Chapter 2 Flashcards
Neurological deficits treated by PTA’s include:
Multiple techniques, signs & symptoms
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
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.
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
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
CNS-
Brain, cerebellum, brainstem, and spinal cord
PNS-
all the components outside the cranium and spinal cord
-Divided into somatic and automatic nervous system
Afferent Neurons
Sensory: receive input from periphery of the body and transport to CNS
Interneurons
Connect neurons to other neurons
Efferent Neurons
“Exit” motor neurons transmit to mm to produce movement
Neuroglia
Non-neuronal, support other neurons
Astrocytes
Maintain capillary endothelium, vascular links to neurons
Oligodendrocytes
Wrap myelin sheaths around axons ( in white matter) Satellite cells produced (in gray matter) help with ion exchange between neurons
White matter
composed of axons, carry information away from cell bodies
-Found in brain and spinal cord
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
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:
- Tactile sensation
- Proprioception and spatial relationships
a. left/ right discrimination
b. body image/body scheme
c. location of body parts in space - Interpretation of sensory input
a. readin
b. naming objects
c. mathematics
Temporal Lobe:
- Hearing
- Language comprehension
a. Wernicke’s area- usually Lt. hemispheres. Allows you to hear and comprehend spoken language. - Memory acquisition
Occipital Lobe:
Primary visual cortex
- Visual field
- 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
- Doral colums, lateral spinothalmic, visual & auditory pathways.
- Relay sensory impulses (except smells) and channels them to appropriate regions
- Thalmus- relays motor info; pain and peripheral numbness
Hypothalmus
Underneath the thalamus
- Regulates homeostasis
- Automatic functions: hunger, thrust, digestion, body temp, blood pressure, sexual activity, sleep/wake cycles.
- Integration: endocrine system and ANS
Cerebellum
- 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
- Vasomotor Control ie: HR,BP
- Respiratory Control
- Arousal / Consciousness
- 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
- Regulation of posture and mm tone
2. Allows for initiation of movement
