The Nervous System Flashcards
0
Q
What’s the autonomic nervous system?
A
“Internal workings”
Sympathetic & parasympathetic
1
Q
What’s the somatic nervous system?
A
“External workings”
CNS & PNS
2
Q
What’s the apgar scale? What’s an adequate score?
A
Eval integrity of function of the nervous system at birth A - appearance P- pulse G - grimace to pain A - activity R - respiration Perfect = 10, adequate = 7
3
Q
Function of cerebral cortex (related to mvmt)
A
Pre-motor, primary motor, & somatosensory processing
4
Q
Function of the thalamus (related to mvmt)
A
Center for sensation, mvmt, emotion & memory converge
5
Q
Function of cerebellum (related to mvmt) (3)
A
Smooth executive of voluntary mvmt, muscle tone & motor planning (via connect with pre-motor cortex)
6
Q
How are deficits with the cerebellum expressed (related to mvmt) (3)
A
Decreased muscle tone, deficits with voluntary mvmt, decreased postural control
7
Q
Function of basal ganglia (related to mvmt) (1)
A
Regulate mvmt via thalamus
8
Q
Probs with basal ganglia result in what deficits? (2)
A
Deficits in involuntary mvmt
Difficulty with initiation of functional mvmt
9
Q
What’s the corticospinal tract?
A
Primary pathway for voluntary mvmt
10
Q
What’s the limbic system responsible for?
A
It "MOVEs" us M - memory, motivation O - olfactory V - visceral/autonomic E - emotion
11
Q
What are the cerebellar tracts? (4)
A
Spinocerebellar
Ventral spinocerebellar
Cuneocerebellar
Rostral spinocerebellar
12
Q
What type of tracts of the cerebellar?
A
Ascending
13
Q
What’s the fasciculus cuneatus? - where’s it located? What info does it carry?
A
Located in dorsal column, ascending tract, info from UE
Prop, fine touch, vibration
14
Q
What’s the fasciculus gracilis? - where’s it located? What info does it carry?
A
Carries info from LE
Located in dorsal columns
Carries prop, fine touch, vibration
15
Q
What’s the spinothalamic? - What info does it carry?
A
Ascending tract
Carries crude touch, pain, pressure & temp
16
Q
What are descending tracts?
A
Rubrospinal
Vestibulospinal
Reticulospinal
Corticospinal
17
Q
What are the cranial nerves? Use the trick!
A
Olfactory Optic Oculomotor Trochlear Trigeminal Abducens Facial Vestibulocochlear Glossopharnyngeal Vagus Accessory Hypoglossal
18
Q
Cranial nerve: which are sensory, motor, or both?
A
Olfactory - s Optic - s Oculomotor - m Trochlear - m Trigeminal - b Abducens - m Facial - b Vestibulocochlear - s Glossopharnyngeal - b Vagus - b Accessory - m Hypoglossal - m
19
Q
How do you remember if a CN is s, m, or b?
A
Some say marry money but my brother says big boobs matter more
20
Q
What’s clonus? How’s it tested? What does it indicate?
A
Involuntary jerking of foot
Tested via quick dorsi flexion at ankle
Indicates prob with descending cortical tracts (UMN)
21
Q
What’s babinski? How’s it tested? What does it indicate?
A
Fanning of toes
Stroke along lateral aspect of foot
Sign of UMN paralysis
22
Q
What’s deep tendon reflex? How’s it tested? What does it indicate (2)?
A
Use quick stretch to elicit response from muscles spindle
A way to assess integrity of muscle spindle
Hyperactive response - issue w/descending motor pathway (umn - stroke, TBI)
Hyporeactive response - prob e/ reflex
arc - issue within spinal cord
23
Q
What’s hypertonia?
A
Increased muscle tone
24
What's spasticity? What type of issue does it indicate?
Increased resistance to mvmt in one direction.
| Indicates UMN lesion
25
What's decorticate posture?
Form of spasticity
Lesion above superior colliculus
UE flexion LE extension
26
What's descerebrate posture?
Form of spasticity
UE & LE extension
Lesion below superior colliculus (in brainstem) (stroke, near drowning
27
What's rigidity?
Increased resistance to mvmt in all directions
28
What's hypotonia? What damage does it indicate?
Decreased tone
| Cerebellum damage or LMN
29
What's chorea? Indicative of what dx?
Quick jerky/irregular mvmts, small amplitude, distal extremities
Huntington's disease
30
What's hemiballism? Indicative of what dx?
Lg involuntary mvmt "flinging"
| Subthalamic nucleus damage
31
What's athetosis? Indicative of what dx?
Slower, irregular mvmt, varying amplitude in entire extremity
Basal ganglia or cerebral palsy
32
What's dystonia? Indicative of what dx?
Slow twisting mvmt - sustained in trunk or extremity
| Globus pallidus lesion
33
What's tremor? Indicative of what dx?
```
Quick regular oscillating mvmt of small amplitude
Substantia nigra (dopamine) a Parkinson's
```
34
4 specific conditions associated with cerebellum damage
1. Dysmetria (over/undershoot reaching for object)
2. Dysdiadokinesia
3. Ataxia
4. Intention tremor
35
Romberg test
Tests systems used to stay upright - ability to stand with eyes occluded (vision, proprioception, vestibular)
36
Spinothalamic tract - carries what info?
Crude touch, pain, & temp
| Crosses in SC - travels contralaterally
37
Spinoreticular tract carries what info?
Dull/aching pain
38
Anterior lesion of spinal cord affects what?
Motor
39
Posterior lesion of spinal cord affects what?
Sensory
40
Describe Brown-Sequad Syndrome
```
Lesion to lateral aspect of spinal cord
Spinothalamic tract - contralateral
Dorsal columns - ipsilateral
So, eg: lesion on R side of SC produces
Lost pain sensation on L
Lost discrimination sensations on R
```
41
The dorsal columns include what tracts? What to they service?
Fasciculus gracilis (lower body)
Fasciculus cuneatus (upper body)
Travel ipsilaterally, cross in the brainstem
Carries light touch (discriminative), vibration, proprioception
Damage indicates positive Romberg test
42
What conditions are associated with damage to the spinal cord? (4)
Hypertonia
Hyperreflexia
Clonus
Paralysis
43
What's clonus?
Spasmodic involuntary contractions of affected muscles - induced via stretching
44
What conditions are associated with damage to the brain stem? (3)
```
Locked-in syndrome
Decerebrate rigidity (UE/LE ext)
Associated reactions (widespread increase in tone - overflow. Eg when one hand grasps an item, the other hand grasps as well)
```
45
What conditions are associated with damage to the basal ganglia? (2)
Athetosis
| Parkinson's (resting tremor, festinating gait)
46
What conditions are associated with damage to the cerebellar level? (5)
```
Ataxia
Dysmetria
Dysdiadochokinesia
Intention tremors
Asthenia (excessive fatigue in voluntary muscles)
```
47
What conditions are associated with damage to the cortical level (cerebral cortex)? (4)
Hemiplegia
Pathological reflexes (presence of reflexes that should be integrated)
Babinski sign
Hoffman's sign (tap fingernail or flex dip joint - elicits pinch action between index finger & thumb)
48
General characteristics associated with "right hemiplegic" (L sided insult) (4)
Language deficits
Anxiety
Slow/disorganized response to familiar tasks
Difficulty understanding verbal instructions
49
General deficits associated with "left hemiplegic" (R side insult) (4)
Impulsivity
Denial of disability
Distorted body image
Depth perception issues
50
Visual deficits: what is strabismus?
Eyes not yoked together (move in different directions)
51
Visual deficits: what is diplopia?
Double vision
52
Visual deficits: what are symptoms of nystagmus?
Oscillopsia (sensation of world moving)
53
Visual deficits: what are symptoms of lagophthalmos?
Incomplete eye closure
54
What's homonymous hemianopsia? What's a tx strategy?
Due to damage to optic pathway - lose half of vision. Compensate via lighthouse strategy
55
What's hemi-inattention? What side of insult is it associated with? Why? Tx strategy?
Visual neglect (eg L sided neglect). Associated with R side injury bc R is "gestalt" (whole pic). Always approach on hemiplegic side.
56
What's convergent insufficiency?
limited ability to bring eyes together along the midline axis (eg difficulty switching focus from far away to nearby)
57
Whats the result of visual field deficits?
Poor mobility - danger of running into things, etc.
58
What is oculomotor dysfunction? Symptoms? Tx?
Difficulty with smooth pursuits & rapid shifting saccades. Vision may be jerky, non-continuous, over or under-shooting objects. Results in difficulty w/ eye-hand action, finding objects, reduced visual memory. Tx - incorporate vestibular input with eye-hand activity
59
Principles of Proprioceptive Neuromuscular Facilitation (PNF) (11)
1. Human potential
2. Development is cervico-caudal & proximal-distal
3. Reflex activity is basis for motor development
4. Shifts between extensor & flexor patterns
5. Reversing mvmts make up functional mvmts
6. Balanced interactions/syngerism of antagonists
7. Development of motor behavior expressed as total pattens of mvmt & posture
8. Normal motor development is orderly, but not step-wise
9. Improved motor ability is dependent on motor learning
10. Repetition = retention
11. Goal-directed activities facilitate learning
60
PNF procedures (6)
1. Positioning
2. Manual contacts
3. Quick stretch
4. Tactile/Approximation
5. Resistance
6. Verbal commands
61
Contraindications for PNF (6)
1. Inflammatory arthritis
2. Malignancy
3. Bone disease
4. Bone fx
5. Congenital bone deformities
6. Joint subluxation
62
General/overall goal of PNF
Speed up the response of the neuromuscular mechanism through stimulation of the proprioceptors, which could result in either facilitation or inhibition
63
PNF - tactile system: gentle touch is used to...
guide the ct's mvmt
64
PNF - tactile system: quick stretch is used to...
initiate mvmt
65
PNF - tactile system: maximal resistance is used to...
strengthen mvmt
66
PNF - tactile system: joint traction is used to...
increase ROM
67
PNF - tactile system: joint approximation is used to...
promote joint stability & control
68
4 specific goals of PNF
1. Restore/enhance postural responses/normal mvmt
2. Enhance stability or mobility
3. Strengthen or stretch a group of muscles
4. Improve motor control for functional activities
69
5 common dx used with PNF
1. Parkinson's
2. SCI
3. CVA
4. TBI
5. Hand injuries
70
What's ideational apraxia? Symptoms?
Loss of ability to conceptualize/plan/execute tool use/use of everyday objects
Difficulty with planning, sequencing, & initiating action
71
Tx for ideational apraxia
Reteach the behavior via: 1. hand over hand, 2. modeling, 3. repetition, 4. simple instruction
72
What's dressing apraxia?
Inability to plan & carry out dressing tasks
| Results in difficulty orienting clothing, putting clothes on incorrectly,
73
Tx for dressing apraxia (4)
1. physical cues
2. chaining
3. using pics
4. highly structured & systematic
74
What's constructional apraxia? What are some practical implications?
Impaired ability to reconstruct 2D/3D designs
| Difficulty orientating clothing, loading dishwasher, assembling furniture, house cleaning, etc.
75
Tx for constructional apraxia
Teach to problem solve, anticipatory planning
76
What's agraphesthesia?
Inability to recognize numbers, letters, or forms traced onto the skin
77
What's ideomotor apraxia?
Inability to perform motor action on command, but is able to perform the mvmt automatically
78
What's topographical disorientation?
Inability to fine one's way around
79
What's anosagnosia?
Ct fails to recognize the presence or severity of their disability, especially paralysis
80
What's somatognosia?
Lack of awareness of body structure & the failure to recognize one's parts & their relationship to each other
81
What's unilateral neglect?
Inability to integrate & use perceptions from one side of the body - typically the left side
82
What's finger agnosia?
Difficulty naming fingers that have been touched
83
What's ideational apraxia?
Inability to form concepts of mvmt & the inability to execute an act in response to a command/automatically or unable to properly sequence
84
Strategies for working with memory impairment (3 internal strategies, 4 external strategies)
```
Internal:
1. Rehearsals (mental repetition)
2. Grouping (chunking) info
3. Verbalization
External:
1. Alert & cue
2. Backward chaining
3. Enviro cues
4. Written info
```
85
Tx approaches for cognitive dysfunction (5)
1. Adaptive (compensate)
2. Remedial (for specific cog deficits)
3. Process approach (changes to changing ct)
4. Multicontext approach
5. Self-monitoring strategies
86
What's Wernicke's aphasia?
AKA receptive aphasia - difficulty understanding language
87
What's Broca's aphasia?
AKA expressive aphasia - ct knows what they want to say, but cannot produce language
88
What's aprosodia? Which hemisphere injury is it associated with?
Inability to interpret emotional info - R hemisphere damage
89
What's dysarthria?
Neurological damage to motor components of speech leads to inability of muscles to articulate
