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37 Cards in this Set
- Front
- Back
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what are UMN and LMN lesions?
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manifest in different signs: reflex response, atrophy, fasciculations, tone
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where do UMN lesions occur?
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in the descending motor tract within the CNS.
cerebral motor cortex, internal capsule, brainstem, spinal cord |
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what are ex. of UMN lesions?
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CP, hydrocephalus, CVA, birth injuries, MS, brain tumors
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what are UMN lesion signs?
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weakness or paralysis, hypertonicity, hyper-reflexia, mild disuse atrophy, abnormal reflexes
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what are examples of LMN lesions and how do they occur?
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lesion affecting the nerve or their axons at or below the level of the brainstem or at the ventral gray column of the SC
Ex: poliomyelitis, tumors, trauma, infection, MD, peripheral nerve lesions. |
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what are LMN lesion signs?
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flaccidity or weakness, decreased tone, fasciculation, muscle atrophy, decreased or absent reflexes
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what is a fasciculation ?
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coarse muscle twitching seen with peripheral motor nerve injury
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what are fabrillations?
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fine, rarely visible, twitching of single muscle fibers, seen with peripheral motor nerve injury
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Reflex sign
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UMN: Hyperactive
LMN: diminished or absent |
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atrophy sign
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UMN: mild from disuse
LMN: present and significant |
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fasiculations and fibrillations sign
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UMN: absent
LMN: present |
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tone sign
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UMN: hypertonic
LMN: hypotonic |
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babinski reflex sign
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UMN: may be present
LMN: not present |
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what is muscle tone?
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resistance of muscle to passive elongation or stretch
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what is tone a result of?
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it is normal, physical inertia, intrinsic mechanical elastic stiffness of muscle and connective tissue, it is also a reflex muscle contraction.
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tone is variable and what can it be affected by?
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voluntary effort, anxiety and pain, position and interaction of tonic reflexes, ambient temp, medication, state of arousal, etc
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what can we do to facilitate tone?
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with cold
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what can we do to inhibit tone?
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with heat
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what is hypertonia?
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increased tone above normal resting levels
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what is hypotonia?
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decreased tone below normal resting levels
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what is dystonia?
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impaired or disordered tonicity
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what is spasticity?
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velocity dependent resistance to passive stretch. the larger the stretch the stronger the spasticity. characteristics of UMN lesions
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what is the Clasp Knife response?
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during rapid movement, initial high resistance is followed by a sudden letting go.
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chronic spasticity may result in ?
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contractures, abnormal posturing, deformities, functional limitations, disability
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what is clonus?
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type of spasticity, cyclical, spasmodic alternation of muscular stretch of a spastic muscle
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where is clonus common?
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plantarflexors , wrist and jaw
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the clonus scale
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1=no clonus
2=minimal clonus (1-2 beats) 3=moderate clonus (3-9 beats) 4=sustained clonus ( 10+ beats) |
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what is rigidity?
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hypertonicity that is characterized by resistance throughout the entire ROM. independent of velocity. associated with basal ganglia lesions.
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What is lead pipe rigidity?
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resistance is uniform throughout the entire ROM
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what is cogwheel rigidity?
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resistance throughout the ROM, but with ratchet like jerkiness.
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chronic rigidity may lead to?
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stiffness, inflexibilty, significant functional limits
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decorticate and decerebrate rigidity results from?
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severe BI (brainstem involvement). pt is in a coma
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decorticate posturing
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abnormal flexor pattern. UE in flexion
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decerebrate posturing
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abnormal extensor pattern. sustained contraction of trunk and ext in extension
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how do we assess tone?
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observation of resting postures and palpation, PROM, AROM
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Tone scale
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0= no response(flaccidity)
1+=decreased response(hypotonia) 2+=normal response 3+=exaggerated response (mild to moderate hypertonia) 4+=sustained response |
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how can you tell the difference between spasticity and rigidity?
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velocity
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