MOTOR IMPAIRMENTS AND EXAM IN NM CONDITIONS

Question 1

tone

Answer 1

The tension attained at any moment between the origin and the
insertion of a muscle. The tension is determined partly by mechanical factors (connective tissue and viscoelastic properties of muscle) and the degree of motor unit activity.

-continuous state of mild contraction
-readiness of a muscle to work
-resistance by a muscle to passive stretch
-resting tension in a muscle

FLACCIDITY–>HYPOTONIA–>NORMAL–> SPASTICITY–> RIGIDITY

Question 2

hypertonicity

Answer 2

The sensation of [increased] resistance felt as one
manipulates a joint through a range of motion, with the subject attempting to relax.

-excessive tone/stiffness/tension in response to palpation of the muscle

-tonic labirynthe reflex that doesn’t get integrated

Question 3

spasticity

Answer 3

a velocity-dependent increase in the tonic stretch reflex with exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex as one component of the upper motor neuron syndrome.

-usually due to injury of cortex or white matter

Question 4

spasm

Answer 4

Persistent increased tension and shortness in a muscle or group of muscles that cannot be released voluntarily.

• In SCI, abnormal triggering of reflexes may occur suddenly and are sometimes named “spasms”. These can be painful and/or uncomfortable
• Sustained clonus triggered by a quick stretch may be annoying and uncomfortable

Question 5

contracture

Answer 5

An abnormal, often permanent shortening, as of muscle or scar tissue, that results in distortion or deformity, especially of a joint of the body.

-may lead to compensatory movement strategies

Question 6

motor learning

Answer 6

A set of processes associated with practice or experience leading to relatively permanent changes in the capability for responding.

Question 7

motor control

Answer 7

The study of how our neuromuscular system
functions to activate and coordinate the muscles and limbs involved in the performance of a motor skill.

Question 8

hypotonia

Answer 8

less than normal tone/stiffness/tension

little or no tension in response to passive stretch

Question 9

clonus

Answer 9

rapid series of rhythmic contractions that are elicited by stretching a muscle

-sustained clonus indicated UMN dysfunction
-an UMN sign

an example of hyper-reflexia

Question 10

reflex

Answer 10

A reflex is an involuntary and nearly instantaneous movement in response to a stimulus. The reflex is an automatic response to a stimulus that does not receive or need conscious thought as it occurs through a reflex arc. Reflex arcs act on an impulse before that impulse reaches the brain.

-deep tendon reflexes
-pathologic reflexes: Babinski
-primitive reflexes: ATNR, STNR, etc.
-UMN signs: babinski, clonus, hoffman’s

Monosynaptic ie contain only two neurons, a sensory and a motor neuron. Examples of monosynaptic reflex arcs in humans include the patellar reflex and the Achilles reflex.

Polysynaptic ie multiple interneurons (also called relay neurons) that interface between the sensory and motor neurons in the reflex pathway.[2]

Question 11

UMN vs LMN signs

Answer 11

In general, damage to an UMN will show increased deep tendon reflexes (DTRs), increased muscle tone, positive Babinski sign, and spastic paralysis with a clasp-knife reaction. Damage to a LMN will show decreased DTRs, decreased muscle tone, negative Babinski sign, flaccid paralysis, muscle atrophy, and fasciculations.

Question 12

hypokinesia

Answer 12

movement system impairment is related to slowness in initiating and executing movement

stoppage of ongoing movement

Question 13

hyperkinesia

Answer 13

Hyperkinetic movement disorders also referred to as Dyskinesias are characterized by abnormal, often repetitive, involuntary movements overlapped to normal motor activity.

may manifest as a tremor

Question 14

dysmetria

Answer 14

associated with motor coordination deficit (scaling deficit)

the inability to control the distance, speed, and range of motion necessary to perform smoothly coordinated movements

Question 15

force production deficit (movement system diagnosis)

Answer 15

The primary movement fault is weakness. The origin of the weakness may be muscle,
neuromuscular junction, peripheral nerve, or central nervous system dysfunction. The presentation may be focal (one joint), segmental (generalized to an extremity or body region) or related to fatigue (of skeletal muscle rather than cardiopulmonary capacity).

Question 16

fractionated movement deficit

Answer 16

The primary movement dysfunction is the inability to fractionate movement associated
with moderate or greater hyperexcitability. May describe the upper or lower extremity or both. Always associated with central neurological deficit, often with abnormal synergies

Question 17

motor coordination deficit (dysmetria, scaling deficit)

Answer 17

The primary movement dysfunction is the inability to coordinate an intersegmental task because of a deficit in timing and sequencing of one segment in relationship to another (dysmetria, scaling segment. The movement dysfunction in the lower extremity is primarily observed during postural control tasks and in the upper extremity during hand manipulation and grasp and release of different objects coupled with reach.

Motor performance typically improves with practice and instruction.

Question 18

hypokinesia deficit

Answer 18

The primary movement system problem is related to slowness in initiating and executing movement. May be associated with stoppage of ongoing movement. Hyperkinesia may manifest as tremor