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Questions and Answers
Which artery supplies the occipital and temporal lobes of the brain?
What is the primary function of the primary motor cortex located in the frontal lobe?
Which brain area is responsible for organizing, integrating, and interpreting visual information?
A patient exhibiting contralateral sensory loss without motor loss may have an infarct in which artery area?
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Which part of the nervous system carries information away from cell bodies?
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Damage to which tract would likely result in a patient being unable to discern between hot and cold stimuli?
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What role does the basal artery play in the brain's blood supply?
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Which lobe is primarily responsible for functions related to short-term memory?
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What do equilibrium tests primarily assess?
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Which stage of PNF techniques is focused on enhancing proprioception during dynamic activities?
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What is the primary goal of the Hold Relax Active Movement technique in PNF?
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Which of the following best describes Controlled Mobility in the context of movement?
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What is the primary focus of Nonequilibrium Tests?
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What differentiates Anterior Cord Syndrome from Central Cord Syndrome?
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Which PNF technique develops strength and control for maintaining posture?
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Which of the following represents the progression from basic to complex movements?
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What is the primary deficit in patients with Posterior Cord Syndrome?
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Which cervical level allows for the ability to perform activities that require independent breathing and shoulder shrugging?
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Which statement is true regarding the outcomes of incomplete spinal cord injuries compared to complete injuries?
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What is the primary functional impact of tenodesis at the C6 level?
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For a patient with a C6, ASIA A injury, which example best reflects selective stretching for functional recovery?
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According to the ASIA Classification Scale, the labeled motor level of a spinal cord injury is defined by which two strength benchmarks?
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Which statement about GMFCS Level II is accurate?
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What is a requirement for participating in Cardiac Rehab Phase II?
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What is a characteristic of GMFCS Level I?
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Which level describes a child who may need a wheelchair for most activities?
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What defines GMFCS Level III?
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Which level includes children who cannot sit or stand independently?
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At which GMFCS level might a child be able to participate in standing transfers?
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Which of the following statements is true about GMFCS Level II?
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Which level indicates a child can perform some mobility tasks independently using powered devices?
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Which description best fits GMFCS Level V?
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What blood pressure response is a termination criterion for a graded exercise test (GXT)?
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What characteristic is true for beta blockers?
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What is the earliest age at which the rooting reflex typically integrates?
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Which of the following heart rate responses indicates stopping a graded exercise test?
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What is a sign of malfunctioning equipment during a graded exercise test?
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What consequence may arise if the plantar grasp reflex does not integrate?
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Which of the following termination criteria is related to symptoms or signs during a graded exercise test?
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What age does the moro reflex typically integrate by?
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Study Notes
Posterior Cerebral Artery
- Contralateral sensory loss without motor loss
Posterior Circulation
- Composed of two vertebral arteries
- Supplies brainstem, cerebellum, medulla, and upper spinal cord
- Vertebral arteries combine to form basilar artery
- Supplies pons and cerebellum
- Basilar divides into right and left posterior cerebral arteries
- Supplies occipital and temporal lobes
- Anterior and posterior communicating arteries interconnect and form the Circle of Willis
White Matter
- Appears white due to fat within myelin
- Composed of axons
- Carries information away from cell bodies
- Found in the brain and spinal cord
- Bundled together to form tracts
Gray Matter
- Areas with large numbers of cell bodies and dendrites
- Cell bodies produce gray color
- Covers the entire cerebrum (the cerebral cortex)
- Also deep in the spinal cord
- Dorsal (posterior) transmits sensory stimuli
- Ventral (anterior) transmits motor impulses
Brain Areas and Functions
- Frontal lobe - primary motor cortex, Broca's area (speech production)
- Parietal lobe - primary sensory cortex, short-term memory functions
- Temporal lobe - primary auditory cortex, Wernicke's area (speech comprehension)
- Occipital lobe - primary visual cortex, organizes, integrates, and interprets visual information
Brain Structures and Functions
- Cerebellum: regulation of posture, muscle tone, and volitional/automatic movement
- Parietal Lobe: primary sensory cortex, short-term memory
- Brain Stem: houses reflex centers for autonomic body functions, responsible for homeostatic function
- Occipital Lobe: organizes, integrates, and interprets visual information
- Cerebellum: controls balance and complex muscular movements, assists with posture maintenance
- Temporal Lobe: primary auditory cortex
- Frontal Lobe: primary motor cortex
Sensory Pathways
- Lateral Spinothalamic Tract: pain and temperature sensation
- Anterior Spinothalamic Tract: crude touch sensation
Equilibrium Tests
- Check balance and ability to stand still
- Performed while standing upright
- Focus on gross motor skills (big movements)
- Looks at both static (still) and dynamic (moving) positions
Nonequilibrium Tests
- Assess movement and balance while sitting
- Performed while seated
- Involves both gross and fine motor skills
- Examines static and mobile aspects of movement
PNF Techniques and Their Primary Stages
- Slow Reversal: Controlled Mobility, promotes smooth transitions between muscle groups, enhances coordination of movements.
- Hold Relax Active Movement: Mobility, increases range of motion by reducing muscle tension, helps overcome restrictions in movement.
- Rhythmic Rotation: Controlled Mobility, improves coordination and timing of movements, enhances proprioception during dynamic activities.
- Rhythmic Stabilization: Stability, strengthens stabilizing muscles, improves ability to maintain position against external forces.
- Alternating Isometrics (AI): Stability, develops strength and control for maintaining posture, enhances ability to resist external forces.
- Agonist Reversal: Controlled Mobility, promotes smooth transitions between muscle groups, improves coordination of movements.
- Resisted Progression: Skill, develops strength and control for complex movements, enhances precision and speed of actions.
Incomplete Spinal Cord Syndromes
- Anterior Cord Syndrome: incomplete, from cervical flexion, loss of motor function, no pain/temperature sense below level of lesion.
- Central Cord Syndrome: incomplete, from cervical hyperextension, damages spinothalamic/corticospinal tract/dorsal columns. Upper extremity deficits are more present, more motor deficits than sensory.
- Posterior Cord Syndrome: incomplete, from a variety of causes, motor function preserved, loss of pain perception, proprioception, 2 point discrimination, stereogenesis.
Spinal Cord Injuries
- Cervical levels:
- C1-C3: head turning
- C4: breathing, shoulder shrug
- C5: arm elevation, elbow flexion
- C6: wrist extension, tenodesis grasp
- C7: elbow extension, hand function
- C8: finger dexterity
- Incomplete injuries have better outcomes than complete injuries.
- T1-T11: therapeutic ambulation with orthoses in parallel bars
- T12-L2: household ambulation with orthoses
- L3: community ambulation with orthoses
- L4-L5: community ambulation, may only need AFO and AD
- S1-S2: AFO
- C6: able to use tenodesis
- C4: will require full-time care
- C7: can independently complete a squat pivot or sliding board transfer
- C8: improved hand function allows for wheelies in a wheelchair
- C5: with adaptations, this is the highest level that may use a manual wheelchair
- Selective stretching of the long finger flexors can enhance grasp with tenodesis in a C6 ASIA A injury.
- ASIA Classification Scale: The labeled motor level of a spinal cord injury is the lowest level with 3/5 strength or the superior segment with 5/5 strength.
Cardiac Rehab Phase II
- EKG is required during all sessions
- EKG is required during the exercise test prior to starting rehab
- Goal is to increase exercise capacity to 7 METS
Cerebral Palsy - GMFCS Levels
- Level 1: walks without limitations, can run and jump with decreased speed and coordination.
- Level 2: walks with limitations, needs assistance with uneven surfaces, can minimally run or jump.
- Level 3: walks using a hand-held mobility device, may be able to climb stairs with a railing, may propel a manual wheelchair.
- Level 4: self-mobility with limitations, may use a powered wheelchair.
- Level 5: transported in a manual wheelchair.
Cardiovascular Testing
- VO2 max testing targets endpoint heart rate.
- Submaximal testing is used for symptomatic individuals.
ACSM Absolute Contraindications
- Severe arterial hypertension (systolic blood pressure > 200mmHg and/or diastolic blood pressure > 110mmHg) at rest.
- Heart rate is used for VO2 calculations.
Termination Criteria for GXT
- Blood pressure:
- SBP fails to rise with increase in workload.
- SBP drops more than 10mmHg.
- SBP increases to more than 250mmHg.
- DBP rises more than 20mmHg from resting value.
- DBP rises above 110-120mmHg.
- Heart rate:
- Decrease in HR with increase in workload.
- Increase in HR > 220 beats per minute.
- Inappropriate bradycardia.
- Signs and symptoms:
- Subject requests to stop.
- Progressive angina (stop at 3+)
- Progressive dyspnea (stop at 3+)
- Marked dyspnea.
- Cyanosis.
- Vasoconstriction (pale, cold, clammy skin).
- Cessation of sweating.
- Syncope.
- Malfunctioning equipment.
Exercise Tests
- Astrand cycling test: steady-state test.
- Bruce Treadmill test: incremental test.
- Seated step test.
Beta Blockers
- "lol" - medications that treat hypertension, heart failure, myocardial infarction, and angina.
Primitive Reflexes
- Integrated by 2-6 months old - spinal cord level
- Rooting: 28 weeks gestation → 3 months - sucking finger, interferes with midline control of head, visual tracking, and interactions.
- Sucking: survival reflex, 28 weeks gestation -> 2-5 months.
- Moro: 28 weeks gestation → 5-6 months - abduction and extension of upper extremities -> supine -> head extends back 20-30 degrees.
- Crossed Extension: 28 weeks gestation → 1-2 months - flexion and adduction of the other leg, extension to push examiner away.
- Plantar grasp: supine - flexes toes - if not integrated, no ability to stand with flat feet, bad balance, no weight shifting in standing.
- Galant: 32 weeks gestation → 2 months - prone brushing on side of trunk -> trunk curves to stimulus (same side) - if not integrated, bad sitting balance can lead to scoliosis.
- Palmer grasp: last simple reflex to integrate - supine; index finger in hand, - if not integrated, weight bearing on open hand for propping is bad, bad creeping, bad protective response.
- Spontaneous Stepping: if bad?
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Description
This quiz covers essential concepts of the brain's circulation, including the anatomy and functions of the posterior cerebral artery and its relation to the vertebral arteries. Additionally, it explores the distinctions between white and gray matter, their structures, and their roles in the nervous system. Challenge your understanding of brain function with this focused quiz.
