Kinesiology - Exam 5

movement is influenced by what factors?

individual
environmental
task
* all 3 interact when we move

multiple structures and systems in the CNS are involved in...

the desire to move, plan a movement, execute a movement, correct a movement

__________ has a key role in some movements

vision

what system in the body provides feedback to tell us where our body is in space?

somatosensory

PNS supplies the CNS with what information?

external environment and internal environment of the body

somatic division

sensory in the dorsal root and cranial ganglia receive information from sensory receptors in the skin, muscles, and joints

autonomic division mediates...

visceral sensation

autonomic division has motor control of...

viscera, vascular system, and endocrine glands

divisions of autonomic system

parasympathetic, sympathetic, enteric

components of CNS

- brain and basal ganglia
- cerebellum
- brainstem
- spinal cord

cerebrum consists of

2 cerebral hemispheres with 5 lobes

frontal lobe

interconnected with all cortical areas, important for higher cognitive processing, motor planning, control of movement

parietal lobe

mediates somatic sensation for internal representation of the body and the body's relationship in the environment

temporal lobe

processes hearing, recognition of objects and faces, through hippocampus and amygdaloid nuclei learning, memory, and emotion

occipital lobe

visual information

limbic lobe

influences unconscious instinctive behavior

cerebral cortex

outer layer of the cerebrum (contains gyrus and fissures)

basal ganglia is a network of...

interconnected nuclei

what is the basal ganglia involved with?

- action selection
- reinforcement learning
- cognition, motivation, affect

brainstem parts

midbrain, pons, medulla oblongata

midbrain

sensory and motor functions such as eye movement, coordination of visual and auditory reflexes

pons conveys information about

movement

medulla includes centers responsible for

vital autonomic functions

brainstem contains nuclei important for...

posture, locomotion, and the nuclei of several cranial nerves

brainstem receives somatosensory input from..

the skin and muscles of the head

diencephalon parts

thalamus and hypothalamus

thalamus

processes most of the information reaching the cortex

hypothalamus

regulates autonomic, endocrine, and visceral function

cerebellum is involved in...

- coordination and accuracy of voluntary movement by modulating force and range of movement
- motor learning
- cognition and emotion

motor areas of the lateral surface may be identified using different terms, such as...

primary motor cortex
M1
area 4

spinal cord extends from what to what?

Base of the skull (foramen magnum) to the first or second lumbar vertebra (L1 or L2)

every spinal segment is associated with...

a pair of spinal nerves

white matter

ascending and descending myelinated fibers (tracks)

grey matter

neurons, simple and complex spinal circuits

pools of motor neurons are associated with...

muscles and movement

____% corticospinal tract originates from...

40% originates from motor cortex

corticospinal tract

connections between brain and spine

most of the corticospinal tract are called the lateral corticospinal tract, about _____% form the ventral corticospinal tract

10%

monosynaptic stretch reflex stimulus

quick stretch, activates stretch receptors in the muscle

stretch receptors activated makes what happen?

action potentials propagate along sensory axon, synapse in LMN in the ventral horn

the action potentials result in

contraction of the stretched muscle

while the deep tendon reflex is monosynaptic, the antagonist muscle is inhibited via...

a polysynaptic pathway

central pattern generators for locomotion are...

neural networks mainly in the lumbar spinal cord

CPGs generated...

the rhythm and pattern for locomotion

normally the CPG is modulated by...

sensory input from the limbs

although the rhythm and pattern of locomotion can be generated in the spinal cord, the initiation, selection, and planning of locomotion require input from...

the supraspinal structures

gross motor, fine motor, standing from a chair, and typing on a keyboard are all what kind of movement?

voluntary

postural adjustments, change in posture in anticipation of catching a ball, and standing on a rocking boat are all forms of what kind of movement?

postural adjustments

steady state walking, breathing at rest, and flexor withdraw/ crossed extension reflex are what kinds of movement?

rhythmical/reflexive movement

CNS motor areas involved in voluntary movement

- supplemental motor area and premotor cortices
- primary motor cortex (UMNs)
- basal ganglia
- spinal cord

CNS motor areas involved in postural adjustments

- basal ganglia
- brainstem nuclei
- spinal cord (LMNs)

CNS motor areas involved in reflexive movement

- midbrain nuclei
- brainstem nuclei
- basal ganglia
- spinal cord

all regions of the CNS contribute to

movement

monosynaptic stretch reflex

deep tendon reflex

stimulus of deep tendon reflex

quick stretch
- stretch receptors in the muscle activated

action potentials propagate along...

sensory axon

DTR synapse on...

the lower motor neuron (alpha motor neuron) in the ventral horn

action potentials propagate along the...

motor axon to the NMJ

action potentials cause

contraction of the stretched muscle

while the deep tendon reflex is monosynaptic, the antagonist muscle is...

inhibited via a poly synaptic pathway

central pattern generator

neural circuitry that is responsible for generating the rhythmic pattern of a behavior such as walking

CPGs for locomotion are neural networks mainly in...

lumbar spinal cord

although the rhythm and pattern of locomotion can be generated in the spinal cord, what requires input from supra spinal structures to the CPG?

initiation, selection, planning of locomotion

principles of motor movement are organized how?

hierarchically and in parallel

hierarchical

voluntary movement of new fine motor skill

parallel

well practiced movements, rhythmical movements

hierarchical movement order

1. motor areas of the cerebral cortex
2. subcortical motor areas
3. spinal cord
4. muscles

parallel movement order

- motor programs
- mesencephalon locomotor region
- brainstem motor areas
- basal ganglia role in movement selection
- spinal cord CPG
- spinal cord reflex action

- identify and treat the movement and alignment impairments contributing to the patient's primary issue/ complaint/ problem

if primary issue is pain, distinguish between..

source vs cause

source

- the tissue or structure that is symptomatic (low back, anterior knee, supraspinatus tendonitis)

cause

- the mechanical factor (movement) that results in tissue irritation
(lumbar extension, tibiofemoral rotation, scapular abduction)

optimal function of the movement system and prevention of dysfunction requires...

- precise movement
- optimal levels of activity and exercise

deviations in precise movement or optimal levels of activity can result in...

movement dysfunction

precise movement

- osteokinematics
- arthrokinematics

optimal levels of activity and exercise

- muscular performance (length, strength, etc)
- skeletal function
- motor control

contributing factors to movement dysfunction

- nervous system
- musculoskeletal system

nervous system problems in movement

- inability of the CNS to recruit and drive motor units at a high frequency
- internal sensory disorganization
- insufficient or inappropriate timing of muscular activity

musculoskeletal system problems in movement

tissue adaptations leading to altered movement patterns, loss of ROM

examination should include:

- observation of movement and alignment
- testing of muscle strengths, lengths, ROM, palpation, joint play, etc

hypothesis driven pathway:

observation -> hypothesis -> prediction -> test -> (evaluate) -> theory or back to hypothesis

2 parts of observation

- everything you see/hear
- more formal examination

what is needed during observation?

- initial data:
- subjective information (what they tell you)
- observed (visual appraisal)

movement exam components

stages of movement
quantity
quality

initial conditions of testing

- environmental context
- alignment

to judge alignment, must know

optimal/ideal alignment in sagittal and frontal planes

should optimal alignment be the goal with everyone?

goal is to achieve a more ideal alignment for that person

preparation

period when movement is being organized in CNS (stimulus identification, response selection, response programming)

temporal sequence

initiation
execution
termination

initiation

what action starts the motion?
- can this initiation be achieved?
- is this the desired motion?
- timing, direction, smoothness

execution

systematic description of segmental motion during task (amplitude, direction, speed, smoothness)

termination

what action completes the task (can they complete the task? what is end alignment?)

quantity of motion critical features:

- what must exist in order to accomplish the task (essential action)
- too much motion
- structural abnormalities

essential action of drinking from a cup

- 130 degrees of flexion

essential action of putting on a sock

requires 120 degrees of flexion

repeated movements and alignments develop....

a tendency for movements and postures in a particular direction
- excessive loading of tissues -> cumulative micro trauma -> pain

path of least resistance

- relative stiffness
- when motion occurs at two joints, the joint that is less stiff will move more readily

kinesiological standards are based on...

data
clinical experience/anecdotal evidence
- necessary to apply what you know in different situations

important to think about movement analysis across...

the lifespan

changes with aging

- alignment changes during development and with aging
- normal movement changes with aging