Neuromuscular Flashcards

1
Q

White Matter

A

Myelinated nerve fibers. Located centrally IN BRAIN and on outside of spinal cord.-Transverse fibers, projection fibers, association fibers

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2
Q

Basal ganglia: name the circuits that exist in the BG

A

Oculomotor circuit, motor loop, limbic circuit

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3
Q

What is the function of the oculomotor circuit in the BG?

A

saccadic eye movements

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4
Q

What is the function of the motor loop of the BG?

A

motor set (prep for movement) and anticipatory movement

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5
Q

What is the function of the limbic circuit in the BG?

A

executive functions, problem solving, motivation, and procedural learning

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6
Q

Functions of the Thalamus:

A

sensory from body, face, eye, ear, tongue (but NOT smell)

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7
Q

Functions of hypothalamus:

A

maintain homeostasis: body temp, eating, water balance, sexual behavior, emotion

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8
Q

Parts of the Brainstem:

A

midbrain, pons, medulla oblongota

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9
Q

Functions of epithalamus:

A

smell, secrete hormones that influence sleep cycle

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10
Q

Functions of midbrain:

A

coordination, motor control and muscle tone, visual reflexes, hearing and auditory reflexes, suppresses pain

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11
Q

Functions of pons:

A

-connects medulla to midbrain-modulate pain and control arousal-Cranial nerve nuclei: abducens, trigeminal, facial, vesitbulocochlear

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12
Q

Functions of medulla oblongata:

A

-connects spinal cord with pons-control of head movements and gaze stabilization (vestibular ocular reflex)-voluntary movement control-cranial nerve nuclei: hypoglossal, dorsal nucleus of vagus and vesitbilocochlear-respiratory, cardiac, and vasomotor centers

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13
Q

Cranial Nerves: Name them

A

Olfactory (Some), Optic (Say), Oculomotor (Marry), Trochlear (Money), Trigeminal (But), Abducens (My), Facial (Brother), Vestibulocochlear (Says), Glossopharyngeal (Big), Vagus (Brains), Accessory (Matter), Hypoglossal (More)

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14
Q

Functions of Cerebellum:

A

-regulate muscle tone-posture-voluntary movement control-coordination of movements (accurate force, direction, extent of movement)-motor learning- maybe cognitive function and mental imagery

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15
Q

Gray Matter

A

Located centrally in spinal cord- anterior horns give rise to = motor neurons-posterior= sensory

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16
Q

Tract: Dorsal Column/Medial Lemniscal

A

proprioception, vibration, tactile discrimination

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17
Q

Spinothalamic Tract

A

pain and temperature, crude touch

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18
Q

Spinocerebellar tract

A

proprioception from muscle spindles, Golgi tendon organs, touch and pressure receptors to cerebellum for control of voluntary movements

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19
Q

Spinoreticular tract

A

deep and chronic pain

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20
Q

Corticospinal tract

A

from primary motor cortex, voluntary movement control

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21
Q

Vestibulospinal tract

A

control muscle tone, antigravity muscles, and posture reflexes

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22
Q

Rubrospinal tract

A

motor function

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23
Q

Reticulospinal system

A

transmit pain sensation and influences spinal reflexes

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24
Q

Tectospinal tract

A

head-turning responses to visual stimuli

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25
Q

Afferent versus efferent nerve fibers

A

Afferent= going to the spinal cord (away from organ)Efferent= going to the organ and away from the spinal cord

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26
Q

Sympathetic NS

A
  • T1 to L2-fight or flight
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27
Q

Parasympathetic

A

Conserves and restores homeostasis- craniosacral division, CN 3, 7, 9, 10, pelvic nerves

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28
Q

Name the cervical, lumbar, and sacral plexus nerve roots

A

Cervical: C1-C4
Lumbar: T12- L4
Sacral: L4- S3

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29
Q

Term for patient that appears drowsy, can respond to questions, but falls asleep easily

A

Lethargy

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30
Q

Term for patient that can only be aroused by painful stimuli and demonstrates minimal awareness of self and environment

A

Stupor

31
Q

Term for state characterized by sleep/wake cycles and lack of cognitive responses

A

Unresponsive vigilance (vegetative) state

32
Q

Term for state characterized by severely altered consciousness but definite evidence of self or environmental awareness

A

Minimally conscious state

33
Q

Glasgow Coma Scale: what are the 3 components

A

looks at eye opening, motor response, and verbal response

34
Q

Glasgow Coma Scale: scoring interpretations

A

(1-8) severe brain injury
(9-12) moderate brain injury
(13-15) mild brain injury

35
Q

Mini Mental State Exam: scoring interpretations

A

Highest, best score is 30
(21-24) mild cognitive impairment
(16-20) moderate
(15 or less) severe

36
Q

Ranchos Los Amigos Scale: scoring interpretations (Levels I through VIII)

A
I = no response
II and III = decreased response level
IV= confused agitated
 V= confused inappropriate
VI = confused appropriate
VII= automatic appropriate
VIII=  Purposeful appropriate
37
Q

Broca’s aphasia: what is it and name the location of this area in brain

A
  • Impairment of speech production

- Broca’s area is in the frontal lobe

38
Q

Wernicke’s aphasia: what is it and name the location of this area in the brain

A
  • Impaired comprehension of speech

- located in temporal lobe

39
Q

What is this type of breathing termed?

- period of apnea lasting 10-60 seconds followed by increasing depth and frequency of respirations

A

Cheyne-Stokes respiration

40
Q

What is this type of breathing termed?

-abnormal respiration marked by prolonged inspiration

A

Apneustic breathing

41
Q

Kernig’s sign and Brudzinski’s sign are tests to look for what?

A

CNS infection or meningeal irritation

42
Q

Decorticate posture

A

Flexion
deCortiCate (C’s)= move in toward core (flexion)
- lesion above superior colliculus (at level of diencephalon)

43
Q

Decerebrate posture

A

extension
dEcErEbratE (E’s)= extension
-lesion below superior colliculus (at level of brainstem)
worse than decerebrate

44
Q

Right homonymous hemianopsia: what is it

A

Loss of visual field on the RIGHT half of each eye (therefore, there is a lesion on LEFT occipital lobe)

45
Q

When a patient cannot recognize a clock by SIGHT but can recognize it by SOUND, what is this termed?

A

agnosia

46
Q

what is ideomotor apraxia?

A

Person cannot perform a task on command but can when left to do the task on their own.

47
Q

what is ideational apraxia?

A

Person cannot perform the commanded task AT ALL

48
Q

A positive Babinski sign in adults (great toe ext.) signifies disruption of what spinal tract?

A

corticospinal (pyramidal) tract

49
Q

Modified Ashworth Scale: what are the six grades?

A
0= no increase in muscle tone
1= slight increase in muscle tone, minimal resistance at END of ROM
1+= slight increase, minimal resistance through LESS THAN HALF of ROM
2= more marked increased in tone, through MOST of ROM, affected part easily moved
3= considerable increase in muscle tone, passive movement difficult
4= affected part RIGID in ext. or flex.
50
Q

What is the term for prolonged, severe spasm of muscles, causing the head, back and heels to arch backward and arms and hands in rigid flexion?

A

Opisthotonos

51
Q

Agnosia

A

inability to interpert information

52
Q

Agraphesthesia

A

inability to recognize symbols, letter, numbers traced on the hand

53
Q

Alexia

A

inability to read or comprehend written language

lesion in dominant lobe of brain

54
Q

Agraphia

A

inability to write, usually found in combo with aphasia

due to lesion in brain

55
Q

Anogsognosia

A

denial or unawareness of one’s illness, often associate with unilateral neglect

56
Q

Apraxia

A

inability to perform purposeful learned movement or activity, even though no sensory or motor impairment hinders completion of task

57
Q

Asterognosis

A

inability to recognize objects through touch

58
Q

constructional apraxia

A

inability to reproduce geometric figures and designs, unable to visually analyze how to perform a task

59
Q

Dysarthria

A

slowed and impaired speech d/t motor deficit of speech muscles

60
Q

Dysphagia

A

inability to swallow

61
Q

dysprosody

A

impairment in rhythm and inflection of speech

62
Q

emotional lability

A

d/t R hemisphere infarct, inability to properly control/use emotions

63
Q

neologism

A

substitution within a word so severe it makes the word unrecognizable

64
Q

perseveration

A

repeatedly performing the same segment of a task or repeatedly saying the same word with out purpose

65
Q

Unilateral neglect

A

inability to interpret stimule on the contralateral side of a hemispheric lesion
L neglect most common with lesion to the R inferior parietal or superior temporal lobes

66
Q

Brunnstorm 7 Stages of Recovery (hemiplegia)

A
  1. no volitional movement
  2. spasticity begins along with appearance of basic limb synergies
  3. synergies performed voluntarily, spasticity increases
  4. spasticity begins to decrease, movement patterns not dictated solely by limb synergies
  5. further decrease in spasticity, indepdence from limb synergies
  6. isolated going movements performed with coordination
  7. normal motor function restored
    * pt may plateau in one stage and never reach 7
67
Q

Raimiste’s phenomenon

A

seen after CVA, involved LE with adduct or abduct with applied resistance to uninvolved LE in same direction

68
Q

Souque’s phenomenon

A

post-CVA, raising involved UE above 100 degrees with elbow ext produces ext and abd of fingers

69
Q

Levels of motor control

A

mobility –> stability –> controlled mobility –> skill

70
Q

ASIA impairment scale - Level A

A

Complete: no sensory or motor fxn perserved in sacral segments S4-S5

71
Q

ASIA impairment scale - Level B

A

Sensory Incomplete: Sensory but NOT motor fun is preserved below the neurological level and extend through sacral segments S4-S5

72
Q

ASIA impairment scale - Level C

A

Motor Incomplete: motor fxn is preserved below neurological level, and most key mms below neuro level have a mm grade LESS than 3

73
Q

ASIA impairment scale - Level D

A

Motor incomplete: motor fxn is preserved below neurological level, and most key mms below the level have a mm grader GREATER THAN OR EQUAL to 3

74
Q

ASIA impairment scale - Level E

A

Normal: sensory and motor fxns are normal