Spasticity and Neural plasticity Flashcards

1
Q

define muscle tone

A

resistance to muscle to passive stretch, encountered when the joint of a relaxed pt is moved. it is an UMN syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is a negative impairment

A

those that represent a loss of previous function e.g weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is a positive impairment

A

new or additional problems e.g proprioceptive reflexes/cutaneous reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

define the term ‘spasticity

A

a motor disorder characterised by a velocity -dependent increase in tonic stretch reflexes with exaggerated stretch reflexes resulting from hyper-excitability of the stretch reflex. Also a component of the UMN syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

define the term ‘rigidity’

A

an increased resistance to relatively slow passive movements, present in both extensors and flexors and independent of direction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the differences between spasticity and rigidity?

A

SPASTICITY: normally UL flexors
RIGIDITY: flexors and extensors equally
SPASTICITY: velocity-dependent increase in tone
RIGIDITY: constant throughout ROM
SPASTICITY: increased tendon relexes
RIGIDITY: normal reflexes
SPASTICITY: UMN pyramidal sign
RIGIDITY: extrapyramidal sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is a phasic stretch reflex?

A

a quick, unsustained contraction of the muscle that occurs in response to a rapid stretch of the muscle. mechanoreceptors are stimulated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the determinants of tone?

A

Degree of motor unit activity
Intrinsic elastic properties of the muscle, tendons and connective tissue
Environmental and sensory input

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

list the inhibitory influences

A
  • reciprocal inhibition
  • autogenic inhibition from golgi tendon organs
  • pain inhibits extensors
  • recurrent (Renshaw cell) inhibition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

define reciprocal inhibition

A

the relaxation of the antagonistic muscle evoked by contraction of the agonist muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

define autogenic inhibition

A

the sudden relaxation of a muscle in response to the development of high tension. Golgi tendon organs are responsible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

define presynaptic inhibition

A

when neurotransmitter acts on inhibitory receptors on the nerve axon to reduce the likelyhood of an action potential firing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

define Reccurrent/Renshaw cell Inhibition

A

the phenomenon in which Renshaw cells (responsible for regulating the firing of the alpha motor neurones) terminate on motorneurones, inhibiting their firing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

list the facilitatory influences

A
  • a stretch to the muscle with activate the muscle spindle
  • annulospiral influence
  • flower spray endings
    -activation of synergist muscles
  • pain facilitates flexors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

define annulospiral influence

A

nerve endings of intrafusal muscle fibers called the annulospiral ring activate stretch-activated channels that depolarise the neuron and thus increase its firing rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are flower spray endings?

A

small nerve fibers that branch out and convey information on the tonic response

17
Q

define the term “neural plasticity’

A

the ability of cells to undergo alterations in form and function in response to environmental influences. This can be induced by manipulating the periphery to invoke changes in target neurons environment. Changes can be adaptive or maladaptive

18
Q

what are the mechanisms involved in neural plasticity?

A

recruiting latent synapses
synaptic hypereffectiveness
synaptic reclamation
axonal/collateral sprouting
terminal regeneration
denervation supersensitivity

19
Q

outline the physiotherapeutic management of spasticity

A
  • movement; assisted/passive
  • relaxation techniques
  • positioning against tonal pattern
  • stretching
  • hydrotherapy
  • heattherapy
  • slow, rhythmical rocking
  • reflex inhibiting patterns
  • weight bearing
  • slow stroking
  • medications
  • PNF techniques
  • visual input
  • inhibitory auditory input
  • cryotherapy
  • serial casting
  • electrical stimulation
20
Q

what are the possible mechanisms of spasticity?

A
  • release of central inhibition
  • local muscle shortening
  • denervaion hypersensitivity
  • synaptic reclamation
    -intraspinal connections
  • fear, pain, insecurity
  • inadequate sensory information