Neuromuscular Flashcards
White Matter
Myelinated nerve fibers. Located centrally IN BRAIN and on outside of spinal cord.-Transverse fibers, projection fibers, association fibers
Basal ganglia: name the circuits that exist in the BG
Oculomotor circuit, motor loop, limbic circuit
What is the function of the oculomotor circuit in the BG?
saccadic eye movements
What is the function of the motor loop of the BG?
motor set (prep for movement) and anticipatory movement
What is the function of the limbic circuit in the BG?
executive functions, problem solving, motivation, and procedural learning
Functions of the Thalamus:
sensory from body, face, eye, ear, tongue (but NOT smell)
Functions of hypothalamus:
maintain homeostasis: body temp, eating, water balance, sexual behavior, emotion
Parts of the Brainstem:
midbrain, pons, medulla oblongota
Functions of epithalamus:
smell, secrete hormones that influence sleep cycle
Functions of midbrain:
coordination, motor control and muscle tone, visual reflexes, hearing and auditory reflexes, suppresses pain
Functions of pons:
-connects medulla to midbrain-modulate pain and control arousal-Cranial nerve nuclei: abducens, trigeminal, facial, vesitbulocochlear
Functions of medulla oblongata:
-connects spinal cord with pons-control of head movements and gaze stabilization (vestibular ocular reflex)-voluntary movement control-cranial nerve nuclei: hypoglossal, dorsal nucleus of vagus and vesitbilocochlear-respiratory, cardiac, and vasomotor centers
Cranial Nerves: Name them
Olfactory (Some), Optic (Say), Oculomotor (Marry), Trochlear (Money), Trigeminal (But), Abducens (My), Facial (Brother), Vestibulocochlear (Says), Glossopharyngeal (Big), Vagus (Brains), Accessory (Matter), Hypoglossal (More)
Functions of Cerebellum:
-regulate muscle tone-posture-voluntary movement control-coordination of movements (accurate force, direction, extent of movement)-motor learning- maybe cognitive function and mental imagery
Gray Matter
Located centrally in spinal cord- anterior horns give rise to = motor neurons-posterior= sensory
Tract: Dorsal Column/Medial Lemniscal
proprioception, vibration, tactile discrimination
Spinothalamic Tract
pain and temperature, crude touch
Spinocerebellar tract
proprioception from muscle spindles, Golgi tendon organs, touch and pressure receptors to cerebellum for control of voluntary movements
Spinoreticular tract
deep and chronic pain
Corticospinal tract
from primary motor cortex, voluntary movement control
Vestibulospinal tract
control muscle tone, antigravity muscles, and posture reflexes
Rubrospinal tract
motor function
Reticulospinal system
transmit pain sensation and influences spinal reflexes
Tectospinal tract
head-turning responses to visual stimuli
Afferent versus efferent nerve fibers
Afferent= going to the spinal cord (away from organ)Efferent= going to the organ and away from the spinal cord
Sympathetic NS
- T1 to L2-fight or flight
Parasympathetic
Conserves and restores homeostasis- craniosacral division, CN 3, 7, 9, 10, pelvic nerves
Name the cervical, lumbar, and sacral plexus nerve roots
Cervical: C1-C4
Lumbar: T12- L4
Sacral: L4- S3
Term for patient that appears drowsy, can respond to questions, but falls asleep easily
Lethargy
Term for patient that can only be aroused by painful stimuli and demonstrates minimal awareness of self and environment
Stupor
Term for state characterized by sleep/wake cycles and lack of cognitive responses
Unresponsive vigilance (vegetative) state
Term for state characterized by severely altered consciousness but definite evidence of self or environmental awareness
Minimally conscious state
Glasgow Coma Scale: what are the 3 components
looks at eye opening, motor response, and verbal response
Glasgow Coma Scale: scoring interpretations
(1-8) severe brain injury
(9-12) moderate brain injury
(13-15) mild brain injury
Mini Mental State Exam: scoring interpretations
Highest, best score is 30
(21-24) mild cognitive impairment
(16-20) moderate
(15 or less) severe
Ranchos Los Amigos Scale: scoring interpretations (Levels I through VIII)
I = no response II and III = decreased response level IV= confused agitated V= confused inappropriate VI = confused appropriate VII= automatic appropriate VIII= Purposeful appropriate
Broca’s aphasia: what is it and name the location of this area in brain
- Impairment of speech production
- Broca’s area is in the frontal lobe
Wernicke’s aphasia: what is it and name the location of this area in the brain
- Impaired comprehension of speech
- located in temporal lobe
What is this type of breathing termed?
- period of apnea lasting 10-60 seconds followed by increasing depth and frequency of respirations
Cheyne-Stokes respiration
What is this type of breathing termed?
-abnormal respiration marked by prolonged inspiration
Apneustic breathing
Kernig’s sign and Brudzinski’s sign are tests to look for what?
CNS infection or meningeal irritation
Decorticate posture
Flexion
deCortiCate (C’s)= move in toward core (flexion)
- lesion above superior colliculus (at level of diencephalon)
Decerebrate posture
extension
dEcErEbratE (E’s)= extension
-lesion below superior colliculus (at level of brainstem)
worse than decerebrate
Right homonymous hemianopsia: what is it
Loss of visual field on the RIGHT half of each eye (therefore, there is a lesion on LEFT occipital lobe)
When a patient cannot recognize a clock by SIGHT but can recognize it by SOUND, what is this termed?
agnosia
what is ideomotor apraxia?
Person cannot perform a task on command but can when left to do the task on their own.
what is ideational apraxia?
Person cannot perform the commanded task AT ALL
A positive Babinski sign in adults (great toe ext.) signifies disruption of what spinal tract?
corticospinal (pyramidal) tract
Modified Ashworth Scale: what are the six grades?
0= no increase in muscle tone 1= slight increase in muscle tone, minimal resistance at END of ROM 1+= slight increase, minimal resistance through LESS THAN HALF of ROM 2= more marked increased in tone, through MOST of ROM, affected part easily moved 3= considerable increase in muscle tone, passive movement difficult 4= affected part RIGID in ext. or flex.
What is the term for prolonged, severe spasm of muscles, causing the head, back and heels to arch backward and arms and hands in rigid flexion?
Opisthotonos
Agnosia
inability to interpert information
Agraphesthesia
inability to recognize symbols, letter, numbers traced on the hand
Alexia
inability to read or comprehend written language
lesion in dominant lobe of brain
Agraphia
inability to write, usually found in combo with aphasia
due to lesion in brain
Anogsognosia
denial or unawareness of one’s illness, often associate with unilateral neglect
Apraxia
inability to perform purposeful learned movement or activity, even though no sensory or motor impairment hinders completion of task
Asterognosis
inability to recognize objects through touch
constructional apraxia
inability to reproduce geometric figures and designs, unable to visually analyze how to perform a task
Dysarthria
slowed and impaired speech d/t motor deficit of speech muscles
Dysphagia
inability to swallow
dysprosody
impairment in rhythm and inflection of speech
emotional lability
d/t R hemisphere infarct, inability to properly control/use emotions
neologism
substitution within a word so severe it makes the word unrecognizable
perseveration
repeatedly performing the same segment of a task or repeatedly saying the same word with out purpose
Unilateral neglect
inability to interpret stimule on the contralateral side of a hemispheric lesion
L neglect most common with lesion to the R inferior parietal or superior temporal lobes
Brunnstorm 7 Stages of Recovery (hemiplegia)
- no volitional movement
- spasticity begins along with appearance of basic limb synergies
- synergies performed voluntarily, spasticity increases
- spasticity begins to decrease, movement patterns not dictated solely by limb synergies
- further decrease in spasticity, indepdence from limb synergies
- isolated going movements performed with coordination
- normal motor function restored
* pt may plateau in one stage and never reach 7
Raimiste’s phenomenon
seen after CVA, involved LE with adduct or abduct with applied resistance to uninvolved LE in same direction
Souque’s phenomenon
post-CVA, raising involved UE above 100 degrees with elbow ext produces ext and abd of fingers
Levels of motor control
mobility –> stability –> controlled mobility –> skill
ASIA impairment scale - Level A
Complete: no sensory or motor fxn perserved in sacral segments S4-S5
ASIA impairment scale - Level B
Sensory Incomplete: Sensory but NOT motor fun is preserved below the neurological level and extend through sacral segments S4-S5
ASIA impairment scale - Level C
Motor Incomplete: motor fxn is preserved below neurological level, and most key mms below neuro level have a mm grade LESS than 3
ASIA impairment scale - Level D
Motor incomplete: motor fxn is preserved below neurological level, and most key mms below the level have a mm grader GREATER THAN OR EQUAL to 3
ASIA impairment scale - Level E
Normal: sensory and motor fxns are normal