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NM PCM > Motor Function > Flashcards

Motor Function Flashcards

1
Q

Motor Control

A

Ability to regulate or direct the mechanisms essential to movement

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2
Q

Motor Skills

A

Learned through interaction and exploration of the environment

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3
Q

Are motor and sensory functions connected?

A

Yes. Motor and sensory brain areas are right next to each other. Lots of cross communications. Sensory stimulation is important for motor development.

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4
Q

Motor Program

A

Abstract representation of movement that results in production of coordinated movement sequence (riding a bike)

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5
Q

Motor plan

A

Idea or plan for purposeful movement that is made up of several component motor programs (AKA complex motor program)

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6
Q

Motor memory

A

a.k.a. PROCEDURAL memory

recall of motor programs or subroutines.

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7
Q

What does procedural memory include information on?

A

Initial movement conditions
Sensory situation
Specific movement parameters
Outcome of movement (KoR)

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8
Q

Neuroplasticity

A

Neural modifiability. short term change (efficiency/strength of synaptic connections), long term change (organization and numbers of neural connections)

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9
Q

Motor Learning

A

Internal processes associated with practice or experience leading to relatively permanent changes in capacity for skilled behavior (sit up, stand, walk, etc)

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10
Q

What does associative learning do?

A

predicts relationships. One stimulus to another (classical conditioning), ones behavior to consequence (operant conditioning)

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11
Q

Feedback

A

Response-produced information received during or after the movement; monitor output for corrective actions

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12
Q

Feedforward

A

Sending signals in advance of movement to ready the system; allows for anticipatory adjustments in postural activity

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13
Q

Factors that influence motor control

A

Task
Individual
Environment

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14
Q

What would you test for mental status in an exam?

A

Memory
Orientation
Level of consciousness
Executive or higher cognitive function

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15
Q

Ascending reticular activating system (RAS)

A

Exerts an excitatory influence on the cerebral cortex to maintain the alert state.
Receives input from all afferent systems [tactile, thermal, vestibular, auditory, chemical]

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16
Q

Levels of consciousness

A 
Alert
Lethargic
Obtunded
Stupor
Coma
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17
Q

Lethargic

A

Slow to respond, drowsy

If you are lethargic it doesn’t take much to get them to an alert state, maybe just say their name

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18
Q

Obtunded

A

Dull, blunted response, difficult to arouse, appears confused
May need to pat on the back or pat their feet. Feet is what you do in the hospital.

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19
Q

Stupor

A

Semiconscious, aroused only with intense stimuli (sternal rub, nail bed pressure)

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20
Q

Coma

A

no response to stimuli at all

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21
Q

What is oriented x3 & x4?

A

Time*
Place*
Person*
Circumstance

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22
Q

Attention

A

the ability to focus and maintain one’s consciousness on a particular stimulus or task without being distracted by other stimuli

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23
Q

How can attention be tested?

A

asking pt to repeat short lists of numbers/letters or objects. Inability to repeat six items indicates attention problems

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24
Q

Types of attention

A

Selective
Sustained
Alternating
Divided

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25
Q

Sustained attention

A

vigilance, time on task. “undivided” attention

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26
Q

Alternating attention

A

Attention flexibility, able to pay attention to two things at one time

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27
Q

Divided attention

A

Performing two tasks simultaneously. I.e. walkie-talkie test

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28
Q

Declarative memory

A

recall of facts/events

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29
Q

Immediate memory

A

recall after a few seconds

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30
Q

Short term memory

A

Recall minutes to days

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31
Q

Long term memory

A

recall years, general knowledge

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32
Q

Amnesia

A

Wake up and can’t remember who you are

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33
Q

Anterograde amnesia

A

i.e. post traumatic amnesia

Poor new learning

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34
Q

Retrograde amnesia

A

Unable to remember previous learning

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35
Q

Tip of tongue phenomena

A

Seems to be retrieval problems

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36
Q

Language functions

A

Spontaneous speech, fluency, comprehension, repetition, naming and word finding, reading and writing.

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37
Q

Dysarthria

A

Hard to get words out, problem with articulation. Timing, vocal quality, pitch, volume, breath control.

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38
Q

Fluent/Wernicke’s aphasia

A

Not using real words. neologisms, circumlocutions, not sure if they understand what you are saying

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39
Q

Non-fluent/Broca’s aphasia

A

Could have no language, could be stuck on a word/phrase or two, anomia, almost always understand but can’t verbalize.

40
Q

Calculation ability

A

very simple addition for example. Basic life skill type of math

41
Q

Fund of knowledge

A

that persons experiences and learning. Whole experiences/concrete knowledge

42
Q

Constructional ability

A

copy figures, shapes, clock.

43
Q

Gnosia/Agnosia

A

could involve any of 5 senses. Lack of knowing

44
Q

Ideomotor apraxia

A

mv’t automatic, not on command [dominant hemisphere damage (frontal, parietal); perseveration] can’t do it on command but can when you need something

45
Q

Ideational apraxia

A

purposeful mv’t not possible, not on command, not when you want to do something.

46
Q

Yerkes-Dodson Law

A

a.k.a inverted U theory of arousal. Motor performance vs. emotional arousal. moderate arousal = maximum performance. Finer skill on lower side, larger gross on upper side

47
Q

Closed loop system of motor control

A

Uses feedback from sensory system, somatosensation

48
Q

Open loop system of motor control

A

Does not use feedback or error detection. Rapid or well learned movements.

49
Q

Tone

A

Resistance of muscle to passive stretch, while attempting to maintain muscle relaxation.

50
Q

What affects tone?

A

physical inertia, intrinsic mechanical-elastic stiffness of muscle/CT, reflex muscle contraction

51
Q

Spasticity

A

Hypertonic motor disorder characterized by

velocity-dependent resistance to passive stretch

52
Q

Clasp-knife response

A

Slow moving and resistance at first then you hit a point where it is moving much better. Difficult at first, then you’ve overcome the resistance.
Injury to corticospinal pathways/pyramidal tracts.
part of UMN syndrome

53
Q

UMN syndrome tests

A

Hyperactive stretch reflexes, involuntary flexor/extensor spasms, clonus, plantar reflex (babinski), oppenheim, exaggerated cutaneous reflex, chaddocks reflex, loss of automatic control

54
Q

Leadpipe rigidity

A

the limb is just straight, its possible to create a Fx before you move someone with leadpipe rigidity. Avulsion Fx not uncommon .
Basal ganglia system problem.

55
Q

Cogwheel rigidity

A

lots of resistance, it will finally give but only a little bit. It doesn’t just get to a place and then give like clasp knife. Commonly seen in patients with Parkinson’s Disease

56
Q

Decorticate rigidity

A

Sustained posturing UE flexion, LE extension (PF, IR, adduction)
Disinhibition of red nucleus, facilitation of rubrospinal tract
Disruption of corticospinal tract
Lesion at diencephalon above superior colliculus

57
Q

Decerebrate rigidity

A

Sustained posturing UE & LE extension (UE wrist and fingers still flexed)
Lesion between superior colliculus and vestibular nucleus

58
Q

Opisthotonus

A

Sustained contraction of neck and trunk extensors
Cant leave them alone in a chair because they can fall out of their chair, tone pushes them forward.
Hard to work with; can’t really sit alone, hard to transfer, etc.

59
Q

Hypotonia

A

Flaccidity: nothing working
Decreased or absent tone
Decreased resistance to passive stretch, decreased or absent stretch reflexes
Part of lower motor neuron (LMN) syndrome
Children with Downs syndrome often have this

60
Q

LMN syndrome

A

Lesion in anterior horn cell, peripheral nerve

61
Q

Symptoms in LMN syndrome

A 
Decreased or absent tone
Decreased or absent reflexes: dulled or no
Paresis
Muscle fasciculations/fibrillations
Neurogenic atrophy
62
Q

Examination of tone

A

Observation
Palpation
PASSIVE motion testing
Active motion testing

63
Q

Grades of Tone

A 
0 - no response (flaccidity
1+ - decreased response (hypotonia)
2+ - Normal 
3+ - Exaggerated response (hypertonia)
4 + - Sustained response (rigidity)
64
Q

What is the modified Ashworth Scale used for?

A

Examination of tone/spasticity for the UE only> would test at slow velocity and fast and document both scores

65
Q

What numbers are on the modified Ashworth scale?

A

0, 1, 1+, 2, 3, 4

66
Q

Grade 1 on modified Ashworth scale?

A

Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension.

67
Q

Grade 1+ on modified Ashworth scale?

A

Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM

68
Q

Grade 2 on modified Ashworth scale?

A

More marked increase in muscle tone through most of the ROM but affected part(s) easily moved

69
Q

Grade 3 on modified Ashworth scale?

A

Considerable increase in muscle tine, passive movement difficult

70
Q

Grade 4 on modified Ashworth scale?

A

Affected part(s) rigid in flexion or extension

71
Q

What do you look for when examining force control?

A

ability to:
initiate, sustain, regulate, terminate force
timing/speed/direction control

72
Q

Deep tendon reflex grades

A

0-5+ (all plus)

none, hypo, normal, hyper, clonus 1-3 beats, >3 or sustained response

73
Q

Flexor Withdrawl

A

Opposite of typical LE extensor synergy. ABduction, ER, flexion.

74
Q

What are associated reactions?

A

Involuntary movements of the resting extremity

75
Q

Types of atrophy

A

neurogenic, disuse

76
Q

What does an active restraint with MMT indicate? passive?

A

abnormal synergies or reflexes

contracture

77
Q

Categories of motor skills

A

mobility, static postural control, dynamic postural control, skill

78
Q

Static postural control

A

COM over BOS at rest – not moving but standing/balancing

79
Q

Dynamic postural control

A

COM over BOS with body movement

Walking, reaching, twisting.

80
Q

Skill

A

Coordinated distal movement with proximal segment stabilized. (typing, piano, etc.)

81
Q

Closed motor skill

A

Performed in a stable, non-changing environment

82
Q

Open motor skill

A

Performed in a variable, changing environment

This is better for the person, they can perfect it and do it in different environments.

83
Q

How to you test limits of stability?

A

maximum distance able to lean in any direction without loss of balance

84
Q

Clinical test for sensory interaction in balance?

A

Nashner’s Foam and Dome.

85
Q

Righting reactions

A 
orient head in space and body to head and support surface
 Optical RR
Labyrinthine RR
Body on head RR
Neck on body RR
Body on body RR
86
Q

Equilibrium reactions

A

Looking for reactions to maintain COG over BOS before using protective extension or stepping strategy

87
Q

Types of balance strategies

A

Ankle, hip, stepping

suspensory

88
Q

Fixed support strategies

A

Ankle, hip, suspensory

89
Q

Change in support strategies

A

Stepping, protective extension

90
Q

How to measure performance changes?

A

FIM (lower score = more assistance) 0-7. 5 or lower need another person
Qualitative changes, error scores, reduced effort and concentration.

91
Q

Retention tests

A

Patient demonstrates skill after period of not practice (retention interval)

92
Q

Transfer tests

A

the gain (or loss) in capability for performance in one task as a result of practice or experience on some other task

93
Q

Positive transfer

A

enhancement or gain of ability

94
Q

Negative transfer

A

diminishes ability

95
Q

Generalizability

A

Extent to which practice on one task contributes to the performance of other, related skills.
Resistance to contextual change
Adaptability required to perform a motor task in altered environmental situations

96
Q

Learning styles

A

Auditory
Visual
Verbal
Kinesthetic

Step-by-step, procedural
Global/intuitive

NM PCM (6 decks)

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