Class 1 Flashcards
Brainstem and Spinal cord - which part of nervous system
Neurology review
Central Nervous System
Peripheral Nervous System contains what 3 systems
Neurology review
- Autonomic Nervous System
- Enteric Nervous System
- Somatic Nervous System
Which 2 systems does the Autonomic nervous system contain?
Neurology review
- Sympathetic
- Parasympathetic
Which nervous system being described?
Autonomic Nervous System
Neurology review
Involuntary, sensory from visceral organs,
motor to smooth muscles/cardiac muscles & glands
Which nervous system being described?
Enteric Nervous System
Neurology review
Involuntary, sensory from chemical changes in the GI tract & stretch,
motor to smooth muscles
Which nervous system being described?
Somatic Nervous System
Neurology review
Consciously controlled & voluntary,
sensory receptors & motor neurons to skeletal muscles
Cranial nerves exit where?
CNS ANATOMY
Brainstem
Nerve roots exit where?
CNS ANATOMY
Spinal cord
Spinal cord carries signals b/w what?
CNS ANATOMY
Brain and peripheral nerves
Which part of brain?
- Continuous with SC
- Contains:
medulla oblongata, pons, midbrain
MAJOR PARTS OF THE BRAIN
Brain Stem
Which part of brain?
Posterior to brain stem
MAJOR PARTS OF THE BRAIN
Cerebellum
Which part of brain?
Superior to brain stem
Contains: thalamus, hypothalamus, epithalamus
MAJOR PARTS OF THE BRAIN
Diencephalon
Which part of brain?
Largest part of brain, sits on diencephalon
MAJOR PARTS OF THE BRAIN
Cerebrum
Where do cranial nerves enter/exit
CRANIAL NERVES
Skull (cranium)
How many cranial nerves do we have?
CRANIAL NERVES
12
What are motor pathways responsible for?
MOTOR PATHWAYS
- Transmission of signals from brain to muscles
- Leads to voluntary mm movements
What are the two main primary motor pathways?
MOTOR PATHWAYS
- Corticospinal pathway
- Extrapyramidal pathway
Damage/disruptions to motor pathways can cause?
MOTOR PATHWAYS
motor impairments:
weakness, tremors, difficulties controlling movements
Where does the corticospinal pathway originate from?
MOTOR PATHWAYS
Primary motor cortex of the brain
What does the corticospinal pathway consist of and travel through?
MOTOR PATHWAYS
Upper motor neurons that travel through internal capsule, brainstem, spinal cord
What do the upper motor neurons do in the corticospinal pathway?
MOTOR PATHWAYS
Synapse with lower motor neurons in spinal cord, which transmit signals to muscles
What does the Extrapyramidal pathway contain?
MOTOR PATHWAYS
Multiple subcortical nuclei and brain regions outside primary motor cortex
What does the extrapyramidal pathway play a role in?
MOTOR PATHWAYS
Coordinating and regulating muscle tone, posture, involuntrary movement
How does the extrapyramidal pathway connections differ from corticospinal?
MOTOR PATHWAYS
More complex and indirect connections
How does muscle contraction occur?
CORTICOSPINAL TRACT
- When LMN receive signals from UMN
- Transmit electrical impulses to skeletal mm
What is a dermatome?
DERMATOMES & MYOTOMES
Area of skin supplied by sensory fibers from single spinal nerve
What do dermatomes do?
DERMATOMES & MYOTOMES
Transmit sensory information from skin to spinal cord then brain
What are myotomes?
DERMATOMES & MYOTOMES
Group of mm innervated by single spinal nerve
What do myotomes do?
DERMATOMES & MYOTOMES
Motor neurons in spinal cord send signals to specific mm enabling movement
Primary actions of these?
C1/C2
C3
C4
C5
C6
C7
C8
DERMATOME & MYOTOME DANCE
C1/C2: neck flexion/extension
C3: neck lateral flexion
C4: shoulder elevation
C5: shoulder abduction
C6: elbow flexion/wrist extension
C7: elxbow extension/wrist flexion
C8: Thumb extension/finger flexion
Primary actions of these?
T1
L2
L3
L4
L5
S1
S2
DERMATOME & MYOTOME DANCE
T1: finger abduction
L2: hip flexion
L3: knee extension
L4: ankle dorsiflexion
L5: big toe extension
S1: ankle plantarflexion/ ankle eversion/ hip extension
S2: knee flexion
What is the purpose of DTR testing?
DEEP TENDON REFLEXES
- Confirm integrity of spinal cord
- Differentiate b/w UMNL and LMNL
Hyperactive DTR means
DEEP TENDON REFLEXES
CNS lesions
Hypoactive DTR means?
DEEP TENDON REFLEXES
PNS, spinal roots, plexus
UMN =
LMN =
DEEP TENDON REFLEXES
UMN = Increase reflexes
LMN = Decreased reflexes
Which DTR is associated?
C5
C6
C7
L4
S1
SPECIAL TESTS
C5 - Biceps Brachii
C6 - Brachioradialis
C7 - Triceps Brachii
L4 - Quadriceps and Patellar
S1 - Gastrocs/Soleus - Achillies
DTR Grading ratings?
0
1+
2+
3+
4+
5+
SPECIAL TESTS
0: Absent
1+: Trace
2+: Normal
3+: Brisk
4+: No sustained clonus (very brisk)
5+: Sustained Clonus
Location
UPPER MOTOR NEURON LESION (UMN):
Within CNS - brain or spinal cord
Effect on muscle tone
UPPER MOTOR NEURON LESION (UMN):
- Increased tone (hypertonia)
- Stiffness, resistance to passive movement
Reflexes
UPPER MOTOR NEURON LESION (UMN):
Hyperactive reflexes, exaggerated or abnormal
Spasticity
UPPER MOTOR NEURON LESION (UMN):
Sudden mm contractions or spasms
Weakness or paralysis
UPPER MOTOR NEURON LESION (UMN):
Can occur due to disruption of signals
Examples of conditions?
UPPER MOTOR NEURON LESION (UMN):
Stroke, traumatic brain injury, MS, cerebral palsy
Location
Lower Motor Neuron Lesion (LMN)
PNS - Nerves from spinal cord to mm
Effect on mm tone
Lower Motor Neuron Lesion (LMN)
- Decreased tone (hypotonia)
- Floppy and lacking resistance to passive movement
Reflexes
Lower Motor Neuron Lesion (LMN)
Reduced or absent
Atrophy
Lower Motor Neuron Lesion (LMN)
May show signs due to lack of neural input
Weakness or paralysis
Lower Motor Neuron Lesion (LMN)
Severe weakness/paralysis can occur due to disruption of signals
Examples of conditions
Lower Motor Neuron Lesion (LMN)
ALS, Spinal muscular atrophy, peripheral nerve injuries, neuropathy
Typical results of UMNL LNML
DIFFERENCES & SIMILARITIES
UMN - Increased mm tone, hyperactive reflexes, spasticity
LMN - Decreased mm tone, reduced/absent reflexes
Resistance of limb to passive movement, abnormal increase in mm tone or stiffness
NEUROLOGICAL SIGNS & SYMPTOMS
Spasticity
Resistance throughout ROM due to overfiring of UMN
NEUROLOGICAL SIGNS & SYMPTOMS
Rigidity
Hypertonic state throughout ROM, simultaneous co-contraction of agonist + antagonist
NEUROLOGICAL SIGNS & SYMPTOMS
Lead- pipe rigidity
Hypertonic state w/ ratchet-like jerkiness
NEUROLOGICAL SIGNS & SYMPTOMS
cogwheel rigidity
decrease or loss of normal mm tone due to deterioration of LMN
GENERAL SIGNS & SYMPTOMS
Flaccidity aka hypotonicity
Dysarthria
defective speech due to muscular dysfunction, mental function is intact
Dyskinesia
a defect in the ability to perform voluntary movement
Dysmnesia
any impairment in memory
Dysphagia
inability to swallow
Dysphasia
impairment of speech resulting from brain lesion
Dyspnea
laboured difficult breathing
Dyspraxia
a disturbance in control and execution of voluntary movement
Dystonia
prolonged muscle contraction that causes twisting and repetitive movement or abnormal posture
Dysesthesia
abnormal sensation on the skin
Ataxia
defective muscular coordination
Paresthesia
sensation of numbness, prickling, tingling
Dysreflexia
individual with T6 or higher spinal cord injury experiences a life threatening uninhibited sympathetic response of the nervous system to a noxious stimulus
Aphasia
inability to speak; may be due to lack of comprehension of words as opposed to dysphasia (inability to coordinate muscles of speech)
Paralysis
temporary or permanent loss of function especially loss of sensation and voluntary control. Can be spastic (upper motor neuron) or flaccid (lower
motor neuron)
What is a reflex?
Involuntary, or automatic, action that the body does in response to a stimulus, without awareness
Neonatal reflexes or primitive reflexes are the inborn
behavioral patterns that develop during uterine life
They should be fully present at birth and gradually inhibited by higher centers of the brain as the infant grows and develops
3 types of developmental reflexes
- General body reflexes
- Facial reflexes
- Oral reflexes
Developmental reflex’s are retained with?
some learning disorders, ADHD,
autism spectrum
