Motor Impairment Flashcards by Rachel Catania

diffrence between a sign and symptom

sign- things i see- bp, hr
symptom- what pt feels (subjective)- pain, dizzyness

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diffrence between primary and secoundary impairment

secondary example- structural and functional changes in muscles and joints (atrophy, stiffness, etc.)

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diffrence between positive vs negitive impairment

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neuroanatomy involved for a lower motor lesion?

alpha motor neuron and out:
-ventral root
-motor nerve plexus
-peripheral motor nerve
-neuromuscular junction

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neuroanatomy involved for a upper motor lesion?

spinal cord proximal to alpha motor neuron:
-motor cortex
-depending motor tracts
-brainstem

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What are the major signs associated with UMN lesions

Weakness, increased reflex and tone

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What are the major signs associated with LMN lesions?

weakness, atrophy, fasciculations (muscle twitch), decreased reflexes and tone

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What are the neural contributions related to strength? (what goes into it)

number/type of motor units recruited
discharge frequency

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explain why reflexes and tone are usually dependent on each other

Reflexes and muscle tone are usually linked because they both rely on the same spinal circuits and sensory feedback from muscle spindles. If one is affected (like by damage or disease), it often changes the other since they share a common neural pathway for regulating muscle activity.

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what is fasciculations

(muscle twitch)

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with a stroke- is it UMN or LMN

UMN

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Brachial plexus injury- UMN or LMN

LMN

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explain the difffrence in discharge frequency between lifting something light vs heavy

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explain how motor recruitment differs in a normal vs abnormal case

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explain how -fiber arrangement could be an MSK contribution related to strength?

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explain how type of muscle fiber could be an MSK contribution related to strength?

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explain how cross-sectional area of muscle could be an MSK contribution related to strength?

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explain how
-length of the movement arm of the muscle
-length/ tension relationship
could be an MSK contribution related to strength?

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when would motor recruitment get worse

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weakness is the inability to gererate __

force

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in the context of neuropathology weakness is the inability to correctly and/or adecuatly ___

recruite/ modulate motor neurons

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5 examples of what a neurologically induced weakness could result from

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paralysis or plegia

total or profound loss of muscle activity

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paresis

mild or partial loss of muscle activity

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monoplegia/ paresis

hemiplegia/ paresis

paraplegia/ paresis or diplegia/ paresis

tetraplegia/paresis

What is a muscle synergist

-assist the primary agonist muscle

what is synergies

ACITVE (only happens in movment) loss of single joint, isolated movment patterns example- the dominence of flexors kick in and its hard for pt to turn them off (hard to reach cup but not hard to bring to face for UE flexor) -instead of reaching for something everything shrivels up

What movements are associated with an upper extremity flexor synergy?

scapula retraction and elevation, shoulder ABD and ER, elbow flexion, supination, wrist and finger flexion

What movements are associated with a lower extremity extensor synergy?

hip exstention, ADD and IR, knee exstention, ankle PF and inversion, toe PF (hard to flex... think walk in exstention)

explain why a LMN result in a reflex abnormality

What areas, when damaged, impact the integrity of the stretch reflex?

supraspinal structures involved in reflex modulation: lateral corticospinal tract, cerebellum spinal cord: interneurons, motor neurons sensory feedback loops

What is the difference between areflexia, hyporeflexia, and hyperreflexia and what type of injury is each associated with?

a= no reflex hypo= low, LMN hyer= high, UMN

explain tone

resistance to passive stretch

what is state of readiness

a state of residual contraction in normal muscles

is tone issues an active or passive prob

passive

what is flaccidity

complete loss of tone

explain hypotonicity and why it happens physiologically

reduction in passive resistence to lengthening "floppy"- collapse into gravity, harder to excite

what can cause hypertonia

spacicity, rigidity

what is spacicity and what can it be assosiated with

VELOCITY dependant increase in resistence to passive movment assosiated w clonus anytime you stretch a reflex

what is spacicity a result of anatomically

damage to the pyramidal tracts: - corticospinal tracts and assosiated anatomy - basis

with spacicity, what can occur relative to the reflexes

loss of inhibitory effect (can result in alterations of threshold of relflex) -clonus

define rigidity vs rigid

rigidity- hightened resistence to passive movment of limb INDEPENDANT OF VELOCITY rigid- cant move at all

what is rigidity commenly seen with anatomicly

basal ganglia dysfunction (like in parksinsons)

define lead pipe rigidity

smooth but consistant resistence throught rom

define cogwheel rigidity

jumpy- alternating episodes of resistence and relaxation

define clasp knife rigidity-

hard initial then it gives - initial rigidity with sudden absence throughout remainder of range

what are some contributions to a normal muscle tone

-inertia, intrinsic mechanical elastic stiffness, reflexes, motor neurons in below tracts, cerebellar inputs cortico, rubro, reticulo, and vestibulo tracts, cerebellar

Why do we see hypotonicity/flaccidity after injury? What types of pathology do we see this reduction in tone with

with an injury we might have a disruption of afferent input from the stretch reflex-> lack of cerebellar influence and decreased motor neurons pathology- PNS and connective tissue disorders

How does acute CNS injuries progression with hypotonicity

progress to hypertonicity/ spacicity once subacute or chronic

Discuss some of the major functional implications of increased and decreased tone

explain dystonia? types?

sustained muscle contractions from damage to basal ganglia - twisting, repeditive, abnormal posture -coactivation of agonist/ anatagonist -focal, segmental, hemibody, or whole

explain tremors

diffrence between resting and action tremor and example

resting: while body is relaxed action: volentary contraction posteral: When you're holding a body part against gravity, but not moving it intentionally Example: Holding your arms outstretched → your hands start to shake intention: During voluntary movement, especially as you approach a target Example: Reaching for a cup → hand shakes more the closer you get

Define choreiform and athetoid movements. How do they differ

define normal coordination

bell shaped velocity, acceloration and deceloration

define incordination

loss of coupling between synergistic joints and muscles

what is incoordination typiclly tied with

motor cortex, basal ganglia, proprioceptive, and cerebellar lesions

What are the functional implications of incoordination?

timing difficulties and activation and sequencing porbs

define rebound phenomanon in regard to functional implcation of incoordination

think leaning on a door and it opens

define dysdiadochokinesia in regard to functional implcation of incoordination

inability to move rapidly thru motor patterms (usually alternating)

incoordination grading scale- dysetria

incoordination grading scale- hypermetria

incoordination grading scale- hypometria

How can we see impairments to ROM and joint alignment after a neurological injury?

increased resistence to stretch - decreased movment attemps inadewuate or inapporpriate motor recruitment- learned non use "i suck at r hand so just gonna use L" increased stiffness in joint- pic›

How does endurance get impacted after a neurological injury

What are some common causes of musculoskeletal pain seen after neurological injury

Motor Impairment Flashcards

(70 cards)