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Systems > Higher Motor Centres > Flashcards

Higher Motor Centres Flashcards

1
Q

Motor Cortex: key words

A

Complexity, intricacy, thought to motor, new learning, highly skillful

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2
Q

Responsibility of which HMC?: Releases command sequences for locomotor activities/primary issuer of command ‘packages’ related to movement

A

Motor Cortex

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3
Q

Responsibility of which HMC?: Key higher motor centre in learning of new motor activities through visual observation (‘see and reproduce’/mimicking), or as part of a process of thought/imagination (invention)

A

Motor Cortex

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4
Q

Responsibility of which HMC?: Primary HMC (higher motor centre) for voluntary (intentional) movement (‘think, then do’)

A

Motor Cortex

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5
Q

Responsibility of which HMC?: Primary HMC for dexterity, fine motor control.

A

Motor Cortex

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6
Q

Responsibility of which HMC?: Key HMC for fxns that combine cognitive and fine motor fxns, such as speech

A

Motor Cortex

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7
Q

Responsibility of which HMC?: Plays a larger role when movements are complex, skillful, bilateral.

A

Motor Cortex

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8
Q

Responsibility of which HMC?: Because it is constantly generating output, contributes a significant amount of baseline motor system tone as a biproduct.

A

Motor Cortex

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9
Q

If the motor cortex is damaged, it could look like/impair…

A

Learning new motor skills
Fine motor control activities
Speech fxns
Generalized hypotonicity (reduction in basic mm tone)
Significant impairment of more complex activities and involuntary movement initiation

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10
Q

Cerebellum: key words

A

Movement memory, balance, proprioception, coordination details

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11
Q

Responsibility of which HMC?: Primary HMC for overall coordination, integration of elements within movement command packages.

A

Cerebellum

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12
Q

Responsibility of which HMC?: Monitors incoming sensory info from external and internal body sources (esp visual and proprioceptive data), and integrates this info into organizing effective, appropriate movements; info is coming in as movement is happening.

A

Cerebellum

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13
Q

Responsibility of which HMC?: Key HMC for the body’s motor adjustments to the horizon and to gravity.

A

Cerebellum

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14
Q

Responsibility of which HMC?: Primary HMC for sequencing/ordering of commands- crucial to perfect movement, esp rapid, complex actions (SSS- speed, sequencing, synchronicity)

A

Cerebellum

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15
Q

Responsibility of which HMC?: Role in learning- helps mobilize motor command packages for newly learned or newly improved activities into and out of memory storage; pulling off new skill base.

A

Cerebellum

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16
Q

Responsibility of which HMC?: Constant fine tuning of motor commands- monitors motor cortex output and makes adjustments, both while the commands are being issued and after (to improve continuous actions or to improve upon learned skills)

A

Cerebellum

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17
Q

Responsibility of which HMC?: Suppression of tremor during purposeful body part activity- through counteracting surge-like qualities of motor cortex output.

A

Cerebellum

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18
Q

Symptom of dysfunction of which HMC?: generalized poor coordination

A

Cerebellum

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19
Q

Symptom of dysfunction of which HMC?: Intention tremor/body part tremors during purposeful activity

A

Cerebellum

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20
Q

Symptom of dysfunction of which HMC?: Decomposition of movement. Rather than one mvmnt that’s simultaneous, it becomes several , separate, voluntary movements. Can be speech decomposition.

A

Cerebellum

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21
Q

Symptom of dysfunction of which HMC?: Dsfxn of balance and equilibrium

A

Cerebellum

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22
Q

Symptom of dysfunction of which HMC?: Impaired motor fxn memory

A

Cerebellum

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23
Q

Symptom of dysfunction of which HMC?: Dysmetria

A

Cerebellum

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24
Q

Symptom of dysfunction of which HMC?: Nystagmus

A

Cerebellum

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25
Q

Symptom of dysfunction of which HMC?: Vertigo

A

Cerebellum

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26
Q

Symptom of dysfunction of which HMC?: Dysdiadochokinisia

A

Cerebellum

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27
Q

Symptom of dysfunction of which HMC?: Dystaxia, ataxia

A

Cerebellum

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28
Q

Dysmetria; def

A

Impaired pin-pointing (pass pointing); dsfxn in moving a body part to a point, in the most direct route.

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29
Q

Nystagmus; def

A

A combo of intention tremor and dysmetria as applied to eye movement. The eyes shimmy back and forth when the person tries to focus on a visual target.

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30
Q

Vertigo; def

A

Hallucination of movement; either of the person’s own body or of the external environment, or both.

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31
Q

Dysdiadochokinesia; def

A

The inability to perform rapidly, alternating movements.

32
Q

Dystaxia, ataxia; def; aka ____

A

AKA drunken sailor’s gait.

Body parts are not working well together and centre of gravity is not stable; person has trouble with foot placement; person has difficulty maintaining a straight course and managing objects in the environment; person often imagines body part and objects are moving when they are not.

33
Q

Basal Nuclei: key words

A

Initiator, watching what’s happening

34
Q

Responsibility of which HMC?: First initiator- ‘alerts’ the other centres to the need for new command sequences to be issued

A

Basal Nuclei

35
Q

Responsibility of which HMC?: The beginning of every motor sequence

A

Basal Nuclei

36
Q

Responsibility of which HMC?: Key HMC in oversight of reflexive relationships in the motor system: agonist/antagonist/synergist relationship- Stabilizes the base or pxml jj during mvmnt; oversees this process.

A

Basal Nuclei

37
Q

Responsibility of which HMC?: Key HMC in oversight of reflexive relationships in the motor system: postural reflexes- long term: cycle through motor units throughout the day; arm swing and hip lift in gait; sway/lean/mms activate to bring trunk back to midline/oversees this process.

A

Basal Nuclei

38
Q

Responsibility of which HMC?: Key HMC in oversight of reflexive relationships in the motor system: ‘background positioning’ of trunk and limb girdles

A

Basal Nuclei

39
Q

Responsibility of which HMC?: Key HMC in oversight of reflexive relationships in the motor system: inherent, automatic types of movement responses.

A

Basal Nuclei

40
Q

Responsibility of which HMC?: Error correction - monitors information coming into the MS and surpresses automatic responses that are not correct for the situation; editing fxnr

A

Basal Nuclei

41
Q

Responsibility of which HMC?: Adds gracefulness and efficiency to movement.

A

Basal Nuclei

42
Q

Responsibility of which HMC?: Suppression of tremor in body parts not engaged in purposeful activity through counteracting surge-like qualities of motor cortex output.

A

Basal Nuclei

43
Q

Basal Nuclei vs Cerebellum - which ‘built’ and which is ‘inherrited’?

A 
BN = inherrited 
Cerebellum = built
44
Q

Symptom of dysfunction of which HMC?: general inefficiency of movement: person is often fatigued by minor amounts of motor activities.

A

Basal Nuclei

45
Q

Symptom of dysfunction of which HMC?: Resting Tremor: body part(s) tremors when not involved in purposeful activity.

A

Basal Nuclei

46
Q

Symptom of dysfunction of which HMC?: Bradykinesia/akinesia

A

Basal Nuclei

47
Q

Bradykinesia/akinesia/def

A

slow movement initiation/inability to initiate movement. Also the inability to stop mvmnt (initiating a ‘stop’command), change mvmnt- can lead to ‘freezing’ during an attempt.

48
Q

How can you get the cerebellum involved in there is a basal nuclei dsxn?

A

Engage reflexes (someone pushing you fwd)

Involving coordinants- putting a ruler in front of a person; black and white tiles.

49
Q

Symptom of dysfunction of which HMC?: Disorders of postural control: postural tremor, disorders of background positioning, impaired/absent post. reflex components, impaired/absent global postural reflexes

A

Basal Nuclei

50
Q

Postural tremor: def/ indicates a problem with which CNS structure?

A

Body part(s) starts to tremor after holding a body part for an abnormally short period of time.

Dsfxn of Basal Nuclei

51
Q

Hypokinesia: Def & name HMC that’s dsfxning

A

Slow movement (eg astronaut in space); BG dsfxn

52
Q

Festination/festinating gait: Def & name HMC that’s dsfxning

A

Person has difficulty starting to walk and usually throws the upper body forward to create momentum. Any decision to change directions or other aspect of the mvmnt will cause the person to slow down or even freeze for a while. Person gen has problems stopping the gait.

Also, walking is absent the knee lift and the toe off reflexes.

Described as shuffling; the cerebellum is holding it together here

BG dxfxn

53
Q

Tic: Def & name HMC that’s dsfxning

A

An involuntary movement; brief, small contraction, often of smaller mm groups- can be larger mm groups, even f/body.

Tics occur one at a time or in series

BG dsfxn

54
Q

Athetosis: Def & name HMC that’s dsfxning

A

An involuntary movement; writhing, intertwining action, often in the wrists, can be the ankles or legs; ‘snake-like’.

BG dsfxn

55
Q

Chorea: Def & name HMC that’s dsfxning

A

Involuntary movement; often called a ‘dance’; a series of jerky/graceful mvmnts that follows a pattern; can involve ind. body parts or be more extensive, even f/body; won’t stop until entire ‘cycle’ has died out.

BG dxfxn

56
Q

Ballism: Def & name HMC that’s dsfxning

A

Involuntary mvmnt; large-scale, explosive body part mvmns, often a limb, but can be more extensive, even f/body.

BG dxfxn

57
Q

Dyskenesia: Def & name HMC that’s dsfxning

A

Involuntary mvmnt; body part(s) and often f/body; moves through a ‘swaying’ , repetitive cycle of mvmnt, gen w/ a circular, looping quality.

Differs from Korea in that it has a more jerky and more of a rigid sequence.

BG dsfxn

58
Q

Dystonia: Def & name HMC that’s dsfxning

A

Involuntary mvnmt; body part migrates into an abnormal position and freezes there for a period of time.

BG dsfxn

59
Q

Rigidity: Def & name HMC that’s dsfxning

A

Dsfxn in mngmnt of the reflexive programming btwn the agonist and antagonist mm groups; results in both groups at a jj responding to mvmnt directives by trying to shorten. Results in:

  • Resistence to mvmnt/very limited mvmnt available
  • A jj jolding position set by which group is strongest.
60
Q

Impacts of rigidity on the libms (2)

A
  1. Lead pipe: continuous mvmnt resistance

2. Cogwheel: intermittent or ‘stop-start’ mvmnt resistance

61
Q

Impacts of rigidity on the face

A

“the mask of parkinsonism’

B/c strength relationships are gen equal in facial expression, the face becomes expression-less. They can make voluntary expressions, but most facial expressions are involuntary so they remain expresion-less.

62
Q

Impacts of rigidity on respiration, RMT caution?

A
  • Apical breathing through only the apex of the lungs
  • Dyspnea, esp. on exertion or under stress, also in certain positions (esp flat supine, flat prone)
  • Ribcage can get stuck in partial excursion.
  • Problem with the management of the synergystic relationships
  • In inspiration and expiration, incl recruitment of 2nd mm, as needed

RMT caution: person is very susceptible to resp infections like bronchitis, pnemonia etc, thus extra care with hygenic precautions, esp. if RMT is sick.

63
Q

Impacts of rigidity on digestion, RMT caution?

A
  • Constpation due to impairment o peristalsis and swallowing reflex
  • Swallowing impairments: dysphagia- Difficulty swallowing, Aphagia- inability to swallow

RMT caution: Choking and aspiration (inhaling rather than swallowing) esp when the patient is supine.

64
Q

What is rigidity ultimately doing to the tissue? Thus, our tx goals will be _____ (3)

A

Causing it to deteriorate.

  1. Optimize tissue health
  2. Increase fxnl capabilities
  3. Decrease pain
65
Q

Contracture: def

A

Passive adaptation of CT/fascia in a body part/s being held in a continuous holding position. Passive = energy efficient b/c the CT is holding, mostly so less/no contraction energy is required.

66
Q

Contracture: Pro’s

A

Less energy expenditure in maintaining holding position

67
Q

Contracture: Con’s (5)

A
  • Promotes ishcemia and toxic conditions in tissue, thus reduces tissue health, poor healing, irritation of motor tone, ischemic pain
  • Re-inforces and increases ROM limitations, re-nforces fxnal impairments
  • Promotes compensation problems

-Promotes degnrtve changes in tissue/jjs (b/c OA happens due to less or no ROM/cx at jj/reduced jj health)

  • Forces altered mechanics, thus less efficient mvmnt and resulting tissue stress
  • Premature activation of protective stretch reflex responsese
68
Q

General guidelines to working with rigidity: List the progressive order (8)

A
  1. Gen relaxation
  2. Optimize perfusion and drainage
  3. Reduce/minimize contracture
  4. Try mm fatigue tchqs
  5. Available reflex techniques
  6. Stretch and mobilization
  7. Medications
69
Q

Tx rigidity: Explain why relaxation is important and how you would go about achieving that.

A

Lowering SyNS activation will help reduce some amount of tone in rigid mms. This will reduce likelihood of recruiting prtective reflexes. This will set you up for more specific approaches to treating the rigidity mores specifically. MMs will be more responsive and you have potential to gain more ROM.

In order to relax, they must be comfortable- consider positioning:

  • Breathing difficulties?
  • Dysphagia? Lying flat may promote choking
70
Q

-Tx rigidity: why is optimizing perfusion and drainage important? How would you do that in a tx?

A

MMs become irritable bc of poor nutrition and waste clearance (due to ischemia). Improving circ helpsreduce tone in mms.

Interventions: Heat or heat-based contrast, manual circ tchqs, PROM within resistance free-range; jj mobs if jj-related.

71
Q

Why is treating contracture an important part of treating rigidity? Interventions?

A

Over and above the rigidity itself, contracture greatly decrease mobility and fxn. They can also cause premature activation of stretch reflex responses = increase tone in rigid mms.

Contracture also adds to ischemia and jj degeneration.

Heat, kneading/stripping/friction tchqs, jj play, PROM and exercise prescription for tx contracture.

72
Q

MM fatiguing techniqes for tx-ing rigidity- which ones, how do they help?

A

Contract-relax; sustained isometric cx (temporary tissue softening).

may be very helpful in fatiguing the target mms and reducing tone.

73
Q

Reflex techniques- which ones will be effective in tx rigidity and which ones will not?

A

Yes = GTO. Maybe vibrations and stroking (facilitate relaxation)

No - Agonist/antagonist tchqs like reciprocal inhibition, antagonist cx tchqs. MM aproximation is also limited.

74
Q

Key tx aims/progression for treating rigidity?

A

We must soften tussue first, to provide ourselves with a short tx window to treat their muscles.

Minimizing contracture and maximizing jj health.

JJ play can be very good- relaxation and jj health.

Passive forced movements can be effective if done properly- carful not to tear tissue, so gently bring them to end of ROM/resistance and test it

75
Q

Tx rigidity: medication: C/I or not?

A

It’s best to treat patientwhen their medication is in full force, as the treatment will be more affective.

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