Lecture 12 - Deafferentation Flashcards

1
Q

How did Flemish art depict sensation?

A

Using the Allegory of the Five Senses

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2
Q

What is the Allegory of the Five Senses?

A

Painting depicting characters demonstrating the five senses

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3
Q

What types of nerves do muscles have?

A

Muscle and sensory

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4
Q

What is proprioception?

A

“Muscle sense”

Conscious perception of body position and movement in the absence of vision

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5
Q

How does the proprioceptive pathway work?

A

Skin/joint/muscle spindle receptors receive info and send it up the spinal cord to the primary and somatic sensory cortex

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6
Q

What are muscle spindles?

A

Stretch receptors located intramuscularly

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7
Q

How do muscle spindles work?

A

Firing pattern corresponds with muscle length and changes in muscle length

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8
Q

What is tendon vibration?

A

Stimulates muscle spindle firing by vibrating at 80-120 Hz to create the illusion of altered position and movement

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9
Q

How can proprioception be measured?

A

Direction testing and matching testing

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10
Q

What are the pros of direction testing?

A

A good indicator of whether a pathway is intact

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11
Q

What are the cons of direction testing?

A

Can’t quantitatively measure acuity or position vs movement sense

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12
Q

What is direction testing?

A

Movement of joints while the subject responds

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13
Q

What are the pros of matching testing?

A

Keeps the pathway intact, is a measure of acuity, keeps position/movement possible

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14
Q

What are the cons of matching testing?

A

Increased cognitive and perceptual demands

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15
Q

What is matching testing?

A

Establishes target and the subject matches

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16
Q

What is deafferentation?

A

A disorder where larger fiber sensory neurons no longer function

17
Q

What is another name for deafferentation?

A

Sensory neuronopathy

18
Q

What is the current incidence of deafferentation

A

Less than 20 known cases in the world

19
Q

What is the cause of deafferentation?

A

Selective apoptosis of 1a afferent neurons

20
Q

What causes apoptosis associated with deafferentation?

A

The cause is unknown. Possibly viral infection

21
Q

What are the signs and symptoms of deafferentation?

A
No sense of movement or touch
No tendon tap reflexes
No sense of body schema
Poor muscle coordination
Poor force control
Inability to walk
Pain and temperature senses intact
22
Q

What is body schema?

A

Concept of the body, full body representation of self.

23
Q

How can deafferentation be simulated?

A

Ischemic nerve block or dorsal rhizotomy

24
Q

How do ischemic nerve blocks simulate deafferentation?

A

By placing a tourniquet to slowly stop blood flow so enough blood allows the motor neurons to work but not the sensory neurons

25
How do dorsal rhizotomies simulate deafferentation?
By cutting off afferent nerves to prevent sensory info from going to the brain
26
How can deafferentation be treated?
Physical therapy, strategy training, and stem cell therapy
27
How can physical therapy be used to treat deafferentation?
By using passive movement and ROM to reduce contractures from inability to walk
28
How can strategy training be used to treat deafferentation?
By teaching patients to compensate with vision
29
How can stem cells be used to treat deafferentation?
By attempting to get cells to differentiate into neurons
30
What are some limitations of physical therapy in deafferentation?
It is unable to bring back proprioception
31
What are some limitations of strategy training?
Patients lose focus of surroundings and fatigue to enable constant focus