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PT 632 Motor Control > Development of Normal Postural Control > Flashcards

Development of Normal Postural Control Flashcards

1
Q

what are the 4 movements problems infant is confronted with

A
  • overcoming effects of gravity
  • mastering head control
  • controlling interactions between head, trunks and limbs
  • control of task specific movements
  • (ability to adapt motor plans to changing environments)
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2
Q

first movements in infancy are what

A

reflexive (primitive reflexes)

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3
Q

is an involuntary response to a sensory stimulus

A

reflex

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4
Q

monosynaptic spinal cord reflexes

A

DTRs

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5
Q

polysynaptic spinal reflexes

A

flexor withdrawal reflex - noxious stimulus

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6
Q

brainstem reflexes that produce changes in muscle tone and postures

A

tonic reflexes (tonic labrythine, ATNR, STNR)

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7
Q

midbrain and motor cortex reflexes that are automatic control of head and trunk against gravity, maintain and recover COG with BOS and persist into adulthood

A

right and equilibrium reflexes

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8
Q

initial movements in infancy are

A

random and unpurposeful

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9
Q

neonatal kicking involves ____ in which both lower limbs and pelvis move together, and unable to _____ one LE from the other

A

coupling, disassociate

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10
Q

maturation of the NS is noted when the infant can kick both legs and pelvis remains still or when _______ is observed

A

reciprocal kicking

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11
Q

how does motor develop occur in terms of proximal and distal and cephalic and caudal

A

proximal —> distal
cephalic —> caudal

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12
Q

where does motor control develop first and second

A
  • First: head, upper trunk, and UE
  • Second: lower trunk, abs, pelvis and LE
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13
Q

midline stability of the neck and trunk occurs before what other muscle stability

A

shoulder and pelvic

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14
Q

head to midline is followed by _____ to midline

A

limbs

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15
Q

grasp develops from _____ first then thumb/index finger

A

ulnar fingers

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16
Q

full-term infants are born in

A

physiological flexion

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17
Q

____ is the dominant tone in all positions in infancy, when at rest and with all passive and active movements

A

flexion

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18
Q

antigravity control develops in extensors _____ flexors in each posture

A

before

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19
Q

which develops first, fine or gross motor

A

gross motor

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20
Q

what is Rood’s sequence

A

mobility –> stability –> controlled mobility –> skill

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21
Q
  • ability to initiate movement
  • initially random moving towards purposeful
  • suggests normal neuromuscular development
  • adult mobility is the available ROM and has sufficient motor unit recruitment
A

mobility of roods sequence

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22
Q
  • able to maintain static posture in WB antigravity positions
  • tonic holding
  • co-contraction
A

stability of roods sequence

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23
Q

isometric contraction of postural extensors

A

tonic holding

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24
Q

antagonist muscle contractions to provide midline or WB

A

co-contraction

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25
Q
  • mobility superimposed on stability
  • dynamic postural control
  • ability to weight shift in a posture
  • proximal segment moves over a fixed distal segment
  • ex: quadruped rocking
  • occurs accidentally at first
  • thousands of practice repetitions
A

controlled mobility of roods sequence

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26
Q
  • most mature movement
  • possible after controlled mobility is mastered
  • proximal segments stability while distal segments are free for movement
  • allows for manipulation and exploration of environment
  • ex: U/L reaching, creeping, crawling, walking
A

skill of roods sequence

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27
Q

WB on ____ extremities occurs before ____ extremities

A

flexed
extended

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28
Q

what are some examples of factors that can influence the developmental process

A

growth, maturation, and adaption

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29
Q

3 components of development of postural control

A
  • tilting and equilibrium reactions
  • protective extension responses
  • righting reactions
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30
Q

maintaining ones center of mass/gravity within one’s base of support; most advanced and last to develop

A

tilting and equilibrium reactions

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31
Q

ability to compensate if balance is disturbed; predictable; rapid perturbation of COG outside BOS causes extension of extremities to prevent fall; elicited when head righting and tilting/equilibrium responses are unable to regain postural control

A

protective extension responses

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32
Q

orient the head in space and keep eyes and mouth horizontal; head maintained in upright position regardless of if body is tilted/rotated; head or body moves to maintain or regain alignment

A

righting reactions

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33
Q

what are the two types of righting reactions

A

neck on body (NOB) and body on body (BOB)

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34
Q

elicited when surface on which the child is sitting or standing is moved causing a shift in COM

A

tilting reaction

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35
Q

the perturbation is a force directed at the child’s body

A

equilibrium reaction

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36
Q

what are the 3 responses to attempt to bring COG back within BOS with tilting/equilibrium reactions

A
  • lateral head and trunk righting occurs away from weight shift
  • trunk rotation away from weight shift
  • opposite limbs will abduct if stimulus is too great
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37
Q

relationship between postural alignment and movement

A

postural control

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38
Q

postural control implies what

A
  • readiness to move
  • ability to adapt or react to threats of balance
  • ability to anticipate postural needs to support a motor plan
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39
Q

what are the 7 components of postural control system

A
  • limits of stability
  • sensory organization
  • eye-head stabilization
  • MSK system
  • motor coordination
  • predictive central set
  • environmental adaptation
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40
Q

the maximum distance an individual can lean away from the BOS without changing BOS

A

limits of stability

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41
Q

limits of stability in adults (ant, post, lateral)

A

ant: 8
post: 4
lateral: 8

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42
Q

amount of sway depends on velocity of movement of COM at the limits of stability

A

sway referenced

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43
Q

application of ground reaction force at the body surface detects the amplitude of sway

A

center of pressure

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44
Q

integration of sensory inputs from visual, vestibular, and somatosensory systems provide NS with information about movement

A

sensory organization

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45
Q

very important for head control in infancy

A

vision

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46
Q

both map together starting at neck, then trunk to extremities and provides feedback and feedforward information

A

vestibular and proprioception

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47
Q

input from tactile and proprioception

A

somatosensation

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48
Q

what 3 components make up sensory organization

A

vision, vestibular, somatosensation

49
Q

we use our eyes to provide visual information of where we are in space and to tell us if our environment is till or moving

A

vision

50
Q

we use our feet to provide sensory cues about the surface, muscular system helps maintain upright posture, and joint proprioception provides us with info about joint position

A

somatosensory

51
Q

inner ears provide info about where we are in space; helps most during movement; inner ear control info about eye and head coordination as well as balance strategies

A

vestibular system

52
Q

what are the 3 functions of the vestibular system

A
  • stabilization of visual images on fovea of retina during head movement to allow clear vision
  • maintain postural stability especially during movement of head
  • provides CNS with exact info used for spatial orientation of head in 3 dimensions
53
Q

what are the names of the 3 semicircular canals (SCC)

A

anterior (superior)
horizontal (lateral)
posterior (inferior)

54
Q

what are the 2 otolith organs

A

utricle and saccule

55
Q

bony and high concentration of NA:K

A

perilymph

56
Q

membranous and high concentration K:NA

A

endolymph

57
Q

what are SCC filled with

A

endolymph

58
Q

contains hair cells and gel matrix known as _____

A

ampulla
cupula

59
Q

sense angular velocity in all 3 planes

A

SCC

60
Q

is deflected with endolymph movement

A

cupula

61
Q

____ toward side you move toward, and _____ the other side

A

excitatory
inhibitory

62
Q

if you move your head to one side, does the fluid move to the same or opposite direction

A

opposite

63
Q

SCC work with mixed pairs

A
  • ant works with opposite post
  • horizontals work together
64
Q

sense linear acceleration

A

otolith organs

65
Q

sense forward and reverse acceleration

A

utricle

66
Q

senses up and down acceleration

A

saccule

67
Q

consists of matrix attached to hair cells

A

maculae

68
Q

what is the normal force of gravity of the vestibular system, which is why the vestibular system functions differently in space

A

1 G

69
Q

what nerve is always firing for the vestibular system

A

vestibulocochlear (8)

70
Q

information travels from hair cells (scarpa’s ganglion) down _____

A

8th CN

71
Q

where are vestibular nuclei located and how many are their

A

pons
- 4 major
- 7 minor

72
Q

VOR (sup/med)

A

vestibulo-occular reflex –> inner ear tells eyes where to move

73
Q

VSR (lateral)

A

vestibulospinal –> balance reactions and postural reactions

74
Q

what are the 2 branches of the vestibular branch of CN 8 and what do they communicate with

A

superior vestibular - communicates with lateral and ant SCC and utricle
inferior vestibular - communicates with post SCC and saccule

75
Q

where does CN 8 exit and with what other structures

A

internal auditory canal
facial N and labyrinthine A

76
Q

processing of vestibular sensory and extravestibular sensory input occur _____

A

simultaneously

77
Q

4 major collections of cell bodies in the brainstem to manage incoming vestibular information and routes information to many different areas to process proprioceptive, visual, tactile, and auditory information needed for postural control and stable gaze

A

vestibular nuclear complex

78
Q

what do vestibular nuclei have connections with

A

cerebellum, reticular activating system, and CN 3, 4, 6

79
Q

receives information from maculae of utricle and projects to lateral vestibulospinal tract and indirectly influences LMN that innervate extensors through VSR

A

lateral vestibular nucleus

80
Q

receives information from cristae ampullaris and projects to the medial vestibulospinal tract; indirectly influences LMN that stabilize head through vestibulocolic reflex (VCR)

A

medial vestibular nucleus

81
Q

receives information from cristae ampullaris and projects to the MLF to coordinate movement of the eyes with head through VOR

A

superior vestibular nucleus

82
Q

receives information from maculae in utricle and from cristae ampullaris and projects to cerebellum to influence balance and postural awareness through medial and lateral vestibulospinal tracts

A

inferior vestibular nucleus

83
Q

is a major recipient of information in and out of the vestibular complex

A

cerebellum

84
Q

information from vestibular complex is relayed to the ______ ______ (midline)

A

cerebellar vermis (AKA flocculonodular region)

85
Q

primarily involved in adjusting and maintaining calibration of VOR and static and dynamic posture via VSR

A

cerebellum

86
Q

vestibular nuclei also send projections to the _____ which is responsible for regulation of autonomic NS functions (N/V, HR, respiration)

A

reticular formation

87
Q

what are the 2 descending extrapyramidal tracts

A

medial and lateral vestibulospinal tracts

88
Q

information from vestibular system also integrates in ____ for spatial mapping

A

hiccocampus

89
Q

pathology of the vestibular system is often seen in what

A

ocular movements

90
Q

what muscles does the anterior SCC connect with to create up torsional movement

A

superior and inferior rectus

91
Q

what muscles does the posterior SCC connect with to create down torsional movement

A

inferior rectus and superior oblique

92
Q

what muscles does the horizontal SCC connect with

A

medial and lateral rectus muscles

93
Q

maintains image stationary on retina (high speed) during head movement; only reflex working at high speed and prevents images from blurring

A

vestibulo-ocular reflex

94
Q

1:1 eye velocity to head velocity with VOR

A

vestibular gain

95
Q

equal but opposite head and eye relationships

A

vestibular phase

96
Q

occurs when somatosensory, visual and vestibular systems work appropriately and seamlessly, normal postural control engages and balance occurs subconsciously

A

sensorimotor integration

97
Q

is the process of the CNS continuously determining/adjusting the percent of input needed from each of the 3 systems to remain upright

A

sensory reweighting

98
Q

our brain is the computer to process the information we receive from our different senses: vision, touch, and inner ear through a process known as

A

sensory integration

99
Q

provide orientation of the head in space and is the stable visual image created even when the head is moving

A

eye-head stabilization

100
Q

anticipatory stabilization of head in space before the body moves

A

head stabilization in space

101
Q

what are 2 important sensory receptors in the head

A

eyes and vestibular

102
Q

resistance from viscoelastic properties of the muscle is under the regulation of what structures

A

muscle spindles, golgi tendon organs, and descending motor tracts

103
Q

ability to coordinate the activation of muscles in sequence to produce controlled motion (synergy of muscles)

A

motor coordination

104
Q

postural readiness is dependent on input from sensation and cognition in anticipation of movement

A

predictive central set

105
Q

anticipated movement before it occurs, you know how much muscle force is likely needed to lift a heavy bookbag from the floor vs table (feedforward)

A

positive predictive central set

106
Q

sensory input that occurs after the movement takes place for comparison and error detection

A

feedback

107
Q

posture and movement adaptation to changes in the environment based on sensory input

A

environmental adaptation

108
Q

what are the 3 sway referenced postural strategies recruited to maintain upright balance

A

ankle, hip, and stepping strategies

109
Q
  • quiet static standing occurs as result of sway at ankles
  • solid surface in contact with feet
  • intact visual, somatosensory, and vestibular input
  • muscle activity intends to bring person back to midline
  • distal to proximal requirement
A

ankle strategy

110
Q

in ankle strategy, backward sway is countered by what muscles

A

anterior tibialis, quads, abdominals

111
Q

in ankle strategy, anterior sway is countered by what muscles

A

gastroc, hamstrings, trunk extensors

112
Q

larger and faster perturbations or if the surface the person is standing on is smaller/narrower than the feet and is a rapid correction by the hips to restore equilibrium; muscles activated in proximal to distal sequence

A

hip strategy

113
Q

if displacing the floor backward (perturbing someone in the back) the subject will stay forward with activation of what

A

hip activation of abdominals and then quadriceps

114
Q

if displace the floor forward (pushing someone in the chest), subject will sway backward with

A

hip action of paraspinals then hamstrings

115
Q

when ankle and hip strategies are not successful to restore balance; usually to expand BOS

A

stepping strategy

116
Q

during the first 3 years of life, which system is dominant

A

visual

117
Q

ankle sway is present as early as ____ but recovery is slower in kids than adults

A

18 months

118
Q

somatosensory dependence emerges around age ___ and matures around age ____ and then predominates through adulthood

A

7
10

119
Q

vestibular information is utilized but slowly matures until _____, least effective in kids

A

15

PT 632 Motor Control (9 decks)

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