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BPK 303 > Week 6: Motor and Sensory Function > Flashcards

Week 6: Motor and Sensory Function Flashcards

1
Q

Somatic nervous system

A

innervates skeletal muscle (voluntary muscle);

provides sensory and motor innervation to all parts of the body

  • touch, pain, temperature, position
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2
Q

autonomic nervous system

A

innervate smooth muscle (involuntary muscle) in the intestines, sweat and salivary glands, myocardium, and some endocrine glands. The autonomic nervous system functions as a unit to maintain constancy in the internal environment

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3
Q

nerve root

A

Nerve root: portion of the peripheral nerve that connects the nerve to the spinal cord

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4
Q

dorsal

A

Dorsal: where incoming sensory nerves comes to synapse

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5
Q

ventral

A

Ventral: where motor nerves exit the spinal cord

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6
Q

Why are peripheral nerves called inert tissues?

A

not contractile

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7
Q

What are some morphological factors that contribute to muscular strength?

A
  • cross sectional area
  • fibre arrangement, pennation increases strength
  • tendon stiffness: stiffer tendon, increased force production
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8
Q

What are some ways muscular strength can be measured?

A
  • max single rep effort
  • manual muscle testing
  • hand held dynamometer
  • modified sphygmomanometer (grip strength)
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9
Q

What could cause drop foot?

A

lesion at L4. disc herniation

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10
Q

Myotomes
- define
- what would happen if a lesion to a single nerve root occured?
- objective of myotome testing?

A

are defined as groups of muscles that are predominantly supplied by a single nerve root

A lesion of a single nerve root is usually associated with paresis (incomplete paralysis) of the myotome (muscles) supplied by that nerve root

objective: identify which nerve root is responsible for pathology; potential lesion

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11
Q

How to test myotome? basically methodology

A

The examiner should place the test joint or joints in a neutral or resting position and then apply a resisted isometric force

The contraction should be held for at least 5 seconds and repeated 3 times to show if there is fatiguable weakness.

Positive findings indicate neurological impairment as opposed to muscle weakness

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12
Q

What are the actions of the lower limb myotomes?

A

Kick!
L1-L2: hip flexion
L3: knee extension
L4: ankle dorsiflexion
L5: toe extension

S1: plantarflexion and eversion

S2: hip extension and knee flexion

S3: knee flexion

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13
Q

What are the actions of the upper limb myotomes

A

yes, listen, huh, salute, at rest, woof, piano

C1-C2: neck flexion
C3: neck side flexion
C4: shoulder elevation
C5: shoulder abduction
C6: elbow flexion and wrist extension
C7: elbow extension, and wrist flexion
C8: thumb extension and ulnar deviation
T1: hand intrinsics (abduction and adduction)

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14
Q

negative features:

A

lessening or absence of normal behaviours

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15
Q

positive features

A

excess or change in normal function

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16
Q

Define: upper motor neuron syndrome

  • negative features
  • positive features
A

Includes lesions involving the corticospinal pathways; Levels of involvement include: brainstem, spinal cord, Cortex, internal capsule

  • weakness, slowness of movement, impaired condition

+ spasticity, hyperactive muscles, rigidity, intensional tremors, dystonia

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17
Q

spasticity

A

hyperexcitability of the muscle - constant problem (example: CP)

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18
Q

dystonia

A

neurological movement disorder characterized by involuntary (unintended) muscle contractions that cause slow repetitive movements or abnormal postures that can sometimes be painful

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19
Q

Define: lower motor neuron syndrome

  • symptoms
    + symptoms
A

Damage to lower motor neuron cell bodies or their peripheral axons

Negative features: Paresis (weakness), Hyporeflexia (decreased or absent reflex response), Rapid atrophy, Fatigue

Positive features: Fasciculations (involuntary muscle contractions), Spasms

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20
Q

paraesthesia

A

Paresthesia can be defined as an abnormal sensation of pins and needles, numbness, or prickling

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21
Q

Sensibility

A

describes the neural events occurring at the periphery, nerve fibers, and nerve receptors.

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22
Q

What is a pain gait

A

provides additional sensory input to override pain (pressure, touch, vibration, etc.) - TENS machine

23
Q

Anterior spinothalamic tract

Function

decussates?

A
  • light touch and pressure

yes

24
Q

Dorsal Column – Medial Lemniscal tract

function

decussates?

A

proprioception

vibration

fine touch

yes

25
Q

What happens if theres a lesion somewhere in the dorsal column medial lemniscal pathway?

A
  • Loss of discrimination: the patient cannot differentiate a single touch from a two-point touch.
  • Loss of vibration sense: the patient cannot perceive the vibration of a tuning fork placed on a bone.
  • Loss of sense of position and movement: the patient cannot state the position of his body in space, without visual input.
26
Q

lateral spinothalamic tract

function

decussates?

A

Pain
Temperature

yes decussates

27
Q

ALP, DPFV, LPT

A

A little parrot, dove past ferrets, veerring left past tarots

Anterior spinothalamic tract
Light Touch
Pressure

Dorsal-column medial lemniscus
Proprioception
Fine touch
Vibration

Lateral spinothalamic tract
Pain
Touch

28
Q

Dermatome

A

A dermatome is defined as the area of skin supplied by a single nerve root. The area innervated by a nerve root is larger than that innervated by a peripheral nerve

29
Q

How can you test dermatomes?

A
  • pain: pin prick vs blunt- ask if they can feel it
  • light touch: tap the person’s skin with a piece of cotton or your finger tips, avoid dragging cotton or finger across skin
  • proprioception: hold the distal phalanx between two fingers, move the finger up and down so the person understands which direction is up an down, ask them to close eyes and move the joint up or down and ask them to say outloud which direction their joint moved. begin with large movements and then gradually reduce size of movements. begin with distal digits then move proximally
30
Q

reflex

A

involuntary, predictable, and specific response to a stimulus dependent on an intact reflex arc

31
Q

Types of Reflexes

A

Deep tendon reflexes
Proprioceptive reflexes
Cutaneous reflexes

32
Q

Describe what makes up a reflex arc

A

afferent sensory neuron

efferent motor neuron

interneurons

muscle

33
Q

Hyporeflexia

A

An absent or diminished response to tapping. It usually indicates a disease that involves one or more of the components of the two-neuron reflex arc itself.

34
Q

Hyperreflexia

A

Hyperactive or repeating (clonic) reflexes

These usually indicate an interruption of corticospinal and other descending pathways that influence the reflex arc due to a suprasegmental lesion, that is, a lesion above the level of the spinal reflex pathways.

35
Q

deep tendon reflex

  • define
A

deep tendon reflex (DTR) results from stimulation of the stretch sensitive IA afferents of the neuromuscular spindle producing muscle contraction via a monosynaptic pathway

36
Q

if DTRs are increased or decreased, what does this indicate?

A

DTRs are increased in upper motor neuron syndrome (e.g., stroke) and decreased in lower motor neuron syndrome (e.g., peripheral neuropathy, nerve root compression), cerebellar syndrome, and muscle disease.

37
Q

deep tendon reflex testing objective and methodology

A

DTR objective: determine if there is an upper motor neuron syndrome or lower motor neuron syndrome causing patient’s sympatmology

DTRs are tested by tapping sharply over the muscle tendon with a standard reflex hammer or with the tips of the therapist’s fingers. They are then rated from 0-4

  • 0 = absent (areflexia)
    1 = diminished (hyporeflexia)
    2 = average (normal)
    3 = exagerrated
    4 = clonus, very brisk (hyperreflexia)
38
Q

Discuss the site of stimulus and expected resonse when checking the DTR of:
- biceps
- triceps

A
  • biceps: biceps tendon; expect bicep contraction; C5-C6
  • triceps: distal triceps tendon above the olecranon process; elbow extension/ muscle contraction, C7-C8
39
Q

Describe Hoffman’s reflex test

Objective

Methodology

Findings

A

objective: verify the presence or absence of an issue arising from the corticospinal tract

loosely holding the middle finger and flicking the fingernail downward, allowing the middle finger to flick upward reflexively

A positive response is seen when there is flexion and adduction of the thumb on the same hand. Eg. in hypertonia, the tips of other fingers flex and the thumb flexes and adducts.

40
Q

Discuss the site of stimulus and expected resonse when checking the DTR of:
- patellar
- achilles
- hamstring

A

patellar: patellar tendon, leg extension, L3-L4

achilles: achilles tendon, plantarflexion of foot, S1-S2

41
Q

clonus test
- objective
- methodolgy
- findings

A
  • objective: determine if upper motor neuron syndrome or lower motor neuron syndrome
  • methodology: extend the wrist or dorsiflex subject’s ankle, then quickly apply overpressure.
  • the subject’s movements should oscillate 1-2 beats but more than 3 beats is a positive sign and indicative of UPNS
42
Q

babinski
- objective
- methodolgy
- positive findings

A
  • objective: determine if upper motor neuron syndrome or lower motor neuron syndrome

methodology: stroke lateral aspect of sole of foot

positive sign: big toe extends and small toes fan out

Corticospinal tract disruption (pyramidal). upper motor neuron syndrome

43
Q

if a person can’t smell coffee, what nerve is affected?

A

cranial nerve 1 - olfactory

44
Q

if a person can’t see fingers in their peripheral vision, what nerve is affected?

A

cranial nerve 2 - optic

45
Q

if a person’s pupils don’t constrict in response to shining light, and/or can’t smoothly pursuit an object up or down, what nerve is affected?

A

CN3- occulomotor

46
Q

if a person can’t follow an object diagonally in their field of vision smoothly - what nerve is affected?

A

CNIV (4) - trochlear

47
Q

if a person can’t feel sensation on their face, or if their jaw muscles can’t open and close well what nerve is affected?

A

CNV - trigeminal

48
Q

if a person can’t follow an object laterally or they say they have double vision, what nerve is affected?

A

CNVI - abducens

49
Q

if a person can’t raise their eyebrows, close eyes, smile, or puff cheeks normally, what nerve is affected?

A

CNVII - FACIAL

50
Q

if a person has different hearing acuity between ears, what nerve is affected?

A

CNVIII - auditory/vestibulocochlear

51
Q

if a person has a lack of gag reflex what nerve is affected?

A

CNIX - glossopharyngeal

52
Q

if a person has asymmetrical elevation of the palate when asked to say ahh, what nerve is affected?

A

CNX - vagus

53
Q

if when a person protrudes their tongue and it deviates from the midline, what nerve is affected?

A

CNXII - hypoglossal

BPK 303 (10 decks)

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