Rehab Exam FINAL Review Flashcards
1
Q
Gait Pattern Deficits of Parkinson’s Disease
A
- Slow speed
- Festinating
- Decreased arm swing
- Decreased trunk movement
- Flexed Posture, Kyphosis
- Narrow BOS
2
Q
Motor Control
A
- Area of study dealing with the understanding of the neural, physical and behavioral aspects of movements
- Everything related to movement
- How brain talks to rest of body (amt of force, speed at which person moves)
3
Q
Motor Skill
A
- Purposeful and functionally based movement
- Learned through interaction and exploration of environment
4
Q
Motor Plan
A
- Idea or plan of action for purposeful movement
5
Q
Motor Program
A
- Set of commands that results in production of coordinated movement
6
Q
Motor Memory
A
- Perform the movements of the sub-routines of the motor program without thought
- Components: Initial movement conditions, sensory, specific movement patterns, outcome of movement
7
Q
Neuroplasticity
A
- Ability of the nervous system to respond to intrinsic or extrinsic stimuli by reorganizing its structure, function and connections
- Can occur during development, response to environment, learning new task, response to disease, relationship to therapy
- Adaptive: Good, postitive; re-routing occurs
- Mal-Adaptive: Does not generate new routes; allows compensation changes
8
Q
Motor Learning
A
- CNS integrates sensory and motor input to produce motor action - leads to relatively permanent changes
- Skill must be important to pt; demonstrate task exactly as it should be done; relate skill to previous skill with which pt is familiar; clear, concise verbal instructions and cues
9
Q
Feedback
A
- Info received about movement and corrective movement response occurs in response to info
- Feedforward: Signals sent in advance of movement to ready sensimotor system
10
Q
Motor Control Theories
A
- Dynamical Systems Control Theory: Organized around specific task demands
- Hierarchal Control Theory: Top-Down
11
Q
Tests and Measures Terms
A
- Validity: Test measures parameters it says it measures
- Reliability: Consistency of results obtained by tester (intra-rater - single examiner over repeated trials, inter-rater - several examiners)
- Sensitivity: Abnormality is present (True positive)
- Specificity: Abnormality is absent (True negative)
12
Q
Types of Aphasia
A
- Receptive (Wernicke’s - fluent): Can talk, but does not understand
- Expressive (Broca’s - nonfluent): Difficulty talking, but can understand
- Global: Receptive + Expressive Aphasia
13
Q
Types of CVA
A
- Ischemic (Clot blocks blood flow - most common 80%)
- Hemorrhagic (Blood vessel ruptures)
14
Q
TIA vs. CVA
A
- TIA: Temporary interruption of blood flow lasts few minutes to no more than 24 hours
- CVA lasts longer than 24 hours; permanent deficits
15
Q
Gait Deficits of CVA
A
- Difficulty walking
16
Q
Choreoathetosis
A
- Rapid, worm-like movements
17
Q
Hemiballism
A
- Jerking movements on one side
18
Q
Delirium
A
- Clouding of consciousness (acute state of confusion, dulling of cognitive processing, impaired alertness)
- Inattention
- Incoherent
- Fluctuations in LOC
- Sometimes hallucinations and/or agitation
19
Q
Attention
A
- Capacity of brain to process info from the environment or from long-term memory
- Ability to select and attend while suppressing extraneous stimuli
- Selective: screen and process relevant info while screen out irrevelant info
- Sustain: length of time pt maintains attention
- Alternating: Switching between 2 different tasks
- Divided: Perform two tasks simultaneously
20
Q
Memory
A
- Store experiences and perceptions for recall
21
Q
Confabulation
A
- Pt fills in missing info (missing because lack of memory, lack of knowledge)
- Not attempt to be deceptive, pt actually believes what they’re saying
22
Q
Perseveration
A
- Pt “gets stuck”
- Continued repetition of words, thoughts, actions
23
Q
Pusher Syndrome
A
- Ipsilateral pushing with stronger extremities towards hemiplegic/weaker side - WS to weaker side
- Active pushing with strong towards weaker side –> fall toward weaker side
- Instability, Asymmetry, difficulty in transfers, standing
24
Q
Working with pt in Pusher Syndrome
A
- Visual cues
- Sit stand with mirror, tape to show midline, reach across midline
- Tapping to promote muscular activation
- Doorway or corner to facilitate symmetry
- If cane, shorten it to facilitate WS to stronger side
- Walk around table (wall) - push into wall
25
Q
Pathophysiology for TBI
A
- External forces act on brain
- Acceleration, deceleration, rotational forces relative to bony skull
- Compression, strain, shearing, displacement of brain tissue
- Penetrating object (ex bullet) –> laceration and contusion of brain tissue
- Glial cells get damaged and die - send toxins from cell death that kill off neurons
26
Q
Rancho Los Amigos Levels
A
- I,II, III: Decreased or Low-Level Response - ROM, Positioning, Improving arousal through sensory stimulation, spasticity management, Guided Techniques for ADL: sitting, grooming
- IV: Confused-Agitated - Work near pt level of function and improve endurance rather than progress; Pt and family education; positive reinforcement
- V, VI: Confused-Inappropriate/Confused-Appropriate - Confused, but with structure, can follow commands; Pt education on safety, BWSTT, CIMT, Facilitation techniques; break down complex tasks into simple commands
- VII, VIII: Appropriate: Late Confused/Appropriate, early stage Automatic-appropriate - Simulate or integrate real-word/community skills, ADLs, Include in decision-making
27
Q
SCI - Manually assist to cough
A
- Work distal to xiphoid
- Push diaphragm in and up while pt coughs
28
Q
Autonomic Dysreflexia - Signs
A
- Occurs in SCI T6 and above
- Noxious stimulus below level of tension
- Sudden onset of symptoms: Pounding, excruciating headache; Profuse sweating; Vasodilation above level of lesion; Vasoconstriction below level of lesion; HTN; Bradycardia; Increased spasticity; Constricted pupils; Nasal congestion; Goosebumps; Blurred vision
29
Q
Autonomic Dysreflexia - How to treat/prevent
A
- Check clothing, catheter; when was last time voided bladder
- Noxious stimulus: Urinary retention, catheter kink, tight clothing
- Immediate intervention: Activate code (some facilities); if pt flat, bring to sitting (lowers BP); Identify stimulus and relieve it (bladder); If do not immediately find stimulus, relieve bladder
30
Q
Pressure sores - How often to change position
A
- Bed: Change position every two hours
- W/C: Change position every 10-15 minutes
- Bony prominences: Sacrum, heels, ischium, greater trochanter, scapula, elbow, ASIS, knees
31
Q
Brown-Sequard Syndrome
A
- Hemisection of SC (usually stabbing)
- Ipsilateral loss: proprioception and vibration
- Contralateral loss: pain and temperature
- Loss is several dermatome levels below lesion level - spinothalamic tract ascends 2-4 segments on same side prior to crossing
32
Q
Central Cord Syndrome
A
- UE involvement > LE involvement
- Can walk, but not move arms
- Cause: cervical hyperextension injury
- Compressive forces –> hemorrhage and edema in central SC
33
Q
Posterior Cord Syndrome
A
- Very rare
- Loss or proprioception, epicritic sensation
- Wide base steppage gait
- Intact pain, light touch, motor
34
Q
Anterior Cord Syndrome
A
- Loss of pain and temperature (spinothalamic tract damaged)
- Loss of motor (corticospinal tract samaged)
- Proprioception and vibration preserved
- Cause: Cervical flexion innjury –> damage to anterior SC
35
Q
Sacral Sparing
A
- Incomplete lesion
- Sacral tracts are spared from injury
- Intact perianal sensation; external sphincter contract
Often first sign of incomplete cervical SCI
36
Q
Cauda Equina Injury
A
- Usually incomplete - b/c large number of nerve roots and large surface area
- Peripheral injury, not central, LMN
- Has potential to regenerate like peripheral nerve
- Full neurological recovery is uncommon (long axons make location of injury far from site of innervation, scarring on axon may block regeneration, muscle may not be functional once regeneration occurs)
