Exam 1 Flashcards

1
Q

alpha motor neuron

A
  • project to extrafusal skeletal muscle
  • ALWAYS LMN - from synapse to muscle
  • have large cell bodies & large myelinated axons
  • release enough ACh that all muscle fibers it innervates contract
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2
Q

gamma motor neuron

A
  • project to intrafusal fibers of muscle spindle

- have medium-sized myelinated axons

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3
Q

muscle spindle

A

type 1a

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4
Q

GTO

A

type 1b

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5
Q

presynaptic inhibition

A

STOPPING A REFLEX: Conscious thought – volition – CNS from brain – Corticospinal tract – presynaptic inhibition to stretch reflex arc by causing hyperpolarization & releases NT GABA (inhibitor) = UMN

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6
Q

Voluntary movement

A
  • Corticospinal tract - UMN
  • Initiated in response to something in the environment
  • Purposeful, meaningful, and goal directed
  • Learned automatic movements like writing or keyboarding
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7
Q

Reflex movement

A

Rapid and involuntary

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8
Q

Central pattern generation

A
  • Interconnection of neurons that produce rhythmic movements like walking and chewing
  • These movements are typical to the individual but may vary across subjects
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9
Q

Coordinated movement

A

-Coordinated movement requires agonist and antagonist movements for both static and dynamic adjustments
-Examples: sitting posture and reaching
-Sensory Information:
Exteroceptors are the representation of the spatial coordinates or self, objects, and the environment
-In order to coordinate movement a variety of proprioceptive and spatial information is needed depending on the activity being performed

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10
Q

Refine movement

A

Basal ganglia & cerebellum

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11
Q

afferent to efferent process

A

Afferent –> thalamus –> parietal (primary somatosensory) –> cortex –> corticospinal (UMN) –> refined by basal ganglia & cerebelum –> spinal cord –> muscle

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12
Q

Feedback

A
  • closed loop model (input, error, instructions, output, feedback)
  • Correct via feedback from proprioception, touch, etc. to tighten grip in slippery water bottle
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13
Q

Feedforward

A
  • Open control (input, instructions, output)
  • Input from gustatory receptors says I’m thirsty & brain decides to pick up glass
  • Feedforward is faster – not relying on any feedback info
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14
Q

Control of Movement

A
  • Top-down (brain to spinal cord to muscle)
  • Motor neurons: control skeletal muscles
  • LMN: innervate skeletal muscles
  • UMN: descending tract
  • Control circuits: Basal ganglia and Cerebellum
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15
Q

Upper Motor Neurons

A

Descending tracts:

  • Postural/gross movement tracts
  • Fine movement & limb flexion tracts
  • Non-specific UMN
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16
Q

ATP

A

A common form in which energy is stored in living systems; consists of a nucleotide (with ribose sugar) with three phosphate groups. The energy coin of the cell

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17
Q

SMA

A
- Supplementary Motor Area
LOCATION:
- Medial portion of Broadman’s area 6
FUNCTION:
- Initiation of movement, orientation of eyes & head, planning bimanual & U/L sequential movements
CONNECTION:
- Thalamic input from  ventral anterior nucleus
- Send to the primary motor area
- Basal Ganglia
- Brainstem
- Spinal Cord
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18
Q

PMA

A
- Pre-Motor Area
LOCATION:
- Broadman's area
- Anterior to the primary motor cortex
FUNCTION: 
- Controls trunk & girdle muscles via medial UMN
CONNECTION:
- Thalamus
- Basal ganglia 
- Brainstem 
- Spinal cord
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19
Q

M1

A

– Area 4 or primary motor cortex
LOCATION:
- Precentral gyrus Broadman’s area 4
FUNCTION:
- Responsible for the execution of skilled movements
- Generates individual muscle movements as well as movements that cross joint
- Responsible for directing the amount of force needed by a muscle or for a movement
CONNECTIONS:
- Receives information form the thalamus ventral lateral nucleus
- Sends to ‘higher order motor areas
-Premotor cortex
-Basal ganglia
-Cerebellum
ORGANIZATION:
- Somatotopical organization of the entire body
- Represents 30% of the corticospinal tract

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20
Q

S1

A

– Primary Sensory Cortex

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21
Q

Dorsolateral Prefrontal Cortex

A

– front side portion of prefrontal cortex

- executive functioning

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22
Q

Cingulate Motor Area

A
LOCATION:
- Cingulate gyrus
- Medial portion of the cerebral cortex
- Broadman’s area 24 and 6
FUNCTION:
- Mediates emotional movements
- Considered part of the limbic system
CONNECTIONS:
- Receives from the amygdala
- Communicates though the basal ganglia to mediate motor movements
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23
Q

Lesions to M1

A
  • Hemiplegia
  • Contralateral weakness
  • Impaired postural righting and equilibrium reactions
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24
Q

Lesions to PM

A

Uncoordinated clumsy movement

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25
Q

Lesions to SMA

A
  • Inability to initiate movement
  • Overall lack of movement referred to as akinesia
  • Apraxia or difficulty with motor planning
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26
Q

Medial UMNs

A
  • medial white columns; postural + girdle
  • 4 tracts:
    Tectospinal
    Medial Reticulospinal
    Medial & Lateral Vestibulospinal
    Medial Corticospinal
  • All tracts are more Automatic
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27
Q

Lateral UMNs

A
  • lateral white columns; distal/fine movt.
  • 3 tracts:
    Lateral Corticopinal
    Rubrospinal
    Lateral reticulopsinal
  • Limb flexion
  • Fine movements of the limbs
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28
Q

Non-specific UMNs

A
  • throughout ventral columns;
    background excitation + local reflex arcs
  • 2 tracts
    Ceruleospinal
    Raphespinal
  • Enhance activity of interneurons and motor neurons in spinal cord
  • Emotional motor system
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29
Q

Medial corticospinal

A
  • straight down from motor cortex – runs near midline
  • (15% of the pyramidal tract):
  • Voluntary movement, primarily of the neck, shoulder & trunk muscles
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30
Q

Lateral vestibulospinal

A

vestibular nucleus in medulla down to spin – regulates more automatic mvmt
- Vestibulospinal - Positioning and movement of the body and head, muscle tone, maintain center of gravity over base of support

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31
Q

Tectospinal

A

– tectum of midbrain (4 colliculi = bumps) – superior colliculi, crosses in midbrain, down to spine
- Reflexive response to visual and auditory stimuli

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32
Q

Medial reticulospinal

A

– reticular activating system of pons to spine

- General positioning (trunk/postural muscles + extensors) and muscle tone

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33
Q

Medial vestibulospinal

A

– vestibular nucleu, crosses in medulla, down to spine
- Vestibulospinal - Positioning and movement of the body and head, muscle tone, maintain center of gravity over base of support

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34
Q

Lateral Corticospinal

A
  • (85% of the pyramidal tract):
  • Voluntary movement, primarily of the extremities,
  • Fractionation/individuation of movement (individual finger movement, in hand manipulation)
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35
Q

Rubrospinal

A

Voluntary movement of trunk and limbs

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36
Q

Lateral Reticulospinal

A

+ flexor motor neurons (excites)

- extensor motor neurons except walking (inhibits)

37
Q

Corticobulbar tracts

A
  • (bulbar = brainstem)
  • Motor cortex –> Cranial nerve nuclei in brainstem
  • Muscles of face, tongue, pharnyx and larnyx, trapezius, sternocleidomastoid
  • Upper face: bilateral innervation
  • Lower face: contralateral innervation
  • Accessory nerve, glossopharyngeal, etc.
38
Q

Diaschisis

A

loss of function of neurons in CNS distant to the injury (Christmas tree lights)

39
Q

preganglionic

A
  • Considered First order
  • Cell body in the CNS
  • Thinly myelinated
  • Uses acetylcholine
40
Q

postganglionic

A
  • Considered Second order
  • Cell body in the PNS
  • Unmyelinated
  • Uses acetylcholine in the PSNS and norepinephrine in the SNS (except sweat glands which used Ach)
41
Q

Paravertebral ganglia

A
  • They are located along side the vertebral column form T1 to L2
  • Arranged as a chain “ANS chain”
  • Functionally is the sympathetic NS
42
Q

Prevertebral ganglia

A
  • This category is located distal to the CNS in the abdomen
  • Innervates the thoracic and lumbar regions
  • Functionally has a combination of sympathetic and parasympathetic synapses
43
Q

Intrinsic ganglia

A
  • Located distal to the CNS
  • Near Organs
  • Parasympathetic
  • Originates from S2-to S4
  • Cranial nerve X
44
Q

Cranial ganglia

A
  • Located in the head
  • Parasympathetic
  • Cranial nerve III, VII, IX
    • Occular motor
    • Facial – lacrimal
    • Glossopharyngeal – parotid gland
45
Q

Autonomic Fiber Pathways by Division: Sympathetic

A
  • Sympathetic (T1 to L2)
  • These fibers originate in the lateral horn of the gray matter
  • They exit the spinal cord through the ventral root
  • These are the fibers that branch off from the spinal nerves
  • The branching area where they travel is called the white communicating ramus
  • They enter the paravertebral ganglion
46
Q

White communicating ramus

A

– preganglionic

47
Q

Gray communicating ramus

A

– postganglionic

48
Q

SympatheticNervous System

A
  • Arousal
  • Fight / Flight
  • Increased Blood Pressure
  • Increased Heart Rate
  • Cessation Peristalsis
49
Q

Sympathetic Fibers

A
  • Synapse
  • Travel though the chain
  • make additional connections
  • Exit to their corresponding targets
50
Q

Parasympathetic Nervous System

A
  • Homeostasis
    • Heart rate
    • Respiration
    • Metabolism
    • Digestion
  • Slowing Body Down
  • Decreased Blood Pressure
  • Decreases Heart Rate
  • Peristalsis
51
Q

Reticular formation

A
  • of the brainstem - plays a role in some autonomic responses:
  • Vasopressor & Vasodilation
  • Cardiac acceleration & deceleration
  • Respiratory responses
52
Q

Sympathetic (ganglia)

A
  • Thoracolumbar region
  • Ganglia close to the spinal cord
  • Myelinated short preganglionic
  • ACH - preganglionic
  • Unmyelinated long postganglionic
  • Norepinephrine - postganglionic
  • Specific or diffuse
  • Long effects - minutes
53
Q

Parasympathetic

A
  • Cranial and sacral
  • Ganglia located near the target
  • Preganglionic myelinated long
  • Preganglionic - ACH
  • Postganglionic unmyelinated short
  • ACH - postganglionic
  • Specific
  • Short effects - seconds
54
Q

Regrowth after transection and repair

A
  • 1.08 mm/day pain fibers

- 0.78 mm/day touch fibers

55
Q

Spindles contain 2 types of fibers:

A

nuclear bag & chain

56
Q

Nuclear chain

A

– length

57
Q

Nuclear bag

A

– length & velocity

58
Q

1a

A

– heavily myelinated – respond to velocity of stretch – faster

59
Q

2

A

– unmyelinated, medium in size

60
Q

Golgi Tendon Organs

A
  • Found in tendons
  • Detects tension and sends message for adjustment of muscle tension
  • Activation of golgi tendon organs results in inhibition of contraction of that muscle
61
Q

Therapeutic use of GTO

A
  • Slow sustained stretch – reduce spasticity by inhibit agonist and facilitate antagonist
  • Sustained pressure on tendon – reduce spasticity
  • Splinting provides slow sustained stretch
  • Serial casting provides slow sustained stretch
  • Positioning techniques (In NDT reflex inhibiting postures)
62
Q

Joint Receptors

A
  • Numerous types of receptors in joint capsule and ligaments
    • Ruffini’s endings (signal end of joint range – respond more to passive mvmt than active mvmt)
    • Paciniform corpuscles
    • Ligament receptors
    • Free nerve endings (pain, temp, inflammation)
  • Signal end range, movement, and pain in joint.
  • Information sent to
    • spinal cord (provide prop. info to motor neuron)
    • cerebellum
63
Q

Algesia

A

– sensitivity to pain

64
Q

Breakthrough pain

A

– chronic pain, have spike in pain

65
Q

Hyperalgesia

A

– extreme sensitivity

66
Q

Idiopathic pain

A

– unknown cause

67
Q

Intractable pain

A

– doesn’t respond to treatment - chronic

68
Q

Pain threshold

A

– point at which stimulus will cause you pain

69
Q

Pain tolerance

A

– how much pain you can take

70
Q

Pain syndrome

A

– multidisciplinary approach, chronic pain

71
Q

Phantom limb pain

A

– amputees but still feel pain

72
Q

Psychogenic pain

A

– pain psychological of nature

73
Q

Radiating pain

A

– spreads out from original site

74
Q

Referred pain

A

– pain in diff. location from where it is

75
Q

Antinociception

A
  • (pain suppression)
  • Chemical or physical intervention at different places along the pain pathway
  • Pain pathway
  • Peripheral receptors
  • Dorsal horn of spinal cord
  • Brainstem
  • Amygdala, thalamus, hypothalamus
  • Cerebral cortex
76
Q

A delta

A

– thinly myelinated – high velocity – high pain, sharp pain

-Fast pain – quicker

77
Q

C fibers

A

– unmyelinated – low velocity

- Slow chronic pain

78
Q

Pain pathways

A

-Spinothalamic
-Ascending
-Dorsal horn to thalamus
-Reticulospinal
-Descending
-Brainstem to spinal
-Trigeminothalamic
-Ascending
-CN5 to thalamus
-Spinotectal
– superior & inferior colliculus
– turn toward pain (inferior auditory, superior visual)
-Reticular formation
– like your main switch
– makes active
– shuts off when go to sleep
-Postcentral gyrus
– analysis of the pain, localization of pain, what kind of pain
-Cingulate gyrus
– emotional part of pain
-Insula
– autnomic responses
– sweating, nauseousness, etc.
-Trigeminothalamic
– a separate pathway from CN5
– ascending
– areas trigeminal nerve innervates in face

79
Q

How the body modulates pain

A
  • Endorphins
  • Stress
  • Distraction
80
Q

Gate control theory of pain

A

-With pain stimulation: small nerve fibers become active. They activate P & block II. B/c activitiy of I is blocked, it cannot block the output of P that connect w/ the brain. The “gate is open” therefore, PAIN!!

81
Q

Counterirritant theory of Pain suppression in dorsal horn

A
  • Rubbing or pressure releases enkephalin (neurotransmitter) in dorsal horn
  • Enkephalin binds with afferent nerves carrying nocioceptive information
  • Causes substance P release to be depressed resulting in hyerpolorization of the neuron and inhibition of the pain signal
82
Q

Neuropathic pain

A

Caused by:

  • Mechanical compression or lesion of nerves
  • E.g. carpal tunnel, peripheral nerve injury
  • Demyelination
  • Ectopic foci
  • Ephaptic transmission
  • Central sensitization
  • Over activity of central neurons lasting beyond initial injury due to neuroplastic changes
  • Structural reorganization of the neurons
  • Chemical disruptions (neurotransmitters, hormones, and enzymes)
83
Q

Complex Regional Pain Syndrome

A
  • Aberrant response to trauma
  • After trauma (often minor)
  • Usually distal extremity
  • May occur soon after or weeks later
  • Signs and symptoms:
  • Sensory
    • Severe spontaneous pain
    • intensified by skin contact, heat, & cold
  • Motor
    • May have paresis, spasms & tremor; muscle atrophy
  • Autonomic
    • Abnormal sweating, vasodilation in skin, atrophy (due to blood flow changes and disuse) of muscles, joints & skin
84
Q

How the body modulates pain

A
  • Endorphins
  • Stress
  • Distraction
85
Q

Gate control theory of pain

A

-With pain stimulation: small nerve fibers become active. They activate P & block II. B/c activitiy of I is blocked, it cannot block the output of P that connect w/ the brain. The “gate is open” therefore, PAIN!!

86
Q

Counterirritant theory of Pain suppression in dorsal horn

A
  • Rubbing or pressure releases enkephalin (neurotransmitter) in dorsal horn
  • Enkephalin binds with afferent nerves carrying nocioceptive information
  • Causes substance P release to be depressed resulting in hyerpolorization of the neuron and inhibition of the pain signal
87
Q

Neuropathic pain

A

Caused by:

  • Mechanical compression or lesion of nerves
  • E.g. carpal tunnel, peripheral nerve injury
  • Demyelination
  • Ectopic foci
  • Ephaptic transmission
  • Central sensitization
  • Over activity of central neurons lasting beyond initial injury due to neuroplastic changes
  • Structural reorganization of the neurons
  • Chemical disruptions (neurotransmitters, hormones, and enzymes)
88
Q

Complex Regional Pain Syndrome

A
  • Aberrant response to trauma
  • After trauma (often minor)
  • Usually distal extremity
  • May occur soon after or weeks later
  • Signs and symptoms:
  • Sensory
    • Severe spontaneous pain
    • intensified by skin contact, heat, & cold
  • Motor
    • May have paresis, spasms & tremor; muscle atrophy
  • Autonomic
    • Abnormal sweating, vasodilation in skin, atrophy (due to blood flow changes and disuse) of muscles, joints & skin
89
Q

Lateral horn only present at:

A
  • T1 – L2 sympathetic & S2-S4 parasympathetic