Neuro Exam I

Front 1

Dysarthria

Back 1

-neurologic motor speech impairment
-characterized by slow, weak, imprecise, or uncooridinated movements of the speech musculature

Front 2

What are the 7 types of dysarthria?

Back 2

Flaccid
Spastic
Ataxic
Hypokinetic
Hyperkinetic
Unilateral Upper Motor Neuron
Mixed

Front 3

Which speech systems can be affected by dysarthria?

Back 3

Respiration
Phonation
Resonance
Articulation
Prosody

Front 4

What can be wrong with the muscles? (Dysarthria)

Back 4

Paralyzed (can't move at all)
Paresis (weakness)
Spasticity (too much tone)
Flaccidity (not enough tone)
Uncooridinated

Front 5

What can be wrong with the muscle movements? (Dysarthria)

Back 5

Overshoot (move too far)
Undershoot (Can't make target)
Move in wrong direction
Move with too much strength
Move with too little strength
Move with poor timing
Involuntary movements

Front 6

Apraxia of Speech

Back 6

-Motor speech disorder
-caused by disturbance in motor planning, or programming of sequential movement for volitional speech production
-The musculature itself is impaired
-Will have difficulty completing sequences of movements for sound production

Front 7

Which systems can be affected by AOS?

Back 7

Articualtion and Prosody

Front 8

Childhood AOS

Back 8

The developmental counterpart to acquired AOS characterized by the impaired motor speech planning and programming in the absence of neuromusculature damage.

Front 9

Flaccid Dysarthria
(localization and neuromotor bases)

Back 9

-Lower motor neuron
-Weakness

Front 10

Spastic Dysarthria

Back 10

-Bilateral upper motor neuron
-Spasticity

Front 11

Ataxic Dysarthria

Back 11

-Cerebellum
-Incooridination

Front 12

Hypokinetic Dysarthria

Back 12

-Basal ganglia control circuit
-Rigidity or reduced range of movement

Front 13

Hyperkinetic Dysarthria

Back 13

-Basal ganglia control circuit
-Abnormal movements

Front 14

Unilateral Upper Motor Neuron Dysarthria

Back 14

-UUMN
-Weakness, Incooridination, or spasticity

Front 15

Mixed

Back 15

-More than one
-More than one

Front 16

Apraxia of Speech
(Localization and Neuromotor Bases)

Back 16

-Left (dominant) hemisphere
-Motor planning or programming

Front 17

What is the function of the Motor System?

Back 17

To organize, control, and execute movements.

Front 18

What are the 4 major functional divisions of the Motor System?

Back 18

1. Final common pathway
2. Direct activation pathway
3. Indirect activation pathway
4. Control circuits (basal ganglia, cerebellum)

Front 19

Final Common Pathway (LMN)
(Basic function, and major structures)

Back 19

-Stimulates muscle contraction and movement; other motor divisions must act through it to influence movement
-Cranial nerves & Spinal nerves

Front 20

Direct Activation Pathway

Back 20

-Influences conscioulsy contolled, voluntary movement
-Corticobulbar tracts & Corticospinal tracts

Front 21

Indirect Activation Pathway

Back 21

-Mediates subconscious, automatic muscle activities including posture, muscle tone, & movement that support and accompany voluntary movement
-Corticorubral tracts, Corticoreticular tracts & relevanant cranial nerves

Front 22

Control Circuits

Back 22

-Integration or cooridination of sensory information and activities of direct & indirect activation pathways to control movement
-Basal ganglia, cerebellum

Front 23

What is another name for the Final Common Pathway?

Back 23

Lower Motor Neuron System

Front 24

What are the two basic functions of the FCP?

Back 24

1. All motor activity is mediated through the FCP
2. Generates activity in muscles for reflexive and voluntary movements

Front 25

What type of muscles can be voluntarily controlled by the FCP?

Back 25

skeletal muscles

Front 26

What are the major structures of the FCP?

Back 26

Cranial nerves and spinal nerves

Front 27

What are the contractile elements of skeletal muscles know as? What controls them?

Back 27

Extrafusal muscle fibers. Alpha motor neurons.

Front 28

Where do alpha motor neurons originate?

Back 28

In the brainstem and in the anterior horns of the spinal cord.

Front 29

What makes up a motor unit?

Back 29

Lower motor neuron and the muscle fibers it innervates.

Front 30

What is the primary influence of the motor unit?

Back 30

the Direct Activation Pathway

Front 31

True or False? Each axon branches to innervate more than one muscle fiber.

Back 31

True

Front 32

True or False? Each muscle fiber is innervated by more than one neuron.

Back 32

True.

Front 33

True or False? Increasing force of muscle movements involves temporal summation (increasing rate of firing of individual motor units) and spatial summation (recruiting a greater number of motor units)

Back 33

True.

Front 34

Automatic Movement

Back 34

Automativ Movement

Front 35

What is the basic function of Gamma Motor neurons?

Back 35

Innervate intrafusal muscle fibers (in the muscle spindle)

Front 36

What are Gamma motor neurons influenced by?

Back 36

Control circuits, indirect activation pathway.

Front 37

What is the function of the Gamma loop?

Back 37

Maintains constant muscle tone, and a readiness to contract.

Front 38

What does the Gamma Loop consist of?

Back 38

-gamma motor neuron
-muscle spindle
-stretch receptor
-sensory neuron
-Lower motor neuron
-extrafusal muscle fiber

Front 39

Gamma Loop Function:
-Gamma Motor Neuron

Back 39

-efferenct component
-firing causes muscle spindles to contract

Front 40

Gamma Loop Function:
-Sensory Receptors

Back 40

-Detect shortening of muscle spindles through sensory receptors
-Sensory neurons send information back to alpha motor neurons in brainstem/spinal cord

Front 41

Gamma Loop Function:
-Alpha Motor Neurons (LMN)

Back 41

- Sends impulse to extrafusal muscle fibers to contract until the same length as muscle spindles

Front 42

Gamma Loop Function
-Sensory Receptors

Back 42

-No longer detect shortening, loop deactivated

Front 43

FCP for speech includes (2):

Back 43

1. Paired cranial nerves that supply muscles involved in phonation, resonance, articulation and prosody.
2. Paired spinal nerves involved in respiratory activities and prosody.

Front 44

Trigeminal (V)

Back 44

-Sensory/motor
-Sensation from face
-Motor to masseters, palate, pharynx
-Damage: paresis or paralysis and eventual atrophy of masticatory muscles on the paralyzed side

Front 45

Facial (VII)

Back 45

-Sensation from anterior tongue
-Motor to facial muscles
-Damage: paralyze muscles on the entire ipsilateral side of the face. Atrophy can lead to facial asymmetry. Fasciculation maybe seen in perioral area and chin.

Front 46

Glossopharyngeal (IX)

Back 46

-Sensation from posterior tongue, soft palate, pharynx
-Motor to pharynx
-Damage: Reduced pharyngeal sensation, decreased gag reflex, reduced pharyngeal elevation during swallowing

Front 47

Vagus (X)

Back 47

-Sensation from viscera
-Motor to laryns, pharynx, viscera
-Damage: weakness of the soft palate, pharynx, and larynx

Front 48

Accessory (XI)

Back 48

-Motor to larynx, chest, shoulder
-Damage: Weaken head rotation toward side opposite lesion, Reduce ability to elevate or shrug the shoulder on the side of the lesion

Front 49

Hypoglossal (XII)

Back 49

-Motor to tongue
-Damage: Atrophy, weakness, and fasciculations of the tongue on the side of the lesion

Front 50

Spinal Nerves

Back 50

-Motor to muscles of respiration
-Damage: abnormal breathing patterns

Front 51

True or False?
Most of the cranial nerves are ipsilateral, but some of the facial and all of the hypoglossal are contralateral.

Back 51

True.

Front 52

What is another name for the Direct Activation Pathway?

Back 52

Pyramidal tract

Front 53

The DAP is a part of the ________________ system.

Back 53

Upper motor neuron system

Front 54

What tracts can the DAP be divided into?

Back 54

The corticobulbar and corticospinal tracts.

Front 55

What do the corticobulbar and corticospinal tracts make up?

Back 55

The corona radita

Front 56

The DAP leads to what type of movement? (3)

Back 56

-voluntary
-finely controlled
-discrete movement

Front 57

Where does the DAP originate?

Back 57

In the cortex, bilaterally in the primary motor contex (and to some extent the premotor cortex and SMA) and courses to the brainstem and spinal cord to innervate cranial and spinal nerves, respectively.

Front 58

What does the DAP directly connect to?

Back 58

The Final Common Pathway.

Front 59

What does the DAP pass through?

Back 59

The internal capsule

Front 60

What does the internal capsule contain?

Back 60

All afferent and efferent fibers going to and from the cortex.