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29 Cards in this Set
- Front
- Back
what leads to pain, soft tissue shortening, ineffective/inefficient movement patterns, and contractures? |
-inefficient or ineffective skeletal muscle recruitment: increased activity at rest or inability to recruit activity, imbalanced activity -static positioning or guarding muscles |
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what is typical head posture post stroke? |
-flexed to involved side, rotation away from involved side |
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what is typical scapula posture post stroke? |
depression and retraction |
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what is typical upper arm/shoulder posture post stroke? |
adduction and internal rotation |
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what is typical elbow//lower arm position post stroke? |
flexion and pronation |
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what is typical wrist position post stroke? |
flexion and ulnar deviation |
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what is typical finger position post stroke? |
flexion |
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what is typical trunk position post stroke? |
posterior tilt, possible rotation, and lateral flexion to involved side |
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what is typical lower extremity pattern: flexion or extension? |
flexor synergy pattern |
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what is typical pelvis position post stroke? |
elevation and retraction (facing backwards) |
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what is typical position post stroke at the hip? |
internal rotation, adduction, and extension |
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what is typical leg position at the knee post stroke? |
extension |
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what is typical foot position post stroke? |
plantar flexion, supination, and inversion -toe flexion |
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what effect does lateral trunk flexion have on scapula movement patterns? |
scapula on flexed side is adducted (retracted) scapula on extended side is abducted (protracted) |
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what effect does side flexion of trunk have on scapular alignment and subluxation and arm function? |
-scapula downward rotates/retracts in relation to the rest of the body when it follows the trunk on the flexed side -this tips the glenoid fossa downwards -supraspinatus (sitting on top of scapula, starts abduction) loses line of mechanical advantage, has difficulty abducting arm and may overstretch |
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what effect does lack of thoracic spine extension (to one side) and scapular adduction have on arm movements (when trying to straighten spine) |
humerus abducts to support spinal extension |
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when should you use a sling? |
-protection of arm during mobility (ie transfers) -to improve balance during transfers and gait -if pain or swelling increases when UE is down during gait -if the client and or caregiver is able to don/doff it safely |
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when should you not use a sling?/ what are the disadvantages? |
-it hinders function of the arm (during times that it would be good to use) -can cause significant pressure on the neck -risks of contractures when arm is immobilized -promotes disregard and sensory deprivation of affected limb |
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what are muscles with high tone typically in the shoulder (to target with botox?) |
-subscapularis (internal rotation of humerus) -rhomboids (retracts scapula) -lattissimus dorsi (adducts and internally rotates humerus) -pectoralis major/minor (internal rotation, adduction of humerus) |
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what are muscles with high tone typically in the arm/ forearm/hands (ie to target with botox)? |
-biceps -brachialis (flexes arm in pronation) -brachioradialis (flexes arm and rotates into midprone) -wrist/finger flexors |
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when is kinesiotape useful? |
-helps support limbs during movement to prevent future damage -useful when muscles or joints are affected |
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when is kinesiotape not useful? |
-people with skin vulnerabilities -people whose muscles and joints are not affected (because there is no point) -people with diabetes (skin damage may lead to amputations, esp with neuropathies) -check with a nurse before using it (for skin vulnerabilities, diabetes, etc) |
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when is a splint that supports the lower arm (in a position where it is not elevated) useful? what are its advantages? |
-a person with good scapular control but distal weakness -allows the forearm and scapula to be in a more natural position -can help with balance while walking -less likely to lead to contractures when compared to holding arm at 90 |
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where should you put the bigger pocket of the sling and why? |
-the larger pocket should go over the hand -this is to prevent edema |
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when the torso is laterally flexed to the right side, what shoulder is more likely to have subluxation? |
the right shoulder (same side as the lateral flexion) |
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what major muscle is involved in protracting and stabilizing the scapula? |
serratus anterior |
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what are common pelvic positions in a stroke? |
-lateral tilt to side of weakness (causing scoliosis) -posterior pelvic tilt with kyphosis -trunk and pelvic rotation to one side when lying down |
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what are some consequences of pelvic rotations? |
-pressure ulcers -affects alignment of the rest of the body, leading to pain and movement difficulties |
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what is a common leg misalignment pattern in stroke after sitting? |
hips move towards extended/unaffected side -hip adduction with knees together -"windswept" hips: unaffected side abducted and externally rotated, affected side adducted and internally rotated -feet not equally bearing weight, foot in front of knee |