Hand Stuff
Bones & joints of the hand
Bones: carpals, metacarpals,proximal phalanges, middle phalanges, distal phalanges
joints:CMC, IP, MCP, PIP, DIP
Types of Memories
short, working, long term
2 sensory tracts in the nervous system
No response, Total Assistance
Level 1
How can visual deficits be addressed in treatment (there's a lot!)
cue to scan, improve lighting, organization of space, high contrast, magnifying glass, Phone accessibility settings, using fall prevention protocols
Compression glove, elevate, lymphadema massage, compression wrap, and taping techniques aid in...
Edema management of hand/arm
Types of Attention
sustained, concentration, selective, divided, shifting
Touch, vibration, proprioception
Purposeful, appropriate- Mod Independent
Level 10
This condition is often referred to "tunnel vision"
Glaucoma
Grasps (3) & Pinches (5)
grasps: cylindrical, spherical,hook
pinches:side to side (cigarette) , lumbrical (holding a plate) , pinch , three jaw chuck, lateral pinch (holding a key)
Mental functions vs Higher level cognitive functions
Mental: higher level cognitive, attention, memory, perception, thought, sequencing, emotional, self & time.
Higher level:judgement, concept formation, meta cognition, executive functions, praxis, cognitive flexibility, insight
Spinothalamic Tract
detects pain, temperature from body to brain
Consistently oriented to person, place, and time
Level 8
Saccades, pursuits, form/visual discrimination, figure ground, form constancy
Saccades:rapid eye movement that shifts focus from one object to another (IE:reading, driving)
Pursuits:smooth continuous tracking following a moving target
Form/visual discrimination:shape and it's orientation (telling the difference between b&d, M&W. p&q)
Figure ground:identifying foreground from background
Form constancy: ability to recognize objects even if it varies in shape, size, position (recognizing the letter a in different fonts, or paper vs whiteboard, etc)
Duputrens, de Quervains tendionpathy, Trigger finger definitions /causes. (pg665 Phys Dis)
Dupuytrens=progressive contraction of fascia in palm of hand that lead to fixed flexionof MCP and PIP joints.Cause-mostly genetics.
de Quervains tendionpathy=first dorsal compartment, radial side of wrist and hand, inflammation/degeneration of tendons. Cause-repetitive thumb abduction and wrist ulnar deviation.
Trigger finger-tenosynovitis of flexor tendon at the A1 pulley/locks, difficult to extend. Cause-repetitive gripping/arthritis.
Global mental functions
conciousness, orientation, temperament/personality, energy/ drive, sleep
T or F, The motor pathway within the spine is the Lateral Cortico Spinal Tract
True
Blinks when strong light crosses visual field and follows moving object passed within visual field
Level 3
A post CVA stoke client presents with homonymous hemianopia. Which area of the client's vision has been lost? (table on pg 177 Phys Dis)
half of the Visual fields in both eyes
Tests for carpel tunnel, nerve compression(s) ,cmc joint arthritis, de Quervains tenosynovitis, arterial flow,and wrist stability. (Pg 664 Phys Dis)
Phalens>Carpal tunnel
Tinels> Ulnar nerve compression at elbow
Elbow flexion>Ulnar nerve compression at elbow
Grind test> CMC joint arthritis
Finkelsteins>de Quervains tenosynovitis
Allen's test> status of arterial flow
Push off test>wrist stability
Global deterioration scale vs Allen Cognitive Levels (table on pg 925 Phys Dis)
Global deterior (level 1 optimal brain function...to level 7 max A)
Allen cognitive (level 6 optimal brain function...to level one max A)
3 main structures of Proprioception that feed back loop to the cerebellum
Muscle spindles=resist the stretch (lives in skeletal muscle, provides constant flow of info of length, tension & load)
Golgi tendon organs=contracting muscle (helps control speed of a contraction for coordinated, fine, and precision movements)
Joint receptors= live in connective tissues that sends proprioceptive info to cerebellum & ventral horn
Able to attend to highly familiar tasks in non-distracting environment for 30 min w/ mod redirection
Level 6
Cranial nerves (4) dedicated to vision (table on pg 175 Phys Dis)
Optic , Oculomotor , Trochlear, Abducens