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Neuro > Clinical Aspects Of Motor Systems > Flashcards

Clinical Aspects Of Motor Systems Flashcards

0
Q

What do you see with issues in muscle strength and Bulk

A

Paralysis
paresis
Atrophy

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1
Q

What do you affect with injury to motor systems

A

Muscle strength and bulk
muscle contraction
muscle tone
muscle stiffness reflexes

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2
Q

What is paralysis

A

The inability to voluntarily produce a muscle contraction

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3
Q

What is paresis

A

Weakness

can produce a muscle contraction but not as strong as it should be

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4
Q

What is hemiplegia

A

Weakness or paralysis on one side or one half of the body

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5
Q

What is paraplegia

A

Weakness or paralysis in the lower extremities

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6
Q

What is tetraplegia or quadriplegia

A

Weakness or paralysis in all four extremities

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7
Q

What is atrophy

A

Decrease in muscle size

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8
Q

What are two kinds of atrophy

A

Disuse atrophy and

neurogenic atrophy

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9
Q

What is the main cause of neurogenic atrophy

A

Lose the nerve to the muscle

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10
Q

Examples of involuntary muscle contractions

A

Spasms
cramps
fasciculations

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11
Q

What might involuntary muscle contractions indicate

A

May or may not indicate pathology

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12
Q

What are fasciculations

A

One motor neuron becomes over excitable and can cause spontaneous contractions almost like a twitch

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13
Q

What are involuntary movements that always indicate a pathological condition

A

Fibrillations

abnormal movements caused by dysfunction in the basal ganglia

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14
Q

What are fibrillations

A

You lose the nerve that goes to the muscle, fibers become more excitable and some start spontaneously contracting
do not see the movement but can pick up through EMG recordings

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15
Q

What are problems in muscle tone

A

Tension in resting muscles

hypotonia and hypertonia

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16
Q

What can cause hypotonia

A

Transection of the ventral root, peripheral nerve, or dorsal root rhizotomy
injury to the cerebellum: often temporary hypotonia

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17
Q

What are the causes of hypertonia

A

Chronic injury to UMN or some basil ganglia

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18
Q

What do you often see in velocity dependent hypertonia

A

Accompanied by hyperreflexia of DTR
clasp knife phenomenon
clonus

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19
Q

What is clasp knife phenomenon

A

Lot of tone when stretching then quick release

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20
Q

What is clonus

A

Rapid dorsiflex and rapid planter and dorsiflex by patient

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21
Q

What is leadpipe rigidity

A

Hi resistance with constant level of increased tone

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22
Q

What is cogwheel rigidity

A

Increased resistance, gives a little, then repeats

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23
Q

What two types of rigidity are seen after severe lesions to the brain

A

Decorticate rigidity

Decerebrate rigidity

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24
Q

Where is the lesion in decorticate rigidity

A

Superior to the midbrain

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25
Q

Where is the lesion decerebrate rigidity

A

In the midbrain level

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26
Q

What do you see in decorticate rigidity

A

Upper extremity flexion lower extremity extension

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27
Q

What do you see in Decerebrate rigidity

A

Extension
upper extremity internal rotation
plantarflexion

28
Q

What does decorticate rigidity separate

A

Separates the cerebral cortex from structures that are caudal to it

29
Q

What does decerebrate rigidity separate

A

Separates cortex and midbrain from brainstem

30
Q

What happens in spinal or cerebral shock

A

Descending motor commands are interrupted by injury to upper motor neurons
lower motor neurons become temporarily inactivated

31
Q

What does spinal or cerebral shock depend on

A

The location of the injury

32
Q

What do you see in spinal or cerebral shock

A

Hypotonia and hyporeflexia that resolves the time

33
Q

What are different causes of disorders of lower motor neurons

A

Trauma
infectious/degenerative/vascular diseases
Tumors

34
Q

Where does the injury occur in the nervous system for a disorder of the lower motor neuron

A

Cell bodies in the spinal cord and brain stem
Ventral root
spinal and peripheral nerve

35
Q

In an upper motor neuron injury where does the injury occur in the nervous system

A

Anywhere from where cell bodies are down to where it lower motor neurons are
Cell bodies in cerebral cortex
axons in the base of the brainstem, cerebral cortex, spinal cord

36
Q

What are abnormal cutaneous reflexes

A

Babinski sign

muscle spasms in response to normally innoculous stimuli

37
Q

When is the Babinski sign normal

A

Until six months of age occurring

after injury to the corticospinal tract

38
Q

What causes the Babinski sign

A

Damage to the lateral corticospinal spinals

39
Q

What happens in paresis

A

Weakness
inability to activate lower motor neurons
loss of ability to fractionate movements

40
Q

What is the loss of ability to fractionate movements occur in

A

Lateral corticospinal tract

41
Q

Myoplastic hyperstiffness post stroke is due to

A

Loss of sarcomeres
increased weak binding of actin and myosin
atrophy of muscle fibers

42
Q

What is hyper stiffness

A

Excessive resistance to muscle stretch

43
Q

What are some changes in muscle fibers after injury

A

Muscle fiber diameter is decreased

selective atrophy of type two fibers

44
Q

After stroke most patients do not have what

A

Hyperactive stretch reflexesw

45
Q

Hyperreflexia is seen only in people with

A

Hemiplegia
severe contractures
spinal cord injury

46
Q

Evidence suggests that hyperreflexia may result from

A

Contractures

47
Q

What changes do you see after incomplete spinal cord injury

A

Contractures
hypertonicity
predominance of type IIb muscle fibers and a decrease in type one muscle fibers

48
Q

What reflexes do you see after spinal cord injury

A

Hypertonia
Decrease in tonic stretch reflex
Clasp knife response
clonus

49
Q

Types of upper motor neuron lesions

A

Spinal cord injury
stroke
congenital lesions

50
Q

What happens in a complete spinal cord injury

A

All descending motor control is last below the level of the lesion
spinal shock

51
Q

When spinal shock is present at and below the level of lesion what happens

A

Muscle tone is decreased
reflexes are lost
voluntary control of movement is lost

52
Q

What happens in spinal shock resolves

A

Tone is increased
monosynaptic reflexes are increased
polysynaptic reflexes are decreased
voluntary muscle control paresis

53
Q

What happens in a stroke

A

Occlusion or hemorrhage of a blood vessel in the CNS

54
Q

What does occlusion produce

A

Lack of blood flow

ischemic stroke

55
Q

What is the most common site for a stroke

A

Middle Cerebral artery

56
Q

What does an MCA stroke do

A

Disrupt connections between the cerebral cortex and the brainstem spinal cord and cerebellum
damages adult upper motor neuron’s

57
Q

What do you see when adult upper motor neuron’s are damaged

A

Paresis

loss of fractionation of movement

58
Q

What also might be damaged in an MCA stroke

A

Communication systems and sensory systems

59
Q

What does an MCA stroke affect on motor systems

A 
Abnormal muscle in activation
Corticospinal is decreased 
lateral reticulospinal is decreased 
medial reticulospinal is active
 the vestibulospinal is  active
60
Q

Standing posture of MCA stroke in the hemiparetic upper extremity

A

Contracture
Weak actin-myosin bonds
atrophy of type two muscle fibers

61
Q

MCA stroke standing posture in the lower extremity

A

Excessive extension in standing and walking

62
Q

What is a congenital disorder of upper motor neuron

A

Spastic cerebral palsy

63
Q

What do you see in spastic cerebral palsy

A

Abnormal tonic stretch flexes at rest and while moving
Reflex irradiation
abnormal cocontraction of antagonist muscles
lack of postural preparation prior to movement

64
Q

Signs more common with spinal cord injury

A

Hyperreflexia of phasic stretch reflexes
clonus
clasp knife phenomenon

65
Q

Signs common with congenital disorders

A

Abnormal Co-contraction of antagonistic muscles

Reflex irradiation

66
Q

Upper Motor neuron injury signs and symptoms

A 
Paresis 
fasciculations 
spasticity 
hyperreflexia 
Babinski sign 
clonus 
Muscle hyper stiffness
Abnormal cutaneous reflexes
 abnormal timing of muscle activation
67
Q

Lower motor neuron signs and symptoms of injury

A 
Fibrillations 
atrophy that is rapid and severe 
paralysis
Loss of reflexes 
Flaccid paralysis

Neuro (4 decks)

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