Module 7 (Ch. 17) Flashcards

1
Q

What is a neuron?

A

Cell specialized to carry electrical signal

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2
Q

What is a nerve impulse?

A

Electrical signal carried by neurons

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3
Q

What are the 3 components of a neuron?

A

Dendrites
Cell body
Axon

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4
Q

What carries nerve impulse toward cell body?

A

Dendrites

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5
Q

What carries nerve impulse away from cell body?

A

Axon

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6
Q

What are afferent neurons?

A

Sensory neurons

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7
Q

What is an integrative neuron?

A

Integrates/processes the sensory stimuli received from sensory neurons

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8
Q

What are efferent neurons?

A

Motor neurons

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9
Q

[Gray/White] matter is on the outside of the cerebrum.

A

Gray

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10
Q

[Gray/White] matter is on the inside of the cerebrum.

A

White

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11
Q

What are isolated clusters of gray matter found within white matter called?

A

Nuclei or ganglia

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12
Q

Why is white matter white?

A

Myelin

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13
Q

What does myelin do?

A

Sheaths axons and helps speed conduction of nerve impulses

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14
Q

Where do connections and processing occur in the brain?

A

Gray matter of cerebrum (then sent to the white matter to carry signals to distant sites)

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15
Q

The inside of the spinal cord is [gray/white] and the outside is [gray/white]

A

Inside: gray
Outside: white

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16
Q

Where do connections occur in the spinal cord?

A

Inner gray matter

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17
Q

What are white matter tracts of the spinal cord composed of?

A

Ascending pathways - sensory information

Descending pathways - motor information

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18
Q

How many pairs of spinal nerves are there?

A

31

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19
Q

How many pairs of cranial nerves are there?

A

12

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20
Q

Can peripheral nerves contain both sensory and motor neurons?

A

While some are one or the other, some nerves are mixed

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21
Q

Where does voluntary motor control originate?

A

Cerebral cortex (outer portion of the cerebrum)

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22
Q

What is an upper motor neuron?

A

Motor neuron that travels down in a descending white matter tract of the spinal cord

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23
Q

What is a reflex arc?

A

Pathway of a reflex has an arc-like shape

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24
Q

What is the purpose of a reflex?

A

Automatic responses to protect from danger (specifically children)

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25
Q

How can we modify a reflex?

A

Descending connections from the brain to the reflex arc via UMN can increase response of a reflex or inhibit it

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26
Q

What is a learned/patterned behavior?

A

Activity that is learned and so well patterned that it is carried out in what appears to be a “reflexive” manner

After so many repetitions, can perform activity without conscious thought (like driving)

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27
Q

What is neural facilitation?

A

How all associations are made and why learned behaviors become so rooted in the nervous system

Functionally - responses reinforced through repetition and intensity
Structurally - physical changes to pathways of neurons that lower thresholds

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28
Q

What is the problem with neural facilitation in terms of a tight muscle?

A

If relationship of muscle tightening is not addressed, pattern of muscle tightening from certain stimuli becomes entrenched; triggering stimulus can tighten muscle more easily next time.

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29
Q

How is neural facilitation used in physical therapy?

A

Working with the nervous system, helping clients to unlearn pattern of response and relearn a new and healthier pattern of response.

Facilitating good technique is crucial in PT.

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30
Q

What is the Feldenkrais technique?

A

movement therapy that seeks to create client awareness of their movements including their faulty patterns of movement

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31
Q

What is reciprocal inhibition?

A

Neurologic reflex that causes antagonist to a joint action to relax when the mover is directed to contract.

Nervous system sends both facilitatory impulses to the LMN that control the mover and inhibitory impulses to the LMN that control the antagonist

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32
Q

How can reciprocal inhibition be used to palpate muscles?

A

If need to palpate a muscle that contracts with others, perform a function that inhibits the surrounding muscles.

Ex: palpating brachialis - flex forearm while pronated to activate brachialis but inhibit biceps

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33
Q

How can reciprocal inhibition be used to stretch muscles?

A

Have client contract mover muscle and inhibit the antagonist, which allows a deeper stretch of the antagonist.

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34
Q

What is proprioception?

A

Ability of the nervous system to know the body’s position in space and the body’s movement through space.

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35
Q

What are mechanoreceptors?

A

Sensory receptor cells sensitive to mechanical pressure stimuli

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36
Q

What are the 3 categories of proprioceptors

A

Fascial/joint
Muscle
Inner ear

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37
Q

What are the 2 major types of fascial/joint proprioceptors?

A

Pacini’s corpuscles

Ruffini’s endings

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38
Q

Muscle proprioceptors create proprioceptive reflexes in order to

A

protect muscles and tendons from injury

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39
Q

What are the 2 major types of muscle proprioceptors?

A

Muscle spindles

Golgi tendon organs

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40
Q

Proprioceptive sensation from the inner ear (both static and dynamic) is often referred to as the sense of…

A

equilibrium

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41
Q

Where are inner ear static proprioceptors for head position located?

A

In vestibule of inner ear

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42
Q

Where are inner ear dynamic proprioceptors for movement located?

A

Semicircular canals of inner ear

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43
Q

What other receptors can provide proprioceptive function besides mechanoreceptors?

A

Vision, pain, touch

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44
Q

Why do you have to close your eyes during a field sobriety test?

A

Alcohol decreases proprioception, but you can use your eyes to help make up for that loss

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45
Q

How does pain work proprioceptively?

A

Draws attention to that body part

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46
Q

What are the 2 deep (and major) mechanoreceptors of touch?

A

Pacini’s corpuscles
Ruffini’s endings

(Also joint proprioceptors)

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47
Q

What are the 4 superficial mechanoreceptors of touch?

A

Meissner’s corpuscles
Merkel’s discs
Krause’s end bulbs
Free nerve endings

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48
Q

Where are joint proprioceptors?

A

Within dense fascia, in and around joint capsules, in deep muscular fascia

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49
Q

What are joint proprioceptors?

A

Mechanoreceptors in and around capsules of joints

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50
Q

When a joint is compressed on one side, it is ______ on the other

A

stretched

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51
Q

What are interstitial myofascial receptors?

A

A 3rd group of mechanoreceptors (aside from Pacini’s corpuscles and Ruffini’s endings) found within joint capsules. Believed to be involved in pain reception and proprioception.

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52
Q

What is the main difference between Pacini’s corpuscles and Ruffini’s endings?

A

How quickly they adapt to the application of mechanical force.

Pacini's = quick
Ruffini's = slow
53
Q

Pacini’s corpuscles are sensitive to and stimulated only by changes in ______

A

position (movement)

[Due to quick adaptation to mechanical force]

54
Q

Ruffini’s endings are sensitive to and stimulated by ______

A

changes in joint position (movement) AND static position of the joint

[Due to slow adaptation to mechanical force; even when joint stops moving, it keeps firing to the CNS]

55
Q

What are examples of pressure reflexes (when pressure is applied to fascial/joint proprioceptors)?

A

Increase in circulation of blood to local area
Decrease in tone of muscles in local area
Decrease in sympathetic NS output

56
Q

What is a muscle spindle?

A

Muscle proprioceptor located within a muscle that is sensitive to stretch (lengthening of muscle - amount and speed)

57
Q

Where are muscle spindle cells?

A

Within the belly of the muscle and parallel to the fibers

58
Q

What muscles have the greatest proportion of muscle spindles?

A

Suboccipital group of the neck

Intertransversarii and rotatores of the spine

59
Q

How are muscle spindles similar to muscle cells?

A

They are contractile

Spindles are considered intrafusal while muscle cells are considered extrafusal

60
Q

What happens when a muscle is stretched and sends this sensory impulse to the CNS?

A

A reflex contraction of the muscle occurs - prevents excessive stretching that might tear the muscle.

61
Q

Why should stretches be done in a slow and gentle manner?

A

Due to the muscle spindle stretch reflex; hard or fast stretches will result in tightening and potential injury

62
Q

What is the muscle spindle reflex also called?

A

Myotactic reflex

63
Q

What is are gamma motor neurons?

A

UMNs and LMNs that set the sensitivity of muscle spindles

[Contracts intrafusal fibers]

64
Q

What are alpha motor neurons?

A

UMNs and LMNs that control muscle contraction

[Contracts extrafusal fibers]

65
Q

Muscle spindles are more sensitive when they are [taut/relaxed]

A

Taut

66
Q

Sensitivity of muscle spindles is set by UMNs based on what 3 factors?

A

Previous and present physical traumas to the region
Need for stability in the region
General emotional and physical stress levels

67
Q

What regions of the brain primarily influence and control gamma UMNs?

A

Brainstem nuclei
Hypothalamus
Amygdala
Cerebellum

68
Q

What other purpose do muscle spindles have outside of protection from injury?

A

Increase the strength of a muscle contraction immediately after it has been quickly stretched - reasons for backswings in sports

Used in plyometric training

69
Q

What sets muscle resting tone?

A

Gamma motor system - sets the sensitivity of spindles

70
Q

What is muscle facilitation?

A

Tone of muscle spindles (and therefore muscle itself) is set high

71
Q

What is muscle inhibition?

A

Tone of muscle spindles (and therefore muscle itself) is set low

72
Q

Positive to muscle facilitation?

A

Poised to respond to any stimulus and contract more quickly - important in sports

73
Q

Negative to muscle facilitation?

A

Muscle may tighten easily

74
Q

Positive to muscle inhibition?

A

Muscle more relaxed, less tight

75
Q

Negative to muscle inhibition?

A

Less able to respond to stimuli and tighten quickly and efficiently

76
Q

Should a muscle be more facilitated or inhibited?

A

Need to find a balance depending on the situation.

77
Q

What are muscles that tend to be overly facilitated?

A
Neck extensors
Pec major/minor
Subscap
Lumbar erector
Hip flexors/adductors
Hamstrings
Plantarflexors
78
Q

What are muscles that tend to be overly inhibited?

A
Longus colli/capitis
Lower traps/rhomboids
Infraspinatus/teres minor
Thoracic erector
Abs
Glute max
Vastus lateralis/medialis
Dorsiflexors
79
Q

What does “locked short” mean?

A

Facilitated muscles that shorten and tighten

80
Q

What does “locked long” mean?

A

Inhibited muscles that are lengthened out by locked short muscles, and are tight

81
Q

Why should bodyworkers know the difference between trigger points and global tightening of a muscle?

A

Trigger points require direct, local work; whereas global tightening is a CNS issue and requires working on the sensitivity setting of the muscle spindles.

82
Q

Where does muscle memory reside?

A

Nervous system

83
Q

What is upper crossed syndrome?

A

Tight upper trap and levator scap
Weak deep neck flexors

Tight pectoralis
Weak rhomboids/serratus anterior

84
Q

What is lower crossed syndrome?

A

Tight iliopsoas
Weak glute max

Tight erector spinae
Weak abdominals

85
Q

What is a golgi tendon organ?

A

Muscle proprioceptor located within a tendon of a muscle; sensitive to a pulling force placed on tendon (typically when muscle contracts)_

86
Q

What are golgi end organs?

A

Golgi receptors located in joint capsules and ligaments

87
Q

What is the Golgi tendon organ reflex (tendon reflex; inverse myotactic reflex)?

A

Reflex relaxation to prevent tearing of the tendon

88
Q

Which reflex is used as part of E-stim?

A

Golgi tendon organ reflex - causes muscle to contract and sustained for 5-10 minutes which triggers the reflex and relaxes the muscle

89
Q

How does the Golgi tendon organ reflex help in stretching?

A

Asking client to contract against resistance, and then relax, allows therapist to stretch the muscle further

Called contract-relax stretching
OR post-isometric relaxation stretching
OR proprioceptive neuromuscular facilitation

90
Q

What are the macula of the inner ear?

A

Provide proprioception info to the brain about the static position of the head

91
Q

What are the crista ampullaris of the inner ear?

A

Provide proprioception info to the brain about movement of the head

92
Q

Information from inner ear (labyrinthine) proprioceptors, as well as sense of hearing from cochlea, travel in which nerve?

A

CN VIII (vestibulocochlear nerve)

93
Q

How many maculae are in the vestibule?

A

2

94
Q

What is a macula made of?

A

Gelatinous substance with hair cells that attach to sensory neurons, and otoliths

95
Q

What are otoliths?

A

Crystals in the gel of a macula that increase its weight, making it more responsive to changes in position

96
Q

How are impulses generated by the macula?

A

Position of the head causes otoliths to fall with gravity, which causes the hairs to bend and stimulate the sensory neurons

97
Q

How many crista ampullaris structures are in the semicircular canals?

A

3 (1 in each canal)

98
Q

What plane do the semicircular canals reside in?

A

1 canal resides in each cardinal plane (sagittal, frontal, transverse)

99
Q

What is a semicircular canal?

A

Fluid-filled canal with an expanded end called the ampulla (where the crista ampullaris is located)

100
Q

What is the crista ampullaris?

A

Structure with hair cells attached to sensory neurons

101
Q

How do the crista ampullaris provide dynamic proprioception?

A

When head moves, fluid is set in motion in 1 or more canal; this bends the hair cells

102
Q

What is the righting reflex?

A

Whenever head becomes unlevel, righting reflex directs muscles of body to alter position of the joints to bring head back to level position

103
Q

What is dizziness?

A

Proprioceptive confusion; when a disagreement exists between what the various proprioceptors of the body report regarding the position and/or movement of the head

104
Q

How does the brain know about trunk posture?

A

Joint and muscular proprioceptors of the neck (whether its straight or bent)

105
Q

How do neck injuries (whiplash, etc) cause dizziness?

A

Incorrect proprioceptive signals may be sent from the neck to the brain, which contradict other signals (like from the eyes) - this causes proprioceptive confusion –> dizziness

106
Q

What is the flexor withdrawal reflex?

A

Flexion withdrawal movement of a body part when that part experiences pain (meant for protection from injury)

Note: reciprocal inhibition occurs in the extensors

107
Q

What is the crossed extensor reflex?

A

This works with the flexor withdrawal reflex; as body part flexes and withdraws, extensor muscles of the contralateral extremity contract into extension (meant to create balanced posture)

Note: reciprocal inhibition occurs in flexors of contralateral extremity

108
Q

What is the tonic neck reflex?

A

Contraction of the arm muscles based on change in position of the neck (e.g., neck rotates to the right, right arm extends and left arm flexes)

Note: reciprocal inhibition occurs in left flexors and right extensors in that scenario

109
Q

What is the purpose of the tonic neck reflex?

A

Orient the body in the direction which the head is oriented

110
Q

What is the purpose of the righting reflex?

A

To keep us upright in a balanced position

111
Q

What is the (labyrinthine) righting reflex?

A

If inner ear perceives posture might lead to falling, information is sent to the brain and then the spinal cord to contract muscles to keep us upright

Ex: during a back dive, the backward bend of the neck causes reflex contraction of trunk and arm flexors (athletes have to override this)

112
Q

What is a hypnic jerk?

A

A sudden and strong muscular twitch when falling asleep

Theory is that when muscles relax, sudden change in joint position is perceived as falling and body is ordered to contract to stop the fall

113
Q

What is the cutaneous reflex?

A

Relaxation in musculature after massage or heat

114
Q

What is the pain-spasm-pain cycle?

A

Vicious cycle of pain causing muscular spasm, which causes further pain, which causes further spasming, and so forth

115
Q

What is muscle splinting?

A

Muscle spasm caused by the nervous system to keep an injured area from moving so it can heal

116
Q

What is body armoring?

A

When a person armors the body by splinting/spasming muscles in a region of the body for emotional or psychologic reasons (ex: broken heart –> chest tightening)

117
Q

As muscle spasming continues, pain increases because of what 2 factors?

A
  1. Strong pull of contraction on attachments at rest as well, increased with movement
  2. Compromised blood flow (closed venous return of blood to heart - waste products contain acidic substances that irritate nerves; if artery is blocked, body cells deprived of nutrients)
118
Q

What is it called when a muscle spasm is so strong that it blocks off arterial blood supply?

A

Ischemia

119
Q

How can trainers help stop the pain-spasm-pain cycle?

A

Guide client through exercises that will gradually stretch and loosen the musculature and facilitate venous return of blood; exercise can also release endorphins

120
Q

What are endorphins?

A

Morphine produced within the body

121
Q

How can bodyworkers help stop the pain-spasm-pain cycle?

A

Soft tissue techniques such as massage and stretching to relax the musculature; massage and range of motion techniques that focus on increasing venous circulation

122
Q

What is the gate theory?

A

Proposes a gating mechanism (in spinal cord) is present in the nervous system that blocks the perception of pain when faster signals of movement or pressure occur at the same time.

Movement and/or pressure sensations can close the gate and prevent transmission of pain signals.

(pain is carried in slow unmyelinated neurons)

123
Q

What senses are carried by slow neurons? fast neurons?

A
Slow = pain
Fast = movement, pressure
124
Q

Why does a person shake or squeeze a hand when it is cut or burned?

A

Gate theory - shaking causes movement signals and squeezing causes pressure signals to enter the brain at the same time as the pain; because they are faster than pain signals, they can block the sensation of pain

125
Q

How does gate theory explain fight or flight?

A

When involved in a potentially dangerous situation, being distracted by pain would hamper our ability to fight or take flight

126
Q

Why is it that you often don’t realize that you overdid it in a workout until hours later or the next day?

A

Gate theory - movement and pressure from the workout blocked pain signals.

127
Q

How do topical balms containing menthol, oil of wintergreen, and eucalyptus use the gate theory?

A

They irritate the skin and distract the body from pain (counterirritant theory)

128
Q

What is counterirritant theory?

A

Using balms to relieve pain via gate theory