Neuro Module 4

Question 1

Define equilibrium

Answer 1

Ability to maintain orientation of the body and its parts in relation to external space (“balance”)

Question 2

Equilibrium requires integration of what sensory input types?

Answer 2

• Proprioception
• Visual
• Vestibular

Question 3

Sensory input is processed via:

Answer 3

Nuclei of brainstem and cerebellum

Question 4

4 functions of cerebellum

Answer 4

1. Maintain balance and posture
2. Coordinated voluntary movements
3. Motor learning
4. Cognitive functions

Question 5

Describe the cerebellum

Answer 5

• 10% of brain’s volume but 50% of neurons

- Major role in motor function but does NOT initiate motor commands

Question 6

What part of the brain is called “little brain”?

Answer 6

Cerebellum

Question 7

3 categories of cerebellum motor impairments

Answer 7

1. Hypotonia (decreased muscle tone)
2. Disequilibrium (loss of balance)
3. Dyssynergia (loss of coordinated activity)

Question 8

How do cerebellar lesions impair motor and sensory activity?

Answer 8

1. Do impair motor activity
2. Do NOT result in motor paralysis
3. Do NOT impair ability to consciously detect sensory input

Question 9

S/S a/w cerebellar lesions are usually:

Answer 9

Ipsilateral OR bilateral

Question 10

Clinical exams to assess hypotonia

Answer 10

• Observation
• DTRs
• Passive ROM

Question 11

Describe hypotonia

Answer 11

• Poor muscle tone

- Floppy, rag doll, pt looks drunk

Question 12

Describe disequilibrium

Answer 12

Loss of balance

Question 13

Clinical exams to assess disequilibrium

Answer 13

• Tandem walking
• Balancing tests
• Romberg’s

Question 14

Describe dyssynergia

Answer 14

• Loss of coordinated activity

- May clinically manifest many ways (dysarthria, dystaxia, dysmetria, nystagmus, tremor, etc.)

Question 15

Describe dysarthria

Answer 15

Uncoordinated speech, difficulty articulating

Question 16

Clinical exams to assess dysarthria

Answer 16

Observation (listening) for slurring, slowing, “scanning” (random or inappropriate variation in volume, emphasizing wrong vowel)

Question 17

Describe dystaxia

Answer 17

• Ataxia

- Lack of coordination in the execution of learned voluntary movement

Question 18

Clinical exams to test dystaxia:

Answer 18

Observation of gait or activity

Question 19

Describe dysmetria

Answer 19

-Inability to stop muscular movement at a desired point in space
“Overshooting” or “past pointing”

Question 20

Clinical exams to assess dysmetria

Answer 20

FNF (finger nose finger)

HKS

Question 21

Define intention tremor

Answer 21

Tremor that occurs with precise voluntary movement

Question 22

Clinical exams to assess intention tremor

Answer 22

• Observation w/precision activity

- Finger to nose, finger to finger

Question 23

Define dysdiadochokinesia

Answer 23

• Inability to perform rapid alternating or repetitive movement
• Disruption of timing of initiation and stopping
• Difficulty in sequencing

Question 24

Clinical exams to assess dysdiadochokinesia

Answer 24

Rapid alternating supination/pronation

Question 25

Define nystagmus

Answer 25

• Ocular dysmetria

- Rhythmic oscillation of the eyeballs

Question 26

What is the arm pull test?

Answer 26

• Test of rebound (cerebellar)

- Let go and pt hits themselves in chest

Question 27

Describe the term “rebound” wrt cerebellar function

Answer 27

Considered inaccurate, it really represents overshooting or undershooting movement

Question 28

What are the deep cerebellar nuclei and which areas of the cerebellum are they associated with?

Answer 28

• Dentate (cerebrocerebellum)
• Interposed (spinocerebellum)
• Fastigial (spinocerebellum)
• Vestibular (vestibulocerebellum)

Question 29

Function of vestibular nuclei (vestibulocerebellum)

Answer 29

Balance and eye movements

Question 30

Function of dentate (cerebrocerebellum) nuclei

Answer 30

Motor planning

Question 31

Function of interposed (spinocerebellum) nuclei

Answer 31

Motor execution

lateral descending systems

Question 32

Function of fastigial (spinocerebellum) nuclei

Answer 32

Motor execution

medial descending systems

Question 33

What is the oldest part of the cerebellum?

Answer 33

Vestibulocerebellum

Question 34

Lesion of vestibulocerebellum causes:

Answer 34

Dysequilibrium
Hypotonia
Nystagmus

Question 35

Lesion of spinocerebellum causes:

Answer 35

Rebound
Ataxia
Hypotonia

Question 36

Lesion of cerebrocerebellum causes:

Answer 36

Dyssynergia