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Neuro BNB
| Question | Answer |
|---|---|
| What are the 9 mvt tests in the Motor Assessment Scale? | 1. Supine to side lying 2. Supine to sitting over side of bed 3. Balanced sitting 4. Sitting to standing 5. Walking 6. Upper arm Fx 7. Hand mvts 8. Advanced Hand activities 9. General tonus |
| What i the scoring system for the MAS? And instructions for attempts? | 0-6 (6 best) Repeat 3 x attempts with best attempt taken. |
| What are 7 possible motor and non-motor impairments that may limit mvts besides muscle weakness? | 1. ROM of jt or muscle 2. Tone - spasticity of a muscle 3. Pain 4. Sensory loss 5. perceptual loss (R CVA) L) hemiparetic pt may have inattention or neglect 6. Receptive loss (L CVA) R) hemiparetic pt may not understand command 7. Apraxia L CVA |
| What are some clinical presentations for a L) middle Cerebral artery (mid frontal + Parietal lobes) | Aphasia, R weakness, R sensory loss, R sided vision loss in both eyes, and dysphagia and apraxia |
| What are some clinical presentations for a R) middle Cerebral artery (mid frontal + Parietal lobes) | L weakness, L sensory loss, L vision loss in both eyes, dysphagia and neglect |
| what is the difference between apraxia, ataxia and neglect? | Apraxia (parietal/frontal lobe) = can't perform purposeful actions despite having strength and coordination Ataxia (in cerebellum) = Movements are clumsy, inaccurate or unsteady Neglect (parietal) = Person ignores one side of their body |
| What are some clinical presentations for an anterior Cerebral artery (frontal pole and medial aspect of frontal and parietal lobes) | Contralateral sided weakness and sensory loss |
| What does the acronym ORDER stand for? | Observe - Prepare/position Request - Engage/ask Direct/demonstrate - Visual/Auditory Enhance - Tactile/proprioception Replace - Stabilisation/faciliatation |
| What are some primary and secondary motor impairements after stroke? | • Loss of strength (upper motor neurone) • Spasticity • Altered co-ordination Secondary: • Disuse weakness • Contracture / decreased length • Increased muscle stiffness • Joint and body system based extras |
| Why do we have loss of strength in neurological conditions? | • Loss / Altered of descending activation pathways • Altered Sensory pathway activation • Lack of activation and Excessive activation |
| What systems do our main sensory info come from? | - Visual - somatosensory - vestibular system |
| Hypertonus includes two impairments, what are these? | • Spasticity: velocity dependent increase in the tonic stretch reflex • Contracture: an increase in resistance to passive stretch as a result of changes in the passive mechanical properties of the muscle. |
| What is the Tardieu Scale? | A scale that is used to differentiate between contracture from spasticity |
| What does the V1-3 stand for? | As slow as possible Speed of the limb segment falling As fast as possible (>natural drop) |
| What are the 2 distinguishable cerebellar syndromes? | Midline/vermis (ocular/trunk): Imbalance, lower tone, nystagmus, poor pursuit Hemispheric cerebellar syndromes (arms/legs): into-ordination of limbs, intention tremor, may be dysarthric |
| What does the PICA supply and what are some symptoms of stroke | - Posterior + Medulla Swallowing + sensory problems + vertigo |
| What does the AICA supply and what are some symptoms of stroke | Ear artery Hearing loss + facial weakness + vertigo |
| What does the SCA supply and what are some symptoms of stroke | Superior = Skilled movement Limb coordination problems |
| What are some things to observe for in disco-ordinated movements? | - Speed - Amplitude - Accuracy - smoothness - ability to follow sequence |
| If you're suspecting a loss in dexterity, what are some symptoms to look for? | • stiffness • Dec ROM • Excessive pre-shaping and use of support surface during upper limb tasks • Excessive BOS, stepping and use of arms during standing and walking • ^speed and difficulty slowing down in walking • ^variability of performance |
| What is Dysmetria Ataxia? | Accuracy of movement (distance/targeting) Over/undershoot, wobbly, erratic, veers off path E.g. Finger-to-nose test They miss the nose or oscillate around it. |
| What is dyssynergia ataxia? | Coordination between joints and muscles (movement sequencing) Mvt broken up, poor jt timing, worng order, veers off e.g. reaching for cup - shoulder moves first |
| What is Dysdiadochokinesia ataxia? | Rapid alternating movements (timing + rhythm) loss of rhythm, slow irregular mvt, fatigue quick E.g. rapid pro/sup of forearm - slow |
| What is the brain area often damaged from Apraxia? and why | Frontal lobe - inferior parietal lobe on L). these areas store complex 3-dimensional respresentations of previously learned patterns and mvts |
| What is limb-kinetic and ideomotor apraxia? | The inability to perform purposeful movement on external commond even though the concept of the task is fully understood |
| What is Ideational Apraxia | a problem with planning and sequencing a multi-step action. The person still understands what the objects are, but they cannot organise the correct order of actions to complete a task. |
| What is Conceptual Apraxia | Conceptual apraxia is a problem with knowledge of how tools and objects are used. The person loses the concept of the tool’s function, so they may use the wrong object or use it incorrectly. |
| What are some frequent errors that occur with ideomotor/limb-kinetic apraxia's? | - use of body parts as objects - spatial orientation problems - temporal imprecision errors (timing error) - errors of force of mvt - poor distal differentiation |
| What are some frequent errors that occur with ideational/conceptual apraxia's? | - omissions to mvt sequence - mis-location or misuse of objects - sequence errors - blending sequences together - action overshoots what is required - action remains incomplete |
| What is constructional apraxia? | May be left or right side brain affected. Impairment in Producing designs in 2 or 3 dimensions By copying, drawing or construction On command or spontaneously Functionally difficult to perform purposeful acts while using objects in environment |
| Unilateral Neglect Commonly noted errors in movement? | As walking run into doorways, objects. Leave affected arm behind when rolling, have it hanging over wheelchair arm, stuck between wheelchair arm rest and thigh Have difficulty crossing the midline Leave behind half their meal not dressing properly |
| What is neglect commonly associated with in terms of rehab outcomes? | - Longer length of stay in rehab - poorer Fx outcome following stroke |
| What are the 3 types of unilateral neglect? | - Sensory neglect - visual/auditory/somato-sensory - action-intentional disorders (motor neglect) - Memory and representational deficits (extra-personal, peri-personal and personal space) |
| What is agnosia? | The inability to recognise objects by touch even through tactile, thermal and proprioceptive functions are intact |
Created by:
HollyRicho