Module 10: School Age Child, Neurological development & learning Flashcards
Voluntary mov’t controlled by which tract?
Mostly Lateral corticospinal.
Voluntary mov’t mostly directed at distal muscle groups
Which spinal tract makes postural adjustments in response to Voluntary mov’t (Skilled mov’t of extremity) mediated by Lateral corticospinal tract?
Anterior Corticospinal tract (Involuntary)
Involuntary Mov’t controlled by which tract?
Mostly Anterior corticospinal.
involuntary mov’t mainly proximal and truncal muscles
What part of the brain mediates our ability to decide on the relevance of the stimulus & direct attention whilst suppressing other stimulus/ distractions?
PFC
Frontal Lobe Functions
- Directing and maintaining attention (focus on specific task)
- Morality
- Problem-solving
- Adjusting behavior to social norms
- Planning
- Ability to shift focus/ change set (allows us to put our attention on tasks that we need to do
while shifting away from distractions) - Working memory (how much we can keep track of in our heads) eg, can child follow multiple instructions or only one at a time?
- Deliberate decisions
- Regulation & expression of emotion (linked w limbic)
- Regulate attention & motor response to stimuli
- Inhibition
- Completing a goal
How to Stimulate PFC
- Movement
- Extension tone
- Good cerebellar functioning
- Co regulation
- Bottom up (Body up)
What does the dorsal & lateral PFC (frontal association areas) regulate?
Attention & motor response to stimuli
(Via the and motor cortex as well as the basal
ganglia & cerebellum)
What are the ventral & medial PFC (frontal association areas) responsible for?
regulation of emotions
ADHD
is a lack of PFC inhibition
- The PFC mediates our ability to decide on the relevance of the stimulus and
directs our attention to it while suppressing distractions - PFC responsible for goal - directed behaviour (Planning, organised search & impulse control)
Inability to change set/ shift focus/ change topic is a sign of?
Frontal rigidity, frontal dysfunction/ deficit
Frontal lobe Functions:
- Motor Control = primary motor cortex. (Balanced, smooth, planned. goal orientated, unwanted mov’ts supressed)
- Movement Planning
- Arousal (is level of arousal appropriate for situation, can the self reg?)
- Awareness
- Attention (focussed, distractible?)
- Understanding Self
- Motivation (can they stick at a task, puzzles)
- Working Memory (can they remember 3 things, can they follow 2-3 instructions whilst getting ready for school?)
- Shift Focus
- Inhibition
- Complete a Goal
PRC = responsible for executive functions - ability to self regulate
What is oculomotor gaze system responsible for? (1 of 2)
moves eyes in the orbit
What is head mov’t system responsible for? (2 of 2 gaze systems)
Moves the orbits in space
What does Saccadic system do?
- Points the fovea toward objects of interest.
- Saccades are rapid eye movements that
redirect gaze to an object of interest and
result in the projection of that object onto
the fovea. - our eyes explore the world in a series of active fixations connected by saccades.
What are the 3 types of Volitional Saccades?
- Anti- Saccade = Avert eyes/ look away from stimulus (two fingers, pt start looking at Dr. start wiggle one finger & direct pt to look at wiggling finger = test saccade, look at finger not wiggling = test anti saccade)
- Memory Saccade = Directing gaze to where something was (depend o intact working memory & spatial orientation)
- Predictive Saccade = gaze directed to where target expected to be
Frontal Lobe Tests:
- Digit span (forwards and backwards)
- Motor strength & tone
- working memory
- Limb control
- Blink rates
- Glabellar tap test (e.g. depression, mania, Parkinson’s, dementia)
- Other release phenomena - lip smacking etc
- Spontaneous lateral eye movements
- Saccade accuracy
- Anti-saccades
- Remembered saccades
Parietal lobe is involved in:
- Regulates somato-sensory functions
- Responsible for cortical processing of touch, pain, body position, body awareness
- Receptive and sensory components of language (wernicke - L temporal/parietal)
- Complex spatial orientation and perception
- Self-perception and interaction with the world
Primary Motor cortex is contained in which lobe?
Frontal
Which Lobe contains the Somatosensory cortex
Parietal
What Spinal Tracts does sensory info travel in on the way to somatosensory cortex (Parietal)?
Information travels through the dorsal column-medial lemniscal system, the spinothalamic tract, trigeminothalamic tract
What are Parietal Functions?
** localisation/ identification
* Location for visual attention
* Location for touch perception
* Goal directed voluntary movements
* Manipulation of objects in space
* Integration of different senses that allows for understanding a single concept
* Building maps of body and world around
Three types of Agnosia (Parietal function)
- Visual = making sense f & identifying objects
- Auditory = Identifying source of a common noise
- Tactile (Sterognosis) = recognising an object by its physical characteristics
What are Signs of Poor Parietal Functioning?
- Inability to attend to more than one object at a time
- Inability to name an object (Anomia)
- Inability to locate the words for writing (Agraphia)/ testing graphesthesia (recognise shapes/ numbers traced on hand)
- Stereognosis (object identification)
- Problems with reading (Alexia)
- Difficulty with drawing objects
- Difficulty in distinguishing left from right (Can they identify R & L body parts? after 4/5 yrs)
- Difficulty with doing mathematics (Dyscalculia)
- Lack of awareness of certain body parts and/or surrounding space that leads to difficulties in
self-care. - Inability to focus visual attention.
- Difficulties with eye and hand co-ordination.
Hemineglect (Unilateral neglect) & How to test
- Patients ignore visual somatosensory or auditory stimuli on affected side despite intact primary sensation. unawareness/ unresponsiveness to objects, people, own limbs & other Stimuli
- Neglect most prominent & long lasting after damage to R hemisphere (esp after stroke) = neglect of L
Testing;
= extinction on double simultaneous stimulus- only unaffected side may be detected.
= construction - drawing objects
= Cancellation task = circle/ cancel all targets
= Line Bisection
How to clinically test Parietal function?
- Parietal awareness/localisation = pt stand eyes closed & both arms out in front. Move one arm and ask pt to match other arm to moved arm. compare side-side (TESTING- Parietal opposite to arm pt moves)
- OPK Pursuit
- stereognosis (object identification )
Postural Stability is mediated by what spinal tracts
- older/ primitive pathways
- vestibulospinal (medial/lateral= postural adjustments response to balance)
- Reticulospinal (Reticular Nuclei in Reticular formation) (muscle tone ass’ w voluntary mov’t & postural stability)
- Rubrospinal (Red nucleus) (facilitates UL flexion)
- Tectospinal (Superior Colliculus) (orientates head & neck in response to eye mov’ts)
Cerebellum
** Coordinator & predictor of cortical output
**Important in movement, facilitates smooth movement by error detection & correction, motor learning, posture, cognitive functions
** Predicts mov’t of world around us, then adjusts our movement in relation to that.
- C effects LMN system VIA BS
- Fastigial N = Eyes/ truncal mov’t
- Iterpossitus (globose & emoliform) = Gross motor UL
- Dentate N = Fine mov’t of hand
- Receives sensory input & sends independent & segregated pathways to LMN & UMN sysytem of BS & Cortex
Basal Ganglia
- INTEGRATOR OF CNS
- group of interconnected nuclei
- regulates thalamic activity , TF regulates cortical activity
- Output from BG either increases or decreases tonic inhibition of thalamus via direct & indirect pathway.
- DIRECT P/W = releases thalamus from tonic inhibition, leading to more cortical output.
- INDIRECT P/W = puts the brakes on direct p/w, decreases cortical output, suppresses behaviour not related to targeted behaviour
- Encode for the DECISIONto move, DIRECTION to move & AMPLITUTDE of mov’t, motor expression & emotions
- receive input from widespread cortical areas, integrates input & projects back to the cortex
Reticulospinal tract
- most primitive descending motor system.
- Primarily ips pathway
- Cortex drives Reticulospinal system = if have cortical fatigue(hemp) will have reduced tone on same side
- RS tract coordinates M group activation for primitive motor behaviours; orientation of body towards or away from stimulus (oncoming ball) & motor behaviours that don’t require dexterity. Integrates distal M actions w proximal M actions & initiate changes in M tone related to voluntary mov’t of limbs.
- EG step on rock and sprain ankle = poor tone/ firing of reticulospinal
- Involved w breathing; activate skeletal muscles of respiration (through cortex)
- RF contains network that uses monoamine neurotransmitters = descending monoamine fibers comprise an emotional motor system that mediates expression of emotion
Purpose of Proprioception
- provides awareness of position sense & Kinaesthesia
- Produces coordinated reflexes of muscle tone & balance
- Provides Peripheral feedback so that CNS can design & modify effective motor programs
What lobe of the brain holds a map of your body?
Parietal
- R Parietal = holds map of whole body/ world
- L Parietal = holds map of R body / world only
How many vestibular receptors/ sense organs are there?
5 in total.
** 2 Otolith organs
- Utricle & Saccule = Measure linear accelerations/ movement
*** 3 semicircular canals
- Anterior, Posterior, horizontal = Measure rotational motion/ angular acceleration
What direction of movement do vestibular otolith organs Utricle & Saccule Measure ?
- Linear acceleration
** Saccule = up & down
** Utricle = fwd & back
What direction of movement do vestibular organs Semi circular canals measure?
- rotational movements/ accelerations
What part of the vestibular system is responsible for transducing mechanical stimuli into neural signals?
- Hair cells in each of the 5 vestibular receptor organs (utricle, saccule, semi circular canals x3)
- Hair cells act as mechanoreceptors
Which cranial Nerve carries vestibular info from vestibular receptor organs to the IPSILATERAL vestibular nuclei (4), cerebellum & reticular formation?
- CN VIII (vestibulocochlear)
Watch: 2 min Neuro science video
- Vestibular system
