Gait apraxia Flashcards
Do we learn gait?
no it is instinctual, stepping movements are early in development
What patterns of gait are present at birth?
stepping patterns
What are operational synergies?
they are contained in the spinal cord in the form of central pattern generators (CPGs)
What can we do consciously to the organized synergies?
we can modify them based upon environmental demands
What structures are involved in gait?
integrated control of cortical areas, cerebellum, basal ganglia, and spinal cord
how do abnormalities of gait occur?
with dysfunction of a variety of nervous system structures
What is ataxic gait?
-wide base of support with irregular/erratic weight shifts and velocity
What structure is the origin of ataxic gait?
cerebellum
What is a tabetic gait? (aka sensory ataxia)
-wide base of support, high stepping (steppage), foot drop, irregular/erratic cadence, ataxia
What is tabetic gait due to?
peripheral nerve damage
What does the term tabetic gait come from?
tabies dorsalis - syphilitic cell death of DRG cells but may be due to other conditions
What is a hemiplegic (spastic gait)?
-slow, stiff leg, circumduction, foot drop, flexed arm posture with no swing
What is a hemiplegic gait caused by?
cerebral stroke
What is diplegic gait?
often faster, ataxic, stiff leg, circumducted, adducted, hip and knees flexed, plantar flexion, foot drop, flexed arm posture with no swing.
What pathology is common to have diplegic gait?
cerebral palsy
What is parkinsonian gait?
- slow, stiff, shuffling gait, no arm swing, but can be a quick, short stepping
What is a dyskinetic gait?
-rapid, fragmented movement intrusions, ataxia, dance like movement
What is dyskinetic gait often caused by?
basal nuclei damage (caudate or subthalamic nucleus)
What is apraxia?
the lack of motor plan to perform voluntary movement (inability to perform a task)
What are the four forms of apraxia?
ideational
ideomotor
kinetic
oral
What is ideational apraxia?
the inability to organize single actions into a sequence for intended purpose as in the loss of knowledge of the movement
What is ideational apraxia caused by?
cortical in origin, no specific area, but parieto occipital area is very important
What is ideomotor apraxia>
the inability to translate the idea of the action into an appropriate motor program
ideomotor apraxia is lacking what?
proper sequencing of movement
what is ideomotor apraxia most associated with?
damage to the supramarginal gyrus or superior parietal lobule
What is kinetic apraxia?
form of clumsiness, loss of hand and finger dexterity, not due to paresis, ataxia or sensory loss.
What is kinetic apraxia typically caused by?
damage to the pre motor cortex
What is oral apraxia?
the inability to execute facial movements on command and is due to damage of the inferior frontal gyrus contiguous with broca’s area
Why do oral apraxia and motor aphasia often coexist?
because of the anatomical proximity of the distributed neural networks subserving praxis and language exists in the left, dominant hemisphere
