Term
| what are the various systems that are involved in maintaining a stable posture (4) |
|
Definition
| vestibular, visual, sensory, musculoskeletal |
|
|
Term
| what are the nervous system components that are involved in maintaining a stable posture (3) |
|
Definition
| vestibular nuclei, oculomotor nuclei, cerebellum |
|
|
Term
| 3 roles of the cerebellum |
|
Definition
| anticipatory, feedback, learning |
|
|
Term
| repetitive practive in varied environments will influence the CPG's. which role of the cerebellum? |
|
Definition
|
|
Term
| did you miss the golf ball? let's give you a bigger ball or a weighted club. these are examples of providing what to the cerebellum? |
|
Definition
|
|
Term
| attempting to pick up a box filled with books but its only filled with air results in you almost falling. which role of the cerebellum prepares you to pick up the box |
|
Definition
|
|
Term
| the ability to hold the body uprigth in opposition to gravity trying to pull us down |
|
Definition
|
|
Term
| Parts of the musculoskeletal system needed to maintain balance (3) |
|
Definition
| AROM, Strength, and Core muscles |
|
|
Term
| somatosensation includes what 5 sensations |
|
Definition
| localization, proprioception, vibration, pain, and temp |
|
|
Term
| somatosensation: patient being able to indicate where you are touching them |
|
Definition
|
|
Term
| somatosensation: patient being able to match the movement of one limb with the other |
|
Definition
|
|
Term
| components of ocular motility for balance (5) |
|
Definition
| smooth pursuits, saccades, convergence, visual field, dynamic visual acuity |
|
|
Term
| ocular motility: how does one test smooth pursuits |
|
Definition
|
|
Term
| ocular motility: how does one test for saccades |
|
Definition
| looking back and forth between the fingers of the PT |
|
|
Term
| ocular motility: how does one test for convergence |
|
Definition
| ptnt focuses on PT's finger. PT bring's their finger to ptnt's nose and asks when double vision occurs. 6 cm is normal |
|
|
Term
| ocular motility: how does one test for visual field |
|
Definition
| which section of the visual field is missing |
|
|
Term
| loss of fixation during vestibuloocular testing indicates what |
|
Definition
| interruption of signals within the brainstem |
|
|
Term
| failing to fixate during the VOR may also be accompanied by these S/S |
|
Definition
| increased dizziness, oscillopsia |
|
|
Term
| what does the Hallpike test for |
|
Definition
| benign paroxysmal postional vertigo |
|
|
Term
| how is benign paroxysmal positional vertigo |
|
Definition
|
|
Term
| how is balance assessed in a functional perspective |
|
Definition
| sitting, standing, static, dynamic, while observing for duration, LOB, hand support |
|
|
Term
| other diagnostic tests used in balance dysfunction (5) |
|
Definition
| posturography, platform, calorics, electronystagmography, videonystagmography |
|
|
Term
| using calorics to test for balance assess what exactly? |
|
Definition
| unilateral vestibular loss |
|
|
Term
| Clinical Test for Sensory Interaction in balance |
|
Definition
| Rhomberg test on/off foam |
|
|
Term
| test which assesses balance while walking variably (changing speed, changing direction of gaze, stepping over objects, stairs) |
|
Definition
|
|
Term
|
Definition
| berg balance, tinettti, fuduka stepping, postural stress test |
|
|
Term
| test in which ptnt marches in place with arms out, if ptnt veers the test is positive |
|
Definition
|
|
Term
| of the 4 named balance tests which is the only one which tells you the underlying impairment |
|
Definition
|
|
Term
| during teh postural stress test, a drop of how many mmHg would indicate postural hypotension |
|
Definition
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness CNS (10) |
|
Definition
| migraine, head truma, brain-stem stroke, vertebrobasilar insuffiency, cerebellar degeneration, MS, CN involvement, coordination testing, spasticity, hyperreflexia |
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness: CNS: migraines could exhibit what symptoms? migraines could be a result of what? |
|
Definition
| dizziness, neck/posturla issues |
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness CNS: Examples of head trauma |
|
Definition
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness CNS S/S of cerebellar degeneation |
|
Definition
| ataxia, coordination deficits |
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness CNS: issues associated with MS |
|
Definition
| vestibular ocular issues, regular motility issues, cerebellar issues |
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness PNS: 7 disorders |
|
Definition
| BPPV, vestibular neuritis, Meniere's Disease, Endolymphatic Hydrops, Perilymphatic fistula, vestibular paroxysmia, bilateral vestibular disorders |
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness PNS: disorder in which one side of teh vestibular nerve is inflammed |
|
Definition
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness PNS: 2 disorders in which there is a problem with the fluid of the inner ear |
|
Definition
| meniere's disease, endolymphatic hydrops |
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness PNS: disorder which PT's do not treat |
|
Definition
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness PNS: disorder in which there is a tear in the oval/round window |
|
Definition
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness PNS: disorder in which there is interrupted blood supply to the nerve in the inner ear and is very difficult to diagnose |
|
Definition
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness PNS: unilateral vestibular disorders cause what symptom |
|
Definition
|
|
Term
| Pathologic conditions that contribute to imbalance, disequilibrium, or dizziness PNS: bilaterael vestibular disorderes caused what sign |
|
Definition
|
|
Term
| 5 PT diagnoses for balance issues |
|
Definition
| gait dysfunction d/t imbalance, BPPV, hypofunctioning unilateral, hypofuncitoning bilatereal, CNS imbalance, Cervicogenic vertigo |
|
|
Term
| vestibular ocular communcation goes through what nervous system structure |
|
Definition
| medial longitudinal fasiculus |
|
|
Term
| a cerebellar lesion would have these types of s/s |
|
Definition
| low tone, hypotonic, d/t cerebellar influence on vestibular/ocular control |
|
|
Term
| how to train OM deficits? |
|
Definition
| perform tests as exercises but with decreased rate, distance, time |
|
|
Term
|
Definition
| coordination deficit characterized by over reaching, staggering/drunken gait, intention tremor, dysmetria |
|
|
Term
| when testing coordination, what is the most important thing to test first |
|
Definition
| whether strength is at least 3/5 |
|
|
Term
| what are the 3 theories on how the cerebellum function (what role does it play for movement) |
|
Definition
| anticipation, motor learning, feedback |
|
|
Term
| term to describe general weakness |
|
Definition
|
|
Term
| term to describe low tone |
|
Definition
|
|
Term
| poor articulation of muscles and mouth, difficulty talking |
|
Definition
|
|
Term
|
Definition
|
|
Term
| when multiple joints need to move together but don't move cohesively, resulting in a slow delayed movement |
|
Definition
|
|
Term
| ability of the cerebellum to turn on/off the antagonist of the muscle |
|
Definition
|
|
Term
| difficulty performing rapid/alternating movements |
|
Definition
|
|
Term
| coordination is tested in 4 main movement capabilites. what are they |
|
Definition
| reciprocal motion, movement composition, movement accuracy, fixation/postural holding |
|
|
Term
| examples of reciprocal motion |
|
Definition
| supination to pronation, toe tapping |
|
|
Term
| examples of movement composition |
|
Definition
| sequencing multiple joints in one extrimty or moving both UE's together thru ROM |
|
|
Term
| examples of movement accuracy |
|
Definition
| absence of dysmetria, intention tremor |
|
|
Term
|
Definition
| proximal holding for stability to complete distal tasks |
|
|
Term
| 3 assumptions to being able to test coordination |
|
Definition
| isolated selective movements are possible, adequate strength, adequate ROM |
|
|
Term
| when testing for coordination, if there is adequate strength then there is adequate ____ |
|
Definition
|
|
Term
| another factor to test in coordination |
|
Definition
| speed, ability of the ptnt to do the activity in a normal period of time and then also at an increased rate |
|
|
Term
| basal ganglia problems include (8) |
|
Definition
| bradykinesia, rigidity, tremor, akinesia, chorea, athetosis, hemiballismus, dystonia |
|
|
Term
| dorsal column lesion problems include (6) |
|
Definition
| proprioceptive loss, WBOS in stance and gait, dysmetria, balance problems, equilibrium problems, slowing of voluntary movements |
|
|
Term
| clinical tests to determine if coordination is intact (7) |
|
Definition
| finger to nose self x5, finger to nose and PT's finger x5 c variable speed, drawing numbers/alphabet with fingers/toes, heel to shin/ankle c/s contact, tracking test, writing, gross movement patterns, rapid alternating movements |
|
|
Term
| 6 standardized tests to determine if coordinationt is intact |
|
Definition
| fitt's tapping test, frenchay arm test, rivermead etst, peg tests, box and blocks test, jebsen hand function |
|
|
Term
| ataxia in which the ptnt walks with a broad BOS and throwing out feet which come down first on the heel and then on the toes with a slapping sound (double tap). Ptnt's watch feet while walking. Gait may appear normal with eyes open, but with eyes closed ptnt may stagger, be unstead, or unable to walk |
|
Definition
|
|
Term
| ataxia in which gait deviation is equally severe with eyes open or closed. gait is wide-based, unsteady, or irregular. Ptnt staggers and is unable to walk tandem or to follow a straight line. |
|
Definition
|
|
Term
| if the cerebellar lesion is localized to one hemisphere which side with the ptnt persistently deviate/sway to? |
|
Definition
|
|
Term
| sensory information is carried to higher centers for integration of the information via what? |
|
Definition
|
|
Term
| sensory information is carried to higher centers for integration of the information via the dorsal columns, more specifially what 2 pathways |
|
Definition
| medial lemniscal system, anterolateral spinothalamic tract |
|
|
Term
| what is carred in the dorsal column medial lemniscal system |
|
Definition
| touch, proprioception, kinesthesia |
|
|
Term
| how do we test if the medial lemnisical system is intact |
|
Definition
| localization, proprioception |
|
|
Term
| what sensations are carred on the anterolateral spinothalamic tract |
|
Definition
| pain and temp, light touch |
|
|
Term
| how do we test if the anterolateral spinothalamic tract is intact |
|
Definition
| test for temperature, light touch, and pain |
|
|
Term
| What does the spinocerebellar tract carry and how do we test the integretiy of this tract |
|
Definition
| fine coordination of posture and kinesthetic sense of limbs |
|
|
Term
| many ptnts with perceptual deficits have a lesion of what lobe primarily? and secondarily? |
|
Definition
|
|
Term
| frontal lobe is involved with what processes (6) |
|
Definition
| planning, abstract reasoning, foresight, premotor cortex, supplemental motor cortex, primary motor cortex |
|
|
Term
| frontal lobe lesion problems include (11) |
|
Definition
| problems in starting, problems in stopping, difficulties inmaking mental or behavioral shifts, lack of self awareness, concrete thinkig problems, memory loss, lack of attention, distractibility, diplopia, homononymous hemianopsia and aphasia |
|
|
Term
| Frontal Lobe Lesions: patients with problems in starting will appear |
|
Definition
|
|
Term
| Frontal Lobe Lesions: patients who present with problems in stopping will appear |
|
Definition
| impulsive, habitual, continually forgets to lock w/c |
|
|
Term
| Frontal Lobe Lesions: patients who present with diffiuclties in making mental or behavioral shifts will appear |
|
Definition
|
|
Term
| Frontal Lobe Lesions: patients who lack self awareness will do this |
|
Definition
| not recognize their own errors |
|
|
Term
| Frontal Lobe Lesions: patients who have a problem with concrete thinking will appear as if they... |
|
Definition
| lack insight, take everything at face value |
|
|
Term
| Frontal Lobe Lesions: which types of memory loss |
|
Definition
| short-term or immediate recall |
|
|
Term
| these deficits can influence motor performance |
|
Definition
|
|
Term
| ability to organize, process, and interpret incoming visual, tactile-kinesthetic or both in order to act appropriately based on the information received |
|
Definition
|
|
Term
| a patient presents with problems in perception, the lesion is most likely located where? |
|
Definition
|
|
Term
| 4 types of perception deficits |
|
Definition
| figure-ground, depth perception, spatial relations, position in space |
|
|
Term
| describe figure-ground deficit |
|
Definition
| can't differentiate a white shirt on unmade bed, spoon in a crowded drawer |
|
|
Term
| describe depth perception deficit |
|
Definition
| inability to correctly determine relative distane between objects, surfaces |
|
|
Term
| describe spatial relations deficit |
|
Definition
| problem with spatial orientaiton of objects, such as navigating a w/c through a doorway |
|
|
Term
| describe position in space deficit |
|
Definition
| unable to understand in/out, up/down, front/back |
|
|
Term
| 5 other perceptual dysfunctions |
|
Definition
| topographical disorientation, somatognosia, unilateral neglect, visual/tactile agnosia, dressing ideomotor and ideational apraxia |
|
|
Term
| describe topographical disorientation |
|
Definition
| inability to understand and remember relationships of places to one and other, directions |
|
|
Term
|
Definition
| lack of awareness of body structure and recognize own body parts, right, left discrimination |
|
|
Term
| describe visual and tactile agnosia |
|
Definition
| inability to recognize objects, visually or with touch |
|
|
Term
| describe dressing, ideomotor, and ideational apraxia |
|
Definition
| inability to carry out purposeful movement on command and more serious can't perform sequenced motor tasks, problems in planning movement and initiating |
|
|
Term
| S/S of lesion in left hemisphere (5) |
|
Definition
| aphasia, ideomotor and ideational apraxias, number alexia, right-left discrimination, slow in organizaiton and performance |
|
|
Term
| Left hemisphere lesion: aphasia example |
|
Definition
|
|
Term
| Left hemisphere lesion: ideomotor and ideational apraxias example |
|
Definition
| can not plan and execute serial steps in performances |
|
|
Term
| Left hemisphere lesion: number alexia example |
|
Definition
| can not recognize symbols to do simple computations |
|
|
Term
| Left hemisphere lesion: sow in organizaiton and performance examples |
|
Definition
| can not remember what they intended to do next |
|
|
Term
| A lesion of the right hemisphere would result in these clinical problems (9) |
|
Definition
| visuospatial, left unilateral neglect, body image, dressing apraxia, constructional apraxia, illusions of shortening of time, number concepts/spacial type, rapid organization and performance, depth of language skils |
|
|
Term
| Right hemisphere lesion: visuospatial clinical example |
|
Definition
| cannot orient self to changes in environment in moving from place to place |
|
|
Term
| Right hemisphere lesion:left unilateral neglect clinical example |
|
Definition
| unaware of objects to the left, could self propel w/c into them |
|
|
Term
| Right hemisphere lesion: body image clinical examples |
|
Definition
| distorted awareness and impression of self |
|
|
Term
| Right hemisphere lesion: dressing apraxia clinical example |
|
Definition
| applies sweater to r but unable to do left side |
|
|
Term
| Right hemisphere lesion: constructional apraxia |
|
Definition
| can't transpose 2-d to 3-d |
|
|
Term
| Right hemisphere lesion: illusion of shortening of time clinical examples |
|
Definition
|
|
Term
| Right hemisphere lesion: number concepts/spatial type clinical examples |
|
Definition
| unable to align columns and rows of digits |
|
|
Term
| Right hemisphere lesion: rapid organization and perforamnce |
|
Definition
| errors from haste, may cause accidents |
|
|
Term
| Right hemisphere lesion: depth of language skills clinical examples |
|
Definition
| may mention task related to prestroke occupation but cannot go into details of it |
|
|
Term
| genu recurvatum is thought to be weakness of what |
|
Definition
| gastroc weakness concentrically, gastroc weakness eccentrically, quadsd |
|
|
Term
| which CVA more likely to have sensory loss but decent motor |
|
Definition
|
|
Term
| which CVA is more likely to have motor loss but decent sensory |
|
Definition
|
|
Term
| the lesion which results in pusher's syndrome is thought to be located where |
|
Definition
|
|
Term
| what connections does the cerebellum have with the spinal cord? |
|
Definition
| sensory only via spinocerebellar tract |
|
|
Term
| oldest part of cerebellum |
|
Definition
|
|
Term
| the vermis of the cerebellum is responsible for what in terms of balance/coordination |
|
Definition
| trunk alignment, midline perception |
|
|
Term
| difficulties with alignment/midline perception may also be demonstrated as what non-cerebellar issues |
|
Definition
| sensory-perceptual deficits |
|
|
Term
| how does the vestibular system communicate with the ocular system |
|
Definition
| medial longitudinal fasiculus |
|
|
Term
| cerebellar lesion presents with what symptoms |
|
Definition
| low tone, hypotonic d/t cerebellar influence on vestibular/ocular control |
|
|
Term
| Lesion of which hemisphere: aphasia |
|
Definition
|
|
Term
| Lesion of which hemisphere: ideomotor and ideational apraxias |
|
Definition
|
|
Term
| Lesion of which hemisphere: number alexia |
|
Definition
|
|
Term
| Lesion of which hemisphere: right left discrimination |
|
Definition
|
|
Term
| Lesion of which hemisphere: slow in organization and performance |
|
Definition
|
|
Term
| Lesion of which hemisphere: visuo-spatial |
|
Definition
|
|
Term
| Lesion of which hemisphere: left unilateral neglect |
|
Definition
|
|
Term
| Lesion of which hemisphere: body image |
|
Definition
|
|
Term
| Lesion of which hemisphere: dressing apraxia |
|
Definition
|
|
Term
| Lesion of which hemisphere: construcitonal apraxia |
|
Definition
|
|
Term
| Lesion of which hemisphere: illusions of shortening of time |
|
Definition
|
|
Term
| Lesion of which hemisphere: number concepts/spatial type |
|
Definition
|
|
Term
| Lesion of which hemisphere: rapid organization and performance |
|
Definition
|
|
Term
| Lesion of which hemisphere: depth of language skills |
|
Definition
|
|
