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109 Cards in this Set
- Front
- Back
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postural model of the body, relationship of body parts to another
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body schema
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considered one of the essential foundations for the performance of all purposeful motor behavior
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body schema
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inability to register and integrate stimuli and perceptions from one side of the body
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unilateral neglect
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lack of awareness of the presence of paralysis
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agnosognosia
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impairment in body scheme, lack of awareness of body structure and relationship of body parts; will not be able to imitate PT movements
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somatoagnosia
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unable to recognize right from left
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right left discrimination disorder
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unable to identify fingers of ones own hands or hands of examiner
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finger agnosia
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tx strategies for unilateral neglect
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clenching fist-assists in aligning walking trajectory
mirror red ribbon place items on uninvolved side |
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inability to distinguish a figure from a background
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figure ground discrimination
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inability to perceive or attend to subtle differences in shape or form; ex: if given toothbrush and pen = will not be able to distinguish them
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form discrimination
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crossing the midlne might be a problem to these or will have difficulty positioning themselves in a wheel chair
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spatial disorientation
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problems with concepts such as up, down, under, over
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position in space
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remembering locations
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topographic disorientation
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inaccurate judgement of distance, depth or direction
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depth and distance perception- problem with stairs and sitting
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treatment strategies for depth perception issues
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red tape on stairs
steps or blocks- placing ft on them |
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inability to recognize objects when using a specific sense, even thought that sense is intact
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agnosia
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can describe an object when they palpate it but they cannot name is
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asterognosis
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can describe it by looking at it but cant tell u the name
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visual agnosia
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cant tell the difference b/w the sound of a doorbell and footsteps for example
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auditory agnosia
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inability to perform a movement or sequence of movements despite intact sensation, automatic motor output and understanding of task
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apraxia
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RLA level 1
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No response
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RLA level 2
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Generalized response
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RLA level 3
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localized response
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RLA level 4
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confused -agitated
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RLA level 5
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confused inappropriate
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RLA level 6
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Automatic appropriate
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RLA level 7
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purposeful appropriate
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no response to sights sounds or movements
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Level 1 RLA
No response |
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begins to respond to lights, sounds, touch, responses may include chewing , sweating, breathing faster, moaning
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Level 2 RLA
generalized response |
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will be awake on and off , more movements and reactions, attempts to watch person move around the room, and may follow simple commands (look at me, squeeze my hands)
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Level 3 RLA
localized response |
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tx for RLA level 1-3
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positioning
ROM improve arousal sitting up turning |
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may get agitated with patient, freightened, may not want to participate in therapy, overreacts
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Level 4
confused and agitated |
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not able to complete everyday activities, overloaded and restless, POOR memory
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Level 5
confused and inappropriate |
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forget and confuse details
confused with changes in routine trouble concentrating when its noisy |
level 6
confused and appropriate |
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follow set schedule, routine self care without help, problems with planning, doesnt realize how his memory will impact future
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level 7
automatic and appropriate |
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compensates for problems, comes up with several solutions, ready for job training eval, overloaded with stressful situations
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level 8
purposeful and appropriate |
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what can be a cause of reversible dementia
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dehydration; with aging you lose thirst reflex, alcohol and drug abuse, CV, hypoglycemia, UTI, stroke, TBI, antidepressants, sensory deprivation
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mini mental state examination only examines..
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cognition
scored 0 -30 <24 - cognitive dysfunction |
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clinical examples of IRREVERSIBLE dementia
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AD, PD, Huntington's, MS, AIDS,
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Meds for AD, early to moderate stages
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cholinesterase inhibitors
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Meds for AD, early to moderate stages
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cholinesterase inhibitors
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What do cholinesterase inhibitors do?
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prevent breakdown acetylcholine
delay worsening of symptoms |
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What do cholinesterase inhibitors do?
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prevent breakdown acetylcholine
delay worsening of symptoms |
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Meds for AD for mod to severe stages
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memantine
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Meds for AD for mod to severe stages
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memantine
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What does memantine do
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regulates glutamate
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What does memantine do
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regulates glutamate
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What vitamin is prescribed usually for tx of AD
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vitamin E
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What vitamin is prescribed usually for tx of AD
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vitamin E
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What does vitamin E do?
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antioxidant
however some studies suggest it slightly inc risk of death especially for those with CAD |
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What does vitamin E do?
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antioxidant
however some studies suggest it slightly inc risk of death especially for those with CAD |
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late day increased confusion (around dusk) with AD patients
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sundowning
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factors that may aggravate sundowning
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end of day exhaustion
biological clock - mix up of day and night reduced lighting and increased shadows less need for sleep common among older adults |
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type of transportation?
same route everyday such as a bus. May or may not have wheel chair access |
fixed route
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Type of transportation?
has w/c lifts, and areas on the bus where scooter or w/c can be secured to floor |
paratransit
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components of a driving evaluation?
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vision, hearing, reaction time, reach, strength, ROM, Cognition, judgement, on road assessment
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What are primary controls?
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devices that control accelerator and braking mechanisms
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What are secondary controls?
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turn signals, horn, headlights, etc....
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how far should steering wheel be away from the sternum?
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10 inches
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3 functions of the peripheral vestibular system?
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-stabilization of visual images on the fovea during head movements
-Postural stability during head movements -Provides info used for spatial orientation |
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What are the 2 movement sensors contained in the labyrinth?
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Semicircular canals (3 on each side) and
Otolinths (2 on each side) |
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Labyrinth movement sensor that is filled with endolymph that moves within each canal in response to ANGULAR acceleration.
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Semicircular Canals
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labryrinth movement sensors that respond to LINEAR acceleration and static head tilt and have crystals embedded within?
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Otolinths
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In what part of the brain are vestibular reflexes controlled by?
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brainstem
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When would PT be contraindicated?
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Meneires disease with fluid that is unstabilized.
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illusion of movement, most common during acute stage of a unilateral vestibular hypofunction?
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vertigo
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faintlike feeling
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lightheadedness
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off balance feeling
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dysequilibrium
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motion of objects in the visual environment that are known to be stationary
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oscillopsia
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T/F nystagmus is usually due to a central vestibular lesion?
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False, peripheral
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Corrective saccades is indicative of ?
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vestibular hypofunction
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Test to examine integrity of VOR.
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Head thrust test
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unilateral vestibular lesions have a good rate of recovery , t/f?
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True, the system has an amazing ability to recover since the nuclei talk to each other through interneurons.
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What will PT address with a unilateral vestibular lesion?
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oscillopsia, postural instability, and dysequilibrium
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allows the eyes to move at the same velocity but opposite direction of the head
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VOR (vestibular ocular reflex); mediated by the SCC.
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T/F the VOR allows for gaze stability?
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True
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What needs to be done before performing a head thrust test?
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clear cervical
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tx for unilateral vestibular lesion?
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X1 and X2 exercises to work on gaze stability, postural stability exercises, and habituation training.
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tx for BPPV?
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canalinth repositioning
brandt daroff exercises |
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post treatment care for canalinth repositioning?
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soft collar, do not sleep on involved side for 5 days, avoid vertical head movements, sleep with head elevated
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most common cause of bilateral vestibular lesion?
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ototoxicity from aminoglycosides
which kills the hair cells |
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T/F for a bilateral lesion, the system will not come back?
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True
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Goal of PT for a pt with a bilateral vestibular lesion?
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heighten the visual and somatosensory systems
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exercises for a bilateral lesion?
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X1 (X2 will be too difficult)
Saccades Imaginary targets Postural exercises |
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When doing postural exercises with a bilateral lesion pt, what should you emphasize?
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GUARDING! b/c they do not have any vestibular input and may easily fall
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Why does motion sickness happen?
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b/c of the Sensory conflict theory, the 3 sensory inputs (proprioception, vestibular, and visual info) do not match sotred neural patterns the brain expects to recognize.
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Condition in which there is increased endolymphatic fluid causing distention of the membraneous tissues.
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Meneire's disease
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Decreased visual acuity will negatively impact ______ stability.
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postural
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3 systems involved with balance and postural control?
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visual, vestibular, somatosensory
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muscles activated using the ankle strategy?
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gastroc- hamstrings- paraspinals
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used for small sways near midline of body
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ankle strategy
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used when sway is large , fast and nearing limit of stability
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hip strategy
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muscles activated with hip strategy
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abs, quads, and ant tib
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cranial nerves involved in swallowing?
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5,7,9,10,12
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cranial nerves involved in speaking?
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5,7,10
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tic de la roux, triggered by stimul not considered noxious such as eating and talking, intense pain but sensation is intact
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trigeminal neuralgia
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often resolves in 1-2 months, droopiness in the face, facial paralysis. etc...
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bells palsy (CN 7)
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Tx for Bells palsy?
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tapping, estim, facilitation techs, mirror, facial exercises
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benign tumor on cranial nerve 8
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Acoustic neuroma
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Acoustic Neuroma, unilateral or bilateral lesion?
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unilateral
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Testing of the optic nerve?
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Snellen eye chart and peripheral vision
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pupillary reflex is testing for which cranial nerve?
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optic and oculomotor
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Testing for oculomotor, trochlear, and abducens?
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finger following and convergence
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Testing for trigeminal nerve?
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corneal reflex, facial sensation (sensory) and palpation of masseter (motor)
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Facial nerve testing?
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smile, frown, puff out cheeks, close eyes, raise eyebrows
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testing of vestibulocochlear nerve ?
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vestibular function-balance
cochlear- tuning fork |
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Glossopharyngeal and vagus testing?
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gag reflex and uvula location
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Spinal accessory nerve testing?
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shoulder shrugs and turning of head
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testing for hypoglossal nerve?
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tongue movements
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