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Neuromus 1 > exam 1: UMN and LMN issue > Flashcards

exam 1: UMN and LMN issue Flashcards

1
Q

MD characterized by too little movement

A

paralysis
hypertonia
bradykinesia

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2
Q

what us paralysis

A

weakness

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3
Q

what are the two types of paralysis

A

UMN para
LMN para

both present very differently

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4
Q

what is UMN lesion characterized by - anatomy wise

A

lesion found in the descending motor tracts
cerebral cortex
BS
internal capsule
SC

but do not forget that the indirect pathways

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5
Q

UMN lesions that lead to paralysis

A

stroke
ALS
MS
traumatic brain injury
CP
SCI

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6
Q

UMN issues is characterized by

A

hypertonia - spasticity
hyper-reflexia
UMN muscle weakness
decrease in motor coordination

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7
Q

selective distribution of muscle weakness is often seen with what kind of issue

A

UMN lesion

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8
Q

UE selective distribution

A

abductor, external rotators and extensor are primarily effected

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9
Q

LE selective distribution

A

flexors (knee), internal rotators and DF

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10
Q

how soon do we see the effects of UMN issue

A

days to weeks

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11
Q

syneries

A

the CNS organizes movement patterns of functionally linked muscles to produce an intended action

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12
Q

Abnormal movement control is often observed as what

A

lack of isolated voluntary movement - moves with poor motor control

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13
Q

abnormal synergy movement patterns

A

The inability to isolate movement of a joint

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14
Q

How do we examine if someone has an abnormal movement synergy?

A

We ask them to voluntarily perform a movement or skill and analysis the movement that we observed. – this is movement analysis.

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15
Q

how do you treat abnormal synergy

A

Repetitive task practice, also if there is secondary soft tissue complications I address those impairments also.

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16
Q

do we see atrophy when we have spasticity

A

little to no

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17
Q

what is a positive babinki

A

toes flare up

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18
Q

LMN paralysis - is casued by

A

lesion of the nerve fibers travels fron the ventral horn of the SC

or

the cranial nerve motor nuclei to the relevant muscle

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19
Q

what is the main characteristic that we use to ID LMN issue

A

flaccid paralysis

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20
Q

signs of LMN issue

A

para is limited to segmental or focal pattern (root innervated pattern)

decrease muscle tone

hypo-reflexia

the present of fasculation or fibrillation

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21
Q

what is the muscle atrophy seen with LMN issue due to

A

loss of trophic influences of the cell body (AHC) on the muscle

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22
Q

fasciulation present as

A

muscle twitches

small groups of muscle fibers

does not denote patho

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23
Q

fibrillations present as

A

involuntary, unsynchronized patho contraction of muscle fibers

seen with EMG

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24
Q

example of patho the result from LMN lesion

A

ALS
guille barre syndrome
poliomyelitis
cauda equina syndrome

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25
Q

what is ALS

A

degeneration and scarring of motor neurons in the lateral aspect of the SCC, BS, and CC

neurodegenerative disease the combines LMN and UMN issues

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26
Q

what does ALS present with

A

peri nerve changes that leads to muscle atrophy or amytrophy

progressive motor dysfunction without sensory issues

27
Q

cognitive impairments and ALS

A

frontotemporal lobar degeneration

28
Q

what does hypertonia mean

A

to much tone

29
Q

two types of hypertonia

A

spasticity
rigidity

30
Q

spasticity is resistance to what kind of movements

A

passive
velo dependent

31
Q

spasticity is secondary to what

A

UMN issue

32
Q

patho of spasticity

A

increase afferent input to AMN - increasing stretch excitation

33
Q

what causes the stretch reflex to fire

A

with any quick movement of the limb

34
Q

how do you treat spasticity

A

cutting the peri nerve

inject the nerve with phenol

pharma interventions - baclofen, Bo-tox

stretching

positioning and splitting

motor re-education with task specific stregthing

35
Q

what is rigidity due to

A

excess supraspinal drive acting on the AMN

36
Q

characteristic of rigidity

A

spinal relfexes are typically normal

not velo dependent

involves agonist and ant

37
Q

lead pipe rig

A

constant hypertonia felt throughout the ROM with passive movement

38
Q

cog wheel rig

A

jerk responses of the muscle when force is applied to bend the limb

39
Q

PD is due to what

A

death of cells in the midbrain (substantia nigra)- these convert AA to dope - which is the release to the striatum of the extrapyramidal motor system

40
Q

treatment of rig

A

add component that involve twisting and reaching

act that require large rhythmic movement to go through ROM

41
Q

what is bradykinesia

A

move slow

42
Q

bradykinesia is due to a issue where

A

extrapyramidal region

43
Q

brady is associated with what patho

A

parkinsons

44
Q

what are example of too much movement

A

tremor
fasciulation
fibrillations
chorea
hemiballisum

45
Q

tremor

A

type of shaking movement

46
Q

what is a resting tremor

A

present when the muscle is resting

may go away when the muscle is activated

47
Q

a tremor is a key sign of what disease

A

PD

48
Q

intentional (action) tremor

A

oscillation that are exaggerated at the end of voluntary movements

the tremor will often go away with rest of effected muscles

49
Q

what is action tremors seen with

A

cere issues

50
Q

physiological tremor

A

normal - reflects the error of the system

51
Q

fascuialtion are caused by what

A

anterior horn cell and motor unit firing without a command

52
Q

chorea

A

movements and rapid and involuntary

non-sterotypical

semi/non purposeful

dance like

more distally involved

53
Q

hemiballisum is a result of what

A

stroke of the subthalamic nucleus

54
Q

how does hemi present like

A

rapid involuntary movements

non-purposeful

violet fling movement

more proximal involvement

55
Q

ataxia

A

uncoordinated movement

hard time regulating forces, range and direction, and timing of movement

56
Q

motor axtia

A

intergration of motor commands there is a dysfunction

57
Q

sensory ataxia

A

sensory pathway are disrupted therefore there is not proprioceptive awareness

58
Q

The role of the primary motor cortex

A

is to initiate and execute voluntary muscle movement

59
Q

location of the primary motor cortex

A

precentral gyrus

60
Q

where is the prefrontal cortex located

A

anterior frontal lobe

61
Q

what is the prefrontal cortex involved in

A

memory, behavior, executive functions

62
Q

subthalmic nucleus is part of what

A

the BG circuit

63
Q

what is the role of the subthalamic nucleus

A

suppression of unwanted movement

Neuromus 1 (15 decks)

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