NC Final: Nuerological conditions and Early Motor Development

What are common symptoms of upper motor nueron issues?

spasticity/rigidity, hypertonia, hypereflexia, affects groups of muscles, clonus, disuse atrophy, no fasculations, + babinski, motor planning deficits, and coordination deficits

What are common symptoms of Lower motor neuron issues?

myalgia, hypotonia, denervation atrophy, weakness, fasciculations, myasthenia, sensory disturbances, reduced or absent DTR, and affects indivdual muscles

What type of pain can be attributed to LMN symptoms?

myalgia

What is myalgia?

( remember: my aches) muscle pain not attributed to referred visceral pain or from other soft tissues

What is paralysis?

total or severe loss of movement

What is paresis?

mild or partial loss of movement

What changes in muscle mass occurs in patients with UMN symptoms?

disuse atrophy

What changes in muscle mass occurs in patient with LMN?

atrophy or denervation atrophy

What is disuse atrophy? Is it often associated with LMN or UMN symptoms?

muscle wasting due to decreased use/activity; UMN

What is atrophy? Is it often associated with UMN or LMN symptoms?

loss of muscle bulk or wasting; LMN

What is denervation atrophy?

the breakdown of nerves due to comprimise or severing of the nerve

What is the activity level (neurogenic) of patients with UMN?

synergies, impaired timing, and associated reactions

What are synergies ? Is it often associated with UMN or LMN symptoms?

(Remember: stuck together, movements) Abnormal engagement of multiple muscles with one joint movement. Movements cannot be dissociated. UMN

What are associated reactions? Is it associated with LMN or UMN symptoms?

unwanted tone or movement in contralateral limb when the other moves; UMN

What is the activity level (nuerogenic) of patients with LMN symptoms?

fasciculations, cramps, and tetany

What are fascuculations?

visible rippling due to brief discharges of indivdual axons to all parts of a motor unit

What are cramps?

acute onset of muscle contraction /c short duration that is relieved by stretching. strong, palpable

What is tetany?

spontaneouus, repetitive discharges of motor units causing intense spasm

What is the activity (myogenic) level that occurs among patients with LMN symptoms?

fibrillation, myotonia, contracture, myasthenia

What is fibrillation?

spontaneous action potentials in a signal muscle fiber not visible by examination

What is myotonia?

(Remember: my muscles won’t relax) delayed relaxation following voluntary movement

What is a contracture?

the tigthening of soft tissue that prevents normal movement

What is myasthenia?

abnormal communication between nerves and muscles resulting in muscles that tire easily

What are tone issues that are often associated with UMN symptoms?

hypertonia, spasticity, clasp knife response, clonus, rigidity, lead pipe rigidity, and cogwheel rigidity

What is hypertonia? Is it often associated with UMN or LMN symptoms?

increased neurological input resutling in stiff, tight muscles

What is spasticity? Is it often associated with UMN or LMN symptoms?

speed dependent resistance to passive movement

What is a clasp knife response? Is it often associated with UMN or LMN symptoms?

(Think: like a pocket knife snapping shut) The sudden inhibition of high tone in response to stretch, UMN

What is clonus? Is it often associated with UMN or LMN symptoms?

cyclical, spasm-like contract/relax of muscle in response to QS

What is rigidity ? Is it often associated with UMN or LMN symptoms?

continous, involuntary muscle contraction

What is lead pipe rigidity? Is it associated with LMN or UMN symptoms?

uniform resitance throughout entire ROM despite velocity

What is cogwheel rigidity?

ratchet like jerkiness when moving through ROM

What type of tone is often associated with LMN?

hypotonia

What is hypotonia? Is it associated with UMN or LMN symptoms?

decreased neurological input resulting in floppy presentation or complete flaccid paralysis; LMN

What are the sensory issues often associated with UMN symptoms?

paresthesia

What are the sensory issues that are often associated with LMN symptoms?

parasthesia and stocking glove distrubution

What is paresthesia ? Is it often associated with UMN or LMN symptoms?

abnormal tingling or prinkling sensation

What is stocking glove distribution? Is it often associated with UMN or LMN symptoms?

parasthesia that begins distally at hands/feet and travels proximally as it worsens

What are involuntary movements associated with UMN symptoms?

athetosis, dystonia, chorea, hemiballismus, tremor, nystagmus, and tics

What is athetosis?

slow torsion or twisting movements

What is dystonia?

sustained contrcation causing torsion

What is chorea?

(Remember: chaotic) quick, non-rhythmic movements of hands or feet; not repetitive

What is hemiballismus?

unilateral flinging/flailing/large amplitude movements

What is a tremor?

alternating muscle contractions causing rhythmic oscillating movements

What is a nystagmus?

rapid, involuntary eye movements

What is a tic?

sudden, repetitive movements or vocalizations

What are coordination issues associated with UMN symptoms?

ataxia, apraxia, hypokinesia, akinesia, and bradykinesia

What is ataxia?

lack of coordinated voluntary muscle movements

What is apraxia?

inability to perform motor activity in absence of other conditions

What is hypokinesia?

overall reduced movement

What is akinesia?

inability to intiate movement

What is bradykinesia?

slowness of movement; delayed intitiation and execution of motor tasks

What type of developmental milestones would you see in a 3 month old?

roll prone+ supine, lift head in prone, head lag in pull to sit

What type of developmental milestones would you see in a 4 month old?

roll supine —>SL, prone on elbbows, and prone extension

What type of developmental milestones would you see in a 5 month old?

hand/feet to midline, pivotts in prone

What type of developmental milestones would you see in a 6 moth old?

segmental rolling and (I) sitting

What type of developmental milestones would you see in a 7 month old?

stand /c A and roll supine —→ prone

What type of developmental milestones would you see in a 8 month old?

(8-QR) assumes and rocks in QP

What type of developmental milestones would you see in a 9 month?

(9 CC) creeps and cruises

What type of developmental milestones would you see in a 10-11 month old?

standing (I) and bear walking

What type of developmental milestones would you see in a 12 month old?

(I) walking, creeps up stairs

What type of developmental milestones would you see in a 24 month old?

runs/kicks

Describe the trends of early motor development.

cephal—> caudal; proximal—> distal, and symetrical —> assymetrical

Early motor development begins with ________ COG, ______ BOS and progresses to ________ COG, ___________ BOS

LOW, wide; HIGH, narrow

Motor development begins with ___________ degrees of freedom to __________ degrees of freedom.

less, more

What are the common motor milestones?

head control, rolling, sitting, creep/crwl, standing, cruising/walking, reaching/grasping and releasing

What is evidence of developmental delay?

cant control head by 4 months

What is the order of developmental postures?

supine, prone, POE, quadreped, sitting, kneeling, modified plantigrade, and standing