Session 2 Flashcards
What is so important about having a strong theoretical base and the implications for the assessment process?
Theory only predicts phenomena about the physical world and normal/abnormal states
a set of integrated info deduced from theoretical info that forms the bases for problem-identification (assessment) and problem-resolution (treatment) relative to each of the underlying skills areas and ADL areas in the OT domain of concern.
Frame of Reference (FOR)
- describes normal and abnormal states of phenomena or constructs/concepts
- used to describe underlying skill areas that are assessed during evaluation process
static theory
- describes theoretical postulates primarily about the learning process or change process
- used during treatment process to delineate treatment principles to promote change in underlying impairments so that they become more functional.
dynamic theory
- delineates all underlying skill areas and UIAs on a continuum.
- provides for assessment procedures or scales
- critical for determining baseline and levels of severity
- used for goal-setting, treatment planning, and activity analysis
function-dysfunction continuua
- problem-resolution detailing treatment principles
- descriptive/prescriptive statements; general and specific guidelines
- environmental set up for change process
postulates regarding change
supplies blood to the frontal lobe and the superior medial parietal lobe
anterior cerebral artery
supplies blood to the majority of the lateral surface of the cerebral hemisphere including most of the parietal and temporal lobes
middle cerebral artery
supplies blood to the occipital lobe
posterior cerebral artery
Describe the vertebral distribution of arteries of the brain (Circle of Willis).
- vertebral arteries become basilar artery.
- basilar artery becomes posterior cerebral artery.
- posterior cerebral artery becomes posterior communicating artery.
- posterior communicating artery becomes middle cerebral artery.
- middle cerebral artery to anterior communicating artery to anterior cerebral artery.
Describe primary to tertiary processing in the cerebral cortex.
- parietal lobes: somatosensation
- occipital lobes: vision
- temporal lobes: audition and language
Describe tertiary to primary processing in the cerebral cortex.
-frontal lobes: motor
initiation of voluntary motor control or movement on a conscious or cortical level
primary motor cortex
movement on command or praxis aka motor planning involving cognition
premotor and supplementary motor areas
higher cognitive functions
prefrontal cortex aka orbitofrontal cortex
expressive speech production
broca’s area
what is the primary processing area of frontal lobe?
primary motor cortex
what is the secondary processing area of the frontal lobe?
premotor and supplementary motor areas
what is the tertiary processing area of the frontal lobe?
prefrontal cortex aka orbitofrontal cortex
initial reception of somatosensory or tactile senses
primary somatosensory cortex
interpretation and discriminative functions
secondary somatosensory association area
further refinement or perceptions and language comprehension
tertiary association areas/inferior parietal lobe
what is the primary processing area of the parietal lobe?
primary somatosensory cortex
what is the secondary processing area of the parietal lobe?
secondary somatosensory association area
what is the tertiary processing area of the parietal lobe?
tertiary association areas (inferior parietal lobe)
initial reception of auditory sensory info
primary auditory cortex
further refinement and language comprehension
wernicke’s area
where is wernicke’s area located?
secondary association area (usually left hemisphere)
n/a
n/a
what is the primary processing area of the temporal lobe?
primary auditory cortex
what is the secondary processing area of the temporal lobe?
secondary association area
what is the tertiary processing area of the temporal lobe?
middle and inferior temporal gyri
initial reception of visual sensory info
primary visual cortex
- continuous with parahippocampal gyrus
- visual processing related to memory
secondary and tertiary association areas
further refinement and interpretation for perception
secondary and tertiary association areas/rest of occipital lobe
Name the 5 parts of the limbic lobes.
- cingulate gyrus
- parahippocampal gyrus
- uncus
- hippocampus
- amygdala
decision making
cingulate gyrus
assigns value, monitors rewards and punishments, interprets and regulates emotions
anterior cingulate cortex (ACC)
memory processing
parahippocampal gyrus and uncus
- critical for long term memory storage
- coordinates widespread brain function for memory storage
hippocampus
- seat of raw emotions, anger, fear, drives
- memory processing
amygdala
- highly influences and modulates motor output or voluntary movement BUT does not affect LMN
- control is automatic, subcortical, or subconscious
- automatic motor patterns or stereotypic motor functions
- influences quality and control of movement
- regulates posture and muscle tone on an unconscious level
basal ganglia
what is the role of the basal ganglia?
quality and control of movement on an unconscious or subcortical level.
the basal ganglia does not affect ____.
LMNs
the control of the basal ganglia is ____.
automatic/subconscious
- regulates posture, balance, and coordination of trunk and limb movement.
- integration of somatosensory, vestibular, and visual systems.
- motor planning and coordination
- connections with memory system
cerebellum
what is the role of the cerebellum?
quality and control of movement on an unconscious or subcortical level (posture and balance)
What does FAST stand for? (strokes)
Face
Arm
Speech
Time
SUDDEN vascular insufficiency due to thrombus or embolus
ischemic stroke
blood clot (usually atherosclerotic plaque)
thrombus
foreign matter that “breaks off” and blocks artery
embolus
name 3 factors that indicate the severity of a stroke.
- size
- distribution
- tissue damage
how long is the full recovery after a transient ischemic attack?
less than 24 hours
trauma or bleed from a ruptured artery
intracerebral hemorrhage
balloon like swelling of bifurcation of artery that grows and ruptures
aneurysm
anastomoses btwn vein and artery that bleeds
arteriovenous malformation (congenital)
name 5 effects of a middle cerebral artery (MCA) stroke of the LEFT hemisphere.
- contralateral hemiplegia/hemiparesis (primary motor cortex)
- contralateral hemisensory loss (primary somatosensory cortex)
- wernicke’s aphasia
- cognitive and perceptual deficits
- apraxias: ideaomotor and ideational
name 4 effects of a middle cerebral artery (MCA) stroke of the RIGHT hemisphere.
- contralateral hemiplegia/hemiparesis (primary motor cortex)
- contralateral hemisensory loss (primary somatosensory cortex)
- perceptual deficits and left neglect syndromes (parietal lobe)
- apraxias: ideomotor and ideational
name 4 effects of a posterior cerebral artery (PCA) stroke.
- memory deficits
- visual and perceptual deficits
- visual receptive sensory field deficits or visual field cuts
- hemianopsias or anopsias vs neglect syndromes
name 4 effects of an anterior cerebral artery (ACA) stroke.
- contralateral hemiplegia/hemiparesis
- contralateral hemisensory loss
- cognitive and executive functions deficits
- apraxias
name 4 effects of a posterior inferior cerebellar artery (PICA) lesion.
- ipsilateral hypertonicity
- vertigo
- nausea
- nystagmus
name 8 effects of an anterior inferior cerebellar artery (AICA) and superior cerebellar artery (SCA) lesion.
- ipsilateral hypertonicity
- incoordination
- intention tremor
- impaired muscle tone
- dysmetria
- dysdiadochokinesia
- dysarthria
- ataxia
name 5 effects of a brainstem (vertebral) artery lesion.
- visual deficits
- ataxic gait
- cranial nerve damage
- vegetative state
- coma
- emergence of primitive reflexes
- spontaneous eye opening
- arousal present yet not interactive purposefully with environment
vegetative state
lesion in reticular formation
coma
where in the brain does damage occur during Parkinson’s Disease and Parkinson’s Syndrome
basal ganglia - damage to the pathway for dopamine
increased hypertonicity and intermittent breaks in muscle tone
cogwheel rigidity
slowed movement and increased hypertonicity
bradykinesia
involuntary or oscillations at rest
resting tremor
poor initiation or termination of movement
festinating gait
impaired righting and equilibrium responses
poor posture and postural control
poor follow through of movement
masked face, micrographia, decreased reciprocal arm swing
Name 8 effects of Parkinson’s Disease.
- cogwheel rigidity
- bradykinesia
- resting tremor
- festinating gait
- poor posture and postural control
- masked face
- micrographia
- decreased reciprocal arm swing
involved in precise timing, coordination of multiple muscle groups, praxis
cerebellum
which effects occur secondary to loss of proprioception in disorders of the cerebellum?
ataxia and ataxic gait
over or undershooting with targets
dysmetria
impaired alternating reciprocal movements
disdiadochokinesia
increased incoordination as approaching target
intention tremor
difficulty regulating speed of movement
rebound phenomenon
Name 5 effects of disorders of the cerebellum.
- ataxia and ataxic giat
- dysmetria
- disdiadochokinesia
- intention tremor
- rebound phenomenon
the process through which the therapist notes observable or objective behaviors that can be physically seen, heard, or touched; or behavior that is usually seen, heard, felt
observation
Why is it important to have strong, keen, careful observation skills?
- must first know typical/functional or normal presentation
- so that you can tell the difference between typical/functional presentation and dysfunctional/abnormal presentation.
name 2 reasons why observable behaviors are highly critical.
- determine how you will grade up or grade down your treatment session (activity synthesis) - adjustment of the human and non-human environment
- become the content that makes up your progress notes and what you state as the “change process” or improvement that is reimbursable.
