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Neuro Rehab Mid Term > Lecture 4: Coordination and Vestibular System > Flashcards

Lecture 4: Coordination and Vestibular System Flashcards

1
Q

What is main function of cerebellum?

A

coordinates and regulates posture, movement and balance

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2
Q

What is main function of brainstem?

A

integrates and sorts sensory information

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3
Q

What is sequence to perform coordinated movement or balance?

A
  1. sensory input (vestib, visual, proprio)
  2. integration of input (brainstem, cerebellum)
  3. motor output
  4. balance
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4
Q

What is coordination?

A

smooth, accurate and controlled movement which involves sequence, timing and force production

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5
Q

What does normal coordination look like?

A

promixal fixation for distal control, postural control, easy and and off and fluid

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6
Q

What is intralimb coordination?

A

occuring with one limb

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7
Q

What is interlimb coordination?

A

integrated performance of two or more limbs

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8
Q

What is visual motor coordination?

A

ability to integrate both visual and motor abilities

aka hand eye coordination

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9
Q

What are key brain structures used for coordination?

A

motor cortex, descending motor tracts, basal ganglia, cerebellum

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10
Q

What does motor cortex and descending pyramidal pathways do?

A

for trunk and proximal control, anticipatory control, initiation

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11
Q

What does basal ganglia do?

A

regulate initiation and gross intentional movements

regulate complex planning and execution

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12
Q

How much of CNS neurons does cerebellum contain?

A

50 %

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13
Q

What cerebellar nuceli are responsible for motor execution?

A

fastigal and interposed

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14
Q

What cerebellar nuclei are responsible for motor planning?

A

denate

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15
Q

What cerebellar nuclei are responsible for balance and eye movements?

A

vestibular nuclei

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16
Q

What is the vermis for?

A

postural control

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17
Q

What are main cerebellar functions?

A

coordinate range, velocity and strength of muscle contractions to produce steady volitional movements

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18
Q

What are other cerebellar functions?

A

equilibrium, muscle tone regulation, eye head coordination, coordination for muscle of speech

comparator- corrects errors of movement
comensator

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19
Q

What type of system is cerebellar functions?

A

closed loop

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20
Q

What is ataxia?

A

cerebellar pathology that results in disordered movement, difficulty initiating volitional movement

errors in rate, rhytym and timing of muscle

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21
Q

What side does ataxia occur on?

A

ipsilateral side of lesion

22
Q

What is etiology of ataxia?

A

congenital, acquired (strokes, tumors, trauma)

23
Q

What is most common sign of cerebellar lesion?

A

ataxic gait, decreased arm swing, uneven step length, increased BOS, high movement variability

24
Q

What is dysdiadochokinesia?

A

decreased rapid alternating movements, antagonistic muscle firing over powers agonist

flipping hand back and forth

25
Q

What is dysmetria?

A

deficit in reaching a target, overshooting a target when pointing

26
Q

What is dyssynergia?

A

breaking down movement into unsmooth motion

27
Q

What is an intention tremor?

A

oscillation of limb with volitional movement, most pronounced with end of movement

28
Q

What is role of vestibular system?

A

critical in control of posture, where are we in relation to gravity, proprioception, sensing and perceiving motion, gaze stability

29
Q

What are two components of peripheral apparatus?

A

bony labrinth and membranous labyrinth

30
Q

What makes up the bony labyrinth?

A
  1. three semi circular canals
  2. cochlea
  3. vestibule
31
Q

What makes up membranous labyrinth?

A

membranous portions of 3 semicircular canals as well as utricle and saccule

filled with endolymph -resembles intracellular fluid

32
Q

What do the semicircular canals do?

A

detect angular head rotation and respond to angular acceleration, provide sensory input about head velocity

33
Q

What are key anatomical features of semicircular canals?

A

the ampulla- contain hair cells
the christa ampullaris
the cupula
endolymph

34
Q

What is otoliths and what does it do?

A

refer to utricle (horizontal) and saccule (vertical)

detect linear acceleration and static head tilt, sensitive to gravity

35
Q

What are hair cells?

A

sensory receptors made up of kinocillia and stereocillia

36
Q

What causes the hair cells to move?

A

caused by motion of endolymph

stereo towards kino- excitation
stereo away from kino- inhibition

37
Q

How are cerebellum and vestibular system connected?

A

cerebellum is calibration of vestibular system, without proper functioning cerebellum then vestibular reflexes are ineffective

38
Q

What are two mechanisms for motor output?

A

VOR- vestibulo ocular

VSR- vestibulo spinal reflex

39
Q

What CNS structures are associated with VOR and VSR?

A

VOR- medial longitudinal fasiculus

VSR- lateral and medial vestibulospinal tracts

40
Q

What is the VOR?

A

maintains stable vision/ gaze stability during head motion, look left eyes go right

one of fastest reflexes in body

41
Q

What is VOR gain?

A

ratio of eye movements to head movement amplitude

normally equals 1.0

42
Q

What is VSR?

A

stabilizes body by using otolithic input, stabilizes body before a fall

strong influence on posture, postural control and stability

43
Q

What is Cervico ocular reflex?

A

supplements to VOR, driven by neck receptors

44
Q

What is vestibulocollic reflex?

A

acts on neck musculature to stabilized head

45
Q

What are clinical signs of vestibular dysfunction?

A

veering towards sign of lesion, nausea, vertigo, dizziness, diplopia, nystagmus

46
Q

What are two categories of coordination testing?

A

non- equilibrium and equilibrium

47
Q

What are some non equilibrium tests?

A

finger to nose, finger opposition, pronation/supination, pointing, heel to shin, tapping (DF/PF)

48
Q

What are equilibrium tests for coordination?

A

tandem stance, perturbations, romberg, walking on heels

49
Q

What can you document during these test?

A

number of trials, patient position, reps done in 10 seconds, eyes open or closed

50
Q

With any coordination dysfunction what do you also need to test for?

A

sensory deficits- proprio, kinesthesia, vibration, sterognosia

dysfunction can cause sensory ataxia which is worse with eyes closed then cerebellar with eyes closed

Neuro Rehab Mid Term (14 decks)

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