Neuro pt. 2 Flashcards
Motor System: if damage occurs ?
↓ or absent function distal to the injury
Motor System: if damage is above crossover in medulla, then problem is on ?
contralateral side
Motor System: if damage is below crossover in medulla, problem is on ?
ipsilateral side
Motor System: 3 kinds of pathways through anterior horn cells (cell bodies in spinal cord) ?
- Corticospinal (pyramidal) tract
- Basal ganglia system
- Cerebellar system
Corticospinal (Pyramidal) tract function ?
Voluntary movement
Delicate skilled movement ( fine motor skills)
Inhibits muscle tone (normal tension at rest)
residual tone
**keeps use from spasiscity or getting spastic **
Corticospinal (Pyramidal) tract damage results in ?
Weakness, paralysis, poor delicate movement
↑ muscle tone ( because it is not inhibited anymore) , ↑ DTR’s
only one that will result in paralysis
Basal Ganglia System function ?
Helps maintain muscle tone so we are not flaccid at rest
Gross movement
**this one increases it the other decreases it **
Basal Ganglia System damage results in ?
Changed muscle tone (increased)
Problems with posture, gait ( gross movements)
Bradykinesia - lowed movement
Involuntary movements
NO paralysis
Cerebellar System function ?
Coordinates motor activity
Maintains equilibrium
Maintains posture
Cerebellar System damage results in ?
Poor coordination
Problems with gait, equilibrium
↓ muscle tone
NO paralysis
Motor Exam Checklist focuses on ?
Involuntary movements
Posturing
Muscle tone, bulk, strength
Coordination
Of Arms, Legs, Trunk
Motor Exam ?
Inspect
Muscle tone
Muscle strength
ME: Inspect ?
Involuntary movements, abnormal positions
Muscle bulk – symmetry, atrophy
ME: Muscle strength ?
Bilaterally, with resistance
Grade it 0-5/5 b/l
Allow for age, sex, conditioning
**ROM to see if they are spastic
5/5 is NL
consider age **
Passive ROM Upper Extremity ?
Put limb through ROM
Grasp forearm and wiggle wrist
-Should be free but not floppy
Muscle Strength Terms: weakness ?
paresis
Ex: hemiparesis
Muscle Strength Terms: absence of strength ?
paralysis, plegia
Ex: quadriplegia, paraplegia
ME: upper extremities ?
Grip strength
Finger abduction
Opposition of thumb
Flex/extend elbow and wrist
ME: lower extremities ?
Flex/extend hip
Abduct/adduct hip
Flex/extend knee
Dorsiflex/plantar flex foot
**resist all of these movement to assess strength **
ME: trunk ?
Flex/extend, lateral bend spine
Thoracic expansion
Coordination requires what ?
Requires integration of all 4 areas working together:
4 ares of coordination ?
Motor system
for muscle strength
Cerebellar system
for rhythmic movement and steady posture
Vestibular system
for balance and coordination
Sensory system
for position sense - proprioception
**problems anywhere = problem with coordination **
Coordination: UE
Rapid alternating movements (for speed, dexterity)
-Pronation/supination of forearms
Fingers to thumb
Point to point testing
-Finger to nose – eyes open, then closed
Pronator drift
-Arms forward, palms up, eyes closed, push down
hand starts to fall away and pronate
Coordination: LE ?
Rapid alternating movements – tap foot
Point to point testing – heel down shin
