PRELIMS: Examination for Motor Function Flashcards
Which tract is involved in the voluntary control of distal musculature?
Corticospinal tract
What is the function of the basal ganglia in motor control?
To initiate and regulate voluntary movement
Which type of muscle fiber is characterized by high endurance and slow contraction speed?
Type I fibers
What is the primary neurotransmitter involved in neuromuscular junctions?
Acetylcholine
Describe the difference between upper motor neurons (UMNs) and lower motor neurons (LMNs).
UMNs originate in the brain and spinal cord, while LMNs directly innervate muscles.
This concept involves storing information about the order, timing, force, and muscles used in movements, with sensory feedback modifying the resulting actions.
Generalized Motor Programs (GMPs)
A complex program for purposeful movement that consists of several component motor programs.
Motor Plan
Includes core neurons in the brainstem that arouse and awaken the brain, controlling the sleep-wake cycle.
Ascending Reticular Activating System
Internal processes linked to practice or experience that lead to permanent changes in skilled behavior.
Motor Learning
This type of memory involves the recall of motor programs, including information on initial movement conditions, sensory parameters, specific performance parameters, and the outcome of the movement.
Motor Memory (Procedural Memory)
A distributed model of motor control where multiple systems, including mechanical, cognitive, and perceptual factors, interact to produce coordinated movement.
Systems Theory
The process of reacquiring the ability to perform movements as before an injury, contrasted with performing movement in a new manner using different muscles or limbs.
Recovery and Compensation
The ability to take in, store, and recall information is a key part of this cognitive component.
Memory
Broad-based memory and learning impairments are typically seen in this condition.
Dementia
The CNS’s adaptive capacity to change and repair, involving both short-term changes in synaptic strength and long-term changes in genes, neurons, and networks.
Neural Plasticity
Refers to the state of arousal with awareness of the environment, where the patient is awake, alert, and oriented.
Consciousness
Involves voluntary movements of distal muscles and includes pathways like the corticospinal and rubrospinal tracts.
Lateral Pathways
This system includes pontine and medullary reticulospinal tracts and plays a role in antigravity reflexes and the extensor tone of the lower extremities.
Descending Reticular Activating System
The state of diminished arousal where the patient is drowsy, can open eyes and respond briefly, but easily falls asleep.
Lethargy
The process of sending signals in advance to prepare the sensorimotor systems for movement.
Feedforward
A state of diminished arousal and awareness where the patient is difficult to arouse, appears confused, and interacts poorly with their environment.
Obtunded State
A state where the patient can only be aroused with vigorous or unpleasant stimuli, showing minimal voluntary responses.
Stupor
This system maintains homeostasis and restores it after SNS activation.
Parasympathetic Nervous System (PNS)
A state in which a patient is unarousable, has no sleep-wake cycles, and does not respond to repeated painful stimuli, often requiring ventilation.
Coma
The information received during or after movement that is used for corrective actions.
Feedback
The capacity to execute smooth, accurate, and controlled motor responses through functionally linked muscle groups.
Coordination
Governs posture and locomotion, involving pathways such as vestibulospinal, tectospinal, pontine, and medullary reticulospinal tracts.
Ventromedial Pathways
Examination showing bilateral small pupils could indicate damage to sympathetic pathways or metabolic encephalopathy.
Pupillary Examination - Bilateral Small Pupils
The awareness of time, location, and personal identity is assessed under this cognitive component.
Orientation
Significant memory deficits, along with confusion, agitation, and hallucinations, can indicate this condition.
Delirium
What is the grading scale for reflexes?
0: Absent, no response
1+: Low normal, diminished
2+: Normal
3+: Brisker than normal
4+: Very brisk, hyperreflexive, with clonus
5+: Sustained clonus
ANS responses such as heart rate, blood pressure, respiratory rate, pupil dilation, and sweating are part of this type of examination.
Baseline ANS Examination
This system activates the fight or flight response during stress.
Sympathetic Nervous System (SNS)
What are the scoring categories for the Glasgow Coma Scale (GCS)?
Severe: ≤ 8, Moderate: 9-12, Mild: 13-15.
What might bilateral small pupils indicate?
Damage to the sympathetic pathway or metabolic encephalopathy.
These drugs may degrade memory function.
Benzodiazepines, Anticholinergic Drugs
Immediate registration and recall of information after a few seconds is assessed under this type of memory.
Immediate Memory
Inability to remember previous learning acquired before a brain insult.
Retrograde Amnesia
What is the difference between spasticity and rigidity?
Spasticity is velocity-dependent, while rigidity is resistance to movement independent of velocity.
The inability to learn material acquired after a brain insult is known as what?
Anterograde Amnesia
Conscious recollection of facts, past events, experiences, and places falls under this type of memory.
Declarative (Explicit) Memory
What does an increased Deep Tendon Reflex (DTR) indicate?
It is indicative of Upper Motor Neuron (UMN) syndrome, such as in stroke.
What is the Jendrassik Maneuver?
A technique where the patient hooks their fingers and pulls them apart to enhance lower extremity reflexes.
What is the mechanism of Deep Tendon Reflexes (DTRs)?
DTRs result from the stimulation of stretch-sensitive IA afferents of the neuromuscular spindle, causing muscle contraction.
What is indicated by large fixed dilated pupils?
Severe anoxia or drug toxicity.
Severe anoxia or drug toxicity.
Speech errors related to timing, vocal quality, pitch, volume, and breath control.
Evolving from neural, physical, and behavioral processes, this concept governs posture and movement, including both genetic reflex patterns and learned motor skills.
Motor Control
What is spasticity?
A velocity-dependent increase in muscle tone with resistance to stretch.
What are common causes of hypotonia?
Lower motor neuron syndrome, cerebellar lesions, and acute upper motor neuron lesions.
involuntary, predictable responses to stimuli that depend on an intact reflex arc, leading to muscle contraction via a monosynaptic pathway.
Deep Tendon Reflexes (DTRs)
What might a decreased Deep Tendon Reflex (DTR) suggest?
It may indicate Lower Motor Neuron (LMN) syndrome, cerebellar syndrome, or muscle disease.
What is the Modified Ashworth Scale (MAS) used for?
Assessing muscle spasticity in patients with CNS lesions.
Reflexes elicited by a light stroke on the skin, causing a brief muscle contraction.
Superficial Cutaneous Reflexes
What does the loss of abdominal reflex suggest?
It may indicate a thoracic spinal cord injury.
What are Primitive Tonic Reflexes?
Reflexes present during infancy as part of normal development, typically integrated by the CNS early in life.
What does the persistence of Primitive Tonic Reflexes in adults indicate?
It suggests neurological involvement, often due to extensive brain damage like stroke or traumatic brain injury (TBI).
What is the grading scale for Primitive and Tonic Reflexes?
0+: Absent
1+: Slight tone change with no movement
2+: Visible movement of extremities
3+: Exaggerated, full movement of extremities
4+: Obligatory and sustained movement lasting over 30 seconds
