-
strongest components in the UE flexion synergy
- elbow flexion
- wrist and finger flexion
-
strongest component in UE ext synergy
shoulder add
-
strongest components in LE ext synnergy
-
5 invol mvmnts seen in extrapyramidal disorders, basal ganglia dysfuntion
- tics (head, face, neck, shoulders)
- chorea
- athetosis
- tremor (resting tremor)
- myoclonus (single, quick jerk)
-
invol mvmnt in cerebellar disorders
intention tremor
-
invol movements in cortical disorders
- epileptic seizures,
- tonic/clonic convulsive mvmnts
-
scoring for gross motor coordination
- 0 unable
- 4 normal performance
-
posterior column (sensory) ataxia will lead to what pos test?
Romberg
-
scores below _ indicate high risk for falls
POMA/Tinetti
Berg
-
scoring on timed up and go
- norm <10 sec
- norm for frail elderly or disabled pts 11-20 sec
- falls risk >20
- high falls risk >30
-
norms for functional reach test
- above av >12.2 inches
- below av <5.6 inches
- falls risk < 10 inches
-
fibrillation on EMG
- spontaneous indep contraction of individual muscle fibers
- present for 1-3 wks after denervation
-
fasciculations on EMG
- sponatneous contractions of all or most fibers in a MU
- can be observed or palpated
- presnt w LMN disorders and denervation, but not with complete LMN lesions
-
3 conditions that'll have decreased conduction velocities
- GBS
- chronic demyelinating polyneuropathy
- Charcot-Marie-Tooth disease
also seen with focal compression of peripheral nerves
-
encephalitis
- severe infection and inflam of the brain
- 2/2 arboviruses, sequela of influenza (Reye's syndrome, eastern equine encephalitis, measles) sinuvitis, otitis, prion-caused disease (kuru, "mad cow" disease)
-
-
brain abscess
infections process w collection of pyogenic material in brain parenchyma (functional tissue of the brain -- neurons and glial cells)
-
irreversible anoxic damage to brain begins after __ min
4-6
-
occlusion to anterior carotid artery -->
minimal deficits due to collateral circulation (circle of Willis)
-
remediation-faclitation approach for CVA
promote awarenes, active mvmnt, use of hemiplegic side
-
3 guidlines for working w pt w L hemisphere lesion
- develop an appropriate communication base (words, gestures, pantomine... assess the level of understanding and use it)
- give frequent feedback and support
- don't underestimate ability to learn
-
5 guidlines for working w pt w R hemisphere lesion
- use verbal cues, (not demos or gestures bc these pts may have visuospatial deficits)
- give frequent feedback, with a focus on slowing and controlling the mvmnt
- focus on safety (pt may be impulsive
- avoid env clutter
- don't overestimate ability to learn
-
confusional state
- mainly a disturbance of attention mechanisms
- all cognitive operations are affected
- can't form new memories
- may demonstrate hypo or hyperarousal
-
middle frontal gyrus of frontal lobe controls what
conjugate eye movements
-
prefrontal area of frontal lob does what?
- motivation, problem solving (dorsolateral)
- emotions, behavior (orbitofrontal)
- olfaction (orbital gyri)
-
Brown-Sequard presentation
- ipsilat loss of tactile discrim, pressure, vibration, proprioception (dorsal columns)
- iplilat loss of motor function w spastic paralysis (corticospinal tracts)
- contral lat loss of pain, temp (spinothalamic)
-
presentation of ant cord syndrome
- loss of motor w spastic paralysis (lateral corticospinal tracts)
- loss of pain and temp (spinothalamic)
- preservation of proprioception, kinesthesia, vibration (dorsal columns)
-
presentation of post cord syndrome
- loss of proprioception, vibration, pressure, epicritic sensations
- preservation of motor, pain, light touch
-
epicritic sensations
- stereognosis, 2-pt discrim
- lost in post cord syndrome
-
absolute contrainds to exercise testing and training for pts w SCI
- autonomic dysreflexia
- infected wt-bearing skin
- symptomatic HoTN
- UTI
- unstable fracture
- uncontrolled hot/humid env
- insufficient ROM to perform exercise
-
BWS TT -- what are the numbers for % support, freq, duration?
- 35% working down to 10% then 0
- 4 days/wk
- mod duration (20-30 min)
- 8-12 wks
-
pyramidal tracts
basically involved w what?
2 tracts?
- vol motor
- corticospinal
- corticobulbar -- CNs (face, chewing, etc)
-
elevated gamma globulin is a sign of
MS
-
dysphagia vs dysphasia vs dysarthria
- dysphagia: difficulty swallowing
- dysphasia: difficulty speaking and maybe comprehending 2/2 brain patho
- dysarthria: difficulty speaking 2/2 motor problem
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