Movement Science Exam 5

embryonic pd

first 8 weeks of dev/gestation

pd where all major differentiation occurs!

development of systems

when do malformations occur

aberrations during the embryonic pd

in nervous sys and/or msk sys

major neurological events in embryonic pd

formation of neural tube and prosencephalon

when does general formation occur

during the embryonic pd

fetal pd

9 weeks to birth

growth and maturation of organ sys

when do deformities occur

if there are aberrations in the fetal pd

deformities of the msk sys

ex of deformation vs malformation

deformation- head shape, club foot, etc

malformation- neural tube doesn't close

what can we do as PTs for malformations vs deformations

we can't change malformations, but could help deal with muscle imbalances that are a result of the malformation

for deformations, we can attempt to correct the forces of the deformation

axial skeleton

vertebral column and ribs

what induces axial skeleton dev

induced by notochord (sends out message to start dev)

what are the three major things that need to happen in axillary dev

closure of neural tube, bones close around that, resegmentation

how does the axial skeleton dev

paraxial mesoderm

thickens either side of notochord, arranges into somites, somites divide

what do somites divide into

sclerotome -> vertebral column and ribs

dermamyotome -> myotome (skeletal mm) and dermotome (dermis/subcutaneous fascia)

what induces appendicular skeleton dev

induced by apical ectodermal ridge (signals limbs to start growing

why is selective cell death important in dev of the appendicular skeleton

needed for the hands! selective cell death allows space between fingers rather than all being connected

appendicular skeleton

pelvic and pectoral girdles and extremities

how does the appendicular skeleton dev

lateral plate mesoderm migrates out to limb buds

when do limb buds appear

at 4th week

after limb buds appear, what happens

initially project out, bend ant at elbows and knees, UE rot ext and LE rot int=anatomical pos

apical ectodermal ridge

induces appendicular skeleton dev

neural tube closure

dev of CNS in within first 8 weeks

has to close, bone close around that, and skin close around bone ->full closure in order to form spinal cord

if neural tube doesn't close what happens

could cause spina bifida, or if bone doesn't close = back pain

sclerotomic resegmentation

spine has to resegment (bones change)

each half came from dif somites so muscles can go from one vertebrae to another

interzone (during jt dev)

in precartilaginous stage, mesenchyme at sites where future joints will be thins out/becomes less dense

genetically determined

after interzone, what happens in joint formation

primitive joint capsules dev, intra articular structures appear (ex- menisci), then cavitation begins jt cavity formation

cavitation begins as a __________ process that appears to be independent of joint activity

enzymatic

after synovial cavity est during 3rd month, what is essential for normal dev of synovial joints

movement! if not moving in utero after 3rd month, atypical jt dev

muscle dev from ______

mesoderm

when do mesenchymal cells modulate into myoblasts

about 4 weeks

myoblasts aggregate into ________

syncycial tubes

when do primitive mm fibers appear

abou 5 weeks

grow in length by incorporating additional myoblasts

at 7 weeks of mm dev, what happens

fibers have become contractile but motor end plates not yet est

when does the motor end plate get est

about 10 weeks

muscle differentiation proceeds _____ to ______

proximal to distal

general overview of muscle dev

stem cells make myoblasts which proliferate, line up and connect to make a mm fiber and then a whole mm

major events in neural dev

neural proliferation and generation of glial cells, neural migration, organization, and myelination

neural proliferation

making neurons that will be in brain

in ventricular zone

neural migration

follow glial cells

get to where they're supposed to be in the brain

organization of neural dev

once they're where they need to be, organize in correct arrangement (crate synapses, form dendrites, layers of the brain, etc)

myelination of neural dev

birth to postnatal

myelin sheath formation to increase speed of nerve transmission

primitive reflexes

type of automatic movement that are present at birth and fade over time

primitive reflex generalizations

present in all infants at certain ages, age range for when each reflex exists, emergence and fading of reflexes is gradual, many primitive reflexes are present in utero and integrated around 4-6 months, can be elicited in normal indiv with sufficient stress, can be tested with a stim/response, elicited actively or passively, never normally obligatory, under neural control but induced by environmental factors, have funct/clinical significance, can be observed functionally or in terms of when they come spontaneously

asymmetrical tonic neck reflex

when turn head one way, ipsilateral arm ext and other bends

if sticks around too long, can't get head to mouth

symmetrical tonic neck reflex

if ext neck, elbows ext and legs flex/vice versa (arms mimc head)

gets in the way of crawling if doesn't go away

tonic labyrinthine reflex

if lying on back, makes you ext more and if lying on stomach, makes you flex more

grasp reflexes

if you put something in their palm, hand will close around it

if sticks around too long, makes it difficult to use hands functionally

plantar grasp reflex

in feet, if stim PIP joint/toes, toes close

inhibits balance if doesn't go away

positive support reaction

if stand baby on feet, stiffen their legs to support their weight (go up on toes)

stepping reflex

hold baby up in standing and tilt them slightly fwd, start taking rhythmical steps

if doesn't go away can make it difficult to walk

suck and swallow reflex

in you put your finger in their mouth, will suck/swallow regularly (important to prevent aspiration)

can affect speech if doesn't go away

rooting reflex

touch corner of mouth, lips deviate to that side (helps find nipple)

affects speech if sticks around too long

galant reflex

when hold baby up and touch their side, flex trunk towards taht side

contr to scoliosis if sticks around too long

crossed ext reflex

if step on something sharp and hold their, other leg comes across leg

moro reflex

if head rops, hands come out then back in together

allows them to grab onto something if falling

when should primitive reflexes go away

around 4-6 months

when is ATNR really strong

at 2 months

how are reactions different than reflexes

reactions can habituate, evolve, and dev over time

righting reactions

automatic movements that serve to maintain and restore vertical pos of head in space and alignment of head/trunk and trunk/limbs (aka keeping head neck and trunk at midline)

equilibrium reactions

serve to maintain and regain balance during movement

not born with! dev over time as primitive reflexes fade

order of equilibrium reactions

1- elongation of wt bearing side

2- flex of non wt bearing side

3- limb counter balancing towards non wt bearing side

4- rotate to reach farther to non wt bearing side

5- if none of the above work, staggering/protective rxns (put hands out or step so you don't fall)

fetal movement before 10 weeks, at 10 weeks, and by 15 weeks

before 10 weeks- movement is wormlike, not org in patterns

at 10 weeks- neurally driven movement begins

by 15 weeks- almost all movement present

what is the order of movements acquired

ext first, then flex, lat flex, and lastly rotation

a one month old will be in _________ and by 2 months will _________

physiological flexion

stretch out into extension

when is a baby strong in their flexors and can get hands/feet up against gravity

at 3 months

when can babies hold their head in the middle, hold hands tg at midline, and have knees/legs up in the air at the same time (all in supine)

by 4 months

when do babies reach full anitgravity flexion (hands to feet)

6 months

when do babies reach full antigravity in prone (swimming)

6 months

3 key things that happen at the hip during dev

retroversion/anteversion

dev of head and neck of femur

angle of inclination

dev of head and neck of femur

at 1st, only 1 growth plate, but then genetic message sends to growth plate to grow and form a second plate

angle of inclination of femur

larger angle at first=femur starts out more straight

eventually becomes more acute due to gravity/forces pushing down on it

anteversion/retroversion of the femur

distal femur is what rotates, not the head/neck!

1st in utero=retroverted, then int rot and are in excessive anteversion when born, then during childhood become less anteverted/normal amount

effects of too much or not enough anteversion

too much anteversion=toe in

too mcuh retroversion=toe out

important dev at the knee

varus (bc stand with ft wide aprt)->valgus (bc ft wide apart, line of gravity inwards causing valgus around 3 yrs)->less valgus (around 6 yrs)

what can result from the hip not dev properly

hip subluxation

foot and ankle important dev

dev of the arch

how does dev of the arch happen

flat footed when first stand bc line of gravity inwards and arch collapses bc no bony contours yet, no foot pad under foot, smooth cartilage, and fib/tib are same length

limb dissociation vs intersegmental dissociation vs intralimb dissociation

moving limbs vs moving limbs separate from each other (one leg ext, other is flex) vs multiple actions of one limb (flex knee but ext foot)

stability vs mobility

stability needed to move well

mobility- too much or too little makes it hard to move well

what parameters can be used to measure growth

height, weight, proportion, head circumference, bone density, dentition (red flag if lose teeth before 6 yrs)

what's an important component of complex movement

weight shift

generalizations about equilibrium rxns

described in terms of response to perturbation, observed in any pos, perturbations to elicit rxns can vary, mechanism of imposition of perturbation varies

what directions are most commonly used in equilibrium rxns

med/lat, ant/post, diagonal

alberta infant motor skill

most observational

put them in pos and see waht they can do spontaneously

difference bw newborns and premature babies

premature babies don't get intrauterine constraint so move more

not in flex when born

what do you do in the NICU for premature babies

imitate their environ in utero- give them constraint by swaddling the,, damp down senses, give them time to sleep, cluster care

synactive theory for high risk infants

physiological stability-> motor organization -> behavioral state organization -> attention/interaction -> self regulation

walking at 2.5 years

kinematics same as an adult, but no heel strike or push off (heel strike around 3 yrs old)

when can kids ride a bike

3 yrs- tricycle, 5 yrs- training wheels, 6 yrs- no wheels

normal motor dev from 1-5 yrs

growth, dev, increased motor control, skill acquisition

2 pds of rapid growth in weight

3rd trimester and infancy

adolescence

2 pds of rapid growth in height

2nd trimester and infancy

adolescence

head circumference

at birth, circumference is 70% of adult size

essentially complete by age 10

muscle growth

greatest inc in number of fibers before birth

inc both number and size of fibers in 1st yr of life

after 1st yr growth primarily from inc fiber size

gait kinematics at 12-13 months (generally anywhere between 9-15 months)

kinematics are immature!

wide BOS, ant pelvic tilt/lordosis, dec trunk and pelvic rot, inc hip and knee flex, lack of armswing

visual perception

vision coming in

shows if eyes are working ok, optic nerve working, transmitting info to occipital cortex

visual cognition

making sense of what you're seeing

involves association cortices

initial hand use

first thing that happens in grasp reflex but not voluntary grasping

stages of grasping

move into finger flex by scratching surfaces, then grab with fist, then use ulnar side and lastly radial side (sophisticated grasp)

_______ is just as important as grasping!

reaching and releasing

when would you refer to an OT

difficulty with reaching, grasping, releasing (fine motor skills)

sensory processing issues

feeding and coordinating mm