tone Flashcards
resistance of muscle to elongation or stretch
a state of slight residual residual contracting in normally innervated, resting muscle
tone
voluntary functional movement patterns that use linked muscles constrained by CNS to act cooperatively
primitive patterns that occur at the spinal cord level from the CNS
synergies
Flexion Synergies UE:
scapular retraction, shoulder abduction/external rotation, elbow flexion, forearm supination, wrist and finger flexion
Flexion Synergies LE:
Hip flexion/abduction/external rotation, knee flexion, ankle DF/inversion, toe DF
Extension Synergies UE:
Scapular protraction, shoulder adduction/internal rotation, elbow extension, forearm pronation, wrist and finger flexion
Extension Synergies LE:
Hip extension/adduction/internal rotation, knee extension, Ankle PF/inversion, toe PF
initial high resistance followed by inhibition
clasp-knife response
cyclical, spasmodic alternation of muscle contract/relaxation in response to sustained stretch of a spastic muscle
- common in flexors, jaw, and wrist
clonus
abnormal tone:
increased uniform resistance persists throughout ROM
independent velocity
associated with lesions of the basal ganglia system (seen in Parkinson’s disease)
excessive UMN firing
stiff and inflexible
rigidity
ratchet-like jerkiness superimposed over hypertonicity
jerkiness - lets go and increases with movement
cogwheel
constant rigidity
throughout ROM
independent of velocity
lead-pipe
severe brain injury causes this type of rigidity
sustained contraction/posturing of upper limbs in flexion and lower limbs in extension
corticospinal tract lesion at the level of the diencephalon (above superior colliculus)
decorticate
sustained contraction/posturing of the trunk and limbs in a position of full extension
corticospinal lesion in the brainstem between the superior colliculus and vestibular nucleus
decerebrate
strong and sustained contraction of the extensor muscles of the neck and trunk resulting in rigid, hyperextended posture
opisthotonus
prolonged involuntary movement disorder characterized by twisting or writhing repetitive movements and increased muscular tone
CNS lesion (commonly basal ganglia), inherited, acquired (Wilson’s/Parkinson’s), or related to metabolic disorders
Dystonia
co-contraction of agonists and antagonists that may last for several minutes-hours
dystonic posturing
decreased or absent muscle tone
- minimal resistance to passive motion, floppy
- hyper extensibility of joints
- decreased DTR’s
- Lower Motor Neuron damage
Flaccidity
temporary state of decreased/absent tone
- UMN/cerebellar lesions may be due to CNS depression due to shock
- recovery varies from days to weeks, followed by spasticity and UMN signs
spinal/cerebral shock
tonal assessment includes:
- observation of posturing, right to left and upper to lower
- palpation
- PROM testing
- Clonus/quick stretch
relfex elicited with mildly noxious/light stroke to skin
ie babinski, chaddock sign, abdominal reflex
superficial cutaneous reflexes
