Nervous System Changes

Question 1

Experience dependent

Answer 1

Unique, unpredictable experiences dependent on the context

Motor learning as part of motor development

Question 2

PNS growth rate

Answer 2

1 mm per day
1 in per month

Better chance of recovery with myelin sheath intact

Question 3

Dead CNS neurons replaced by…

Answer 3

Glia

Question 4

Vicariation of fx

Answer 4

Another part of brain takes over fx of damaged areas

Question 5

Brain weight changes

Answer 5

@ birth = 25% of adult brain

Puberty = adult brain weight obtained

Question 6

Periods for brain growth?

Answer 6

Yes and it is related to stages of cognitive development and language development

Question 7

Decline in brain weight…

Answer 7

20

Cortex becomes thinner
Majority of loss occurs in WHITE matter (myelin)
Frontal + temporal > Parietal

15% loss throughout lifespan

Question 8

Frontal lobe

Answer 8

Executive fx
Decision making
Personality
Primary motor cx

Question 9

Parietal lobe

Answer 9

Somatosensory

Question 10

Temporal lobe

Answer 10

Memory
Language
Communication
Limbic system

Question 11

Max neuron and glial cells…

Answer 11

Prenatal period

Question 12

Dendritic branching

Answer 12

Adult levels at 12-16 years

Question 13

Hippocampus

Answer 13

30% loss after 30

ST to LT memory integration
Spatial navigation

Question 14

Brain structures that don’t typically show significant loss of neurons

Answer 14

Basal ganglia

Vital fx areas of brain stem

Question 15

Neuronal shrinkage v death

Answer 15

Shrinkage more dominant when aging

Question 16

Glial changes

Answer 16

Increased number of astrocytes and microglia

Decreased number of oligodendrocytes

Question 17

CNS adaptability

Answer 17

Into 70!

Question 18

Glucose metabolism

Answer 18

Measure of fxl maturation of brain

Newborn: primary motor and sensory cx, thalamus, brain stem, and midline of cerebellum

2-3 mo: P, T, primary visual cx, basal ganglia, and cerebellum hemispheres

6-8 mo: increase in frontal lobes

8-12 mo: frontal the most

Question 19

Glucose metabolism lower in…

Answer 19

Infancy

Question 20

NCV

Answer 20

PNS myelination done at birth
All CN except optic myelinated
Increases quickly after birth
Begins to decline at 30

Decreased by 1 m/sec each decade after 15-24 years

Question 21

Rxn time

Answer 21

Time btwn stimulus and motor response

Slower in children than adults
Peaks in young adulthood
Slows by 15-30% in older adulthood

Question 22

3 parts of rxn time

Answer 22

1. Sensory transmission of input

“Visual cue”

2. Motor execution time

“Foot from gas to break”

3. Central processing - majority loss c age, but TRAINABLE

Stimulus ID - that’s a light
Response selection - what are you going to do
Response programming - motor planning

Question 23

Implicit memory

Answer 23

Procedural

Riding a bike

Question 24

Explicit memory

Answer 24

Declarative

Recall

Question 25

Working memory

Answer 25

Process of integrating ST into LT memory

Question 26

Intellectual ability peak

Answer 26

20-30 Maintained til 75

Question 27

Dementia

Answer 27

Impairment of some or all aspects of intellectual functioning as compared to previous level of cognition Reversible - TBI, concussion Irreversible - disease ``` Affects at least one... Abstract thinking Judgement and problem solving Language Personality ```

Question 28

Criteria for dementia diagnosis

Answer 28

* Unmistakable deterioration in at least 2 cognitive domains * History of intellectual decline * Formal mental status testing

Question 29

Mini-Mental State

Answer 29

30 is normal | Lower = lower cognitive level

Question 30

Benign Senescent Forgetfulness

Answer 30

Persons with evidence of cognitive impairment who do not meet present clinical criteria for dementia

Question 31

Mild cognitive impairment

Answer 31

Mild but measurable impairment in thinking skills without presence of dementia Memory-related: forget they had a convo, forget appts Non-memory related: more prevalent * thinking skills * making sound decisions * abstract thinking impaired

Question 32

AD

Answer 32

Prevalent Onset after 65 Females > males (estrogen, longer life expectancy) No known cause

Question 33

AD genetic predisposition

Answer 33

RISK gene apolipoprotein E-e4 (APOE-e4) Deterministic genes - APP, PS-1, PS-2 *if caused by these, it's called ADAD or familial Alzheimer's

Question 34

AD Risk Factors

Answer 34

``` Age APOE-e4 Fewer years formal education Head trauma HTN High cholesterol Family history ```

Question 35

AD clinical manifestations

Answer 35

``` Gradual memory loss Decline in ability to perform routine tasks Disorientation time and space Impaired judgment Personality changes Difficulty in learning Loss of language and communication skills General physical decline ```

Question 36

AD pathology

Answer 36

Atrophy and dilation of ventricles Neurotic (beta-amyloid) plaques Neurofibrillary tangles (tau) Larger # in T + P with extension into F Narrow gyri Wide sulci Seen especially in F and T lobes

Question 37

Pick's disease

Answer 37

Degenerative dementia of unknown origin Personality changes precede intellectual decline MRI: + for frontal and temporal lobe atrophy

Question 38

AD course/prognosis

Answer 38

May be periods of plateau Initial symptoms = memory loss Later = physical deficits and will need complete care

Question 39

Appropriate goals for AD stages

Answer 39

Early stage - balance training, caregiver education Middle stage - gait training, mm disuse atrophy, flexibility, rxn times Late stage - PROM, caregiver instruction, assistive device use, bed mobility

Question 40

AD implications for PT

Answer 40

Physical activity - can alter progression Motor learning - implicit/procedural learning and memory remain intact later BLOCKED practice

Question 41

AD outcome measures

Answer 41

TUG 6MWT Gait speed

Question 42

Experience expectant

Answer 42

If exposed to expected environmental stimuli = appropriate development