Module 10 Flashcards
What does the cerebrum do?
Higher brain function, planning and executing movements, sensation, senses etc
What does the cerebellum do?
Coordination, coordinates timing and integration of voluntary movements, muscular activity, coordination, balance, speech and posture
What does the brain stem do?
Conduction, all information must pass through brain stem, base of cranial nerves, regulating our bodily functions (breathing, sleeping, eating, and awareness)
Afferent pathways
Information coming back to the brain, coming back from the peripery
Efferent
Information being sent from the brain, down to the periphery
UMS (Upper motor neurons)
All the descending pathways that control the activities of neurons that supply muscles
-Originate in motor cortex and synapse with LMS
LMNS
-Directly innervate skeletal muscles
-Originate in the spinal cord and brain stem and receive input from UMNs
What are some common neurological conditions we will face as physios?
Stroke, TBI, autoimmune disorders like MS, degenerative (parkinsons), spinal cord injury
What is a hemorrhagic stroke?
Where a blood vessel bursts in the brain (more rare)
What is an ischemic stroke?
When a blood clot blocks the blood flow in an artery within the brain
Primary impairments following a stroke
Sensory loss, sense changes, vision and hearing, spasticity, centrally mediated weakness (reduced ability to activate muscles)
Secondary impairments following a stroke
Contracture and muscle shortening- spasticity in these muscles (primary then secondary)
-Peripherally mediated weakness (immobilisation- cant move, muscle atrophies and weakens) (isnt a result of
changes in the brain)
Weakness following a stroke
-Difficulty in generating and sustaining muscle force due to peripheral neural changes or muscle changes or central activation
Decreased motor control following a stroke
-The inability to activate time, sequence muscle groups to complete movements appropriately due to central neural changes
Hemiplegia
Paralysis on one side of the body
Hemiparesis
Slight paralysis
How to assess function for neuro using quantiative appraoch
-Using standardised scales or temporal spatial measures
-Easy to administer
-Does their gait improve etc
How to assess function for neuro using qualitative approach
Compare to normal or unaffected side
-Requires a good understanding of components of normal movement
What activities might we want to assess in a neuro patient
Ability to move in bed, roll over, sitting, sitting balance, standing balance, sit to stand, walking, upper limbs, picking up drink, fine motor movements, GAIT
Functions and components of upper arm movement
-Major function of the arm is to position the hand for manipulation and reaching
-Key components: shoulder flexion, shoulder external rotation, shoulder abduction, elbow flexion and extension
- Hand: grasp, release and manipulate objects
- Radial deviation and wrist extension, wrist extension whilst holding object, opposition of thumb and finders, extension of MCP jts with IP jts in flexion, supination/pronation of forearm while holding object
What is the MAS?
Measures a range of functional activties from balance, mobility and upper limb function
-8 items that assess motor function (sitting extension of wrist- placing object in hand, lift object off table without elbow flexion etc)
-0 is nothing 6 is yes
What is the BBS (Berg Balance Scale)?
-Purpose: assesses status and dynamic balance and fall risk in adult populations
-14 items that assess balance in different positions and settings within each item there are 5 levels of scoring, 0-4
-0 is poor, 4 is optimal
-Non standardised outcomes may be more appropriate
-Doesn’t detect small levels of change etc
What is TUG?
-Timed up and go (3 metre walk)
-Patient sits in chair with back against chair back
-On the command go patient rises, walks 3 metres and turns and walks back and sits down
-Quicker than MAS and more accessible
