Module 10

Question 1

What does the cerebrum do?

Answer 1

Higher brain function, planning and executing movements, sensation, senses etc

Question 2

What does the cerebellum do?

Answer 2

Coordination, coordinates timing and integration of voluntary movements, muscular activity, coordination, balance, speech and posture

Question 3

What does the brain stem do?

Answer 3

Conduction, all information must pass through brain stem, base of cranial nerves, regulating our bodily functions (breathing, sleeping, eating, and awareness)

Question 4

Afferent pathways

Answer 4

Information coming back to the brain, coming back from the peripery

Question 5

Efferent

Answer 5

Information being sent from the brain, down to the periphery

Question 6

UMS (Upper motor neurons)

Answer 6

All the descending pathways that control the activities of neurons that supply muscles
-Originate in motor cortex and synapse with LMS

Question 7

LMNS

Answer 7

-Directly innervate skeletal muscles
-Originate in the spinal cord and brain stem and receive input from UMNs

Question 8

What are some common neurological conditions we will face as physios?

Answer 8

Stroke, TBI, autoimmune disorders like MS, degenerative (parkinsons), spinal cord injury

Question 9

What is a hemorrhagic stroke?

Answer 9

Where a blood vessel bursts in the brain (more rare)

Question 10

What is an ischemic stroke?

Answer 10

When a blood clot blocks the blood flow in an artery within the brain

Question 11

Primary impairments following a stroke

Answer 11

Sensory loss, sense changes, vision and hearing, spasticity, centrally mediated weakness (reduced ability to activate muscles)

Question 12

Secondary impairments following a stroke

Answer 12

Contracture and muscle shortening- spasticity in these muscles (primary then secondary)
-Peripherally mediated weakness (immobilisation- cant move, muscle atrophies and weakens) (isnt a result of
changes in the brain)

Question 13

Weakness following a stroke

Answer 13

-Difficulty in generating and sustaining muscle force due to peripheral neural changes or muscle changes or central activation

Question 14

Decreased motor control following a stroke

Answer 14

-The inability to activate time, sequence muscle groups to complete movements appropriately due to central neural changes

Question 15

Hemiplegia

Answer 15

Paralysis on one side of the body

Question 16

Hemiparesis

Answer 16

Slight paralysis

Question 17

How to assess function for neuro using quantiative appraoch

Answer 17

-Using standardised scales or temporal spatial measures
-Easy to administer
-Does their gait improve etc

Question 18

How to assess function for neuro using qualitative approach

Answer 18

Compare to normal or unaffected side
-Requires a good understanding of components of normal movement

Question 19

What activities might we want to assess in a neuro patient

Answer 19

Ability to move in bed, roll over, sitting, sitting balance, standing balance, sit to stand, walking, upper limbs, picking up drink, fine motor movements, GAIT

Question 20

Functions and components of upper arm movement

Answer 20

-Major function of the arm is to position the hand for manipulation and reaching
-Key components: shoulder flexion, shoulder external rotation, shoulder abduction, elbow flexion and extension
- Hand: grasp, release and manipulate objects
- Radial deviation and wrist extension, wrist extension whilst holding object, opposition of thumb and finders, extension of MCP jts with IP jts in flexion, supination/pronation of forearm while holding object

Question 21

What is the MAS?

Answer 21

Measures a range of functional activties from balance, mobility and upper limb function
-8 items that assess motor function (sitting extension of wrist- placing object in hand, lift object off table without elbow flexion etc)
-0 is nothing 6 is yes

Question 22

What is the BBS (Berg Balance Scale)?

Answer 22

-Purpose: assesses status and dynamic balance and fall risk in adult populations
-14 items that assess balance in different positions and settings within each item there are 5 levels of scoring, 0-4
-0 is poor, 4 is optimal
-Non standardised outcomes may be more appropriate
-Doesn’t detect small levels of change etc

Question 23

What is TUG?

Answer 23

-Timed up and go (3 metre walk)
-Patient sits in chair with back against chair back
-On the command go patient rises, walks 3 metres and turns and walks back and sits down
-Quicker than MAS and more accessible