quiz #2

Question 1

necrosis of tissue in CNS results in formation of ____, which is referred to as a lesion

Answer 1

scar tissue

Question 2

progressive CNS conditions
*symptoms & degree of disability increase over time as a result of disease process

Answer 2

Parkinson’s & MS

Question 3

non-progressive CNS conditions
*specific symptoms caused by lesion do not get worse

Answer 3

hemiplegia, spinal cord injuries & cerebral palsy

Question 4

what type of gait is present with hemiplegia or MS?

Answer 4

circumduction gait

(also CP if clt is able to walk)

Question 5

what type of gait is present with Parkinson’s?

Answer 5

festinating gait

Question 6

spasticity can occur with what type of disorders?

Answer 6

hemiplegia, MS, spinal cord injury, cerebral palsy

Question 7

loss of inhibition of alpha motor neuron firing, resistance of a limb to passive movement

Answer 7

spasticity

Question 8

flexor pattern of the upper body

Answer 8

-flexion of head & trunk towards affected side
-depression of SH
-retraction of scapula
-int.R & ADD of GH joint
-flexion of elbow
-pronation of forearm
-flexion of wrist
-fingers with thumb ADD

Question 9

extensor pattern of the upper body

Answer 9

-slight ext of NK & head with trunk bent away from affected side
-scapula retracted
-int.R of GH joint
-elbow rigidly extended
-pronation of forearm
-hand either in flexion forming tight first, or in flexion at PIP & DIP joint
-palm faces backwards

Question 10

flexor pattern of the lower body

Answer 10

-ABD, ext.R & flexion of hip
-flexion of knee
-dorsiflexion & inversion of ankle
-flexion of toes

Question 11

extensor pattern of the lower body

Answer 11

-ADD, int.R & extension of hip
-extension of knee
-plantarflexion & inversion of ankle

Question 12

causes person to vigorously extend limbs while arching back, triggered by stimulation or pressure to back of head or trunk

Answer 12

extensor thrust pattern

Question 13

can accompany extensor thrust pattern, teeth clenched together with extreme force, most common with head injuries

Answer 13

bite reflex

Question 14

stiffening of legs in extension or tight flexion, can occur in response to pressure on ball of foot or stretching of plantar surface of foot by dorsiflexing toes

Answer 14

positive supporting reaction

Question 15

stimulus to palmar surface of hand can elicit ____ reflex which results in withdrawal of entire arm into a tightly flexed position

Answer 15

grasp reflex

Question 16

factors influencing spasticity

Answer 16

limb position, emotional state, physical exertion, pain, communication challenges, meeting new people

Question 17

resistance to movement in flexion, extension & rotation
commonly present in clients with Parkinson’s

Answer 17

rigidity

*can result in painful cramps, pain, numbness, achiness

Question 18

rigidity - palpated as a uniform resistance throughout the ROM of an affected joint

Answer 18

lead pipe rigidity

Question 19

rigidity - ratchet-like movement of affected limb, limb moved a short distance through the ROM but movement is interrupted by a tremor

Answer 19

cogwheel rigidity

Question 20

techniques to reduce spasticity

Answer 20

gentle, repetitive stroking, GTO release, rhythmical rocking
*movements never forced

Question 21

techniques to reduce rigidity

Answer 21

decreasing SNS, swedish techniques followed by heat, slow, passive stretches

Question 22

CI for a client with MS

Answer 22

extreme hydrotherapy

Question 23

a non-progressive condition of paralysis on one side of the body as a result of a brain lesion

Answer 23

hemiplegia

*occurs on one side of body, opposite to side on which lesion has occurred

Question 24

stroke that lasts for less than 24 hours is called a…

Answer 24

transient ischemic attack (TIA)

Question 25

most common causes of strokes which result in hemiplegia

Answer 25

cerebral thrombus cerebral hemorrhage due to aneurysm cerebral embolism

Question 26

hemiplegia that results from a cerebrovascular accident

Answer 26

stroke

Question 27

left sided CVA will result in ____-sided hemiplegia and vice versa

Answer 27

right

Question 28

immediately after stroke or head trauma, mm on affected side will be weak/ flaccid this is considered what phase?

Answer 28

acute

Question 29

most common pattern in hemiplegia

Answer 29

flexor pattern in upper limbs combined with extensor pattern in lower limbs

Question 30

hemiplegic shoulder

Answer 30

SH in ADD & int.R combined with retracted scapula due to reflex patterns & spasticity flaccidity in SH girdle mm & poor positioning of person’s body often result in an inferior subluxation of humerus

Question 31

shoulder-hand syndrome - hemiplegia

Answer 31

-decreased ROM of SH & hand, followed by throbbing pain & edema -elbow remains symptom free -usually occurs with lesion of premotor cortex

Question 32

if hemiplegic shoulder is present, how should you position the client?

Answer 32

scapula pillowed in a protracted position, humerus supported in a slightly superior orientation

Question 33

a condition in which demyelination of the nerve occurs

Answer 33

multiple sclerosis (MS)

Question 34

MS - scar tissue, known as ____, develops at the sites of demyelination

Answer 34

sclerotic plaques

Question 35

MS lesions are most commonly found where?

Answer 35

brain stem, cerebellum, spinal cord

Question 36

two cranial nerves involved in MS

Answer 36

optic & trigeminal

Question 37

MS - mild form, few exacerbations followed by complete recovery & client remains asymptomatic

Answer 37

benign MS

Question 38

MS - repeated cycles of exacerbation & remission, double vision, slurred speech, numbness & tingling anywhere in body

Answer 38

attack-remitting MS

Question 39

two types of attack-remitting MS

Answer 39

benign or mild: causes only mild disability when attack subsides chronic progressive: results in increased symptoms following attacks, in some cases remission periods become less and less frequent & disability increases continuously

Question 40

MS - rapid progression of symptoms & disability, can be fatal within a few years

Answer 40

acute progressive MS

Question 41

4 factors involved in the cause of MS

Answer 41

1. genetic 2. environmental 3. viral 4. immunologic

Question 42

symptom picture of MS

Answer 42

fatigue, tingling, numbness, blurred vision, slurred speech, spasticity, weakness, tremors, altered gait

Question 43

a term used for motor function disorders that result from damage to the immature brain, non-progressive

Answer 43

cerebral palsy

Question 44

when does cerebral palsy occur?

Answer 44

perinatal period from half-way through pregnancy to 7 days postpartum and up to 3 years of age

Question 45

causes of cerebral palsy

Answer 45

-hypoxia & ischemia -trauma to/ rupture of cerebral blood vessels -toxicity & infection

Question 46

4 types of cerebral palsy

Answer 46

1. spastic (increased tone) - most common 2. athetoid (uncontrolled movement) 3. ataxic (poor coordination) - least common 4. mixed (usually spastic & athetoid)

Question 47

cerebral palsy - spasticity

Answer 47

-most common -increases with pain, stress & emotions such as fear & anxiety -rigidity possible

Question 48

cerebral palsy - athetoid

Answer 48

-movements are slow & writhing -increase with voluntary movement & stop with sleep

Question 49

cerebral palsy - choreiform

Answer 49

-movements quick, uncontrolled & without purpose -do not stop with sleep

Question 50

cerebral palsy - ataxia

Answer 50

-lack of coordination & clumsiness of movements -ataxia in face causes grimacing & sometimes accompanied by intention tremor

Question 51

cerebral palsy - flaccidity

Answer 51

-may be present in first year or two -will then change to spasticity or athetoid movement

Question 52

cerebral palsy - reflex movements

Answer 52

-may be early developmental reflexes that would usually disappear as child develops -affected mm are usually sensitive to stretching

Question 53

whole body Tx considerations for cerebral palsy

Answer 53

stand on client’s affected side, techniques applied simultaneously to both sides of body (with diplegia, focus to integrate affected legs with unaffected arms)

Question 54

monoplegia

Answer 54

one arm or leg

Question 55

diplegia

Answer 55

usually both legs

Question 56

triplegia

Answer 56

three limbs

Question 57

quadriplegia

Answer 57

all four limbs

Question 58

hemiplegia

Answer 58

arm & leg on one side of body

Question 59

cerebral cortex - stiff muscles (spasticity), associated with damage to or developmental differences in the...

Answer 59

cerebral cortex

Question 60

cerebral cortex - uncontrollable movements (dyskinesia), associated with damage to the...

Answer 60

basal ganglia

Question 61

cerebral cortex - poor balance and coordination (ataxia), associated with damage to the...

Answer 61

cerebellum

Question 62

cerebral cortex - mixed, a combination of two or more types, associated with damage to...

Answer 62

multiple areas of the brain