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inability to interpret information


inability to recognize symbols, letters, or numbers TRACED on skin


inability to WRITE due to lesion on brain




inability to communicate or comprehend due to damage to the brain


inability to perform PURPOSEFUL learned mvmts although there is no sensory or motor impairment


inability to recognize objects by sense of TOUCH

asymmetrical tonic neck reflex (ATNR)

with head turned to one side, arm and leg on face side are extended and arm and leg on scalp side are flexed. this reflex could interfere with an infant's ability to roll from prone to supine.

ATNR normal age of response

6 months


inability to perform COORDINATED mvmts


INVOLUNTARY mvmts and INSTABILITY of POSTURE. usually due to damage to basal ganglia.


slow movements


movements that are SUDDEN, RANDOM, and INVOLUNTARY


INVOLUNTARY ALTERNATING SPASMODIC CONTRACTION of a muscle precipitated by a QUICK STRETCH REFLEX. characteristic of an upper motor neuron lesion


double vision


slurred and impaired speech due to MOTOR deficits of tongue or other muscles


INABILITY to CONTROL range of movement and the FORCE of MUSCLE ACTIVITY




WEAKNESS on one side of body


PARALYSIS on one side of body


ability to PERCEIVE the DIRECTION and EXTENT OF MOVEMENT of a joint or body part

symmetrical tonic neck reflex (STNR)

head positioned in flexion or extension

STNR normal age of response

6-8 months

STNR with head positioned in extension

arms are extended, legs are flexed

STNR with head positioned in flexion

arms are flexed, legs extended.

postural drainage

techniques for therapists to help dislodge mucous from lungs

upper lobes anterior segment

supine with pillow under knees. claps btwn clavicle and nipple on each side

upper lobes apical segment

leans back on pillow at 30 degree angle against therapist, bed flat. claps over area btwn clavicle and top of scap on each side

upper lobes posterior sgmt

pt leans over pillow at 30 degree angle. claps over upper back on each side.

left upper lobe lingular

foot of bed elevated 16 inches. lies prone on rt side and rotates 1/4 turn backward. claps over left nipple area

right middle lobe

foot of bed elevated 16 inches. prone on left side and rotates 1/4 turn backward. claps over right nipple area

lower lobe anterior basal

foot of bed elevated 20 inches. sidelying, head down, pillow under knees. claps over lower ribs.

lower lobe lateral basal

foot of bed elevated 20 inches. prone, head down, rotates 1/4 turn upward. claps over uppermost portion of lower ribs.

lower lobes posterior basal

foot of bed elevated 20 inches. prone, head down, pillow under hips. claps over lower ribs close to spine on each side

lower lobes superior segments

bed flat. patient prone with 2 pillows under hips. claps over middle of back at tip of scap on either side of spine

arterial insufficiency

usually caused by arteriosclerosis. acute stage: acute arterial obstruction, distal pain, sudden onset. vascular: decreased or absent pulses, pallor of forefoot on elevation, dependent rubor. risk factors: smoking, diabetes, hypertension

arterial insufficiency: skin

dry skin, NO EDEMA, loss of hair

arterial insufficiency

severe muscle ischemia, intermittent claudication, worse with exercise, relieved by rest. rest pain means severe involvement. will present with muscle fatigue, cramping, numbness, paresthesia overtime

chronic venous insufficiency

acute stage: dvt, calf pain, aching, EDEMA, muscle tenderness. caused by vein obstruction

chronic venous insufficiency: skin

ulcers: sides of ankles, mostly MEDIAL MALLEOLUS. will be DARK, BROWN, MAY LEAD TO STASIS DERMATITIS, CELLULITIS, skin thick

venous insufficiency

vascular: venous dilation. edema: moderate to severe. risk factors: venous hypertension, varicose veins. pain: minimal to moderate steady pain. aching pain with prolonged standing or sitting

w/c for C1-C4 lesions

electric w/c with tilt in space or reclining back

w/c for C5

can use manual w/c with projections. C5's have shoulder function and elbow function.

w/c for C6

manual w/c w/friction surface and hand rims independently. ability to drive a car independently. use of radial wrist extensors

w/c for C7

manual w/c w/friction surface hand rims independently. has use of triceps (elbow extension - can push up on arm rests)

w/c for C8-T1

may use manual w/c with standard hand rims. use of hands.

ERV-expiratory reserve volume

max amt of air expired after a normal expiration. 1000 mL

FVC-forced vital capacity

amount of air forcefully expired after maximal inspiration

FRC-functional residual capacity

amount of air in lungs after a normal exhalation. ERV+RV

RV-residual volume

volume of air remaining in airways and lungs after max expiration

tidal volume

volume of air inspired OR expired in one breath. 500 mL

TLC-total lung capacity

total amt of air lungs can hold. total amount after a max inspiration. IRV+TV+ERV+RC

vital capacity

max volume of air that can be forcefully expired after a max inspiration. 4000-5000 mL

moro reflex

when head drops into extension for a few inches the arms abduct with fingers open, crosses trunk into adduction. 28 wks of gestation to 5 months

palmar grasp reflex

pressure in palm will produce reflex of flexion/strong grip. birth to 4 months

plantar grasp reflex

pressure to base of toes will produce reflex of toe flexion. 28 weeks of gestation to 9 months

positive support reflex

weight placed on balls of feet will produce stiffening or legs and trunk into extension. 35 weeks of gestation to 2 months

cold therapy/cryotherapy contraindications

infection, ischemic tissue, peripheral vascular disease, hypertension

hot therapy/superficial heat contraindications

arterial disease, bleeding, circulation issues, malignancy, thrombophlebitis

ultrasound contraindications

epiphyseal areas in children, pain/temp/sensory deficits

traction contraindications

tumor, pregnancy, acute sprain or fracture, osteoporosis

compression contraindications

heart failure

estim contraindications

pacemaker, arrythmia, heart failure, malignancy, broken skin

cervical traction guidelines

supine, force between 10-15 lbs and progress to 7% of body weight

lumbar traction guidelines

supine or prone. force of less than half of body weight for initial treatment, 25 to 50% of body weight required for actual separation. for muscle spasm, 25% of body weight should be used.

intermittent compression

used primarily to reduce chronic or post traumatic edema. can use for venous insufficiency


increasing size of one of 2 electrodes will decrease current density

estim pulsed/alternating/biphasic

muscle retraining, spasticity, stimulating denervated muscles

estim direct current/monopolar

used with iontophoresis

ultrasound for muscle/deep tissue

frequency: 1 MHz, intensity: 1.5-2.0 w/cm2. up to 5 cm

ultrasound for superficial/bony

frequency: 3 MHz, intensity: .5-1.0 w/cm2. up to 2 cm

pulsed u/s

produces nonthermal effects, 20% DC

continuous u/s

produces thermal effects, 100% DC

u/s BNR

5:1 or 6:1

u/s ERA transducer head

ERA=1/2 size of transducer head

standard manual w/c dimensions

average: 16x18x20 (depth, width, height), BUT to properly measure, seat width=hip width + 2 inches; seat depth=posterior buttock to popliteal space - 2 inches. if those were both 16 after measuring a patient, best fit would be seat width 18 inches, seat depth 14 inches.

doorway width for w/c


hallway width for w/c


ramp dimensions for w/c

12:1 rise/run

u/s for stroke, upper motor neuron lesion

use alternating/pulsed current

estim for pressure ulcer

enhances healing. use monophasic pulsed current

what muscles should be stimulated for Bell's Palsy?


arterial insufficiency will cause

reactive delayed hyperemia (increase of blood flow to tissues)

Parkinsons-what exercises for preventing falls?

postural exercises

tight hip flexors will cause

anterior pelvic tilt and increased lumbar lordosis

hyperthyroidism often presents with


diagnostic procedures to confirm disc herniation

MRI, CT scan, myleogram

intervention exercises for lumbar stenosis

pts will tolerate flexion exercises

lumbar stenosis

involves multilevel impingement in spine ligaments. pain is worse when ambulating or extending spine.

best exercises for ankylosing spondylitis

pts tend to assume flexed postures, so back extension exercises would be most important. ankylosing spondylitis is a form of rheumatic disease w/inflammation of spine. will exhibit posture such as forward head, increased kyphosis, loss of lumbar curvature.

which nerve is compressed - carpal tunnel syndrome

median. causes atrophy and weakness of thenar muscles and lateral lumbricals. positive tinel's and phalens

regular exercise for diabetics will

lower blood glucose levels and decrease amount of insulin required

compensations of shoulder motions

flexion: extension of spine. abduction: lateral flexion. scap protraction: IR. scap elevation: shoulder hyperextension

orthostatic hypotension after bed rest

most likely result of inadequate ventricular filling during diastole - decreased venous tone

most appropriate exercise for new dx of hyperthyroidism

decrease intensity, increased time

traumatic brain injury - tonic reflexes

tonic reflexes are released. TL supine reflex results in flexor stimulation when in prone, and extensor tone while in supine

bicipital tendonitis

inflammation of long head. impingement of proximal tendon btwn anterior acromion and bicipital groove. speed's test

colles fracture

most common fracture caused by FOOSH. immobilized for 5-8 weeks

idiopathic scoliosis

2 types: structural: irreversible lateral curve with rotation. nonstructural: reversible lateral curve w/o rotation which straightens with flexion. over 45 degrees would require surgery

piriformis syndrome

piriformis overworked with overpronation (due to hip IR).

plantar fasciitis

chronic irritation of fascia from overpronation


fracture of par interarticularis


anterior/posterior slippage of one vertebra on another following bilateral spondylolysis. avoid extension, lateral flexion, rotation.

thoracic outlet syndrome (TOS)

compression of neurovascular bundle

tibial plateau fracture

valgus and compressive forces to knee with knee in flexion. often in conjunction with MCL injury


spasm/tightness of SCM. laterally flex towards affected side, rotation away from affected side.

ulnar collateral ligament injury

due to repetitive valgus strain (overhead throw). pain at medial elbow at distal insertion, sometimes parasthesia in ulnar nerve distribution with positive tinel's sign.

end feels

firm (stretch) ex: ankle dorsiflexion. hard (bone to bone) ex: elbow extension. soft (soft tissue approximation) ex: elbow flexion, knee flexion

abnormal end feels

empty: cannot reach end feel due to pain, ex: joint inflammation, fracture. firm: increased tone, tightening of capsule. hard: fracture, osteoarthritis. soft: edema, synovitis.

ROM requirements for normal gait

hip flexion: 0-30, hip extension: 0-15, knee flexion: 0-60, knee extension: 0, ankle DF: 0-10, ankle PF: 0-20

trendelenburg gait

glute medius weakness, excessive lateral trunk flexion and weight shifting over stance leg. drop in pelvis on the left during right stance phase is often indicative of right gluteus medius weakness.

RA pathologies

boutonniere deformity: DIP extension. Swan neck deformity: DIP flexion


increased volume of fluid within a joint capsule

Q angle

degree of angulation when measuring from midpatella to ASIS, and tibial tubercle. measured in supine with knee straight: 13 degrees average for male, 18 degrees average for female. excessive Q angle can lead to pathology and abnormal tracking.


see page 70

Brunnstrom's 7 stages of recovery (spasticity and tone)

1=no volitional mvmt, 2=beginning of spasticity, 3=synergies are voluntarily, spasticity increases, 4=decreasing spasticity, 5 further decrease spasticity, 6=isolated jt movements with coordination, 7=normal motor function is restored

UE: D1 Flexion

starts in shoulder flexion, adduction and ER, forearm supination, wrist flexion, and finger flexion. ends in shoulder extension, abduction, IR, forearm pronation, wrist extension and finger extension.

UE: D1 Extension

starts in shoulder extension, abduction, IR, forearm pronation, wrist extension and finger extension.

UE: D2 Flexion


UE: D2 Extension


LE: D1 Flexion


LE: D1 Extension


LE: D2 Flexion


LE: D2 Extension


Ranchos Los Amigos Levels of Cognitive Functioning (TBI)

p 101

carpal bones mnemonic

Some Lovers Try Positions That They Can't Handle: Scaphoid, Lunate, Triquetral, Pisiform, Trapezium, Trapezoid, Capitate, Hamate (proximal row, then distal row)

PNF technique "repeated contractions" should be applied when

at the point where the desired muscular response begins to diminish

To increase pt's ambulation distance (w/chronic arteriosclerotic vascular disease) with INTERMITTENT CLAUDICATION, best way is to:

short duration, frequent intervals

to stretch hip flexors (could be in Parkinson's patient)

prone lying would be best choice. increased flexibility in hip flexors will improve standing posture

blood pressure response to exercise

systolic pressure increases, diastolic remains the same

when ascending a curb with axillary crutches using 3 pt gait, should lead with

the uninvolved lower extremity.

action that would place greatest stress on achilles tendon

eccentric contraction of gastroc and soleus

a quad cane should be used in the UE that is

opposite from affected LE. the longer legs should be positioned away from patient

how much pressure for compression garment to control LE edema?

30-40 mmHg

which stage of bone healing is associated with the termination of external fixation?

clinical union

most appropriate method to selectively train VMO is

quad setting exercises and biofeedback


go over origins and insertions.

when working with a Parkinson's patient on controlled mobility, what would be best intervention? when working with same patient on motor control, which technique should be utilized?

promote weight shifting and rotational trunk control for controlled mobility. for motor control, should use rhythmic initiation.

which component of the vertebral artery test is most likely to assess patency of intervertebral foramen?

extension to assess intervertebral foramen; lateral flexion and rotation have a greater effect on vertebral artery

how to address a patient with diplopia during interventions

place a patch over one of the eyes

movements in frontal plane occur as

side to side movements, such as ab and adduction or lateral movements. (pt rehabing from ankle surgery would have most difficulty in 6 inch "lateral" step down)

most appropriate rate to release pressure when obtaining bp measurement?

rate of 2-3 mm Hg per second.

most significant differences between heat exhaustion and heat stroke:

mental status and skin temp. heat stroke: altered mental status and elevated skin temp.

primary purpose of "anterior control" TLSO

prevent thoracic flexion

to avoid burning a pt during iontophoresis, pta should

increase size of cathode relative to anode (decreases the density)

post polio syndrome

symptoms that occur years after onset of poliomyelitis. remaining motor units become more dysfunctional. (sensation not affected.)

conventional TENS parameters

50-100 pps, short phase duration, low intensity

lab values


pronation of foot consists of:

eversion of heel, abduction of forefoot and dorsiflexion of subtalar and midtarsal joints

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