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Neurophysiology > Motor Systems Components > Flashcards

Motor Systems Components Flashcards

1
Q

What are some primary neuromusclar impairments that can result from a neurological pathology?

A
  1. Muscle weakness
  2. Abnormal tone
  3. Coordination deficits
  4. involuntary movements
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2
Q

What are some secondary neuromusclar impairments that can result from a neurological pathology like an UMN lesion?

A
  1. ROM and alignment issues
  2. Endurance issues
  3. Pain
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3
Q

how would you define muscle weakness as a neuromusclar impairment?

A

inability to generate force or recruit/modulate motor units

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4
Q

list some neural contributions that can result in the primary neuromusclar impairment of muscle weakness

A

Change in:

  1. # of motor units recruited
  2. D/C frequency
  3. type of motor unit recruited
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5
Q

What are some potential neurological pathologies that can result in neuromusclar weakness as an impairment?

A
  1. Cortical lesions
  2. lesions in descending pathways
  3. disruption of impulses to alpha motor neurons
  4. peripheral nerve injury
  5. synaptic dysfunction at NMJ
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6
Q

Muscle weakness as a neurological impairment can result in what secondary impairments/observations?

A
  1. postural abnormalities
  2. asymmetrical weight bearing
  3. abnormal synergies
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7
Q

list 2 types of abnormal synergies

A
  1. Flexor synergy (UE)
  2. Extensor synergy (LE)
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8
Q

describe a flexory synergy?

A

scapular retraction and elevation

shoulder abduction and ER

elbow flexion

supination

wrist and finger flexion

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9
Q

describe an extensor synergy

A

hip extension, adduction and IR

knee extension

ankle PF and inversion

toe PF

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10
Q

what is tone?

A

muscles’ resistance to passive stretch

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11
Q

Describe the continuum/varying levels of tone

A

From too little to too much

  1. Flaccid
  2. Hypotonicity
  3. normal
  4. hypertonic/spasticity
  5. Rigid
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12
Q
A
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13
Q

what are the neural contributions to normal tone?

A

net balance of descending input on motor neurons from:

corticospinal tracts

rubrospinal tracts

reticulospinal tracts

vestibulospinal tracts

as well as the sensitivity of synaptic connections

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14
Q

what are the non neural contributions to normal tone?

A
  1. CT plasticity
  2. viscoelastic properties of the muscles, tendons, and joints
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15
Q

How is spasticity different from hypertonia?

A

spasticity is velocity dependent and hypertonia is not

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16
Q

Spasticity can sometime be described as a ___________

A

clasp-knife phenomenon

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17
Q

what is a typical cause of spasticity and a common result/association?

A

damage to pyramidal tract or other nearby descending paths

can be associated with clonus (commonly in distal > proximal extremities)

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18
Q

Describe the mechanism by which spasticity occurs

A
  1. changes in neural contributions
  2. results in decreased descending activity
  3. reduction of inhibitory synaptic input
  4. increases tonic excitatory input
  5. results in alterations to threshold of stretch reflex
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19
Q

List 2 scales typically used to measure tone

A
  1. Modified Ashworth Scale
  2. Tardieu scale
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20
Q

which scale used to measure tone, also gives us info on spasticity?

A

Tardieau

since we vary the velocities (V1, 2, 3)

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21
Q

which applied velocities equate to spasticity on the Tardieau scale?

A

V2 = speed of limb falling under gravity

V3 = fast as possible

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22
Q

In what muscle group is hypertonia typically observed?

A

Flexors

23
Q

When testing hypertonia with movements, it can be described as _________ or _________

A

leadpipe or cogwheel

24
Q

what is the difference between leadpipe and cogwheel hypertonia?

A

leadpipe = constant resistance to movements throughotu entire ROM

Cogwheel = alternating episodes of resistance and relaxation

25
Q

what is hypertonia at rest called?

A

Posturing

26
Q

What are the 2 types of posturing?

A

decorticate = UE flexion, LE extension/IR/PF

decerebrate = UE and LE extension

27
Q

what type of posturing is due to a lesion at or above the level of the red nucleus?

A

decorticate posturing

28
Q

characteristic of the tone abnormality depends on what factors?

A
  1. type and location of pathology
  2. Chronicity
    • increases in nonneural changes = increased “stiffness”
29
Q

List the type of abnormal tone that would result if a lesion occured at the cortical, brainstem, and basal ganglia level?

A
  1. cortical: pyramidal → change in descending inputs of alpha motor neurons → spasticity
  2. Basal ganglia: extra pyramidal → rigidity
  3. brainstem: above/below red nucleus → decorticate/decerebrate posturing
30
Q

List some pathologies in which hypertonicity is commonly observed

A
  1. CVA
  2. TBI
  3. MS
  4. Parkinsons Disease (rigidity)
31
Q

define hypotonicity

A

reduction in resistance to lengthening

reduction in “stiffness”

32
Q

hypotonicity can be described as _______ or _______

A

floppy = collapse into gravity, harder to excite

flaccidity = complete loss of muscle tone

33
Q

what causes hypotonicity?

A

disruption of afferent input from stretch reflex →

lack of cerebellar efference influence →

result in decreased input to gamma motor neurons

34
Q

List some pathologies where hypotonicity is commonly observed

A
  1. Cerebellar lesions
  2. down syndrome
  3. musclar dystrophies
  4. late stage ALS
  5. post-polio
  6. Acute CNS injuries → typically end up resulting in hypertonicity/spasticity once subactue phase is over
35
Q

what are the functional implications for increased tone?

A
  1. abnormal posturing
  2. misalignment
  3. high risk for injury during prolonged rest (skin breakdown)
  4. bias with recruitment
    1. increased likelihood of synergistic movement
  5. destabilization with changes in position (clonus, increased risk for contractures)
36
Q

what are the functional implications for decreased tone?

A
  1. fall into gravity
  2. high risk for injury during dynamic tasks
37
Q

define coordination

A

ability to use parts of the body together smoothly and efficiently

38
Q

what are the critical components of coordination?

A
  1. sequencing
  2. timing
  3. grading
39
Q

define incoordination

A

movements that are awkward, uneven, inaccurate

disrupting of sequencing, timing and grading

loss of coupling between synergistic joints and muscles

40
Q

incoordination is typically observed with what types of lesions?

A

motor cortex

basal ganglia

cerebellar

(proprioceptive lesions too)

41
Q

the functional implications of incoordination can be divided into what categories?

A
  1. grading/scaling dysfunction
  2. timing difficulties
  3. activation and sequencing problems
42
Q

what are the types of grading/scaling dysfunctions found with incoordination?

A
  1. dysmetria = under/overshooting intended position (a type of ataxia)
  2. hypermetria = moving beyond intended goal
  3. hypometria = moving short of intended goal
43
Q

list some timing difficulties that are a result of incoordination

A
  1. increased reaction times
  2. slowed movement times
  3. difficulty terminating movements
  4. rebound phenomenon
  5. dysdiadochokinesia
44
Q

list some activation and sequencing problems that occur with incoordination

A
  1. abnormal synergies
  2. coactivation
  3. impaired inter-joint coordination
45
Q

what are the components of the coordination examination?

A
  1. finger to nose
  2. alternating pronation/supination
  3. hand or foot tapping
  4. heel to shin
46
Q

List several categories/types of involuntary movements that are primary neuromusclar impairments

A
  1. dystonia
  2. tremors
  3. choreiform
  4. athetosis
47
Q

what is dystonia?

A

syndrome dominated by sustained muscle contractions

causing twisting, repetitive movements, and abnormal postures

48
Q

what region of the brain is dystonia correlated with?

A

basal ganglia

49
Q

what are tremors?

A

rhythmic, involuntary oscillatory movement of a body part

can be intermittent or constant, sporadic or as a sequale to a disease or injury

50
Q

what is the difference between a resting and active tremor?

A

resting = occurs in a body part that is not voluntarily activated (it’s relaxed)

active = any tremor produced by voluntary contraction of muscle (can be postural or intention)

51
Q

what is a postural tremor? Intention tremor?

A

postural = person maintains a part of body against gravity

intention = produced with purposeful movement

52
Q

what is a choreiform?

A

involuntary, rapid, irregular and jerky movements

seen with Huntingtons disease and is a SE of PD meds

53
Q

what is athetosis?

A

slow, writhing and twisting movements

UE > LE

common in CP

54
Q

What causes endurance issues to be a secondary neuromuscular impairment?

A
  1. decrease in central drive to spinal cord motor neurons
  2. decrease in activity level/immobility

Neurophysiology (9 decks)

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