Term
|
Definition
-Do NOT require balance
-Preform with eyes open then eyes closed
Ex: finger to nose, finger to finger, mass grasp, rebound test, etc |
|
|
Term
|
Definition
-patient holds a position where a slight change of COG occurs
Ex: Standing (EO/EC), standing with feet together, tandem stance, unilateral standing, alter arm position in standing, etc |
|
|
Term
| Dynamic equilibrium tests |
|
Definition
-testing in motion
Ex: marching in place,walking tandem, walking a line, waltering walking speed, walk in a circle, walk and pivot, stair climbing, agility activities, etc |
|
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Term
|
Definition
-number of extremities involved
-distrobution(proimal/distal)
-situation that alter coordination/balance
-amount of time to perform
-level of safety
-history of falls |
|
|
Term
| A pt comes in and you conclude that the pt has hypertonia. You find though testing that their hypertonia increases at increased speeds. What type of Hypertonia to they show signs of? |
|
Definition
|
|
Term
| A pt comes to you with hypotonia and you check thier UE reflexes. What do you expect to find? |
|
Definition
| There will be a decrease in DTRs (0, 1+ range on your tonal examination) |
|
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Term
| A pt comes to you and they go to shake you hand and miss. You begin by performing nonequilibrium tests. The pt has trouble putting thier finger to their nose. What would you call this characteristic? |
|
Definition
|
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Term
| A patient comes to you with a CNS disorder. During your examination, you decide to do that Babinski reflex test. If the test was abnormal what would you expect to find? |
|
Definition
Abnormal: Extension of great toe, abduction of toes or fanning of the lateral four toes
(Normal: Flexion and aadduction of toes) |
|
|
Term
|
Definition
The resistance to of a muscle to passive stretch
May be due to
-physical inertia
-intrinsic mechanical-elastic stiffness of muscle and connective tissue
-reflex muscle contraction |
|
|
Term
|
Definition
|
|
Term
|
Definition
Hypertonia.
Increased muscle tone at increased speeds |
|
|
Term
|
Definition
Hypertonia.
Initial increased resistance then no resistance |
|
|
Term
|
Definition
Hypertonia.
Involuntary muscle contractions and relaxations |
|
|
Term
|
Definition
Similar amount of hypertonia at all speeds
-cogwheel
-leadpipe
-decerebrate (ext. of all extremities) [brain stem]
-Decorticate (UE flexed, LE extrended) [separated cortex from rest of system] |
|
|
Term
|
Definition
Decreased muscle tone
-decreased DTRs
-may appear weak
Flaccidity |
|
|
Term
|
Definition
Sustained muscle contractions that result in twisted movements and abnormal posture
-segmental/focal
- hemidystonia
-generalized
Subclassified
-Action induced
-Posture induced |
|
|
Term
|
Definition
| SCM contracts resulting ins lateral flex. And rotation to the opposite side |
|
|
Term
| Barry Albright dystonic scale |
|
Definition
How much time (hours in a day)
Measures 6 body parts –eyes, mouth, neck, trunk, UE and LE
0-NORMAL
1-Slight (<10 %)
2-Mild (<50%)
3-Moderate (>50 % and/or INTERFERES with normal positioning/functioning)
4-Severe (>50% and/or PREVENTS with normal positioning/functioning) |
|
|
Term
|
Definition
0-No response, flaccid
1-Decreased response, hypotonia
2-NORMAL
3-Exaggerated response, mild to moderate hypertonia
4-Sustained response, severe hypertonia |
|
|
Term
|
Definition
For Spasticity
Test muscle at different speeds |
|
|
Term
|
Definition
0 - No increase in tone, NORMAL
1 - Slight increase, catch and release
1+ - slight increase, initial catch followed by minimal resistance through partial range
2 – increased tone throughout most ROM
3 - increased tone, PROM difficult
4 - Rigid in ext. or flex. |
|
|
Term
|
Definition
| Tardieu scale – more objective, tested at three speeds (slow, speed of gravity, fast) and based on 2 factors – quality and angle of catch |
|
|
Term
|
Definition
Pendulum test
-assess spasticity
Drop Arm Test
-Used to test integrity of automatic proprioceptive reactions as limb falls |
|
|
Term
| Factors that influence tone (7) |
|
Definition
-Position and interaction with tonic reflexes
-Stress and anxiety
-Volitional effort and movement
-Medications
-State of CNS arousal
-Environmental Temperature
-General health
-fever, infection, metabolic/electrolyte imbalance |
|
|
Term
|
Definition
Normal: no reaction to neck extension/flexion
Abnormal: neck extends(arms extend and legs flex) or neck flexion(arms flex and legs extend) |
|
|
Term
|
Definition
| Serve to maintain body alignment and/or orientation to the environment |
|
|
Term
|
Definition
| When center of mass moves too far beyond base of support |
|
|
Term
|
Definition
Attempt to maintain center of mass over base of support
-lifting versus postural fixation |
|
|
Term
|
Definition
Defined as the stability produced on each side of a vertical axis: COM over BOS
-acheived using multiple CNS inputs/outputs
--Assessed using standardized tools or observation of functional activities |
|
|
Term
|
Definition
Definition: Ability to execute smooth, accurate, controlled movements
-deficits are often related to CNS disorders |
|
|
Term
|
Definition
| Inability to make smooth, accurate coordinated movements |
|
|
Term
|
Definition
| Disturbance in distance or range of movement |
|
|
Term
|
Definition
| Involuntary, slow, twisting, writhing, continuous movements especially seen in distal parts of extremities and perioral area |
|
|
Term
|
Definition
| Involuntary, abrupt, rapid, bried, unsustained, arhymical random movements |
|
|
Term
|
Definition
rythmical oscillating movements
2-4Hz (cerebral disease)
4-5Hz (Parkinson's)
6-12Hz (postural when body is held against gravity) |
|
|
Term
|
Definition
(Simple or Complex)
repetitive, stereotyped, involuntary movements that occur randomly |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Inability to perform rapidly alternating movements |
|
|
Term
|
Definition
-Finger to nose
-Finger to finger
-Rebound test
-Heel to shin
-Alternate heel to knee, heel to toe
-Drawing circle |
|
|
Term
Coordination Examinations
(5 main areas of assessment) |
|
Definition
-Alternate or reciprocal movement
-Movement synergy/composition
-Movement accuracy
-Fixation or limb hooking
-Equilibrium and posture holding |
|
|
Term
| Superficial cutaneous reflexes |
|
Definition
| examples: plantar (Babinski's), Chaddock's (Babinski's with LE flexion), and abdominal |
|
|
Term
|
Definition
| flexor withdrawal and crossed extension |
|
|
Term
|
Definition
-Begin at T7 and test each dermatome down to T12
-Normal response is contraction of abdominals with umbilical deviation toward the stimulus |
|
|
Term
| Plantar or Babinski reflex |
|
Definition
-pressure is firm but not painful
-Normal response: flexion and adduction of toes, can be accompanied by hip and knee flexion |
|
|
Term
|
Definition
| abnormal resonse to Babinski reflex test. Extension of great toe along with abduction or fanning of lateral four toes. |
|
|
Term
|
Definition
-Tonic Labyrinthine
-symmetrical or asymmetrical Tonic neck |
|
|
Term
| Tonic labyrinthine (prone) |
|
Definition
-Normal repsonse (negative): no increase in flexor tone
-abnormal response (positive): unable to extend head, trunk, arms or legs or retract shoulders |
|
|
Term
| Tonic labyrinthine (supine) |
|
Definition
-Normal response (negative): no increase in extensor tone
-Abnormal response (positive): unable to flex head, trunk, arms, or legs |
|
|
Term
|
Definition
-Normal response: no reaction to head rotation
-abnormal response: extension on face side or increase in extensor tone, flexion on skull side or increase in flexor tone |
|
|
Term
|
Definition
-Normal response: no reaction to neck extension/flexion
-Abnormal response: -neck extends and arms extend or increase in extensor tone and legs flex or increase in flexor tone - or neck flexes and arms flex or increase flexor tone and legs extend or increase extension tone |
|
|
Term
|
Definition
-Normal response: no reaction to neck extension/flexion
-Abnormal response: -neck extends and arms extend or increase in extensor tone and legs flex or increase in flexor tone - or neck flexes and arms flex or increase flexor tone and legs extend or increase extension tone |
|
|
Term
Neurological Exam
Components-1 to 7 |
|
Definition
There were 15 components of a neuro exam given in lecture.
The first 7 are:
Neurological history
Cognition
Communication
Mental status
Sensation
Perception
Muscle tone |
|
|
Term
Neurological Exam
Components-8 to 15 |
|
Definition
There were 15 components of a neuro exam given in lecture.
The last 8 are:
Strength
Reflexes
Cranial nerves
Movement patterns
Balance
Coordination
Gait
Functional abilities |
|
|
Term
Neurological Exam
Components-History |
|
Definition
Disturbance of consciousness
Seizures
Headaches
Altered vision
Tinnitus
Vertigo, dizziness
Nausea, vomiting
Weakness, stiffness
Paresthesias
Disturbances in bowel & bladder
control
Speech disorders
Incoordination |
|
|
Term
Neurological Exam
Components-Cognition |
|
Definition
Exam for Cognition includes
– memory
judgement
attention span |
|
|
Term
Neurological Exam
Components-Communication |
|
Definition
Exam for Communication includes
articulation deficits
receptive/expressive language disorders
(ex Aphasia/Dsyphasia) |
|
|
Term
Neurological Exam
Components-Mental Status |
|
Definition
Exam of mental status includes
Orientation (to familiar or current environment)
– Attention and state of consciousness |
|
|
Term
Neurological Exam
Components-Examination of Mental Status |
|
Definition
Two common instruments are:
MiniMental State Exam (MMSE)
• <24 cognitive impairment
• <20 dementia/affective disorder
• sensitivity .91
specificity .92
– Mini-Cog (repeat 3 items, clock drawing, recall 3 items)
sensitivity .99/specificity .93 |
|
|
Term
Neurological Exam
Components-Sensation |
|
Definition
Protective Sensation
– pain
– temperature
light touch
crudely localized touch
Discrimatory
– vibration
– proprioception
-stereognosis
– barognosis
– graphesthesia
– texture
– 2 point discrimination |
|
|
Term
Neurological Exam
Components-Perception |
|
Definition
– body scheme/image
– spatial relations
– agnosias-The inability to recognize and identify objects or persons previously known.
– apraxias-loss of the ability to execute learned purposeful movements, despite having desire and the physical ability to do so.
• ideomotor-inability to carry out a motor command
• ideational-inability to create a plan for or idea of a specific movement
ex. 'pick up this pen and write your name' |
|
|
Term
Neurological Exam
Components-Tone |
|
Definition
Examination for Tone includes:
Observation
– At rest and during movement
Palpation (consistency)
Passive movement
– Changing speed and performing reversals
Deep tendon reflexes (DTRs) |
|
|
Term
Neurological Exam
Components-Tone-DTRs |
|
Definition
Deep Tendon Reflexes (DTRs) reaveal information about the nerves that control the muscle and tendon tested.
– jaw (trigeminal nerve)
– biceps (C 5)
– brachioradialis(C 6)
– triceps (C 7-8)
– patellar (L 2-4)
– ankle (S 1-2) |
|
|
Term
Neurological Exam
Components-Tone-DTRs-Tendon/Nerve relationships |
|
Definition
– jaw (trigeminal nerve)
– biceps (C 5)
– brachioradialis(C 6)
– triceps (C 7-8)
– patellar (L 2-4)
– ankle (S 1-2) |
|
|
Term
Neurological Exam
DTRs-Tendon/Nerve relationships
JAW |
|
Definition
|
|
Term
Neurological Exam
DTRs-Tendon/Nerve relationships
Biceps |
|
Definition
| C5 (Root of musculocutaneous nerve) |
|
|
Term
Neurological Exam
DTRs-Tendon/Nerve relationships
Brachioradialis |
|
Definition
|
|
Term
DTRs-Tendon/Nerve relationships
Triceps |
|
Definition
|
|
Term
DTRs-Tendon/Nerve relationships
Patella |
|
Definition
|
|
Term
DTRs-Tendon/Nerve relationships
Ankle |
|
Definition
|
|
Term
Neurological Exam
Components-Tone-DTRs-Scoring |
|
Definition
• 0 = no response
• 1+ = decreased response
• 2+ = normal response (slight muscle
contraction with slight movement)
• 3+ = exaggerated response (brisk muscle contraction with moderate joint movement
• 4+ = clonus (1-3 beats)
• 5+ = sustained clonus |
|
|
Term
Neurological Exam
Components-Tone-DTRs-Clonus definition |
|
Definition
| a rhythmic series of alternating contractions and partial relaxations of a muscle that in some nervous diseases occurs in the form of convulsive spasms. Results from alteration of the normal pattern of motor neuron discharge |
|
|
Term
| Neurological Exam Components-Tone-DTRs-Charting |
|
Definition
Charting of DTRs is done graphically:
[image] |
|
|
Term
Neurological Exam
Components-Muscle Tone |
|
Definition
Muscle tone can be indicated by
Appearance
– atrophy
– pseudohypertrophy
– fasciculations
Flexor or extensor spasms |
|
|
Term
Neurological Exam
Components-Muscle Tone-Definition |
|
Definition
| Definition: the resistance of muscle to passive stretch |
|
|
Term
Neurological Exam
Components-Muscle Tone-Causes |
|
Definition
may be due to
– physical inertia
– intrinsic mechanical-elastic stiffness of muscle and connective tissue
– reflex muscle contraction |
|
|
Term
Neurological Exam
Components-Muscle Tone-Categories |
|
Definition
– hypertonia
– hypotonia
– dystonia |
|
|
Term
| you are treating a child who when laying supine and turns his head to the right to look at you, the right side of his body goes into extension, and his left into flexion. what implications would this have on your treatment for him? |
|
Definition
| the child is exhbiting ATNR (asymetric tonic neck reflex) and this would hinder you teaching him how to roll. |
|
|
Term
| you are conducting a neuro exam with a pt and they report that a few weeks ago there were a few times that they just couldn't speak when then wanted to, but it passed so they aren't worried about it. upon further exam you find that they also have weakness, what might this pat be exhibiting early sxs of? |
|
Definition
| TIA's of "brain attacks" weakness, and periods of being unable to talk that pass are the first two signs |
|
|
Term
| you are seeing a pt in your clinic and you have very limited time but you want to administer a congition test, which one would you choose? |
|
Definition
| mini-cog, it is quicker than the mini-mental |
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|
