Lecture 11: Posture and Balance Flashcards

1
Q

what is Centre of mass (CoM)

A

point where the mass of the body is equally distributed

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2
Q

what is Base of support (BoS)

A

area of the body in contact with the support surface

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3
Q

what is Centre of pressure (CoP)

A

Center of distribution of force applied to the supporting surface

Moves continuously around the CoM to keep it within the BoS (hearding dog)

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4
Q

what is postural control

A

umbrella term

Controlling body position for orientation and stability

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5
Q

what is postural orientation

A

ability to maintain an appropriate position

(lean forward when walking up hill)

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6
Q

what is postural stability/balance

A

Ability to control centre of mass (COM) relative to gravity and base of support (BOS)

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7
Q

what is the stability if a person is sitting reading a book

A

large base of support

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8
Q

what is the stability of a person standing to read

A

more demands than sitting because base of support is smaller

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9
Q

what is the stability of a person walking and looking forward

A

centre of mass does not stay within base of support, so there is a continuous state of imbalance

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10
Q

do postural control requirements change wit the task and environment

A

yes

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11
Q

3 main sources of sensory input to the CNS

A

somatosensory (70%)

vestibular system (20%)

Vision (10%)

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12
Q

when learning a new skill, do we rely more on somatosensory input or vision for postural stability

A

vision

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13
Q

what are the 2 parts of Vestibular Apparatus

A

bony labyrinth

membranous labyrinth

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14
Q

what is the membranous labyrinth

A

Suspended within bony labyrinth

Filled with fluid (endolymph)

Sensory receptors (hair cells) that tell us where our head has moved

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15
Q

what are the Semicircular Canals

A

3 perpendicular bones in each ear

has cupula (gelatinous mass) with hair bundles inside

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16
Q

what displaces hair cells in ear

A

Angular acceleration which
depolarizes all hair cells together

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17
Q

what is the purpose of the semicircular canals

A

stabilize vision during head turns

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18
Q

what are the names of the 3 Semicircular Canals and how are they positioned

A

anterior(superior), posterior, and horizontal canals

Oriented at 90 degrees to one another

anterior and posterior canals are 45 degrees from midline

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19
Q

what is the counter balanced design

A

Each canal works with a partner on the opposite side

Canals activate more strongly in response to movement in a particular plane

We increase activity in the semicircular canal on the side we are moving toward and decrease activity the side we are moving away from

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20
Q

what movement are the horizontal canals sensitive to

A

Rotation in the transverse plane (head turns)

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21
Q

what 2 movements are the Superior/anterior and posterior canals sensitive to

A

Movement in sagittal plane (nodding)

Movement in the coronal plane (side-bending)

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22
Q

in general, the direction of head movement corresponds to what in canals

A

an increase in the activity of that canal

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23
Q

how are semicircular canals sensitive to angular acceleration

A

Frequency of action potentials increases with higher acceleration

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24
Q

what are the 2 types of otolith organs

A

Saccule and Utricle

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25
Q

what are otolith organs

A

One utricle and saccule on each side that mirror the other side

Each contain a sensory epithelium (macula)

topped by crystals (otoconia)

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26
Q

what type of movement are otolith organs sensitive to

A

linear movements and static head tilts

27
Q

what is the orientation of the utricle and what is it responsive to

A

more horizontal

responsive to horizontal movement (side bending, lateral displacement)

28
Q

what is the orientation of the Saccule and what is it responsive to

A

more vertical

responsive to vertical movement (up/down, forward/backward)

29
Q

how are hair cells in otoliths orientated and what movement are they sensitive to

A

Hair cells oriented in different directions

On opposite sides of each macula, hair cells are sensitive to opposite motions (half depolarizes)

30
Q

are otoliths sensitive to acceleration?

A

no. they have Tonic or sustained pattern of activation

31
Q

what 2 things are special about vestibular inputs

A

They are multisensory (receive visual and vestibular input)

vestibular nuclei provide very fast compensatory eye and head movements

32
Q

why is it important that the vestibular pathways are multi sensory

A
  • Essential for postural control and control of eye movements
33
Q

what is the Medial longitudina lfasciculus (MLF)

A

connection between vestibular and visual systems

tells the eyes which way they should move

Involved in the vestibular- ocular reflex (VOR)

34
Q

what is the vestibular- ocular reflex (VOR)

A

as head turns to the right while looking at something,

Right horizontal semicircular canal is active; left horizontal semicircular canal is inhibited

Eye musculature responsible for moving eyes to left are activated

Eye musculature responsible for moving eyes to the right are inhibited

35
Q

what is the function of the Involved in the vestibular- ocular reflex (VOR)

A

Keep eyes on target while head is moving

36
Q

what are Vestibulospinal Tracts

A

Involved in the control of postural orientation and stability

Vestibular nuclei give rise to the lateral and medial vestibulospinal tracts

37
Q

what is the Medial Vestibulospinal Tract

A

Arises from medial vestibular nucleus

Descends bilaterally in spinal cord

Regulates head/neck position

38
Q

which reflex is the medial vestibulospinal tract involved with

A

Vestibular cervical reflex

Moves head in opposite direction of motion

when falling forward, neck extends to protect neck

39
Q

what is the Lateral Vestibulospinal Tract

A

Arises from lateral vestibular nuclei

Controls proximal extensor muscle tone for maintenance of posture in legs

40
Q

what reflex is involved with the Lateral Vestibulospinal Tract

A

Vestibular spinal reflex (VSR)

Body flexes in opposite direction of motion

if our body is pushed to the right, we lean to the left to come upright

41
Q

what does the cerebellum do

A

Cerebellum provides input to medial and lateral vestibular nuclei

42
Q

what 2 things does the cerebellum distinguish between

A

Motions detected by otoliths and semicircular canals

Active vs passive movements

43
Q

what is the Vestibular Cortical System

A

vestibular information ascends bilaterally to the thalamus, then to the parietal cortex and insula

generates a head-in-space picture

44
Q

are vestibular and visual systems are matched to one another

A

yes

45
Q

what is Physiological vertigo

A

conflict between sensory systems (motion sickness)

46
Q

what is pathological vertigo

A

caused by a sudden imbalance of vestibular signals

47
Q

what is Spontaneous Nystagmus

A

movement of the eyes without stimulus.

48
Q

what is Benign Paroxysmal Positional Vertigo (BPPV)

A

Most common cause of vertigo

Displacement of otoconia from the otoliths into the posterior semicircular canal

Signals to the brain that movement is occurring despite no movement

49
Q

what is the Epley Maneuver

A

Treatment of posterior canal BPPV

Displaces the otoconia back into the otoliths using gravity

50
Q

what is the feedforward mechanism

A

anticipatory postural adjustments in anticipation of postural instability

51
Q

what is the feedback mechanism

A

corrective postural control strategies in response to unanticipated postural instability

52
Q

what are the 3 types of balance control

A

Static/Steady State balance

Anticipatory/Proactive balance

Reactive balance

53
Q

what is Static/Steady State balance

A

Ability to control the COM relative to the BOS in predictable and unchanging conditions

(standing on leg, keeping self balanced)

54
Q

what is Anticipatory/Proactive balance

A

Ability to activate muscles for balance in advance of potentially destabilizing voluntary movements (ie. picking up a box)

  • Using feedforward mechanisms
55
Q

what is Reactive balance

A

Ability to recover a stable position following an unexpected perturbation

  • Using feedback mechanisms

(bus hits the breaks and we need to rebalance)

56
Q

why is Static and dynamic balance really a continuum

A

when we are “static” we still sway so we are still moving

57
Q

what are the 2 postural stability functions

A

anticipatory (minimize upcoming issues - feedforward)

reactive (correct errors - feedback)

58
Q

what is Anticipatory Postural Adjustment

A

Activation of postural muscles before execution of voluntary goal

59
Q

why is Reticulospinal Tract important for postural control

A

Bilateral terminations

Postural control to support skilled/coordinated movements

Muscle tone

60
Q

what is ankle strategy

A

Activated during small perturbations and firm surfaces

Rely heavily on somatosensory input

Distal muscles activated first

61
Q

what is the hip strategy

A

(standing on balance beam)

Activated during larger or faster perturbations

Rely more on vestibular and visual inputs

Proximal muscles activated first

62
Q

what is change in support strategies

A

Moving the limbs to change the BOS

Humans can adapt by shifting from one strategy to another

reaching or stepping

63
Q

what does abnormal postural control look like

A

Increased sway

slower anticipatory control

Increased reliance on hip and stepping strategies

64
Q

how does cognition contribute to abnormal postural control in people with strokes

A

Reaction times increase with increasing postural control demands