Chapter 7 Neuro through 11.13.18 Flashcards
What would be an important distinction between the symptoms of an upper or lower motor neuron lesion?
the presence or absence of spasticity or flaccidity
an afferent nerve transmits what type of signal?
sensory information from the body to the CNS
An efferent nerve transmits what type of signal?
motor signals from the CNS to the muscles
CNS includes
brain and spinal cord
PNS includes
spinal and cranial nerves
frontal lobe
language, cognition, thoughts, memories (hippocampus); limbic (emotion and personality)
parietal lobe
sensory; premotor coordination
temporal lobe
auditory, language processing, interpretation
cerebellum
coordination
proprioception
motor cortex and somatosensory cortex work together
thalmus
gatekeeper; removes extra info
myelination
increases rate of synapse; on axons to propagate signals properly; oligodendricites and Schwann cells; comes over times; after birth still myelinating head to tail
spinal bifida
problems with the way tube is formed (neural tube)
neural tube
epithelial cells-neurons
cavity becomes spinal canal-center of cavity; central canal continuous into brain (CSF inside)
primitive reflexes
postural rxns, abnormal postural rxns
labyrinthine
rxns due to stimulation of vestibular system
primitive reflexes divided into:
supporting rxns
tonic neck and labyrinthine rxns: stimulated by the movement of the head on the body.
tonic neck reflex
ATNR; involuntary movement; fencing reflex; normally vanishes around 3 mths old
symmetric tonic neck reflex
flex babies neck and they’ll curl up
extend babies neck and the whole body extends
normal postural rxn
righting rxn: develop immediately after birth; right themselves if tilted to the side
equilibrium rxn: develop at about 7 months;
motor abilities 1-3 months
head lag during pull to a sitting position; rising on forearms; prone creeping
motor abilities 3-6 months
vertical head control; rolls from prone to supine; sits with trunk support; prone resting on forearms or hands with head control
motor abilities 6-9 months
rolls supine to prone and back; sits without support; reaches to play with feet; maintains on all fours position; takes weight through feet and steps if help upright
motor abilities 9-12 months
moves from lying to sitting; crawls; stands supported; pulls up to stand; cruises in standing holding on to furniture; walks with hand held or alone at 12 mths
motor abilities 12-18 months
walks alone; wide BOS; kneels upright; squats when playing; stoops from standing to pick up toys; crawls up stairs-down on buttocks; starts to walk up stairs by 18 mths; starts to run stiffly by 18 mths
motor abilities 18 mths-2 yrs
runs, changes direction and stops; walks upstairs and downstairs holding on, one step at a time; walks backwards with toys; throws ball and attempts to kick a ball
motor abilities 2-2.5 yrs
climbs stairs without holding on, may alternate feet; descends stairs holding on, one foot at a time; run; climbs simple appartus; jumps both feet at once; stands on tiptoe; kicks large ball; walks with mature gait pattern; starts to ride a tricycle
motor abilities 2.5-3 yrs
climbs stairs alternating feet; descends stairs alternating feet by 3 yrs; able to walk in all directions and avoid obstacles; runs and walks on tiptoe; stands on one leg for a few seconds; walks on narrow board with assistance
motor abilities 3-4 yrs
climbs ladders and trees; hops on one leg; throws and catches a ball; uses a bat
motor abilities 4-5 yrs
dances; skips; hops for several yards on either foot; walks along a narrow line
nodal propagation
nodes of ranvier; signal jumps which makes it faster
signs of upper motor neuron lesions
weakness-more diffuse atrophy-mild, general atrophy vs weakness-severe weakness with mild atrophy fasciculations-never seen muscle tone-increases spasticity muscle stretch reflex-increased clonus-may be present pathological reflexes-may be present
signs of lower motor neuron lesions
weakness-more focal atrophy-severe, focal atrophy vs weakness-severe atrophy with mild weakness fasciculations-may be present muscle tone-decreased muscle stretch reflex-decreased to absent clonus-never present pathological reflexes-absent
motor unit
motor neuron and muscle fibers it innervates
what controls motor neurons
the primary motor cortex in the cerebrum
stroke
medial cerebral artery affects face; look for face drop as a symptom
upper motor neuron damage
immediate; flaccid paralysis; shuts everything down; return of some primitive reflex (babinski’s reflex); clasp knife effect; clonus
upper motor neuron damage means no inhibitory signal which causes a big reflex arc after stroke then makes muscles rigid and unable to move out of contracted position
clasp knife effect
increase tone in hand; clasped tight; a stretch reflex with a rapid decrease in resistance when attempting to flex a joint; like a pocket knife
clonus
stretch reflex; test in wrist an foot; stretch reflex will do a “beat” (moving several times before it stops); rapid intermittent contraction in response to a sudden stretch of a muscle
to check for spasticity
rapid change in velocity at joint; flexion/extension slow then quick (velocity change); will see a reflexive rxn to the change; feel the change with the catch
babinski
positive babinski test-foot withdrawn in plantar stimulation to foot is applied; present at birth and disappears by age 2; myelination completes by age 2
parts of the brain in CNS
cerebrum (2 hemispheres); cerebellum; diencephalon (epithalamus, subthalamus, hypothalamus, thalamus); medulla, pons and midbrain; basal ganglia; spinal cord
meninges: dura mater; arachnoid mater; pia mater (dura mater is continuous through PNS around the spinal cord and peripheral nerves)
arterial supply to the brain
internal carotid and vertebral arteries
internal carotid divides into middle cerebral artery (MCA) and is where a large majority of strokes happen and the anterior cerebral artery (ACA)
blood brain barrier
combination of the arachnoid layer, the blood and cerebrospinal fluid and the selectively permeable endothelial cell layer of the cerebral capillaries; barrier prevents passage of bacteria and meds into the tissue of the brain
CSF (in arachnoid layer) functions
shock absorber; bathes neurons of CNS and assists in transport of hormones activated by the nervous system; nutrients
hydrocephalus
medical emergency that occurs when drainage system for the CSF is compromised in any way resulting in the amount of CSF within the ventricles to build up, expanding the ventricles resulting in increased pressure on the brain
hydrocephalus signs and symptoms
fontanelle sign (pressure bubbles up in the fontanelle); headache; impaired vision; cognitive changes (child-digresses); loss of coordination; incontenence; balance disorders
hydrocephalus treatment
meds-diuretics-forces body to expel fluids; not a long term fix
med proc-ventriculoperitoneal shunt (VP shunt); dumps CSF into abdomen for reabsorption
signs of VP shunt malfunction
if shunt becomes kinked or blocked, maybe an autoimmune problem
headache, vomiting, letharg, swelling or redness along the shunt tract, confusion, seizures (immediate problem)
