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Neuromuscular > Test 1 > Flashcards

Test 1 Flashcards

0
Q

Symptoms

A

Subjective findings

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1
Q

Signs

A

Objective findings

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2
Q

Positive symptoms

A

Release of abnormal behaviors

Spasticity

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3
Q

Negative symptoms

A

Loss of normal behaviors

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4
Q

Motor cortex deficits

A

Motor weakness
Abnormal synergies
Coactivation
Abnormal muscle tone

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5
Q

Neural aspects of strength

A

Number of motor units recruited
Type of motor units recruited
Discharge frequency

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6
Q

Weakness

A

Inability to generate normal levels of force

Major impairment in those with UMN lesions

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8
Q

Paresis

A

Mild or partial loss of muscle captivity
From lesion in descending motor pathways
Interferes with central excitatory drive to the motor units

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9
Q

Paralysis or paresis

A

Decreased voluntary motor unit recruitment

Inability to recruit skeletal motor units to generate torque or movement

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10
Q

Reduced descending drive is associated with…

A

Failure to recruit high threshold motor units
Reduced ability to increase motor unit discharge to increase voluntary forces
More distally than proximally

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11
Q

Reduced excitatory input to the spinal motor neurons…

A

Reduces maximal voluntary power

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12
Q

Lesions to corticospinal centers

A

Can lead to loss of ability to recruit a limited number of muscles controlling movement
Inability to control individual joints
Mass movements called abnormal synergies

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13
Q

Abnormal synergies

A

Stereotypical patterns of movement that cannot be changed or adapted to changes in task or environmental demands
Reflect lack of fractionation
Muscles so strongly linked, movement outside of fixed pattern not possible

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14
Q

Fractionation

A

Ability to move single joint without simultaneously generating movements in other joint

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15
Q

Co activation

A

Common characteristic of unskilled early stages of learning

Not necessarily a result of impairment of function but rather a primitive form of coordinating

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16
Q

Spasticity

A

A motor disorder characterized by a velocity dependent increase in tonic stretch reflexes with exaggerated tendon jerks resulting from hyper excitability of the stretch reflex
- abnormalities within segmental stretch reflex

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17
Q

Lesion in the descending motor systems result in…

A

Increase in alpha motor neuron excitability with a resulting increase in muscle tone and exaggerated tendon jerks
- I.e hypertonicity

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18
Q

Spasticity is a combination of

A

A decrease in stretch reflex threshold

Reflex hyper excitability

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19
Q

Enhanced stretch reflex can occur because…

A

The alpha motor neuron pool at the segmental levels is hyper excitable
The amount of excitatory afferent input is increased
Or both

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20
Q

Hyper excitability of alpha motor neuron pool can be due to

A

A loss of descending inhibitory input
Post synaptic denervation hyper sensitivity
Shortening of the motor neuron dendrites
Collateral sprouting of dorsal root afferents

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21
Q

Behavioral indications of spasticity can include:

A

Change in the resting position of a limb

Presence of characteristic movement patterns

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22
Q

Pendulum or drop test for what?

A

Spasticity

Hypotonicity

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23
Q

Impairments associated with cerebellar pathology

A

Hypotonia
Coordination
Intention tremor
Impaired error correction affecting motor learning

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24
Q

Lesions of the vermis and fastigial nuclei

A

Disturbances in axial and postural control, balance, speech deficits
Medial- axial
Lateral- distal

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25
Q

Damage to intermediate cerebellum or imposed nuclei

A

Action tremor in limbs

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26
Q

Lateral cerebellar lesions

A

Delay in initiating movement

Impaired control of multi joint movements

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27
Q

Hallmark sign of cerebellar pathology

A

Coordination problems

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28
Q

Coordination problems

A

Movement trajectories uneven and lack a bell shaped profile

- because of the loss of coordinated coupling between synergistic muscles and joints

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29
Q

Paralysis

A

Total or severe loss of muscle activity

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30
Q

Coordination problems could present as

A

Delayed reaction time
Errors in range and direction of movement
Inability to sustain regular rhythmic movements
Decomposition- moving one joint at a time bc cannot time or scale multi joint movements
Inability to terminate movement and change direction
- stop agonist and generate force in antagonist
- rebound phenomena

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31
Q

Dysmetria

A

Problems judging the distance or range of a movement

Scale forces appropriately for a task performance

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32
Q

Intention tremor

A

Occurs during performance of a voluntary movement

Most marked at the end when the person attempts to brake the movement

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33
Q

Impaired error correction affecting motor learning

A

Cerebellum provides internal feedback reporting intended movement and external feedback that report actual movement
Creates a feed forward signal to reduce subsequent errors
Lesions affecting error reporting contribute to motor learning deficits

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34
Q

Dysmetria and intention tremor result from

A

Disruption of feed forward mechanisms

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35
Q

BG pathology include

A

Hypokinetic
Hyperkinetic
Dystonia
Dyscoordination

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36
Q

Parkinson’s disease

A

Flexed posture and impaired gait and balance
From degeneration of dopamine
Akinesia, bradykinesia, rigidity, resting tremor

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37
Q

Akinesia

A

Reduced ability to initiate spontaneous movement

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38
Q

Bradykinesia

A

Slow and reduced amplitude voluntary movements

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39
Q

Rigidity

A

Increased muscle tone regardless of velocity
Hyperactivity in fusimotor system
Predominantly in flexors of the trunk

In motor impairments as well

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40
Q

Resting tremor

A

Tremor occurring in a body part that is not voluntarily activated and is supported against gravity
Amplitude increases during mental stress or movement of another body part (gait)

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41
Q

Action tremor

A

Produced by voluntary contraction of a muscle

  • postural: voluntarily maintaining position against gravity
  • kinetic: during a voluntary movement
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42
Q

Akinesia and bradykinesia coordination problems seen in…

A

Handwriting because of a reduced capacity for coordinating wrist and finger movements

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43
Q

Frontotemporal dementia

A

Inappropriate behaviors
Language problems
Difficulty with thinking and concentration
Movement problems

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44
Q

Hyperkinetic disorders

A

Excessive and involuntary movements and decreased muscle tone
Chorea
Athetoid

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45
Q

Chorea

A

Involuntary rapid irregular jerky movements

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46
Q

Athetoid

A

Slow involuntary writhing and twisting movements usually involving UE>LE
May also involve neck, face, and tongue

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47
Q

Dystonia

A 
Sustained muscle contraction
Twisting and repetitive movements of abnormal posture
Diverse; can be slow or quick
Cocontraction of agonist and antagonist
Focal, hemi, multi focal
Idiopathic, symptomatic
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48
Q

Lesion of medial lemniscus

A

Loss of discriminative touch

- light touch, kinesthetic sense

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49
Q

Lesion of lateral spinothalamic

A

Pain
Temperature
Course touch
Kinesthetic discrimination

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50
Q

Lesion of somatosensory cortex/ DC

A

Loss of discriminative sensations; proprioception, 2 point discrimination, stereognosis, and localization of touch
Contralateral to side of lesion

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51
Q

Visual deficits following unilateral damage to cerebral cortex

A

Homonymous hemianopsia

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52
Q

Vestibular deficits

A

Gaze stabilization
Blurred vision due to disruption of vestibuloocular reflex
Posture and balance
Vertigo and dizziness

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53
Q

Body imaging disorders associated with parietal and temporal lobe lesions

A

Parietal lobe damage present with deficiencies related to body image and perception of spatial relations

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54
Q

Body scheme

A

Awareness of body parts and their relationship to one another and the environment
Difficulty dressing and unsafe transfers

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55
Q

Somatagnosia

A

Lack of awareness of the body structure and relationship of body parts to one another

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56
Q

Unilateral spatial neglect

A

Inability to perceive and integrate stimuli one one side of the body
Temporoparietal junction and posterior parietal cortex
Looks like lack of attention to the left side

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57
Q

Perceptual impairments

A

Body image
Spatial relation disorders
Apraxia

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58
Q

Anosognosia

A

Denial of presence or severity of ones paralysis
Unsafe functional activities
Perceptual deficit

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59
Q

Spatial relation disorders

A

Difficulty perceiving oneself in relation to other objects or other objects in relation to oneself
Topographic
Figure ground
Position in space

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60
Q

Topographic disorientation

A

Inability to remember the relationship of one place to another

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61
Q

Figure ground perception

A

Inability to distinguish foreground from background

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62
Q

Apraxia

A

Inability to carry out purposeful movement in the presence of intact sensation, movement, coordination
Usually in left sided brain damage

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63
Q

5 types of apraxia

A 
Verbal
Buccofacial
Limb
Constructional
Dressing
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64
Q

Limb apraxia 2 types

A

Ideomotor: cannot carry out command
Ideational: purposeful movement not possible automatically or on command

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65
Q

Perception

A

Integration of sensory impressions into psychologically meaningful information

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66
Q

Deficits in cognitive and perceptual systems

A

Affect patients ability to move effectively and efficiently throughout their environment

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67
Q

Impairment in association cortices- gershman

A

Right hand dominant with lesions in left angular gyrus

  • confusion between right and left
  • difficulty naming fingers
  • difficulty writing although sensory and motor are intact
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68
Q

Primary motor cortex lesions

A

Weakness or paralysis

Change in tone

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69
Q

Sensory cortex lesion

A

Loss of sensation, perception, proprioception

Problems with motor control

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70
Q

Premotor cortex lesions

A

Weakness from disuse

Difficulty with planning motor tasks,purposeful movement, apraxia

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71
Q

Supplemental motor region lesion

A

Weakness

Difficulty with complex motor tasks

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72
Q

BG lesion

A

Absence of movement
Weakness
Abnormal movement
Abnormal tone

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73
Q

Cerebellar lesion

A

Incoordination
Weakness
Balance

74
Q

Corticospinal tract lesion

A

Weakness

75
Q

Alpha motor neuron lesion

A

Weakness

Atrophy

76
Q

Afferent sensory input impairment

A

Loss of sensory awareness
Uncoordinated movements
Balance

77
Q

Frontal lobe

A 
Personality
Behavior
Emotions
Judgement
Planning
Problem solving
Intelligence
Speaking
Writing
Self awareness
78
Q

Parietal lobe

A 
Interpretation of language
Sensation of touch, pain, and temperature
Vision
Hearing
Memory and visual/ spatial perception
79
Q

Temporal

A 
Understanding language (Wernickes)
Memory
Hearing
Sequencing
Organizing
80
Q

Cortical layer

A

Outer gray matter

Location of cell bodies (neurons,glia)

81
Q

Subcortical

A

White matter ( includes internal capsule)
-Highways that connect cell bodies
Deep nuclei: gray matter
-BG, thalamus, hypothalamus

82
Q

Meninges outside to in

A 
Epidural
-dura mater
Subdural
-arachnoid mater
Subarachnoid
- pia mater
83
Q

Epidural space

A

Arterial blood

Torn meningeal artery- bleed out

84
Q

Subdural space

A

Venous blood

Torn bridging vein

85
Q

Subarachnoid space

A

Usually contains CSF

Arterial blood : aneurysm rupture

86
Q

Path of CSF

A 
Lateral ventricles
Foramen of Monroe
Third ventricle
Cerebral aqueduct
4th ventricle
Subarachnoid space
Arachnoid villi project from SAS into sinuses
87
Q

Anterior circulation of the brain

A

2 carotid arteries

88
Q

Posterior circulation of the brain

A

2 vertebral arteries

89
Q

Lateral corticospinal tract

A

Volitional movement

The UMN

90
Q

DC/ML

A 
Larger fiber
Proprioception/ kinesthesia
Discriminative touch
Vibration
Dull
91
Q

Spinothalamic tract

A 
Small fiber
Pain 
Temp 
Crude touch
Itch 
Tickle
Sharp

Pain and temp are lateral
Crude touch and pressure are anterior

92
Q

Primary efferent track in spinal cord

A

Lateral corticospinal

93
Q

Cells in CNS that give rise to efferent track

A

Pyramidal

94
Q

Pain, touch, volitional movement is controlled be…

A

Contralateral side

95
Q

Thalamus infarcts usually affect

A

Pain and touch

96
Q

Impairments in right lateral cerebellum

A

Difficulty in verb generation

Learning & performing complex nonmotor tasks

97
Q

warning signs of stroke

A

Face
Arms
Speech
Time

98
Q

modifiable stroke risk factors

A 
blood pressure
education
smoking
diabetes
weight gain
cholesterol
inactivity 
sleep apnea
99
Q

non modifiable stroke risk factors

A 
TIA
gender: females
Age 
Race 
Family history
100
Q

Types of stroke

A 
Ischemic: 87%
- embolic
- thrombotic
- lacunar
Hemorrhagic: 13%
TIA
101
Q

Ischemic Stroke

A

Result of thrombus, embolus, or conditions that produce low systemic perfusion pressures
Lack of cerebral blood flow deprives the brain of oxygen and leads to injury and death of tissues

102
Q

Embolic stroke

A

most common type of ischemic stroke
Blood clot that forms in another location and moves to the brain
Cardiac origin most common; 80% of cardiac emboli occlude the MCA
Vascular origin: starts as plaque formation and moves forward. Most commonly the aorta or vessels of the aorta
May be paradoxical
- congenital such as patent foramen oval, DVT

103
Q

Thrombotic stroke

A
  • forms in arteries directly feeding the brain
  • typically related to abnormalities w/in the vessel wall such as atherosclerosis, arteritis, dissections, and external compression of the vessels- Due to risk factors
  • Common precursor is htn
  • may also be caused by hematologic disorders and/or hypercholersterolemia
  • large vessel thrombosis that occurs in extra cranial vessels such as the carotid and vertebral arteries can lead to severe strokes.
104
Q

Lacunar strokr

A

small vessel strokes. ischemia in one distal or small artery
typically assoc with chronic HTN and diabetic microvascular disease
size of infarct from 2mm- 3cm in size
about 25% of all ischemic strokes.

105
Q

different types of lacunar strokes

A 
pure motor
pure sensory
sensorimotor
ataxic hemiparesis
clumsy hand syndrome
dysarthria-just speech issues
106
Q

hemorrhagic stroke

A

approx. 13%
cellular destruction caused by ischemia secondary to pressure/bursting
- mechanical injury caused by edema and the pressure of blood collection
75% of hemorrhagic strokes caused by a bleeding blood vessel occur in people who have htn

107
Q

Common causes of hemorrhagic stroke

A

hypertensive bleed

ICH in the presence of an AVM or tumor, ruptured aneurysm- SAH, TBI

108
Q

stroke from an aneurysm is called…

A

subarachnoid hemorrhage

109
Q

ACA

A

medial aspect of frontal and parietal lobes

sub cortical structures such as the BG

110
Q

MCA

A

entire lateral aspect of the cerebral hemisphere (frontal, temporal, parietal)

111
Q

PCA

A 
occipital lobe
medial/ inferior temporal lobe
upper brain stem
midbrain
thalamus
112
Q

Differentiation of stroke types

A
  • hemorrhagic strokes do not follow an artery distribution, sx may not follow typical pattern
  • vomiting, severe headache, and/or impaired consciousness are sx that may differentiate hemorrhagic from ischemic
  • important to determine hemorrhagic from ischemic for medical management
113
Q

TIA

A

symptoms include focal deficits of an ischemic stroke and typically follow a vascular distribution
- resolve in 24 hours. may not be completely normal, but resolve
Reversible; no infarction of cerebral tissue
35% of people with TIAs have a stroke w/in 5 years
work up essential to determine the cause and prevent future stroke

114
Q

hemorrhagic conversion

A
  • ischemic infarct may convert into hemorrhagic lesion
  • thrombi can migrate, lyse, and reperfuse into an ischemic area leading to small hemorrhages
  • damaged capillaries and small blood vessels no longer maintain their integrity
  • more common in large infarcts such as occluded MCA
115
Q

Tissue plasminogen activator

A

Assists with bleeding for ischemic stroke
Thrombolysis; powerful clot buster
clinical diagnosis of ischemic stroke
no recent trauma, surgery, or bleeding (may cause bleeding elsewhere)
No rapidly improving symptoms (TIA)
BP <185/110
treatable w/in 3 hrs of onset
CT w/out ICH or major early infarct signs (will not reverse it)
normal blu and platelets (PT/PTT)

116
Q

Homunculus

A

discovered in 3rd century AD
map of the primary sensory cortex
shows areas of the cortex that respond to somatosensory stimulation
shows area of the brain that controls motor and sensory input from different portions of the body

117
Q

left sided stroke presentation

A 
right sided weakness
right sided sensory deficits
speech and language deficits
- non fluent (brocas)
-fluent (wernickes)
-global aphasia
slow, cautious behavioral style
difficulty planning and sequencing movements
- apraxia more common (ideomotor, ideational)
disorganized problem solving
very aware of impairments
anxious about poor performance
difficulty with processing delays
difficulty expressing positive emotion
difficulty processing verbal cues and commands
memory deficits: typically related to language
118
Q

right sided stroke presentation

A

left sided weakness
left sided sensory deficits
spatial perceptual deficits
- left sided unilateral neglect
- agnosia
Difficulty sustaining movement
quick, impulsive behavioral style
difficulty grasping overall pattern, problem solving, synthesizing info
unaware of impairments; poor judgement
rigidity of thought; no abstract reasoning
difficulty processing visual cues
difficulty with perception of emotion and expressing negative emotion
memory deficits: typically related to spatial- perceptual information

119
Q

clinical signs of brain stem stroke

A 
changes in:
breathing
movement
sensation
eye movement
heart rate
blood pressure
120
Q

clinical signs of cerebellar stroke

A 
abnormal reflexes of the head and torso
impaired coordination
ataxic movement/ gait
balance issues
dizziness
vomiting
121
Q

ACA syndrome

A

occlusion of the ACA

- cognition, personality, reasoning, decision making, talking

122
Q

ACA syndrome clinical signs

A

contralateral hemiparesis involving mainly LE
contralateral hemisensory loss involving mainly LE
urinary incontinence
slowness, delay, motor inaction

123
Q

MCA syndrome clinical signs

A

contralateral hemisensory loss/ hemiparesis (mainly UE and face)
motor speech impairment (Brocas or non fluent aphasia with slow speech)
Receptive speech impairment (wernicke’s or fluent aphasia)
global aphasia
perceptual deficits and limb kinetic apraxia
ataxia of contralateral limbs

124
Q

PCA syndrome clinical signs

A

occlusion of the PCA, peripheral territory
contralateral homonymous hemianopsia
visual agnosia
memory deficits

To test: come in from side and find where they see you

125
Q

thalamic pain syndrome

A

occlusion of the central territory of PCA

126
Q

thalamic pain syndrome clinical signs

A

involuntary movements: stroke doesn’t cause pain, the result of it does
contralateral hemiplegia
paresis of vertical eye movement

127
Q

Medial medullary syndrome

A

Dejerine syndrome

occlusion of the vertebral artery, medullary branch

128
Q

medial medullary syndrome signs

A

ipsilateral:
- paralysis with atrophy of 1/2 of tongue with deviation to paralyzed side

Contralateral:

  • paralysis of UE and LE
  • impaired tactile and proprioceptive sense
129
Q

Lateral Medullary syndrome

A

wallenburg’s syndrome

occlusion of PICA or vertebral artery

130
Q

Lateral Medullary syndrome signs

A

ipsilateral:

  • decreased pain and temperature sensation to the face
  • cerebellar ataxia
  • vertigo/ nausea
  • nystagmus
  • dysphagia

contralateral:
- impaired pain and thermal sense over 50% of the body

131
Q

Complete basilar artery syndrome

A 
locked in syndrome
signs:
- hemiparesis to quadriplegia
- bilateral cranial nerve palsy
- consciousness and sensation are spared
- patient cannot more or speak but remains alert and oriented
132
Q

medial inferior pontine syndrome

A

foville’s syndrome

occlusion of paramedic branch of basilar artery

133
Q

medial inferior pontine syndrome signs

A

ipsilateral:

  • paralysis of conjugate gaze to side of lesion
  • nystagmus
  • ataxic gait
  • double vision with lateral gaze

Contralateral:

  • paresis of face, UE, and LE
  • impaired tactile and proprioceptive sense over 50% of the body
134
Q

lateral inferior pontine syndrome

A

occlusion of the AICA

135
Q

lateral inferior pontine syndrome signs

A

ipsilateral:

  • horizontal and vertical nystagmus, vertigo, nausea, and vomiting
  • facial paralysis
  • deafness/ tinnitus
  • ataxia
  • impaired sensation over face

Contralateral:
- impaired pain and thermal sense over 1/2 the body

136
Q

PT precautions with stroke

A
  • acute pt usually on bed rest for first 24-48hrs. check activity order
  • may be taking anticoagulant and considered a fall risk
  • monitor vitals carefully; be aware of MAP ranges
    • ischemic: 130-140
    • hemorrhagic <110
  • MAP= (2DBP+SBP)/3
  • If pt presenting with new stroke like symptoms, place flat and call an MD
137
Q

Evaluation tips for stroke

A
  • determine ability to communicate. consider expressive, receptive, and global aphasia; watch documentation
  • hemorrhagic strokes may present similar to TBI
  • if patient moving in synergistic pattern- pronation, flexion of the elbow
  • important to demonstrate standing and ambulation for rehab acceptance; may also attempt w/c mobility
  • watch for change in symptoms- evolving stroke
138
Q

factors that determine motor recovery

A
  • CNS damage promotes shift to intact neural subsystems rather than spared components within lesioned area
  • reorganization dependent upon learning styles, timeliness of tx, age and envt of brain, active engagement, unmasking latent pathways
139
Q

treatment techniques for stroke

A
  • want to decrease pain first
  • if neglect, orient them to body position, want to acclimate them and make them aware of their envt
  • stand on side of neglect to increase awareness
  • if decreased tone in shoulders, provide elbow support to prevent shoulder subluxation
  • to facilitate move outside of synergy patterns, position pt in positions to isolate targeted muscle group
  • reduce spasticity: PROM and stretching with slow gradual movements
140
Q

circuit training and stroke

A

greater gains in gait velocity over the course of inpatient rehab compared to the standard care

141
Q

ESTIM and stroke

A

found FES to perineal nerve had higher success avoiding obstacles than AFO
lower muscle strength benefit the most

142
Q

negative effects of constraint induced movement therapy and stroke

A

may alter CoG temporarily limiting postural control
limits functional training: transitions in infants/ toddlers
increased patient irritability secondary to restraint

143
Q

positive effects of constraint induced movement therapy

A

allows for emphasis on postural control and stability
long term improvement in functional mobility from using B UE for functional tasks
opportunity to focus on other primary impairments (endurance, balance)

144
Q

PT sessions and CIMT

A

with restraint on, focus on postural control
perform functional mobility tasks with emphasis on affected UE use
focus on other impairments: balance, endurance

145
Q

Acute care PT implications

A

Do not break test pt to determine strength
assess sensation and corresponding dermatomes
pt family education essential
decreased arousal may be due to medications
pain management essential
note what they are connected to

146
Q

RBC

A

delivers oxygen to tissues, absorption of cellular metabolic byproducts, maintains acid base balance
normal: 3.6to 5.0x10^6

147
Q

anemia

A 
decreased RBC
increased fatigue
watch for signs of hypoxia
chest pain
dizziness
SOB
muscle cramping
148
Q

polycythemia

A

compensatory increase in RBC
may occur due to reduction in plasma volume
results in increased blood viscosity which may decrease peripheral flow

149
Q

hematocrit

A

measurement of the percentage of whole blood occupied by cells
women: 37-47%
men: 41-53%
no exercise <25%

150
Q

hemoglobin

A

iron containing protein with strong affinity for oxygen
single RBC carries 4 Hb molecules
men: 13-18
women: 12-16
therapy contraindicated when < 5 leads to heart failure

151
Q

platelets

A

essential in clotting blood
normal: 150,000-300,000
no exercise when <120,000

152
Q

thrombocytopenia

A

platelets <140,000
increased risk of bleeding
avoid activities that may cause bruising or loss of balance

153
Q

prothrombin time

A

time required for clot to form

normal is 11-13.5 seconds (oral meds, coumadin may effect)

154
Q

Partial thromboplastin time

A

blood separated into plasma and cells
looks at intrinsic cascade
normal is 30-45 sec (IV meds/ heparin)

155
Q

international normalized ratio

A

unitless measure used to correct for differences in prothrombin time by various institutions
2-3 may be therapeutic

156
Q

alert

A

state of being aware, attentive, and mentally functional

157
Q

agitated

A

pt is excessively restless

demonstrates increased physical and/or mental activity

158
Q

delirium

A

state of disorientation accompanied by irritability, agitation, suspicious, and/or fear
pt may also misperceive stimuli

159
Q

dementia

A

state of altered mental processes that usually does not change arousability

160
Q

somnolent

A

prolonged drowsiness

resembles a sleepy trance

161
Q

obtundant

A

dulled response to stimuli

patient typically confused and requires constant stimulation for all activities

162
Q

stupor

A

patient aroused only by intense stimuli

motor response and reflex reaction typically preserved

163
Q

coma

A

unconsciousness without spontaneous eye opening and with minimal or no response to external stimuli

164
Q

modified ashworth scale

A

0-no increase
1- slight catch, release at end of motion
1+ resistance after catch
2 increase tone throughout
3 difficult to move throughout but can get through
4 rigid

165
Q

3 sensory inputs to balance

A

visual
vestibular
somatosensory/ proprioception

166
Q

reflex theory

A

reflexes are building blocks of motor control

work in sequence to create movement

167
Q

reflex theory limitations

A

they require an external stimulus to be generated

does not explain spontaneous or volitional movement

168
Q

hierarchical theory

A

top down approach to control of movement
higher, middle, lower levels of control
higher control middle, middle control lower without variation

169
Q

hierarchical theory limitations

A

cannot explain withdrawal reflex
in a top down, the motor could only be initiated by the higher cortical center not by a reflexive lower level pain response

170
Q

motor programming theory

A

motor programs (CPGs) drive movement without the need for sensory input

171
Q

motor programming limitations

A

same motor program can produce different results depending on the external forces at work

172
Q

systems theory

A

look at whole body as a mechanical system and integrate all the forces acting on the body to control or influence movement
DF
all of the varied DF in any given movement need to be coordinated in order for a smooth motion
use synergistic patterns to control

173
Q

systems theory limitations

A

does not account for the environmental influences on movement

174
Q

dynamic action theory

A

movement emerges as a result of the elements in the environment as needed
- not a result of specific commands from the CNS or premeditated motor programs
Control parameters can change and create a change in the system and a new motor behavior
increasing velocity of gait will transition one into a jog and then a run

175
Q

dynamic action theory limitations

A

relegates the CNS to a relatively unimportant role

176
Q

ecological theory

A

we detect information from our environment relevant to action and use that information to control movement
perception more important than basic sensation
nervous system is perception action system not a sensory motor
- person chooses higher chair in room

177
Q

ecological limitations

A

less emphasis on organization and function of the nervous system

178
Q

closed loop theory

A

sensory feedback aids in learning the skill to perform it better on the subsequent trials

  • perceptual trace: knowledge of the correct movement, detects error in movement and corrects
  • Memory trace: selection and initiation of movement
179
Q

schema theory

A

novel movement is completed
ML enhanced by practicing specific motor tasks under different conditions
- Recall schema: same movement with difference force using memory to choose correct response
- recognition schema: evaluates the response

180
Q

fitts and posner 3 stage

A

cognitive: what to do and determines what to do to complete it
Associative: how to do, determines strategy
Autonomous: how to succeed

181
Q

systems 3 stage model

A

novice: simplify movement to decreases DF
advanced: release some DF, allowing more joints to be involved
Expert: releases all DF needed for task

Neuromuscular (3 decks)

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