Basic Sciences II Comprehensive Review

Comprehensive practice flashcards covering Basal Ganglia anatomy/pathologies, Movement Analysis frameworks, Neuropathology (CVA, TBI, SCI, tumors, demyelinating diseases), Speech and Language systems, and Introductory Pharmacology.

What are the two main functional communication pathways of the basal ganglia and how do they affect movement?

The direct pathway is excitatory, disinhibits the thalamus via D1 receptors, and facilitates movement. The indirect pathway is inhibitory, increases inhibition to the thalamus via D2 receptors, and inhibits movement.

What primary neuropathological change causes Parkinson's disease and what are its cardinal motor symptoms?

Parkinson's disease is caused by the degeneration of dopamine-producing neurons in the substantia nigra pars compacta. Its cardinal motor symptoms include akinesia, bradykinesia, muscle rigidity, resting tremor, and postural instability.

What pathway impairment causes the hyperkinetic symptoms seen in Huntington's disease?

Huntington's disease is characterized by an impairment of the indirect (inhibitory) pathway of the basal ganglia, leading to decreased inhibition of the thalamus and excessive movement.

How is chorea defined in basal ganglia movement disorders?

Chorea is defined as uncontrolled, often continuous, random (non-rhythmically repetitive), abrupt, jerking movements primarily affecting the distal extremities and face.

What are the six sequential stages of the movement continuum according to Hedman et al. (1996)?

The six stages of the movement continuum are: Initial Conditions, Preparation, Initiation, Execution, Termination, and Outcome.

What is the primary conceptual difference between a medical diagnosis and a physical therapy diagnosis?

A medical diagnosis identifies the cell, tissue, or organ causes of diseases, disorders, or injuries. A physical therapy diagnosis identifies the consequences of those conditions, including movement system impairments, activity limitations, and participation restrictions.

Which six body systems integrate to form the human movement system according to the APTA?

The movement system integrates the Nervous, Musculoskeletal, Endocrine, Cardiovascular, Integumentary, and Pulmonary systems.

What are the four primary domains of movement dysfunction used in movement analysis?

The four domains of movement dysfunction are Neural, Physiological, Biomechanical, and Behavioral.

What is the difference between a thrombotic ischemic stroke and an embolic ischemic stroke?

A thrombotic stroke is caused by a blood clot that develops locally within the cerebral arteries of the brain, whereas an embolic stroke is caused by a clot (or blood clot, air, or fat) that forms elsewhere in the body and travels to the brain.

How do clinical deficits typically differ between left-hemisphere and right-hemisphere CVAs?

Left-hemisphere CVAs typically result in speech/language deficits (aphasia), reasoning impairments, and motor planning deficits (apraxias). Right-hemisphere CVAs typically cause visual-spatial impairments, poor insight into deficits (impulsivity), and difficulty with abstract thinking.

How do motor deficits differ between middle cerebral artery (MCA) and anterior cerebral artery (ACA) vascular territory infarcts?

An MCA infarct causes motor deficits predominantly affecting the upper extremity and face (UE > LE), whereas an ACA infarct causes motor deficits predominantly affecting the lower extremity (LE > UE).

How are the four World Health Organization (WHO) grades for brain tumors classified?

Grade I tumors are benign and slow-growing; Grade II tumors are benign but can recur or progress; Grade III tumors are malignant; Grade IV tumors are highly aggressive, malignant, possess their own blood supply, and contain necrotic tissue.

According to the Glasgow Coma Scale (GCS), what score ranges define mild, moderate, and severe traumatic brain injury?

A GCS score of $13-15$ indicates a Mild TBI, $9-12$ indicates a Moderate TBI, and $≤ 8$ indicates a Severe TBI.

What pattern of motor and sensory deficits is produced by Brown-Séquard syndrome?

Brown-Séquard syndrome produces ipsilateral loss of voluntary motor function (spastic paralysis) and proprioception/vibration below the lesion level, and contralateral loss of pain and temperature sensation.

What is the typical clinical presentation of Central Cord Syndrome?

Central Cord Syndrome presents with severe motor weakness predominantly in both upper extremities while the lower extremities are spared, along with variable sensory loss and variable bowel/bladder control.

How do Upper Motor Neuron (UMN) and Lower Motor Neuron (LMN) lesions differ regarding tone, reflexes, muscle atrophy, and fasciculations?

UMN lesions cause hypertonicity, hyperreflexia, minimal atrophy, and absent fasciculations. LMN lesions cause flaccidity/hypotonia, hyporeflexia, profound muscle atrophy, and present fasciculations.

What is the typical pathogenesis and symptom presentation of Guillain-Barré Syndrome (GBS)?

GBS is an acute post-infectious polyneuritis causing autoimmune demyelination of peripheral spinal and cranial nerves (LMN). Symptoms present as symmetrical weakness or paresthesias starting distally in the lower extremities and progressing proximally.

What is the primary neuropathology underlying Amyotrophic Lateral Sclerosis (ALS)?

ALS is a progressive neurodegenerative disease characterized by the insidious degeneration and loss of both upper motor neurons (in the motor cortex) and lower motor neurons (in the spinal cord ventral horn and brainstem), resulting in progressive muscle denervation without primary sensory loss.

What is the distinction between speech and language?

Speech is the physical, motor motor ability to produce vocal sounds via coordinated respiratory, phonatory, articulatory, and resonatory systems. Language is a symbolic system of communication governed by grammatical rules using words, signs, or written symbols.

How is nonverbal communication organized into paralinguistic and nonlinguistic components?

Paralinguistic components modify vocal delivery (pitch, loudness, pause, quality, rate). Nonlinguistic components convey meaning without vocalization (body language, kinesics, proxemics, haptics, oculesics).

What anatomical white matter tract connects Wernicke's area to Broca's area in the dominant left hemisphere?

The arcuate fasciculus is the bundle of nerve fibers connecting Wernicke's area to Broca's area; it is essential for repeating heard speech.

How do the clinical features of Broca's aphasia contrast with Wernicke's aphasia?

Broca's aphasia is non-fluent, effortful, telegraphic speech with relative preservation of comprehension and reduced awareness of repetition errors. Wernicke's aphasia is fluent, effortless, nonsensical speech with severely impaired auditory comprehension and lack of deficit awareness.

How do dysarthria and speech apraxia differ regarding their underlying physiological impairment?

Dysarthria is a speech motor execution disorder caused by weakness, slowness, or abnormal tone of speech musculature. Speech apraxia is a speech motor planning disorder affecting the ability to program articulatory movements in the absence of muscle weakness.

What is the distinction between pharmacodynamics and pharmacokinetics?

Pharmacodynamics refers to what the drug does to the body (cellular and systemic target effects). Pharmacokinetics refers to what the body does to the drug (administration, absorption, distribution, storage, and elimination).

What is the first-pass effect and which enteral administration route undergoes it?

The first-pass effect is the initial hepatic biotransformation and clearance of a drug absorbed from the gastrointestinal tract before it reaches systemic circulation. Oral administration is subject to the first-pass effect, whereas sublingual/buccal administration bypasses it.

How is the Therapeutic Index (TI) calculated, and what does a higher TI value indicate?

The Therapeutic Index is calculated as $\text{TI} = \frac{\text{TD}_{50}}{\text{ED}_{50}}$, where $\text{TD}_{50}$ is the median toxic dose and $\text{ED}_{50}$ is the median effective dose. A higher TI value indicates a safer drug.

What functional characteristics differentiate a drug agonist from a drug antagonist?

An agonist binds to a receptor and activates it to produce a functional cellular change (possesses both receptor affinity and efficacy). An antagonist binds to a receptor without causing a cell response, blocking agonists from binding (possesses affinity but lacks efficacy).

What is the primary tissue site for drug storage in the human body?

Adipose tissue (fat) is the primary site for long-term drug storage in the human body due to the lipophilic nature of many drugs.

Which primary organs are responsible for drug metabolism and drug excretion, respectively?

The liver is the primary organ responsible for drug metabolism (biotransformation), and the kidneys are the primary organ responsible for drug excretion.

What is the scope of practice for physical therapists regarding drug prescription and administration?

Prescribing or recommending medications (prescription or OTC) is strictly outside the scope of physical therapy practice. Medications used during PT interventions like iontophoresis require a patient-specific prescription issued by an authorized physician.