Up to Quiz 1 Flashcards
What technique would be: rhythmical, predictable, slow rocking movement
linear acceleration (or slow vestibular stimulation)
What technique would be: application of moderate/neutral heat to an area of spasticity - slightly warmer than just skin or air, NOT hot
neutral warmth
What technique would be: slow, firm stroking from proximal to distal, in a rhytmical and predictable pattern. Pressure is light but deep enough so to not trigger a ticklish response
slow stroking
What technique would be: firm pressure over the muscle belly or tendon - can carefully bow the tendon or the muscle belly and/or superior attachment. Using sandbags would be an example of this.
inhibitory pressure
What technique would be: maintained pressure or contact - NOT deep or firm pressure, just the weight of your hands. Cue is to have them imagine your hands are melting into their tissue, maintained for 60-90 seconds with diaphragmatic breathing.
maintained touch
Proximal to distal, fine vibrations would be considered a ___ technique.
Distal to proximal, coarse vibrations would be considered a ___ technique.
inhibitory
facilitatory
What technique would be: use of a soft brush or tissue, anything with a soft texture, used proximal to distal, slow and rhythmically
inhibitory brushing
Describe or demonstrate an upper limb flexor synergy.
wrist & elbow flexed
forearm supinated
shoulder externally rotated, abducted, elevated and retracted
Describe or demonstrate an upper limb extensor synergy.
everything is opposite to upper limb flexor synergy except the wrist in flexion
wrist flexed
forearm pronated
elbow extended
shoulder adducted, internally rotated, protracted and depressed
Describe or demonstrate a lower limb extensor synergy.
toes & ankle plantarflexed
knee extended
hip adducted & internally rotated
kind of like a ballet move/position
Describe or demonstrate a lower limb flexor synergy.
toes & ankle dorsiflexed and inverted
knee flexed
hip flexed, abducted and externally rotated
Which spinal cord syndrome is fairly rare, d/t hyperextension injury (usually in c/s) and sees upper limbs more affected than lower, loss of propathic sensory loss below injury level
central cord syndrome
Which spinal cord syndrome sees loss of: ipsilateral motor function, two point discrimination, proprioception and vibration sensory capacity
AND
contralateral loss of pain and temperature sensation
Brown-Sequard syndrome
Epicritic neurons are found in the ____ tract, protopathic neurons are found in the ___ tract.
Where does each decussate
epicritic: dorsal column -> decussate in medulla
protopathic: spinothalamic tract -> decussate at same level as spinal nerve
Which spinal cord syndrome sees: BL loss of motor function, pain, temperature, and crude touch (epicritic ok), and is usually d/t direct trauma/hyperflexion injury?
anterior cord syndrome
UMN lesions at or above T12 will result in ___ of distal muscles and ___reflexia
spasticity and hyperreflexia
LMN lesions at T12 or below will result in __ of distal muscles and ___reflexia
flaccid (fully or partial) and hyporeflexia (diminished or absent)
Mixed spinal cord lesions result in mixed responds, occurring at level…
T12-L1
Everyone with cervical spinal cord lesions will have ____. There is a higher incidence of this with incomplete lesions.
spasticity
Sudden increases in spasticity may signal a medical problem, such as…
pressure sore, bladder/UTI
With spinal cord lesions above __ to __, the person will be dependent on artificial ventilation
C1-C2
Define heterotopic ossification:
formation of bone in the muscle or connective tissue after SCI, occurring usually 1-4 months post-injury
Define autonomic dysreflexia:
acute episodes of exaggerated sympathetic response - bradycardia, severe HTN, sudden pounding headache, vasospasms and skin pallor, anxiety, sweating, flushed skin
When is autonomic dysreflexia usually a risk?
persons with lesions at or above T6, M/C if quadriplegic
What triggers autonomic dysreflexia?
primarily by painful or uncomfortable stimuli, especially in the abdomen or pelvic area -> includes a full bladder, muscle spasm, extensive muscle stretch, presence of infection or bed sore.
What do you do if autonomic dysreflexia is triggered?
place the client in an upright position with the head raised up to 45 degrees, remove or loosen any tight clothing and noxious stimuli
seek medical attention if it continues
What do you need to consider if someone has orthostatic HTN?
positional changes should be slow/gradual or dizziness, pallor, sweating and fainting may occur
Prone and supine position are CI’d for SCI patients IF…
diaphragm function is severely compromised
Why is massage beneficial even in areas without or with reduced sensation?
maintaining joint/tissue health and integration of the whole body
Lower motor neurons originate in the ____ and ___ and directly innervate ____
brainstem and spinal cord, skeletal muscles
Define hypokinetic:
diminished power of movement or motor function which may or may not be accompanied by mild paralysis
Myotonia
Chorea
Spasticity
and hyperkinetic movement disorders
are all results of…
UMN lesions
Spasticity usually involves __ of the upper limb and __ of the lower limb.
flexors of arms, extensors of legs
Hypertonicity is usually associated with __ deep reflexes and ___ superficial reflexes.
increased, decreased
Define myotonia:
condition in which a muscle or group of muscles does not readily relax after contracting
Define chorea:
involuntary, purposeless, rapid motions such as flexing/extending the fingers, raising and lowering the shoulders, or grimacing
appear to be well coordinated and often go along with irritability, emotional instability, weakness, restlessness
Paraplegia results from lesions at level __ and below, and quadriplegia at levels _ and above
T2, T1
Paraplegia results from lesions at level __ and below, and quadriplegia at levels _ and above
T2, T1
Approximation facilitates ___ of a ___ joint
extension of a flexed joint
Heterotopic ossification occurs in __ %SCI patients
20% or 1/5
What roods technique is this?
rapid fingertip tapotement over the muscle belly
quick stretch
What roods technique is this?
rest the weight of your hand very gently on the patient’s forearm and ask them to really think about doing or imagine themselves completing a bicep curl. you will feel a tremor if you’re using too much pressure.
resistance
What does traction facilitate?
flexion
What roods technique is this:
lightly stroke the muscle belly manually or with ice, from distal to proximal
light touch
In order for vibrations to be facilitatory, they would need to be __ and __
distal to proximal and coarse
Define manual contact:
firm, deep pressure applied with the hands on an area of the body
Differentiate manual contact from maintained touch from inhibitory pressure
Manual contact: deep, firm pressure to a specific area of the body
Maintained touch: maintained pressure or contact - very light
Inhibitory pressure: firm, long held pressure
CI’s for spasticity include…
no heat
no facilitatory tqs
no overpowering the pt
CI’s for flaccid tissue include…
extreme temperatures that cannot be sensed, too deep of pressure, inhibitory tqs, overpowering the pt, stretching
