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Neurorehabilitation > The Nervous System > Flashcards

The Nervous System Flashcards

0
Q

What’s the autonomic nervous system?

A

“Internal workings”

Sympathetic & parasympathetic

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1
Q

What’s the somatic nervous system?

A

“External workings”

CNS & PNS

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2
Q

What’s the apgar scale? What’s an adequate score?

A 
Eval integrity of function of the nervous system at birth
A - appearance
P- pulse
G - grimace to pain
A - activity
R - respiration
Perfect = 10, adequate = 7
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3
Q

Function of cerebral cortex (related to mvmt)

A

Pre-motor, primary motor, & somatosensory processing

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4
Q

Function of the thalamus (related to mvmt)

A

Center for sensation, mvmt, emotion & memory converge

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5
Q

Function of cerebellum (related to mvmt) (3)

A

Smooth executive of voluntary mvmt, muscle tone & motor planning (via connect with pre-motor cortex)

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6
Q

How are deficits with the cerebellum expressed (related to mvmt) (3)

A

Decreased muscle tone, deficits with voluntary mvmt, decreased postural control

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7
Q

Function of basal ganglia (related to mvmt) (1)

A

Regulate mvmt via thalamus

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8
Q

Probs with basal ganglia result in what deficits? (2)

A

Deficits in involuntary mvmt

Difficulty with initiation of functional mvmt

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9
Q

What’s the corticospinal tract?

A

Primary pathway for voluntary mvmt

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10
Q

What’s the limbic system responsible for?

A 
It "MOVEs" us
M - memory, motivation 
O - olfactory
V - visceral/autonomic
E - emotion
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11
Q

What are the cerebellar tracts? (4)

A

Spinocerebellar
Ventral spinocerebellar
Cuneocerebellar
Rostral spinocerebellar

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12
Q

What type of tracts of the cerebellar?

A

Ascending

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13
Q

What’s the fasciculus cuneatus? - where’s it located? What info does it carry?

A

Located in dorsal column, ascending tract, info from UE

Prop, fine touch, vibration

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14
Q

What’s the fasciculus gracilis? - where’s it located? What info does it carry?

A

Carries info from LE
Located in dorsal columns
Carries prop, fine touch, vibration

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15
Q

What’s the spinothalamic? - What info does it carry?

A

Ascending tract

Carries crude touch, pain, pressure & temp

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16
Q

What are descending tracts?

A

Rubrospinal
Vestibulospinal
Reticulospinal
Corticospinal

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17
Q

What are the cranial nerves? Use the trick!

A 
Olfactory 
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
Vestibulocochlear
Glossopharnyngeal
Vagus
Accessory
Hypoglossal
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18
Q

Cranial nerve: which are sensory, motor, or both?

A 
Olfactory - s
Optic - s
Oculomotor - m
Trochlear - m
Trigeminal - b
Abducens - m 
Facial - b
Vestibulocochlear - s
Glossopharnyngeal - b
Vagus - b
Accessory - m
Hypoglossal - m
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19
Q

How do you remember if a CN is s, m, or b?

A

Some say marry money but my brother says big boobs matter more

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20
Q

What’s clonus? How’s it tested? What does it indicate?

A

Involuntary jerking of foot
Tested via quick dorsi flexion at ankle
Indicates prob with descending cortical tracts (UMN)

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21
Q

What’s babinski? How’s it tested? What does it indicate?

A

Fanning of toes
Stroke along lateral aspect of foot
Sign of UMN paralysis

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22
Q

What’s deep tendon reflex? How’s it tested? What does it indicate (2)?

A

Use quick stretch to elicit response from muscles spindle
A way to assess integrity of muscle spindle
Hyperactive response - issue w/descending motor pathway (umn - stroke, TBI)
Hyporeactive response - prob e/ reflex
arc - issue within spinal cord

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23
Q

What’s hypertonia?

A

Increased muscle tone

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24
Q

What’s spasticity? What type of issue does it indicate?

A

Increased resistance to mvmt in one direction.

Indicates UMN lesion

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25
Q

What’s decorticate posture?

A

Form of spasticity
Lesion above superior colliculus
UE flexion LE extension

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26
Q

What’s descerebrate posture?

A

Form of spasticity
UE & LE extension
Lesion below superior colliculus (in brainstem) (stroke, near drowning

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27
Q

What’s rigidity?

A

Increased resistance to mvmt in all directions

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28
Q

What’s hypotonia? What damage does it indicate?

A

Decreased tone

Cerebellum damage or LMN

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29
Q

What’s chorea? Indicative of what dx?

A

Quick jerky/irregular mvmts, small amplitude, distal extremities
Huntington’s disease

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30
Q

What’s hemiballism? Indicative of what dx?

A

Lg involuntary mvmt “flinging”

Subthalamic nucleus damage

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31
Q

What’s athetosis? Indicative of what dx?

A

Slower, irregular mvmt, varying amplitude in entire extremity
Basal ganglia or cerebral palsy

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32
Q

What’s dystonia? Indicative of what dx?

A

Slow twisting mvmt - sustained in trunk or extremity

Globus pallidus lesion

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33
Q

What’s tremor? Indicative of what dx?

A 
Quick regular oscillating mvmt of small amplitude
Substantia nigra (dopamine) a Parkinson's
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34
Q

4 specific conditions associated with cerebellum damage

A
  1. Dysmetria (over/undershoot reaching for object)
  2. Dysdiadokinesia
  3. Ataxia
  4. Intention tremor
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35
Q

Romberg test

A

Tests systems used to stay upright - ability to stand with eyes occluded (vision, proprioception, vestibular)

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36
Q

Spinothalamic tract - carries what info?

A

Crude touch, pain, & temp

Crosses in SC - travels contralaterally

37
Q

Spinoreticular tract carries what info?

A

Dull/aching pain

38
Q

Anterior lesion of spinal cord affects what?

A

Motor

39
Q

Posterior lesion of spinal cord affects what?

A

Sensory

40
Q

Describe Brown-Sequad Syndrome

A 
Lesion to lateral aspect of spinal cord
Spinothalamic tract - contralateral
Dorsal columns - ipsilateral
So, eg: lesion on R side of SC produces
Lost pain sensation on L
Lost discrimination sensations on R
41
Q

The dorsal columns include what tracts? What to they service?

A

Fasciculus gracilis (lower body)
Fasciculus cuneatus (upper body)
Travel ipsilaterally, cross in the brainstem
Carries light touch (discriminative), vibration, proprioception
Damage indicates positive Romberg test

42
Q

What conditions are associated with damage to the spinal cord? (4)

A

Hypertonia
Hyperreflexia
Clonus
Paralysis

43
Q

What’s clonus?

A

Spasmodic involuntary contractions of affected muscles - induced via stretching

44
Q

What conditions are associated with damage to the brain stem? (3)

A 
Locked-in syndrome
Decerebrate rigidity (UE/LE ext)
Associated reactions (widespread increase in tone - overflow. Eg when one hand grasps an item, the other hand grasps as well)
45
Q

What conditions are associated with damage to the basal ganglia? (2)

A

Athetosis

Parkinson’s (resting tremor, festinating gait)

46
Q

What conditions are associated with damage to the cerebellar level? (5)

A 
Ataxia
Dysmetria
Dysdiadochokinesia
Intention tremors 
Asthenia (excessive fatigue in voluntary muscles)
47
Q

What conditions are associated with damage to the cortical level (cerebral cortex)? (4)

A

Hemiplegia
Pathological reflexes (presence of reflexes that should be integrated)
Babinski sign
Hoffman’s sign (tap fingernail or flex dip joint - elicits pinch action between index finger & thumb)

48
Q

General characteristics associated with “right hemiplegic” (L sided insult) (4)

A

Language deficits
Anxiety
Slow/disorganized response to familiar tasks
Difficulty understanding verbal instructions

49
Q

General deficits associated with “left hemiplegic” (R side insult) (4)

A

Impulsivity
Denial of disability
Distorted body image
Depth perception issues

50
Q

Visual deficits: what is strabismus?

A

Eyes not yoked together (move in different directions)

51
Q

Visual deficits: what is diplopia?

A

Double vision

52
Q

Visual deficits: what are symptoms of nystagmus?

A

Oscillopsia (sensation of world moving)

53
Q

Visual deficits: what are symptoms of lagophthalmos?

A

Incomplete eye closure

54
Q

What’s homonymous hemianopsia? What’s a tx strategy?

A

Due to damage to optic pathway - lose half of vision. Compensate via lighthouse strategy

55
Q

What’s hemi-inattention? What side of insult is it associated with? Why? Tx strategy?

A

Visual neglect (eg L sided neglect). Associated with R side injury bc R is “gestalt” (whole pic). Always approach on hemiplegic side.

56
Q

What’s convergent insufficiency?

A

limited ability to bring eyes together along the midline axis (eg difficulty switching focus from far away to nearby)

57
Q

Whats the result of visual field deficits?

A

Poor mobility - danger of running into things, etc.

58
Q

What is oculomotor dysfunction? Symptoms? Tx?

A

Difficulty with smooth pursuits & rapid shifting saccades. Vision may be jerky, non-continuous, over or under-shooting objects. Results in difficulty w/ eye-hand action, finding objects, reduced visual memory. Tx - incorporate vestibular input with eye-hand activity

59
Q

Principles of Proprioceptive Neuromuscular Facilitation (PNF) (11)

A
  1. Human potential
  2. Development is cervico-caudal & proximal-distal
  3. Reflex activity is basis for motor development
  4. Shifts between extensor & flexor patterns
  5. Reversing mvmts make up functional mvmts
  6. Balanced interactions/syngerism of antagonists
  7. Development of motor behavior expressed as total pattens of mvmt & posture
  8. Normal motor development is orderly, but not step-wise
  9. Improved motor ability is dependent on motor learning
  10. Repetition = retention
  11. Goal-directed activities facilitate learning
60
Q

PNF procedures (6)

A
  1. Positioning
  2. Manual contacts
  3. Quick stretch
  4. Tactile/Approximation
  5. Resistance
  6. Verbal commands
61
Q

Contraindications for PNF (6)

A
  1. Inflammatory arthritis
  2. Malignancy
  3. Bone disease
  4. Bone fx
  5. Congenital bone deformities
  6. Joint subluxation
62
Q

General/overall goal of PNF

A

Speed up the response of the neuromuscular mechanism through stimulation of the proprioceptors, which could result in either facilitation or inhibition

63
Q

PNF - tactile system: gentle touch is used to…

A

guide the ct’s mvmt

64
Q

PNF - tactile system: quick stretch is used to…

A

initiate mvmt

65
Q

PNF - tactile system: maximal resistance is used to…

A

strengthen mvmt

66
Q

PNF - tactile system: joint traction is used to…

A

increase ROM

67
Q

PNF - tactile system: joint approximation is used to…

A

promote joint stability & control

68
Q

4 specific goals of PNF

A
  1. Restore/enhance postural responses/normal mvmt
  2. Enhance stability or mobility
  3. Strengthen or stretch a group of muscles
  4. Improve motor control for functional activities
69
Q

5 common dx used with PNF

A
  1. Parkinson’s
  2. SCI
  3. CVA
  4. TBI
  5. Hand injuries
70
Q

What’s ideational apraxia? Symptoms?

A

Loss of ability to conceptualize/plan/execute tool use/use of everyday objects
Difficulty with planning, sequencing, & initiating action

71
Q

Tx for ideational apraxia

A

Reteach the behavior via: 1. hand over hand, 2. modeling, 3. repetition, 4. simple instruction

72
Q

What’s dressing apraxia?

A

Inability to plan & carry out dressing tasks

Results in difficulty orienting clothing, putting clothes on incorrectly,

73
Q

Tx for dressing apraxia (4)

A
  1. physical cues
  2. chaining
  3. using pics
  4. highly structured & systematic
74
Q

What’s constructional apraxia? What are some practical implications?

A

Impaired ability to reconstruct 2D/3D designs

Difficulty orientating clothing, loading dishwasher, assembling furniture, house cleaning, etc.

75
Q

Tx for constructional apraxia

A

Teach to problem solve, anticipatory planning

76
Q

What’s agraphesthesia?

A

Inability to recognize numbers, letters, or forms traced onto the skin

77
Q

What’s ideomotor apraxia?

A

Inability to perform motor action on command, but is able to perform the mvmt automatically

78
Q

What’s topographical disorientation?

A

Inability to fine one’s way around

79
Q

What’s anosagnosia?

A

Ct fails to recognize the presence or severity of their disability, especially paralysis

80
Q

What’s somatognosia?

A

Lack of awareness of body structure & the failure to recognize one’s parts & their relationship to each other

81
Q

What’s unilateral neglect?

A

Inability to integrate & use perceptions from one side of the body - typically the left side

82
Q

What’s finger agnosia?

A

Difficulty naming fingers that have been touched

83
Q

What’s ideational apraxia?

A

Inability to form concepts of mvmt & the inability to execute an act in response to a command/automatically or unable to properly sequence

84
Q

Strategies for working with memory impairment (3 internal strategies, 4 external strategies)

A 
Internal:
1.  Rehearsals (mental repetition)
2.  Grouping (chunking) info
3.  Verbalization 
External:
1.  Alert & cue
2.  Backward chaining
3.  Enviro cues
4.  Written info
85
Q

Tx approaches for cognitive dysfunction (5)

A
  1. Adaptive (compensate)
  2. Remedial (for specific cog deficits)
  3. Process approach (changes to changing ct)
  4. Multicontext approach
  5. Self-monitoring strategies
86
Q

What’s Wernicke’s aphasia?

A

AKA receptive aphasia - difficulty understanding language

87
Q

What’s Broca’s aphasia?

A

AKA expressive aphasia - ct knows what they want to say, but cannot produce language

88
Q

What’s aprosodia? Which hemisphere injury is it associated with?

A

Inability to interpret emotional info - R hemisphere damage

89
Q

What’s dysarthria?

A

Neurological damage to motor components of speech leads to inability of muscles to articulate

Neurorehabilitation (5 decks)

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