E-TEST 1 Flashcards
(103 cards)
1
Q
What are the functions of the frontal lobe?
A
Voluntary movement, expressive language, managing higher-order functions (e.g., executive functions)
2
Q
What is executive functioning?
A
Higher-level cognitive skills you use to control and coordinate other cognitive abilities
3
Q
What are the association areas of the frontal lobe?
A
Supplementary motor cortex & premotor cortex
4
Q
What is the supplementary cortex involved in?
A
Involved in programming complex sequences of movement & bilateral movements
5
Q
What is the premotor cortex involved in?
A
Planning and organising movements and actions
6
Q
What happens when there is damage to the frontal lobe?
A
Deficits in thinking, flexibility, problem-solving and voluntary movement
7
Q
What is the function of Broca’s area and what occurs when there is damage to this area?
A
Located in the frontal lobe
Concerned with the production of speech (frontal lobe)
Broca’s aphasia = characterised by hesitant, fragmented speech with little grammatical structure
8
Q
What is the function of the parietal lobe?
A
Responsible for receiving and processing sensory input such as touch, pressure, heat/cold, and pain, also involved in the perception of body awareness in relation to the environment
9
Q
What happens when there is damage to the parietal lobe?
A
Trouble identifying sensation location or type & spatial disorientation and navigation difficulties
10
Q
What are the association areas of the parietal lobe?
A
Somatosensory cortex = processes sensory information
11
Q
What is the function of the superior colliculus?
A
Physically directs the sensory structures of the head towards stimuli of interest (located in the midbrain)
12
Q
What is the function of the pretectal area?
A
Composed of 7 nuclei and is a part of the midbrain a part of the subcortical visual system
Involved in modulating motor responses to visual input
13
Q
What is the function of the primary motor cortex (pre-central gyrus)?
A
Deals with pure motor information and plays a role in producing movement (planning & initiation)
14
Q
What is the function of the primary sensory cortex (post-central gyrus)?
A
Plays a role in processing somatic sensations
15
Q
What are the functions of association areas?
A
Help to interpret the information from primary sensory areas in ways that are meaningful to self and the environment
Responsible for the processes that go on between the arrival of input from primary sensory areas and the generation of behaviour
16
Q
What happens when there is damage to association areas?
A
E.g., pre-motor cortex damage = an individual can generate movement but will be limited in the ability to make that movement organised and purposeful for specific tasks (motor apraxia)
17
Q
What is the function of the temporal lobe?
A
Plays a role in processing auditory information and with the encoding of memory
Also plays a role in processing emotions and understanding language
18
Q
What happens when there is damage to the temporal lobe?
A
Difficulty understanding language and loss of skill associated memory
19
Q
What is the function of Wernicke’s area and what happens when there is damage to this area?
A
Located in the temporal lobe (Brodmann area 22)
Role in understanding language and critical for speech production
Wernicke’s aphasia = impaired language comprehension (normal rate, rhythm, grammar)
20
Q
What is the function of the occipital lobe?
A
Associated with visuospatial processing (distance, depth, perception, colour determination), object & face recognition and memory formation
21
Q
What happens when there is damage to the occipital lobe?
A
Difficulty recognising objects & words and inaccuracy in seeing
22
Q
What is the role of the primary visual cortex?
A
Receives, segments and integrates visual information
23
Q
What is the function of the reticulospinal tract?
A
Controls posture, muscle tone, spinal reflexes, reciprocal inhibition, control of autonomic functions (HR & breathing) and control of sympathetic/parasympathetic outflow
24
Q
What is the function of the tectospinal tract?
A
Controls blinking reflexes and eye pursuit movements when tracking an object
25
What is the function of the rubospinal tract?
Modulation of flexor tone and flexor withdrawal reflex
26
What is the function of the vestibulospinal tract?
Acts on anti-gravity muscles to maintain upright posture (balance)
27
What are the descending (motor) pathways?
Reticulospinal tract, tectospinal tract, rubospinal tract, vestibulospinal tract & corticospinal tract
28
What is the function of the corticospinal tract?
Responsible for the production of movement, fractionated movement and regulates muscle tone
29
Describe the course of the corticospinal tract
Originates in the primary motor cortex travels through the internal capsule and the midbrain (pons)
Here 85% of fibres cross at the medulla to travel down the lateral tract, through the spinal cord to synapse with a LMN in the ventral horn which reaches the effector muscle
15% of fibres descend down the ventral tract, descends ipsilaterally down the spinal cord and crosses at the level of a LMN then reaching the effector muscle
30
What happens when there is damage to the corticospinal tract?
Paralysis (severe/total loss of muscle function)
Paresis (mild/moderate muscle weakness)
Plegia (weakness)
Spasticity (increased tone)
Loss of fractionation (the ability to control 2 adjacent body systems separately)
31
What are upper motor neurons and where do they originate and terminate?
Nerve fibres responsible for communication between the brain and spinal cord
Originate within the cerebral cortex, pass through the midbrain and terminate at the spinal cord
32
What happens when there is damage to UMN's?
Spasticity (increased muscle tone on the opposite side of the body)
Hyperflexia (increase in deep tendon reflexes)
Decreased muscle control
Weakness
33
What are lower motor neurons and where do they originate and terminate?
Responsible for transmitting information from UMN's to the effector muscle to perform a movement
Originate within the spinal cord and terminate at the muscle/gland
34
What happens when there is damage to LMN's?
Loss of muscle tone
Hypoflexia (reduction in deep tendon reflexes)
Muscle atrophy (decrease in muscle size and muscle wasting)
Flaccid paralysis of muscle (loose/floppy limbs)
35
How can the reflex arc be over-ridden?
It is not only pain that can trigger a reflex action of the muscle
If only the lower motor neurons were working other triggers could create muscle reflex action including; muscle lengthening, stress, noise etc.,
Upper motor neurons can thus act as inhibitors of the reflex arc - that is, you can decide in some situations not to withdraw your finger from the hot iron
If the upper motor neuron that inhibits that lower motor neuron is not working - then the lower motor neuron will respond to any stimuli in a primal way (it will fire)
36
What are the ascending pathways?
Spinocerebellar tract, spinothalamic tract and dorsal column/medical lemniscal system
37
What is the function of the spinocerebellar tract?
A somatosensory part of the sensory nervous system that relays unconscious proprioceptive information from the lower limbs and trunk to the cerebellum (ipsilateral)
38
What is the function of the dorsal column/medial lemniscal system?
Deals with conscious appreciation of fine touch (kinesthesia), 2 point discrimination, conscious proprioception, vibration sensations from the entire body except the brain (contralateral)
39
What is the function of the spinothalamic tract?
Sensory tract that carries nociceptive (noxious stimuli such as tissue damage), temperature, crude touch and pressure from our skin to the somatosensory area of the thalamus
40
What are the 3 core motor areas of the brain?
Corticospinal tract, basal ganglia and cerebellum
41
What is the function of the basal ganglia?
Subcortical - a collection of nuclei at the base of the cerebrum
Involved in learned motor patterns (autopilot = why we can walk normally without thinking about it)
Executes the go and no-go pathways
Modulates the size and vigour of automatic movements
42
What disease is associated with damage to the basal ganglia and what is it characterised by?
Parkinson's disease = characterised by problems controlling speech, movement and posture
Damage to BG = trouble starting/stopping or sustaining movements
43
What is the function of the cerebellum?
Works with descending pathways and basal ganglia to produce skilled movement
Modulates and coordinates skilled voluntary movement (including speech) by comparing actual motor output to intended motor output and correcting errors as necessary for the future (feed-forward mechanism) - does this via communication with the cortex
Regulates movement in response to feedback (feedback mechanism)
Receives input from the spinal cord via spinocerebellar tracts
Regulates the accuracy of movement but does not actually produce it
44
What happens when there is damage to the cerebellum?
Balance dysfunction
Ataxia (loss of muscle control)
Uncoordinated movements
45
What are the main somatosensations?
Kinesthesia, pain/temperature and discriminative touch
46
What is the typical sensory weighting (healthy person, well-lit, firm surface)?
Somatosensation (70%), vestibular (20%) & vision (10%)
47
What is kinaesthesia?
Body parts in relation to each other for movement control - joint movement sense & joint position
Helps to control and coordinate movement
48
How does information about kinaesthesia travel through the body?
Collected by receptors in joint structures (golgi tendon bodies & muscle spindles) and travels through the dorsal column
49
What is pain/temperature?
Sharp, hot vs cold, protective sensation to help avoid injury
50
How does information about pain/temperature travel through the body?
Pain is picked up by nociceptors and temperature is detected by thermoreceptors
Travels through spinothalamic pathway
51
What is discriminative touch?
Manipulating tools and recognising and localising light touch
Helps with hand coordination and object manipulation
52
How does information about discriminative touch travel through the body?
Collected by Merkel cells in the spine (fine tactile receptors)
Travels through the dorsal column
53
What is the function of vision in movement?
Interact with the world and identify hazards (interpret the environment)
Critical in controlling movement through space (identifying hazards, interacting with objects)
54
How does information about vision travel through the body?
Visual information is collected by the retina and travels via the optic nerve to the brain
55
What is gaze stability?
Maintaining a stable image on the retina despite head movement
56
What is saccades?
Fast eye movement
57
What is smooth pursuit?
Slow visual tracking
58
What is the optokinetic reflex?
Eye movement following a visual target
59
What is primary sensation?
Recognition of the presence and modality of sensation
60
What is the function of the vestibular system?
Awareness of spatial position of head in relation to gravity/acceleration (rotational and linear)
Afferent/sensory pathway for reflexes related to vision and head movement
Vestibular sensory input is processed by the vestibular nuclei (who have a descending motor tract = vestibulospinal tract)
Balances the body in line with gravity
61
What makes up the vestibular labyrinth?
Inner ear
3x semicircular canals & 2x otoliths (utricle and saccule)
62
What is the function of the vestibular labyrinth?
Pure sensory organ - critical to balance
Helps to generate reflexes so that people can see clearly when the head is moving
Information about orientation within gravity travels via the vestibular nerve to the brainstem
Gives information about body position and movement in relation to gravity and other forces
63
What is the vestibular ocular reflex?
Eye movements equal and opposite to head movement to maintain image on the retina
64
What is endolymph and what is its function?
Extracellular fluid that flows through the cochlea and semi-circular canals
Vibrational waves transmitted following the displacement of this fluid from outside stimuli convey information about sound, position and balance to central sensory neural structures
65
How can alcohol affect the function of endolymph?
Alcohol can cause endolymph to become less dense, hair cells can move more easily within the ear canal which sends signals to the brain and results in exaggerated and overcompensated movements of the body
Vertigo = "the spins"
66
What is the orientation of verticality?
The ability to accurately orientate the body to verticle which is important to avoid falling over
67
Why are cognitive processes important in physiotherapy?
Attention and awareness are important for everyday tasks such as study and event planning - some cognition is important for successful movement
People with disabilities need to problem solve alternative ways of moving to achieve success in a difficult movement
Attention to hazards (including insight into own abilities), focus, dual tasking
68
What is higher cortical function?
Refers to the complex processes that involve the integration of multiple brain regions and includes functions such as; perception, attention, memory, problem solving, language and decision-making
69
What is the role of higher cortical functions in physiotherapy?
Tasks such as playing a ball game require planning, context and the ability to relate oneself to the environment
Negotiating obstacles in the environment (hazards)
Goal setting and planning future activities - identifying goals, planning steps, memory of past experiences, motivation, concept of future
Language
70
What are the characteristics of frontal lobe lesions?
Thinking & cognition
Dysexecutive syndrome = deficits in planning, thinking, abstract reasoning, judgement, mental flexibility, career progression, independent living and managing change
Disinhibited behaviour = aggression, impulsivity, sexual disinhibition
Abulia/apathy = lack of inhibition
71
What are the characteristics of right fronto/parietal lobe lesions?
Perception (processing sensory information into meaning) & attention deficits
Visuospatial perceptual impairments = unilateral neglect (size, depth, movement, direction)
Body schema deficits = asomatognosia (feeling that a part of the body is missing)
Lateropulsion = verticality impairment - pusher syndrome (lateral posture imbalance)
Agnosias = patient is unable to recognise/identify objects, people or sounds
72
What are the characteristics of left fronto/parietal lobe lesions?
Motor & planning
Motor apraxia - motor planning/organisation dysfunction (related to the planning not the production of movement - often worse with cognitive tasks - automatic movements may be observed but no movement to instruction & inconsistencies in movement)
Aphasia = language dysfunction
73
What are the common causes of frontal lobe, right & left fronto/parietal lobe dysfunction?
Frontal lobe = head trauma, stroke, tumour, MS
Right/left fronto/parietal (middle cerebral artery territory) = MCA stroke, tumours, MS, brain injury
74
How do infants learn to control movement?
Through trial and error, with appropriate stimulation and through practice, opportunity and experience infants learn to control movement such as, developing postural control, limb control, map sensations to action and interact with people and the environment
They are learning to integrate motor and sensory information and interpret the world around them
75
What are the major motor infant milestones?
0-3 months = holding head up
4-5 months = rolling over both ways
5-7 months = rising to hands
6-8 months = crawling and sitting without support
9-10 months = standing without support
11-15 months = walking
76
How are infants' early movements characterised?
Infants are born with almost no functional movement control with their early movements characterised by simple reflexes and uncontrolled movements
77
What is continence?
Normal continence includes the ability to sense the need to go to the toilet, delay voiding, physically make it to the toilet, manage clothing as well as post-toilet hygiene
Usually required for independent living
78
What is incontinence?
Can develop from damage to gynaecological structures from injury, illness, medical treatments
Problems with continence are also a risk factor for falling where people often rush to the toilet despite not having the ability to safely move at that speed
Social implications of incontinence
79
What is torque?
The measure of force causing an object to rotate around an axis
The longer the lever (moment arm) the more torque you get for the same muscle force generation
80
What is momentum?
Measure of mass in motion
Force is needed to initiate and decelerate momentum
E.g., jumping = concentric contraction (power) to generate, eccentric contraction to control landing - the timing of muscle contraction is critical for coordination
Generating momentum makes a task easier
Coordination requirements are higher during peak force
81
What are the 3 types of motor skills?
Discrete, serial and continuous
82
What are the 5 indications to look at when observing performance?
Improvement: increased level of skill over-time
Consistency: characteristics of performance become more similar
Stability: performance less affected by external or internal disruptions
Persistence: improved performance lasts after a period of no practice
Adaptability: can perform kill in a variety of contexts
83
What is motor learning (skill acquisition)?
A complex process occurring in the brain in response to practice or experience resulting in changes in the CNS
A change in the capability to perform a skill
84
What are the characteristics of motor learning?
Requires practice
Persistence of learning requires neuroplasticity
Cannot observe learning only performance
Complexity varies with; movement challenges, environmental complexity, object manipulation and emotional factors
85
What is neuroplasticity?
Adaptability of the CNS
Neurons and other brain cells possess the ability to alter structures and function in response to internal and external pressures including behavioural training
The mechanism by which the brain encodes experience and learns new behaviours
Driven by changes in behavioural, sensory and cognitive experiences
86
What are regulatory conditions?
Features of the task + environment
Determines success parameters
87
Why does motor learning require practice?
With practice, people develop rules about their motor behaviour, not individual movements which allows the use of that skill in different contexts
Practice is required at the activity level (quantity, quality & intense)
Salience (meaning) = we are more likely to remember things that have meaning (brain is more likely to build connections)
88
What is the difference between impairment level and activity level changes in motor learning?
Strength, conditioning and general improvements in motor performance can contribute to the restoration of normal functioning (impairment level)
Improvements in technique can reduce the strength and motor demands of a task enabling improvements/success despite impairments (activity level = skill acquisition)
Segmenting a task can reduce the peak physical requirements and allows a person to prepare for each component of the task
89
What is the difference between performance and motor learning?
Motor learning is a relatively permanent change in the ability to execute a motor skill as a result of practice and experience
Performance is the act of executing a motor skill that results in temporary non-permanent change (particular time & place)
Cannot observe learning only performance
90
What is neurogenesis?
The process by which new neurons are formed in the brain
Peaks at 28-30 weeks gestation; continues until 5 months
91
What is synaptogenesis?
The formation of synapses between neurons in the nervous system
Peaks at 1-2 years of age
92
What is synaptic pruning?
Unneeded cells/connections are removed
The cortex thins from age 2 to 20
93
What are the stages of an action potential?
1. Initial depolarisation
2. Opening of sodium channels and +ve charge in the cell (once threshold potential has been reached)
3. Peak = sodium channels close and potassium flows into the cell
4. Repolarisation (decreased ve) and hyperpolarisation (-ve) (refractory period)
94
Describe what happens when a nerve impulse arrives at a presynaptic terminal
1. Nerve impulse arrives
2. This causes calcium ion channels to open resulting in an influx of calcium ions in the terminal
3. This causes synaptic vesicles to fuse with the terminal membrane, releasing neurotransmitter into the gap between the neurons, known as the synaptic cleft
4. The neurotransmitters bind to receptor sites on ion channel in the postsynaptic membrane, causing them to open
5. Ions flow into the postsynaptic neuron which generated an action potential when a threshold level is reached
95
What are the short-term changes associated with neuroplasticity?
Changes in synaptic facilitation and depression can occur in seconds to minutes
Vesicle depletion = as the main cause of synaptic depression; vesical replenishment can accelerate after intensive stimulation
Synaptic facilitation = can be caused by accumulation of residual calcium in the synaptic terminal
Receptor desensitisation = affected by the amount of transmitter released and the time course
96
What are the long-term changes associated with neuroplasticity?
Structural and functional plasticity in the brain
Adult neurogenesis: new neurons added to the brain network - occurs in hippocampus throughout lifespan (learning and memory)
Synaptogenesis = increasing synapse number and dendritic complexity
Angiogenesis = growing new blood vessels
Functional change = networks learning to work together
97
What is balance?
A complex skill based on the interaction of dynamic sensorimotor processes
98
What are the sections of the postural control framework?
Biomechanical/musculoskeletal, vertical orientation with gravity, motor strategies (e.g., fractionation, coordination), control of dynamics, sensory strategies and higher cortical function
99
What are some characteristics of balance?
Balance is at the activity level (needs practice)
Dynamic balance is required for human function (postural responses) (static balance is COM over BOS)
Upper limb balance strategies
100
What are the 2 main functional goals of postural balance?
Postural orientation & postural equilibrium
101
What is postural equilibrium?
Involves the coordination of movement strategies to stabilise the centre of mass during internal and external disturbances of stability
102
What is postural orientation?
Involves the active alignment and tone of the trunk and head with respect to gravity, support surface, visual environment and internal references
103
What are some factors that contribute to neuroplasticity?
Use it or lose it
Use it and improve it
Specificity
Repetition
Intensity
Time
Salience
Age
Transference
Interference
