exam 1: UMN and LMN issue

Question 1

MD characterized by too little movement

Answer 1

paralysis
hypertonia
bradykinesia

Question 2

what us paralysis

Answer 2

weakness

Question 3

what are the two types of paralysis

Answer 3

UMN para
LMN para

both present very differently

Question 4

what is UMN lesion characterized by - anatomy wise

Answer 4

lesion found in the descending motor tracts
cerebral cortex
BS
internal capsule
SC

but do not forget that the indirect pathways

Question 5

UMN lesions that lead to paralysis

Answer 5

stroke
ALS
MS
traumatic brain injury
CP
SCI

Question 6

UMN issues is characterized by

Answer 6

hypertonia - spasticity
hyper-reflexia
UMN muscle weakness
decrease in motor coordination

Question 7

selective distribution of muscle weakness is often seen with what kind of issue

Answer 7

UMN lesion

Question 8

UE selective distribution

Answer 8

abductor, external rotators and extensor are primarily effected

Question 9

LE selective distribution

Answer 9

flexors (knee), internal rotators and DF

Question 10

how soon do we see the effects of UMN issue

Answer 10

days to weeks

Question 11

syneries

Answer 11

the CNS organizes movement patterns of functionally linked muscles to produce an intended action

Question 12

Abnormal movement control is often observed as what

Answer 12

lack of isolated voluntary movement - moves with poor motor control

Question 13

abnormal synergy movement patterns

Answer 13

The inability to isolate movement of a joint

Question 14

How do we examine if someone has an abnormal movement synergy?

Answer 14

We ask them to voluntarily perform a movement or skill and analysis the movement that we observed. – this is movement analysis.

Question 15

how do you treat abnormal synergy

Answer 15

Repetitive task practice, also if there is secondary soft tissue complications I address those impairments also.

Question 16

do we see atrophy when we have spasticity

Answer 16

little to no

Question 17

what is a positive babinki

Answer 17

toes flare up

Question 18

LMN paralysis - is casued by

Answer 18

lesion of the nerve fibers travels fron the ventral horn of the SC

or

the cranial nerve motor nuclei to the relevant muscle

Question 19

what is the main characteristic that we use to ID LMN issue

Answer 19

flaccid paralysis

Question 20

signs of LMN issue

Answer 20

para is limited to segmental or focal pattern (root innervated pattern)

decrease muscle tone

hypo-reflexia

the present of fasculation or fibrillation

Question 21

what is the muscle atrophy seen with LMN issue due to

Answer 21

loss of trophic influences of the cell body (AHC) on the muscle

Question 22

fasciulation present as

Answer 22

muscle twitches

small groups of muscle fibers

does not denote patho

Question 23

fibrillations present as

Answer 23

involuntary, unsynchronized patho contraction of muscle fibers

seen with EMG

Question 24

example of patho the result from LMN lesion

Answer 24

ALS
guille barre syndrome
poliomyelitis
cauda equina syndrome

Question 25

what is ALS

Answer 25

degeneration and scarring of motor neurons in the lateral aspect of the SCC, BS, and CC neurodegenerative disease the combines LMN and UMN issues

Question 26

what does ALS present with

Answer 26

peri nerve changes that leads to muscle atrophy or amytrophy progressive motor dysfunction without sensory issues

Question 27

cognitive impairments and ALS

Answer 27

frontotemporal lobar degeneration

Question 28

what does hypertonia mean

Answer 28

to much tone

Question 29

two types of hypertonia

Answer 29

spasticity rigidity

Question 30

spasticity is resistance to what kind of movements

Answer 30

passive velo dependent

Question 31

spasticity is secondary to what

Answer 31

UMN issue

Question 32

patho of spasticity

Answer 32

increase afferent input to AMN - increasing stretch excitation

Question 33

what causes the stretch reflex to fire

Answer 33

with any quick movement of the limb

Question 34

how do you treat spasticity

Answer 34

cutting the peri nerve inject the nerve with phenol pharma interventions - baclofen, Bo-tox stretching positioning and splitting motor re-education with task specific stregthing

Question 35

what is rigidity due to

Answer 35

excess supraspinal drive acting on the AMN

Question 36

characteristic of rigidity

Answer 36

spinal relfexes are typically normal not velo dependent involves agonist and ant

Question 37

lead pipe rig

Answer 37

constant hypertonia felt throughout the ROM with passive movement

Question 38

cog wheel rig

Answer 38

jerk responses of the muscle when force is applied to bend the limb

Question 39

PD is due to what

Answer 39

death of cells in the midbrain (substantia nigra)- these convert AA to dope - which is the release to the striatum of the extrapyramidal motor system

Question 40

treatment of rig

Answer 40

add component that involve twisting and reaching act that require large rhythmic movement to go through ROM

Question 41

what is bradykinesia

Answer 41

move slow

Question 42

bradykinesia is due to a issue where

Answer 42

extrapyramidal region

Question 43

brady is associated with what patho

Answer 43

parkinsons

Question 44

what are example of too much movement

Answer 44

tremor fasciulation fibrillations chorea hemiballisum

Question 45

tremor

Answer 45

type of shaking movement

Question 46

what is a resting tremor

Answer 46

present when the muscle is resting may go away when the muscle is activated

Question 47

a tremor is a key sign of what disease

Answer 47

PD

Question 48

intentional (action) tremor

Answer 48

oscillation that are exaggerated at the end of voluntary movements the tremor will often go away with rest of effected muscles

Question 49

what is action tremors seen with

Answer 49

cere issues

Question 50

physiological tremor

Answer 50

normal - reflects the error of the system

Question 51

fascuialtion are caused by what

Answer 51

anterior horn cell and motor unit firing without a command

Question 52

chorea

Answer 52

movements and rapid and involuntary non-sterotypical semi/non purposeful dance like more distally involved

Question 53

hemiballisum is a result of what

Answer 53

stroke of the subthalamic nucleus

Question 54

how does hemi present like

Answer 54

rapid involuntary movements non-purposeful violet fling movement more proximal involvement

Question 55

ataxia

Answer 55

uncoordinated movement hard time regulating forces, range and direction, and timing of movement

Question 56

motor axtia

Answer 56

intergration of motor commands there is a dysfunction

Question 57

sensory ataxia

Answer 57

sensory pathway are disrupted therefore there is not proprioceptive awareness

Question 58

The role of the primary motor cortex

Answer 58

is to initiate and execute voluntary muscle movement

Question 59

location of the primary motor cortex

Answer 59

precentral gyrus

Question 60

where is the prefrontal cortex located

Answer 60

anterior frontal lobe

Question 61

what is the prefrontal cortex involved in

Answer 61

memory, behavior, executive functions

Question 62

subthalmic nucleus is part of what

Answer 62

the BG circuit

Question 63

what is the role of the subthalamic nucleus

Answer 63

suppression of unwanted movement