Week 5: Cerebellum and Basal Ganglia

Question 1

Cerebellum

Answer 1

“The little brain”
- Voluntary motor coordination
- Timing after movement initiation
- Planning of movement, especially force
- Gross motor, fine motor, and occulomotor coordination
- Balance and anticipatory postural adjustments

Question 2

Cerebrocerebellum

Answer 2

Coordination, planning, and timing of movements (vision and language too)

Question 3

Spinocerebellum

Answer 3

• Movement information from cortex, proprioceptive information (receive and correct)
• Allows for anticipatory and corrective postural adjustments of trunk and feet

Question 4

Vestibulocerebellum

Answer 4

Head movement/position with respect to gravity

Question 5

Basal Ganglia

Answer 5

Disagreements on what is or is not included
- Important for motor planning, movement initiation, control, and learning, reward processing
- Struggle to initiate movement

Question 6

Movement decomposition

Answer 6

a manifestation of cerebellar disease in which a muscular movement is not carried out smoothly but in a series of component motions.

Question 7

Dysmetria

Answer 7

Dysmetria is a condition in which there is improper measuring of distance in muscular acts;

Question 8

Asthenia

Answer 8

weakness, either confined to both legs or generalized, fatigue, malaise, lack of strength or energy, or in ability to perform daily tasks.

Question 9

Motor impersistence

Answer 9

the inability to sustain certain simple voluntary acts such as keeping eyes closed, .

Question 10

Ataxia

Answer 10

Ataxia means without coordination. People with ataxia lose muscle control in their arms and legs. This may lead to a lack of balance, coordination, and trouble walking. Romberg Balance.

Question 11

Nystagmus

Answer 11

a vision condition in which the eyes make repetitive, uncontrolled movements

Question 12

Dysarthria

Answer 12

Dysarthria is where you have difficulty speaking because the muscles you use for speech are weak.

Question 13

Akinesia

Answer 13

loss or impairment of the power of voluntary movement.

Question 14

Bradykinesia

Answer 14

Bradykinesia means slowness of movement and speed (or progressive hesitations/halts) as movements are continued

Question 15

Cuncation-festinating gait

Answer 15

FSG is described as; rapid, small steps, done in an attempt to keep the center of gravity (COG) in between the feet while the trunk leans forward involuntarily and shift the COG forward.

Question 16

Chorea

Answer 16

Chorea is a movement disorder that causes sudden, unintended, and uncontrollable jerky movements of the arms, legs, and facial muscles.

Question 17

Athetosis

Answer 17

Athetosis is defined as slow, writhing, and continuous worm-like movement of the limbs or trunk.

Question 18

Hemiballismus

Answer 18

Hemiballismus is a hyperkinetic involuntary movement disorder characterized by intermittent, sudden, violent, involuntary, flinging, or ballistic high amplitude movements involving the ipsilateral arm and leg

Question 19

Tics

Answer 19

Tics are fast, repetitive muscle movements that result in sudden and difficult to control body jolts or sounds.

Question 20

Finger to nose

Answer 20

Coordination - making sure our body is able to work together smoothly and efficiently
1. Place the pt. in a seated position with UE abducted to 90 degrees with elbows extended.
2. Instruct the pt. to touch his or her nose alternately with the left and right index fingers. The pt. performs the task first with eyes open, then with eyes closed.

Question 21

Finger to Finger

Answer 21

1. Place pt. in a seated position
2. Instruct the pt. to abduct both UE to 90 degrees with elbows extended.
3. Ask the pt. to bring both hands towards the midline and touch the index fingers together. The pt. performs the task first with eyes open, then with eyes closed.

Question 22

Finger to Therapists finger

Answer 22

1. Sit opposite from the pt., who should also be seated
2. Hold your index finger in front of the pt. and instruct the pt. to touch the tip of your finger with his or her own index finger
3. Change the position of your finger during screening to assess the pt. ability to change the distance, direction, and force of movement

Question 23

Alternate patients nose to therapists finger

Answer 23

1. Sit opposite from the pt., who should also be seated
2. Hold your index finger in front of the pt. and instruct the pt. to alternately touch the tip of your finger and the tip of his or hers own nose
3. Change the position of your finger during screening to assess the pt. ability to change the distance, direction, and force of movement

Question 24

Dysdiadokokinesia

Answer 24

Impaired ability to perform rapid alternating movement
1. Place the pt. in a seated position with elbows flexed to 90 degrees
2. Instruct the pt. to turn his or her palms up and down rapidly and simultaneously

Question 25

Ataxia test

Answer 25

1. Ask the pt. to stand with eyes open. Observe the pt. upright posture and bodily sway
2. Instruct the pt. to remain standing but with eyes closed. Note whether the pt. balance deteriorates without visual cues.
3. As the pt. is standing with eyes open, gently displace his or her balance unexpectedly. Maintain close contact guard to prevent falls or injury.
4. Repeat the procedure with the pt. eyes closed.
5. Ask the pt. to stand on 1 foot, first with eyes open, then with eyes closed.
6. Observe the pt. ability to maintain balance on 1 foot. Note whether balance deteriorates with eyes closed.
7. Instruct the pt. to perform the following movements
   - Walk on a straight line taped to the floor
   - Walk sideways and backwards
   - March in place
   - Walk on heels or toes

Question 26

A OTR is covering a shift and reads the coverage note that the next client has ataxia and would like to work on bathroom transfers. Which of the following materials will the OT need.

Answer 26

Gait belt and walker

Question 27

An OTR administered the therapist’s finger to nose assessment and the client over shot the therapist’s finger on 2/3 attempts. This indicates which of the following impairments.

Answer 27

Dysmetria

Question 28

Which of the following is the assessment for dysdiadochokinesia

Answer 28

Client rapidly alternating palms up and down

Question 29

An OTR is about to see a client with a cerebellar stroke. Which of the following impairments should the OTR anticipate.

Answer 29

Ataxia

Question 30

Match the following terms

Answer 30

Akinesia - Inability to initiate voluntary movement
Bradykinesia - Slow or decreased movement
Chorea - Sudden, rapid, involuntary movement
Athetosis - slow, flailing, twisting movement

Question 31

Which of the following is an essential function of the cerebellum

Answer 31

Error Detection

Question 32

Cerebellar Motor control is

Answer 32

Ipsilateral (i.e., right side controls right side)

Question 33

Which of the following is not an essential function of the basal ganglia

Answer 33

Error detection (Motor planning, reward processing, and movement initiation is)

Question 34

The indirect pathway of the basal ganglia has tonic (ongoing) activity which causes

Answer 34

Inhibition of movement

Question 35

The cerebellum

Answer 35

Aids in movement corrections mid-movement