Chapter 2 Flashcards by Kasi Gardner

Neurological deficits treated by PTA’s include:

Multiple techniques, signs & symptoms

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Parts of Nagi disablement Model

Disease: (Physician) Interruption or interference with normal processes
Impairments: (PT & PTA) Anatomical physiological, mental or emotional abnormality or loss
Functional Limitations: (PT &PTA) Limitation in performance at the level of the person.
Disability: (PT & PTA) Limitation in performance of socially defined roles and tasks within the environment

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Spasticity is?

Excessive muscle tone producing resistance to passive movement.
INcreased resistance to passive movement of the joint secondary to abnormal mm tone which varies with amplitude and speed of the displacement of a joint.

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Ashworth scale to grade spasticity

0 None
1- catch and release or min resistance @ end range
1+catch followed by min resistance through remaining range
2- increased tone through most range but easily moved
3-considerable tone and passive range is difficult
4- Rigidity

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Spasticity Vs Rigidity?

Spasticity: uni-directional velocity and amplitude dependent. Caused by: cortico-spinal tract. Example: clasp Knife
Rigidity: Bi-directional, non-velocity, non-amplitude dependent. Caused by: usually extra pyramidal origins. Example: cog-wheel

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CNS-

Brain, cerebellum, brainstem, and spinal cord

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PNS-

all the components outside the cranium and spinal cord

-Divided into somatic and automatic nervous system

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Afferent Neurons

Sensory: receive input from periphery of the body and transport to CNS

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Interneurons

Connect neurons to other neurons

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Efferent Neurons

“Exit” motor neurons transmit to mm to produce movement

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Neuroglia

Non-neuronal, support other neurons

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Astrocytes

Maintain capillary endothelium, vascular links to neurons

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Oligodendrocytes

Wrap myelin sheaths around axons ( in white matter) Satellite cells produced (in gray matter) help with ion exchange between neurons

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White matter

composed of axons, carry information away from cell bodies

-Found in brain and spinal cord

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Gray matter

large number of nerve cell bodies and dendrites (give grayish coloration
a. covers cerebrum, called cerebral cortex
b.present deep in spinal cord
Note: cerebrum covers 2/3 of the brain mass and lies over and around most brain structures

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Brain

Cerebrum divided right/left hemispheres

a. protect/ support
1. skull or cranium
2. Meninges- three layers

Dura mater

Outermost layer, connects to cranium, fibrous tissue and thick

Arachnoid

Middle Layer

Pia mater

innermost layer; adheres to the brain itself

Cerebrospinal fluid

bathes the brain and circulates in the subarachnoid space.

Frontal lobe

Primary motor cortex:
1. planning & initiation of voluntary, intentional movements.
2. Movement memory; patterned motor activity
3. Expressive Language (written and spoken)
a. Broca’s area: primary motor region for
speech

Left hemisphere:

Plans mouth movements to produce speech

Right hemisphere:

Nonverbal communication (gestures, tone of voice)

Cognitive (Executive) functions of the Frontal Lobe

Judgement
Self-awareness
Attention to a task
Abstract thinking
Insight
Organization
Problem solving: awareness of consequences of actions

Parietal Lobe:

Primary Sensory cortex: 1. Tactile sensation 2. Proprioception and spatial relationships a. left/ right discrimination b. body image/body scheme c. location of body parts in space 3. Interpretation of sensory input a. readin b. naming objects c. mathematics

Temporal Lobe:

1. Hearing 2. Language comprehension a. Wernicke's area- usually Lt. hemispheres. Allows you to hear and comprehend spoken language. 3. Memory acquisition

Occipital Lobe:

Primary visual cortex 1. Visual field 2. Interpretation of visual information a. recognition of objects, words, colors; etc.

Internal Capsule

Subcortical structures 1. Corticospinal tract: travels in the posterior portion and allows information to be transmitted from cortex to brain stem and spinal cord.

Diencephalon

Composed of thalamus and hypothalamus 1. Doral colums, lateral spinothalmic, visual & auditory pathways. 2. Relay sensory impulses (except smells) and channels them to appropriate regions 3. Thalmus- relays motor info; pain and peripheral numbness

Hypothalmus

Underneath the thalamus 1. Regulates homeostasis 2. Automatic functions: hunger, thrust, digestion, body temp, blood pressure, sexual activity, sleep/wake cycles. 3. Integration: endocrine system and ANS

Cerebellum

1. Coordination of voluntary movement a. functions as an error-correcting mechanism by comparing the command sent from pre-central gyrus with the actual motor performance, then sending corrective feedback to various brain areas b. influences initiation, timing, sequencing and force generation of mm's

Balance

- Cerebellum - There are multiple special tests to assess cerevellar damage ie: turning over of the hands in opposite directions, heel on the shin, touching nose

Brain Stem

1. Vasomotor Control ie: HR,BP 2. Respiratory Control 3. Arousal / Consciousness 4. Various Reflexes ie: Coughing, sneezing, swallowing,vomiting, startle response

Limbic System

- Controls primitive emotional reactions | ie: pain, pressure, rage, affection, sexual interest, fear, sorrow and memory

Labile

- Damage to the Limbic System, causing a sudden change of emotions

Basal Ganglia

1. Regulation of posture and mm tone | 2. Allows for initiation of movement