Final Exam Flashcards
1
Q
What are problems of inverse kinematics
A
Joint Angles
2
Q
what are problems with inverse dynamics
A
Joint Torques
3
Q
Bernstin Problem:
Two approaches:
- The central controller finds a unique solution each time a problem emerges
- Central controller facilitates groups of equally acceptable solutions rather than unique solutions
A
The first one says that there is only one choice
The second says that Instead of having to settle on one decision, there are several choices as long as it is in an acceptable range
4
Q
This allows selection for a unique solution to a problem:
A
Optimization Approaches:
•A common approach to the problem of motor redundancy is to apply optimization criteria
5
Q
Cost Function:
A
Cost function:
•Particular function of a system’s performance the controller tries to keep optimized, commonly at a minimum value
•Imagine a single joint movement being performed as quickly as possible
•Movement time is a cost function to be minimized
6
Q
Abundancy:(principle of abundance)
A
Abundancy:(principle of abundance)
- Instead of redundancy, there is abundancy (multiple possibilities)
- the degrees of freedom at teach level of the movement system do not pose computational problems
- instead of searching for unique solutions, the controller can facilitate similar solutions that can solve the task.
7
Q
_________•a task-specific organization of elements, while each element within a structural unit is itself a structural unit at a different level of the analysis
A
•Structural units: a task specific organization of elements, while each element within a structural unit is itself a structural unit at a different level of the analysis
8
Q
•__________: purposes of structural units
A
•Synergies: purposes of structural units
9
Q
•____________: extrinsic patterns reflecting a synergy under particular external conditions
A
•Behaviors: extrinsic patterns reflecting a synergy under particular external conditions
10
Q
- __________: based on a structural unit that consists of a neural network uniting different extremities.
- _________of the arms or legs is based on a structural unit comprising individual joint rotations.
A
- Locomotion: based on a structural unit that consists of a neural network uniting different extremities.
- Motion of the arms or legs is based on a structural unit comprising individual joint rotations.
11
Q
- Each joint rotation is based on a structural unit involving muscle actions as elements.
- Each muscle is a structural unit of its motor units.
A
- Each joint rotation is based on a structural unit involving muscle actions as elements.
- Each muscle is a structural unit of its motor units.
12
Q
________:an inverted in the field of gravity
A
Posture :an inverted in the field of gravity
13
Q
_________________: maintenance of body alignment and spatial orientation in order to put the body in a position to enable effective movement
A
Postural control: maintenance of body alignment and spatial orientation in order to put the body in a position to enable effective movement.
14
Q
____________: Maintaining stability, upright stability, resisting disturbances to stability.
A
Postural Control: Maintaining stability, upright stability, resisting disturbances to stability.
15
Q
Sources of Problems:
- High center of mass/center of gravity
- Multiple Joints
- Small support area (1 square foot)
- Stability: a position that is resistant to disturbance or returns to its normal state After disturbance
A
Sources of Problems:
- High center of mass/center of gravity
- Multiple Joints
- Small support area (1 square foot)
- Stability: a position that is resistant to disturbance or returns to its normal state After disturbance
16
Q
What is the center of gravity for Males & Females?
A
- Female’s CG is ~ 55% of standing height.
- Male’s CG is ~ 57% of standing height.
17
Q
in quiet standing, the _______ can be considered to be almost directly over the center of pressure.
A
in quiet standing, the Center of gravity can be considered to be almost directly over the center of pressure.
18
Q
Sway increases under these conditions:
A
The following will increase sway:
- Closed eyes (one needs a reference frame)
- standing on a narrow support
- age, disorder
19
Q
Sway decreases under these conditions:
A
Decreases sway
- light finger touch (to virtually any part of the body)
- Holding an object connected to the external world
20
Q
_________ must remain within the base of support in order to maintain equilibrium.
A
Center of gravity must remain within the base of support in order to maintain equilibrium.
21
Q
________ base of support = less mobility
A
Larger/wider base of support = less mobility
22
Q
___________: migration of the reference point, with respect to which equilibrium is instantly maintained; likely a reflection of a central search process Supraspinal process
A
Rambling: migration of the reference point, with respect to which equilibrium is instantly maintained; likely a reflection of a central search process Supraspinal process
23
Q
_________\_: likely a reflection of the Mechanical properties of the effectors and reflex loops Subspinal process
A
Trembling: likely a reflection of the Mechanical properties of the effectors and reflex loops Subspinal process
24
Q
•They are innervated by the peripheral ends of bipolar sensory neurons in the ampullary nerve.
A
Vestibular hair cells
25
The ___________ is covered by a gelatinous,diaphragm-like mass called the cupula.
The **_ampullary crest_** is covered by a gelatinous,diaphragm-like mass called the **cupula**.
26
\_\_\_\_\_\_\_\_\_\_\_\_: sensitive to angular acceleration of the head
* The fluid in the semicircular canals move when the head rotates
* This fluid acts on the cupula and displaces the hair cells, which generate APs
**_Semicircular canals_**: sensitive to angular acceleration of the head
* The fluid in the semicircular canals move when the head rotates
* This fluid acts on the cupula and displaces the hair cells, which generate APs
27
\_\_\_\_\_\_\_\_\_\_\_: sensitive to **linear** acceleration of the head
* In the utricle, a portion of the floor is thickened and contains hair receptors
* This zone is called the macula It is covered with a gelatinous substance containing crystals of calcium carbonate (\_\_\_\_\_\_)
* When you tilt your head or accelerate in a certain direction, the otoliths deform the gelatinous surface, which bend the hair cells (generate APs)
**_Otoliths_**: sensitive to **linear** acceleration of the head
* In the utricle, a portion of the floor is thickened and contains hair receptors
* This zone is called the macula It is covered with a gelatinous substance containing crystals of calcium carbonate ( **_Otoliths_** )
* When you tilt your head or accelerate in a certain direction, the otoliths deform the gelatinous surface, which bend the hair cells (generate APs)
28
* Innervated by the ______ nerve via Scarpa’s (vestibular) ganglion. Neurons here are bipolar.
* Vestibular nuclei occupy a large part of the medulla
* Innervated by the **_eighth_** nerve via Scarpa’s (vestibular) ganglion. Neurons here are bipolar.
* vestibular nuclei occupy a large part of the medulla
29
The sensation of moving forward will have a ______ sway of the body?
The sensation of moving forward will have a **_backward_** sway of the body?
30
**What Is Necessary**
**to Maintain Posture?**
**What Is Necessary**
**to Maintain Posture?**
* Adequate perception of a reference point or reference vertical
* Timely generation of appropriate muscle torques
* Control of posture under external and internal perturbations
31
Many differences of ____________ \_\_\_\_\_\_\_\_\_, some caused by our own movements
* Many Voluntary movements are associated with changes in the activity of postural muscles, even before the movement begins
* These ________ \_\_\_\_\_\_\_\_ ________ (APAs) are to minimize perturbations to vertical posture
* Many differences in **_postural perturbations,_** some caused by our own movements
* Many Voluntary movements are associated with changes in the activity of postural muscles, even before the movement begins
* **These _anticipatory postural adjustments_ (APAs) are to minimize perturbations to vertical posture**
32
What mechanisms help maintain Posture?
* APA's \<0 sec (Based on a prediction of a perturbation)
* Muscle elasticity 0sec
* monosynaptic reflex 30ms
* polysynaptic reflex 50ms
* preprogramed reaction 70ms
* voluntary action 150ms (LATE)
33
A fast arm movement by a standing person is a source of a _____________ perturbation because of the joint coupling.
A fast arm movement by a standing person is a source of a **_strong postural perturbation_** because of the joint coupling.
**A fast shoulder _flexion_ creates reactive torques (Tr) that try to tilt the body Backward.**
34
* ________ are generated prior to a perturbation.
* It helps if the perturbation is predictable.
* The perturbation is typically associated with an action by the person.
* _________ produce forces/torques acting against the expected perturbation.
* ________ are always suboptimal.
* **_APAs_** are generated prior to a perturbation.
* It helps if the perturbation is predictable.
* The perturbation is typically associated with an action by the person.
* **_APAs_** produce forces/torques acting against the expected perturbation.
* **_APAs_** are always suboptimal.
35
**_Posture: Ankle Strategy vs. Hip Strategy_**
* Slow forward or backward translations leads to an ____ strategy among young participants
* Older subjects would use a ___ strategy
* Young participants use the ____ strategy when standing on a narrow surface or during fast translations
* Ankle movement leads to larger horizontal displacement of the Center of mass
Why?
\_\_\_\_\_\_\_\_ ______ is more effective, but increases the risk!
_Posture: Ankle Strategy vs. Hip Strategy_
* Slow forward or backward translations leads to an **ankle** strategy among young participants
* Older subjects would use a **hip** strategy
* Young participants use the **hip** strategy when standing on a narrow surface or during fast translations
* Ankle movement leads to larger horizontal displacement of the COM
Why?
* **Ankle strategy** is more effective, but increases the risk
36
* _________ is a task Specific organization of many elements (elemental variables) by a controller.
* Its purpose is to stabilize a value or a pattern of an important performance variable or of several variables.
* A ___________ is a Combination of control signals sent to several muscles to ensure stability of a limb or whole body either in anticipation of a predictable postural perturbation or in response to an actual perturbation.
**Postural Synergies:**
* **_Synergy_** is a task Specific organization of many elements (elemental variables) by a controller.
* Its purpose is to stabilize a value or a pattern of an important performance variable or of several variables.
* A **postural synergy** is a Combination of control signals sent to several muscles to ensure stability of a limb or whole body either in anticipation of a predictable postural perturbation or in response to an actual perturbation.
37
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is an activity leading to a change in the location of the body in external space. Examples: walking, running, hopping, swimming, flying, crawling, etc.
**_Locomotion:_** is an activity leading to a change in the location of the body in external space. Examples: walking, running, hopping, swimming, flying, crawling, etc.
Important characteristics:
* Velocity
* Stride length
* Relation between the support and swing phases
* Relative timing of the extremities (gait)
38
**_Motor programming:_**
* **_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\__**- hypothetical neural structure that generates a neural activity, activity is transformed into rhythmic muscle activity, leading to rhythmic behavior
**_Motor programming:_**
* **_Central pattern generators_**- hypothetical neural structure that generates a neural activity, activity is transformed into rhythmic muscle activity, leading to rhythmic behavior
39
\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_
* **Rhythmicity of locomotion is caused by interaction of neural activity and the periphery \_\_\_\_\_\_\_\_\_\_\_\_\_\_**
**Dynamic systems**
* Rhythmicity of locomotion is caused by interaction of neural activity and the periphery **(environment)**
40
**_Early Views of Locomotion:_**
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* locomotion was a pattern produced by alternating reflex responses.
* voluntary movement is a result of modulating reflexes
**_Early Views of Locomotion:_**
**_Sherrington:_**
* locomotion was a pattern produced by alternating reflex responses.
* voluntary movement is a result of modulating reflexes
41
**_Early Views of Locomotion:_**
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* rhythmic motor pattern of locomotion was produced by a special neural network (CPG) that could produce activity even in the absence of reflexes
**_Early Views of Locomotion:_**
**_Brown:_**
* rhythmic motor pattern of locomotion was produced by a special neural network (CPG) that could produce activity even in the absence of reflexes
42
* A _________ is a hypothetical structure in the central nervous system that can generate patterned (rhythmical) activity.
* It can be driven by “Highter” centers as well as by peripheral information.
* Both sources of information can lead to gait changes.
* A **_Central Pattern Generator_** is a hypothetical structure in the central nervous system that can generate patterned (rhythmical) activity.
* It can be driven by “Highter” centers as well as by peripheral information.
* Both sources of information can lead to gait changes.
43
**Approaches to Locomotion:**
**Motor Programming**: lacks _________ all details of coordination are delegated by the ultimate controller
**Dynamic systems:** coordination can emerge without supreme problem solver, but it \_\_\_\_\_\_\_\_\_\_\_\_
**Combination**: all elements are \_\_\_\_\_\_, and there is an upper neural structure that can send descending signals
**Motor Programming:** lacks **_coordination_** all details of coordination are delegated by the ultimate controller
**Dynamic systems:** coordination can emerge without supreme problem solver, but it **_lacks control_**
**Combination**: all elements are **_Linked_**, and there is an upper neural structure that can send descending signals
44
**Corrective Stumbling reaction:**
* **Occurs during \_\_\_\_\_\_\_\_\_**
* **Can be induced by a mechanical stimulus to the foot**
* **Represents a complex pattern of EMG changes**
* **Leads to a quick step over the obstacle**
**Corrective Stumbling reaction:**
* **Occurs during _locomotion_**
* **Can be induced by a mechanical stimulus to the foot**
* **Represents a complex pattern of EMG changes**
* **Leads to a quick step over the obstacle**
45
**\_\_\_\_\_\_\_\_\_\_\_\_\_\_**
* Awareness of the position of the body segments in space and relation to each other
* Allows us to perform movements without continuous visual control, to adjust patterns of control variables, and perform tasks requiring multi-limb coordination
* Proprioceptors are the source of kinesthetic information
**_Kinesthesia_**
* Awareness of the position of the body segments in space and relation to each other
* Allows us to perform movements without continuous visual control, to adjust patterns of control variables, and perform tasks requiring multi-limb coordination
* Proprioceptors are the source of kinesthetic information
46
\_\_\_\_\_\_\_\_\_\_\_\_\_ _______ – voluntary copy of a motor command
**_Efferent copy_** – voluntary copy of a motor command
* The efferent copy participates in deciphering the mixed information from peripheral receptors, thus reducing the cognitive load
* Likely occurs in the thalmus
47
* **_\_\_\_\_\_\_\_\__**
* General changes in the neuromuscular system
* Strength decline
* Longer reaction time
* Impaired control of posture/gait
* Impaired control of force/movement
* Unintended force production
* **_Aging_**
* General changes in the neuromuscular system
* Strength decline
* Longer reaction time
* Impaired control of posture/gait
* Impaired control of force/movement
* Unintended force production
48
**Behavioral** **changes with** **aging:**
* **\_\_\_\_\_\_\_\_**
* \_\_\_\_\_\_\_\_\_
* **\_\_\_\_\_\_\_**
*
**Behavioral** **changes with** **aging:**
* Weakness
* Slowness
* Higher variability
* Larger postural sway; delayed APAs
49
**_Central (CNS) changes:(aging)_**
* \_\_\_\_\_\_\_
* \_\_\_\_\_\_
* \_\_\_\_\_\_
* \_\_\_\_\_\_\_\_
**_Central (CNS) changes:(aging)_**
* Longer reaction time
* Slower movements
* Higher antagonist co-contraction
* Higher safety margins
* Changed synergies
50
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-:**_
* Decline in the number of alpha motoneurons
* Muscle fiber denervation (loss of innervation) and atrophy of skeletal muscle
* Re-innervation by surviving motoneurons
* Higher innervation ratio
* Smaller motor units are most affected, which impairs fine motor control
* Summary: fewer motoneurons and motor units are present, and on average they are larger in size and slower
* Force production becomes more irregular (less smooth)
**_Changes in Motor Units with Age:_**
* Decline in the number of alpha motoneurons
* Muscle fiber denervation (loss of innervation) and atrophy of skeletal muscle
* Re-innervation by surviving motoneurons
* Higher innervation ratio
* Smaller motor units are most affected, which impairs fine motor control
* Summary: fewer motoneurons and motor units are present, and on average they are larger in size and slower
* Force production becomes more irregular (less smooth)
51
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Loss in muscle mass, cross sectional area, normalized force
* Increase in co-activation of antagonist muscles, possibly by 30%
* Typically affects distal muscles more than proximal muscles
**_Changes in Strength with Age:_**
* Loss in muscle mass, cross sectional area, normalized force
* Increase in co-activation of antagonist muscles, possibly by 30%
* Typically affects distal muscles more than proximal muscles
52
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* H-reflex amplitude may be slightly reduced and show a delay (longer latency). Same with the T-reflex.
* Polysynaptic reflexes are weaker
* Simple reaction time is increased
**_Changes in reflexes with Age:_**
* H-reflex amplitude may be slightly reduced and show a delay (longer latency). Same with the T-reflex.
* Polysynaptic reflexes are weaker
* Simple reaction time is increased
53
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Postural sway is increased
* APAs become asynchronous (not as coordinated) and delayed
* Pre-programmed reactions are weaker and have a greater latency
* Switch occurs from an ankle to hip strategy
* Greater co-activation of antagonist muscles
* Higher variability when walking
**_Changes in Posture/Gait with Age:_**
* Postural sway is increased
* APAs become asynchronous (not as coordinated) and delayed
* Pre-programmed reactions are weaker and have a greater latency
* Switch occurs from an ankle to hip strategy
* Greater co-activation of antagonist muscles
* Higher variability when walking
54
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Higher forces can be produced
* A lower antagonist co-contraction is possible
* Small changes in muscle cross-sectional area, most changes are likely due to positive neural adaptations
**_Effects of Training/Exercise/Rehabilitation:_**
* Higher forces can be produced
* A lower antagonist co-contraction is possible
* Small changes in muscle cross-sectional area, most changes are likely due to positive neural adaptations
55
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Posture and postural reflexes
* Increased trunk and cervical flexion, increased knee and elbow extension
* Spontaneous and induced postural sway is exaggerated and increased
* Difficult to recover after a perturbation
* Short, slow strides and a wide base of support
**_Impairments in Posture and Gait:_**
* Posture and postural reflexes
* Increased trunk and cervical flexion, increased knee and elbow extension
* Spontaneous and induced postural sway is exaggerated and increased
* Difficult to recover after a perturbation
* Short, slow strides and a wide base of support
56
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Trisomy 21 (extra copy of the 21st chromosome)
* Motor consequences (the motor consequences of _______________ are similar to the motor consequences of aging, but for different reasons).
* Longer reaction time
* Longer movement time
* Irregular trajectories
* High variability
* Preference for co-activation patterns:
* during movements
* during preprogrammed reactions
* during anticipatory postural adjustments
* High safety margin in grip tasks
* Stunning effects of practice (can show significant improvement in motor performance with training/rehabilitation, especially with force production, speed of movement, coordination, and less co-contraction of the antagonist muscles)
* **A lower cerebellum weight has been reported in persons in \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, this could explain some of the difficulty with coordination**
**_Down syndrome:_**
* Trisomy 21 (extra copy of the 21st chromosome)
* Motor consequences (the motor consequences of Down syndrome are similar to the motor consequences of aging, but for different reasons).
* Longer reaction time
* Longer movement time
* Irregular trajectories
* High variability
* Preference for co-activation patterns:
* during movements
* during preprogrammed reactions
* during anticipatory postural adjustments
* High safety margin in grip tasks
* Stunning effects of practice (can show significant improvement in motor performance with training/rehabilitation, especially with force production, speed of movement, coordination, and less co-contraction of the antagonist muscles)
* **A lower cerebellum weight has been reported in persons in Down syndrome, this could explain some of the difficulty with coordination**
57
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Causes are unknown
* More common in boys
* Typical features:
* Tripping
* Running into others
* Dropping objects
* Unsteady gait
* Speech problems (sometimes)
* Can result in developmental delays, increased level of co-contraction, and higher safety margins
* Typically associated with a smaller cerebellum
* Neurologists do not prefer this terminology because it does not really describe exactly what is causing the lack of coordination
**_Developmental Coordination Disorder:_**
* Causes are unknown
* More common in boys
* Typical features:
* Tripping
* Running into others
* Dropping objects
* Unsteady gait
* Speech problems (sometimes)
* Can result in developmental delays, increased level of co-contraction, and higher safety margins
* Typically associated with a smaller cerebellum
* Neurologists do not prefer this terminology because it does not really describe exactly what is causing the lack of coordination
58
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site:\_\_\_\_\_\_\_\_\_\_\_\_\_**
**Disorder: ALS (Lou Gehrig's Disease)**
**_Peripheral Muscular and Neurological Disorders:_**
Sites of damage in nerve and muscle:
**Site: _Neuron Cell Body_**
**Disorder: ALS (Lou Gehrig's Disease)**
59
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site:\_\_\_\_\_\_\_\_\_\_\_\_\_**
**Disorder: Cervical or lumbar radiculopathy**
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site: _Root (dorsal/ventral)_**
**Disorder: Cervical or lumbar radiculopathy**
60
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site:\_\_\_\_\_\_\_\_\_\_\_\_\_**
**Disorder: Axonal neuropathy**
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site: _Axon_**
**Disorder: Axonal neuropathy**
61
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site:\_\_\_\_\_\_\_\_\_\_\_\_\_**
**Disorder: Axonal neuropathy**
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site: _Axon_**
**Disorder: Axonal neuropathy**
62
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site:\_\_\_\_\_\_\_\_\_\_\_\_\_**
**Disorder:Guillain-Barré syndrome**
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site: _Demyelination (PNS)_**
**Disorder: Guillain-Barré syndrome**
63
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site:\_\_\_\_\_\_\_\_\_\_\_\_\_**
**Disorder:Myasthenia gravis**
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site: _Neuromuscular synapse_**
**Disorder: Myasthenia gravis**
64
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site:\_\_\_\_\_\_\_\_\_\_\_\_\_**
**Disorder: Muscular dystrophy or myopathy**
**_Peripheral Muscular and Neurological Disorders:_**
_Sites of damage in nerve and muscle:_
**Site: _Muscle_**
**Disorder: Muscular dystrophy or myopathy**
65
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:
* Genetic disorder that causes progressive weakness and degeneration of skeletal muscles
* Effects males more than females
**_Muscular dystrophies:_**
* Genetic disorder that causes progressive weakness and degeneration of skeletal muscles
* Effects males more than females
66
_**(\_\_\_\_\_\_\_\_\_\_\_)muscular dystrophy:**_
* Mutation of a gene responsible for dystrophin, a protein involved in maintaining integrity of muscle fibers
* Clinical symptoms present at 2 to 6 years; all muscles are ultimately affected
* Late to walk; waddling, unsteady gait
* Respirator dependence by the age of 20
**_Duchenne muscular dystrophy:_**
* Mutation of a gene responsible for dystrophin, a protein involved in maintaining integrity of muscle fibers
* Clinical symptoms present at 2 to 6 years; all muscles are ultimately affected
* Late to walk; waddling, unsteady gait
* Respirator dependence by the age of 20
67
**_( )Dystrophy:_**
* Similar to Duchenne dystrophy; mutation of a gene responsible for dystrophin
* Clinical symptoms appear at adolescence
* Slower disease progression; longer life expectancy
**_Becker Dystrophy:_**
* Similar to Duchenne dystrophy; mutation of a gene responsible for dystrophin
* Clinical symptoms appear at adolescence
* Slower disease progression; longer life expectancy
68
**_( ) Dystrophy:_**
* Most common adult form of muscular dystrophy
* Myotonia: prolonged episode of muscle activity after its voluntary contraction
* **_Commonly in finger and facial muscles_**
* High-stepping, floppy-footed gait (drop foot)
* **_Long face; drooping eyelids_**
**_Myotonic Dystrophy:_**
* Most common adult form of muscular dystrophy
* Myotonia: prolonged episode of muscle activity after its voluntary contraction
* **_Commonly in finger and facial muscles_**
* High-stepping, floppy-footed gait (drop foot)
* **_Long face; drooping eyelids_**
69
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_ (one peripheral nerve is affected, slowed conduction in a single nerve)
* Reduced amplitude of motor and/or sensory potentials
* Signs of denervation
* Common\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ include:
* **Carpal tunnel syndrome**: entrapment of the median nerve at the wrist, most common mononeuropathy
* Ulnar nerve can be entrapped near the elbow
* **Brachial plexus lesions**: mostly seen in muscles innervated by median and ulnar nerves
* **Peroneal:** peroneal pressure palsy
* **Tibial:** tarsal tunnel syndrome
* Sciatic nerve (Sciatica)
**_Mononeuropathies:_** (one peripheral nerve is affected, slowed conduction in a single nerve)
* Reduced amplitude of motor and/or sensory potentials
* Signs of denervation
* Common **_Mononeuropathies_** include:
* Carpal tunnel syndrome: entrapment of the median nerve at the wrist, most common mononeuropathy
* Ulnar nerve can be entrapped near the elbow
* Brachial plexus lesions: mostly seen in muscles innervated by median and ulnar nerves
* Peroneal: peroneal pressure palsy
* Tibial: tarsal tunnel syndrome
* Sciatic nerve (Sciatica)
70
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
(not a neuromuscular disease, but it can have neuromuscular consequences)
* Peripheral sensory neuropathy
* Peripheral motor neuropathy
* Loss of autonomic nerve function
* Atrophy of peripheral tissues
* Results in loss of balance and coordination with an increased probability of falls, fractures, and bruises
**_Diabetes Mellitus:_**
(not a neuromuscular disease, but it can have neuromuscular consequences)
* Peripheral sensory neuropathy
* Peripheral motor neuropathy
* Loss of autonomic nerve function
* Atrophy of peripheral tissues
* Results in loss of balance and coordination with an increased probability of falls, fractures, and bruises
71
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Peripheral neuropathy, may affect several neurons in the PNS
* Causes reduced recruitment and possibly conduction block, may result in permanent axonal loss if not treated quickly enough
**_Guillan-Barre syndrome:_**
* Peripheral neuropathy, may affect several neurons in the PNS
* Causes reduced recruitment and possibly conduction block, may result in permanent axonal loss if not treated quickly enough
72
_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Upper motor neuron syndrome (affects the motor neurons in the primary motor area)
* The earliest symptoms may include twitching, cramping, or stiffness of muscles; muscle weakness affecting an arm or a leg; slurred and nasal speech; or difficulty chewing or swallowing.
* Patients have increasing:
* _problems with moving, swallowing_ (**dysphagia**),
* _speaking or forming words_ **(dysarthria)**.
* _Patients have tight and stiff muscles_ **(spasticity)**
* _exaggerated reflexes_ **(hyperreflexia).**
**_Amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease):_**
* Upper motor neuron syndrome (affects the motor neurons in the primary motor area)
* The earliest symptoms may include twitching, cramping, or stiffness of muscles; muscle weakness affecting an arm or a leg; slurred and nasal speech; or difficulty chewing or swallowing.
* Patients have increasing:
* _problems with moving, swallowing_ (**dysphagia**),
* _speaking or forming words_ **(dysarthria)**.
* _Patients have tight and stiff muscles_ **(spasticity)**
* _exaggerated reflexes_ **(hyperreflexia).**
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**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:problems with moving, swallowing**
**_Dysphagia_****:problems with moving, swallowing**
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_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_ speaking or forming words
**_Dysarthria:_** speaking or forming words
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_**\_\_\_\_\_\_\_\_\_\_\_:**_ Patients have tight and stiff muscles
**_Spasticity:_** Patients have tight and stiff muscles
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\_\_\_\_\_\_\_\_\_\_\_\_\_\_:exaggerated reflexes
**_Hyperreflexia_** :exaggerated reflexes
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**_Spinal Cord Injury:_** (most common cause is motor vehicle accidents)
* **_Paresis_**: partial loss of voluntary control of muscle activity
* **_Plegia_**: total loss of voluntary motor control
* **_Para_**: two extremities are involved—forelimbs (arms) or hindlimbs (legs)
* **_Hemi_**: half of the body (left or right) is involved
* **_Quadri_**: all four extremities are involved
* **Spastic**: with positive signs of spasticity (hyperreflexia)
* **_Flaccid_**: without positive signs of spasticity (areflexia)
*
**_Spinal Cord Injury:_** (most common cause is motor vehicle accidents)
* **_Paresis_**: partial loss of voluntary control of muscle activity
* **_Plegia_**: total loss of voluntary motor control
* **_Para_**: two extremities are involved—forelimbs (arms) or hindlimbs (legs)
* **_Hemi_**: half of the body (left or right) is involved
* **_Quadri_**: all four extremities are involved
* **Spastic**: with positive signs of spasticity (hyperreflexia)
* **_Flaccid_**: without positive signs of spasticity (areflexia)
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**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**:
* Commonly paraplegia
* Hands not affected
* At T-1 to T-8, poor trunk control as the result of lack of abdominal muscle control
* Lower T injuries (T-9 to T-12) allow good trunk control and good abdominal muscle control; sitting balance is very good
* Lumbar and sacral injuries yield decreasing control of the hip flexors and legs
*
**_Thoracic-Lumbar Injuries_**:
* Commonly paraplegia
* Hands not affected
* At T-1 to T-8, poor trunk control as the result of lack of abdominal muscle control
* Lower T injuries (T-9 to T-12) allow good trunk control and good abdominal muscle control; sitting balance is very good
* Lumbar and sacral injuries yield decreasing control of the hip flexors and legs
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_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**_:
* Commonly quadriplegia
* Above the C-4 level may require a ventilator
* C-5 injuries often result in shoulder and biceps control, but no control at the wrist or hand
* C-6 injuries generally yield wrist control, but no hand function
* C-7 and T-1 injuries: can straighten arms but may have dexterity problems with the hand and fingers
**_Cervical Injuries_**:
* Commonly quadriplegia
* Above the C-4 level may require a ventilator
* C-5 injuries often result in shoulder and biceps control, but no control at the wrist or hand
* C-6 injuries generally yield wrist control, but no hand function
* C-7 and T-1 injuries: can straighten arms but may have dexterity problems with the hand and fingers
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_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Demyelination of axons within the CNS
* Auto-immune disorder, the immune system attacks the myelin sheath, leaving the axon exposed, causing it to harden (sclerosis)
**_Multiple Sclerosis:_**
* Demyelination of axons within the CNS
* Auto-immune disorder, the immune system attacks the myelin sheath, leaving the axon exposed, causing it to harden (sclerosis)
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_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Hypokinetic disorder, specifically effects dopamine production in the substantia nigra of the basal ganglia
* Signs and symptoms
* Bradykinesia
* Tremor
* Postural deficits
**_Parkinson’s Disease:_**
* Hypokinetic disorder, specifically effects dopamine production in the substantia nigra of the basal ganglia
* Signs and symptoms
* Bradykinesia
* Tremor
* Postural deficits
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**_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:_**
* Hyperkinetic disorder of the basal ganglia, specifically affects the caudate nucleus
* Neurodegenerative disorder
* Hereditary (the gene has been located)
* Starts in midlife
* Characterized by chorea and dementia
* Death after 15–20 years
**_Huntingdon’s Disease:_**
* Hyperkinetic disorder of the basal ganglia, specifically affects the caudate nucleus
* Neurodegenerative disorder
* Hereditary (the gene has been located)
* Starts in midlife
* Characterized by chorea and dementia
* Death after 15–20 years
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**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**:
* Delay in movement initiation (clumsiness, but movement execution is not prevented)
* Incomplete and inaccurate movement forms (errors of force, velocity, and timing)
* Muscle strength is diminished somewhat (gait changes include wide base stance, truncal tremor, irregularly placed steps, excessive leg lift)
* Lack of coordination (ataxia)
* Intention tremor
* Astasia-abasia
* Dysarthria
_**Cerebellar Disorders**:_
* Delay in movement initiation (clumsiness, but movement execution is not prevented)
* Incomplete and inaccurate movement forms (errors of force, velocity, and timing)
* Muscle strength is diminished somewhat (gait changes include wide base stance, truncal tremor, irregularly placed steps, excessive leg lift)
* Lack of coordination (ataxia)
* Intention tremor
* Astasia-abasia
* Dysarthria
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**_\_\_\_\_\_\_\_\_\_\_\_:_**
* Excessive copper deposits in the brain (specifically the cerebral cortex and basal ganglia, also in the liver and other internal organs
**_Wilson’s Disease:_**
* Excessive copper deposits in the brain (specifically the cerebral cortex and basal ganglia, also in the liver and other internal organs
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_**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:**_
* Non-progressive disorder in young children causes problems with motor function such as ataxia, spasticity, dystonia, and dysarthria
* Can also cause epilepsy, reduced mental capacity, and visual disturbances
**_Cerebral Palsy:_**
* Non-progressive disorder in young children causes problems with motor function such as ataxia, spasticity, dystonia, and dysarthria
* Can also cause epilepsy, reduced mental capacity, and visual disturbances
