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UM - Neuro Science > Muscle Spindle & GTO Neurophysiology & Application - E1 > Flashcards

Muscle Spindle & GTO Neurophysiology & Application - E1 Flashcards

Learn the basics of mm spindle and GTO fibers and neurons and apply it to reflex Arcs, DTR, Clonus, Tonic Reflexes

1
Q

What do muscle spindles sense?

A

Change in muscle length

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2
Q

What do GTOs sense?

A

Change in muscle tension/force

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3
Q

MM spindles run __ to true mm fibers (extrafusile)

A

Parallel

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4
Q

GTO run ___ to true mm fibers (extrafusile)

A

In series

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5
Q

What are mm spindles and GTOs primary function?

A

Proprioception

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6
Q

Where is the GTO?

A

At the musculotendinous junction b/t the tendon and muscle

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7
Q

List the two types of mm spindle fibers

A

Nuclear bag

Nuclear chain

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8
Q

What is a nuclear bag?

A

Either static or dynamic, a type of mm spindle fiber with a large diameter, with clustered, central nuclei

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9
Q

What is a nuclear chain?

A

A type of mm spindle fiber with a small diameter and nuclei spread out

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10
Q

T or F : mm spindles can contract

A

True - note striations at the end of mm spindle fibers

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11
Q

What is the primary receptor type of …
Ia phasics
Ia tonics

A

a&b) annulospiral receptors

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12
Q

What do a/b/c arise from?

a) Ia phasics
b) Ia tonics
c) Ib afferents

A

a) Dynamic nuclear bag cnetral area
b) Nuclear chain area
c) In GTO

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13
Q

What does (a/b/c) sense?

a) Ia phasics
b) Ia tonics
c) Ib afferents

A

a) Rate of mm lengthening (velocity) and mm length changes
b) Just mm length changes
c) Tension/force changes (passive/active elongation)

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14
Q

Ia phasics [facilitate/inhibit] the agonist via ___

A

Ia phasics FACILITATE the agonist via the alpha motor neuron (monosynaptic reflex arc)

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15
Q

Ia tonics [facilitate/inhibit] the agonist via ___

A

Ia tonics Facilitate the agonist via the alpha motor neuron (monosynaptic reflex arc)

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16
Q

Ia phasics [facilitate/inhibit] the antagonist via ___

A

Ia phasics INHIBIT the antagonist through the interneuron (diasynaptic reflex arc)

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17
Q

Ia tonics [facilitate/inhibit] the antagonist via ___

A

Ia tonics INHIBIT the antagonist through the interneuron (diasynaptic reflex arc)

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18
Q

What do the ascending fibers of Ia tonics, Ia phasics, and II afferents form?

A

The P/DCML

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19
Q

What does the quick stretch reflex stimulate?

A

The Ia tonic and Ia phasics

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20
Q

Give an example of reciprocal inhibition in an individual with a C7 SCI

A

Elicit contraction of triceps to facilitate (+) the triceps and inhibit the antagonist - biceps

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21
Q

Ib afferents [facilitate/inhibit] the agonist via ___

A

Ib afferent inhibit the agonist via an IN to alpha motor neuron (diasynaptic)

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22
Q

Ib afferents [facilitate/inhibit] the antagonist via ___

A

Ib afferent facilitate the antagonist via the alpha motor neuron (monosynaptic)

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23
Q

What is the basic mechanism to stimulate the GTO

A

cross fiber massage

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24
Q

How many mm fibers is a GTO connected to?

A

15-20 mm fibers

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25
Q

T or F: GTOs only respond to concentric changes

A

FALSE - respond to isometric, concentric, or eccentric w/as little as 2-25 g of force

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26
Q

Which fibers are responsible for crude gait?

A

II afferents with the crossed flexion-extension reflex (flexion ipsilateral, extension CL)

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27
Q

What neuron types are best at sensing quick stretch?

A

Ia phasics

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28
Q

What is clonus

A

Repeated, sustained contractions due to a quick stretch reflex

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29
Q

II afferents arise from ….

A

Flower spray receptors on the polar ends of the nuclear chain fibers and the static nuclear bag fibers

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30
Q

Stretch of mm spindle causes II afferents to ….

A

Send sensory information to the spinal cord

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31
Q

What neuron fibers contribute to crossed extension reflex?

A

II afferents

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32
Q

II afferents [facilitate/inhibit] the …. via _____

a) IPSI flexor
b) IPSI extensor
c) CL flexor
d) CL extensor

A

a) Facilitate the ipsilateral flexors via the alpha motor neuron (monosynaptic)
b) Inhibit the ipsilateral extensors via an IN to the alpha motor neuron (diasynaptic)
c) Inhibit the contralateral flexors via an interneuron to the alpha motor neuron (diasynaptic)
d) Facilitate the contralateral extensors via the alpha motor neuron (monosynaptic)

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33
Q

What are the key mm still function for an individual with a C4 SCI

A

Upper Traps, Accessory neck mm, deep neck mm, diaphragm

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34
Q

What are the key mm still function for an individual with a C5 SCI

A

Biceps, wrist extensors (ASIA - elbow flexors)

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35
Q

What are the key mm still function for an individual with a C6 SCI

A

Wrist extensors, SA, Lats (ASIA - wrist extensors)

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36
Q

What are the key mm still function for an individual with a C7 SCI

A

Triceps, Intercostals mm of first seven ribs, back extensors C1-C7 (ASIA - elbow extensors)

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37
Q

What is the scoring system for DTR?

A

A continuum:
0 & 1: hypoactive
2: normal
3 & 4: hyperactive

0     = absent
\+      = hypoactive
\++    = normal
\+++  = brisk
\++++ = hyperactive
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38
Q

What is a hypertonic reflex indicative of?

A

An UMN lesion -

An uncontrolled or uninhibited reflex arc activity

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39
Q

What is a hypotonic reflex indicative of?

A

A LMN or UMN lesion -

An underfacilitated relfex arc activity

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40
Q

What do you measure with a modified ashworth scale (MAS)?

A

Hypertonicity only

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41
Q

What do you measure with DTRs?

A

Hypertonicity or hypotonicity

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42
Q

What is the scoring system of the modified ashworth scale (MAS)?

A

A continuum:
0 = normal
1, 1+, 2, 3, 4 = increasing levels of hypertonicity

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43
Q

When is passive stretching the MOST appropriate?

A

When there are NO FUNCTIONING mm around the joint - neither agonist, synergist, or antagonist

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44
Q

What is the most appropriate stretching mechanism with a mm contraction end-feel?

A

Active stretching technique to stretch mm better

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45
Q

What is the most appropriate stretching mechanism with a myofascial restriction end-feel?

A

Myofascial release techniques

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46
Q

What is the most appropriate stretching mechanism with a soft end-feel?

A

Soft tissue mobilization (superficial to deep), scar mobilization, or functional massage

47
Q

What is the most appropriate stretching mechanism with a joint/capsular end-feel?

A

Joint mobilization - not quite a “stretch”

48
Q

Contract - Relax steps

A

1) go to point of restriction
2) pull against resistance (allow Pt to move a little)
3) As Pt relaxes, take the Pt out as far as they can –> new point of resistance

49
Q

What is the neurophysiology behind contract - relax

A

Active concentric contraction of the agnoist may induce relaxation of the agonist (mm spindle neurophys)

50
Q

Hold - Relax steps

A

1) Go to the point of restriction
2) Have Pt hooooooooold against resistance (NO MVMT)
3) As Pt relaxes, bring them into a new range

51
Q

What is the neurophysiology behind hold- relax

A

Strong contraction of the agonist may trigger the GTO to inhibit the agonist (GTO neurophys) OR may cause immediate relax of the agonist after the strong contraction (mm spindle neurophys)

52
Q

What are the steps of reciprocal inhibition

A

1) Go to the point of restriction
2) Have Pt hold against antagonist
3) Bring Pt into new range

53
Q

What is the neurophysiology behind reciprocal inhibition

A

Facilitate the agnoist and Inhibit the antagonist via the mm spindle neurophys (Ia phasics come in and go to IN to inhibit the antagonist )

54
Q

Cross fiber massage steps

A

1) Find mm tendon @ musculotendinous junction
2) Start at end of range
3) do cross fiber massage to stimulate GTO to get inhibition and more range
4) Move Pt into the new range

55
Q

What is mm spindle bias?

A

The tendency for the mm to resume its original length since the mm spindle wants to assume its original, pre-stretch length

56
Q

What is TVR?

A

Tonic vibratory reflex: vibrating the skeletal mm at a high frequency to induce a tonic contraction of the mm being vibrated

57
Q

How does TVR work?

A

It selectively stimulates the mm spindle (Ia phasics) causing them to fire at the same frequency of the vibrator to facilitate the agonist and inhibit the antagonist

58
Q

What Hz do you want to do TVR at?

A

60 Hz kids
100-120 for adults
over 200 can cause damage

59
Q

Where should you be cautions with TVR?

A

Around the carotid arteries or other major blood vessels

- do not want to dislodge a clot and cause a stroke

60
Q

What is the neurophys behind cross fiber massage

A

Cause firing of the GTO to be >

Ib sensory nerve firing to inhibit agonist and facilitate the antagonist

61
Q

What is the primary function of sensory receptors

A

To monitor the internal and external environment (detect force, proprioception, explore/manipulate the environment, detect harm)

62
Q

Define sensation

A

Receptors receive and route info to SC to higher centers (for processing)

63
Q

Define perception

A

The integration of sensory info from many sensory sources

64
Q

What are III and IV afferents?

A

Cutaneous and joint receptors that bring proprioceptive info to the SC, cerebellum, and cortex BUT mostly just at extremes of range

65
Q

What gives us the best information about joint position?

A

MM spindles and GTOs

66
Q

How does the CNS regulate the sensitivity of our proprioceptive system?

A

Efferent motor neurons -

when they are firing, they create enhanced sensitivity of the mm spindle

67
Q

List some efferent neurons

A

Gamma motor neurons - static and dynamic

Alpha motor neurons

68
Q

What do … innervate?

a) static gamma mn
b) dynamic gamma mn
c) alpha mn

A

a) static gamma mn innervate the contractile ends of the static nuclear bag and nuclear chain fibers (intrafusal)
b) dynamic gamma mn innervate the contractile ends of the dynamic nuclear bag fibers (intrafusal)
c) alpha mn innervate the extrafusal mm fibers

69
Q

What regulates the efferent mn pathways?

A

Descending motor tracts

eg: CST, VST, RST, etc

70
Q

Give an example of enhanced proprioception

A

The firing of dynamic and static gamma mn at night to help increase proprioception to sense objects while walking at night

71
Q

What composes a sensory unit?

A

Sensory receptors, a sensory neuron, and its many branches

72
Q

List the sensory receptors - superficial to deep

A 
Meissner's corpuscle
Merkle corpuscle
Free nerve endings
Krause
Corpuscle of ruffini
Pacinian corpuscle
73
Q

T or F: Sensory receptors are transducers

A

True; they all convert one type of E to another (electro-chemical end result)

74
Q

What is modality specific

A

when a receptor responds most efficiently to one type of sensory stimulus

75
Q

What is a polymodal recptor?

A

responds to multiple stimuli - free nerve endings

76
Q

What do meissner’s corpuscles sense?

A

Pressure and touch (they are mechanoreceptors)

77
Q

What do Krause receptors sense?

A

Cold

78
Q

What do ruffini corpuscles sense

A

Warm

79
Q

What to pacinian corpuscles sense

A

Touch and vibration in joints, tendon sheaths, and skin (mechanoreceptors)

80
Q

What is a free nerve ending?

A

An unmyelinated terminal of myelinated and unmyelinated neurons

81
Q

How are we able to sense the direction our hair is moved?

A

Free nerve endings that wrap around a hair follicle tell us direction of light touch

82
Q

What do free nerve endings sense?

A

Cold, warm, touch, and pain

83
Q

Define mechanoreceptor

A

Respond to physical stimulation that causes mechanical displacement of one or more tissues

84
Q

Where do you typically find meissner’s corpuscles

A

In the hairless portions of the skin (palms, soles, toes, fingers)

85
Q

How does a pacinian corpuscle work?

A

It is a phasic receptor -

1) Pressure touch deforms it (depolorization) “on”
2) Fluid redistributes quickly in the corpuscle following deformation “off”
3) when stimulus is then removed, PC changes shape again (depolorazation) “on”

86
Q

Phasic vs tonic receptor

A

Phasics are fast adapting (miliseconds) and tonic receptors are slow adapting (minutes, hours, days)

87
Q

What are examples of phasic receptors?

A 
Meissner's corpuscle (RA1)
Pacinian corpuscle (RA 2)
88
Q

What are examples of tonic receptors?

A 
MM spindle
GTO
Merkel cell (SA 1)
Ruffini ending (SA 2)
Carotid baroreceptor
89
Q

What is on the pain ends of temperature feeling? (cold-pain and hot-pain)

A

Free nerve endings

0-15 and >45-50

90
Q

What is the approximate T range for Krause receptors to be active (Celcius)

A

10-45 C w/peak between 20 & 30

91
Q

What is the approximate T range for Ruffini receptors to be active (Celcius)

A

30-45 w/peak 40-45 C

92
Q

What factors contribute to our perceievd temperature?

A

Air T
Wind speed
Solar and thermal radiation
Humidity

93
Q

What are nociceptors

A

Detect pain -

They detect actual or potentially destructive mechanical, chemical, or thermal changes in the immediate tissue

94
Q

Hypertonicity is a result of a _MN lesion

A

UMN always

95
Q

Hypotonicity is a result of a _MN lesion

A

UMN or LMN lesion

96
Q

Two-point discrimination - from closest to farthest

a) forearm
b) back
c) Fingertip

A

Finger tip > forearm > back

97
Q

What broadman areas is the pre-central gyrus

A

4

98
Q

What broadman areas is the post-central gyrus

A

3, 1, 2

99
Q

What is a receptive field

A

An area of the sense organ that when stimulated, will activate a single afferent neuron w/the center being the most sensitive to the stimulus

100
Q

How does 2-pt discrimination work?

A

You will only perceive two different points if you overlap 2 different receptive fields. Receptive field size changes dependent upon where you are

101
Q

Relationship b/t size of receptive field and sensory acuity

A

Inversely proportional - the smaller the receptive field the greater the sensory acuity

102
Q

What is perception?

Give an example

A

The integration of sensory information from many sensory sources (Vision, hearing, smelling, and touching)
- Recognizing your dog or cat as your own

103
Q

What is graphesthesia

A

The ability to identify characters that are written on the skin - tests cortical sensation/perception

104
Q

What are some ways to test cortical sensation/perception

A

Graphesthesia and sterognosis

105
Q

What is sterognosis

A

The ability to identify objects placed in the hand with eyes closed

106
Q

Asterognosis

A

The inability to distinguish two objects placed in the hand (tactile agnosia) or by sight (visual agnosia)

107
Q

What is body image

A

Awareness of body parts and their relationship to one another and the environment

108
Q

What are body image disorders?

A

Perceptual disorders associated w/PARIETAL*** and temporal lobe lesions (most commonly w/Right brain lesions)

109
Q

What is asomatognosia

A

Lack of awareness of the body structure and the rln of body parts to one another

110
Q

What is hemi-asomatognosia

A

Decreased awareness of one side of the body (usually on the Left)

111
Q

What is hemi-spatial neglect

A

Most common on the RIGHT (non-dominant) PARIETAL cortex, causing patients to neglect the left side of their environment

112
Q

What is apraxia

A

inability to follow a motor command that is not due to a primary motor deficit or language impairment, but a deficit in higher-order planning PLUS inability to carry out the motor plan

113
Q

What is ideomotor apraxia

A

Can plan/conceptualize, but not carry out the motor tasks

able to make gestures spontaneously, but cannot produce same movements if asked

114
Q

What is ideational apraxia

A

Cannot come up with the plan or concept of the task & cannot carry out the action spontaneously or on command

UM - Neuro Science (9 decks)

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