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70 Cards in this Set
- Front
- Back
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What does the term dermatome refer to?
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To the skin area supplied by one dorsal root
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Contralateral loss or impairment of pain and temperature perception is suggestive of lesions in the what tract?
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Anterolateral spinothalamic tract
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Deficits in discriminative sensations such as vibration and two-point discrimination suggest lesions of the what?
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Dorsal column medial lemniscal system
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_______ are responsible for the superficial sensations, such as pain, temperature, light touch, and pressure.
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Exteroreceptors
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______are responsible for deep sensations, such as position sense, awareness of joints at rest, movement awareness, and vibration
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Proprioceptors
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The combination of superficial and deep sensory mechanisms and includes tactile location, recognition of texture, and double simultaneous response
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Cortical sensations
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The afferent fibers of this spinal pathway are small in diameter, slowly conductive
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Anterolateral spinalthalamic
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The afferent fibers of this pathway are large and rapidly conductive
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Dorsal column medial lemniscal
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What is sensory object recognition
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Stereognosis
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When testing pain sensation this is also referred to as ______ discrimination and indicates function of protective sensation
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Sharp/dull discrimination
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What tests the awareness of motion for deep sensation?
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Kinesthesia test
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A traced figure identification testing for cortical sensory is called
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Graphesthesia
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What is barognosis?
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The recognition of different weights
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Term or terms used to describe decreased or absent muscular tone
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Hypotonia or flaccidity
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_______ muscles will feel soft, and flabby, whereas _______ muscles will feel taut and harder than normal
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Hypotonic
Hypertonic |
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Muscle tone should be tested passively. T or F?
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True
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What are fasciculations of the muscles?
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Muscle twitches
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CP, CVA, and MS are examples of UMN or LMN lesions?
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UMN lesion
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MD, poliomyelitis, and peripheral nerve lesions are examples of UMN or LMN lesions
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LMN lesions
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These lesions affect the nerve or their axons at or below the level of the brainstem
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LMN lesions
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Hypertonicity, hyper-reflexia, abnormal reflexes are signs of
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UMN lesion
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Decreased tone, fasciculations, and decreased reflexes are signs of
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LMN lesion
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Cyclical spasmodic alternation of muscular stretch of a spastic muscle
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Clonus
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Spasticity is a characteristic of UMN lesions because it has ________ dependent resistance
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Velocity
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Term that describes the spastic catch followed by a sudden inhibition or letting go
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Clasp knife response
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2 types of rigidity
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Lead pipe and cogwheel
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Is rigidity velocity dependent?
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No
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Asthenia
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Generalized muscle weakness
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Tone scale 0-4
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0= no response
1+= decreased response 2+= normal response 3+= exaggerated response 4+= sustained response |
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Characterized by disordered tone with large involuntary movement portions of the body; ex-Parkinson's
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Dystonia
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Decerebrate rigidity posturing
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Supine
LE - same as decorticate UE - extension, ADD, wrist flexion |
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Golden standard for hypertonicity assessment
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Modified ashworth scale (MAS)
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What is the MAS limited to?
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Extremity testing
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Balance is the integration of what 3 systems
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Vestibular (central and peripheral)
Somatosensory Visual |
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What are perturbations
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External forces acting on the body to displace the COM
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Somatosensory input includes ______ and ______ info that is provided to the brain.
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Proprioceptive
Tactile |
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What are challenges
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Changing stationary surface to test the somatosensory input
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clonus scale
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1= no clonus
2=minimal clonus (1-2 beats) 3=moderate clonus (3-9 beats) 4=sustained clonus (10+ beats) |
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what are DTR's
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motor response in response to sensory stimulation
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grading reflexes scale
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0=no response
1=diminished/depressed response 2= active normal response 3= brisk/exaggerated response 4= very brisk/hyperactive; abnormal response |
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things to remember when testing DTR
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Pt should be relaxed
muscle placed in slight stretch test both sides of body for comparison reflex graded |
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enhancing response to elicite a reflex if hyporeflexia is present
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hook fingers together for LE
squeeze knees, clench teeth, make a fist(contralateral side) for UE |
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DTR innervations
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jaw-CN V
biceps- C5-6 spinal level Brachioradialis- C5-6 Triceps- C7-8 Patella- L3-4 Achilles- S1-2 |
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resistance of muscle to passive elongation or stretch
(PROM) |
tone
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types of hypertonicity
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spasticity and rigidity
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difference b/w spasticity and rigidity
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spasticity is velocity dependent and rigidity is not
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when documenting tone things to remember
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location of tone
type of tone(spasticity or rigidity) are changes symmetrical or asymmetrical resting posture KEY-the effect of tone on function |
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allows recovery of funtion after injury or disease
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neuroplasticity
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ability to perform a movement as a result of internal processes and leads to skilled behavior
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motor learning
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when pt cannot do the task in the prior or usual way adoption of alternative behavioral strategies to complete the task.
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compensation
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a plan used to produce a specific result or outcome that wil influence the structure of system
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strategy
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a state of physical equalibrium
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balance
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what allows for head eye movement coordination and supports gaze stabilization
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VOR vestibulo-ocular reflex
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stabilizes the body and controls movement (postural tone is regulated with this)
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VSR vestibul-spinal reflex
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4 automatic postural strategies
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ankle
hip suspensory stepping |
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knee flexion, crouching and squatting is an example of which postural strategy?
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suspensory
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sense of movement and rotation of self and environment
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vertigo
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abnormal eye movements with eyes bouncing back and forth
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nystagmus
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BBS
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berg balance scale
assesses fall risk 14 tasks scored 0-4 max 56 less than 45 indicates higher risk of fall Key-doesnt involve gait |
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BBS risk of fall scoring
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Max score 56
>45 normal 41-45 mild 34-41 moderate <35 severe |
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funtional reach test
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assess standing balance and risk of falling
yard stick to measure reach average 3 trials can be measured standing or sitting (SCI) KEY-also part of BBS |
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TUG
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get up and go test
assesses level of mobility and balance |
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TUG scoring
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Normal<10 sec
mild impairment 11-15 sec moderate 15-20 sec severe >20 sec |
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Romberg test
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assess proprioceptive contributions
Pt unsupported standing feet together UE folded EO then EC normal=able to maintain position for 30 sec |
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what is the score for romberg indicate - pt is able to stand with no or minimal sway with EO, but increased instability with EC?
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positive test
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tinetti POMA
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assesses risk of falling
2 sections-balance and gait balance max score of 16 gait max score of 12 |
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tinetti scoring
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max score 28
>24 normal 21-24 mild 17-20 moderate < 17 severe |
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CTSIB
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clinical test for sensory interaction in balance
determines the effectiveness of the different balance input systems 1st condition determines baseline of all 3 systems 1st 3 conditions only challenge vestibular and vision 4-6 conditions test all three with unstable foam surface for somatosensory |
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ABC scale
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activity balance confidence scale
assesses fall risk self reported-pt answers questions 16 point scale |
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FES
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Falls Efficacy scale
self report-pt answers questions 0=not confident 10=completely confident score of 70=fear of falling |
