Section 8.10

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ANNichols
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71497
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Section 8.10
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2011-03-09 17:54:31
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General Review Lab Sections
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Section 8.10
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  1. Romberg Test
    • used to determine if the pt can stand w/ both feet together, arms out to their side, eyes open or closed.
    • if they can do so w/o swayin gor losing their balance, they do not have a positive (+) Romberg Test.
  2. Tandem Walking Test
    • used to determine balance at a slightly higher level than the basic Romberg Test.
    • Pt walks heel to toe for several feet with or w/o eyes open and ifthey can maintain balance, the test is negative.
  3. Others test can be used that are more formal balance test
    • Tinettie Assessment Tool
    • Berg Balance Scale
    • Get Up and Go Test
  4. Cranial Nerve Assessment
    Olfactory Assessment I
    Sense of Smell
  5. Cranial Nerve Assessment
    Optic II
    • Visual acuity
    • ability to see near and far
  6. Cranial Nerve Assessment
    Oculomotor III
    • visual tracking
    • depth perception
    • pupil response to light
    • peripheral vision
  7. Cranial Nerve Assessment
    Troclear IV
    visual tracking (vertically)
  8. Cranial Nerve Assessment
    Trigiminal V
    • motor to mastication muscles,
    • sensory, pain and temp to the TMJ, face oral and eye structures, nasal cavity, frotnal sinuses, side of head and scalp
  9. Cranial nerve assessment
    Abducens VI
    visual tracking (laterally)
  10. Cranial Nerve Assessment
    Facial VII
    • motor for facial expressions and gland productions
    • sensory to anterior 2/3 of tongue and small area of skin behind the ear
  11. Cranial Nerve Assessment
    Vestibulocochlear VIII
    • hearing
    • balance
  12. Cranial Nerve Assessment
    Glossopharyngeal IX
    • Motor for gag reflex and swallowing
    • Sensory to posterior 1/2 of tongue, skin of external ear, taste from posterior 1/3 of tongue and parotid gland production
  13. Cranial Nerve Assessment
    Vagus X
    • motor to pharynx, larynx and swallowing
    • sensory to skin around ear, pharynx esophagus, trachea, organs alimentary canal and aortic arch
  14. Cranial Nerve Assessment
    Spinal Accessory XI
    motor to SCM and trapezius
  15. Cranial Nerve Assessment
    Hypoglossal XII
    motor to tongue muscles
  16. Deep Tendon Reflex Testing
    Biceps Reflex
    • (C5, C6)
    • hammer over the biceps tendong to elicit elbow flexion
  17. Deep Tendon Reflex Testing
    Brachioradialis Reflex
    • (C5, C6)
    • Hammer over the brachioradialis tendon to elicit elbow flexion
  18. Deep Tendon Reflex Testing
    Triceps Reflex
    • (C6, C7)
    • hammer over the triceps tendon to elicity elbow extension
  19. Deep Tendon Reflex Testing
    Quadriceps Reflex
    • (L2-L4)
    • hammer over the patellar tendon to elicity knee extension
  20. Deep Tendon Reflex Testing
    Achilles Reflex
    • (S1-S2)
    • hammer over the calcaneus tendon to elicit ankle plantar flexion
  21. Mobility
    • Rhythmical Rotation (RRo)
    • Rhythmic Initiation (RI)
    • Hold Relax Active Contraction (HRAC)
    • Hold Relax (HR)
    • Traction (Tx)
  22. Stability
    • Rhythmic Stabilization (RS)
    • Alternating Isometrics (AI)
    • Slow Reversal (SR)
    • Contract Relax (CR)
    • Traction (Tx)
  23. Controlled Mobility
    • Repeated Contractions (RC)
    • Agonistic Reversal (AR)
    • Timing for Emphasis (TE)
  24. Skill
    • Resisted Progression (RP)
    • Normal Timing (NT)
  25. Facilitation of Muscle Contractions
    • Quick stretch
    • Tapping/manual contact (ayers and rood)
    • Resistance
    • Vibration (ayers and rood)
    • Approximation
    • quick ice (rood)
    • burshing (rood)
  26. Inhibition Techniques
    • Prolonged stretch
    • Pressure on long tendongs
    • Slow stroking down posterior rami
    • Traction
    • Neutral Warmth
  27. The format for PNF pattersn is learned by following the five activities listed
    • Movement overview
    • Normal Timing
    • Manual Contacts
    • Commands
    • Range limiting factors
  28. Movement overview
    a general picture of th emotion for the limb or trunk
  29. Normal Timing
    • the normal firing pattern for the muscle groups
    • e.g. proximal to distal or vice versa
  30. Manual Contacts
    for the right and left hand for each movement
  31. Commands
    For Preparatory and for Action fo reach movement
  32. Range limiting factors
    what structures if tight will limit the motion
  33. Trunk Patterns
    • Flexion/Rotation (R)-Command is
    • "Up and twist right, down and return to neutral
    • Flexion/Rotation (L)-Command is
    • "up and twist left, down and return to neutral"
  34. Upper Extremity Patterns
    • Flexion/Adduction (D1)-Command is
    • "up and in, down and out"
    • Flexion/Abduction (D2)-Command is
    • "down and in, up and out"
  35. Lower Extremity Patterns
    • Flexion/Adduction (D1)-Command is
    • "up and in, down and out"
    • Flexion/Abduction(D2)-Command is
    • "down and in, up and out"
  36. PNF Technique
    Approximation
    • Therapist's Role-Joint compression manually or w/ gravity through weight bearing
    • Patient's Role-Help maintain joint integrity
    • Activity Enhanced-Stability, postural control, weakness
  37. PNF Technique
    Agonist Reversals (AR)
    • Therapist's Role-Move pt. through full range w/ slow contraction in increments
    • Patient's Role-Maintains balance during incremental contraction of concentric and then eccentric lengthening of same muscle groups
    • Activity Enhanced-Postural contro, weakness and transition skills
  38. PNF Technique
    Alternating Isometrics (AI)
    • Therapist's Role-Applying resistance first in one direction and then in the opposite direction
    • Patient's Role-Maintaion position isometrically w/o losing blaance or stability
    • Activity Enahnced-Stability, postural control, weakness
  39. PNF Technique
    Contract-Relax (CR)
    • Therapist's Role-Take passively to end range, rotate, resist movement, move thorough new range, passively
    • Patient's Role-Contract against resistance at end range in rotation, relax, allow movement through new range passively.
    • Activity Enhanced-Flexibility, strength and endurance
  40. PNF Technique
    Contract-Relax Active Contraction (CRAC)
    • Therapist's Role-Take passively to end range, rotate, resist movement move thorough new range, actively
    • Patient's Role-Contract against resistance at end range in rotation, relax, actively help with movement though new range
  41. PNF Technique
    Active-Assistive Movement (AAM)
    • Tehrapist's Role-Move passively through pattern and then aid movement, actively
    • Patient's Role-Allow passive movement through pattern and then help actively
    • Activity Enahanced-ROM, strength, and endurance.
  42. PNF Technique
    Hold-Relax (HR)
    • Therapist's Role-Take passively to end range, resist contraction w/o movement, move thorough new range, passively
    • Patient's Role-Contract isometrically against resistance at end range, relax allow movement through new range, passively
    • Activity Enhanced-ROM, spasms, pain and flexibility
  43. PNF Technique
    Hold-Relax Active Contraction (HRAC)
    • Therapist's Role-Take passively to end range, resist contraction w/o movement, move through new range, actively
    • Ptient's Role-Contract isometrically against resistance at end range, relax, actively help w/ movement through new range
    • Activity Enhanced-ROM, spasms, pain, and flexibility
  44. PNF Technique
    Hold-Relax Active Motion (HRAM)
    • Therapist's Role-Start in mid or shortened range, resist contraction w/o movement, move to lengthened range, passively
    • Patient's Role-Resist movement in mid or shortened range isometrically, allow passive range to full length of muscle, resist full range
    • Acivity Enhanced-Poor initiation of movment, pain, weakness
  45. PNF Technique
    Repeated Contractions (RCs)
    • Therapist's Role-Move through range against resistance to point of weakness, apply quick stretch, continue w/ pattern
    • Patient's Role-Resist movement w/ contraction until point of weakness, relax at stretch, move into contraction again
    • Activity Enhanced-Weakness, endurance and coordination
  46. PNF Technique
    Traction
    • Therapist's Role-Distraction applied to joints
    • Patient's Role-Maintain stability through pattern
    • Activity Enhanced-Weakness, mobilization
  47. PNF Technique
    Resisted Progression (RP)
    • Therapist's Role-Resist pattern of movement w/ stretch or tracking resistance
    • Patient's Role-Move against patterns of resistance and maintain balance
    • Activity Enhanced-Poor timing and endurance
  48. PNF Technique
    Rhythmic Initiation (RI)
    • Therapist's Role-Begin in relaxed state, passive movements through increments of range, AAM to resisted movements wi/ tracking resistance
    • Patient's Role-Relax through increments of movement, AAM to resisted movements / contractions
    • Activity Enhanced-Relaxation, decrease hpertonicity
  49. PNF Technique
    Rhythmic Rotation (RRo)
    • Therapist's Role-Relax, slow passive rotation around longitudinal axis, passive movement opposite spastic pattern
    • Patient's Role-Relax, passive movement in rotational pattern, passive movement in opposite direction
    • Activity Enhanced-ROM, hypertonicity
  50. PNF Technique
    Rhythmic Stabilization (RS)
    • Therapist's Role-Resist contraction of opposite muscle groups, isometrically, no relaxation
    • Patient's Role-Resist isometricall w/ no relaxation
    • Activity Enhanced-ROM, stability and postural control
  51. PNF Technique
    Shortened Held Resisted Contraction (SHRC)
    • Therapists's Role-Place in shortened position, isometric contraction w/ resistance
    • Patient's Role-Isometric contraction against tracking resistance in shortened range
    • Activity Enhanced-Stability postural control and weakness
  52. PNF Technique
    Slow Reversals (SRs)
    • Therapist's Role-Begin in limited, slow range, increas range w/ grading of resistance
    • Patient's Role-Slow, isotonic contraction through range and return back through range
    • Activity Enhanced-Progression of movement patterns and transition skills
  53. PNF Technique
    Slow Reversal-Hold (SRH)
    • Therapist's Rols-Begin in limited, slow range, increase range w/ grading of resistance, hold isometrically at end range
    • Patient's Role-Slow, isotonic contraction through range and return back through range, hold isometrically at end range
    • Activity Enhanced-Progression of movement paterns and transition skills
  54. PNF Techniques
    Tapping
    • Therapist's Role-Taping stimulus over muscle belly
    • Patient's Role-Stimultes muscle spindle increasing muscle activity
    • Activity Enhanced-Weakness and hypotonia

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