Neuro Final

• Two types of PNF techniques are irradiation and joint approximation
• Rhythmic initiation is a mobility exercise
• Slow reversals are a controlled mobility exercise
• Homonymous hemianopsia occurs due to a lesion of the optic tract
• Brunnstrom's stages of recovery

  Stage 6 = return to near normal function
• From a neurometabolic standpoint, in adults the brain returns to normal in 14 days
• cerebral blood flow can be reduced up to 50% during the metabolic cascade
• adults with concussion heal faster than kids with concussion
• TBI causes an increase in excitatory neurotransmitters (glutamate)
• Velocity storage allows the vestibular system to work at lower frequencies
• if a patient has vestibular neuritis and shows a right beating nystagmus, which side is the lesion on?

  left
• J shape is testing CN IV
• CN IX (glossopharyngeal) helps with salivary secretions
• CN V (trigeminal) does the corneal reflex
• L side of the brain has to do with speech centers
• Posterolateral thalamic infarct causes pusher syndrome
• the BERG can help predict discharge disposition in stroke
• Normal adult gait speed is 1.3 m/s
• TUG cutoff score for a patient following a stroke is 14 seconds
• Spasticity management:

  • cold packs
  • compression or air splints
  • positioning
  • PNF patterns
• Lift motion is D2 flexion
• C1-3 contribute to vision and cervical postural stability
• Adult male gait speed is 1.37 m/s
• lesion to the internal capsule causes hemiplegia
• 10 degrees of dorsiflexion is needed for terminal stance
• in the elderly, the gastroc-soleus may be weak (linked to mortality) which can cause an inadequate pre-swing
• Lower vermis cerebellar lesion will cause omnidirectional sway
• need 60 degrees of knee flexion during the initial swing phase of the gait cycle
• Swing limb iliac crest has to drop >5 degrees to be a trendelenberg
• Double support lasts for 10% of the stance phase
• 15 degrees of plantar flexion is needed during pre-swing
• need 50 degrees of great toe extension during pre-swing
• the center of mass at the pelvic girdle will displace 4 cm laterally and 2.5 cm vertically during normal gait
• Total arm movement of flexion and extension during gait is 25 degrees
• Stride length = walking speed/(1/2cadence)
• Locomotion requires postural control, adaptation, and progression
• ALS (anterolateral spinothalamic tract)

  • pain, temperature, crude touch, sexual sensation, tickle
  • Crosses in the cord 1-2 segments above entry
• DCML: dosal column medial lemniscal

  • proprioception, kinesthesia, vibration, pressure
  • Decussates in the medulla
• Sensory system affected with aging:

  • decreased acuity
  • degeneration of neurons
  • loss of myelin sheaths
  • decrease in enzymes and neurotransmitters
  • Depletion in dendrites
• Upper motor neuron signs:

  • hypertonia
  • hyperreflexia
  • rigidity, spasticity
  • (+) babinskis, clonus
  • Muscle spasms
  • Disuse atrophy