Ultimate Review Pt. 1 Flashcards
1
Q
fibrous joints
A
(synarthroses) minimal movement. ex: sutures, syndesmosis, gomphosis
2
Q
cartilaginous joints
A
(amphiarthroses) has cartilage to connect one bone to another. slightly moveable joints. ex: syndchondrosis, symphysis
3
Q
synovial joints
A
(diarthroses) provide free mvmt btwn bones they join. have five characteristics: joint cavity, articular cartilage, synovial membrane and fluid, and fibrous capsule. ex: uniaxial joint (elbow), biaxial (condyloid: finger, saddle: thumb), multi-axial (plane: carpal jts, ball & socket: hip)
4
Q
shoulder complex articulations
A
sternoclavicular, acromioclavicular, glenhumeral, scapulothoracic articulation
5
Q
elbow
A
hinge joint, reinforced by ulnar collateral and radial collateral ligaments
6
Q
wrist and hand
A
radiocarpal and midcarpal joints. mcp joints, prox and distal interphalangeal joints, and cmc joints
7
Q
hip
A
ball and socket joint. stability provided at joint by: acetabulum, iliofemoral ligament, pubofemoral ligament, and ischiofemoral ligament
8
Q
knee
A
hinge joint. stability by these ligaments: anterior cruciate, posterior cruciate, medial collateral, lateral collateral, ad deep medial capsular
9
Q
ankle
A
hinge joint formed by articulation of tibia and fibula w/talus. medial ligaments: deltoid. lateral ligaments: anterior tibiofibular, anterior talofibular, calcaneofibular, lateral talocalcaneal, and posterior talofibular
10
Q
joint receptors
A
?
11
Q
frontal plane
A
divides body into anterior and posterior. motions are abduction and adduction, occur around an anterior-posterior axis.
12
Q
sagittal plane
A
divides body into right and left sections. flexion and extension occur around a medial=lateral axis.
13
Q
transverse plane
A
divides body into upper and lower sections. rotation occurs around vertical axis.
14
Q
class 1 lever
A
very few class 1 levers in body. one example is triceps force on olectranon with an external counter force pushing on forearm. (seesaw). axis of rotation is btwn effort (force) and resistance (load).
15
Q
class 2 lever
A
resistance (load is btwn axis of rotation and effort (force). length of effort arm is always longer than resistance arm. most instances, gravity is effort and muscle activity is resistance. ex: wheelbarrow
16
Q
class 3 lever
A
effort (force) btwn axis of rotation and resistance (load). shoulder abduction with weight at wrist is a class 3 lever example. most common type of lever in body.
17
Q
ATP-PC system
A
energy system producing ATP during high intensity, short duration exercise. Phosphocreatine decomposes and releases large amount of energy used to construct ATP. provides energy for muscle contraction for up to 15 seconds.
18
Q
anaerobic clycolysis
A
major supplier of ATP during high intensity, short duration activities. 50% slower than ATP-PC system and can provide a person with 30-40 secs of muscle contraction
19
Q
aerobic metabolism
A
used predominantly during low intensity, long duration exercises. yields by far the most atp, but requires chemical reactions.
20
Q
Type 1 Muscle Fibers
A
Aerobic, Red, Tonic, Slow twitch, Slow-oxidative: low fatigability, high capillary density, high myoglobin content, smaller fibers, extensive blood supply, large amt of mitochondria (ex: marathon, swimming)
21
Q
Type 2 Muscle Fibers
A
Anaerobic, White, Phasic, Fast twitch, Fast-glycolytic: high fatigability, low capillary density, low myoglobin content, larger fibers, less blood supply, fewer mitochondria (ex: high jump, sprinting)
22
Q
muscle receptors: muscle spindle
A
throughout belly of muscle. send info to nervous system about muscle LENGTH and or RATE of change of LENGTH. important in control of posture and involuntary mvmts.
23
Q
golgi tendon organ
A
sensory receptors through which muscle tendons pass immediately beyond attachment to muscle fibers. very sensitive to TENSION when produced from an active muscle contraction. average of 10-15 muscle fibers are connected in series with each golgi tendon organ. stimulated through the tension produced by muscle fibers.
24
Q
concentric contraction
A
when muscle shortens while developing tension
25
eccentric contraction
occurs when muscle lengthens while developing tension
26
isometric contraction
occurs when tension develops but no change in length of muscle
27
isotonic
occurs when muscle shortens or lengthens while resisting a constant load
28
isokinetic contraction
occurs when tension developed by muscle is maximal over full range of motion while shortening or lengthening at a constant speed.
29
open-chain activity
involve distal segment, usually hand or foot, moving freely in space. example: kicking a ball with LE
30
closed-chain activity
involve body moving over a fixed distal segment. example: squat lift
31
densitometry: hydrostatic weighing
method of calculating density of body by immersing in water and measuring amt of water that becomes displaced.
32
densitometry: plethysmography
method of calculating body density utilizing amt of air displacement during testing within a closed chamber.
33
anthropometry: skinfold msrmt
determines overall % of body fat thru msrmt of 9 standardized sites.
34
end feel
type of resistance that is felt when passively moving a joint thru end range of motion.
35
firm end feel
(stretch) ex: ankle DF, finger extension, hip medial rotation, forearm supination
36
hard end feel
(bone to bone) ex: elbow extension
37
soft end feel
(soft tissue approximation) ex: elbow flexion, knee flexion
38
abnormal end feel: empty
cannot reach end feel due to PAIN, ex: joint inflammation, fracture or bursitis
39
abnormal end feel: firm
ex: increased tone, tightening of capsule, ligament shortening
40
abnormal end feel: hard
ex: fracture, OA, osteophyte formation
41
abnormal end feel: soft
ex: edema, synovitis, ligament instability/tear
42
MMT 0/5
no muscle contraction felt
43
5-Jan
no movement, but can feel muscle contraction
44
2-/5
does not complete ROM in gravity eliminated position
45
5-Feb
completes ROM with gravity eliminated
46
2+/5
able to initiate mvmt against gravity
47
3-/5
does not complete ROM against gravity, but completes more than half the range
48
5-Mar
completes ROM against gravity w/o manual resistance
49
3+/5
completes ROM against gravity with only minimal resistance
50
4-/5
completes ROM against gravity with min/mod resistance
51
5-Apr
completes ROM against gravity with mod resistance
52
4+/5
completes ROM against gravity with mod/max resistance
53
5-May
completes ROM against gravity with max resistance
54
Gait: Standard - Stance Phase (60% of gait cycle)
Heel strike: instant heel touches ground to begin stance phase
55
standard - foot flat
point in which entire foot makes contact with ground and should occur directly after heel strike
56
standard - midstance
point during stance phase when entire body weight is over the stance limb
57
standard - heel off
point in which heel of the stance limb leaves ground
58
standard - toe off
point in which only toe of stance limb remains on ground
59
standard - swing phase (40% of gait cycle)
acceleration: begins when toe off is complete and reference limb swings until positioned directly under body
60
standard - midswing
point when swing limb is directly under body
61
standard - deceleration
begins directly after midswing as swing limb begins to extend and ends just prior to heel strike
62
rancho los amigos terminology
initial contact, loading response, midstance, terminal stance, pre-swing; initial swing, midswing, and terminal swing
63
ROM requirements for normal gait
hip flexion: 0-30, hip extension: 0-15, knee flexion: 0-60, knee extension: 0, ankle DF: 0-10, ankle PF: 0-20
64
Gait muscles: tibialis anterior
activity just after heel strike. eccentric lowering of foot into PF.
65
gait muscles: gastroc/soleus
activity during late stance phase. concentric raising of heel during toe off.
66
gait muscles: quads
single support during early stance phase, and just before toe off to initiate swing phase.
67
gait muscles: hams
activity during late swing phase. decelerating unsupported limb.
68
base of support
distance msrd btwn left and right foot during progression of gait. average BOS is 2-4 inches
69
cadence
of steps an individual will walk over a period of time. average value for an adult is 110-120 steps per minute
70
double support phase
refers to the two times during a gait cycle where both feet are on the ground. does not exist when running
71
gait cycle
sequence of motions that occur from one initial contact of the heel to the next initial contact of the same heel.
72
single support phase
occurs when only one foot is on the ground and occurs 2ce during a single gait cycle
73
step length
distance measured btwn right heel strike and left heel strike. average step length for adult is 13-16 inches
74
stride
distance measured btwn right heel strike and the following right heel strike. average stride length for an adult is 26-32 inches.
75
antalgic gait
involved step length is decreased in order to avoid weight bearing due to pain
76
ataxic gait
gait characterized by staggering and unsteadiness, wide BOS and movements are exaggerated.
77
cerebellar gait
staggering gait
78
circumduction
circular motion to advance leg during swing phase
79
double step
alternate steps are of a different length or different rate
80
equine
gait pattern with high steps, excessive use of gastrocs
81
festinating
patient walks on toes as though pushed. starts slowly, increases and may continue until patient grabs an object in order to stop
82
hemiplegic
abducts paralyzed limb, swings it around and brings forward so that foot comes to ground in front of them
83
parkinsonian
increased forward flexion of trunk and knees, shuffling with quick and small steps.
84
scissor gait pattern
legs cross midline upon advancement
85
spastic
stiff mvmt, toes catch and drag, legs held together, hip and knee joints slightly flexed
86
steppage
gait pattern in which feet and toes are lifted thru hip and knee flexion to excessive heights; usually secondary to DF weakness.
87
tabetic
high stepping ataxic gait pattern where feet slap ground
88
trendelenburg
glute medius weakness; excessive lateral trunk flexion and weight shifting over stance leg
89
vaulting
swing leg advances by compensating thru combination of elevation of pelvis and PF of stance leg
90
muscle insufficiency
muscle contraction that is less than optimal due to an extremely lengthened, or extremely shortened position of the muscle.
91
active insufficiency
when a 2 joint muscle contracts (shortens) across both joints simultaneously
92
passive insufficiency
when a 2 joint muscle is lengthened over both joints simultaneously
93
dynamometer
measures strength through use of a load cell or spring loaded gauge. (ex: grip strength-pounds)
94
dynamometry: make test
eval procedure where a patient is asked to apply a force against the dynamometer.
95
dynamometry: break test:
eval procedure where patient is asked to hold a contraction against pressure that is applied in opposite direction to contraction.
96
joint mobilization
passive movement technique designed to improve joint function
97
indications for joint mobs
restricted joint mobility, restricted accessory motion, desire neuro effects
98
contraindications for joint mobs
active disease, infection, advanced osteoporosis, articular hypermobility, fracture, acute inflammation, muscle guarding, muscle guarding, joint replacement
99
grade I
small movement performed at beginning of range
100
grade II
large amplitude movement performed within the range, but not reaching limit of range and not returning to beginning of range
101
grade III
large amplitude movement performed to limit of range
102
grade IV
small amplitude movement performed at limit of range
103
rheumatism
condition found in a number of disorders characterized by inflammation, degeneration or metabolic derangement of connective tissue, soreness, joint pain and stiffness of muscles. different conditions present with rheumatism. goals are to alleviate pain, decrease inflammation, maintain strength and functional mobility
104
osteoarthritis
chronic disease that primarily involves weight bearing joints. causes a degeneration of articular cartilage. risk factors include trauma, repetitive microtrauma, and obesity. cartilage becomes soft and damaged, bone thickens.
105
RA
systemic autoimmune disorder of unknown etiology. presents with a chronic inflammatory reaction in synovial tissues of a joint that results in erosion of cartilage and supporting structures within the capsule.
106
avulsion fracture
portion of bone becomes fragmented at site of tendon attachment from a traumatic and sudden stretch of tendon
107
closed fracture
break in a bone where skin over site remains intact
108
comminuted fracture
bone that breaks into fragments at the site of injury
109
compound fracture
break in a bone that protrudes thru skin
110
greenstick fracture
break on one side of a bone that does not damage periosteum on opposite side. often seen in children.
111
nonunion fracture
break in a bone that has failed to unite and heal after 9-12 months
112
stress fracture
break in a bone due to repeated forces to a particular portion of the bone
113
spiral fracture
break in a bone shaped as an S due to torsion and twisting
114
bursitis
condition caused by acute or chronic inflammation of bursae. pain and swelling limits range.
115
contusion
sudden blow to part of body that can result in mild to severe damage to superficial and deep structures. ROM, ice, compression are treatments
116
edema
increased volume of fluid in soft tissue outside of a joint capsule
117
effusion
increased volume of fluid within a joint capsule
118
genu valgum
knees touch while standing with feet separated. will increase compression of lateral condyle and increase stress to medial structures. also called knock-knee.
119
genu varum
bowing of knees. will increase compression of medial tibial condyle and increase stress to lateral structures. also called bowleg.
120
kyphosis
excessive curvature of spine in posterior direction usually in thoracic spine.
121
lordosis
excessive curvature of spine in anterior direction usually in cervical and lumbar spine.
122
myositis ossificans
condition of heterotopic bone formation that occurs 3 to 4 wks after a contusion or trauma within the soft tissue
123
osteoporosis
thinning of bone matrix with eventual bone loss and increased risk for fracture. usually found in postmenopausal women
124
q angle
degree of angle when measureing from midpatella to ASIS and tibial tubercle. normal q angle is 13 degrees for man and 18 degrees for a woman.
125
scoliosis
lateral curvature of spine.
126
shoulder dislocation
true separation of humerus from glenoid fossa
127
shoulder separation
disruption in stability of acromioclavicular joint
128
sprain
acute injury of ligament. grade I: mild pain and swelling, little or no tear of ligament. grade II: mod pain and swelling, minimal instability of joint, min to mod tearing of ligament resulting in decreased ROM. grade III: severe pain and swelling, substantial joint instability, total tear of ligament, substantial decrease in ROM
129
strain
acute injury of tendon, muscle. grade I: localized pain, min swelling and tenderness. grade II: localized pain, mod swelling, tenderness and impaired motor function. grade III: palpable defect of muscle, severe pain and poor motor function
130
tendonitis
acute or chronic inflammation of a tendon.
131
(start of peds) congenital hip dysplasia
malalignment of femoral head with acetabulum. develops during last trimester in utero. asymmetrical hip abdution with tightness and apparent femoral shortening of involved side. testing includes ortolani test, barlow maneuver, and u/s. treatment initially attempts to reposition femoral head within the acetabulum thru constant use of a harness, brace, splint or traction. PT may be indicated after cast removal for stretching, strengthening, and caregiver education.
132
congenital limb deficiencies
malformation that occurs in utero secondary to impaired developmental course. classified longitudinal or transverse. causative factor is an abnormality present at conception when a bone lacks potential to form. primary characteristic is a missing long bone suce as the radius. treatment may focus on symmetrical mvmts, strengthening, ROM, weight bearing and prosthetic training.
133
congenital torticollis
characterized by a unilateral contracture of the SCM muscle. causative factors include malposition in utero, breech position and birth trauma. usually dx'd within first three weeks of life. lateral flexion to same side as contracture, rotation toward opposite side. treatment conservative for the first year with emphasis on stretching, active ROM, position and caregiver education. possible surgery.
134
legg-calve-perthes disease
degeneration of femoral head due to avascular necrosis. disease is self limiting and has 4 phases: condensation, fragmentation, re-ossification and remodeling. presents with pain, decreased ROM, antalgic gait, positive Trendelenburg sign. primary treatment focus is to relieve pain and maintain femoral head in proper psition.
135
osgood-schlatter disease
also known as traction apophysis that results from repetitive traction on the tibial tuberosity apophysis. caused by repeated tension to the patella tendon over the tibial tuberosity in young athletes which results in a small avulsion of the tuberosity and swelling. self limiting condition includes point tenderness over patella tendon at insertion on tibial tubercle, antalgic gait and pain with increasing activity. treatment is conservative with focus on education, icing, and eliminating placing strain on the patella tendon.
136
osteogenesis imperfecta
connective tissue disorder that affects formation of collagen during bone development. 4 classifications of osteogenesis imperfecta vary in levels of severity. caused by genetic inheritance with type I and IV considered autosomal dominant traits, and types II and III considered autosomal recessive traits. characteristics: brittle bones, weakness, impaired respiratory function. treatment begins at birth with education on proper handling and facilitation of movement.
137
scoliosis
lateral curvature of spine that can be classified as infantile, juvenile, adolescent or adult. structural curve cannot be corrected with active or passive mvmt and there is rotation of vertebrae towards the convexity of the curve. results in a rib hump over thoracic region. primary causative factor for a non structural curve is a leg length discrepancy. treatment is based on type and severity, generally curves that are less than 25 degrees require monitoring, btwn 25 and 40 degrees are treated with orthotic management, and beyond 40 degrees require surgery.
138
talipes equinovarus
deformity of ankle/foot known as clubfoot.
139
juvenile rhematoid arthritis
most common chronic rheumatic disease in children and presents with inflammation of joints and connective tissues. systemic juvenile RA occurs in 10-20% of children with JRA and presents with acute onset and other symptoms. polyarticular JRA accounts for 30-40% of children with JRA and presents with high femal incidence, RF+ majority and arthritis in more than 5 joints. oligoarticular (pauciarticular) JRA accounts for 40-60% of children with JRA and affects less than 5 joints. treatment includes medication to relieve inflammation and pain and PT.
140
Foot orthotics
semirigid or rigid insert worn inside a shoe that corrects foot alignment and improves function.
141
AFO
primary purpose is to assist with dorsiflexion and prevent foot drop, can also influence knee control. commonly described for patients with peripheral neuropathy, nerve lesions or hemiplegia
142
KAFO
provide support and stability to knee and ankle. allow for a lock mechanism at the knee that provides stability. ankle is also held at proper alignment.
143
craig-scott KAFO
designed specifically for persons with paraplegia. allows a person to stand with a posterior lean of trunk.
144
HKAFO
indicated for patients with hip, foot, knee, and ankle weakness. can control rotation at hip and abduction/adduction. heavy and restricts patients to a swing to or swing thru gait pattern.
145
reciprocating gait orthosis (RGO)
incorporates a cable system to assist with advancement of lower extremities during gait. when patient shifts weight onto a selected lower extremity, the cable system advances the opposite LE.
146
parapodium
standing frame designed to allow a patient to sit when necessary. primarily used in peds.
147
corset
constructed of fabric to provide abdominal compression and support.
148
halo vest orthosis
invasive cervical thoracic orthosis that provides full restriction of all cervical motion. commonly used with cervical spinal cord injuries to prevent further damage or dislocation.
149
milwaukee orthosis
designed to promote realignment of spine due to scoliotic curvature.
150
taylor brace
thoracolumbosacral orthosis that limits trunk flexion and extension through a 3 point control design.
151
thoracolumbosaral orthosis (TLSO)
utilized to prevent all trunk motions and is commonly utilized as a means of post surgical stabilization.
152
factors that influence vascular disease
hypertension, aging, diabetes, infection, poor nutrition, cigarette smoking
153
risk factors for amputation
vascular disease (atherosclerosis, arteriosclerosis), venous insufficiency, buerger's disease, diabetes. malignancy/tumor (osteosarcoma), congenital deformities, infection, and trauma
154
types of LE amputations
hemicorporectomy (surgical removal of pelvis and both LEs), hemipelvectomy (surgical removal of one half of the pelvis and LE), hip disarticulation (surgical removal of lower extremity from pelvis), transfemoral (surgical removal of LE above knee joint) knee disarticulation: thru knee joint, transtibial: below knee joint, syme's foot at ankle joint with removal of malleoli, chopart's: disarticulation at midtarsal joint, transmetatarsal: midsection of metatarsals
155
prosthetic training for transfemoral amputation
length of residual limb with regard to leverage and energy expenditure, no ability to weight bear thru the end of the residual limb, susceptible to hip flexion contracture, adaptation required for balance, weight of prosthesis, and energy expenditure
156
prosthetic training for transtibial amputation
loss of ankle and foot functions, residual limb does not allow for weight bearing at its end, WB in prosthesis should be distributed over the total residual limb, patella tendon should be the area of primary weight bearing, adaptations required for balance, and susceptible to knee flexion contracture.
157
possible complications with amputations
neuroma: bundle of nerve endings that group together an d produce pain due to scar tissue. phantom limb: refers to a painless sensation where patient feels that limb is still present. phantom pain: refers to patient's perception of some form of painful stimuli.
158
wrapping guidelines for amputees
elastic wrap should not have wrinkles, diagonal and angular patterns should be used and should not be wrapped in circular patterns, provide pressure distally to enhance shaping, anchor wrap above knee for transtibial amputations, anchor wrap around pelvis for transfemoral amputations, promote full knee extension for transtibial amputations, promote full hip extension for transfemoral amputations. secure wrap with tape, do not use clips, use 3-4 inch wrap for transtibial and 6 inch wrap for transfemoral, rewrap frequently to maintain proper pressure.
159
components of a prosthesis
socket, suspension, knee, shank, foot
160
gait deviations of amputee: lateral bending
causes: prosthesis too short, improperly shaped lateral wall, high medial wall, prosthesis aligned in abduction, poor balance, abduction contracture, improper training, short residual limb, weak hip abductors on prosthetic side, hypersensitive and painful residual limb
161
gait deviations of amputee: abducted gait
causes: prosthesis may be too long, high medial wall, poorly shaped lateral wall, prosthesis position in abduction, inadequate suspension, abduction contracture, improper training, adductor roll, weak HF and adductors, pain over lateral residual limb
162
gait deviations of amputee: circumducted gait
causes: prosthesis may be too long, too much friction in knee, socket too small, excessive PF of prosthetic foot, abduction contracture, improper training, weak HF, inability to initiate prosthetic knee flexion
163
gait deviations of amputee: excessive knee flexion during stance
socket set forward in relation to foot, foot set in excessive DF, stiff heel, prosthesis too long, knee flexion contracture, hip flexion contracture, poor balance, decrease in quad strength
164
gait deviations of amputee: vaulting
causes: prosthesis may be too long, inadequate socket suspension, excessive alignment stability, foot in excess PF, residual limb discomfort, improper training, short residual limb
165
gait deviations of amputee: rotation of forefoot at heel strike
causes: excessive toe-out built in, loose fitting socket, inadequate suspension, rigid SACH heel cushion, poor muscle control, weak medial rotators, short residual limb
166
gait deviations of amputee: forward trunk flexion
causes: socket too big, poor suspension, knee instability, hip flexion contracture, weak hip extensors
167
gait deviations of amputee: medial or lateral whip
causes: excessive rotation of the knee, tight socket fit, valgus in prosthetic knee, improper alignment of toe break, improper training, weak hip rotators, knee instability
168
Start of Neuro
...
169
CNS
Brain & Spinal Cord
170
PNS (Peripheral)
cranial nerves and their ganglia, spinal nerves and their glania and plexuses, efferent and afferent somatic nerves outside the CNS, ANS (autonomic nervous system) including sympathetic (fight or flight) and parasympathetic (activated during time of rest)
171
Brain (encephalon)
Parts include brainstem, cerebellum, diencephalon, cerebral hemispheres, fissures, sulci, meninges, ventricular system and dural spaces
172
brainstem
midbrain, pons, medulla oblongata
173
diencephalon
hypothalamus, infundibulum, optic chiasm
174
cerebral hemispheres
cortex, white matter, basal nuclei. 2 hemispheres: deep white matter, basal ganglia, and lateral ventricles
175
fissures
interhemispheric fissure: separates the two cerebral hemispheres. Sylvian or lateral fissure: (anterior portion) separates the temporal from frontal lobes; (posterior portion): separates temporal from parietal lobes
176
sulci
central sulcus: separates frontal and parietal lobes laterally. parietal-occipital sulcus: separates the parietal and occipital lobes medially. calcarine sulcus: separates the occipital lobe into superior and inferior halves
177
meninges
term to describe the three layers of connective tissue covering brain and spinal cord
178
meninges: dura mater
outermost meninge, has 4 folds, lines periosteum of skull.
179
meninges: arachnoid
middle meninge, surrounds brain in a loose manner
180
meninges: pia mater
innermost meninge, covers contours of brain, forms choroid plexus in the ventricular system
181
ventricular system
designed to protect and nourish brain. comprised for 4 ventricles and multiple foramen that allow passages of CSF. CSF acts as a cushion around brain and spinal cord, and is produced by the choroid plexus of each ventricle.
182
dural spaces: epidural space
space occupied between the skull and outer dura mater
183
dural spaces: subdural space
space occupied btwn the dura and arachnoid meninges
184
dural spaces: subarachnoid space
space occupied btwn the arachnoid and pia mater that contains CSF and the circulatory system for the cortex
185
ascending and descending tracts
...
186
corticospinal tract (anterior)
pyramidal motor tract responsible for ipsilateral voluntary mvmt
187
corticospinal tract (lateral)
pyramidal motor tract responsible or contralateral voluntary fine mvmt
188
fasciculus gracilis
sensory tract for trunk and LE proprioception, 2 pt discrimination, vibration and graphesthesia
189
fasciculus cuneatus
sensory tract for trunk, neck and UE proprioception, vibration, 2 pt discrimination, graphesthesia
190
rubrospinal tract
extrapyramidal motor tract for motor input of gross postural tone
191
spinocerebellar tract (dorsal)
sensory tract for ipsilateral and contralateral subconscious proprioception
192
spinocerebellar tract (ventral)
sensory tract for ipsilateral subconscious proprioception
193
spinothalamic tract (lateral)
sensory tract for pain, light touch, and temperature
194
tectospinal tract
extrapyramidal motor tract for contralateral posture muscle tone associated with auditory/visual stimuli
195
vestibulospinal tract
extrapyramidal motor tract for ipsilateral gross postural adjustments subsequent to head movements
196
Nerve Root Dermatomes
...
197
C1
vertex of skull.
198
C2
temple, forehead, occiput. myotome: longus colli, SCM, rectus capitis
199
C3
entire neck, posterior cheek, temporal area, prolongation forward under mandible. myotome: trap, splenius capitis
200
C4
shoulder area, clavicular and upper scap area. myotome: trap, levator scapulae
201
C5
deltoid area, anterior aspect of entire arm to base of thumb. myotome: supraspinatus, deltoid, biceps
202
C6
anterior arm, radial side of hand to thumb and index finger. myotome: biceps, supinator, wrist extensors.
203
C7
lateral arm and forearm to index, long and ring fingers. myotome: triceps, wrist flexors
204
C8
medial arm and forearm to long, ring and little fingers. myotome: ulnar deviators, thumb extensors, thumb adductors
205
T1
medial side of forearm to base of little finger.
206
T2
medial side of upper arm to medial elbow, pectoral and midscapular areas
207
T3-T6
upper thorax
208
T5-T7
cotal margin
209
T8-T12
abs and lumbar region
210
L1
back, over trochanter and groin
211
L2
back, front of thigh to knee. myotome: psoas, hip adductors
212
L3
back, upper buttock, anterior thigh and knee, medial lower leg. myotome: psoas ,quads, thigh atrophy
213
L4
medial buttock, lateral thigh, medial leg, dorsum of foot, big toe. myotome: tib anterior, extensor hallicus
214
L5
buttock, posterior and lateral thigh, lateral aspect of leg, dorsum of foot, medial half of sole, first second and third toes. myotome: extensor hallucis, peroneals, gluteus medius, dorsiflexors, hamstring and calf atrophy
215
S1
buttock, thigh and posterior leg. myotome: calf and hamstring, wasting of gluteals, peorneals, PFs
216
S2
same as S1. mytome: same as S1 except peroneals
217
S3
groin and medial thigh to knee.
218
S4
perineum, genitals, lower sacrum. myotome: bladder, rectum
219
LE: Sciatic nerve innervates:
semitendinosous, soleus, popliteus, semimembranosous, plantaris, tib posterior, gastroc, biceps femoris, flexor hallucis lonus, flexor digitorum longus.
220
LE: lumbar plexus innervates:
psoas minor, psoas major
221
LE: sacral plexus innervates:
piriformis, superior gemelli, obturator internus, inferior gemelli, quadratus femoris
222
LE: inferior gluteal nerve innervates:
gluteus maximus
223
LE: deep peroneal nerve innervates:
extensor digitorum longus and tib anterior
224
LE: superior gluteal nerve innervates:
gluteus medius, gluteus minimus, tensor fasciae latae
225
LE: superficial peroneal nerve innervates:
peroneals (longus and brevis)
226
LE: femoral nerve innervates:
iliacus, vastus lateralis, intermedius and medialis; recturs femoris, sartorious, pectineus
227
LE: medial plantar nerve innervates:
abductor hallucis, lumbricale I, flexor digitorum brevis, flexor hallucis longis
228
LE: obturator nerve innervates:
adductor longus, gracilis, adductor brevis, obturator externus, and adductor magnus
229
LE: lateral plantar nerve innervates:
abductor digiti minimi, dorsal interossei, quadratus plantae, adductor hallucis, lumbricale II, III, IV, plantar interossei, flexor digiti minimi brevis
230
UE: dorsal scapular nerve innervates:
rhomboids, levator scapulae
231
UE: long thoracic nerve innervates:
serratus anterior
232
UE: nerve to subclavius innervates
subclavius
233
UE: suprascapular nerve innervates
infraspinatus, supraspinatus
234
UE: lateral pectoral nerve innervates
pect major, pect minor
235
UE: musculocutaneous nerve innervates
coracobrachialis, biceps brachii, brachialis
236
UE: lateral root of the median nerve innervates
flexor muscles in forearm, 5 muscles in hand
237
UE: medial pectoral nerve innervates:
pect major and minor
238
UE: ulnar nerve innervates
1 1/2 muscles of forearm and most small muscles of hand
239
UE: medial root of the median nerve innervates
flexor muscles in forearm, 5 muscles of hand
240
UE: upper subscapular nerve innervates
subscapularis
241
UE: thoracodorsal nerve innervates
latissimus dorsi
242
UE: lower subscapular nerve innervates
subscapularis, teres major
243
UE: axillary nerve innervates
deltoid, teres minor
244
UE: radial nerve innervates
brachioradialis, extensor muscles of forearm
245
AFFERENT NERVES
SENSORY
246
EFFERENT NERVES
MOTOR
247
Cranial Nerves
olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal
248
olfactory
smell
249
optic
sight
250
oculomotor
voluntary movement of eye
251
trochlear
voluntary motor movement of eye
252
trigeminal
touch, pain: skin of face, chewing
253
abducens
voluntary motor: muscle of eyeball, lateral
254
facial
taste: anterior tongue, voluntary motor: facial muscles. autonomic: lacrimal, submandibular, sublingual glands
255
vestibulocochlear (acoustic nerve)
hearing/balance: ear
256
glossopharyngeal
touch, pain: posterior tongue, taste: tongue. swallowing
257
vagus
touch, pain: pharynx, larynx, bronchi. taste: tongue, epiglottis.
258
accessory
voluntary motor: SCM and trapezius muscle
259
hypoglossal
voluntary motor: muscles of tongue
260
types of sensory testing
light touch, deep pain, superficial pain, vibration, proprioception, kinesthesia, temperature, stereognosis, graphesthesia, 2 point discrimination
261
light touch
light pressure with cotton ball
262
deep pain
squeeze forearm or calf muscle
263
superficial pain
pen cap, paper clip end, pin
264
vibration
tuning fork
265
proprioception
identify a static position of an extremity/part
266
kinesthesia
identify direction and extent of mvmt of a joint or body part
267
temperature
hot and cold test tubes
268
stereognosis
identify an object without sight
269
graphesthesia
draw a number or letter on skin with finger, identify without sight
270
2 pt discrimination
2 point caliper on skin, identify one or two points without sight
271
DTR: deep tendon reflexes
reflex is a motor response to a sensory stimulation that is used in an assessment to observe the integrity of the nervous system. DTRs elicit a muscle contraction when the muscle's tendon is stimulated.
272
DTR grades
0=no response. 1+=diminished/depressed response. 2+=active normal response. 3+=brisk/exaggerated response. 4+=very brisk/hyperactive, abnormal response.
273
DTR normal responses:
biceps tendon: flexion/contraction of biceps. brachioradialis tendon: elbow flexion and/or forearm pronation. triceps tendon: elbow extension or contraction of triceps muscle. patellar tendon: knee extension. tibialis posterior tendon: PF/inversion of foot. achilles tendon: PF of foot.
274
PNS: peripheral nervous system
nervous system outside of brain and spinal cord. consists of motor, sensory, and autonomic neurons. neurons are located in cranial, spinal, and peripheral nerves. PNS consists of 12 pairs of cranial nerves, 31 prs of spinal nerves, and associated ganglia and sensory receptors. most peripheral nerves contain motor (efferent) and sensory (afferent) components.
275
A fibers
large, myelinated, high conduction rate. contained in alpha and gamma motor systems. sensory components in muscle spindles, golgi tendon organs, bare nerve endings, mechanoreceptors
276
B fibers
medium, myelinated, reasonably fast conduction rate. pre ganglionic fibers of ANS.
277
C fibers
small nerve fibers, poorly myelinated or unmyelinated. slow conduction rate. post ganglionic fibers of sympathetic system. exteroceptors for pain, temp, and touch.
278
types of nerve injury
mechanical (compression), crush and percussion (fracture, compartment syndrome), laceration, penetrating trauma (stab wound), stretch (traction injury), high velocity trauma (MVA), and cold (frostbite).
279
neurapraxia
mildest form of injury. conduction block usually due to myelin dysfunction. axonal continuity conserved. nerve conduction is preserved proximal and distal to lesion. nerve fibers are not damaged. recovery will occur within 4/6 weeks.
280
axonotmesis
a more severe grade of injury to a peripheral nerve. is reversible injury to damaged fibers. damage occurs to the axons with preservation to endoneurium. nerve can regenerate distal to the site of lesion by one millimeter per day.
281
neurotmesis
most severe grade of injury to a peripheral nerve. all components are damaged and irreversible. all motor and sensory loss is permanently impaired.
282
upper motor neuron disease
characterized by a lesion found in descending motor tracts within the cerebral motor cortex, internal capsule, brainstem or spinal cord. symptoms include weakness of involved muscles, hypertonicity, hyperreflexia, mild disuse atrophy, and abnormal reflexes. damaged tracts are in lateral white column of spinal cord.
283
lower motor neuron disease
characterized by a lesion that affects nerves or their axons at or below level of brainstem, usually within the "final common pathway." ventral gray column of spinal cord may also be affected. symptoms include flaccidity or weakness of muscles, decreased tone, fasciculations, muscle atrophy, and decreased or absent reflexes.
284
upper motor neuron lesions
CP, hydrocephalus, CVA, birth injuries, MS, brain tumors.
285
lower motor neuron lesions
poliomyelitis, tumors involving spinal cord, trauma, infection, muscular dystrophy.
286
blood supply to brain
PCA: posterior cerebral artery, MCA: middle cerebral artery, and vertebrobasilar artery.
287
PCA
portion of midbrain, subthalamic nucleus, basal nucleus, thalamus, inferior temporal lobe, occipital and occipitoparietal cortices
288
MCA
most of outer cerebrum, basal ganglia, posterior and anterior internal capsule, putamen, pallidum, lentiform nucleus
289
vertebrobasila artery
medulla, cerebellum, pons, middle occipital cortex
290
CEREBRAL HEMISPHERE FUNCTION
...
291
frontal lobe
responsible for: voluntary motor function, advanced motor planning, initiation of action, cranial nerves 3, 4, 6, 9, 10, 12; emotion interpretation, personality, judgment, planning, motivation, bladder & bowel inhibition, broca's motor speech center, appreciation of intonation, understanding gestures.
292
frontal lob impairments
contralateral weakness, contralateral head and eye paralysis, personality changes, antisocial behavior, ataxia, primitive reflexes, broca's aphasia, delayed or poor initiation
293
parietal lobe
responsible for: processing perceptual and sensory info, body schema, contralateral pain, posture, touch, proprioception (to arm, trunk and leg), perform calculations, spatial awareness, sensory: speech comprehension, visual tract, taste perception
294
parietal lobe impairments
agraphia, finger agnosia, constructional apraxia, dressing apraxia, anosognosia, wernicke's aphasia (receptive), homonymous visual deficits, impaired language comprehension, impairment in taste
295
temporal lobe
responsible for: auditory and limbic processing, appreciation of language, music and sound, memory, learning, affective mood centers (primitive behaviors), short term memory
296
temporal lobe impairments
auditory and hearing, impaired appreciation of music, memory deficits, learning deficits, wernicke's aphasia, antisocial behaviors
297
occipital lobe
responsible for: primary processing area of visual info, visual tract, perception of vision
298
occipital lobe impairments
homonymous hemianopsia (only seeing half of one visual field), impaired extraocular muscle movement
299
cerebellum
responsible for: coordination of motor skills, postural tone, sensory/motor input for trunk and extremities, coordination of gait
300
cerebellum impairments
ataxia, discoordination of trunk and extremities, intention tremor, balance deficits, ipsilateral facial sensory loss, dysdiadochokinesia (inability to perform rapidly alternating movements)
301
hemisphere specialization/dominance
left: language, sequence and perform movements, understanding language, produce written and spoken language, analytical, controlled. right: nonverbal processing, processing information in a holistic manner, artistic abilities, general concept comprehension, hand-eye coordination, spatial relationships
302
balance
state of physical equilibrium needing input from these three systems: somatosensory, visual and vestibular.
303
somatosensory input
receptors located in joints, muscles, ligaments, and skin to provide proprioceptive info regarding length, tension, pressure, pain, joint position.
304
visual input
visual receptors allow for perceptual acuity regarding verticality, motion of objects and self, environmental orientation, postural sway, and movements of the head/neck. children rely heavily on this system for maintenance of balance.
305
vestibular input
provides CNS with feedback regarding position and movement of the head with relation to gravity.
306
Balance Reflexes: Vestibuloocular reflex (VOR):
allows for head/eye movement coordination. reflex supports gaze stabilization where eyes can move while head is fixed; visual tracking can also occur when both eyes and head are moving.
307
Balance Reflexes: Vestibulospinal reflex (VSR):
attempts to stabilize body and control movement. reflex assists with stability while head is moving as well as coordination of trunk during upright postures.
308
automatic postural strategies
automatic motor responses that are used to maintain center of gravity over base of support.
309
ankle strategy
first strategy to be elicited by a small range and slow velocity perturbation when feet are on the ground. muscles contract in a distal to proximal fashion to control postural sway from ankle joint
310
hip strategy
elicited by a greater force, challenge or perturbation thru pelvis and hips. hips will move in opposite direction from head in order to maintain balance. muscles contract in a proximal to distal fashion in order to counteract the loss of balance
311
suspensory strategy
used to lower the center of gravity during standing or ambulation in order to better control the COG. examples: knee flexion, crouching or squatting. often used when both mobility and stability are required during a task such as surfing.
312
stepping strategy
elicited thru unexpected challenges or perturbations during static standing or when the perturbation produces such a movement that the COG is beyond the BOS. LEs step and/or UE reach to regain a new BOS
313
vertigo
unbalance due to ear disease
314
nystagmus
abnormal eye mvmt that entails nonvolitional, rhythmic oscillation of eyes. spontaneous, peripheral, and central
315
vestibular rehabilitation
intervention that can be successful for pts with vestibular or balance disorders. utilizes compensation, adaptation, and plasticity to increase brain's sensitivity, restore symmetry
316
goals for vestibular rehab:
improve balance and stability, increase strength and ROM, decrease falls, minimize dizziness
317
balance tests (types)
romberg, one legged stance test, tinetti, berg balance, get up and go test, timed get up and go test
318
pharmacological intervention for managing vestibular disorders
antihistamine treats vertigo, anticholinergic agents decrease conduction in vestibular-cerebellar pathways. benzodiazepine (valium) treats vertigo and emesis. phenothiazine (phenergan) treats emesis. monoaminergic (ephedrine) treats vertigo
319
COMMUNICATION DISORDERS
...
320
aphasia
acquired neuro impairment of processing for receptive and/or expressive language. result of brain injury, head trauma, CVA, tumor or infection.
321
fluent aphasia
lesion often in temporoparietal lobe of dominant hemisphere. word output is functional. empty speech or jargon. speech lacks any substance. uses of paraphasias (substitution of incorrect words)
322
wernicke's aphasia
lesion found at posterior region of superior temporal gyrus. major fluent aphasia. also known as "receptive" aphasia. comprehension is impaired, but good articulation
323
broca's aphasia
major non-fluent aphasia. also known as "expressive" aphasia. most common form. lesions in frontal lobe.
324
non-fluent aphasia
poor word output, increased effort for producing speech. poor articulation.
325
global aphasia
major non-fluent aphasia. lesion of frontal, temporal, and parietal lobes. comprehension (reading and auditory) is severely impaired.
326
dysarthria
motor disorder of speech that is caused by an upper motor neuron lesion that affects muscles that are used to articulate words and sounds. speech is often slurred.
327
CVA
cerebrovascular accident
328
completed stroke
cva that presents with total neuro deficits at onset.
329
stroke in evolution
cva usually caused by a thrombus that gradually progresses. deficits are not seen for one to two days after onset.
330
ischemic stroke
when there is a loss of perfusion to a portion of the brain within just seconds, there is a central area of irreversible infarction surrounded by an area of potential ischemia.
331
embolus (20% of ischemic CVAs)
associated with cardiovascular disease, an embolus may be a solid, liquid or gas, and con originate in any part of the body. travels thru bloodstream to the cerebral arteries causing occlusion of a blood vessel and a resultant infarct. middle cerebral artery is most commonly affected by an embolus from internal carotid arteries. often presents with a headache.
332
thrombus
artherosclerotic plaque develops in an artery and eventually occludes the artery or a branching artery causing an infarct. usually occurs during sleep or upon awakening, after a MI or post surgical procedure
333
hemorrhage (10-15% of CVAs)
abnormal bleeding in brain due to rupture in blood supply. due to disruption of oxygen to an area of brain and compression from accumulation of blood. hypertension is usually a precipitating factor causing rupture of an aneurysm or arteriovenous malformation. 50% of deaths from hemorrhagic stroke occur within first 48 hours.
334
TIA
transient ischemic attack
335
TIA
usually linked to an atherosclerotic thrombosis. temporary interruption of blood supply to an area. effects may be similar to a CVA, by symptoms resolve quickly. often occurs in the carotid and vertebrobasilar arteries, and may indicate future CVA.
336
CVA risk factors
hypertension, heart disease, DM, smoking, TIAs, obesity, high cholesterol, behaviors related to hypertension, physical inactivity, increased alcohol consumption
337
If CVA is in anterior cerebral artery:
impairments include LE involvement, loss of bowel/bladder control, loss of behavioral inhibition, mental changes, may see neglect, may see aphasia, apraxia and agraphia, perseveration
338
If CVA is in vertebral-basilar artery
impairments include loss of consciousness, hemi or tetraplegia, comatose or vegetative state, inability to speak, locked in syndrome, vertigo, nystagmus, dysphagia, dysarthria, syncope, ataxia
339
if CVA is in posterior cerebral artery
impairments include pain and temp sensory loss, contralateral hemiplegia, ataxia, athetosis or coreiform mvmt, quality of mvmt is impaired, thalamic pain syndrome, anomia, prosopagnosia with occipital infarct, hemiballismus, visual agnosia, homonymous hemianopsia, mild hemiparesis, memory impairment, dyschromatopsia, palinopsia, micropsia, macropsia, alexia, dyslexia, achromatopsia
340
if CVA is in middle cerebral artery (most common area)
impairments include wernicke's aphasia, homonymous hemianopsia, apraxia, flat affect in rt hemisphere, impaired body schema
341
characteristics of a CVA in RIGHT hemisphere
weakness, paralysis of LEFT side, decreased attention span, left hemianopsia, decreased awareness and judgment, memory deficits, left inattention, decreased abstract reasoning, emotional lability, impulsive behaviors, decreased spatial orientation
342
characteristics of a CVA in LEFT hemisphere
weakness, paralysis of RIGHT side, increased frustration, decreased processing, possible aphasia, dysphagia, motor apraxia, decreased discrimination btwn left and right, right hemianopsia
343
characteristics of a brainstem CVA
unstable vital signs, decreased consciousness, ability to swallow, weakness and paralysis on both sides
344
characteristics of a cerebellum CVA
decreased balance, ataxia, decreased coordination, nausea, decreased ability for postural adjustment, nystagmus
345
synergy patterns
result when higher centers of the brain lose control and the uncontrolled or partially controlled stereotyped patterns of the middle and lower centers emerge.
346
flexor synergy pattern
seen when patient attempts to lift up their arm or reach for an object. characterized by great toe extension and flexion of the remaining toes secondary to spasticity.
347
NDT
neuromuscular developmental treatment: concept recognizes that interference of normal function of the brain caused by CNS dysfunction leads to a slowing down or cessation of motor development and the inhibition of righting reactions, equilibrium reactions, and automatic movements. patient should learn to control mvmt thru activities that promote normal mvmt patterns that integrate function.
348
NDT: facilitation
technique utilized to elicit voluntary muscular contraction.
349
NDT: inhibition
technique utilized to decrease excessive tone or movement.
350
NDT: key points of control
specific handling of designated areas of the body (shoulder, pelvis, hand, foot) will influence and facilitate posture, alignment and control.
351
NDT: placing
act of moving an extremity into a position that the patient must hold against gravity.
352
NDT: reflex inhibiting posture
designated static positions that Bobath found to inhibit abnormal tonal influences and reflexes.
353
Brunnstrom's 7 stages of recovery
stage 1: no volitional mvmt initiated. stage 2: beginning of spasticity. stage 3: voluntary synergies. spasticity increases. stage 4: spasticity begins to DEcrease. stage 5: decrease in spasticity. stage 6: jt mvmts are performed with coordination. stage 7: normal motor function is restored
354
associated reaction
involuntary and automatic mvmt of a body part as a result of an intentional active or resistive mvmt in another body part.
355
homolateral synkinesis
flexion pattern of the involved UE facilitates flexion of the involved LE
356
limb synergies
group of muscles that produce a predictable pattern of mvmt in flexion or extension patterns
357
raimiste's phenomenon
involved LE will abduct/adduct with applied resistance to the uninvolved LE in the same direction
358
souque's phenomenon
raising the involved UE above 100 degrees with elbow extension with produce extension and abduction of the fingers
359
PNF
proprioceptive neuromuscular facilitation
360
PNF
approach is based on the premise that stronger parts of the body are utilized to stimulate and strengthen the weaker parts. development will follow normal sequence thru a component of motor learning. PNF places great emphasis on manual contacts and correct handling. movement patterns follow diagonals or spirals that each possess a flexion, extension, and rotary component and are directed toward or away from midline.
361
chopping (PNF):
combination of bilateral UE asymmetrical extensor patterns performed as a closed chain activity
362
developmental sequence (PNF):
progression of motor skill acquisition. stages of motor control include mobility, stability, controlled mobility, and skill.
363
mass mvmt patterns (PNF):
hip, knee, and ankle move into flexion or extension simultaneously
364
overflow (PNF):
muscle activation of an involved extremity due to intense action of an uninvolved muscle or group of muscles
365
levels of motor control
mobility, stability, controlled mobility, skill
366
agonist reversals
isotonic concentric contraction performed against resistance followed by alternating concentric and eccentric contractions with resistance. (controlled mobility, skill)
367
alternating isometrics
isometric contractions performed alternating from muscles on one side of joint to the other side w/o rest (stability)
368
contract-relax
technique used to increase ROM. as extremity reaches point of limitation the pt performs a maximal contraction of the antagonistic muscle group. therapist resists mvmt for 8-10 secs with relaxation following. technique is repeated until no further gains in ROM are noted during session (mobility)
369
hold-relax
isometric contraction used to increase ROM. contraction is facilitated for all muscle groups at the limiting point in the ROM. relaxation occurs and extremity moves thru the newly acquired range to the next point of limitation until no further increases in ROM occur. used for patients that present with pain usually. (mobility)
370
hold-relax active
technique to improve initiation of mvmt to muscle groups tested at 1/5 or less. (mobility)
371
joint distraction
proprioceptive component used to increase ROM around a joint. manual traction is provided slowly and usually in combo with mobilization techniques. (mobility)
372
normal timing
used to improve coordination of all components of a task. performed distal to proximal sequence. (skill)
373
repeated contractions
used to initiate mvmt and sustain a contraction through the ROM. therapist provides a quick stretch followed by isometric or isotonic contractions (mobility)
374
resisted progression
used to emphasize coordination of proximal components during gait. resistance is applied to an area such as the pelvis, hips, or extremity during the gait cycle in order to enhance coordination, strength or endurance (skill)
375
rhythmic initiation
used to assist initiating movement when hypertonia exists. mvmt progresses from passive to active assist, to slightly resistive. (mobility)
376
rhythmic rotation
passive technique used to decrease hypertonia by slowing rotating an extremity around the axis. relaxation of extremity will increase ROM. (mobility)
377
rhythmic stabilization
used to increase ROM and coordinate isometric contractions. requires isometric contractions of all muscles around a joint against progressive resistance. pt should relax and move into newly acquired range and repeat. (mobility, stability)
378
slow reversal
technique of slow and resisted concentric contractions of agonists and antagonists around a joint w/o rest btwn reversals. used to improve control of movement and posture. (stability, controlled mobility, skill)
379
slow reversal hold
using slow reversal with the addition of an isometric contraction that is performed at the end of each mvmt in order to gain stability. (stability, controlled mobility, skill)
380
compensation
ability to utilize alternate motor and sensory strategies due to an impairment that limits the normal completion of a task.
381
motor learning
ability to perform a mvmt as a result of internal processes that interact with the environment and produce a consistent strategy to generate the correct mvmt
382
plasticity
ability to modify or change at the synapse level either temporarily or permanently in order to perform a particular function
383
postural control
ability of the motor and sensory systems to stabilize position and control mvmt.
384
recovery
ability to utilize previous strategies to return to the same level of functioning
385
strategy
plan used to produce a specific result or outcome that will influence the structure or system
386
task oriented approach
to motor control: utilizes a systems theory of motor control that views the entire body as a mechanical system with many interacting subsystems that all work cooperatively in managing internal and environmental influences. (compensation, motor learning, plasticity, postural control, recovery and strategy are all keys to this approach)
387
Rood theory
says that all motor output was the result of both past and present sensory input. treatment is based on sensorimotor learning. takes into account the autonomic nervous system and emotional factors as well as motor ability. goal is to obtain homeostasis in motor output and to activate muscles and perform a task independently of a stimulus. examples: icing and brushing in order to elicit desired reflex motor responses.
388
sensory stimulation techniques (facilitation)
approximation, joint compression, icing, light touch, quick stretch, resistance, tapping, traction
389
sensory stimulation techniques (inhibition)
deep pressure, prolonged stretch, warmth, prolonged cold, carotid reflex
390
pharmacological interventions for CVA management
include thrombolytic agents, antiplatelet agents, cholesterol-lowering agents, antiarrhythmic agents, neuroprotective agents, antihypertensive agents
391
thrombolytic agents (heparin, activase, coumadin
produces anticoagulation effects, destroys thrombus or emboli
392
antiplatelet agents (aspirin, plavix, ascriptin)
reduces atherosclerotic events and decrease the risk for CVA
393
cholesterol-lowering agents (lipitor, zocor, pravachol)
decreases the triglycerides and low-density lipoproteins in the bloodstream
394
neuroprotective agents (N-methyl-D-aspartate: NMDA)
administered only within the acute stage of CVA (within 3 hrs)
395
antiarrhythmic agents: prevention of arrhythmias, ischemia and hypertension
sodium channel blockers: norpace, Xylocaine. beta-blockers: tenormin, lopressor, inderal. Refractory period alterations: cordarone, corvert. Calcium channel blockers: norvasc, cardizem, verapamil.
396
antihypertensive agents: assists to lower blood pressure; decreases tension within circulation system
diuretics: lasix, bumex, thiazide. beta-blockers: sectral, inderal, lopressor. calcium channel blockers: cardizem, calan. alpha-blockers: cardura, minipress
397
agnosia
inability to interpret information
398
agraphesthesia
inability to recognize symbols, letters or numbers traced on the skin
399
agraphia
inability to write due to a lesion within the brain
400
akinesia
inability to initiate mvmt; commonly seen with parkinson's
401
aphasia
inability to communicate or comprehend due to damage to specific areas of brain
402
apraxia
inability to perform purposeful learned mvmts, although there is no sensory or motor impairment
403
astereognosis
inability to recognize objects by sense of touch
404
ataxia
inability to perform coordinated movements
405
athetosis
condition that presents with involuntary mvmts combined with instability of posture. peripheral mvmts occur without central stability
406
bradykinesia
mvmt that is very slow
407
chorea
mvmts that are sudden, random and involuntary
408
clonus
characteristic of an upper motor neuron lesion; involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex
409
constructional apraxia
inability to reproduce geometric figures
410
decerebrate rigidity
characteristic of a corticospinal lesion at level of brainstem that results in extension of trunk and all extremities
411
decorticate rigidity
characteristic of a corticoapinal lesion at level of diencephalon where the trunk and LEs are positioned in extension, and the UEs are positioned in flexion
412
diplopia
double vision
413
dysarthria
slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech.
414
dysdiadochokinesia
inability to perform rapidly alternating mvmts
415
dsymetria
inability to control the range of a mvmt and the force of muscular activity
416
dysphagia
inability to properly swallow
417
dystonia
closely related to athetosis; however there is larger axial muscle involvement rather than appendicular muscles
418
emotional lability
characteristic of a right hemisphere infarct where there is an inability to control emotions and outbursts of laughing or crying that are inconsistent with the situation
419
hemiballism
involuntary and violent mvmt of a large body part
420
hemiparesis
condition of weakness on one side of body
421
hemiplegia
condition of paralysis on one side of the body
422
homonymous hemianopsia
loss of right or left half of vision in both eyes
423
ideational apraxia
inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for mvmt is impaired
424
ideomotor apraxia
condition where a person plans a mvmt or task, but cannot volitionally perform it. automatic mvmt may occur, but a person cannot impose additional mvmt on command.
425
kinesthesia
ability to perceive the direction and extent of mvmt of a joint or body part
426
neglect
inability to interpret stimuli on the left side of the body due to a lesion of the rt frontal lob of brain
427
perseveration
state of repeatedly performing the same segment of a task or repeatedly saying the same word/phrase without purpose
428
proprioception
ability to perceive the static position of a joint or body part
429
rigidity
state of severe hypertonicity where a sustained muscle contraction does not allow for any mvmt at a specified joint
430
synergy
result of brain damage that presents with mass mvmt patterns that are primitive in nature and coupled with spasticity
431
SCI
spinal cord injury
432
complete lesion
lesion to SC where there is no preserved motor or sensory function below the level of lesion
433
incomplete lesion
lesion to the SC with incomplete damage to the cord. there may be scattered motor function, sensory function or both below the level of injury/lesion.
434
incomplete: anterior cord syndrome
results from compression and damage to the anterior part of SC or anterior spinal artery. usually cervical flexion is mechanism of injury. loss of motor function and pain and temp sense below lesion due to damage of the corticospinal and spinothalamic tracts
435
incomplete: brown-sequard's syndrome
usually caused by a stab wound, which produces a hemisection of the sc. paralysis and loss of vibratory and position sense on same side as lesion due to damage to corticospinal tract and dorsal columns. loss of pain and temp sense on opposite side of lesion from damage to lateral spinothalamic tract. rare since most spinal cord lesions are atypical.
436
incomplete: cauda equina injuries
injury that occurs below L1 spinal level where long nerve roots transcend. mostly incomplete but rarely can be complete as well. considered a peripheral nerve injury. flaccidity, areflexia, impairment of bowel/bladder function. full recovery not typical due to distance needed for axonal regeneration.
437
incomplete: central cord syndrome
results from compression and damage to the central portion of sc. injury is usually cervical hyperextension that damages spinothalamic tract, corticospinal tract, and dorsal columns. UEs present with greater involvement than LEs, and greater motor deficits than sensory deficits.
438
incomplete: posterior cord syndrome
rare syndrome that is caused by compression of posterior spinal artery and is characterized by loss of pain perception, proprioception, 2 pt discrimination, and stereognosis. motor function is preserved.
439
autonomic dysreflexia
dangerious complication of sci. can occur in pts with lesions above T6. noxious stimuls below lesion level triggers autonomic nervous system, causing a sudden elevation in blood pressure. common causes include distended or full bladder, kink or blockage in catheter, bladder infections, pressure ulcers, tight clothing.
440
symptoms of autonomic dysreflexia
high bp, severe headache, blurred vision, stuffy nose, profuse sweating, goose bumps below level of lesion, and vasodilation (flushing) above level of injury.
441
treatment of autonomic dysreflexia
check catheter for blockage first. bowel should also be checked for impaction. pt should remain in a sitting position. lying a patient down is CONTRAindicated.
442
deep vein thrombosis (DVT)
formation of a blood clot that becomes dislodged and is termed an embolus. can become serious since the embolus may obstruct a selected artery. sci pts have a greater risk of developing a DVT due to the absence or decrease of activity in LEs.
443
symptoms of DVT
swelling of LEs, pain, sensitivity over area of clot, warmth
444
treatment of DVT
no active or passive mvmt performed to involved LE. bed rest and anticoagulant drug therapy are usually indicated
445
ectopic bone
(or heterotopic ossification): spontaneous formation of bone in the soft tissue. occurs adjacent to larger joints such as knees or hips.
446
symptoms of ectopic bone
edema, decreased ROM, increased temp of involved joint
447
treatment of ectopic bone
drug intervention usually involves diphosphates that inhibit ectopic bone formation.
448
orthostatic hypotension
occurs due to a loss of sympathetic control of vasoconstriction in combination with absent or severely reduced muscle tone. decrease in systolic blood pressure greater than 20 mm HG after moving from a supine position to a sitting position is typically indicative of orthostatic hypotension.
449
symptoms of orthostatic hypotension
complaints of dizziness, light-headedness, nausea, blacking out when going from a horizontal to a vertical position
450
treatment of ortho hypo
monitoring of vital signs, use of elastic stockings, ace wraps to LEs, abdominal binders. gradual progression to a vertical position using a tilt table is often used. drug intervention is sometimes used to increase blood pressure.
451
pressure ulcers
caused by sustained pressure, friction, and or shearing to a surface. require immediate medical attention and can delay PT/rehab
452
symptoms of pressure ulcers:
reddened area that persists; an open area
453
treatment of pressure ulcers:
prevention is important. change positions frequently, maintain proper skin care, sit on appropriate cushions, consistent weight shifting, maintenance of proper nutrition and hydration.
454
spasticity
can sometimes be useful for a sci patient.
455
spasticity treatment for sci
positioning, aquatic therapy, weight bearing, estim, ROM, resting splints and inhibitive casting
456
aggressive spasticity treatment for sci
phenol blocks, rhizotomies, myelotomies, other surgical interventions
457
myelotomy
surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function
458
neurectomy
surgical removal of a segment of a nerve in order to decrease spasticity and improve function
459
neurogenic bladder
bladder empties reflexively for a pt with an injury above level of S2. sacral reflex arc remains intact.
460
neurologic level
lowest segment of the sc with intact strength and sensation.
461
nonreflexive bladder
bladder is flaccid as a result of a cauda equina or conus medullaris lesion. sacral reflex arc is damaged
462
rhizotomy
surgical resection of sensory component of a spinal nerve in order to decrease spasticity and improve function
463
sacral sparing
incomplete lesion where some of the innermost tracts remain innervated. characteristics include sensation of the saddle area, mvmt of toe flexors, and rectal sphincter contraction
464
spinal shock
physiologic response that occurs between 30 and 60 minutes after trauma to the spinal cord and can last up to several weeks. spinal shock presents with total flaccid paralysis and loss of all reflexes below the level of injury.
465
tenotomy
surgical release of a tendon in order to decrease spasticity and improve function
466
zone of preservation
poor or trace motor or sensory function for up to 3 levels below the neurologic level of injury
467
tbi: open injury
injury of direct penetration thru skull to brain. ex: gsw, knife or sharp object penetration, skull fragments, direct trauma
468
tbi: closed injury
injury to brain w/o penetration thru skull. ex: concussion, contusion (bruise), hematoma (solid swelling of clotted blood in tissues), injury to extracranial blood vessels, hypoxia, drug overdose, near drowning, acceleration/deceleration injuries
469
tbi: primary injury
initial injury to brain sustained by impact. ex: skull penetration, skull fractures, and contusions to gray and white matter
470
primary injury: coup lesion
direct lesion of brain under point of impact. local brain damage is sustained
471
primary injury: contrecoup lesion
injury that results on opposite side of brain. lesion is due to rebound effect of brain after impact.
472
secondary injury
brain damage that occurs as a response to the initial injury. ex: hematoma, hypoxia, ischemia, increased intracranial pressure, and post-traumatic epilepsy
473
secondary injury: epidural hematoma
hemorrhage that forms btwn skull and dura mater
474
secondary injury: subdural hematoma
hemorrhage that forms due to venous rupture btwn dura and arachnoid
475
coma
state of unconsciousness and a level of unresponsiveness to all internal and external stimuli
476
stupor
state of general unresponsiveness with arousal occurring from repeated stimuli
477
obtundity
state of consciousness that is characterized by a state of sleep, reduced alertness to arousal, and delayed responses to stimuli
478
delirium
state of consciousness that is characterized by disorientation, confusion, agitation, and loudness
479
clouding of consciousness
state of consciousness that is characterized by quiet behavior, confusion, poor attention, and delayed responses
480
consciousness
state of alertness, awareness, orientation and memory
481
acute diagnostic management
glasgow coma scale, CAT scan, x-ray, MRI, cerebral angiography, evoked potential/electroencephalogram, positron emission tomography, ventriculography, radioisotope imaging
482
glasgow coma scale
neuro assessment tool used initially after injury to determine arousal and cerebral cortex function. total score of 8 or less correlates to coma in 90% of patients. scores of 9-12 indicate moderate brain injuries and scores from 13-15 indicate mild brain injuries.
483
rancho los amigos (levels of cognitive functioning
neuro assessment tool. 1-8 levels. 1=no response. 2=generalized response. 3=localized response. 4=confused-agitated (heightened state of activity. behavior is bizarre.) 5=confused-inappropriate (pt is able to respond to simple commands fairly consistently, but more complex task responses are non-purposeful, random or fragmented.) 6=confused-appropriate (pt shows goal oriented behavior, but is dependent on external input or direction). 7=automatic-appropriate: pt appears appropriate and oriented within the hospital and home setting but frequently robot-like. 8=purposeful-appropriate (pt is able to recall and integrate past and recent events and is aware and responsive to environment.
484
anterograde memory impairment
inability to create new memory. usually last to recover after a comatose state.
485
post-traumatic memory impairment
time btwn injury and when patient is able to recall recent events. pt does not recall injury or events up until this point of recovery.
486
retrograde amnesia
inability to remember events prior to the injury. retrograde amnesia may progressively decrease with recovery
487
pharmacological interventions for tbi management
diuretic agents to decrease volume of fluid in brain and pressure (mannitol, glycerol) anticonvulsant agents to prevent early seizures in head injury (dilantin, tegretol, klonopin) calcium channel blocker agents to improve outcome for traumatic subarachnoid hemorrhage (nimotop), antidepressant agents to reduce aggressive or disruptive behavior (elavil, prozac) electrolytes because adequate stores are needed during acute phase of head injury (magnesium sulfate) selective serotonin reuptake inhibitor agents may benefit patients with head injury and emotional inhibition or impairment (zoloft, paxil)
488
cardiac reflexes
quick acting nervous system mechanisms that influence heart rate when triggered.
489
baroreceptor reflex
produced by a group of mechanoreceptors that are found w/in walls of the heart. the reflex is activated when pressure rises w/in the large arteries above 60 mm Hg. peak in activity at approx 180 mm Hg. results in vasodilation secondary to inhibition of the vasomotor centers w/in the medulla as well as a decrease in heart rate and strength of contraction secondary to vagal stimulation
490
bainbridge reflex
occurs when mechanoreceptors embedded within the right atrial myocardium respond to an increase in pressure and stretch (distention of the right atrium). stimulates the vasomotor centers of the medulla and results in increased sympathetic input and heart rate. reflex can also influence a decrease in heart rate when heart is beating too fast.
491
chemoreceptor reflex
responds to need for increased depth and rate of ventilation. chemoreceptors are located on the carotid and aortic bodies and detect lack of oxygen, responding to an increase in arterial CO2 levels.
492
Heart sounds: S1
lub: mitral and tricupsid valves closing at beginning of systole
493
Heart sounds: S2
dub: aortic and pulmonary valves closing at onset of diastole
494
Heart sounds: S3
ventricular gallop: abnormal in older adults: noncompliant left ventricle. may be associated with CHF
495
Heart sounds: S4
vibration of ventricular wall with ventricular filling and atrial contraction; may be associated with hypertension, stenosis, hypertensive heart disease or myocardial infarction
496
cardiac output
amount of blood pumped out of heart through the aorta each minute. males: 5.6L/min. females: 10-20% less. CO=stroke volume X heart rate
497
venous return
amount of blood comes from the veins to the right atrium each minute
498
stroke volume
amount of blood ejected from ventricles with each contraction. factors that can influence stroke volume include preload (influenced by end-diastolic volume), afterload, and contractility
499
cardiac index
amount of blood pumped out of heart per minute per sq meter of body mass. normal ranges btwn 2.5 to 4.2 L/min/meter2
500
blood volume
usually 7-8% of body weight. blood is pumped thru body at 30 cm/sec w/total circulation time of 20 seconds.
501
# Reveresed
(synarthroses) minimal movement. ex: sutures, syndesmosis, gomphosis
fibrous joints
502
# Reveresed
(amphiarthroses) has cartilage to connect one bone to another. slightly moveable joints. ex: syndchondrosis, symphysis
cartilaginous joints
503
# Reveresed
(diarthroses) provide free mvmt btwn bones they join. have five characteristics: joint cavity, articular cartilage, synovial membrane and fluid, and fibrous capsule. ex: uniaxial joint (elbow), biaxial (condyloid: finger, saddle: thumb), multi-axial (plane: carpal jts, ball & socket: hip)
synovial joints
504
# Reveresed
sternoclavicular, acromioclavicular, glenhumeral, scapulothoracic articulation
shoulder complex articulations
505
# Reveresed
hinge joint, reinforced by ulnar collateral and radial collateral ligaments
elbow
506
# Reveresed
radiocarpal and midcarpal joints. mcp joints, prox and distal interphalangeal joints, and cmc joints
wrist and hand
507
# Reveresed
ball and socket joint. stability provided at joint by: acetabulum, iliofemoral ligament, pubofemoral ligament, and ischiofemoral ligament
hip
508
# Reveresed
hinge joint. stability by these ligaments: anterior cruciate, posterior cruciate, medial collateral, lateral collateral, ad deep medial capsular
knee
509
# Reveresed
hinge joint formed by articulation of tibia and fibula w/talus. medial ligaments: deltoid. lateral ligaments: anterior tibiofibular, anterior talofibular, calcaneofibular, lateral talocalcaneal, and posterior talofibular
ankle
510
# Reveresed
?
joint receptors
511
# Reveresed
divides body into anterior and posterior. motions are abduction and adduction, occur around an anterior-posterior axis.
frontal plane
512
# Reveresed
divides body into right and left sections. flexion and extension occur around a medial=lateral axis.
sagittal plane
513
# Reveresed
divides body into upper and lower sections. rotation occurs around vertical axis.
transverse plane
514
# Reveresed
very few class 1 levers in body. one example is triceps force on olectranon with an external counter force pushing on forearm. (seesaw). axis of rotation is btwn effort (force) and resistance (load).
class 1 lever
515
# Reveresed
resistance (load is btwn axis of rotation and effort (force). length of effort arm is always longer than resistance arm. most instances, gravity is effort and muscle activity is resistance. ex: wheelbarrow
class 2 lever
516
# Reveresed
effort (force) btwn axis of rotation and resistance (load). shoulder abduction with weight at wrist is a class 3 lever example. most common type of lever in body.
class 3 lever
517
# Reveresed
energy system producing ATP during high intensity, short duration exercise. Phosphocreatine decomposes and releases large amount of energy used to construct ATP. provides energy for muscle contraction for up to 15 seconds.
ATP-PC system
518
# Reveresed
major supplier of ATP during high intensity, short duration activities. 50% slower than ATP-PC system and can provide a person with 30-40 secs of muscle contraction
anaerobic clycolysis
519
# Reveresed
used predominantly during low intensity, long duration exercises. yields by far the most atp, but requires chemical reactions.
aerobic metabolism
520
# Reveresed
Aerobic, Red, Tonic, Slow twitch, Slow-oxidative: low fatigability, high capillary density, high myoglobin content, smaller fibers, extensive blood supply, large amt of mitochondria (ex: marathon, swimming)
Type 1 Muscle Fibers
521
# Reveresed
Anaerobic, White, Phasic, Fast twitch, Fast-glycolytic: high fatigability, low capillary density, low myoglobin content, larger fibers, less blood supply, fewer mitochondria (ex: high jump, sprinting)
Type 2 Muscle Fibers
522
# Reveresed
throughout belly of muscle. send info to nervous system about muscle LENGTH and or RATE of change of LENGTH. important in control of posture and involuntary mvmts.
muscle receptors: muscle spindle
523
# Reveresed
sensory receptors through which muscle tendons pass immediately beyond attachment to muscle fibers. very sensitive to TENSION when produced from an active muscle contraction. average of 10-15 muscle fibers are connected in series with each golgi tendon organ. stimulated through the tension produced by muscle fibers.
golgi tendon organ
524
# Reveresed
when muscle shortens while developing tension
concentric contraction
525
# Reveresed
occurs when muscle lengthens while developing tension
eccentric contraction
526
# Reveresed
occurs when tension develops but no change in length of muscle
isometric contraction
527
# Reveresed
occurs when muscle shortens or lengthens while resisting a constant load
isotonic
528
# Reveresed
occurs when tension developed by muscle is maximal over full range of motion while shortening or lengthening at a constant speed.
isokinetic contraction
529
# Reveresed
involve distal segment, usually hand or foot, moving freely in space. example: kicking a ball with LE
open-chain activity
530
# Reveresed
involve body moving over a fixed distal segment. example: squat lift
closed-chain activity
531
# Reveresed
method of calculating density of body by immersing in water and measuring amt of water that becomes displaced.
densitometry: hydrostatic weighing
532
# Reveresed
method of calculating body density utilizing amt of air displacement during testing within a closed chamber.
densitometry: plethysmography
533
# Reveresed
determines overall % of body fat thru msrmt of 9 standardized sites.
anthropometry: skinfold msrmt
534
# Reveresed
type of resistance that is felt when passively moving a joint thru end range of motion.
end feel
535
# Reveresed
(stretch) ex: ankle DF, finger extension, hip medial rotation, forearm supination
firm end feel
536
# Reveresed
(bone to bone) ex: elbow extension
hard end feel
537
# Reveresed
(soft tissue approximation) ex: elbow flexion, knee flexion
soft end feel
538
# Reveresed
cannot reach end feel due to PAIN, ex: joint inflammation, fracture or bursitis
abnormal end feel: empty
539
# Reveresed
ex: increased tone, tightening of capsule, ligament shortening
abnormal end feel: firm
540
# Reveresed
ex: fracture, OA, osteophyte formation
abnormal end feel: hard
541
# Reveresed
ex: edema, synovitis, ligament instability/tear
abnormal end feel: soft
542
# Reveresed
no muscle contraction felt
MMT 0/5
543
# Reveresed
no movement, but can feel muscle contraction
5-Jan
544
# Reveresed
does not complete ROM in gravity eliminated position
2-/5
545
# Reveresed
completes ROM with gravity eliminated
5-Feb
546
# Reveresed
able to initiate mvmt against gravity
2+/5
547
# Reveresed
does not complete ROM against gravity, but completes more than half the range
3-/5
548
# Reveresed
completes ROM against gravity w/o manual resistance
5-Mar
549
# Reveresed
completes ROM against gravity with only minimal resistance
3+/5
550
# Reveresed
completes ROM against gravity with min/mod resistance
4-/5
551
# Reveresed
completes ROM against gravity with mod resistance
5-Apr
552
# Reveresed
completes ROM against gravity with mod/max resistance
4+/5
553
# Reveresed
completes ROM against gravity with max resistance
5-May
554
# Reveresed
Heel strike: instant heel touches ground to begin stance phase
Gait: Standard - Stance Phase (60% of gait cycle)
555
# Reveresed
point in which entire foot makes contact with ground and should occur directly after heel strike
standard - foot flat
556
# Reveresed
point during stance phase when entire body weight is over the stance limb
standard - midstance
557
# Reveresed
point in which heel of the stance limb leaves ground
standard - heel off
558
# Reveresed
point in which only toe of stance limb remains on ground
standard - toe off
559
# Reveresed
acceleration: begins when toe off is complete and reference limb swings until positioned directly under body
standard - swing phase (40% of gait cycle)
560
# Reveresed
point when swing limb is directly under body
standard - midswing
561
# Reveresed
begins directly after midswing as swing limb begins to extend and ends just prior to heel strike
standard - deceleration
562
# Reveresed
initial contact, loading response, midstance, terminal stance, pre-swing; initial swing, midswing, and terminal swing
rancho los amigos terminology
563
# Reveresed
hip flexion: 0-30, hip extension: 0-15, knee flexion: 0-60, knee extension: 0, ankle DF: 0-10, ankle PF: 0-20
ROM requirements for normal gait
564
# Reveresed
activity just after heel strike. eccentric lowering of foot into PF.
Gait muscles: tibialis anterior
565
# Reveresed
activity during late stance phase. concentric raising of heel during toe off.
gait muscles: gastroc/soleus
566
# Reveresed
single support during early stance phase, and just before toe off to initiate swing phase.
gait muscles: quads
567
# Reveresed
activity during late swing phase. decelerating unsupported limb.
gait muscles: hams
568
# Reveresed
distance msrd btwn left and right foot during progression of gait. average BOS is 2-4 inches
base of support
569
# Reveresed
of steps an individual will walk over a period of time. average value for an adult is 110-120 steps per minute
cadence
570
# Reveresed
refers to the two times during a gait cycle where both feet are on the ground. does not exist when running
double support phase
571
# Reveresed
sequence of motions that occur from one initial contact of the heel to the next initial contact of the same heel.
gait cycle
572
# Reveresed
occurs when only one foot is on the ground and occurs 2ce during a single gait cycle
single support phase
573
# Reveresed
distance measured btwn right heel strike and left heel strike. average step length for adult is 13-16 inches
step length
574
# Reveresed
distance measured btwn right heel strike and the following right heel strike. average stride length for an adult is 26-32 inches.
stride
575
# Reveresed
involved step length is decreased in order to avoid weight bearing due to pain
antalgic gait
576
# Reveresed
gait characterized by staggering and unsteadiness, wide BOS and movements are exaggerated.
ataxic gait
577
# Reveresed
staggering gait
cerebellar gait
578
# Reveresed
circular motion to advance leg during swing phase
circumduction
579
# Reveresed
alternate steps are of a different length or different rate
double step
580
# Reveresed
gait pattern with high steps, excessive use of gastrocs
equine
581
# Reveresed
patient walks on toes as though pushed. starts slowly, increases and may continue until patient grabs an object in order to stop
festinating
582
# Reveresed
abducts paralyzed limb, swings it around and brings forward so that foot comes to ground in front of them
hemiplegic
583
# Reveresed
increased forward flexion of trunk and knees, shuffling with quick and small steps.
parkinsonian
584
# Reveresed
legs cross midline upon advancement
scissor gait pattern
585
# Reveresed
stiff mvmt, toes catch and drag, legs held together, hip and knee joints slightly flexed
spastic
586
# Reveresed
gait pattern in which feet and toes are lifted thru hip and knee flexion to excessive heights; usually secondary to DF weakness.
steppage
587
# Reveresed
high stepping ataxic gait pattern where feet slap ground
tabetic
588
# Reveresed
glute medius weakness; excessive lateral trunk flexion and weight shifting over stance leg
trendelenburg
589
# Reveresed
swing leg advances by compensating thru combination of elevation of pelvis and PF of stance leg
vaulting
590
# Reveresed
muscle contraction that is less than optimal due to an extremely lengthened, or extremely shortened position of the muscle.
muscle insufficiency
591
# Reveresed
when a 2 joint muscle contracts (shortens) across both joints simultaneously
active insufficiency
592
# Reveresed
when a 2 joint muscle is lengthened over both joints simultaneously
passive insufficiency
593
# Reveresed
measures strength through use of a load cell or spring loaded gauge. (ex: grip strength-pounds)
dynamometer
594
# Reveresed
eval procedure where a patient is asked to apply a force against the dynamometer.
dynamometry: make test
595
# Reveresed
eval procedure where patient is asked to hold a contraction against pressure that is applied in opposite direction to contraction.
dynamometry: break test:
596
# Reveresed
passive movement technique designed to improve joint function
joint mobilization
597
# Reveresed
restricted joint mobility, restricted accessory motion, desire neuro effects
indications for joint mobs
598
# Reveresed
active disease, infection, advanced osteoporosis, articular hypermobility, fracture, acute inflammation, muscle guarding, muscle guarding, joint replacement
contraindications for joint mobs
599
# Reveresed
small movement performed at beginning of range
grade I
600
# Reveresed
large amplitude movement performed within the range, but not reaching limit of range and not returning to beginning of range
grade II
601
# Reveresed
large amplitude movement performed to limit of range
grade III
602
# Reveresed
small amplitude movement performed at limit of range
grade IV
603
# Reveresed
condition found in a number of disorders characterized by inflammation, degeneration or metabolic derangement of connective tissue, soreness, joint pain and stiffness of muscles. different conditions present with rheumatism. goals are to alleviate pain, decrease inflammation, maintain strength and functional mobility
rheumatism
604
# Reveresed
chronic disease that primarily involves weight bearing joints. causes a degeneration of articular cartilage. risk factors include trauma, repetitive microtrauma, and obesity. cartilage becomes soft and damaged, bone thickens.
osteoarthritis
605
# Reveresed
systemic autoimmune disorder of unknown etiology. presents with a chronic inflammatory reaction in synovial tissues of a joint that results in erosion of cartilage and supporting structures within the capsule.
RA
606
# Reveresed
portion of bone becomes fragmented at site of tendon attachment from a traumatic and sudden stretch of tendon
avulsion fracture
607
# Reveresed
break in a bone where skin over site remains intact
closed fracture
608
# Reveresed
bone that breaks into fragments at the site of injury
comminuted fracture
609
# Reveresed
break in a bone that protrudes thru skin
compound fracture
610
# Reveresed
break on one side of a bone that does not damage periosteum on opposite side. often seen in children.
greenstick fracture
611
# Reveresed
break in a bone that has failed to unite and heal after 9-12 months
nonunion fracture
612
# Reveresed
break in a bone due to repeated forces to a particular portion of the bone
stress fracture
613
# Reveresed
break in a bone shaped as an S due to torsion and twisting
spiral fracture
614
# Reveresed
condition caused by acute or chronic inflammation of bursae. pain and swelling limits range.
bursitis
615
# Reveresed
sudden blow to part of body that can result in mild to severe damage to superficial and deep structures. ROM, ice, compression are treatments
contusion
616
# Reveresed
increased volume of fluid in soft tissue outside of a joint capsule
edema
617
# Reveresed
increased volume of fluid within a joint capsule
effusion
618
# Reveresed
knees touch while standing with feet separated. will increase compression of lateral condyle and increase stress to medial structures. also called knock-knee.
genu valgum
619
# Reveresed
bowing of knees. will increase compression of medial tibial condyle and increase stress to lateral structures. also called bowleg.
genu varum
620
# Reveresed
excessive curvature of spine in posterior direction usually in thoracic spine.
kyphosis
621
# Reveresed
excessive curvature of spine in anterior direction usually in cervical and lumbar spine.
lordosis
622
# Reveresed
condition of heterotopic bone formation that occurs 3 to 4 wks after a contusion or trauma within the soft tissue
myositis ossificans
623
# Reveresed
thinning of bone matrix with eventual bone loss and increased risk for fracture. usually found in postmenopausal women
osteoporosis
624
# Reveresed
degree of angle when measureing from midpatella to ASIS and tibial tubercle. normal q angle is 13 degrees for man and 18 degrees for a woman.
q angle
625
# Reveresed
lateral curvature of spine.
scoliosis
626
# Reveresed
true separation of humerus from glenoid fossa
shoulder dislocation
627
# Reveresed
disruption in stability of acromioclavicular joint
shoulder separation
628
# Reveresed
acute injury of ligament. grade I: mild pain and swelling, little or no tear of ligament. grade II: mod pain and swelling, minimal instability of joint, min to mod tearing of ligament resulting in decreased ROM. grade III: severe pain and swelling, substantial joint instability, total tear of ligament, substantial decrease in ROM
sprain
629
# Reveresed
acute injury of tendon, muscle. grade I: localized pain, min swelling and tenderness. grade II: localized pain, mod swelling, tenderness and impaired motor function. grade III: palpable defect of muscle, severe pain and poor motor function
strain
630
# Reveresed
acute or chronic inflammation of a tendon.
tendonitis
631
# Reveresed
malalignment of femoral head with acetabulum. develops during last trimester in utero. asymmetrical hip abdution with tightness and apparent femoral shortening of involved side. testing includes ortolani test, barlow maneuver, and u/s. treatment initially attempts to reposition femoral head within the acetabulum thru constant use of a harness, brace, splint or traction. PT may be indicated after cast removal for stretching, strengthening, and caregiver education.
(start of peds) congenital hip dysplasia
632
# Reveresed
malformation that occurs in utero secondary to impaired developmental course. classified longitudinal or transverse. causative factor is an abnormality present at conception when a bone lacks potential to form. primary characteristic is a missing long bone suce as the radius. treatment may focus on symmetrical mvmts, strengthening, ROM, weight bearing and prosthetic training.
congenital limb deficiencies
633
# Reveresed
characterized by a unilateral contracture of the SCM muscle. causative factors include malposition in utero, breech position and birth trauma. usually dx'd within first three weeks of life. lateral flexion to same side as contracture, rotation toward opposite side. treatment conservative for the first year with emphasis on stretching, active ROM, position and caregiver education. possible surgery.
congenital torticollis
634
# Reveresed
degeneration of femoral head due to avascular necrosis. disease is self limiting and has 4 phases: condensation, fragmentation, re-ossification and remodeling. presents with pain, decreased ROM, antalgic gait, positive Trendelenburg sign. primary treatment focus is to relieve pain and maintain femoral head in proper psition.
legg-calve-perthes disease
635
# Reveresed
also known as traction apophysis that results from repetitive traction on the tibial tuberosity apophysis. caused by repeated tension to the patella tendon over the tibial tuberosity in young athletes which results in a small avulsion of the tuberosity and swelling. self limiting condition includes point tenderness over patella tendon at insertion on tibial tubercle, antalgic gait and pain with increasing activity. treatment is conservative with focus on education, icing, and eliminating placing strain on the patella tendon.
osgood-schlatter disease
636
# Reveresed
connective tissue disorder that affects formation of collagen during bone development. 4 classifications of osteogenesis imperfecta vary in levels of severity. caused by genetic inheritance with type I and IV considered autosomal dominant traits, and types II and III considered autosomal recessive traits. characteristics: brittle bones, weakness, impaired respiratory function. treatment begins at birth with education on proper handling and facilitation of movement.
osteogenesis imperfecta
637
# Reveresed
lateral curvature of spine that can be classified as infantile, juvenile, adolescent or adult. structural curve cannot be corrected with active or passive mvmt and there is rotation of vertebrae towards the convexity of the curve. results in a rib hump over thoracic region. primary causative factor for a non structural curve is a leg length discrepancy. treatment is based on type and severity, generally curves that are less than 25 degrees require monitoring, btwn 25 and 40 degrees are treated with orthotic management, and beyond 40 degrees require surgery.
scoliosis
638
# Reveresed
deformity of ankle/foot known as clubfoot.
talipes equinovarus
639
# Reveresed
most common chronic rheumatic disease in children and presents with inflammation of joints and connective tissues. systemic juvenile RA occurs in 10-20% of children with JRA and presents with acute onset and other symptoms. polyarticular JRA accounts for 30-40% of children with JRA and presents with high femal incidence, RF+ majority and arthritis in more than 5 joints. oligoarticular (pauciarticular) JRA accounts for 40-60% of children with JRA and affects less than 5 joints. treatment includes medication to relieve inflammation and pain and PT.
juvenile rhematoid arthritis
640
# Reveresed
semirigid or rigid insert worn inside a shoe that corrects foot alignment and improves function.
Foot orthotics
641
# Reveresed
primary purpose is to assist with dorsiflexion and prevent foot drop, can also influence knee control. commonly described for patients with peripheral neuropathy, nerve lesions or hemiplegia
AFO
642
# Reveresed
provide support and stability to knee and ankle. allow for a lock mechanism at the knee that provides stability. ankle is also held at proper alignment.
KAFO
643
# Reveresed
designed specifically for persons with paraplegia. allows a person to stand with a posterior lean of trunk.
craig-scott KAFO
644
# Reveresed
indicated for patients with hip, foot, knee, and ankle weakness. can control rotation at hip and abduction/adduction. heavy and restricts patients to a swing to or swing thru gait pattern.
HKAFO
645
# Reveresed
incorporates a cable system to assist with advancement of lower extremities during gait. when patient shifts weight onto a selected lower extremity, the cable system advances the opposite LE.
reciprocating gait orthosis (RGO)
646
# Reveresed
standing frame designed to allow a patient to sit when necessary. primarily used in peds.
parapodium
647
# Reveresed
constructed of fabric to provide abdominal compression and support.
corset
648
# Reveresed
invasive cervical thoracic orthosis that provides full restriction of all cervical motion. commonly used with cervical spinal cord injuries to prevent further damage or dislocation.
halo vest orthosis
649
# Reveresed
designed to promote realignment of spine due to scoliotic curvature.
milwaukee orthosis
650
# Reveresed
thoracolumbosacral orthosis that limits trunk flexion and extension through a 3 point control design.
taylor brace
651
# Reveresed
utilized to prevent all trunk motions and is commonly utilized as a means of post surgical stabilization.
thoracolumbosaral orthosis (TLSO)
652
# Reveresed
hypertension, aging, diabetes, infection, poor nutrition, cigarette smoking
factors that influence vascular disease
653
# Reveresed
vascular disease (atherosclerosis, arteriosclerosis), venous insufficiency, buerger's disease, diabetes. malignancy/tumor (osteosarcoma), congenital deformities, infection, and trauma
risk factors for amputation
654
# Reveresed
hemicorporectomy (surgical removal of pelvis and both LEs), hemipelvectomy (surgical removal of one half of the pelvis and LE), hip disarticulation (surgical removal of lower extremity from pelvis), transfemoral (surgical removal of LE above knee joint) knee disarticulation: thru knee joint, transtibial: below knee joint, syme's foot at ankle joint with removal of malleoli, chopart's: disarticulation at midtarsal joint, transmetatarsal: midsection of metatarsals
types of LE amputations
655
# Reveresed
length of residual limb with regard to leverage and energy expenditure, no ability to weight bear thru the end of the residual limb, susceptible to hip flexion contracture, adaptation required for balance, weight of prosthesis, and energy expenditure
prosthetic training for transfemoral amputation
656
# Reveresed
loss of ankle and foot functions, residual limb does not allow for weight bearing at its end, WB in prosthesis should be distributed over the total residual limb, patella tendon should be the area of primary weight bearing, adaptations required for balance, and susceptible to knee flexion contracture.
prosthetic training for transtibial amputation
657
# Reveresed
neuroma: bundle of nerve endings that group together an d produce pain due to scar tissue. phantom limb: refers to a painless sensation where patient feels that limb is still present. phantom pain: refers to patient's perception of some form of painful stimuli.
possible complications with amputations
658
# Reveresed
elastic wrap should not have wrinkles, diagonal and angular patterns should be used and should not be wrapped in circular patterns, provide pressure distally to enhance shaping, anchor wrap above knee for transtibial amputations, anchor wrap around pelvis for transfemoral amputations, promote full knee extension for transtibial amputations, promote full hip extension for transfemoral amputations. secure wrap with tape, do not use clips, use 3-4 inch wrap for transtibial and 6 inch wrap for transfemoral, rewrap frequently to maintain proper pressure.
wrapping guidelines for amputees
659
# Reveresed
socket, suspension, knee, shank, foot
components of a prosthesis
660
# Reveresed
causes: prosthesis too short, improperly shaped lateral wall, high medial wall, prosthesis aligned in abduction, poor balance, abduction contracture, improper training, short residual limb, weak hip abductors on prosthetic side, hypersensitive and painful residual limb
gait deviations of amputee: lateral bending
661
# Reveresed
causes: prosthesis may be too long, high medial wall, poorly shaped lateral wall, prosthesis position in abduction, inadequate suspension, abduction contracture, improper training, adductor roll, weak HF and adductors, pain over lateral residual limb
gait deviations of amputee: abducted gait
662
# Reveresed
causes: prosthesis may be too long, too much friction in knee, socket too small, excessive PF of prosthetic foot, abduction contracture, improper training, weak HF, inability to initiate prosthetic knee flexion
gait deviations of amputee: circumducted gait
663
# Reveresed
socket set forward in relation to foot, foot set in excessive DF, stiff heel, prosthesis too long, knee flexion contracture, hip flexion contracture, poor balance, decrease in quad strength
gait deviations of amputee: excessive knee flexion during stance
664
# Reveresed
causes: prosthesis may be too long, inadequate socket suspension, excessive alignment stability, foot in excess PF, residual limb discomfort, improper training, short residual limb
gait deviations of amputee: vaulting
665
# Reveresed
causes: excessive toe-out built in, loose fitting socket, inadequate suspension, rigid SACH heel cushion, poor muscle control, weak medial rotators, short residual limb
gait deviations of amputee: rotation of forefoot at heel strike
666
# Reveresed
causes: socket too big, poor suspension, knee instability, hip flexion contracture, weak hip extensors
gait deviations of amputee: forward trunk flexion
667
# Reveresed
causes: excessive rotation of the knee, tight socket fit, valgus in prosthetic knee, improper alignment of toe break, improper training, weak hip rotators, knee instability
gait deviations of amputee: medial or lateral whip
668
# Reveresed
...
Start of Neuro
669
# Reveresed
Brain & Spinal Cord
CNS
670
# Reveresed
cranial nerves and their ganglia, spinal nerves and their glania and plexuses, efferent and afferent somatic nerves outside the CNS, ANS (autonomic nervous system) including sympathetic (fight or flight) and parasympathetic (activated during time of rest)
PNS (Peripheral)
671
# Reveresed
Parts include brainstem, cerebellum, diencephalon, cerebral hemispheres, fissures, sulci, meninges, ventricular system and dural spaces
Brain (encephalon)
672
# Reveresed
midbrain, pons, medulla oblongata
brainstem
673
# Reveresed
hypothalamus, infundibulum, optic chiasm
diencephalon
674
# Reveresed
cortex, white matter, basal nuclei. 2 hemispheres: deep white matter, basal ganglia, and lateral ventricles
cerebral hemispheres
675
# Reveresed
interhemispheric fissure: separates the two cerebral hemispheres. Sylvian or lateral fissure: (anterior portion) separates the temporal from frontal lobes; (posterior portion): separates temporal from parietal lobes
fissures
676
# Reveresed
central sulcus: separates frontal and parietal lobes laterally. parietal-occipital sulcus: separates the parietal and occipital lobes medially. calcarine sulcus: separates the occipital lobe into superior and inferior halves
sulci
677
# Reveresed
term to describe the three layers of connective tissue covering brain and spinal cord
meninges
678
# Reveresed
outermost meninge, has 4 folds, lines periosteum of skull.
meninges: dura mater
679
# Reveresed
middle meninge, surrounds brain in a loose manner
meninges: arachnoid
680
# Reveresed
innermost meninge, covers contours of brain, forms choroid plexus in the ventricular system
meninges: pia mater
681
# Reveresed
designed to protect and nourish brain. comprised for 4 ventricles and multiple foramen that allow passages of CSF. CSF acts as a cushion around brain and spinal cord, and is produced by the choroid plexus of each ventricle.
ventricular system
682
# Reveresed
space occupied between the skull and outer dura mater
dural spaces: epidural space
683
# Reveresed
space occupied btwn the dura and arachnoid meninges
dural spaces: subdural space
684
# Reveresed
space occupied btwn the arachnoid and pia mater that contains CSF and the circulatory system for the cortex
dural spaces: subarachnoid space
685
# Reveresed
...
ascending and descending tracts
686
# Reveresed
pyramidal motor tract responsible for ipsilateral voluntary mvmt
corticospinal tract (anterior)
687
# Reveresed
pyramidal motor tract responsible or contralateral voluntary fine mvmt
corticospinal tract (lateral)
688
# Reveresed
sensory tract for trunk and LE proprioception, 2 pt discrimination, vibration and graphesthesia
fasciculus gracilis
689
# Reveresed
sensory tract for trunk, neck and UE proprioception, vibration, 2 pt discrimination, graphesthesia
fasciculus cuneatus
690
# Reveresed
extrapyramidal motor tract for motor input of gross postural tone
rubrospinal tract
691
# Reveresed
sensory tract for ipsilateral and contralateral subconscious proprioception
spinocerebellar tract (dorsal)
692
# Reveresed
sensory tract for ipsilateral subconscious proprioception
spinocerebellar tract (ventral)
693
# Reveresed
sensory tract for pain, light touch, and temperature
spinothalamic tract (lateral)
694
# Reveresed
extrapyramidal motor tract for contralateral posture muscle tone associated with auditory/visual stimuli
tectospinal tract
695
# Reveresed
extrapyramidal motor tract for ipsilateral gross postural adjustments subsequent to head movements
vestibulospinal tract
696
# Reveresed
...
Nerve Root Dermatomes
697
# Reveresed
vertex of skull.
C1
698
# Reveresed
temple, forehead, occiput. myotome: longus colli, SCM, rectus capitis
C2
699
# Reveresed
entire neck, posterior cheek, temporal area, prolongation forward under mandible. myotome: trap, splenius capitis
C3
700
# Reveresed
shoulder area, clavicular and upper scap area. myotome: trap, levator scapulae
C4
701
# Reveresed
deltoid area, anterior aspect of entire arm to base of thumb. myotome: supraspinatus, deltoid, biceps
C5
702
# Reveresed
anterior arm, radial side of hand to thumb and index finger. myotome: biceps, supinator, wrist extensors.
C6
703
# Reveresed
lateral arm and forearm to index, long and ring fingers. myotome: triceps, wrist flexors
C7
704
# Reveresed
medial arm and forearm to long, ring and little fingers. myotome: ulnar deviators, thumb extensors, thumb adductors
C8
705
# Reveresed
medial side of forearm to base of little finger.
T1
706
# Reveresed
medial side of upper arm to medial elbow, pectoral and midscapular areas
T2
707
# Reveresed
upper thorax
T3-T6
708
# Reveresed
cotal margin
T5-T7
709
# Reveresed
abs and lumbar region
T8-T12
710
# Reveresed
back, over trochanter and groin
L1
711
# Reveresed
back, front of thigh to knee. myotome: psoas, hip adductors
L2
712
# Reveresed
back, upper buttock, anterior thigh and knee, medial lower leg. myotome: psoas ,quads, thigh atrophy
L3
713
# Reveresed
medial buttock, lateral thigh, medial leg, dorsum of foot, big toe. myotome: tib anterior, extensor hallicus
L4
714
# Reveresed
buttock, posterior and lateral thigh, lateral aspect of leg, dorsum of foot, medial half of sole, first second and third toes. myotome: extensor hallucis, peroneals, gluteus medius, dorsiflexors, hamstring and calf atrophy
L5
715
# Reveresed
buttock, thigh and posterior leg. myotome: calf and hamstring, wasting of gluteals, peorneals, PFs
S1
716
# Reveresed
same as S1. mytome: same as S1 except peroneals
S2
717
# Reveresed
groin and medial thigh to knee.
S3
718
# Reveresed
perineum, genitals, lower sacrum. myotome: bladder, rectum
S4
719
# Reveresed
semitendinosous, soleus, popliteus, semimembranosous, plantaris, tib posterior, gastroc, biceps femoris, flexor hallucis lonus, flexor digitorum longus.
LE: Sciatic nerve innervates:
720
# Reveresed
psoas minor, psoas major
LE: lumbar plexus innervates:
721
# Reveresed
piriformis, superior gemelli, obturator internus, inferior gemelli, quadratus femoris
LE: sacral plexus innervates:
722
# Reveresed
gluteus maximus
LE: inferior gluteal nerve innervates:
723
# Reveresed
extensor digitorum longus and tib anterior
LE: deep peroneal nerve innervates:
724
# Reveresed
gluteus medius, gluteus minimus, tensor fasciae latae
LE: superior gluteal nerve innervates:
725
# Reveresed
peroneals (longus and brevis)
LE: superficial peroneal nerve innervates:
726
# Reveresed
iliacus, vastus lateralis, intermedius and medialis; recturs femoris, sartorious, pectineus
LE: femoral nerve innervates:
727
# Reveresed
abductor hallucis, lumbricale I, flexor digitorum brevis, flexor hallucis longis
LE: medial plantar nerve innervates:
728
# Reveresed
adductor longus, gracilis, adductor brevis, obturator externus, and adductor magnus
LE: obturator nerve innervates:
729
# Reveresed
abductor digiti minimi, dorsal interossei, quadratus plantae, adductor hallucis, lumbricale II, III, IV, plantar interossei, flexor digiti minimi brevis
LE: lateral plantar nerve innervates:
730
# Reveresed
rhomboids, levator scapulae
UE: dorsal scapular nerve innervates:
731
# Reveresed
serratus anterior
UE: long thoracic nerve innervates:
732
# Reveresed
subclavius
UE: nerve to subclavius innervates
733
# Reveresed
infraspinatus, supraspinatus
UE: suprascapular nerve innervates
734
# Reveresed
pect major, pect minor
UE: lateral pectoral nerve innervates
735
# Reveresed
coracobrachialis, biceps brachii, brachialis
UE: musculocutaneous nerve innervates
736
# Reveresed
flexor muscles in forearm, 5 muscles in hand
UE: lateral root of the median nerve innervates
737
# Reveresed
pect major and minor
UE: medial pectoral nerve innervates:
738
# Reveresed
1 1/2 muscles of forearm and most small muscles of hand
UE: ulnar nerve innervates
739
# Reveresed
flexor muscles in forearm, 5 muscles of hand
UE: medial root of the median nerve innervates
740
# Reveresed
subscapularis
UE: upper subscapular nerve innervates
741
# Reveresed
latissimus dorsi
UE: thoracodorsal nerve innervates
742
# Reveresed
subscapularis, teres major
UE: lower subscapular nerve innervates
743
# Reveresed
deltoid, teres minor
UE: axillary nerve innervates
744
# Reveresed
brachioradialis, extensor muscles of forearm
UE: radial nerve innervates
745
# Reveresed
SENSORY
AFFERENT NERVES
746
# Reveresed
MOTOR
EFFERENT NERVES
747
# Reveresed
olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal
Cranial Nerves
748
# Reveresed
smell
olfactory
749
# Reveresed
sight
optic
750
# Reveresed
voluntary movement of eye
oculomotor
751
# Reveresed
voluntary motor movement of eye
trochlear
752
# Reveresed
touch, pain: skin of face, chewing
trigeminal
753
# Reveresed
voluntary motor: muscle of eyeball, lateral
abducens
754
# Reveresed
taste: anterior tongue, voluntary motor: facial muscles. autonomic: lacrimal, submandibular, sublingual glands
facial
755
# Reveresed
hearing/balance: ear
vestibulocochlear (acoustic nerve)
756
# Reveresed
touch, pain: posterior tongue, taste: tongue. swallowing
glossopharyngeal
757
# Reveresed
touch, pain: pharynx, larynx, bronchi. taste: tongue, epiglottis.
vagus
758
# Reveresed
voluntary motor: SCM and trapezius muscle
accessory
759
# Reveresed
voluntary motor: muscles of tongue
hypoglossal
760
# Reveresed
light touch, deep pain, superficial pain, vibration, proprioception, kinesthesia, temperature, stereognosis, graphesthesia, 2 point discrimination
types of sensory testing
761
# Reveresed
light pressure with cotton ball
light touch
762
# Reveresed
squeeze forearm or calf muscle
deep pain
763
# Reveresed
pen cap, paper clip end, pin
superficial pain
764
# Reveresed
tuning fork
vibration
765
# Reveresed
identify a static position of an extremity/part
proprioception
766
# Reveresed
identify direction and extent of mvmt of a joint or body part
kinesthesia
767
# Reveresed
hot and cold test tubes
temperature
768
# Reveresed
identify an object without sight
stereognosis
769
# Reveresed
draw a number or letter on skin with finger, identify without sight
graphesthesia
770
# Reveresed
2 point caliper on skin, identify one or two points without sight
2 pt discrimination
771
# Reveresed
reflex is a motor response to a sensory stimulation that is used in an assessment to observe the integrity of the nervous system. DTRs elicit a muscle contraction when the muscle's tendon is stimulated.
DTR: deep tendon reflexes
772
# Reveresed
0=no response. 1+=diminished/depressed response. 2+=active normal response. 3+=brisk/exaggerated response. 4+=very brisk/hyperactive, abnormal response.
DTR grades
773
# Reveresed
biceps tendon: flexion/contraction of biceps. brachioradialis tendon: elbow flexion and/or forearm pronation. triceps tendon: elbow extension or contraction of triceps muscle. patellar tendon: knee extension. tibialis posterior tendon: PF/inversion of foot. achilles tendon: PF of foot.
DTR normal responses:
774
# Reveresed
nervous system outside of brain and spinal cord. consists of motor, sensory, and autonomic neurons. neurons are located in cranial, spinal, and peripheral nerves. PNS consists of 12 pairs of cranial nerves, 31 prs of spinal nerves, and associated ganglia and sensory receptors. most peripheral nerves contain motor (efferent) and sensory (afferent) components.
PNS: peripheral nervous system
775
# Reveresed
large, myelinated, high conduction rate. contained in alpha and gamma motor systems. sensory components in muscle spindles, golgi tendon organs, bare nerve endings, mechanoreceptors
A fibers
776
# Reveresed
medium, myelinated, reasonably fast conduction rate. pre ganglionic fibers of ANS.
B fibers
777
# Reveresed
small nerve fibers, poorly myelinated or unmyelinated. slow conduction rate. post ganglionic fibers of sympathetic system. exteroceptors for pain, temp, and touch.
C fibers
778
# Reveresed
mechanical (compression), crush and percussion (fracture, compartment syndrome), laceration, penetrating trauma (stab wound), stretch (traction injury), high velocity trauma (MVA), and cold (frostbite).
types of nerve injury
779
# Reveresed
mildest form of injury. conduction block usually due to myelin dysfunction. axonal continuity conserved. nerve conduction is preserved proximal and distal to lesion. nerve fibers are not damaged. recovery will occur within 4/6 weeks.
neurapraxia
780
# Reveresed
a more severe grade of injury to a peripheral nerve. is reversible injury to damaged fibers. damage occurs to the axons with preservation to endoneurium. nerve can regenerate distal to the site of lesion by one millimeter per day.
axonotmesis
781
# Reveresed
most severe grade of injury to a peripheral nerve. all components are damaged and irreversible. all motor and sensory loss is permanently impaired.
neurotmesis
782
# Reveresed
characterized by a lesion found in descending motor tracts within the cerebral motor cortex, internal capsule, brainstem or spinal cord. symptoms include weakness of involved muscles, hypertonicity, hyperreflexia, mild disuse atrophy, and abnormal reflexes. damaged tracts are in lateral white column of spinal cord.
upper motor neuron disease
783
# Reveresed
characterized by a lesion that affects nerves or their axons at or below level of brainstem, usually within the "final common pathway." ventral gray column of spinal cord may also be affected. symptoms include flaccidity or weakness of muscles, decreased tone, fasciculations, muscle atrophy, and decreased or absent reflexes.
lower motor neuron disease
784
# Reveresed
CP, hydrocephalus, CVA, birth injuries, MS, brain tumors.
upper motor neuron lesions
785
# Reveresed
poliomyelitis, tumors involving spinal cord, trauma, infection, muscular dystrophy.
lower motor neuron lesions
786
# Reveresed
PCA: posterior cerebral artery, MCA: middle cerebral artery, and vertebrobasilar artery.
blood supply to brain
787
# Reveresed
portion of midbrain, subthalamic nucleus, basal nucleus, thalamus, inferior temporal lobe, occipital and occipitoparietal cortices
PCA
788
# Reveresed
most of outer cerebrum, basal ganglia, posterior and anterior internal capsule, putamen, pallidum, lentiform nucleus
MCA
789
# Reveresed
medulla, cerebellum, pons, middle occipital cortex
vertebrobasila artery
790
# Reveresed
...
CEREBRAL HEMISPHERE FUNCTION
791
# Reveresed
responsible for: voluntary motor function, advanced motor planning, initiation of action, cranial nerves 3, 4, 6, 9, 10, 12; emotion interpretation, personality, judgment, planning, motivation, bladder & bowel inhibition, broca's motor speech center, appreciation of intonation, understanding gestures.
frontal lobe
792
# Reveresed
contralateral weakness, contralateral head and eye paralysis, personality changes, antisocial behavior, ataxia, primitive reflexes, broca's aphasia, delayed or poor initiation
frontal lob impairments
793
# Reveresed
responsible for: processing perceptual and sensory info, body schema, contralateral pain, posture, touch, proprioception (to arm, trunk and leg), perform calculations, spatial awareness, sensory: speech comprehension, visual tract, taste perception
parietal lobe
794
# Reveresed
agraphia, finger agnosia, constructional apraxia, dressing apraxia, anosognosia, wernicke's aphasia (receptive), homonymous visual deficits, impaired language comprehension, impairment in taste
parietal lobe impairments
795
# Reveresed
responsible for: auditory and limbic processing, appreciation of language, music and sound, memory, learning, affective mood centers (primitive behaviors), short term memory
temporal lobe
796
# Reveresed
auditory and hearing, impaired appreciation of music, memory deficits, learning deficits, wernicke's aphasia, antisocial behaviors
temporal lobe impairments
797
# Reveresed
responsible for: primary processing area of visual info, visual tract, perception of vision
occipital lobe
798
# Reveresed
homonymous hemianopsia (only seeing half of one visual field), impaired extraocular muscle movement
occipital lobe impairments
799
# Reveresed
responsible for: coordination of motor skills, postural tone, sensory/motor input for trunk and extremities, coordination of gait
cerebellum
800
# Reveresed
ataxia, discoordination of trunk and extremities, intention tremor, balance deficits, ipsilateral facial sensory loss, dysdiadochokinesia (inability to perform rapidly alternating movements)
cerebellum impairments
801
# Reveresed
left: language, sequence and perform movements, understanding language, produce written and spoken language, analytical, controlled. right: nonverbal processing, processing information in a holistic manner, artistic abilities, general concept comprehension, hand-eye coordination, spatial relationships
hemisphere specialization/dominance
802
# Reveresed
state of physical equilibrium needing input from these three systems: somatosensory, visual and vestibular.
balance
803
# Reveresed
receptors located in joints, muscles, ligaments, and skin to provide proprioceptive info regarding length, tension, pressure, pain, joint position.
somatosensory input
804
# Reveresed
visual receptors allow for perceptual acuity regarding verticality, motion of objects and self, environmental orientation, postural sway, and movements of the head/neck. children rely heavily on this system for maintenance of balance.
visual input
805
# Reveresed
provides CNS with feedback regarding position and movement of the head with relation to gravity.
vestibular input
806
# Reveresed
allows for head/eye movement coordination. reflex supports gaze stabilization where eyes can move while head is fixed; visual tracking can also occur when both eyes and head are moving.
Balance Reflexes: Vestibuloocular reflex (VOR):
807
# Reveresed
attempts to stabilize body and control movement. reflex assists with stability while head is moving as well as coordination of trunk during upright postures.
Balance Reflexes: Vestibulospinal reflex (VSR):
808
# Reveresed
automatic motor responses that are used to maintain center of gravity over base of support.
automatic postural strategies
809
# Reveresed
first strategy to be elicited by a small range and slow velocity perturbation when feet are on the ground. muscles contract in a distal to proximal fashion to control postural sway from ankle joint
ankle strategy
810
# Reveresed
elicited by a greater force, challenge or perturbation thru pelvis and hips. hips will move in opposite direction from head in order to maintain balance. muscles contract in a proximal to distal fashion in order to counteract the loss of balance
hip strategy
811
# Reveresed
used to lower the center of gravity during standing or ambulation in order to better control the COG. examples: knee flexion, crouching or squatting. often used when both mobility and stability are required during a task such as surfing.
suspensory strategy
812
# Reveresed
elicited thru unexpected challenges or perturbations during static standing or when the perturbation produces such a movement that the COG is beyond the BOS. LEs step and/or UE reach to regain a new BOS
stepping strategy
813
# Reveresed
unbalance due to ear disease
vertigo
814
# Reveresed
abnormal eye mvmt that entails nonvolitional, rhythmic oscillation of eyes. spontaneous, peripheral, and central
nystagmus
815
# Reveresed
intervention that can be successful for pts with vestibular or balance disorders. utilizes compensation, adaptation, and plasticity to increase brain's sensitivity, restore symmetry
vestibular rehabilitation
816
# Reveresed
improve balance and stability, increase strength and ROM, decrease falls, minimize dizziness
goals for vestibular rehab:
817
# Reveresed
romberg, one legged stance test, tinetti, berg balance, get up and go test, timed get up and go test
balance tests (types)
818
# Reveresed
antihistamine treats vertigo, anticholinergic agents decrease conduction in vestibular-cerebellar pathways. benzodiazepine (valium) treats vertigo and emesis. phenothiazine (phenergan) treats emesis. monoaminergic (ephedrine) treats vertigo
pharmacological intervention for managing vestibular disorders
819
# Reveresed
...
COMMUNICATION DISORDERS
820
# Reveresed
acquired neuro impairment of processing for receptive and/or expressive language. result of brain injury, head trauma, CVA, tumor or infection.
aphasia
821
# Reveresed
lesion often in temporoparietal lobe of dominant hemisphere. word output is functional. empty speech or jargon. speech lacks any substance. uses of paraphasias (substitution of incorrect words)
fluent aphasia
822
# Reveresed
lesion found at posterior region of superior temporal gyrus. major fluent aphasia. also known as "receptive" aphasia. comprehension is impaired, but good articulation
wernicke's aphasia
823
# Reveresed
major non-fluent aphasia. also known as "expressive" aphasia. most common form. lesions in frontal lobe.
broca's aphasia
824
# Reveresed
poor word output, increased effort for producing speech. poor articulation.
non-fluent aphasia
825
# Reveresed
major non-fluent aphasia. lesion of frontal, temporal, and parietal lobes. comprehension (reading and auditory) is severely impaired.
global aphasia
826
# Reveresed
motor disorder of speech that is caused by an upper motor neuron lesion that affects muscles that are used to articulate words and sounds. speech is often slurred.
dysarthria
827
# Reveresed
cerebrovascular accident
CVA
828
# Reveresed
cva that presents with total neuro deficits at onset.
completed stroke
829
# Reveresed
cva usually caused by a thrombus that gradually progresses. deficits are not seen for one to two days after onset.
stroke in evolution
830
# Reveresed
when there is a loss of perfusion to a portion of the brain within just seconds, there is a central area of irreversible infarction surrounded by an area of potential ischemia.
ischemic stroke
831
# Reveresed
associated with cardiovascular disease, an embolus may be a solid, liquid or gas, and con originate in any part of the body. travels thru bloodstream to the cerebral arteries causing occlusion of a blood vessel and a resultant infarct. middle cerebral artery is most commonly affected by an embolus from internal carotid arteries. often presents with a headache.
embolus (20% of ischemic CVAs)
832
# Reveresed
artherosclerotic plaque develops in an artery and eventually occludes the artery or a branching artery causing an infarct. usually occurs during sleep or upon awakening, after a MI or post surgical procedure
thrombus
833
# Reveresed
abnormal bleeding in brain due to rupture in blood supply. due to disruption of oxygen to an area of brain and compression from accumulation of blood. hypertension is usually a precipitating factor causing rupture of an aneurysm or arteriovenous malformation. 50% of deaths from hemorrhagic stroke occur within first 48 hours.
hemorrhage (10-15% of CVAs)
834
# Reveresed
transient ischemic attack
TIA
835
# Reveresed
usually linked to an atherosclerotic thrombosis. temporary interruption of blood supply to an area. effects may be similar to a CVA, by symptoms resolve quickly. often occurs in the carotid and vertebrobasilar arteries, and may indicate future CVA.
TIA
836
# Reveresed
hypertension, heart disease, DM, smoking, TIAs, obesity, high cholesterol, behaviors related to hypertension, physical inactivity, increased alcohol consumption
CVA risk factors
837
# Reveresed
impairments include LE involvement, loss of bowel/bladder control, loss of behavioral inhibition, mental changes, may see neglect, may see aphasia, apraxia and agraphia, perseveration
If CVA is in anterior cerebral artery:
838
# Reveresed
impairments include loss of consciousness, hemi or tetraplegia, comatose or vegetative state, inability to speak, locked in syndrome, vertigo, nystagmus, dysphagia, dysarthria, syncope, ataxia
If CVA is in vertebral-basilar artery
839
# Reveresed
impairments include pain and temp sensory loss, contralateral hemiplegia, ataxia, athetosis or coreiform mvmt, quality of mvmt is impaired, thalamic pain syndrome, anomia, prosopagnosia with occipital infarct, hemiballismus, visual agnosia, homonymous hemianopsia, mild hemiparesis, memory impairment, dyschromatopsia, palinopsia, micropsia, macropsia, alexia, dyslexia, achromatopsia
if CVA is in posterior cerebral artery
840
# Reveresed
impairments include wernicke's aphasia, homonymous hemianopsia, apraxia, flat affect in rt hemisphere, impaired body schema
if CVA is in middle cerebral artery (most common area)
841
# Reveresed
weakness, paralysis of LEFT side, decreased attention span, left hemianopsia, decreased awareness and judgment, memory deficits, left inattention, decreased abstract reasoning, emotional lability, impulsive behaviors, decreased spatial orientation
characteristics of a CVA in RIGHT hemisphere
842
# Reveresed
weakness, paralysis of RIGHT side, increased frustration, decreased processing, possible aphasia, dysphagia, motor apraxia, decreased discrimination btwn left and right, right hemianopsia
characteristics of a CVA in LEFT hemisphere
843
# Reveresed
unstable vital signs, decreased consciousness, ability to swallow, weakness and paralysis on both sides
characteristics of a brainstem CVA
844
# Reveresed
decreased balance, ataxia, decreased coordination, nausea, decreased ability for postural adjustment, nystagmus
characteristics of a cerebellum CVA
845
# Reveresed
result when higher centers of the brain lose control and the uncontrolled or partially controlled stereotyped patterns of the middle and lower centers emerge.
synergy patterns
846
# Reveresed
seen when patient attempts to lift up their arm or reach for an object. characterized by great toe extension and flexion of the remaining toes secondary to spasticity.
flexor synergy pattern
847
# Reveresed
neuromuscular developmental treatment: concept recognizes that interference of normal function of the brain caused by CNS dysfunction leads to a slowing down or cessation of motor development and the inhibition of righting reactions, equilibrium reactions, and automatic movements. patient should learn to control mvmt thru activities that promote normal mvmt patterns that integrate function.
NDT
848
# Reveresed
technique utilized to elicit voluntary muscular contraction.
NDT: facilitation
849
# Reveresed
technique utilized to decrease excessive tone or movement.
NDT: inhibition
850
# Reveresed
specific handling of designated areas of the body (shoulder, pelvis, hand, foot) will influence and facilitate posture, alignment and control.
NDT: key points of control
851
# Reveresed
act of moving an extremity into a position that the patient must hold against gravity.
NDT: placing
852
# Reveresed
designated static positions that Bobath found to inhibit abnormal tonal influences and reflexes.
NDT: reflex inhibiting posture
853
# Reveresed
stage 1: no volitional mvmt initiated. stage 2: beginning of spasticity. stage 3: voluntary synergies. spasticity increases. stage 4: spasticity begins to DEcrease. stage 5: decrease in spasticity. stage 6: jt mvmts are performed with coordination. stage 7: normal motor function is restored
Brunnstrom's 7 stages of recovery
854
# Reveresed
involuntary and automatic mvmt of a body part as a result of an intentional active or resistive mvmt in another body part.
associated reaction
855
# Reveresed
flexion pattern of the involved UE facilitates flexion of the involved LE
homolateral synkinesis
856
# Reveresed
group of muscles that produce a predictable pattern of mvmt in flexion or extension patterns
limb synergies
857
# Reveresed
involved LE will abduct/adduct with applied resistance to the uninvolved LE in the same direction
raimiste's phenomenon
858
# Reveresed
raising the involved UE above 100 degrees with elbow extension with produce extension and abduction of the fingers
souque's phenomenon
859
# Reveresed
proprioceptive neuromuscular facilitation
PNF
860
# Reveresed
approach is based on the premise that stronger parts of the body are utilized to stimulate and strengthen the weaker parts. development will follow normal sequence thru a component of motor learning. PNF places great emphasis on manual contacts and correct handling. movement patterns follow diagonals or spirals that each possess a flexion, extension, and rotary component and are directed toward or away from midline.
PNF
861
# Reveresed
combination of bilateral UE asymmetrical extensor patterns performed as a closed chain activity
chopping (PNF):
862
# Reveresed
progression of motor skill acquisition. stages of motor control include mobility, stability, controlled mobility, and skill.
developmental sequence (PNF):
863
# Reveresed
hip, knee, and ankle move into flexion or extension simultaneously
mass mvmt patterns (PNF):
864
# Reveresed
muscle activation of an involved extremity due to intense action of an uninvolved muscle or group of muscles
overflow (PNF):
865
# Reveresed
mobility, stability, controlled mobility, skill
levels of motor control
866
# Reveresed
isotonic concentric contraction performed against resistance followed by alternating concentric and eccentric contractions with resistance. (controlled mobility, skill)
agonist reversals
867
# Reveresed
isometric contractions performed alternating from muscles on one side of joint to the other side w/o rest (stability)
alternating isometrics
868
# Reveresed
technique used to increase ROM. as extremity reaches point of limitation the pt performs a maximal contraction of the antagonistic muscle group. therapist resists mvmt for 8-10 secs with relaxation following. technique is repeated until no further gains in ROM are noted during session (mobility)
contract-relax
869
# Reveresed
isometric contraction used to increase ROM. contraction is facilitated for all muscle groups at the limiting point in the ROM. relaxation occurs and extremity moves thru the newly acquired range to the next point of limitation until no further increases in ROM occur. used for patients that present with pain usually. (mobility)
hold-relax
870
# Reveresed
technique to improve initiation of mvmt to muscle groups tested at 1/5 or less. (mobility)
hold-relax active
871
# Reveresed
proprioceptive component used to increase ROM around a joint. manual traction is provided slowly and usually in combo with mobilization techniques. (mobility)
joint distraction
872
# Reveresed
used to improve coordination of all components of a task. performed distal to proximal sequence. (skill)
normal timing
873
# Reveresed
used to initiate mvmt and sustain a contraction through the ROM. therapist provides a quick stretch followed by isometric or isotonic contractions (mobility)
repeated contractions
874
# Reveresed
used to emphasize coordination of proximal components during gait. resistance is applied to an area such as the pelvis, hips, or extremity during the gait cycle in order to enhance coordination, strength or endurance (skill)
resisted progression
875
# Reveresed
used to assist initiating movement when hypertonia exists. mvmt progresses from passive to active assist, to slightly resistive. (mobility)
rhythmic initiation
876
# Reveresed
passive technique used to decrease hypertonia by slowing rotating an extremity around the axis. relaxation of extremity will increase ROM. (mobility)
rhythmic rotation
877
# Reveresed
used to increase ROM and coordinate isometric contractions. requires isometric contractions of all muscles around a joint against progressive resistance. pt should relax and move into newly acquired range and repeat. (mobility, stability)
rhythmic stabilization
878
# Reveresed
technique of slow and resisted concentric contractions of agonists and antagonists around a joint w/o rest btwn reversals. used to improve control of movement and posture. (stability, controlled mobility, skill)
slow reversal
879
# Reveresed
using slow reversal with the addition of an isometric contraction that is performed at the end of each mvmt in order to gain stability. (stability, controlled mobility, skill)
slow reversal hold
880
# Reveresed
ability to utilize alternate motor and sensory strategies due to an impairment that limits the normal completion of a task.
compensation
881
# Reveresed
ability to perform a mvmt as a result of internal processes that interact with the environment and produce a consistent strategy to generate the correct mvmt
motor learning
882
# Reveresed
ability to modify or change at the synapse level either temporarily or permanently in order to perform a particular function
plasticity
883
# Reveresed
ability of the motor and sensory systems to stabilize position and control mvmt.
postural control
884
# Reveresed
ability to utilize previous strategies to return to the same level of functioning
recovery
885
# Reveresed
plan used to produce a specific result or outcome that will influence the structure or system
strategy
886
# Reveresed
to motor control: utilizes a systems theory of motor control that views the entire body as a mechanical system with many interacting subsystems that all work cooperatively in managing internal and environmental influences. (compensation, motor learning, plasticity, postural control, recovery and strategy are all keys to this approach)
task oriented approach
887
# Reveresed
says that all motor output was the result of both past and present sensory input. treatment is based on sensorimotor learning. takes into account the autonomic nervous system and emotional factors as well as motor ability. goal is to obtain homeostasis in motor output and to activate muscles and perform a task independently of a stimulus. examples: icing and brushing in order to elicit desired reflex motor responses.
Rood theory
888
# Reveresed
approximation, joint compression, icing, light touch, quick stretch, resistance, tapping, traction
sensory stimulation techniques (facilitation)
888
# Reveresed
approximation, joint compression, icing, light touch, quick stretch, resistance, tapping, traction
sensory stimulation techniques (facilitation)
889
# Reveresed
deep pressure, prolonged stretch, warmth, prolonged cold, carotid reflex
sensory stimulation techniques (inhibition)
890
# Reveresed
include thrombolytic agents, antiplatelet agents, cholesterol-lowering agents, antiarrhythmic agents, neuroprotective agents, antihypertensive agents
pharmacological interventions for CVA management
890
# Reveresed
include thrombolytic agents, antiplatelet agents, cholesterol-lowering agents, antiarrhythmic agents, neuroprotective agents, antihypertensive agents
pharmacological interventions for CVA management
891
# Reveresed
produces anticoagulation effects, destroys thrombus or emboli
thrombolytic agents (heparin, activase, coumadin
891
# Reveresed
produces anticoagulation effects, destroys thrombus or emboli
thrombolytic agents (heparin, activase, coumadin
892
# Reveresed
reduces atherosclerotic events and decrease the risk for CVA
antiplatelet agents (aspirin, plavix, ascriptin)
892
# Reveresed
reduces atherosclerotic events and decrease the risk for CVA
antiplatelet agents (aspirin, plavix, ascriptin)
893
# Reveresed
decreases the triglycerides and low-density lipoproteins in the bloodstream
cholesterol-lowering agents (lipitor, zocor, pravachol)
894
# Reveresed
administered only within the acute stage of CVA (within 3 hrs)
neuroprotective agents (N-methyl-D-aspartate: NMDA)
894
# Reveresed
administered only within the acute stage of CVA (within 3 hrs)
neuroprotective agents (N-methyl-D-aspartate: NMDA)
895
# Reveresed
sodium channel blockers: norpace, Xylocaine. beta-blockers: tenormin, lopressor, inderal. Refractory period alterations: cordarone, corvert. Calcium channel blockers: norvasc, cardizem, verapamil.
antiarrhythmic agents: prevention of arrhythmias, ischemia and hypertension
896
# Reveresed
diuretics: lasix, bumex, thiazide. beta-blockers: sectral, inderal, lopressor. calcium channel blockers: cardizem, calan. alpha-blockers: cardura, minipress
antihypertensive agents: assists to lower blood pressure; decreases tension within circulation system
896
# Reveresed
diuretics: lasix, bumex, thiazide. beta-blockers: sectral, inderal, lopressor. calcium channel blockers: cardizem, calan. alpha-blockers: cardura, minipress
antihypertensive agents: assists to lower blood pressure; decreases tension within circulation system
897
# Reveresed
inability to interpret information
agnosia
897
# Reveresed
inability to interpret information
agnosia
898
# Reveresed
inability to recognize symbols, letters or numbers traced on the skin
agraphesthesia
898
# Reveresed
inability to recognize symbols, letters or numbers traced on the skin
agraphesthesia
899
# Reveresed
inability to write due to a lesion within the brain
agraphia
899
# Reveresed
inability to write due to a lesion within the brain
agraphia
900
# Reveresed
inability to initiate mvmt; commonly seen with parkinson's
akinesia
900
# Reveresed
inability to initiate mvmt; commonly seen with parkinson's
akinesia
901
# Reveresed
inability to communicate or comprehend due to damage to specific areas of brain
aphasia
901
# Reveresed
inability to communicate or comprehend due to damage to specific areas of brain
aphasia
902
# Reveresed
inability to perform purposeful learned mvmts, although there is no sensory or motor impairment
apraxia
902
# Reveresed
inability to perform purposeful learned mvmts, although there is no sensory or motor impairment
apraxia
903
# Reveresed
inability to recognize objects by sense of touch
astereognosis
904
# Reveresed
inability to perform coordinated movements
ataxia
905
# Reveresed
condition that presents with involuntary mvmts combined with instability of posture. peripheral mvmts occur without central stability
athetosis
905
# Reveresed
condition that presents with involuntary mvmts combined with instability of posture. peripheral mvmts occur without central stability
athetosis
906
# Reveresed
mvmt that is very slow
bradykinesia
906
# Reveresed
mvmt that is very slow
bradykinesia
907
# Reveresed
mvmts that are sudden, random and involuntary
chorea
907
# Reveresed
mvmts that are sudden, random and involuntary
chorea
908
# Reveresed
characteristic of an upper motor neuron lesion; involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex
clonus
908
# Reveresed
characteristic of an upper motor neuron lesion; involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex
clonus
909
# Reveresed
inability to reproduce geometric figures
constructional apraxia
909
# Reveresed
inability to reproduce geometric figures
constructional apraxia
910
# Reveresed
characteristic of a corticospinal lesion at level of brainstem that results in extension of trunk and all extremities
decerebrate rigidity
910
# Reveresed
characteristic of a corticospinal lesion at level of brainstem that results in extension of trunk and all extremities
decerebrate rigidity
911
# Reveresed
characteristic of a corticoapinal lesion at level of diencephalon where the trunk and LEs are positioned in extension, and the UEs are positioned in flexion
decorticate rigidity
911
# Reveresed
characteristic of a corticoapinal lesion at level of diencephalon where the trunk and LEs are positioned in extension, and the UEs are positioned in flexion
decorticate rigidity
912
# Reveresed
double vision
diplopia
912
# Reveresed
double vision
diplopia
913
# Reveresed
slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech.
dysarthria
913
# Reveresed
slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech.
dysarthria
914
# Reveresed
inability to perform rapidly alternating mvmts
dysdiadochokinesia
914
# Reveresed
inability to perform rapidly alternating mvmts
dysdiadochokinesia
915
# Reveresed
inability to control the range of a mvmt and the force of muscular activity
dsymetria
915
# Reveresed
inability to control the range of a mvmt and the force of muscular activity
dsymetria
916
# Reveresed
inability to properly swallow
dysphagia
916
# Reveresed
inability to properly swallow
dysphagia
917
# Reveresed
closely related to athetosis; however there is larger axial muscle involvement rather than appendicular muscles
dystonia
917
# Reveresed
closely related to athetosis; however there is larger axial muscle involvement rather than appendicular muscles
dystonia
918
# Reveresed
characteristic of a right hemisphere infarct where there is an inability to control emotions and outbursts of laughing or crying that are inconsistent with the situation
emotional lability
918
# Reveresed
characteristic of a right hemisphere infarct where there is an inability to control emotions and outbursts of laughing or crying that are inconsistent with the situation
emotional lability
919
# Reveresed
involuntary and violent mvmt of a large body part
hemiballism
919
# Reveresed
involuntary and violent mvmt of a large body part
hemiballism
920
# Reveresed
condition of weakness on one side of body
hemiparesis
920
# Reveresed
condition of weakness on one side of body
hemiparesis
921
# Reveresed
condition of paralysis on one side of the body
hemiplegia
921
# Reveresed
condition of paralysis on one side of the body
hemiplegia
922
# Reveresed
loss of right or left half of vision in both eyes
homonymous hemianopsia
923
# Reveresed
inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for mvmt is impaired
ideational apraxia
923
# Reveresed
inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for mvmt is impaired
ideational apraxia
924
# Reveresed
condition where a person plans a mvmt or task, but cannot volitionally perform it. automatic mvmt may occur, but a person cannot impose additional mvmt on command.
ideomotor apraxia
925
# Reveresed
ability to perceive the direction and extent of mvmt of a joint or body part
kinesthesia
925
# Reveresed
ability to perceive the direction and extent of mvmt of a joint or body part
kinesthesia
926
# Reveresed
inability to interpret stimuli on the left side of the body due to a lesion of the rt frontal lob of brain
neglect
927
# Reveresed
state of repeatedly performing the same segment of a task or repeatedly saying the same word/phrase without purpose
perseveration
927
# Reveresed
state of repeatedly performing the same segment of a task or repeatedly saying the same word/phrase without purpose
perseveration
928
# Reveresed
ability to perceive the static position of a joint or body part
proprioception
929
# Reveresed
state of severe hypertonicity where a sustained muscle contraction does not allow for any mvmt at a specified joint
rigidity
930
# Reveresed
result of brain damage that presents with mass mvmt patterns that are primitive in nature and coupled with spasticity
synergy
930
# Reveresed
result of brain damage that presents with mass mvmt patterns that are primitive in nature and coupled with spasticity
synergy
931
# Reveresed
spinal cord injury
SCI
931
# Reveresed
spinal cord injury
SCI
932
# Reveresed
lesion to SC where there is no preserved motor or sensory function below the level of lesion
complete lesion
932
# Reveresed
lesion to SC where there is no preserved motor or sensory function below the level of lesion
complete lesion
933
# Reveresed
lesion to the SC with incomplete damage to the cord. there may be scattered motor function, sensory function or both below the level of injury/lesion.
incomplete lesion
934
# Reveresed
results from compression and damage to the anterior part of SC or anterior spinal artery. usually cervical flexion is mechanism of injury. loss of motor function and pain and temp sense below lesion due to damage of the corticospinal and spinothalamic tracts
incomplete: anterior cord syndrome
934
# Reveresed
results from compression and damage to the anterior part of SC or anterior spinal artery. usually cervical flexion is mechanism of injury. loss of motor function and pain and temp sense below lesion due to damage of the corticospinal and spinothalamic tracts
incomplete: anterior cord syndrome
935
# Reveresed
usually caused by a stab wound, which produces a hemisection of the sc. paralysis and loss of vibratory and position sense on same side as lesion due to damage to corticospinal tract and dorsal columns. loss of pain and temp sense on opposite side of lesion from damage to lateral spinothalamic tract. rare since most spinal cord lesions are atypical.
incomplete: brown-sequard's syndrome
935
# Reveresed
usually caused by a stab wound, which produces a hemisection of the sc. paralysis and loss of vibratory and position sense on same side as lesion due to damage to corticospinal tract and dorsal columns. loss of pain and temp sense on opposite side of lesion from damage to lateral spinothalamic tract. rare since most spinal cord lesions are atypical.
incomplete: brown-sequard's syndrome
936
# Reveresed
injury that occurs below L1 spinal level where long nerve roots transcend. mostly incomplete but rarely can be complete as well. considered a peripheral nerve injury. flaccidity, areflexia, impairment of bowel/bladder function. full recovery not typical due to distance needed for axonal regeneration.
incomplete: cauda equina injuries
937
# Reveresed
results from compression and damage to the central portion of sc. injury is usually cervical hyperextension that damages spinothalamic tract, corticospinal tract, and dorsal columns. UEs present with greater involvement than LEs, and greater motor deficits than sensory deficits.
incomplete: central cord syndrome
938
# Reveresed
rare syndrome that is caused by compression of posterior spinal artery and is characterized by loss of pain perception, proprioception, 2 pt discrimination, and stereognosis. motor function is preserved.
incomplete: posterior cord syndrome
938
# Reveresed
rare syndrome that is caused by compression of posterior spinal artery and is characterized by loss of pain perception, proprioception, 2 pt discrimination, and stereognosis. motor function is preserved.
incomplete: posterior cord syndrome
939
# Reveresed
dangerious complication of sci. can occur in pts with lesions above T6. noxious stimuls below lesion level triggers autonomic nervous system, causing a sudden elevation in blood pressure. common causes include distended or full bladder, kink or blockage in catheter, bladder infections, pressure ulcers, tight clothing.
autonomic dysreflexia
940
# Reveresed
high bp, severe headache, blurred vision, stuffy nose, profuse sweating, goose bumps below level of lesion, and vasodilation (flushing) above level of injury.
symptoms of autonomic dysreflexia
941
# Reveresed
high bp, severe headache, blurred vision, stuffy nose, profuse sweating, goose bumps below level of lesion, and vasodilation (flushing) above level of injury.
symptoms of autonomic dysreflexia
941
# Reveresed
check catheter for blockage first. bowel should also be checked for impaction. pt should remain in a sitting position. lying a patient down is CONTRAindicated.
treatment of autonomic dysreflexia
942
# Reveresed
formation of a blood clot that becomes dislodged and is termed an embolus. can become serious since the embolus may obstruct a selected artery. sci pts have a greater risk of developing a DVT due to the absence or decrease of activity in LEs.
deep vein thrombosis (DVT)
942
# Reveresed
formation of a blood clot that becomes dislodged and is termed an embolus. can become serious since the embolus may obstruct a selected artery. sci pts have a greater risk of developing a DVT due to the absence or decrease of activity in LEs.
deep vein thrombosis (DVT)
943
# Reveresed
swelling of LEs, pain, sensitivity over area of clot, warmth
symptoms of DVT
943
# Reveresed
swelling of LEs, pain, sensitivity over area of clot, warmth
symptoms of DVT
944
# Reveresed
no active or passive mvmt performed to involved LE. bed rest and anticoagulant drug therapy are usually indicated
treatment of DVT
945
# Reveresed
no active or passive mvmt performed to involved LE. bed rest and anticoagulant drug therapy are usually indicated
treatment of DVT
945
# Reveresed
(or heterotopic ossification): spontaneous formation of bone in the soft tissue. occurs adjacent to larger joints such as knees or hips.
ectopic bone
946
# Reveresed
edema, decreased ROM, increased temp of involved joint
symptoms of ectopic bone
946
# Reveresed
edema, decreased ROM, increased temp of involved joint
symptoms of ectopic bone
947
# Reveresed
drug intervention usually involves diphosphates that inhibit ectopic bone formation.
treatment of ectopic bone
947
# Reveresed
drug intervention usually involves diphosphates that inhibit ectopic bone formation.
treatment of ectopic bone
948
# Reveresed
occurs due to a loss of sympathetic control of vasoconstriction in combination with absent or severely reduced muscle tone. decrease in systolic blood pressure greater than 20 mm HG after moving from a supine position to a sitting position is typically indicative of orthostatic hypotension.
orthostatic hypotension
948
# Reveresed
occurs due to a loss of sympathetic control of vasoconstriction in combination with absent or severely reduced muscle tone. decrease in systolic blood pressure greater than 20 mm HG after moving from a supine position to a sitting position is typically indicative of orthostatic hypotension.
orthostatic hypotension
949
# Reveresed
complaints of dizziness, light-headedness, nausea, blacking out when going from a horizontal to a vertical position
symptoms of orthostatic hypotension
949
# Reveresed
complaints of dizziness, light-headedness, nausea, blacking out when going from a horizontal to a vertical position
symptoms of orthostatic hypotension
950
# Reveresed
monitoring of vital signs, use of elastic stockings, ace wraps to LEs, abdominal binders. gradual progression to a vertical position using a tilt table is often used. drug intervention is sometimes used to increase blood pressure.
treatment of ortho hypo
950
# Reveresed
monitoring of vital signs, use of elastic stockings, ace wraps to LEs, abdominal binders. gradual progression to a vertical position using a tilt table is often used. drug intervention is sometimes used to increase blood pressure.
treatment of ortho hypo
951
# Reveresed
caused by sustained pressure, friction, and or shearing to a surface. require immediate medical attention and can delay PT/rehab
pressure ulcers
951
# Reveresed
caused by sustained pressure, friction, and or shearing to a surface. require immediate medical attention and can delay PT/rehab
pressure ulcers
952
# Reveresed
reddened area that persists; an open area
symptoms of pressure ulcers:
952
# Reveresed
reddened area that persists; an open area
symptoms of pressure ulcers:
953
# Reveresed
prevention is important. change positions frequently, maintain proper skin care, sit on appropriate cushions, consistent weight shifting, maintenance of proper nutrition and hydration.
treatment of pressure ulcers:
953
# Reveresed
prevention is important. change positions frequently, maintain proper skin care, sit on appropriate cushions, consistent weight shifting, maintenance of proper nutrition and hydration.
treatment of pressure ulcers:
954
# Reveresed
can sometimes be useful for a sci patient.
spasticity
954
# Reveresed
can sometimes be useful for a sci patient.
spasticity
955
# Reveresed
positioning, aquatic therapy, weight bearing, estim, ROM, resting splints and inhibitive casting
spasticity treatment for sci
955
# Reveresed
positioning, aquatic therapy, weight bearing, estim, ROM, resting splints and inhibitive casting
spasticity treatment for sci
956
# Reveresed
phenol blocks, rhizotomies, myelotomies, other surgical interventions
aggressive spasticity treatment for sci
957
# Reveresed
surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function
myelotomy
957
# Reveresed
surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function
myelotomy
958
# Reveresed
surgical removal of a segment of a nerve in order to decrease spasticity and improve function
neurectomy
958
# Reveresed
surgical removal of a segment of a nerve in order to decrease spasticity and improve function
neurectomy
959
# Reveresed
bladder empties reflexively for a pt with an injury above level of S2. sacral reflex arc remains intact.
neurogenic bladder
960
# Reveresed
lowest segment of the sc with intact strength and sensation.
neurologic level
960
# Reveresed
lowest segment of the sc with intact strength and sensation.
neurologic level
961
# Reveresed
bladder is flaccid as a result of a cauda equina or conus medullaris lesion. sacral reflex arc is damaged
nonreflexive bladder
962
# Reveresed
surgical resection of sensory component of a spinal nerve in order to decrease spasticity and improve function
rhizotomy
962
# Reveresed
surgical resection of sensory component of a spinal nerve in order to decrease spasticity and improve function
rhizotomy
963
# Reveresed
incomplete lesion where some of the innermost tracts remain innervated. characteristics include sensation of the saddle area, mvmt of toe flexors, and rectal sphincter contraction
sacral sparing
963
# Reveresed
incomplete lesion where some of the innermost tracts remain innervated. characteristics include sensation of the saddle area, mvmt of toe flexors, and rectal sphincter contraction
sacral sparing
964
# Reveresed
physiologic response that occurs between 30 and 60 minutes after trauma to the spinal cord and can last up to several weeks. spinal shock presents with total flaccid paralysis and loss of all reflexes below the level of injury.
spinal shock
964
# Reveresed
physiologic response that occurs between 30 and 60 minutes after trauma to the spinal cord and can last up to several weeks. spinal shock presents with total flaccid paralysis and loss of all reflexes below the level of injury.
spinal shock
965
# Reveresed
surgical release of a tendon in order to decrease spasticity and improve function
tenotomy
966
# Reveresed
poor or trace motor or sensory function for up to 3 levels below the neurologic level of injury
zone of preservation
966
# Reveresed
poor or trace motor or sensory function for up to 3 levels below the neurologic level of injury
zone of preservation
967
# Reveresed
injury of direct penetration thru skull to brain. ex: gsw, knife or sharp object penetration, skull fragments, direct trauma
tbi: open injury
967
# Reveresed
injury of direct penetration thru skull to brain. ex: gsw, knife or sharp object penetration, skull fragments, direct trauma
tbi: open injury
968
# Reveresed
injury to brain w/o penetration thru skull. ex: concussion, contusion (bruise), hematoma (solid swelling of clotted blood in tissues), injury to extracranial blood vessels, hypoxia, drug overdose, near drowning, acceleration/deceleration injuries
tbi: closed injury
969
# Reveresed
initial injury to brain sustained by impact. ex: skull penetration, skull fractures, and contusions to gray and white matter
tbi: primary injury
969
# Reveresed
initial injury to brain sustained by impact. ex: skull penetration, skull fractures, and contusions to gray and white matter
tbi: primary injury
970
# Reveresed
direct lesion of brain under point of impact. local brain damage is sustained
primary injury: coup lesion
971
# Reveresed
injury that results on opposite side of brain. lesion is due to rebound effect of brain after impact.
primary injury: contrecoup lesion
971
# Reveresed
injury that results on opposite side of brain. lesion is due to rebound effect of brain after impact.
primary injury: contrecoup lesion
972
# Reveresed
brain damage that occurs as a response to the initial injury. ex: hematoma, hypoxia, ischemia, increased intracranial pressure, and post-traumatic epilepsy
secondary injury
972
# Reveresed
brain damage that occurs as a response to the initial injury. ex: hematoma, hypoxia, ischemia, increased intracranial pressure, and post-traumatic epilepsy
secondary injury
973
# Reveresed
hemorrhage that forms btwn skull and dura mater
secondary injury: epidural hematoma
974
# Reveresed
hemorrhage that forms btwn skull and dura mater
secondary injury: epidural hematoma
974
# Reveresed
hemorrhage that forms due to venous rupture btwn dura and arachnoid
secondary injury: subdural hematoma
975
# Reveresed
state of unconsciousness and a level of unresponsiveness to all internal and external stimuli
coma
975
# Reveresed
state of unconsciousness and a level of unresponsiveness to all internal and external stimuli
coma
976
# Reveresed
state of general unresponsiveness with arousal occurring from repeated stimuli
stupor
976
# Reveresed
state of general unresponsiveness with arousal occurring from repeated stimuli
stupor
977
# Reveresed
state of consciousness that is characterized by a state of sleep, reduced alertness to arousal, and delayed responses to stimuli
obtundity
977
# Reveresed
state of consciousness that is characterized by a state of sleep, reduced alertness to arousal, and delayed responses to stimuli
obtundity
978
# Reveresed
state of consciousness that is characterized by disorientation, confusion, agitation, and loudness
delirium
978
# Reveresed
state of consciousness that is characterized by disorientation, confusion, agitation, and loudness
delirium
979
# Reveresed
state of consciousness that is characterized by quiet behavior, confusion, poor attention, and delayed responses
clouding of consciousness
979
# Reveresed
state of consciousness that is characterized by quiet behavior, confusion, poor attention, and delayed responses
clouding of consciousness
980
# Reveresed
state of alertness, awareness, orientation and memory
consciousness
980
# Reveresed
state of alertness, awareness, orientation and memory
consciousness
981
# Reveresed
glasgow coma scale, CAT scan, x-ray, MRI, cerebral angiography, evoked potential/electroencephalogram, positron emission tomography, ventriculography, radioisotope imaging
acute diagnostic management
981
# Reveresed
glasgow coma scale, CAT scan, x-ray, MRI, cerebral angiography, evoked potential/electroencephalogram, positron emission tomography, ventriculography, radioisotope imaging
acute diagnostic management
982
# Reveresed
neuro assessment tool used initially after injury to determine arousal and cerebral cortex function. total score of 8 or less correlates to coma in 90% of patients. scores of 9-12 indicate moderate brain injuries and scores from 13-15 indicate mild brain injuries.
glasgow coma scale
982
# Reveresed
neuro assessment tool used initially after injury to determine arousal and cerebral cortex function. total score of 8 or less correlates to coma in 90% of patients. scores of 9-12 indicate moderate brain injuries and scores from 13-15 indicate mild brain injuries.
glasgow coma scale
983
# Reveresed
neuro assessment tool. 1-8 levels. 1=no response. 2=generalized response. 3=localized response. 4=confused-agitated (heightened state of activity. behavior is bizarre.) 5=confused-inappropriate (pt is able to respond to simple commands fairly consistently, but more complex task responses are non-purposeful, random or fragmented.) 6=confused-appropriate (pt shows goal oriented behavior, but is dependent on external input or direction). 7=automatic-appropriate: pt appears appropriate and oriented within the hospital and home setting but frequently robot-like. 8=purposeful-appropriate (pt is able to recall and integrate past and recent events and is aware and responsive to environment.
rancho los amigos (levels of cognitive functioning
983
# Reveresed
neuro assessment tool. 1-8 levels. 1=no response. 2=generalized response. 3=localized response. 4=confused-agitated (heightened state of activity. behavior is bizarre.) 5=confused-inappropriate (pt is able to respond to simple commands fairly consistently, but more complex task responses are non-purposeful, random or fragmented.) 6=confused-appropriate (pt shows goal oriented behavior, but is dependent on external input or direction). 7=automatic-appropriate: pt appears appropriate and oriented within the hospital and home setting but frequently robot-like. 8=purposeful-appropriate (pt is able to recall and integrate past and recent events and is aware and responsive to environment.
rancho los amigos (levels of cognitive functioning
984
# Reveresed
inability to create new memory. usually last to recover after a comatose state.
anterograde memory impairment
984
# Reveresed
inability to create new memory. usually last to recover after a comatose state.
anterograde memory impairment
985
# Reveresed
time btwn injury and when patient is able to recall recent events. pt does not recall injury or events up until this point of recovery.
post-traumatic memory impairment
985
# Reveresed
time btwn injury and when patient is able to recall recent events. pt does not recall injury or events up until this point of recovery.
post-traumatic memory impairment
986
# Reveresed
inability to remember events prior to the injury. retrograde amnesia may progressively decrease with recovery
retrograde amnesia
986
# Reveresed
inability to remember events prior to the injury. retrograde amnesia may progressively decrease with recovery
retrograde amnesia
987
# Reveresed
diuretic agents to decrease volume of fluid in brain and pressure (mannitol, glycerol) anticonvulsant agents to prevent early seizures in head injury (dilantin, tegretol, klonopin) calcium channel blocker agents to improve outcome for traumatic subarachnoid hemorrhage (nimotop), antidepressant agents to reduce aggressive or disruptive behavior (elavil, prozac) electrolytes because adequate stores are needed during acute phase of head injury (magnesium sulfate) selective serotonin reuptake inhibitor agents may benefit patients with head injury and emotional inhibition or impairment (zoloft, paxil)
pharmacological interventions for tbi management
988
# Reveresed
quick acting nervous system mechanisms that influence heart rate when triggered.
cardiac reflexes
988
# Reveresed
quick acting nervous system mechanisms that influence heart rate when triggered.
cardiac reflexes
989
# Reveresed
produced by a group of mechanoreceptors that are found w/in walls of the heart. the reflex is activated when pressure rises w/in the large arteries above 60 mm Hg. peak in activity at approx 180 mm Hg. results in vasodilation secondary to inhibition of the vasomotor centers w/in the medulla as well as a decrease in heart rate and strength of contraction secondary to vagal stimulation
baroreceptor reflex
989
# Reveresed
produced by a group of mechanoreceptors that are found w/in walls of the heart. the reflex is activated when pressure rises w/in the large arteries above 60 mm Hg. peak in activity at approx 180 mm Hg. results in vasodilation secondary to inhibition of the vasomotor centers w/in the medulla as well as a decrease in heart rate and strength of contraction secondary to vagal stimulation
baroreceptor reflex
990
# Reveresed
occurs when mechanoreceptors embedded within the right atrial myocardium respond to an increase in pressure and stretch (distention of the right atrium). stimulates the vasomotor centers of the medulla and results in increased sympathetic input and heart rate. reflex can also influence a decrease in heart rate when heart is beating too fast.
bainbridge reflex
991
# Reveresed
responds to need for increased depth and rate of ventilation. chemoreceptors are located on the carotid and aortic bodies and detect lack of oxygen, responding to an increase in arterial CO2 levels.
chemoreceptor reflex
991
# Reveresed
responds to need for increased depth and rate of ventilation. chemoreceptors are located on the carotid and aortic bodies and detect lack of oxygen, responding to an increase in arterial CO2 levels.
chemoreceptor reflex
992
# Reveresed
lub: mitral and tricupsid valves closing at beginning of systole
Heart sounds: S1
992
# Reveresed
lub: mitral and tricupsid valves closing at beginning of systole
Heart sounds: S1
993
# Reveresed
dub: aortic and pulmonary valves closing at onset of diastole
Heart sounds: S2
994
# Reveresed
ventricular gallop: abnormal in older adults: noncompliant left ventricle. may be associated with CHF
Heart sounds: S3
994
# Reveresed
ventricular gallop: abnormal in older adults: noncompliant left ventricle. may be associated with CHF
Heart sounds: S3
995
# Reveresed
vibration of ventricular wall with ventricular filling and atrial contraction; may be associated with hypertension, stenosis, hypertensive heart disease or myocardial infarction
Heart sounds: S4
995
# Reveresed
vibration of ventricular wall with ventricular filling and atrial contraction; may be associated with hypertension, stenosis, hypertensive heart disease or myocardial infarction
Heart sounds: S4
996
# Reveresed
amount of blood pumped out of heart through the aorta each minute. males: 5.6L/min. females: 10-20% less. CO=stroke volume X heart rate
cardiac output
996
# Reveresed
amount of blood pumped out of heart through the aorta each minute. males: 5.6L/min. females: 10-20% less. CO=stroke volume X heart rate
cardiac output
997
# Reveresed
amount of blood comes from the veins to the right atrium each minute
venous return
997
# Reveresed
amount of blood comes from the veins to the right atrium each minute
venous return
998
# Reveresed
amount of blood ejected from ventricles with each contraction. factors that can influence stroke volume include preload (influenced by end-diastolic volume), afterload, and contractility
stroke volume
999
# Reveresed
amount of blood pumped out of heart per minute per sq meter of body mass. normal ranges btwn 2.5 to 4.2 L/min/meter2
cardiac index
999
# Reveresed
amount of blood pumped out of heart per minute per sq meter of body mass. normal ranges btwn 2.5 to 4.2 L/min/meter2
cardiac index
1000
# Reveresed
usually 7-8% of body weight. blood is pumped thru body at 30 cm/sec w/total circulation time of 20 seconds.
blood volume
1000
# Reveresed
usually 7-8% of body weight. blood is pumped thru body at 30 cm/sec w/total circulation time of 20 seconds.
blood volume
