Neuro Final Flashcards
What is Motor Control
The ability to maintain and change movement and posture
Motor, Cognitive, Sensory Perception
Reflex is the basic unit of ________
Movement
Hierarchy of Reflexes
Primitive Reflexes
Tonic Reflexes
Righting/Protective/Equilibrium
Primitive Reflexes
reflexes needed to survive
ex: suck, swallow, rooting
Tonic Reflexes
Develop tone in neck and trunk
ex: Labrinthe, ATNR
Righting/Protective/Equilibrium
Most Advanced
Cortex= Equilibrium
Midbrain= Righting Reactions
Brainstem= Postural Tonic
Spinal Cord= Phasic Primitive Reflex
Righting Reactions: Neck on Body
head-turning leads to trunk turning to follow head
ex: Log roll, baby will roll following head turn
Righting Reactions: Body on Body
one half of the body is rotated, other half will follow
Ex: used in bed mobility- supine rolling
Protective Reactions
forward parachute reflex
backward parachute reflex
sideward parachute reflew
Equilibrium Reactions
Most advanced of postural reactions and develops last
Incorporates already learned righting reactions, ADD extremity responses or trunk rotations
Expected Sequence in Equilibrium Reactions
prone, supine, sitting, quadruped, standing
Motor Control Stage 1
Mobility
initiation of movement that is random, erratic, lack of purpose, reflex based
*Random movement
Motor Control Stage 2
Stability
Maintain steadiness in weight-bearing, antigravity, posture
1. Tonic Holding
2. CoContraction
*maintenance of posture
Motor Control Stage 3
Controlled Mobility
Proximal mobility, Distal Stability
Limbs weight-bearing, weight shifts
*movement within posture
Motor Controls Stage 4
Skill
Proximal segment stabilize while distal segments are free of movement
*Moving one posture to another
Cognition and Motivation to move is influenced by what 3 things?
Motor Control
Motor Learning
Motor Development
*impaired cognition affects ability to learn how to move
Piaget’s Theory Sensorimotor
Infant
learns to understand the world by associating sensory experiences with physical actions
Piaget’s Theory Preoperational
2-7 Years old
The world is represented in symbols (playing pretend) and increased use of language
Piaget’s Theory Concrete Operations
7-11 Years Old
Logical thought occurs
Piaget’s Theory Formal Operations
12 Years old
Abstract thinking
Optimization Principle
during development or recovery
and the body chooses how to do a movement based on efficiency
*Initially useful, then becomes habitual
What is Motor Learning
the process that brings a permanent change in performance due to practice or experience
Motor Learning Stage 1: Cognitive
Thinking about movement
where movements are stiff, inconsistent, non-fluid and with Errors
Motor Learning Stage 2: Associative
Movement is refined with improved coordination, consistent, efficient, more fluid and with fewer errors
Motor Learning Stage 3: Autonomous
Movement is independent that is efficient, smooth, fluid, and consistent with self-correction of errors
Neural control of posture is distributed how?
- Spinal cord- Central Pattern
- Cerebellum- control of timing and coordination
- Basal Ganglia- movement initiation
Motor Learning Tasks- Open
Environments change over time
Motor Learning Tasks- Closed
parameters are the same
Experience -Dependent
Learning is based on experiences, culture, and individual situations
Experience- Expectant
Physically brain able to develop, but requires experience to make it happen
When do movement pattern changes occur?
Adolescence and Adult hood
In a counter-coup injury, where does the damage to the brain occur?
Opposite side of impact
What is the most common type of TBI?
Concussion
What are the common biggest problems of a TBI in patients?
Irritability, Lability, Aggression
What stimulus would not be appropriate to present during intervention with a TBI patient in a coma?
Playing their least favorite music
What is the most common cause of a TBI?
Falls
What are the two major types of TBI?
Open or Closed Head Injuries
Low initial scores in which areas of Glasgow Coma Scale are indicative of poor outcome?
Eye opening and Motor Response
Treatment of the patient is based on What?
Concussion clinical trajectory
Is damage from TBI widespread?
YES
PNF pattern for forward stooped posture?
D2 Flexion
to increase hamstring length, which PNF pattern do you use?
Contract Relax
Lateral weight shifts in prone on elbows, what technique is used to increase dynamic stability?
Approximation
What is a technique used to increase LE strenght?
Repeated contractions
Standing facing a corner with shoulders abducted 90degrees, elbows flexed 90 degrees, etc
Self stretching routine called
Hold-Relax
treatment intervention best for early treatment in GBS would be…
Alternating ISO of trunk flexors and extensors
PTA positions a patient to test for clonus, what is the best way to position them?
Provide quick stretch to plantar flexors why flexing the knee (flexing the knee takes the gastroc out of it, leaving the soleus)
What are indicators of sympathetic nervous system involvment?
Anxiety, distractibility
Mottled shiny cold skin
rapid shallow breathing
Cerebellar dysfunctions include:
Dysmetria
Ataxia
Nystagmus
A pta completes a developmental assessment, assuming everything is normal, what would be the last to occur?
Modified plantigrade
Primary goal of baby with osteogenesis imperfecta would be….
Promote safe handling and positioning
A child with CP shows a toe drag during swing phase of gait, what would NOT contribute to this gait deviation?
Spasticity of the the dorsiflexors
A child with CP presents with slow, involuntary, writhing movements of the upper and lower extremities what type of motor disturbance is most representative
Athetosis
2 year old spina bifida T10 recieves PT for gait training, what does the child use?
Parapodium and parallel bars
What time of day should an MS patient come in for therapy?
Earlier in the day
What is areflexia?
muscle does not respond to stimuli
Working with a patient with post pollio syndrome, what would least likely be affected based on patient diagnosis?
Sensation
What is ALS
Central nervous system degeneration of anterior horn motor in spinal cord
What therapeutic intervention would be best for a typical parkinsons disease patient?
trunk rotation activities
Attention is dependent on capacity of the brain to ___________ info from the environment or LTM
PROCESS
What internal structure acts as a relay station of sensory information
Thalamus
Which term describes loss of muscle coordination that may affect gait or movement patterns in the trunk or extremities?
Ataxia
Where are anterior horn cells located?
In the gray matter
The inability to stop opposing motion by quick activation of the antagonist group is called?
Rebounding
What info is carried by to the corticospinal tracts?
MOTOR
What artery supplies blood to the cerebellum?
Basilar
Which lobe has the primary sensory cortex?
Parietal
Which artery is responsible for the dorsal region of the spinal cord?
Posterior
Which type of hypertonicity is not velocity dependent?
Rigidity
Which cranial nerve provides sensation to the face?
Trigeminal
What internal structure regulates posture, muscle tone and volitional movement?
Basal Nuclei
Which internal structure controls emotion reactions such as fear and rage?
Limbic System
Brocca’s Aphasia
Expressive Aphasia, Most common, Non-fluent
Wernicke’s Aphasia
Receptive Aphasia, comprehension impaired
Antiepileptic Agents
Reduces seizure activity in the brain
Dilantin, Tegretol
Antispasticity Agents
Promotes relaxation in spastic muscles
Can make patients drowsy, confused, headaches
Dantrium, Baclofen
Dopamine Replacements
agents cross blood barrier through active transport to transform to dopamine in the brain
Sinemet, Madopar
Muscle Relaxants
Valium, Flexeril
Secondary Parkinson’s is the result of what other conditions?
Encephalitis
Alcoholism
TBI
Psychotropic medications
What are the clinical features of Parkinson’s disease (TRAP)?
Tremor
Rigidity
Akinesia/Bradykinesia
Posture instability
Additional: fatigue, gait,falls, systemic manifestations
What are the 5s of unfreezing in Parkinson’s
Stop (focus)
Sit/stand (adjust posture)
Shake it off (relax)
Shift Weight (rock back and forth/prep)
Step/shoot up (large powerful movement)
Landau
Tummy supported
Super Man position
Righting
keeps head oriented in space so eyes and mouth are horizontal
Keeps alignment of head and body
Neck on Body
Body on Body
Equilibrium
SLOW response
adapts to change of COM and BOS
