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alert (conscious)
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Terms in this set (81)
alert (conscious)
state of alertness, awareness, orientation, memory
lethargic
drowsiness where patient can be aroused by moderate stimuli and drift back to sleep
clouding of consciousness
state of consciousness characterized by quiet behavior, confusion, poor attention and delayed responses
delirium
state of consciousness characterized by disorientation, confusion, agitation and loudness
obtunded
state of consciousness characterized by state of sleep, reduced alertness to arousal and delayed responses to stimuli
stupor
state of general unresponsiveness with arousal occurring from repeated stimuli
coma
state of unconsciousness and a level of unresponsiveness to all internal and external stimuli
declarative
explicit learning (facts/events)
mental practice, recalling and attention
procedural
implicit learning (how to do motor tasks)
stages of motor learning
1. cognitive
2. associative
3. autonomous
Level 1 - No responsedeep sleep and completely unresponsive to any stimulilevel 2 - generalized responseinconsistent, non-purposeful response in a non-specific mannerlevel 3 - localized responsereacts specifically to a stimuli but inconsistently may follow simple commands i.e. open eyes or squeeze handslevel 4 - confused -agitatedheightened state of activity bizarre behavior can't discriminate persons/objects can't cooperate directly in treatment lack of short and long term recall vocalizations incoherent/inappropriate gross attention brief, selective attention non-existentlevel 5 - confused inappropriateresponds to simple commands consistently complex commands non-purposeful, random or fragmented lacks concentration memory impaired may perform previous tasks but can't learn new taskslevel 6 - confused appropriategoal-directed behavior carryover of re-learned new tasks appropriate to situation detail with past memories than recentlevel 7 - automatic appropriateoriented to surroundings daily routine automatic but robot like minimal to no confusion, shallow recall of activities carryover of new learning but slow rate wit structure able to initiate social or recreational activity impaired judgmentlevel 8 - purposeful appropriaterecall past and recent events recall new learning with no supervisionallodyniasensation of pain in response to stimulus that typically not produce painanalgesiaabsence of pain while remaining consciousanesthesiaabsence of sensation of touchcausalgiaconstant, relentless, burning hyperesthesia and hyperpathia that develops after a PN injurydysthesiasdistortion of senses especially touchhyperesthesiaincreased sensationhyperpathiaextreme exaggerated response to painhypesthesiadiminished sensation to painneuralgiasevere and multiple shock like pains that radiate from a specific nerve distributionpallanesthesialoss of vibration sensationparasthesiaabnormal sensation such as numbness, tingling, pins and needles or burning sensationsclasp-knife phenomenenhypertonic joint where greatest resistance at initiation of range that lessens with movement throughout ROMclonusUMN lesion involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretchcogwheel rigidityresistance to movement has a phasic quality Parkinsonslead pipe rigidityuniform and constant resistance to ROM BG lesiondecorticate rigiditycorticospinal lesion at level of diencephalon trunk and LE positioned in extension UE positioned in flexiondecerebrate rigiditycorticospinal lesion at level of brainstem extension of trunk and all extremitiesModified Ashworth grade 0 =no increase in muscle toneModified Ashworth grade 1 =slight increase in muscle tone, catch and release at end of ROMModified Ashworth grade 1+ =slight increase in muscle tone, catch then by resistance throughout 1/2 of ROMModified Ashworth grade 2 =marked increase in muscle tone throughout ROM affected parts easily movedModified Ashworth grade 3 =considerable increase in muscle tone, passive movement is difficultModified Ashworth grade 4 =parts are rigid in flexion or extensionparesis = , plegia =paresis = weakness plegia = paralysisSCI injuries most often at C4-C5 levelextension injuriesSCI injuries most often at C5-C6 levelflexion injuriescervical ___ causes anterior cord syndrome what is lostflexion corticospinal and spinothalamic tracts lost loss of motor and pain and temp below level of lesionstab wounds causesbrown sequard syndromebrown sequardhemisection of SC loss loss of vibratory and paralysis on same side (corticospinal and dorsal columns) loss of pain and temp on contralateral side (lateral spinothalamic)cauda equina injuriesL1 and below areflexia, flaccidity loss of bowel and bladdercentral cord MOIcervical hyperextensioncentral cord lossspinothalamic, corticospinal and dorsal columnloss UE or LE more and motor or sensory more in central cordUE > LE loss motor > sensory lossposterior cord syndromerare due to compression of posterior spinal artery loss of DCML tracts motor preservedakinesiainability to initiate movement common in parkinsonsastheniageneralized weakness, typically secondary to cerebellar pathologyataxiainability to perform coordinated movementsathetosisslow, writhing, twisting movements involuntary movements with instability of posture, peripheral movements occur without central stability extremity involvement BG pathologybradykinesiaslow movementchoreabrief, rapid, irregular movements, random and involuntary damage to caudate nucleus huntington's diseasedysdiachokinesiainability to perform rapidly alternating movementsdystoniaclosely related to athetosis larger axial muscle involvement (head/trunk) rather then appendicular muscles sustained contractionsfasciculationmuscular twitch caused by random discharge of LMN and its muscle fibers suggests LMN but can be benignhemiballisminvoluntary and large flailing violent movement og large body part ballism --> damage to subthalamic nucleuskinesthesiaability to perceive direction and extent of movement of a joint or body partticssudden, brief, repetitive, coordinated movements usually occur at irregular intervals tourette syndrometremorsinvoluntary, rhythmic, oscillatory movements secondary to lesion in BGpill rolling tremorresting tremor - parkinsonsintention (kinetic) tremor associated withMSspontaneous nystagmusdrift in one direction countered by quick movement in opposite direction acute vestibular lesion and lasts approx 24 hourspositional nystagmusinduced with head positions semicircular canals stimulate nystagmus only lasts a few secondsgaze-evoked nystagmuseyes shift from primary position to alternate position inability to maintain gaze stabilization indicates CNS pathology, brain injury and MScentral lesions nystagmusuni/bidirectional not inhibited by fixation mild vertigo sx may be chronic length etiology: vascular lesion, cancer and demyelination of nervesperipheral lesion nystagmusunidirectional fast segment of movement = opposite side of lesion visual fixation will inhibit nystagmus and vertigo significant vertigo sx can be over minutes, days, weeks, finite period, recurrent etiology: menieres disease, trauma, toxicity, ear infection, vascular disorderseducation for all handicapped children act (enacted 1975)law to support states and localities in protecting the rights of meeting individual needs of and improving the results for infants, toddlers, children and youths with disabilities and their families origin of individuals with disabilities education improvement act (IDEA)Carl D. Perkins Vocational Education Act (1984)each state required to meet special needs of individuals with handicaps or adults that are disadvantaged, adults in need of training and retraining, single parents or homemakers, programs designed to eliminate sex bias/stereotyping and criminal offendersPerkins vocational and applied technology act (enacted 1990)re authorization act and modification of the education for all handicapped children act (EHA) provides free, appropriate education in the least restrictive environment for individuals with disabilities from age 3-21IDEA (Individuals with disabilities education improvement act) amendments (enacted 1991)reauthorized early intervention, established Federal Inter agency Coordination CouncilRehabilitation act amendments (enacted 1992)transition planning at high school graduation includes coordination of assistive technology services and the rehab systemIDEA amendments (enacted 1997)-restructuring of IDEA into 4 distinct individual parts -defines responsibilities of school districts in providing services to ensure that children with certain specified disabilities receive free, appropriate education -individualized education program (IEP) for each eligible child -services include speech, PT, OT, counselingNo child left behind act (Enacted 2002)-most sweeping reform of elementary and secondary education act since its enactments in 1965 -re-defines federal role in K-12 education -requires accountability for all children including student groups based on poverty, race and ethnicity, disability and limited English Proficiency (LEP) -goal is to close the achievement gap between disadvantaged, disabled and minority students and their peersbefore the IDEA1/5 disabled children were educated >1 million children with disabilities excluded from the system 3.5 million children with disabilities did not receive appropriate servicesafter the IDEAcurrently 6.5 million children served with disabilities 96% students with disabilities now served in a regular school setting increase in number of children from birth - 3 that receives services