Ment 72 Test # 3 Sensory, CP, and Ortho
How we learn through sight
imitating/mimicking modeled tasks
Ability to taste is proportional to...
number of taste buds
plantar grasp reflex
pressure on bottom of foot = flexion of toes
Palmar grasp reflex
pressure on palm = flexion/grasp of fingers
Stereognosis
the sense that perceives the solidity of objects, their size, shape, and texture
Musculature aims of MOVE program
to Increase strength of *EXTENSOR* Muscles
Laterality
Awareness of *Two sides* and use SEPARATELY or TOGETHER
Orientation
Awareness of body in relation to environment
Going Down a step in a wheelchair
Backwards
Baclofen Pump
*ANTISPASTICITY* agent Given *INTRATHECALLY* c/ in a *SHEATH* Less S/E than PO
Athetoid
*Fluxuating* muscle tone Ex: Writhing of limbs
Obligatory
*HAVING* to *occur*
Botulinum Toxin (Botox)
*NEUROTOXIN* produced by bacteria *PARALYSES MUSCLES* Will last 3-6 months Low S/E given 2 specific site
Intrathecally
*RESERVOIR* in abdomen, filled w/ medication given through *CATHETER* DIRECTLY into * SPINAL AREA*
Ataxic
*Uncoordinated* VOLUNTARY movements *CEREBELLUM* Vestibular balance issue
What to do first before putting on an orthotic
*VISUALIZE* prior to placement
Benefits of earlier intervention in CP
- Higher Success and *ADAPTATION* - *Adaptive devices* will become second nature as adults - *COMPLICATIONS* less likely to develop
General types of meds for CP
- Muscle Relaxants - CNS depressants - Botox
Piaget's Sensory Motor periods
0-12 months *LEARN TO MOVE* @ 12 months, no more primitive reflexes 12-24 *MOVE TO LEARN*
Intervention for Independence for Blind
1. *Don't change Environment* 2. Supplies w/ in arm reach 3. Encourage RESIDUAL VISION
3 factors that interfere w/ sensory motor development
1. Environmental Deprivation 2. Developmental Delay 3. Physical Disability
Training Goals for Blind
1. FUNCTIONAL 2. INDEPENDENCE
3 areas of concern for Staff and CP
1. Movement and Mobility 2. Communication 3. Eating/Feeding
4 Principles of Bracing
1. Prevent or correct *DEFORMITY* 2. Allow for MAXIMUM USE and *FUNCTION* 3. Prevent *PRESSURE SORES* 4. Provide *COMFORT*
How many tastebuds does the human mouth have?
10,000 Location: Tongue, soft palate, upper esophagus, sheek, and epiglottis
Legal Blindness
20/200 You can see at 20 feet what others can see at 200 can have *RESIDUAL VISION*
Positioning for sleeping in CP
90 90 90 flex w/ midline even while lying down. *LAY ON SIDE* w/ *PILLOW* under head and knees
What will help you determine abilities and function of a person?
APIE, 2nd level assessment
Agility
Ability to change position of body in space acurately
Differentiation
Ability to sort out and use *INDEPENDENT PARTS* of body in *SPECIFIC* CONTROLLED MANNER.
Regulator
Act on receiving Information Nerve Impulses -> Nerve Tract -> Motor System -> Muscles
Move Program Major Aim
Age Appropriate *NON SEQUENTIAL* Based on NEEDS *Person Centered*
What do orthotics do to the sensory motor system?
CALM the *Proprioceptive* System Sustained heavy stretching is occurring Keeps limb in FUNCTIONAL position
Dantrolene
Calcium Channel Blocker, PO Controls *spasticity* *LOWERS CNS ACTIVITY* S/E outweigh Benefits
Why is mobility instruction so important for the blind?
Can't MIMIC Processing time prolonged Need to be told CONCISE, SINGLE MEANING WORDS CHECK FOR UNDERSTANDING
Protective extension or Propping reflex
Center of gravity disturbed = extension and abduction on extremity on side of displacement to prevent falling
Directionality of growth
Cephalo -- Caudal Proximal -- Distal Simple -- Complex Reflexive -- Volitional
Receptive Language
Cognator
Body Image
Complete *Awareness of body* and its POSSIBILITY of *movement and performance*.
HKAFO's
Could help w/ HEMIPLEGIA
There is ___________ in risk of exploration of the environment
DIGNITY
Problem w/ PO route for Baclofen and Dantrolene
Dose needed exceeds therapeutic dose. S/E outweigh benefits
Examples of Gravitational INsecurity
Dragging feet, staying close to ground
Benefits of expanded core curriculum
Education *SOCIAL* interactions
Focus for Training Blind
Encourage Exploration by *Highlighting OTHER SENSES*
Rigidity
Extremely high Involuntary Hypertonia
What IQ doesn't measure
FUNCTION or ABILITY
How are orientation and mobility taught?
Familiar (HOME) --> Expand to community
Blind Mannerisms
Fingers in eye sockets Eye pressing Forceful Blinking Head Rolling Looking up at lights
Symmetrical Tonic Neck Reflex (STNR)
Flex Neck = arms flex, legs extend Extend neck = Arms extend, legs flex
Going up a step in a wheelchair
Front forward w/ tilt up
Perceptual Motor-Matching Example
Go to pick up a coke can and crush it *CP may not have it*
What sense is a major component of communication
HEARING
Training Method for BLIND or DEAF BLINDNESS
Hand *UNDER* Hand
Atonic Neck Reflex (ATNR)
Head to Side = Arm Extend, opp arm flex Ex: Heisman trophy pose Tx: Midline, present object in front, support pillow to sleep
UCBL
Helps w/ stability of foot only
Mobility
How you move given your orientation info
Spasticity
INVLOLUNTARY HYPERTONIA Interferes w/ voluntary movements STOP and START Trouble *Initiating, sustaining, and terminating* movement More VOLUNTARY movements seen than when compared to RIGIDITY
Cognator
Input and Processing, RECIEVING
Strength of CP
It is non-progressive
Muscle memory
Key component of motor learning *UNCONSCIOUS process*
Inadequate postural control
Leaning on hands, sluggish posture Could result in ROUNDED BACK
Outcome of sensory motor exploration
Learning Reflexes -->> Purposeful Movement
Habilitative Approach to Tx of CP
MAXIMIZE FUNCTION MINIMIZE DISABILITY
AKO's
May help stop PSR from being triggered
Total Blindness
NO residual vision
overstimulation of the vestibular system can cause...
Nausea, dizzy, sick
Can a LPT administer Botulinum Toxin (Botox)?
No
Protective Extension
Not a primitive reflex. Only get it when sensory maturation occurs. It is a sign/reflex of a mature neurological system.
Reflexes should never be __________ in a typical person
Obligatory
Balance
One side of the body working against the other side, to *Maintain upright position*
What has to happen to MAXIMIZE LEARNING
People have to be in an *IDEAL STATE* to learn *READINESS TO LEARN*
Signs of hearing impairment
Poor *ARTICULATION* Can't MIMIC Inattention Chronic ear infections
Non-Custom molded wheelchairs will have?
Postural Panel and Sit Board As opposed to slings.
when does sensory maturation occur?
Preschool to *Kindergarten*
PSR
Pressure on ball of foot = leg extend/stiffen Tx: AFO's, foot braces
Proprioceptive (Kinesthetic Movement)
Receptors are in MUSCLES, JOINTS, and TENDONS
Expressive Language
Regulator
Exteroceptve
Relating to information *OUTSIDE* the person's BODY
Trust v. Mistrust (Erikson)
Routine and Structure *LEARN TO MOVE*
Conditions associated with hearing loss
Rubella CMV Down Syndrome
TLSO is also known as
Scoliosis Brace
Sensory Deficit can cause
Sensory motivated behaviors
Somatosensory (Tactile/Touch)
Skin and sense of touch, temp, pressure, etc
Mild CP
Slight Impairment of affected limbs
Major area of concern for Client w/ CP
Social, Emotional issues
Augmented communication
Speaks for you
Intervention for any degree of hearing impairment
Stimulate *RESIDUAL* Hearing
What could Surgery in CP indicate?
Sub Par Care. It is a non-progressive d/o. Last Resort
Tonic Labyrinthine Reflex
Supine = Extensor Tone Prone = Flexor tone
Gustatory system
Taste
Autonomy v. Doubt (Erikson)
This or That choices *MOVE TO LEARN*
Application techniques of a WHO
Tighten Joint area First
Aim/Reason for CP Bracing
To promote *PURPOSEFUL/FUNCTIONAL MOVEMENT*
Rooting Reflex
Touch corner of mouth/cheek = turn to suckle
Stereotypies
Voluntary, RHYTHMIC, Repetitive, Calming
Praxis
ability to organize and conceptualize a new motor activity *Tactile system*
@ What age are Primitive reflexes typically integrated?
about 12 months
Anti-depressants, beta blockers, ACE inhibitors, and some cholesterol meds can...
affect an individual's ability to taste.
Sensory maturation occurs when
around 12 months
