Stroke Syndromes Flashcards
1
Q
Supplemental Motor Area (SMA) Location
A
- Part of motor association cortex (area 6)
- Medial surface of frontal lobe just in front of primary motor area
2
Q
Supplemental Motor Area is strongly associated with
A
Basal ganglia - coordinates responses across brain regions and switches motor programs
3
Q
Supplemental Motor Area Function
A
- Associated with internal initiated movements
- Associated with movements that were previously learned
- Assembles subroutines of complex movements
- Active during mental practice
4
Q
Premotor Cortex (PMC) Location
A
- Area 6 - lateral hemisphere just in front of primary motor cortex
5
Q
Premotor cortex (PMC) is strongly associated with
A
- Cerebellum - monitors & updates movement based on sensory feedback; error detection; optimizes movement plan
6
Q
Premotor Cortex (PMC) Function
A
- Activated when movement initiation is dependent on external cue
- Associates with specific sensory cues with specific movements
- More active when movement is visually guided
- More active in early phases of learning
- Mirror neurons are found here
7
Q
SMA v. PMC Activities
A
- PMC more active with early practice with explicit information
- SMA more active when sequence is more automatic
8
Q
Primary Motor Cortex (Area 6) Function
A
- Movement initiation
- Fine motor control
- Novel movements
- Highly fractionated movements
- Good control over force and speed of movements
9
Q
Primary Motor Cortex Afferents
A
- Supplemental motor cortex
- Premotor cortex
10
Q
Inferior Parietal Lobule
A
- Generates spatial map of body and environment
- Codes parameters for movement between body and environmental targets and informs premotor cortex
- Mirror neurons located here
11
Q
Apraxia
A
- Difficulty or inability in executing appropriate or purposeful movements despite absence of paresis, ataxia, or sensory loss, comprehension, attention, or willingness to perform movement
- Affects previously learned and new tasks
- Affects non-paretic side
12
Q
Apraxia results from damage to
A
- Parietal lobe damage, especially inferior parietal lobule
- Sometimes frontal motor association areas
- Usually dominant (left) hemisphere
13
Q
Types of apraxia
A
- Ideomotor apraxia
- Oral motor apraxia
- Ideational apraxia
- Constructional apraxia
- Dressing apraxia
14
Q
Ideomotor Apraxia
A
- Has form of concept but cannot translate to execution
- Most common form of apraxia
- Associated with inferior parietal lobule
- Motor planning deficits
- Has difficulty performing movements on commands but can perform spontaneously
- Movement is clumsy and awkward
15
Q
Oral Motor Apraxia
A
- Common in children and can happen in adults after stroke
- Affecting lips and face
- Affects purposeful movements associated with speaking and facial expression
16
Q
Ideational Apraxia
A
- More severe motor planning deficit
- Associated with dominant parietal lobe
- Cannot conceptualize the motor task (no idea of what to do)
- With more severe involvement, cannot perform appropriately either automatically or on command
17
Q
Constructional Apraxia
A
- Inability to construct or copy simple design or models
- Visual association cortex of non-dominant parietal lobe affected
- Aware of mistakes
- Inability to comprehend, interpret, and reproduce reciprocal relationships of objects in space
18
Q
Dressing Apraxia
A
- Inability to dress oneself properly due to disorder in body schema or spatial relationships
- Damage to non-dominant occipital or parietal lobe
19
Q
Clinical Tests of Apraxia
A
- See if patient can use common objects for ADLs
- See if patient can imitate gesture like peace, sign, okay sign
- Is response clumsy?
- Does pt perseverate?
- Can pt do things spontaneously that they cannot do on command?
- Do they know what to do with object?
20
Q
Treatment principles for patients with apraxia
A
- Explicit information or not
- Give short, simple commands
- Pt should repeat aloud or in their heads
- Verbal or visual mediation of the task
- As therapist, adjust or facilitate movement
- Start and master first component before moving on
- Task should be done same way each time
- Repetition
