Chapter 1- Neurophysiology Flashcards
What is the sequence of the Nagi Classification
Disease-Impairment-Functional Limitation-Disability-Handicap
What is another word for Disease
Pathology
What is ‘impairment’
An alteration of structure and function
What is ‘functional limitation’
Difficulty performing routine tasks
What is a ‘disability’
SIGNIFICANT functional limitation
What is ‘handicap’
SOCIAL disadvantage of disability
What are four points that a PTA does to assist a PT with a NEURO client
- Have client sit/lie on SIDE on low plynths
- Support key positions (ex.sit behind them)
- Have 2 people working together
- Work with client for short time (20min; fatique otherwise)
3 roles of a PTA
- Carry out exercise programs; ROM, strething, strengthening, balance exercises
- Adjusting aids and other devices
- Teaching family members
PROMOTE complete INDEPENDENCE !!
Who else is part of the Rehab Team
- Doctors
- Physiatrists (Rehab medicine Dr.)
- Nurses
- Patient
- Family
- OT,PT,RT
- SLP (Speech Language Pathologist)
What is the function of the parietal lobe (largest lobe)
Integrates SENSORY input; sets Somatosensory cortex
What is the function of a frontal lobe
Conscious (Motor) Movement
-Personality
What is the function of a temporal lobe (sides of brain)
Hearing and Language
What is the function of the occipital lobe
Vision
Is the sciatic nerve part of the somatic or autonomic nervous system?
-Somatic neverous system
Sciatic: relates to body; nerves UP the back
What is a myotome
Myo=muscle
-Primary single spinal nerve root innervating: 3 nerves (L2,L3,L4)
What is the key myotome of C5
abductors:deltoid
What is the key myotome for C6
elbow flexors; biceps
What is the key myotome for C7
elbow etension; tricepts
What is the key myotome for C8
Thumb extension
What is the key myotome for T1
finger abduction/adduction
What is the key myotome for L3
leg extension/quads
What is the key myotome for L4
Dorsiflexors
What is the myotome for L5
Toe extensors
What is the myotome of S1
plantarflexors
What is a dermatome
area of skin supplied by a single nerve: MOTOR and SENSORY nerve
(Derm=skin)
What is info is carried in the corticospinal tract
Motor info descending from the cortex to spine
Cortico=cortex
What are the 3 Cerebral branches from the ‘Circle of Willis’
- Anterior
- Middle
- Posterior Cerebral Artery
Is ACETYLCHOLINE a facilitatory (excitatory) or inhibitory NT?
Facilitatory (Excitatory)
What is the resting membrane potential?
Electrical charge inside and excitatory cell, around (-70 to 90mv)
What are the 4 chemical elements in a membrane potential
- Sodium
- Potassium
- Chlorine
- Calcium
Where on the continuum of tone is SPASTICITY
High-tone
What are the different types of tones and give and example for each
NORMAL tone: from relaxed to higher to higher extension
LOW-tone: flaccid
(ex. down syndrome)
HIGH-tone: Spasticity (ex. MS/Autism)
MOTOR control is defined as
the ability to MAINTAIN and CHANGE posture and movement
Is Motor control a quick or long learning process
QUICK learning process (fractions of a second)
What does the motor control allow the nervous system to do
direct WHAT muscles will be used, in what ORDER, and how QUICKLY in order to solve a movement problem
Is Motor learning a quick or long learning process
LONG learning process
hours,days,or weeks
What plays an important role in Motor control
Sensory information
How does sensation play an important role in motor control
INITIALLY; it cues REFLEXIVE movement
(ex. stroking a baby’s cheek causes them to turn towards the contact)
LATER; provides important feedback for reaching/creeping
(ex. sound/sight feedsback to brain, responding in a movement response
What are the 2 Motor Control Theories
- Hierarchy Model (top-down theory)
2. System Model
From where and to is information sent in the HIERARCHICAL Theory
From the CORTEX downt to SUBCORTICAL structures
What is the initial part of the Hierarchical Theory that makes you move a certain way
Person ‘thinks’ about moving and NERVOUS system carries out command
When is voluntary movement achieved tin the Hierarchical Theory
through maturation of the cortex
How is the maturation of the cortex assessed in the Hierarchical Theory
through reflexes
Are reflexes primitive or trained
Primitive
ex. Feeding Reflex, Palmar grasp
What is the basis of all Movement in the Hierarchical Ttheory
Reflex
After PRIMITIVE reflexes, the next higher level of reflexes are the ?
TONIC reflexes
assoc. with the brainstem
What is the acronym for ATNR
Assymetrical Tonic Neck Reflex
ie. right-left extremity: baby moving arms towards one direction
What is the acronym for STNR
Symmetrical Tonic Neck Reflex
ie. upper-lower extremity: when arms and neck FLEX, leg EXTEND
What is the acronym for TLR
Tonic Labyrinthine Reflex
(ie. when head is extended whole body is extended, if head is in flexion whole body is in flexion; increased extensor tone when an infant is supine)
When should Primitive and Tonic Reflexes be integrated (gone) already
By 4-6 months
The farther one moves up the hierarchy, the more inhibition of…
Lower structures
tonic reflexes inhibit which reflexes?
Spinal Reflexes
ex.one smooths out the other ie: from primitive -tonic reflexes
List five Primitive Reflees
- Rooting
- Moro
- ATNR
- STNR
- Palmar grasp
At what age should the ROOTING reflex be gone
3 months
At what age should the MORO reflex be gone
between 4-6 months
At what age should the ATNR be gone
between 4-6 months
At what age should the STNR be gone
between 8-12 months
At what age should the Plantar Grasp reflex be gone
9 months
What is reflex that stays present throughout adulthood
Gagging reflex
What are POSTURAL responses and and BALANCE reactions associated with
Midbrain and Cortex
What must be gained before MOBILITY
Stability
What are the key stages (in sequence) of acquiring POSTURE in Developing Motor Control
- Prone on elbows before crawling
- Sitting unsupported before standing
What is the cephalocaudal (Hierarchicaly) postural control sequence
- Head righting reactions
- Righting reactions (keep head + trunk vertically aligned
- Equilibrium reactions(whole body trying to reach to center when gravity changes)
What is the RIGHTING REACTION
Keeping head + trunk vertically aligned
How does the SYSTEM Model differ from the Hierarchical Theory
Many systems are working at the same time in a complex manner
What is a fundamental characteristic of the system model and why is it used
Feedback (making sure client is aware of their reflexes) to CONTROL movement
When using feedback, to control movement, what is key for the patient to know
Whether the movement has been successful in the past!!
What are the (7) components of the POSTURAL CONTROL system
- Limits of stability
- Environmental Adaption
- Musculoskeletal system
- Predictive central set
- Motor coordination
- Eye-head stabilization and sensory
- Sensory Organization
What are the (3) common sway strategies in STANDING in Postural Control
- Ankle strategy
- Hip strategy
- Stepping Strategy
What (3) muscles are used to maintain ankle posture
- Peronius (around ankel)
- Tibialis Anterior (around tibia)
- Gastrocnemius
What are the (3) systems that determine the STANDING SWAY strategy in Postural Control
- Visual System
- Vestibular (close to ear-sens of balance) System
- Somatosensory (sensation anywhere in body) System
Which Model/Theory best explains the acquisition of posture and movement across the LIFESPAN: the Hierarchical System Model
System
Babies and toddles tend to function according to__ and adults will solve a new motor problem through the__
- Hierarchical Theory
- System Model
This term brings about permanent change in motor performance as a result of practice and experience.
Motor Learning
What are the (3) phases to Motor Learning
- COGNITIVE- high degree of concentration required)
- ASSOCIATIVE -frequent errors during learning;concentration on “how” to do task
- AUTONOMOUS phase-task is au autonomic; few mistakes
What is the difference between CLOSED and OPEN loop feedback
Open: someone is telling me what is going on
Closed: you dont need somebody to tell you, you automatically feel what to do
What are the two qualities a brain has
Plastic- permanent change
Elastic- is able to work around damage
What is AXONIAL SPROUTING
new axons (from cell) work/spread around dead zone in brain
WHO proposed the neuro-developmental treatment (NDT) approach
Karl and Berta Bobath
WHO developed the approach for CVA patients
Brunnstrom- typical course for recovery from stroke
Who developed the PNF (Proprioceptive neuromuscular facilitation)
Kobat, Knott, and Voss
What are 5 common Neuro Pathologies
- Stroke (most common)
- CP
- Autism
- Down Syndrome
- Spina Bifida
Mass patterns of movement+ primitive reflex are replaced by__ like Isometric control percedes ___
-Selective voluntary control
What are the major Gross-Motor milestones
- Head control (4 months)
- Walking (12 months)
- Jumping
How long does it take for a child to jump from one foot to the same foot rhythmically
42 months (3 and 1/2)
What are 2 examples of primitive reflexes
Rooting and Palmar Grasp
