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Neuro Rehab 1 > ANS & Sensory Considerations in Neurorehab > Flashcards

ANS & Sensory Considerations in Neurorehab Flashcards

1
Q

what system controls the ANS

A

limbic system

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2
Q

what is the role of the hypothalamus

A

initiation motor activity for meeting homeostasis needs, ANS functions

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3
Q

what is the role of the hippocampal formation

A

memory formation

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4
Q

what is the role of the amygdala

A

emotional memory

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5
Q

what are notable limbic system structures in the brain

A

hypothalamus
hippocampal formation
amygdala

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6
Q

how is an emotional memory different from a regular memory

A

emotional memory can sometimes be more powerful
- and can elicit ANS response

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7
Q

what does the limbic system have the ability to affect (4)

A

arousal
participation
learning
compliance

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8
Q

how is the limbic system set up structurally

A

complex network w multiple interneurons
- linked to association areas in cortex for all sensory systems

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9
Q

what are 3 functions of the ANS

A

control activity of smooth ms, cardiac ms, glands

regulation and coordination of visceral activity

balance of sympathetic and parasympathetic responses appropriate to situation for homeostasis (ie fight or flight, response to stress)

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10
Q

what systems are required for survival

A

ANS
sensorimotor
limbic

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11
Q

describe the physiological reaction you see in a ANS sympathetic response (5)

A

hyper-vigilant, pupils dilate
BP, HR, and RR inc
sweating
inc blood flow to ms, dec to GI and skin
inc glucose production and release

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12
Q

why do you want to inc glucose production and release in an ANS sympathetic response

A

need energy and sugars to do whatever we need to do

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13
Q

describe the physiological reaction you see in a ANS parasympathetic response (5)

A

dec awareness of environment
pupils constrict
BP, HR, and RR dec
sweating stops
inc blood flow to GI tract, relax ms

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14
Q

what triggers a sympathetic ANS response

A

perceived or actual threats

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15
Q

what might you observe in a pt’s behavior after a sympathetic ANS response to perceived or actual threats

A

anxiety
agitation
irritability
aggression

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16
Q

what should you monitor for in pts

A

signs of sympathetic response during treatment
- changes in ANS function may be related to health condition rather than threats
- assess environmental/sensory factors inducing physiological stress

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17
Q

how does a pt’s ANS factor into a PT’s treatment

A

modify PT treatment to provide homeostasis
- do you need to decompress the sympathetic ?

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18
Q

what are 6 techniques for dec sympathetic response

A
  1. slow, continued effleurage of paravertebrals
  2. slow, smooth, pain free PROM or AAROM
  3. maintained deep pressure on abdomen, palms, soles of feet or skin above upper lip
  4. deep breathing exercises
  5. craniosacral manipulation
  6. progressive ms relaxation
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19
Q

what is ms scanning

A

tighten a ms and then relax it

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20
Q

what is included in the sensory systems

A

auditory
visual
vestibular
tactile/exteroreceptors
proprioception
- ms spindle
- golgi tendon organ
- joint receptors

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21
Q

what proprioceptive strategies can dec a sympathetic response

A

inc pressure
joint approximation

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22
Q

what can ringing in your ears be indicative of

A

equilibrium path

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23
Q

what is turning volume down to read a sign when driving an ex of

A

regulating sensory input

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24
Q

what is the auditory system connected to and what are the implications of this

A

vestibular system - CN VIII
- auditory stim may cause problems w equilibrium

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25
Q

where is the auditory cortex

A

temporal lobe

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26
Q

what function occurs in the auditory cortex

A

ability to process verbal commands

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27
Q

collaterals form the auditory cortex synapse where

A

RAS (reticular activating system)
cerebellum
many auditory association centers

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28
Q

what response do soft, steady sounds elicit

A

parasympathetic activation
- calming
- dec tone

29
Q

what response do loud, fluctuating tones elicit

A

sympathetic activation
- inc arousal
- inc ms tone

30
Q

what impact can extraneous noise have

A

can overwhelm or agitate

31
Q

what % of CNS afferent and efferent fibers are visual system

A

38% of all

32
Q

where is visual cortex located

A

occipital lobe

33
Q

what function happens in the visual cortex

A

ability to perceive visual stimuli, detect movement and orientation of body parts in space (visual proprioception)

34
Q

what connections does the visual cortex have

A

vast interneuronal connections
- thalamus
- RAS
- cerebellum
- cortical association pathways

35
Q

what do the vast interneuronal connections of the visual system impact

A

ms tone
balance
emotion
level of arousal

36
Q

how is vestibular stimuli relayed within the vestibular structures

A

peripheral vestibular apparatus
- mechanoreceptor w/i inner ear

afferents via CN VIII to CNS

37
Q

what are specific structures in the peripheral vestibular apparatus and what are their functions

A

otoliths (saccule and utricle)
- linear movements & orientation of head relative to gravity

semicircular canals
- detect angular acceleration

38
Q

how do slow, sustained, rhythmical movements (ie rocking) impact the vestibular system

A

dec ms tone and level of arousal
calming

otolith activation

39
Q

how do fast, arrhythmical, spinning motions impact the vestibular system

A

inc tone
inc arousal level
inc motor response

semi-circular canal activation

40
Q

what systems is the vestibular system highly connected to

A

proprioceptive
extrapyramidal motor

41
Q

how is posture impacted by vestibular system

A

vestibular system affects postural tone and control

42
Q

how does vestibular system impact the ANS

A

bp changes in response to position changes

43
Q

what system is involved w tactile exteroceptors

A

spinothalamic system

44
Q

DCML vs spinothalamic: touch info

A

DCML - more discriminative info
spinothalamic - more gross, travels slower

45
Q

what response is the spinothalamic system responsible for

A

primitive, protective responses
- like pain

46
Q

what type of touch can the spinothalamic system detect

A

poorly localized light touch

47
Q

afferents from the spinothalamic system synapse with what

A

reticular formation
limbic system
ANS regulators

48
Q

what is activated from exteroceptor stimulation

A

both ANS and sensory systems simultaneously

49
Q

what dictates the ANS response elicited when ANS is simultaneously activated by exteroceptor stim

A

type of application effects response of ANS

50
Q

what are ways to promote exteroceptor facilitation (2)

A

quick swipe, stroke
quick ice - more noxious

51
Q

what are ways to promote exteroceptor inhibition (4)

A

slow stroking
neutral warmth
prolonged ice / ice massage
maintained pressure

52
Q

where are proprioceptors found

A

ms spindle
GTO
joint receptors

53
Q

what do proprioceptors connect to and what is the importance of these connections

A

cortex, brainstem, and cerebellum

important - modulate relevance of afferent info

54
Q

what are proprioceptors important for

A

motor learning and adaptation

55
Q

what is located in ms spindle and GTO

A

stretch receptors
- monitor length and tension

56
Q

the response elicited from stretch receptor stim is dependent on what

A

rate and degree of lengthening

57
Q

what are techniques to promote a faciliatory proprioceptive response (4)

A

quick stretch
tapping
vibration
graded resistance

58
Q

what is a technique to promote an inhibitory proprioceptive response

A

prolonged stretch or maintained pressure

59
Q

what are techniques for distraction of joint receptors (3)

A

manual
weights
gravity

(open chain)

60
Q

what does distraction at joint receptors facilitate

A

agonist flexor response

61
Q

how can you promote approximation at joint receptors (4)

A

manual compression
jamming/pounding
weights
gravity

(closed chain)

62
Q

what does approximation at the joint receptors facilitate (2)

A

postural extensor response
co-contraction for inc stability in WB

63
Q

how can joint approximation techniques be changed to be more faciliatory or inhibitory

A

faciliatory - more intervals, consistently jamming joint together

inhibitory - constant deep pressure

64
Q

what are 5 sensory considerations given the role of PT

A
  1. part of sensory environment
  2. promote homeostasis
  3. constantly monitor & modify sensory environment to achieve desired response
  4. provide appropriate sensory experiences
    - augmented therapeutic intervention - external input to facilitate desired motor output
  5. critical to promote motor learning by dec sensory stim once skill acquired
65
Q

what are 4 questions to ask in a problem-solving approach

A
  1. what can alter state of ANS
  2. what sensory systems are available
  3. what techniques will influence CNS and thereby affect motor output
  4. what input and/or environmental factors will promote homeostasis, motor performance, and learning
66
Q

what ab ANS will impact pt treatment

A

status and functioning

67
Q

what do sensory inputs have a significant impact on

A

ANS
motor performance

68
Q

why do we want to promote homeostasis in pts

A

optimal pt participation and performance

69
Q

how and why do we want to manipulate sensory inputs

A

how - affects ANS, motor status, mood

why - optimize outcomes and learning

Neuro Rehab 1 (27 decks)

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