Exam 4

Question 1

UMN tract for cranial nerves

Answer 1

corticobrainstem tracts

Question 2

UMN tracts that don’t guide movement. Partially depolarize LMN to enable quick action

Answer 2

nonspecific activating tracts

Question 3

partial loss of muscle strength

Answer 3

paresis

Question 4

complete loss of muscle strength

Answer 4

paralysis (-plegia)

Question 5

which motor neurons will have more severe atrophy if damaged

Answer 5

lower motor neurons

Question 6

the atrophy of denervation is associated with which motor neurons

Answer 6

LMN

Question 7

short-lived involuntary contraction of muscle tissue often due to metabolic or muscular issues

Answer 7

muscle spasm

Question 8

a prolonged contraction of muscle tissue often due to metabolic or muscular issues

Answer 8

muscle cramp

Question 9

involuntary contractions of entire motor units. Generally indicate irritation of motor neuron. Can be benign or pathologic

Answer 9

fasciculations

Question 10

involuntary contraction of multiple muscles (limb or whole body) that typically occurs between sleep and wake state. No proximate cause

Answer 10

myoclonus

Question 11

generally indicative of neural damage

can be resting or intention: suggestive of pathology in the cerebellum

Answer 11

tremors

Question 12

very important diagnostic finding that cannot be observed. The spontaneous contraction of 1 muscle fiber that has lost its nerve. Indicates denervation (muscle fiber has lost it’s nerve)

Answer 12

fibrillations

Question 13

type of hypertonia where if a muscle is moved slowly, there is no hypertonia. When a muscle is quickly stretched, the muscle overreacts.

Answer 13

velocity dependent

Question 14

type of hypertonia where speed doesn’t matter, there is always high tone

Answer 14

velocity independent

Question 15

posturing due to too much activity from the brainstem UMN. Involuntary continuous contraction of extensor muscles in UE and LE

Answer 15

decerebrate

Question 16

posturing where connection from cortex to brainstem has been severed. Pattern is involuntary hypertonia in flexion of arms and extension of legs.

Answer 16

decorticate

Question 17

potential sources of damage to LMN

Answer 17

Trauma (sharp or blunt) 
Infection (e.g., polio)
Degenerative disorders (e.g., ALS)
Vascular disorders
Tumors

Question 18

a tremor at rest suggests what pathology

Answer 18

Parkinson’s Disease

Question 19

an intention tremor is suggestive of pathology of the _____

Answer 19

cerebellum

Question 20

Signs and symptoms of LMN disorder

Answer 20

Loss of reflexes
Atrophy (more likely atrophy of denervation)
Flaccid paralysis: low tone inability to move
Fibrillations

Question 21

potential sources of damage to UMN

Answer 21

Spinal cord injury
Cerebral palsy
Multiple sclerosis
Degeneration (e.g., Parkinson’s Disease)
Trauma
Loss of blood supply (e.g., Stroke)

Question 22

Signs and symptoms of UMN disorder

Answer 22

paresis
paralysis 
loss of "fractionated" movement 
abnormal cutaneous reflexes (babinski response...limb withdrawal)
muscle stretch hyperreflexia 
clonus 
clasp-knife response

Question 23

what does the process of collateral sprouting create

Answer 23

giant motor unit (one axon innervates more muscle fibers than normal)

Question 24

if a person had a stroke that only damaged the cortex, they would have ___

Answer 24

paresis

Question 25

Exaggerated reflex response when descending inhibition is missing or much reduced or when UMN is damaged

Answer 25

muscle stretch hyperreflexia

Question 26

2 ways to help muscle stretch hyperreflexia

Answer 26

don't stretch quickly and use pharmacology to turn down LMN (act like GABA)

Question 27

how do you elicit clonus

Answer 27

quick stretch

Question 28

Rhythmic, repeating (usually involuntary) contraction | A series of hyperreflexia responses when there is a continuing stimulus of stretch

Answer 28

clonus

Question 29

how to prevent clonus

Answer 29

Pharmacology Position ankles in extreme dorsiflexion Lift leg and set it back down slowly Lean on that leg

Question 30

when clonus is sustained, this is an indication of what

Answer 30

UMN damage

Question 31

example of hyperreflexic response to stretch that goes away (UMN damage)

Answer 31

clasp-knife response

Question 32

what are 2 ways that the muscle changes in response to lack of movement due to UMN injury

Answer 32

atrophy and increased mechanical stiffness/contracture

Question 33

what are different ways we can have hypertonia or spasticity

Answer 33

hyperreflexia or brainstem UMN overactivity

Question 34

types of brainstem overractivity

Answer 34

more tonic or resting (i.e. "rigidity" of PD) | more activity dependent (i.e. muscle overactivity of CVA that create abnormal synergies)

Question 35

where does the basal ganglia motor loop output to

Answer 35

cortical UMN via thalamus and brainstem UMN via pedunculopontine nucleus

Question 36

predict the effects of various actions, then make and execute action plans

Answer 36

basal ganglia

Question 37

piece of basal ganglia that malfunctiosn to cause PD

Answer 37

substantia nigra

Question 38

excitatory neurotransmitter that has input signals from other brain regions to Putamen

Answer 38

glutamate

Question 39

5 basal ganglia loops

Answer 39

``` motor oculomotor executive behavior flexibility and control limbic ```

Question 40

loop from basal ganglia to pre central gyrus and back. Contains the plan to move

Answer 40

motor

Question 41

loop from basal ganglia to prefrontal cortex. Decides what to do

Answer 41

executive

Question 42

As a group, basal ganglia "loops" help with

Answer 42

``` predicting future events selecting desired behaviors preventing undesired behaviors motor learning (procedural memory) shifting attention spatial working memory ```

Question 43

Motor "loop" regulates

Answer 43

Muscle contraction Muscle force Multijoint movements Sequencing of movements

Question 44

is the basal ganglia motor loop excitatory or inhibitory

Answer 44

inhibitory

Question 45

pathology where there is death of dopamine producing cells in substantial nigra

Answer 45

akinetic/rigid PD

Question 46

excitatory and is the neurotransmitter that makes the basal ganglia circuitry work properly to plan movements. Without it, the basal ganglia malfunction

Answer 46

dopamine

Question 47

with dopamine gone, the output of basal ganglia increases, leading to

Answer 47

Too little activation of voluntary muscles Too much activation of postural and girdle muscles Too little activation of midbrain locomotor region

Question 48

signs and symptoms of akinetic/rigid parkinson's disease

Answer 48

akinesia/hypokinesia rigidity postural instability resting tremor

Question 49

hyperkinetic disorder involving the basal ganglia where it doesn't output enough

Answer 49

Huntington's disease

Question 50

degeneration of striatum and cerebral cortex

Answer 50

Huntington's disease

Question 51

tremor of movement where you miss the target and correct it

Answer 51

action tremor

Question 52

inability to rapidly/smoothly alternate the direction of movement

Answer 52

Dysdiadochokinesia

Question 53

Wide-based, unsteady, staggering, veering gait

Answer 53

ataxic gait

Question 54

side effects of spinocerebellum damage

Answer 54

ataxic gait dysdiadochokinesia dysmetria action tremor

Question 55

side effects of vestsbulocerebellum damage

Answer 55

Nystagmus Dysequilibrium Balance deficit (truncal ataxia)

Question 56

side effect of paravermis and hemisphere damage

Answer 56

Dysarthria (“ataxic”):

Question 57

side effect of cerebrocerebellar damage

Answer 57

Hand ataxia | Incoordination of fine finger movements

Question 58

side effect of spinocerebellar damage

Answer 58

gait ataxia

Question 59

strategies to improve function of pt with cerebellar damage

Answer 59

slow down use vision to guide movement think about what you're doing simplify movements

Question 60

what is damaged if a person has ataxia whether eyes are open or closed and their sensation tests have normal results

Answer 60

cerebellum

Question 61

what is damaged if a person has ataxia only when eyes are closed and their sensation tests have abnormal results

Answer 61

somatosensory

Question 62

all neural structures distal to the spinal nerves

Answer 62

peripheral nervous system

Question 63

surrounds individual axons

Answer 63

endoneurium

Question 64

surrounds bundles of axons

Answer 64

perineurium

Question 65

surrounds bundles of fascicles

Answer 65

epineurium

Question 66

All peripheral nerves have axons of ___, ____ and ____ (usually SNS) function

Answer 66

motor, sensory, autonomic

Question 67

A-alpha are

Answer 67

efferent, extrafusal

Question 68

Ia, Ib, II are

Answer 68

afferent, proprioception

Question 69

A-beta are

Answer 69

afferent, exteroception

Question 70

A-gamma are

Answer 70

efferent-intrafusal

Question 71

A-delta are

Answer 71

afferent- pain, temperature, viscera

Question 72

B are

Answer 72

efferent- presynaptic autonomic

Question 73

C are

Answer 73

afferent-pain, temperature, viscera | efferent-postsynaptic autonomic