Neuromuscular & nervous system Flashcards
Agnosia
Loss of ability to recognize common objects, people, or sounds.
Apraxia
Inability to execute learned purposeful movements
Alexia
Inability to understand written words
Agraphia
Inability to communicate through writing
Anasognosia
Unaware of the existence of his disability
Basal ganglia
Structure
Function
Associated disorders
Caudate, putamen, globus pallidus, substantia nigra, subthalamic nuclei
Voluntary mvmnt, regulation of autonomic mvmnt, posture, mucle tone, control of motor responses
PD Huntington's Tourette's ADD OCD Many addictions
Amydala
Emotional and social processing
Fear and pleasure responses
Arousal
Processing of memory and forming emotional memory
Frontal lobe lesion deficits
Range from: paralysis and apraxia to loss of executive fxn and goal directed behaviors.
Modifications to therapy may include response to perseveration, apraxia, and impaired executive fxn.
Apathy or may be uninhibited, distractible, and lack judgement.
Parietal lobe lesion deficits
Abnormal sensory awareness, perception, and interpretation. Abnormal mvmnt patterns.
Dominant hemisphere (left): agraphia, alexia, agnosia
Non-Dominant hemisphere (right): dressing apraxia, constructnal apraxia, anosognosia
Contralateral sensory deficits
Impaired language comprehension
Impaired taste
Temporal lesion deficits
Modifications to therapy
Affect short and long term memory. Learning deficits.
Wernicke’s area: inability to comprehend spoken language.
PT to provide a more kinesthetic approach, relying on demonstration.
New learning is available, but pt.s are usually unable to recall steps surrounding new skill.
Occipital lobe lesion deficits
Therapy modifications
Various visual deficits
Ability to receive, but not perceive visual info
Avoid use of diagrams, written materials, reading
Environmental modifications secondary to visual deficits, field cuts, and potential for visual agnosia.
Thalamus (Diencephalon)
Fxn
Damage to it.
Coordinates sensory info that goes to the cerebral cortex. It receives info from all sensory pathways except the olfactory tract. Then relays the info to the appropriate association cortex.
Damage can produce thalamic pain syndrome where their is spontaneous pain on the contralateral side of the body to the thalamus.
Hypothalamus (diencephalon)
Fxn
Damage
Receives and integrates info from the ANS, assists in regulating hormones. Hunger, thirst, sexual behavior, sleeping, regulates body temp, adrenal and pituitary glands.
Deficits depend on location of lesion: obesity, sexual disinterest, poor temp control, diabetes.
Subthalamus (diencephalon)
Regulates mvmnts produced by the skeletal muscles.
Epithalamus (diencephalon)
Pineal gland: secretes melatonin, circadian rhythms, emotions.
Midbrain fxn and key areas
Mesencephalon
Reflex center for visual, auditory, and tactile responses
Tectum: superor and inferior colliculi
Tegmentum: cerebral acqueduct, periaquaductal grey, reticular formation, substantia nigra, red nucleus
Hindbrain (rhombencephalon) consists of:
Damage
Cerebellum (metencephalon): balance, posture, perform rapid alternating mvmnts. Consists of two hemispheres
Damage to one of side results in ipsilateral impairment to the body.
Ie. ataxia, nystagmus, tremor, hypermetria, poor coordination, deficits in postural reflexes, balance, equilibrium.
Pons (metencephalon): assists with regulation of respiratory rate, orientation of head in relation to visual and auditory stimuli.
Cranial nerves 5-8 originate from pons.
Medulla (myelencephalon): regulates ANS activity, resp rate, heart rate. Reflex centers for vomiting, coughing, sneezing.
Damage to motor tracts crossing the medulla produces contralateral impairments. Also relays somatic sensorybinfo from internal organs and controls arousal and sleep.
Cranial nerves 9-12 originate from medulla.
Brainstem consists of:
Fxn
Damage
Midbrain, pons, medulla
Primitive fxns essential for survival: resp rate, heart rate, the reticular activating system.
Damage: brain death
The majority of cranial nerves originate here.
Blood supply to the brain by the ACA (anterior cerebral artery) and expected possible impairment based on extent of vascular involvment
Contralateral LE motor and sensory involvement
B/B control loss
Loss of behavioral control
Significant mental changes
Anterior frontal lobe
Medial surface of frontal and parietal lobes
Neglect
Aphasia
Apraxia and agraphia
Perseveration ( uncontrollable repetition of word phrase or gesture)
Akinetic mutism with significant bilateral involvement (conscious unresponsiveness)
Blood supply to the brain by the MCA (middle cerebral artery) and expected possible impairment based on extent of vascular involvment
Most of outer cerebrum, basal ganglia, post and anterior internal capsule, putamen, pallidum, lentiform nucleus.
Most common site of CVA. Wernicke aphasia in dominant hemisphere Homonymous hemianopsia Apraxia Flat affect with R hemisphere damage Contralateral weakness and sensory loss of face and upper extremity with lesser involvement in the LE Impaired spatial relations Anosognosia in dominant hemisphere Impaired body schema
Blood supply to the brain by the PCA (posterior cerebral artery) and expected possible impairment based on extent of vascular involvement
Portion of midbrain Subthalamic nucleus Basal nucleus Thalamus Inferior temporal lobe Occipital and occipitoparietal cortices
Contralateral pain and temp sensory loss
Contralateral hemiplegia, mild hemiparesis
Ataxia, athetosis or choreiform mvmnt
Thalamic pain syndrome: abnorm sensation of pain, temp, touch, and proprioception.
Anomia
Prosopragnosia…inability to recognize faces… With occipital infarct
Hemiballismus…flailing, ballistic uncontrolled mvmnt
Visual agnosia
Homonymous hemianopsia
Memory impairment
Alexia, dyslexia
Cortical blindness from bilateral impairment
Blood supply to the brain by the vertebral- basilar and expected possible impairment based on extent of vascular involvement
Cerebellum
Medulla
Pons
Midbrain and thalamus
Severe impairment: locked in syndrome or coma
Wallenberg syndrome secondary to lateral medullary artery infarct: ipsilateral fascial pain, ipsilat ataxia, vertigo, contrlat pain and temp impairment.
Meningitis
Inflammation of the meninges of brain and SC.
Fatal in hours
Sxs:
Fever, HA, vomiting
C/o stiff painful neck, nuchal rigidity
Pain in lumbar area and posterior thigh
Brudzinski’s sign: flxn of neck facilitates flxn of hips and knees
Kernig’s sign: pain with hip flxn combined with knee ext.
Sensitivity to light
Lumbar puncture is gold stndrd for dx
Tx: antibiotic, antimicrobial, steroid drugs
Subarachnoid space
Area between the arachnoid and pia mater
Contains CSF and circulatory system for the brain.
