Neuro Flashcards
allodynia
sensation of pain in response to a stimulus that would not typically produce pain
analgesia
absence of pain while remaining conscious
anesthesia
absence of touch sensation
causalgia
constant, relentless, burning hyperesthesia and hyperalgesia that develops after a peripheral nerve injury
dysesthesia
distortion of any of the senses, especially the sense of touch
hyperesthesia
heightened sensation
hyperpathia
an extreme exaggerated response to pain
hypesthesia
diminished sensation of touch
neuralgia
severe and multiple shock-like pains that radiate from a specific nerve distribution
pallanesthesia
loss of vibration sensation
paresthesia
abnormal sensations such as tingling, pins and needles, or burning sensations
akinesia
inability to initiate movement; commonly seen in patients with Parkinson’s disease
asthenia
generalized weakness, typically secondary to cerebellar pathology
ataxia
inability to perform coordinated movements
athetosis
condition that presents with involuntary movements combined with instability of posture.
Peripheral movements occur without central stability
bradykinesia
movement that is very slow
chorea
movements that are sudden, random, and involuntary
clasp-knife response
form of resistance seen during ROM of a hypertonic joint where there is greatest resistance at the initiation of range that lessens with movement through the ROM
clonus
characteristic of an UMN lesion; involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex
cogwheel rigidity
a form of rigidity where resistance to movement has a phasic quality to it; often seen with Parkinson’s disease
dysdiadochokinesia
inability to perform rapidly alternating movements
dysmetria
inability to control the range of movement and the force of muscular activity
dystonia
closely related to athetosis, however, there is larger axial muscle involvement rather than appendicular muscles
fasciculation
muscular twitch that is caused by random discharge of a LMN and its muscle fibers; suggests LMN disease; however, it can be benign
hemiballism
involuntary and violent movement of a large body part
kinesthesia
ability to perceive the direction and extend of movement of a joint or body part
lead pipe rigidity
form of rigidity where there is uniform and constant resistance to ROM; often associated with lesions of the basal ganglia
rigidity
state of severe hypertonicity where a sustained muscle contraction does not allow for any movement at a specified joint
tremor
involuntary, rhythmic, oscillatory movements secondary to a basal ganglia lesion. There are various classifications secondary to a specific etiology.
closed-system model
characterized by transfer of information that incorporates multiple feedback loops and larger distribution of control.
NS is seen as an active “participant” with the ability to enable the initiation of movement as opposed to solely “reacting” to stimuli
compensation
ability to utilize alternate motor and sensory strategies due to an impairment that limits the normal completion of a task
habituation
decrease in response that will occur as a result of consistent exposure to non-painful stimuli
learning
process of acquiring knowledge about the world that leads to a relatively permanent change in a persons capability to perform a skilled action
non-associative learning
a single, repeated stimulus (habituation, sensitization)
associative learning
gaining understanding of the relationship between two stimuli, causal relationships or stimulus and consequence (classical conditioning, operant conditioning)
procedural learning
learning tasks that can be performed without attention or concentration to the task; a task is learned by forming movement habits (developing a habit through repetitive practice)
declarative learning
requires attention, awareness, and reflection in order to attain knowledge that can be consciously recalled (mental practice)
motor learning
ability to perform a movement as a result of internal processes that interact with the environment and produce a consistent strategy to generate the correct movement.
It is the acquisition of, or modification of movement
motor program
a concept of a central motor pattern that can be activated by sensory stimuli or central processes. Motor programs are seen as containing the rules for creating spatial and temporal patterns of motor activity needed to carry out a given motor task
open system model
characterized by a single transfer of information without any feedback loop (reflexive hierarchal theory). In this theory, the NS is seen as awaiting stimuli in order to react
performance
a temporary change in motor behavior seen during a particular session of practice that is a result of many variables; however, only one variable is focusing on the act of learning. Performance is not an absolute measure of learning since there are multiple variables that potentially affect performance
plasticity
ability to modify or change at the synapse level either temporarily or permanently in order to perform a particular function
postural control
ability of the motor and sensory systems to stabilize position and control movement
recovery
ability to utilize previous strategies to return to the same level of functioning
sensitization
the increase in response that will occur as a result of a noxious stimuli
strategy
a plan used to produce a specific result or outcome that will influence the structure or system
agnosia
inability to interpret information
agraphesthesia
inability to recognize symbols, letters, or numbers traced on the skin
agraphia
inability to write due to a lesion within the brain and is typically found in combination with aphasia
alexia
inability to read or comprehend written language secondary to a lesion within the dominant lobe of the brain
anosognosia
the denial or unawareness of one’s illness; often associated with unilateral neglect
aphasia
inability to communicate or comprehend due to damage to specific areas of the brain
apraxia
inability to perform purposeful learned movements or activities even though there is no sensory or motor impairment that would hinder completion of the task
astereognosis
inability to recognize objects by sense of touch
body schema
having an understanding of the body as a whole and the relationship of its parts to the whole
constructional apraxia
inability to reproduce geometric figures and designs. A person is often unable to visually analyze how to perform a task
decerebrate rigidity
characteristic of a corticospinal lesion at the level of the brainstem that results in extension of the trunk and all extremities
decorticate rigidity
characteristic of corticospinal lesion at the level of the diencephalon where the trunk and lower extremities are positioned in extension and the upper extremities are positioned in flexion
diplopia
double vision
dysarthria
slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech
dysphagia
inability to properly swallow
dysprosody
impairment in the rhythm and inflection of speech
emotional lability
a characteristic of right hemisphere infarct where there is an inability to control emotions and outbursts of laughing or crying that are inconsistent with the situation
fluent aphasia
characteristic of receptive aphasia where speech produces functional output regarding articulation, but lacks content and is typically dysprosodic using neologistic jargon
hemiparesis
condition of weakness on one side of the body
hemiplegia
condition of paralysis on one side of the body
homonymous hemianopsia
loss of the right or left half o the field of vision in both eyes
ideational apraxia
inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for movements is impaired
ideomotor apraxia
a condition where a person plans a movements or task, but cannot volitionally perform it. Automatic movements may occur, however, a person cannot impose additional movements on command
neologism
substitution within a word that is so severe that it makes the word unrecognizable
non-fluent aphasia
characteristic of expressive aphasia where speech is non-functional, effortful, and contains paraphasias.
Writing is also impaired
perseveration
the state of repeatedly performing the same segment of a task or repeatedly saying the same word/phrase without purpose
synergy
mass movement patterns that are primitive in nature and coupled with spasticity due to brain damage
unilateral neglect
the inability to interpret stimuli and events on the contralateral side of a hemispheric lesion. Left-sided neglect is most common withe a lesion to the right inferior parietal or superior temporal lobes
cauda equina injury
term used to describe injuries that occur below the L1 level of the spine. A cauda equina injury is considered to be a LMN lesion
dermatome
designated sensory areas based on spinal segment innervation
head-hips relationship
principle of mechanics used during mobility training with UE WBing used as a fulcrum for activity.
Technique requires the head to move in the opposite direction from the hips
myelotomy
surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function
myotome
designated motor areas based on spinal segment innervation
neurectomy
surgical removal of a segment of a nerve in order to decrease spasticity and improve function
neurogenic non-reflexive bladder
bladder is flaccid as a result of cauda equina or conus medullaris lesion.
Sacral reflex arc is damaged
neurogenic reflexive bladder
bladder empties reflexively for a patient with an injury above the level of T12.
Sacral reflex arc remains intact
neurologic level
lowest segment (most caudal) of the spinal cord with intact strength and sensation.
Muscle groups at this level receive a grade of fair
paradoxical breathing
a form of abdominal breathing that is common in tetraplegia where the abdomen rises and the chest is pulled inward during inspiration. On expiration, the abdomen falls and the chest expands
paraplegia
term used to describe injuries that occur at the level of the thoracic, lumbar, or sacral spine
rhizotomy
surgical resection of the sensory component of a spinal nerve in order to decrease spasticity and improve function
sacral sparing
incomplete lesion where some of the innermost tracts remain innervated. Characteristics include sensation of the saddle area, movement of the toe flexors, and rectal sphincter contraction
spinal shock
a physiologic response that occurs between 30-60mins after trauma to the SC and can last up to several weeks.
Spinal shock presents with total flaccid paralysis and loss of all reflexes below the level of injury
tenodesis
patients with tetraplegia that do not possess motor control for grasp can utilize the tight finger flexors in combination with wrist extension to produce a form of grasp
tenotomy
a surgical release of a tendon in order to decrease spasticity and improve function
tetraplegia (quadriplegia)
a term adopted by the American Spinal Injury Association to describe injuries that occur at the level of the cervical spine
zone of preservation
term used to describe poor or trace motor or sensory function for up to 3 levels below the neurologic level of injury
double crush syndrome
existence of two of separate lesions along the same nerve that create more severe symptoms than if only one lesion existed
mononeuropathy
an isolated nerve lesion; associated conditions include trauma and entrapement
neuroma
abnormal growth of nerve cells; associated conditions include vasculitis, AIDS, and amyloidosis
peripheral neuropathy
impairment or dysfunction of the peripheral nerves; associated conditions include diabetic peripheral neuropathy, trauma, alcoholism
polyneuropathy
diffuse nerve dysfunction that is symmetrical and typically secondary to pathology and not trauma; associated conditions include GBS, peripheral neuropathy, use of neurotoxic drugs, and HIV
axon
projection of a nerve away from the cell body that conducts impulses
dendrite
extension of the cell body that receives signals from other neurons
endoneurium
innermost covering of a peripheral nerve that surrounds each individual axon
epineurium
the outermost covering of a peripheral nerve that surrounds the entire nerve and provides a buffer for the peripheral nerve
motor unit
a single motor neuron and all of the muscle fibers that it innervates
myelin
proteins and lipids that form to create a sheath around particular nerves; increases conductivity of the nerve impulse
nerve conduction velocity
measure the speed of a nerve impulse along the axon of a nerve
neurons
nerve cells that receive and send signals to other nerve cells; compromised of a cell body, axon, and dendrites
nodes of Ranvier
brief gaps in myelination of an axon; serves to facilitate rapid conduction of a nerve impulse via jumping from gap node to gap node
perineurium
the middle layer of covering surrounding the peripheral nerve that envelopes fascicles or groups of axons and maintains the blood-nerve barrier
saltatory conduction
an action potential moving along an axon in a jumping fashion from node to node; decreases the use of sodium-potassium pumps and increases speed of conduction
schwann cell
cells that cover the nerve fibers within the peripheral nervous system and form the myelin sheath
barognosis (screening procedure)
perceive the weight of different objects in the hand
deep pain (screening procedure)
squeeze the forearm or calf muscle
graphesthesia (screening procedure)
identify a number or letter drawn on the skin without visual input
kinesthesia (screening procedure)
identify direction and extent of movements of a joint or body part
light touch (screening procedure)
perceive touch through light pressure or use of a cotton ball
localization (screening procedure)
ability to identify the exact location of light touch on the body using a verbal response or gesturing
proprioception (screening procedure)
identify a static position of an extremity or body part
stereognosis (screening procedure)
identify an object without sight
superficial pain (screening procedure)
perceive noxious stimulus using a pen cap, paper clip end, or pin
temperature (screening procedure)
perceive warm and cold test tubes
two-point discrimination (screening procedure)
using a two-point caliper on the skin, identify one or two points without visual input
vibration (screening procedure)
perceive vibration or pain though a tuning fork
intrinsic (inherent) feedback
represents all feedback that comes to the person through sensory systems as a result of the movement including visual, vestibular, proprioceptive, and somatosensory inputs
extrinsic (augmented) feedback
represents the information that can be provided while a task or movements is in progress or subsequent to the movement. This is typically in the form of verbal feedback or manual contacts
knowledge of results
is an important form of extrinsic feedback and includes terminal feedback regarding the outcome of a movement that has been performed in relation to the movement’s goals
knowledge of performance
is extrinsic feedback that relates to the actual movement pattern that someone used to achieve their goal of movement
massed practice
practice time in a trial is greater than the amount of rest between trials
distributed practice
amount of rest time between trials is equal to or greater than the amount of practice time for each trial
constant practice
practice of a given task under a uniform condition
variable practice
practice of a given task under differing conditions
random practice
varying practice amongst different tasks
blocked practice
consistent practice of a single task
whole training
practice of an entire task
part training
practice of an individual component or selected components of a task
closed motor skill
a skill that is performed under a stable and unchanging environment
knowledge of results
providing the patient with external feedback regarding a patients performance on a task. This can include observations as well as objective data and can be positive or negative in nature with the goal of influencing the learner.
open motor skill
a skill that is performed under a consistently changing environment
transfer of learning
an action cannot be separated from the environment that is performed in. A patient must be able to transfer the skill or motor task into different environments
facilitation
a technique utilized to elicit voluntary muscular contraction
inhibition
a technique utilized to decrease excessive tone or movement
key points of control
specific handling of designated areas of the body (shoulder, pelvis, hand, and foot) will influence and facilitate posture, alignment, and control
placing
the act of moving an extremity into position that ht patient must hold against gravity
reflex inhibiting posture
designated static positions that Bobath found to inhibit abnormal tonal influences and reflexes
associated reaction
an involuntary and automatic movement of a body part as a result of an intentional active or resistive movement in another body part
homolateral synkinesis
a flexion pattern of the involved upper extremity facilitates flexion of the involved lower extremity
limb synergies
a group of muscles that produce a predictable pattern of movement in flexion or extension patterns
Raimiste’s phenomenon
the involved LE will abduct or adduct with applied resistance to the uninvolved lower extremity in the same direction
Souques’ phenomenon
raising the involved UE above 100 degrees with elbow extension will produce extension and abduction of the fingers
