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Neuro PT Midterm
Definitions
107
Other
Graduate
10/13/2014

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Term
Hypertonia
Definition
Elevated resting tension in the muscles, draws the body out of normal position
Term
Alert
Definition
the state of being aware, attentive, and mentally functional
Term
Agitated
Definition
the pt is excessively restless, demonstrates increased physical activity and/or mental activity
Term
Delirium
Definition
the state of disorientation accompanied by irritability, agitation, suspicion, and/or fear. The pt may also misperceive stimuli
Term
Demenntia
Definition
the state of altered mental processes that usually does not change arousal
Term
Somnolent
Definition
prolonged drowsiness, a condition that resembles a sleepy trance
Term
Obtundant
Definition
dulled response to stimuli. The pt is typically confused and requires constant stimulation for all activities
Term
Stupor
Definition
the pt is aroused only by intense stimuli. Motor response and reflex reaction are typically preserved
Term
Coma
Definition
defined as unconsciousness without spontaneous eye opening and with minimal or no response to external stimuli
Term
Dysarthria
Definition
difficulty with motor component of speech. They know what they want to say, but they can't get it out
Term
Dysphagia
Definition
Difficulty swallowing
Term
Aphasia
Definition
Inability to communicate
Term
Broca's aphasia (motor, expressive and non-fluent aphasia)
Definition
difficulty with expression of language (verbal and written), ability to understand language and speak preserved, pt may become frustrated but can follow commands
Term
Wernicke's aphasia (receptive aphasia)
Definition
comprehension of language is impaired, production of sound not impaired but output is meaningless, pt will not be able to follow commands
Term
Conduction aphasia
Definition
caused by damaged connection of Wernicke's & Broca's areas, speech and writing impaired but comprehension of both spared
Term
Global aphasia
Definition
inability to use language in any form; usually poor outcome, often caused by large lesion in left hemisphere
Term
Damage to the non-dominant hemisphere(usually right) corresponding to Broca's area causes:
Definition
impaired expression of non-verbal communication with lack of emotional component of speech (facial expressions and gestures)
Term
Damage to the non-dominant hemisphere (usually right) corresponding to Wernicke's area causes:
Definition
Impaired reception of non-verbal communication (may not be able to distinguish between joke "get out of here" and truely meaning for the person to leave)
Damage to the area may also cause neglect/in-attention
Term
Systems included in the systems review
Definition
cardiovascular/pulmonary
musculoskeletal
integument
neuromuscular
communication
endocrine
GI/hepatobiliary
hematologic
Term
Sensation examination areas
Definition
light touch
pain
temperature
vibration
deep pressue/pain
Term
Assessing joint position
Definition
instruct the pt to close their eyes while the examiner passively moves an extremity/joint into a static position, ask the pt to identify the end position.
Start at the distal extremity and move proximally
Term
Assessing movement sense (kinesthesia)
Definition
instruct the pt to close their eyes while passively moving an extremity/joint, ask the pt to describe the motion while the extremity is in motion
the examiner may also instruct the pt to duplicate the movement with the other extremity
Term
Hemianopsia
Definition
loss of half of the visual field
Term
Saccades
Definition
Quick eye position change from one side to the next
Term
Motor Skill
Definition
action or task with a goal
-voluntary movement of body and/or limbs required to achieve the goal
Term
Gross motor skills
Definition
motor tasks that involve large muscle groups and goals that do not require precise movements (running and jumping)
Term
Fine motor skills
Definition
requires control of small muscles to achieve (writing, buttoning, etc. dexterity)
Term
Components of movement
Definition
Task, individual, environment
Term
Reactive movements
Definition
adaptations in response to ongoing feedaback
Term
Proactive movements
Definition
adaptations made in advance of movements; feed forward
Term
CLosed skills
Definition
movements that occur in a fixed environment
Term
OPen skills
Definition
movements in a changing or variable environment
Term
Discrete motor skills
Definition
task has a defined beginning and end
Term
Serial motor skills
Definition
discrete skills are put together in a series
Term
continuous motor skills
Definition
arbitrary beginning and end points
Term
self paced action
Definition
skills initiated at will, typically closed skills
Term
Externally paced action
Definition
skills initiated and dictated by the external environment
Term
Initial mobility
Definition
discrete movements that are not well controlled
Term
Stability
Definition
ability to maintain a steady position in weight-bearing, anti-gravity position
Term
COntrolled mobility
Definition
ability to maintain postural stability while superimposing mobility
Term
SKill
Definition
highly coordinated movement involving adaptability of movements to meet demands of individual and environment
Term
Motor Control
Definition
the ability to regulate or direct the mechanisms essential to movement
Term
Apraxia
Definition
unable to perform tasks or movements when asked, even though they understand the directions asked
Term
Dynamic systems model
Definition
Sensing - Perceiving - interpreting - conceptualization - strategy/plan - activation - execution
Term
Deep Tendon Reflexes (DTR)
Definition
Stimulation if IA afferents of the muscle spindle produces muscle contraction via monosynaptic pathway
Term
Jaw
Definition
CN V
Term
Biceps musculocutaneous nerve
Definition
C5, C6
Term
Brachioradialis radial nerve
Definition
C5, C6
Term
Triceps
Definition
C6, C7
Term
Finger Flexors, median nerve
Definition
C6 - T1
Term
Hamstrings
Definition
L5, S1, S2
Term
Quadriceps, femoral nerve
Definition
L2, L3, L4
Term
Achilles, tibial nerve
Definition
S1, S2
Term
SUperficial Cutaneous Reflexes
Definition
expected response is brief contraction of muscles innervated by spinal segments receiving afferent input
Term
Plantar - superficial cutaneous reflex
Definition
light stroke to sole of foot along lateral border up across ball of foot
Normal response: flexion big toe
Abnormal response: babinski sig
Term
Babinski sign
Definition
extension of great toe and fanning of other toes
UMN
Term
Abdominal - superficial cutaneous reflex
Definition
light stroke on skin over abs should elicit contraction of abs underneath
lack of response may occur with obesity and/or pathology (SCI)
asymmetrical response also sign of either UMN or LMN involvement
Term
Primitive Spinal Reflexes
Definition
flexor withdraw
crossed extension
Grasp reflex
Moro
Startle
Term
Brainstem REflex
Definition
positive supporting reaction
symmetrical tonic labyrinthine reflex (supine)
Tonic labyrinthine reflex (prone)
Symmetrical tonic neck
Asymmetrical tonic neck (ATNR)
Term
Myostatic (stretch) reflex
Definition
Jaw, Biceps, brachioradialis, triceps, finger flexors, hamstrings, quadriceps, achillies
Term
Associated reactions
Definition
UE limb synkinesis
LE limb synkinesis
Homolateral limb synkinesis
Raimiste's phenomena
Souques phenomena
Term
UE Limb synkinesis
Definition
active flexion of one arm may evoke an assocaited reaction of flexion in the other arm, same for extension
Term
LE Limb synkinesis
Definition
Active flexor evokes an extensor pattern in the other let, active extesnion evokes a flexor pattern in the other leg
Term
homolateral limb synkinesis
Definition
active flexion in an arm or leg evokes flexion in the other lomb on the same side of the body
Term
Raimiste's phenomena
Definition
active abduction in uninvolved leg with some resistance applied facilitates abduction in the other leg, same for add
Term
Souques Phenomena
Definition
raising the involved UE about 100 degrees with with elbow extension facilitates extension and abduction of the fingers
Term
Postural control
Definition
controlling the bodies position in space for both stability and orientation
Term
Postural orientation
Definition
the ability to maintain an appropriate relationship between body segments as well as between the body and environment for task completion
Term
Postural stability
Definition
AKA Balance
the ability to control the COM over BOS
Term
Steady state balance
Definition
allows us to remain upright when sitting or standing
Factors contributing:
-alignment
-muscle tone
Term
Steady state control
Definition
Maintenance of COG over BOS during continuously maintained task
-siting
-standing
-walking
-running
Term
feed forward
Definition
postural response made in anticipation of voluntary movement
Term
feedback
Definition
response to sensory feedback from external perturbation
Term
limits of stability
Definition
refers to how far the COM can move outside the BOS before loss of stability
neurocom
Term
Anticipatory balance reactions
Definition
adjustments made to the postural control system in anticipation of planned movements. Required to smoothly move into and out of a steady state
Term
Adaptive balance control
Definition
measures how well a person responds to changes in the environment to maintain balance
Term
Reactive control
Definition
movement strategies in response to perturbations.
Keeps the COM over the COG
Term
MOvement strategies
Definition
Ankle, hip, stepping, suspensory
Term
Examining extremities for impairment in motor performance
Definition
Part I: describing movement and strength
Part II: testing and documenting PROM and tone
Part III: Assessing coordination
Part IV: assess timing of movement/motor control
Part V: consider secondary impairment
Term
involuntary movement impairments
Definition
Abnormal positioning and reflexes (emergence of primitive/developmental reflexes), dystonia, association response (the stereotyped spastic pattern)
Tremor
Choreiform or athetoid movements
Term
Synergistic
Definition
coupling together of a number of joint movements (can be normal or abnormal)
Term
Clonus
Definition
involuntary, repeating, rhythmic muscle contractions
UMN
Term
Voluntary/synergistic
Definition
movement is under voluntary control but joints are coupled. Abnormal stroke synergies, primitive reactions or associated reactions used in function
Term
Voluntary/isolated
Definition
movement is under voluntary control. THe person can move one joint in one direction at a time
Term
Involuntary/synergistic
Definition
movement occurs without conscious command. Stereotypical abnormal patterns.
Term
involuntary/isolated
Definition
ataxic tremors, alien hand syndrome, stretch reflex
Term
Brunnstrom's Stroke Theories
Definition
Uses primitive synergistic patterns that emerge post stroke by improving motor control through central facilitation.
Term
Brunnstrom Stage 1
Definition
flaccidity (immediately post onset)
No voluntary movements on the affected side can be initiated, absence of tone
Term
Brunnstrom Stage 2
Definition
Spasticity developing.
Association reactions present. Some voluntary movements in synergies.
Term
Brunnstrom Stage 3
Definition
Patient gains voluntary control over synergies. Increased spasticity, can move limb 1/3 ROM voluntarily
Term
Brunnstrom Stage 4
Definition
Voluntary movement available.
Starting to move out of synergy, spasticity starts to decrease
Term
Brunnstrom stage 5
Definition
synergy loses dominance.
Movement is more out of synergy
Term
Brunnstrom Stage 6
Definition
Isolated movement is available.
No spasticity is readily evident but may emerge with stress, coordination is near normal.
Term
Brunnstrom Stage 7
Definition
normal function is restored.
normal speed, strength and coordination
Term
Monoparesis/monoplegia
Definition
one leg or arm
Term
Paraparesis/paraplegia
Definition
both legs
Term
Hemiparesis/hemiplegia
Definition
one arm and one leg on either side of the body
Term
Diparesis/diplegia
Definition
symmetrical parts of the body
ie: 2 arms or 2 legs
Term
Tetraparesis/tetraplegia
Definition
all four limbs
Term
Scales that describe movement following neurologic impairment
Definition
The Fugi-meyer Physical PerformanceBattery assessment (FMA), Wolf Motor function test, Motor Assessment scale, Rivermead stroke assessment, Stroke Rehabilitation Assessment of Movement (STREAM), and Chedoke-McMaster Stroke Assessment
Term
Ataxia
Definition
Jerky movements
Term
Action Tremor
Definition
tremor that increases with movement (aka inattention tremor)
Term
Dysmetria
Definition
over or undershooting a target, unable to move the precise distance required to locate a target
Term
Dysdiadochokinesia
Definition
Impaired ability to complete rapid alternating movements
Term
Asthenia
Definition
Lack of strenght
Term
Hypotonia
Definition
Abnormally low tone, flaccidity resulting in movement limitations
Term
Dysynergia
Definition
inability to coordinate voluntary muscle movements
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