Lecture 4: Coordination and Vestibular System Flashcards

(50 cards)

1
Q

What is main function of cerebellum?

A

coordinates and regulates posture, movement and balance

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2
Q

What is main function of brainstem?

A

integrates and sorts sensory information

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3
Q

What is sequence to perform coordinated movement or balance?

A
  1. sensory input (vestib, visual, proprio)
  2. integration of input (brainstem, cerebellum)
  3. motor output
  4. balance
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4
Q

What is coordination?

A

smooth, accurate and controlled movement which involves sequence, timing and force production

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5
Q

What does normal coordination look like?

A

promixal fixation for distal control, postural control, easy and and off and fluid

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6
Q

What is intralimb coordination?

A

occuring with one limb

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7
Q

What is interlimb coordination?

A

integrated performance of two or more limbs

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8
Q

What is visual motor coordination?

A

ability to integrate both visual and motor abilities

aka hand eye coordination

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9
Q

What are key brain structures used for coordination?

A

motor cortex, descending motor tracts, basal ganglia, cerebellum

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10
Q

What does motor cortex and descending pyramidal pathways do?

A

for trunk and proximal control, anticipatory control, initiation

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11
Q

What does basal ganglia do?

A

regulate initiation and gross intentional movements

regulate complex planning and execution

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12
Q

How much of CNS neurons does cerebellum contain?

A

50 %

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13
Q

What cerebellar nuceli are responsible for motor execution?

A

fastigal and interposed

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14
Q

What cerebellar nuclei are responsible for motor planning?

A

denate

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15
Q

What cerebellar nuclei are responsible for balance and eye movements?

A

vestibular nuclei

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16
Q

What is the vermis for?

A

postural control

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17
Q

What are main cerebellar functions?

A

coordinate range, velocity and strength of muscle contractions to produce steady volitional movements

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18
Q

What are other cerebellar functions?

A

equilibrium, muscle tone regulation, eye head coordination, coordination for muscle of speech

comparator- corrects errors of movement
comensator

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19
Q

What type of system is cerebellar functions?

A

closed loop

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20
Q

What is ataxia?

A

cerebellar pathology that results in disordered movement, difficulty initiating volitional movement

errors in rate, rhytym and timing of muscle

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21
Q

What side does ataxia occur on?

A

ipsilateral side of lesion

22
Q

What is etiology of ataxia?

A

congenital, acquired (strokes, tumors, trauma)

23
Q

What is most common sign of cerebellar lesion?

A

ataxic gait, decreased arm swing, uneven step length, increased BOS, high movement variability

24
Q

What is dysdiadochokinesia?

A

decreased rapid alternating movements, antagonistic muscle firing over powers agonist

flipping hand back and forth

25
What is dysmetria?
deficit in reaching a target, overshooting a target when pointing
26
What is dyssynergia?
breaking down movement into unsmooth motion
27
What is an intention tremor?
oscillation of limb with volitional movement, most pronounced with end of movement
28
What is role of vestibular system?
critical in control of posture, where are we in relation to gravity, proprioception, sensing and perceiving motion, gaze stability
29
What are two components of peripheral apparatus?
bony labrinth and membranous labyrinth
30
What makes up the bony labyrinth?
1. three semi circular canals 2. cochlea 3. vestibule
31
What makes up membranous labyrinth?
membranous portions of 3 semicircular canals as well as utricle and saccule filled with endolymph -resembles intracellular fluid
32
What do the semicircular canals do?
detect angular head rotation and respond to angular acceleration, provide sensory input about head velocity
33
What are key anatomical features of semicircular canals?
the ampulla- contain hair cells the christa ampullaris the cupula endolymph
34
What is otoliths and what does it do?
refer to utricle (horizontal) and saccule (vertical) detect linear acceleration and static head tilt, sensitive to gravity
35
What are hair cells?
sensory receptors made up of kinocillia and stereocillia
36
What causes the hair cells to move?
caused by motion of endolymph stereo towards kino- excitation stereo away from kino- inhibition
37
How are cerebellum and vestibular system connected?
cerebellum is calibration of vestibular system, without proper functioning cerebellum then vestibular reflexes are ineffective
38
What are two mechanisms for motor output?
VOR- vestibulo ocular | VSR- vestibulo spinal reflex
39
What CNS structures are associated with VOR and VSR?
VOR- medial longitudinal fasiculus | VSR- lateral and medial vestibulospinal tracts
40
What is the VOR?
maintains stable vision/ gaze stability during head motion, look left eyes go right one of fastest reflexes in body
41
What is VOR gain?
ratio of eye movements to head movement amplitude normally equals 1.0
42
What is VSR?
stabilizes body by using otolithic input, stabilizes body before a fall strong influence on posture, postural control and stability
43
What is Cervico ocular reflex?
supplements to VOR, driven by neck receptors
44
What is vestibulocollic reflex?
acts on neck musculature to stabilized head
45
What are clinical signs of vestibular dysfunction?
veering towards sign of lesion, nausea, vertigo, dizziness, diplopia, nystagmus
46
What are two categories of coordination testing?
non- equilibrium and equilibrium
47
What are some non equilibrium tests?
finger to nose, finger opposition, pronation/supination, pointing, heel to shin, tapping (DF/PF)
48
What are equilibrium tests for coordination?
tandem stance, perturbations, romberg, walking on heels
49
What can you document during these test?
number of trials, patient position, reps done in 10 seconds, eyes open or closed
50
With any coordination dysfunction what do you also need to test for?
sensory deficits- proprio, kinesthesia, vibration, sterognosia dysfunction can cause sensory ataxia which is worse with eyes closed then cerebellar with eyes closed