’s context (e.g. we are doing this to work on your coordination so you don’t fall as often, as this is something you are concerned about)

48
Q

COMMUNICATION: What is needed in instructions for an exercise?

A
  • Simple and specific verbal instructions
  • Demonstration of exercise
  • Consideration of cognitive impairments to understanding instructions
49
Q

COMMUNICATION: What is needed for feedback for an exercise?

A

Knowledge of performance: given during exercise (unless cognitively slow) to indicate they are completing exercise correctly or not
Knowledge of results: given at end of training to indicate how many times they were successful in completing the exercise

50
Q

DEFINITIONS: Weakness

A

Reduction in peak torque and ability to generate force rapidly

51
Q

DEFINITIONS: Spasticity

A

A velocity-dependent increase in tonic stretch reflexes w/ exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex

52
Q

DEFINITIONS: Muscle tone

A

Resistance of normal, relaxed limb to passive stretch

53
Q

DEFINITIONS: Hypertonia

A

Increased resistance of relaxed limb to passive stretch

54
Q

DEFINITIONS: Hypotonia

A

Decreased resistance of relaxed limb to passive stretch

55
Q

DEFINITIONS: Contracture

A

Decreased compliance to passive stretch due to change in mechanical properties of a muscle

56
Q

DEFINITIONS: Balance

A

The ability to control the centre of mass relative to the base of support

57
Q

DEFINITIONS: Coordination

A

The ability to solve any motor task precisely, quickly, rationally and deftly w/ flexibility with respect to the changing environment

58
Q

DEFINITIONS: Dysphagia

A

Difficulty swallowing

59
Q

DEFINITIONS: Aphasia

A

Loss of ability to produce and/or comprehend language

60
Q

DEFINITIONS: Neglect

A

Spatial inattention, meaning a decreased ability to attend to information on both sides of the body and/or environment

61
Q

DEFINITIONS: Short-term memory loss

A

Decreased ability to recall recent events

62
Q

DEFINITIONS: Post traumatic amnesia (PTA)

A

Disorientation to time and place, inability to lay down memories. Common after TBI

63
Q

DEFINITIONS: Apathy

A

Reduced goal-directed behaviour

64
Q

DEFINITIONS: Emotional lability

A

Outbursts of uncontrolled and inappropriate emotion (e.g. crying or laughing)

65
Q

DEFINITIONS: Disinhibition

A

Failure to control drives (e.g. anger, sexual, hunger)

66
Q

DEFINITIONS: Dysarthria

A

A motor speech coordination problem resulting in difficult or unclear articulation of speech

67
Q

DEFINITIONS: Tremor

A

A more or less rhythmic, involuntary movement. Tremor in PD is a resting tremor (disappears w/ action and sleep) more prominent in distal areas

68
Q

DEFINITIONS: Postural tremor

A

Tremor present while maintaining a position against gravity

69
Q

DEFINITIONS: Kinetic tremor

A

Tremor present during voluntary movement

70
Q

DEFINITIONS: Rigidity

A

Increased stiffness throughout joint PROM, present during bidirectional movements

71
Q

DEFINITIONS: Bradykinesia

A

Slowness of movement

72
Q

DEFINITIONS: Akinesia

A

Reduced spontaneous movement (freezing)

73
Q

DEFINITIONS: Hypokinesia

A

Reduced amplitude of movement

74
Q

DEFINITIONS: Freezing

A

Difficulty commencing or continuing a rhythmic repetitive movement

75
Q

DEFINITIONS: Dyskinesia

A

Involuntary, purposeless movements (common side effect of PD medications wear off)

76
Q

DEFINITIONS: Dystonia

A

Prolonged muscle spasms and persistent postures of the body (occur in PD when medication is not effective)

Physiotherapy Practice C (2 decks)

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