Apraxia Flashcards
T/F: with mental rehearsal, blood flow is seen in the primary motor / sensory and SMA area.
False, only SMA.
What type of movement runs through the premotor cortex?
Externally initiated movement.
-early phase of practice with explicit info
When is the SMA more active?
Internally driven movements
- Mental practice
- When sequence is more automatic
What is the role of the CB in movement?
Updates movement
- error detection
- optimizes movement plan
What is the role of the basal ganglia in movement?
Coordinates responses across brain
-switch motor programs
From where does the primary motor cortex receive afferents, and what does it control?
SMC and premotor
Fine, highly fractionated movements, usually single joint.
-force and speed
What pathway is contained by the inferior parietal lobe?
Where.
What is apraxia?
Inability to execute appropriate movement despite lack of paresis, ataxia or sensory loss
What’s the difference between ideational and ideomotor?
Ideational means they don’t have a concept of movement, which is more severe
How do you test apraxia?
Have them initiate fine motor movements that are common, eg. OK sign, thumbs up, brushing teeth
What is agnosia and what types exist?
Inability to recognize:
- touch
- sight
- sound
- self (autopagnosia)
- faces (prosopagnosia)
What are two tests that look for neglect?
- Line bisection test
- Cancellation test
OR
Drawing houses
What’s the difference between homonymous hemianopsia and unilateral neglect?
- HH has insight into deficit
- UN has some evidence of visual processing
What deficits do you see with a left MCA superior division?
- Broca’s aphasia
- R face and hand
- may be left gaze pref
What deficits do you see with a left MCA inferior division?
- Wernicke’s aphasia (fluent)
- R visual field loss
- usually absent motor findings
- may be apraxia
What deficits do you see with a left MCA deep territory?
Pure motor hemiparesis
What deficits do you see with a left MCA stem?
- combo of motor and sensation loss on R
- HH
- global aphasia
What is the difference between an ACA and PCA stroke?
ACA = leg hemiplegia, behavioral abnormalities
PCA = HH
Where is the best place to get a stroke (pure motor)?
Posterior limb of internal capsule!
Where does stroke occur for it to be pure sensory?
VPL nucleus of thalmus
What are bulbar and pseudobulbar signs?
When stroke directly affects CN.
- brisk reflexes
- spasticity
What is the weakness hierachy for a borderzone or watershed stroke?
shoulder > arm > face
The SMA is associated with the ___ and the PMC is associated with the ___.
Basal ganglia, cerebellum
