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OCTH 721 exam 2
| Question | Answer |
|---|---|
| group(s) of functionally- or structurally-related cell bodies in CNS | nucleus |
| group(s) of functionally- or structurally-related cell bodies in PNS | ganglion |
| group(s) of parallel axons in CNS | tract, fasiculus, lemniscus |
| group(s) of parallel axons in PNS | nerve, ramus, root |
| group(s) of several parallel tracts of fasiculi in CNS | funiculus, columns |
| sensory info is (ascending/descending) | ascending |
| motor info is (ascending/descending) | descending |
| cone-shaped caudal end of SC located around vertebral level of L1-L2 | conus medullaris |
| enlarged subarachnoid space from end of SC at vertebral level of L1-L2 to end of dural sheath at vertebral level S2 | lumbar cistern |
| dorsal and ventral nerve bundles on end of SC | cauda equina |
| central part of SC ("butterfly"), CSF-filled space continuous with ventricular system, contains mostly cell bodies but also dendrites and axons that move within the segment (horizontally), divided into parts | gray matter |
| part of gray matter: reaches surface where dorsal rootlets of spinal nerves enter, contains mostly interneurons and projection neurons, where info enters SC | posterior / dorsal horn |
| part of gray matter: between anterior and posterior horns, contains features of both, intermediolateral cell column/lateral horn, T1-L3 and contains sympathetic nervous system neurons, gray commissure | intermediate gray matter |
| part of gray matter: connects 2 sides of gray matter | gray commissure |
| part of gray matter: does not reach surface of SC, contains cell bodies of motor neurons that supply skeletal muscle, where info leaves SC | anterior / ventral horn |
| outer part of SC; consists of tracts, or fasiculi, and bundles of axons that have same origin, course, and termination; each 1/2 of SC contains 3 main funiculi; has different parts | white matter |
| funiculi of white matter: located between posterior median sulcus and posterior horn | posterior funiculus |
| funiculi of white matter: located between sites where dorsal and ventral roots emerge from SC | lateral funiculus |
| funiculi of white matter: located between site where ventral roots emerge from SC and anterior median fissure | anterior funiculus |
| part of white matter: connects 2 sides of white matter, lies just anterior to gray commissure and contains decussating axons | anterior white commissure |
| information flow structure | rootlets, roots, nerves |
| a dorsal root and ventral root connect to form a spinal n., dorsal root ganglion, dorsal roots split into dorsal rootlets, info comes into SC through posterolateral sulcus on each side of posterior SC, afferent | sensory structures |
| collection of cell bodies of sensory nn. entering SC, just proximal to spinal n. in PNS | dorsal root ganglion |
| info leaves SC thru anterolateral sulcus on each side of anterior SC, ventral rootlets merge into ventral roots, a ventral root and a dorsal root connect to form a spinal n. | motor structures |
| exit intervertebral foramina of vertebrae, named based on exit/location/corresponding vertebrae | spinal nerves |
| area of skin innervated by a single spinal cord segment (specifically a single DRG); sensory innervation; common landmarks: C2-back of head, T4-nipple line, T10-belly button, S5-anal area | dermatomes |
| group of muscles innervated by a single spinal cord segment (specifically a single ventral root), motor innervation, most muscles are innervated by 1+ spinal segment | myotomes |
| motor neuron that descends from cortex or brainstem and ends/synapses on an LMN; carry motor info from cortex or subcortical regions down to ventral horn; in CNS; lesion leads to spasticity, hyperactive reflexes, and clonus; more | upper motor neuron |
| motor neuron whose cell body is in CNS but whose axon innervates muscles; carry info from motor cell bodies in ventral horn to skeletal mm.; in CNS and PNS; lesion leads to flaccidity, hyporeflexia, atrophy (fibrillations and fasciculations); less | lower motor neuron |
| travel of motor neuron: begins in cortex, travels to but does not enter ventral horn of SC | upper motor neuron |
| travel of motor neuron: begins in ventral horn, travels to m. | lower motor neuron |
| this type of root supplies sensory info to spinal cord, from somatic/body and visceral/organ sites, fibers either synapse ipsilateral gray matter or continue to ascend toward brainstem | dorsal root |
| this type of root transmit motor info to somatic/body and visceral/organ sites, voluntary and involuntary movement | ventral root |
| if sensory info is going to the cortex it is relayed through what structure with olfaction as an exception | thalamus |
| typically named for orientation in SC and area of origination/termination | spinal cord tracts |
| type of tract, sensory info from PNS->dorsal roots in SC->thalamus->brain (postcentral gyrus of parietal lobe) | ascending tracts |
| spinal tract: ascending, posterior cord, made up of FG and FC which travel to cortex together as medial lemniscus after decussation | dorsal columns tract |
| spinal tract: functions-discriminative touch, pressure, vibration, proprioception, and kinesthesia origin-sensory receptors of UEs and LEs decussate-lower caudal medulla termination-postcentral gyrus | dorsal columns tract |
| spinal tract: complete lesion-complete spinal cord injury causes loss of touch, pressure, vibration, proprioception, and kinesthesia below lesion, bilateral; sensory info not felt below lesion | dorsal columns tract |
| spinal tract: hemi lesion below decussation-below medulla, ipsilateral sensory loss | dorsal columns tract |
| spinal tract: hemi lesion above decussation-above caudal medulla or postcentral gyrus/cortex, contralateral sensory loss since it crossed | dorsal columns tract |
| spinal tract: ascending functions-sensory for pain, temp, and light touch origin-sensory receptors in PNS decussation-upon entering SC termination-postcentral gyrus | lateral spinothalamic tract |
| spinal tract: complete lesion-bilateral loss of pain and temp sensation below level of lesion | lateral spinothalamic tract |
| spinal tract: hemi lesion at level of decussation-bilateral loss of pain and temp sensation at level of lesion and contralateral loss of pain and temp sensation below lesion level | lateral spinothalamic tract |
| spinal tract: hemi lesion in brainstem or postcentral gyrus above decussation-contralateral loss of pain and temp sensation | lateral spinothalamic tract |
| motor info from precentral gyrus, brainstem, and cerebellum->ventral horn->PNS to m. | descending tracts |
| spinal tract: descending functions-conscious/voluntary motor info from precentral gyrus to ventral horn decussation-medulla right before exiting cord origin-precentral gyrus termination-ventral horn | corticospinal tract |
| what function does not differentiate between dorsal columns and lateral spinothalamic tract | light touch |
| spinal tract: which part of the corticospinal tract decussates in medulla | lateral corticospinal |
| spinal tract: which part of the corticospinal tract decussates right before entering cord | anterior corticospinal |
| spinal tract: what percent of the corticospinal tract decussates in the medulla and becomes the lateral corticospinal tract | 90% |
| spinal tract: hemi lesion above decussation-primary motor cortex/precentral gyrus or internal capsule or anywhere above decussation; contralateral loss of voluntary movement, spasticity of distal musculature, hyperactive reflexes (UMN signs) | corticospinal tract |
| spinal tract: hemi lesion below decussation-ipsilateral loss of voluntary movement, spasticity of distal musculature, hyperactive reflexes; UMN signs | corticospinal tract |
| spinal tract: complete lesion-bilateral loss of voluntary movement, spasticity below lesion (UMN sign), flaccidity at lesion (LMN sign) | corticospinal tract |
| bilateral corticospinal damage, UEs spastic flexion, LEs spastic extension, spasticity due to dysfunction of pyramidal system (UMN system with efferent n. fibers), all functions are impacted | decorticate rigidity |
| damage to vestibulospinal, rubrospinal, medullary reticulospinal, and pontine reticulospinal tracts; UEs spastic extension; LEs spastic extension; all functional tasks impacted | decerebrate rigidity |
| part of dorsal columns tract: carries info from LEs | fasiculus gracilis |
| part of dorsal columns tract: carries info from UEs | fasiculus cuneatus |
| spinal cord injury that causes absence of all sensory and motor functions below lesion | complete SCI |
| spinal cord injury that causes partial preservation of sensory or motor functions below lesion | incomplete SCI |
| causes: transection (MVA, knife/gunshot wound, diving accident), compression (tumor, degenerative vertebral disease), infection (Polio), or degenerative disorder (ALS) | spinal cord injuries |
| sensory & motor functions absent below; poss of some function to be preserved at level of injury; symptoms-bilateral loss of pain and temp sensation, bilateral motor loss, bilateral loss of tactile discrimination, vibration, pressure, and proprioception | complete SCI / transverse lesion |
| SCI: hemi-section of SC; dorsal columns, spinothalamic, & corticospinal tracts; symptoms-ipsilat motor loss, contralat loss of pain and temp sensation below lesion and bilat at lesion; ipsilat loss of touch, pressure, vibration, and proprioception | Brown-Sequard syndrome |
| SCI: compression in cervical segments, neck hyperext., spinal stenosis of cervical vertebrae (aging and arthritic pops); causes more UE impairment; symptoms and severity dependent on size of lesion | central cord syndrome |
| SCI: symptoms-spinothalamic tracts bilat pain and temp loss 1st due to tracts entering dorsal horn & decussating when they enter cord, then ventral horn of central spinal cord (flaccid paralysis of UEs), if large lesion it presents more like complete SCI | central cord syndrome |
| SCI: dorsal columns affected bilaterally; symptoms-bilateral loss of tactile discrimination, vibration, pressure, and proprioception | posterior cord syndrome |
| SCI: anterior 2/3 of cord lost; spinothalamic and corticospinal tracts affected; ventral horn loss at level of lesion; intact dorsal columns; symptoms-bilateral loss of pain and temp, bilateral spastic paralysis below lesion and flaccid paralysis at level | anterior cord syndrome |
| conduit functions (ascending and descending tracts travel through this), integrative functions (complex motor patterns, life-sustaining functions, and regulating consciousness), CN functions (CNs 3-7 emerge from this) | functions of brainstem |
| central core of brainstem that appears diffusely organized; located in tegmentum; functions-modulates pain pathways, control of movement through connections with SC and cerebellum, autonomic reflexes, control of arousal and consciousness | reticular formation |
| system that supplies midbrain (post. cerebral a.), pons (pontine aa.), anterolateral medulla (vertebral aa. and ant. spinal a.), and posterolateral medulla (PICA and post. spinal a.) | vertebrobasilar system |
| 3 primary regions of brainstem | tectum, tegmentum, appended structures |
| region of brainstem: posterior to ventricular space, in midbrain only (superior and inferior colliculi), roof of 4th ventricle | tectum |
| region of brainstem: anterior to ventricular space; central core of brainstem found in all 3 parts; consists of reticular formation, CN nuclei and tracts, ascending pathways from SC, and some descending pathways | tegmentum |
| region of brainstem: large structures appended to anterior surface; medulla (pyramids); midbrain (cerebral peduncles); pons (basal pons); contains descending tracts from cortex to SC, certain CN nuclei, or to pontine nuclei, mostly motor neurons | appended structures |
| part of brainstem found rostral/superior to pons | midbrain |
| found on posterior midbrain: involved in visual pathway, most posterior | superior colliculi |
| found on posterior midbrain: involved in auditory pathway, located posterior to cerebral aqueduct in tectum | inferior colliculi |
| found on posterior midbrain: broad, low ridge extending rostrally from IC to thalamic nucleus for hearing, medial geniculate nucleus, connects IC to lateral structures | brachium of inferior colliculus |
| found on anterior midbrain: connects brainstem to cerebrum, carries corticospinal and corticopontine fibers | cerebral peduncles |
| part of midbrain: continuation of superior cerebellar peduncle, involved in motor functions | red nucleus |
| part of midbrain: involved in synthesis of neurotransmitters GABA and dopamine, dark streak in brain tissue | substantia nigra |
| loss of dopamine-producing neurons in substantia nigra can lead to... | Parkinson's disease |
| part of midbrain: surrounds cerebral aqueduct, important in pain control | periaqueductal gray |
| part of midbrain: anterior to 4th ventricle, rostral to medulla | pons |
| part of pons: bulge on anterior surface | basal pons |
| part of pons: anterior midline sulcus where basilar a. lies | basilar sulcus |
| part of pons: anterior, transverse massive fiber bundle, connects pons to cerebellum | middle cerebellar peduncle |
| part of pons: forms roof of 4th ventricle, conns cerebellum->brainstem, contains afferent & efferent fibers-most efferent (cerebellum to thalamus & midbrain, specifically red nucleus of midbrain) some afferent (sensorimotor fibers from pons->cerebellum) | superior cerebellar peduncle |
| part of pons: reorientation of dorsal column fibers, begins to slump (turn more horizontally) | medial lemniscus |
| part of pons: reorientation of fibers, contains longitudinally arranged fibers (corticospinal and corticopontine tracts) and horizontally arranged fibers and pontine nuclei | pyramidal tract |
| part of pons: massive, formed by pontine nuclei fibers, mostly a cerebellar afferent (info to cerebellum) | middle cerebellar peduncle |
| part of brainstem: between SC and pons, anterior to cerebellum, superior to SC and foramen magnum, infeiror to pons, similar to SC, 2 divisions-caudal or closed portion (contains central canal) and rostral or open position (opens to 4th ventricle) | medulla |
| part of medulla: anterior, separates pyramids | anterior median fissure |
| part of medulla: anterior, briefly interrupts anterior median fissure at junction between SC and medulla, 90% of corticospinal fibers cross here | pyramidal decussation |
| part of medulla: vertical bulges along anterior midline, carry motor fibers | pyramids |
| part of medulla: separates pyramid and olive, anterior | anterolateral sulcus |
| part of medulla: oval bulges just lateral to anterolateral sulci, role in hearing | olives |
| part of medulla: lowermost fibers connecting cerebellum to brainstem, mostly cerebellar afferents | inferior cerebellar peduncle |
| part of medulla: junction between 4th ventricle and central canal | obex |
| damage of this structure is typically caused by hemorrhage, lack of blood flow, or other vascular problems; symptoms are problems with CNs, sensory and motor deficits, and autonomic dysfunction (reticular formation damage) | brainstem |
| brainstem clinical implication: large infarct of basilar pons; sig. loss to corticospinal and corticopontine tracts; full paralysis of limbs, trunk, and face; blinking and some eye movements are spared; full cognitive abilities are spared | locked - in syndrome |
| which part of the nervous system are cranial nerves part of | PNS |
| lesions of CNs typically produce ____ symptoms | ipsilateral |
| functional category of CN: contain motor axons for ordinary skeletal m. and little or nothing else; considered LMNs; 3, 4, 6, 12 | somatic motor nn. |
| functional category of CN: contain special sensory fibers and little or nothing else; 1, 2, 8 | special sensory nn. |
| functional category of CN: more complex nn. that typically contain several functional components; all innervate brachial arch musculature and most (not 10) also contain other functional components; 5, 7, 9, 10, 11 | branchiomeric nn. |
| CN: functions-special sensory, carries info from chemoreceptors in nose pathway-chemoreceptors in nose->inferior frontal lobe->CN 1->hippocampal formation in temporal lobe lesions-unilateral (no deficits), bilateral (anosmia/lack of smell) | olfactory n. |
| CN: functions-special sensory, visual acuity pathway-photoreceptors (rods/cones)->CN 2->optic chiasm->optic tracts->LGN of thalamus->superior colliculus->thalamus->occipital lobe lesions-unilateral (ipsilat blindness), bilateral (bilat blindness) | optic n. |
| CN: functions-somatic motor, eye movements, accommodation (adjustment of lens to focus on object), pupillary reflex, consentuality (1 constricts/dilates so other does), convergence | oculomotor n. |
| CN: muscles-levator palpebrae, superior rectus, inferior oblique, inferior rectus, and medial rectus n. reflexes-pupillary, consentuality, accommodation, convergence | oculomotor n. |
| CN lesions: strabismus-abnormal eye positions at rest, leads to double vision (diplopia) ptosis-levator palpebrae loses innervation which causes eyelid drooping nystagmus-shaking of eyes during tracking | oculomotor n. |
| CN: functions-somatic motor, superior oblique m. lesions-decreased ability to depress and abduct, vertical/lateral strabismus if IO unopposed, diplopia, vertical/medial strabismus if MR and SR working, nystagmus | trochlear n. |
| CN: functions-somatic motor, lateral rectus m. lesion-intact medial eye musculature->inward turning of eye->diplopia, nystagmus | abducens n. |
| CN: functions-somatic sensory and branchiomeric motor; motor=mm. of mastication, sensory=face, head, cornea, and oral cavity lesion-ipsilat loss of sensation, weakness of mm. of mastication, jaw deviates to affected side, trigeminal neuralgia | trigeminal n. |
| CN: functions-visceral sensory & branchiomeric motor, sensory=taste on ant tongue, motor=facial expression, eyelid closing, stapedius m lesion-decreased taste, decreased corneal reflex, inability for facial expression, hyperacusis (sounds exaggerated) | facial n. |
| CN: functions-special sensory, auditory (vibrations), vestibular (balance, equilibrium, and head position) pathways-auditory=hair cells in organ of Corti, vestibular=semicircular canals, utricles, saccules | vestibulocochlear n. |
| CN: lesions-auditory=deafness or tinnitus; vestibular=nystagmus, vertigo, decreased balance, decreased protective response, changes in extensor tone | vestibulocochlear n. |
| CN: functions-visceral sensory and branchiomeric motor, sensory=taste on post. tongue, motor=swallowing lesion-sensory=loss of taste, motor=loss of swallow and gag reflexes, dysphagia (difficulty swallowing) | glossopharyngeal n. |
| CN: functions-visceral sensory (taste sensation, parasympathetic responses for heart, lungs, esophagus, GI tract); branchiomeric motor (motor response for larynx, pharynx, and upper esophagus for swallowing and speaking) | vagus n. |
| CN: lesion-visceral branch=tachycardia and dyspnea; bilateral visceral branch=asphyxia; skeletal m. branch=dysphonia (hoarseness), dysphagia, dysarthria (impaired articulation) | vagus n. |
| CN: cranial and spinal roots functions-branchiomeric motor and somatic motor; cranial=elevation of larynx; spinal=neck rotation, flex/extend, shoulder elevation through SCM and upper trapezius | spinal accessory n. |
| CN: lesion-cranial=dysphagia due to decreased laryngeal elevation; spinal=weak neck rotation, flex/extend, elevating shoulders, flex arms over 90 degrees | spinal accessory n. |
| CN: functions-somatic motor, innervates mm. of tongue lesion-dysarthria, dysphagia, ipsilateral deviation, and/or atrophy of tongue | hypoglossal n. |
| large mass of gray matter; center of brain; separated by 3rd ventricle; boundaries: ant=ant commissure, post=post commissure, inf=base of hypothalamus, sup=body of lateral ventricle, med=3rd ventricle, lat=int capsule; made up of 4 structures | diencephalon |
| structure of diencephalon: largest (80%), egg-shaped collection of nuclei located above brainstem, 1 lobe on each side of brain connected by interthalamic adhesion; 3 major groups of nuclei (ant, lat, and med) | thalamus |
| structure of diencephalon: functions-"gateway" that relays info going to cortex; receives from cortex, brainstem, limbic sys, BS, cerebellum, and sensory systems other than olfaction; also process, regulate, distribute emotional, cog, and sensory info | thalamus |
| separates thalamic groups of nuclei | medullary lamina |
| divides thalamic lobes, Y-shaped | internal medullary lamina |
| nuclei located within internal medullary lamina | intralaminar nuclei |
| thin collection of nuclei that lie adjacent to 3rd ventricle | middle thalamic nuclei |
| extensive, thin sheet of nuclei enveloping lateral thalamus | thalamic reticular nucleus |
| thalamic function-input: ascending from body to thalamus; convey sensory info via a specific pathway; ex. dorsal columns/medial lemniscus to VPL nucleus and optic tract to LGN; minority of inputs | specific input |
| thalamic function-input: descending from cortex to thalamus, contribute to decisions about form in which info leaves thalamus and will be received by cortex, regulates action/output of thalamus back to cortex, majority of inputs, complex process | regulatory input |
| functional classification of thalamic nuclei: convey info from sensory systems (except olfactory), basal ganglia, cerebellum to cortex; receive specific inputs and project to specific functional areas of cortex; ex. LGN, MGN | relay nuclei |
| functional classification of thalamic nuclei: project to association areas of cortex; process emotional and some memory info or integrate different types of sensation; ex. LPN | association nuclei |
| functional classification of thalamic nuclei: regulate consciousness, arousal, and attention; ex. midline, intralaminar, and reticular nuclei; receive info from viscera and reticular systems | nonspecific nuclei |
| thalamic nuclei: region-anterior function-memory | anterior nucleus |
| thalamic nuclei: region-medial function-emotions | dorsomedial / mediodorsal nucleus |
| thalamic nuclei: region-lateral ventral tier function-relay sensory info from body to cortex | ventral posterior lateral nuclei |
| thalamic nuclei: region-lateral ventral tier function-relay sensory info from head to cortex | ventral posterior medial nuclei |
| thalamic nuclei: region-lateral ventral tier function-relays visual info | lateral geniculate nucleus |
| thalamic nuclei: region-lateral ventral tier function-relays auditory info | medial geniculate nucleus |
| thalamic nuclei: region-lateral ventral tier function-motor control, relays motor info from basal ganglia to cortex | ventral anterior nucleus |
| thalamic nuclei: region-lateral ventral tier function-motor control, relays motor info from cerebellum to cortex | ventral lateral nucleus |
| thalamic nuclei: region-lateral dorsal tier function-somewhat unknown, role in spatial learning and memory | lateral dorsal nucleus |
| thalamic nuclei: region-lateral dorsal tier function-integrates sensory inputs with cognitive functions | lateral posterior nucleus |
| thalamic nuclei: region-lateral dorsal tier function-involved in cognitive functions with visual and auditory stimuli | pulvinar nucleus |
| most clinical considerations related to the thalamus are a result of what | vascular accidents |
| clinical consideration of thalamus: usually results from CVA; lesion to thalamus (usually involves VPL/VPM) that results in alteration of sensory perception; consists of thalamic pain (burning sensation), hemianesthesia, sensory ataxia | thalamic syndrome |
| structure of diencephalon: 1 lobe in each hemisphere; ant and inf to thalamus, sup to pituitary gland, rostral to midbrain, caudal to optic chiasm; infundibular stalk connects this to pituitary gland | hypothalamus |
| structure of diencephalon: functions-major control center of ANS-maintaining homeostasis, eating and defensive behaviors, emotional expression, regulation of circadian rhythms; link between neural and endocrine systems (growth, metabolism, repro organs) | hypothalamus |
| structure of diencephalon: has important regulatory influence over 4 systems-homeostatic, endocrine, autonomic, limbic | hypothalamus |
| interconnection between emotion and ANS (palms sweat and stomach churns when nervous), interconnection between emotion and immune system (more susceptible to infection if depressed) | hypothalamic - limbic pathway |
| part of pituitary gland: contains glandular cells that secrete hormones into circulation, neurons from hypothalamus control release of these hormones into hypophysial portal system | anterior pituitary |
| part of pituitary gland: contains axons and terminals of neurons whose cell bodies are located in hypothalamus, secretes oxytocin and vasopressin into circulation | posterior pituitary |
| structure of diencephalon: locations-post and sup to thalamus and ant to pineal gland structures-habenula, stria medullaris, habenular commissure, pineal gland functions-connects limbic system with other brain regions | epithalamus |
| gland in epithalamus: midline, unpaired, endocrine gland with no neural outputs; secretes melatonin and regulates circadian rhythms; regulates melatonin during darkness; influences secretions of pituitary, adrenal, and parathyroid glands | pineal gland |
| tumors of this gland may lead to: hydrocephalus due to compression of cerebral aqueduct, changes in sexual development such as early puberty, and deficits of eye movements due to compression of midbrain where CNs 3 & 4 are located | pineal gland |
| structure of diencephalon: inf to thalamus, lat to hypothalamus, sup to midbrain functions-part of neural circuit that helps control movement, not well understood, component of basal ganglia (regulates movement, action selection, and impulse control) | subthalamus |
| location-between thalamus and caudate nucleus med, between thalamus and globus pallidus/putamen lat functions-descending fibers from cerebral cortex to brainstem and SC, ascending fibers from thalamus to cortex | internal capsule |
| fibers of this fan out into corona radiata | internal capsule |
| located superior to internal capsule, curves inferiorly into cerebral peduncles, continuous curved sheet of fibers from internal capsule, not possible to see all parts in 1 section or plane | corona radiata |
| components: anterior limb, genu, posterior limb, retrolenticular part, sublenticular part, | internal capsule |
| branches of what a. provide blood supply to most of internal capsule | middle cerebral a. |
| group(s) of functionally or structurally related cell bodies (gray matter) in PNS, although basal are in CNS | ganglia |
| comprised of 6 structures: caudate nucleus, nucleus accumbens, putamen, globus pallidus, subthalamic nuclei, susbtantia nigra | basal ganglia |
| responsible for skill and speed of movement by balancing inhibitory and excitatory impulses; responsible for stereotypic, automatic movement patterns, and tone; precision control due to effects of dopamine and Ach; cognition, emotions, motivation | basal ganglia |
| overall result in involuntary movements, problems initiating movement, and disturbance in muscle tone; hyperkinetic disorders, hypokinetic disorders, dystonia, and other | clinical implications of basal ganglia |
| clinical implication of basal ganglia: excessive movement and decreased m. tone; ex. hemiballismus, athetosis, chorea | hyperkinetic disorders |
| clinical implication of basal ganglia: impaired initiation of movement, bradykinesia, and increased m. tone; ex. resting tremors, Parkinson's | hypokinetic disorders |
| clinical implication of basal ganglia: tics | other |
| clinical implication of basal ganglia: disturbances in tone; ex. dystonia, dyskinesia, and tardive dyskinesia | dystonia |
| hyperkinetic disorder: violent trashing movements of extremities; can be ipsilateral or bilateral; most often seen in older adults who have had strokes affecting this region | hemiballismus / ballismus |
| hyperkinetic disorder: slow, flailing, twisting movements, wormlike; continuous, writhing movement, aimless and purposeless; combo of spasticity and hypotonicity; involves neck, face, trunk, and extremities (upper more typical); cerebral palsy | athetosis |
| hyperkinetic disorder: sudden, rapid, involuntary jerky movements of face and extremities; appears more coordinated; symptoms-shoulder shrugs, hip movement, crossing/uncrossing legs, facial grimaces, tongue protrusions | chorea |
| clinical implication of basal ganglia: chronic, degenerative, inherited; typically appear ~30-50 years old; involves progressive dementia, mood alterations, and motor disturbance; degeneration prominent in striatum (caudate nucleus) but also cortex | Huntington's disease |
| hypokinetic disorder: involuntary oscillating movement at rest; aka pill-rolling tremors; seems to stop once voluntary movement begins; worsens with emotional stress due to autonomic changes, adrenaline surge; Parkinson's disease | resting tremor |
| hypokinetic disorder: motor symptoms-tremors, rigidity (lead-pipe or cog-wheel), bradykinesia and hypokinesia, stooped posture, cunctation-festinating gait with loss of arm swing | resting tremor |
| dystonia disorder: movement disorder from increased m. tone causing distorted, twisted postures of neck, trunk, and prox. extremities; symptoms-torsion spasms lasting seconds to hours, blepharospasm (forced eyelid closing), torticollis, truncal dystonia | dystonia |
| dystonia disorder: drug-induced movement disorder; choreiform movements, dystonia, tics, and myoclonus; involuntary movements of tongue and face; cause-long-term Levodopa use and other antipsychotics due to low level of dopamine in system | tardive dyskinesia |
| disorder of basal ganglia: other; repetitive, brief, rapid, involuntary movements involving single m. or group of mm.; symptoms-brief, isolated movements (eye blinks, shoulder shrugs), variety of sounds (throat clearing, repitition) | tics |
| anterior, posterior, and flocculonodular lobes | lobes of cerebellum |
| 2 hemispheres; dense with neurons (contains as many as the rest of CNS combined); superficial and deep areas-cerebellar cortex, medullary center; convoluted surface | cerebellum |
| general functions: coordination/synergy of movement, precision control (error-correcting device), attention shifting, practice-related learning, spatial organization, memory, maintain posture and equilibrium, ipsilateral control | cerebellum |
| specific functions: lateral hemispheres-planning and programming of vol movements, learned, skillful movements that become more rapid, precise, and automatic with practice; medial hemispheres-error detecting device | cerebellum |
| functions: postural adjustments and stereotyped movements | vermis |
| part of cerebellum: functions-equilibrium and eye tracking movements | flocculonodular lobe and vermis |
| functions: balance and spatial orientation, part of cerebellum | flocculonodular lobe |
| functions: influences m. tone and precision movement of body and limbs, part of ceebellum | anterior lobe of cerebellum |
| functions: planning anticipatory movement and some cognitive functions, lobe of cerebellum | posterior lobe of cerebellum |
| middle and inf cerebellar peduncles bring sensory info to cerebellum, info makes its way to cerebellar cortex, purkinje cells in cerebellar cortex project to deep cerebellar nuclei, deep cerebellar nuclei project to various sites in brainstem and thalamus | cerebellar info flow |
| umbrella term to describe uncoordinated patterns of movement leading to inability to produce smooth movements; presents as uncoordinated gait, posture, or UE control | ataxia |
| tremors that occur during voluntary movement; increases as limb nears intended goal; increase in tremors or difficulty touching target show impairment | intention tremors |
| movements are broken up into their component parts (robot-like) | dyssynergia / movement decomposition |
| inability to judge distance and range of movement (overshooting or undershooting) | dysmetria |
| impaired ability to perform rapid, alternating movements; cannot quickly pronate/supinate, open/close grasp; bilateral movements no longer simultaneous | dysdiadochokinesia |
| inability to regulate action (speed and force) of opposing m. groups; impairment-inability to regulate opposing m. groups quickly enough, limb will hit torso/chest | rebound phenomenon |
| m. weakness | asthenia |
| inability to maintain both UEs in same position without client's awareness (affected extremity drifts involuntarily); impairment-limb drifts due to lack of proprioceptive awareness | motor impersistence |
| decreased m. tone or decreased/absent reflexes, also seen with SC lesion below L1 and LMN injury | hypotonicity / hyporeflexia |
| increased m. tone or increased reflexes, also seen with UMN injury | hypertonicity / hyperreflexia |
| involuntary back-and-forth movement of eyes in a jerky or oscillating fashion | nystagmus |
| impairment of motor movements of speech with lack of enunciation; broken speech with prolonged, slow, slurred syllables | dysarthria |
| responsible for initiation of voluntary movement of contralateral extremities | primary motor cortex |
| contains premotor cortex and supplementary motor area | motor association cortex |
| responsible for motor planning/praxis | premotor cortex |
| responsible for bilateral control of posture, postural adjustments | supplementary motor area |
| cerebellar cortex lesion: inability to understand motor demands of a task (unable to understand idea of task), damage to motor association area | ideational apraxia |
| cerebellar cortex lesion: damage to premotor area or primary motor area, type 1-problems accessing appropriate motor plan, type 2-difficulties carrying out/executing motor plan | ideomotor apraxia |
| 1st order neuron, travels from cortex to ventral horn, synapse on LMN, located entirely within CNS and comprise various pathways | UMN |
| 2nd order neuron, cell body in ventral horn or in brainstem, axons exit CNS to innervate m. | LMN |
| single LMN (spinal or cranial n.) and all m. fibers it innervates | motor unit |
| LMNs are clustered in a systematic arrangement in what part of SC; at C8 axial mm. are located more medially, distal mm. are located more laterally, flexors are more posterior, extensors are more anterior | ventral horn |
| map that depicts each body part's cortical representation for voluntary movement; face, mouth, and hands have largest cortical representation for speech/eating in fine motor control; organization is not permanent and boundaries are not exact | motor homunculus |
| existing cortical map is changed to create a new cortical map | cortical re-organization / remapping |
| gait condition: circumduction of paretic side with elbow flexed, shoulder adduction, forearm pronated, and leg extended | hemiparetic gait |
| gait condition: both LEs demonstrate flexion at hips and knees, knock-kneed, feet extended, internal rotation of hip, and circumduction pattern; scissor gait; ex. cerebral palsy | diplegic / spastic gait |
| gait condition: distal LE unable to dorsiflex causing foot drop, increased knee and hip flexion to clear foot; ex. diabetic neuropathy | neuropathic gait |
| gait condition: weakness of pelvic girdle causing non weight bearing hip drop; ex. muscular dystrophy | myopathic gait |
| gait condition: stooped over with difficulty initiating steps, small festinating steps, and difficulties turning; ex. parkinson's disease | hypokinetic gait |
| gait condition: associated/extra movements while walking (grimacing or UE movement) that does not affect balance for the most part; ex. chorea | hyperkinetic gait |
| gait condition: wide base with difficulty narrowing stance, truncal movements, sideways jerking, difficulty with tandem stance, difficulty maintaining balance | ataxic gait |
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emma.scarmon-coyotes
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