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T3 SYSTEMS > CNS Class 6 - Rigidity & HMC Coordination > Flashcards

CNS Class 6 - Rigidity & HMC Coordination Flashcards

1
Q

One possible manifestation of _____ _______ dysfunction is rigidity.

A

Basal Ganglia

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2
Q

Hypertonia where the resistance to externally imposed joint movement is present at very low speeds of movement.

A

Rigidity

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3
Q

T/F - Rigidity depends on imposed speed of movement, as it exhibits a speed or angle threshold.

A

False - Rigidity DOES NOT depend on imposed speed of movement, as it DOES NOT exhibit a speed or angle threshold.

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4
Q

Hypertonia where simultaneous co-contraction of agonists and antagonist may occur, and this is reflected in an immediate resistance to a reversal of the direction of movement about a joint.

A

Rigidity

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5
Q

T/F - A limb with rigidity does not tend to return toward a particular fixed posture or extreme joint angle.

A

True

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6
Q

T/F - Voluntary activity in distant muscle groups leads to involuntary movements about rigid joints, and rigidity may worsen.

A

False - Voluntary activity in distant muscle groups DOES NOT lead to involuntary movements about rigid joints, ALTHOUGH rigidity may worsen.

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7
Q

Areas where ________ can be present include limbs (e.g. lead pipe, cogwheel), facial, respiratory and GI tract.

A

Rigidity

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8
Q

Overall __________ and lowering of sympathetic activation will help reduce some amount of tone in rigid muscles.

A

Relaxation

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9
Q

T/F - The more relaxed a person is means they are less likely to recruit early protective reflexes in response to aspects of a massage treatment.

A

True

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10
Q

It makes sense to focus on achieving a relaxation response _____ in the treatment in order to set the stage for your more specific approaches to rigid muscles.

A

Early

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11
Q

T/F - Even if the person is relaxed, the rigid muscles won’t be more responsive to your work and available range of motion will not change.

A

False - WHEN the person is relaxed, the rigid muscles WILL be more responsive to your work and THERE MAY BE MORE available range of motion.

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12
Q

_________ difficulties may require position adaptation so that the patient can feel at ease. If the patient has _________, lying completely flat in supine may promote choking.

A

Breathing
Dysphagia

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13
Q

Rigid muscles are prone to ________ for obvious reasons, so in addition to their basic neurological disorder, they tend to become irritable because of poor nutrition and _____ clearance.

A

Ischemia
Waste

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14
Q

T/F - Improving circulation helps reduce tone in muscles generally, and even more so in hypertoned muscles.

A

True

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15
Q

____ or ____-based contrast are the best hydrotherapy modes to optimize perfusion for rigid muscles.

A

Heat/Heat-Based

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16
Q

To the extent that it is possible given the rigidity, _______ ROM within resistance-free range will also aid circulation.

A

Passive

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17
Q

T/F - Joint mobilization techniques cannot help increase joint-related circulation.

A

False - Joint mobilization techniques CAN help increase joint-related circulation.

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18
Q

Commonly referred to as adaptive shortening. The result of fascial elements passively conforming to holding patterns, which can greatly increase range of motion loss.

A

Contracture

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19
Q

Over and above the rigidity itself, ____________ can decrease mobility and function. They can also cause premature activation of _______ ______ responses to increase tone in rigid muscles.

A

Contractures
Stretch Reflex

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20
Q

T/F - Contractures can add to muscle ischemia and joint degeneration.

A

True

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21
Q

Some reasonable approaches to working with ____________ include:
- Heat application
- Kneading, stripping and friction techniques
- Joint play
- Passive ROM
- Exercise prescription

A

Contractures

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22
Q

Having the person use _________ contraction, against resistance provided by you during treatment, may be very helpful in _________ the target muscles and reducing tone.

A

Isometric
Fatiguing

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23
Q

The most effective reflex technique for rigidity is ______ release, which can be used extensively to get temporary reductions in tone, in order to facilitate direct work on muscles and joints.

A

GTO

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24
Q

T/F - Light vibrations and stroking may prevent relaxation responses in rigidity.

A

False - Light vibrations and stroking may INDUCE relaxation responses in rigidity.

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25
Q

The least effective reflex techniques for rigidity is __________ inhibition and antagonist contraction techniques. Muscle _____________ will also have limited usefulness because of the decrease in available ROM.

A

Reciprocal
Approximation

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26
Q

“_______ ________” can help renormalize reflex sensitivity, so combinations of temperature, touch/pressure and movement may create some release of the rigidity.

A

“Sensory Overload”

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27
Q

T/F - There is no harm in trying a range of reflex techniques, as success in using these mechanisms varies depending on the degree of rigidity.

A

True

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28
Q

Rigidity has an obvious resistance to ________, but it is important to stay focused on objective of minimizing ____________ and maximizing joint health.

A

Movement
Contractures

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29
Q

Joint play can be very good for rigidity, both to stimulate reflex muscle relaxation and to provide joint __________.

A

Succussion

30
Q

Passive ______ movements can be effective if done properly. This involves:
- Move joint to point of resistance
- Hold with gentle overpressure
- Joint will usually “give” a bit
- Take to next resistance point
- Repeat one or more times

A

Forced

31
Q

T/F - GTO release cannot be combined with stretch for patients with rigidity and mobilization is best done after other tone-reducing work.

A

False - GTO release CAN be combined with stretch for patients with rigidity and mobilization is best done after other tone-reducing work.

32
Q

T/F - It is not best to treat when the patient’s rigidity-influencing medication is in full force.

A

False - IT IS best to treat when the patient’s rigidity-influencing medication is in full force.

33
Q

They receive inputs from multiple areas within each hemisphere of the brain and integrate incoming sensory information, while also forming connections between sensory and motor areas.

A

Association Areas

34
Q

Because they are involved in organizing information that comes from various other areas of the brain, ___________ _____ are often linked to complex functions.

A

Association Areas

35
Q

___________ _____ work together on the same function such as:
- Sensory info
- Safety/fight or flight
- Creation/invention/artistic expression
- Moving from place to place/work use of skills
- Improving & refining motor activities

A

Association Areas

36
Q

________ association areas stimulate HMCs to act, which then plan the response together and the motor cortex releases the plan to the corticospinal tract in the direct/_________ pathway to the anterior/ventral horn of the spinal cord to alpha neurons, which will activate muscles.

A

Cortical
Pyramidal

37
Q

Fibres that connect the corresponding regions across the two cerebral hemispheres.

A

Commissural/Transverse Fibres

38
Q

The ______ ________ is the primary commissural region of the brain.

A

Corpus Callosum

39
Q

Fibres that connect the cortex and lower parts of the brain and spinal cord.

A

Projection Fibres

40
Q

What are the 2 major descending systems of projection fibres for motor signals?

A

1) Pyramidal
2) Extrapyramidal

41
Q

The pathway for voluntary movement involving direct connection from the brain to motor nerves. Responsible for skilled movements and controls primarily distal muscles used for fine motor control on the opposite side of the body.

A

Pyramidal (aka. Direct, Voluntary) Pathway

42
Q

For pyramidal pathways, most fibres originate in the _____ ______ and cross to the contralateral side at the _______.

A

Motor Cortex
Medulla

43
Q

T/F - The pyramidal system is newer than the extrapyramidal system.

A

True

44
Q

What are the 2 tracts of the pyramidal system?

A

1) Corticospinal
2) Corticobulbar

45
Q

The _____________ tract synapses directly in the anterior horn of the spinal cord with interneurons and the lower motor neurons innervating the muscles in the limbs and trunk.

A

Corticospinal

46
Q

T/F - When it comes to the corticospinal tract, 80% of the fibres are part of the anterior tract and 20% of the fibres are part of the lateral tract.

A

False - When it comes to the corticospinal tract, 80% of the fibres are part of the LATERAL tract and 20% of the fibres are part of the ANTERIOR tract.

47
Q

The _____________ tract synapses directly with the cranial neurons to control muscular movements of the face, head and neck.

A

Corticobulbar

48
Q

T/F - A lesion on the pyramidal pathway will cause loss of distal motor function on the opposite side of the body.

A

True

49
Q

The pathway for involuntary control where there is no direct control of the motor cortex or basal ganglia on the spinal cord, but indirectly via nuclei in the midbrain and brainstem. Responsible for coordination of movement, as well as control of posture, muscle tone and axial movement.

A

Extrapyramidal (aka. Indirect, Involuntary, Postural) Pathway

50
Q

T/F - Extrapyramidal fibres have influence of the HMCs, which can stimulate or inhibit nuclei in the midbrain and brainstem.

A

True

51
Q

______________ pathways include:
- Basal ganglia
- Parts of thalamus
- Brainstem nuclei (e.g. red nuclei, vestibular nuclei, superior colliculus & reticular formation)

A

Extrapyramidal

52
Q

Cerebellar projections fall under the extrapyramidal system because they influence both the brainstem motor pathways, and the motor cortex itself via the _______________ projection.

A

Dentatothalamic

53
Q

Some of the main purposes of the ______________ pathway includes:
- Dampen erratic motions
- Maintain muscle tone & truncal stability
- Prepare muscles to make smooth/economical movements
- Provide motor manifestations of emotions
- Affects gamma system
- Maintain rhythmic/phasic behaviour (e.g. walking)

A

Extrapyramidal

54
Q

The _____ system mechanism sets the baseline level of activity in alpha motor neurons and helps to regulate muscle length/tone

A

Gamma

55
Q

When putting on mascara, there is an increase in _____ activity to use reflex parameters versus involving the motor cortex, as it uses ____ energy and effort.

A

Gamma
Less

56
Q

What are the 4 tracts of the extrapyramidal system?

A

1) Rubrospinal
2) Tectospinal
3) Vestibulospinal
4) Reticulospinal

57
Q

The ___________ tract is responsible for modulation of flexor muscle tone and reflex activity, as well as inhibition of anti-gravity muscles.

A

Rubrospinal

58
Q

The ___________ tract is primarily responsible for mediating reflex responses to visual stimuli, including involuntary adjustment of head position in response to visual information.

A

Tectospinal

59
Q

The _______________ tract is responsible for increasing anti-gravity muscle tone in response to the head being tilted to one side.

A

Vestibulospinal

60
Q

____-_______ muscles are extensor muscles in the limbs unconsciously adjusting posture to maintain balance.

A

Anti-Gravity

61
Q

The ______________ tract is responsible for locomotion and postural control.

A

Reticulospinal

62
Q

T/F - Both the vestibulospinal and reticulospinal are subdivided into medial and lateral tracts.

A

True

63
Q

T/F - Both the rubrospinal and tectospinal do not decussate, therefore providing ipsilateral innervation.

A

False - Both the rubrospinal and tectospinal DECUSSATE , therefore providing CONTRALATERAL innervation.

64
Q

The _______________ and ______________ tracts do not decussate, therefore they provide ipsilateral innervation.

A

Vestibulospinal
Reticulospinal

65
Q

T/F - We spend a lot of time between both direct and indirect pathways when learning a motor skill.

A

True

66
Q

The brain regions that have direct control over the spinal cord include the _________ and ________ cortex.

A

Brainstem
Cerebral

67
Q

_________ pathways that project to the spinal cord include the extrapyramidal reticulospinal, vestibulospinal, rubrospinal and tectospinal tracts.

A

Brainstem

68
Q

The ________ cortex gives rise to both pyramidal corticospinal and corticobulbar fibres.

A

Cerebral

69
Q

The _____ ganglia and __________ play important roles in the regulation of motor functions.

A

Basal
Cerebellum

70
Q

The _____ ganglia participate in the control of movement by receiving significant inputs from the ________ cortex and feeding back signals to different regions of the frontal cortex involved in the initiation of movement.

A

Basal
Cerebral

71
Q

T/F - The basal ganglia serve to modulate activity of neurons of the motor regions of the cotex.

A

True

72
Q

The __________ recieves inputs from most parts of the CNS that contribute to motor functions. In turn, it sends back messages to each of these regions. The presence of these ________ circuits enables it to serve as a principal integrator of motor function by synchronizing the output messages distributed to each of these regions at any given point in time.

A

Cerebellum
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