Motor Development Test 1

Parietal lobe = "______"

"Where is it and how do I interact with it?"

Long-loop reflex

"functional stretch reflex"

Movement Time

initiation of response to the end of the movement

Information processing model

input [signals] → processing → output [motor response]

Response- programming would ______ with more complex movements

increase

Process of vision

Light is focused by the cornea and lens → travels to the retina where rods/cones are located

Preparatory phase = Compensatory phase =

Preparatory phase = feedforward Compensatory phase = feedback

type 1a sensory afferent is most sensitive to: type 1b sensory afferent is most sensitive to:

1a: dynamic stretch 1b: static stretch

motor skills that develop in the _______of life & form basis for attainment of functional motor skills

1st year

foreperiod of ____ seconds is best to decrease but anything greater _____ will increase

2-3 seconds 12 seconds

Clinical implications to motor programming theory

abnormal movement is not just reflexive, re-train movement is important to task

Hypertonia

abnormally high muscle tone

hypotonia

abnormally low muscle tone

Fixed base of support strategies for perturbed stance [2]

ankle and hip

Lobes of cerebellum

anterior, posterior, Flocculonodular [nodulus and flocculus]

Feedforward main concepts

anticipation, old movements (seen/done before)

face validity

appear to measure what it is set out to measure at face-value

Action system = areas of ________ that perform processing essential to _________ of movement

areas of nervous system that perform processing essential to control of movement

causes of apraxia:

brain injury or neurodegenerative illness or congenital

Normal to have ______ at rest but with postural control deficits it increases

small amounts of postural sway

Central Set

state of the nervous system that is influenced or determined by the context of a task

Motor cortex deficits is presented as _______

weakness [paresis]

______ have the highest number of cutaneous receptors for safety and dexterity

Fingers

Sensory organization test [SOT]:

Firm w/ vision, firm w/ no vision, firm w/ inaccurate vision, foam w/ vision, foam w/ no vision, foam w/ inaccurate vision

Steady state postural control ["static"]:

ability to control COM relative to BOS in predictable conditions

Dysdiadochokinesia:

inability to perform rapid alternating muscle movements

Primary descending pathways split into __________

lateral and medial motor systems

Example of cross-extensor reflex:

o Ex: step on something sharp - 1 flex and 1 extends to protect

Locations of greatest # of muscle spindles

neck, extraocular m., hand

Clinical implications of dynamic systems theory

need to understand physical properties of the body, other properties such as velocity can be used to facilitate movement

Muscle tone = normal ______ resistance to ______

normal passive resistance to stretch

Advantage of feedforward

not replying on sensory feedback - good for fast movements

Reactive postural control - multi-directional stability states not _____

not simple reflexes or fixed muscle synergies

2 things monosynaptic stretch reflex loop utilizes

o Activation of agonist o Reciprocal inhibition

Feedback is used for ______ movements

slower

constant validity

instrument measure all the dimensions of the function

more senses involved =

more information

Motor unit size relates to _______

dexterity and power needed

temporal lobe= "______"

"what is this?"

Parietal lobe/ dorsal stream = "_______"

"where is it and how do I interact with it?"

Factors of response-programming [3]

# of moving parts, accuracy of movement, and movement duration

- Center of mass: - Center of gravity: - Base of support: - Center of pressure:

- Center of mass: point at the center of total body mass - Center of gravity: vertical projection of center of mass - Base of support: area of the body in contact with support surface - Center of pressure: center of the distribution of total force applied to the supporting surface

Hypothetical model:

- Cerebral cortex → basal ganglia or spinal cord - From basal ganglia → inhibit thalamus or excite brain stem

according to cortical homunculus - Laterally = - Medially =

- Laterally = more trunk/thorax/face - Medially = more LE/legs

- Orientation (______): - Stability (________):

- Orientation (posture): able to maintain balance between body's segment, body, and environment for a task - Stability (balance): ability to control center of mass in relationship to the base of support

reflexes involved in locomotion - Reciprocal inhibition: - Cross-extensor reflex: - Reflex-reversal phenomenon

- Reciprocal inhibition: flexors are automatically inhibited when the extensors are activated and vice versa - Cross-extensor reflex: extensors of one knee are activated when the flexors of the opposite knee are activated - Reflex-reversal phenomenon [opposing responses as a function of gait cycle]

Functions of the following - prefrontal cortex: -premotor cortex: -supplementary motor cortex: -primary motor cortex: -primary somatosensory cortex: -posterior parietal cortex: -primary visual cortex: -cerebellum: -brainstem:

- prefrontal cortex: planning of movement, specifies goal of movement [not details] -premotor cortex: organizes sequences of movement -supplementary motor cortex: coordination of complex learned responses [throwing/typing], coordination of large muscles for posture -primary motor cortex: intentions produce output to spinal cord that yields motor outcomes -primary somatosensory cortex: touch input from entire body with some output to prefrontal and spinal cord -posterior parietal cortex: ingrates body position and location of external objects, output goes directly to prefrontal cortex -primary visual cortex: identifies colors, lines, edges, depth, etc. -cerebellum: - motor learning & fine correction of speed and distance of ongoing movements -brainstem: origin of motor neurons to spinal cord

Primary direct circuits -Cortex to striatum: -Striatum to globus pallidus: -GPi to thalamus (VA/VL):

-Cortex to striatum: glutamate (+) -Striatum to globus pallidus: GABA (-) -GPi to thalamus (VA/VL): GABA (-)

Types of apraxia -Apraxia of speech: -Constructional apraxia: -Ideational/conceptual apraxia: -Ideomotor apraxia:

-Apraxia of speech: difficulty planning and coordinating the movement needed to speech -Constructional apraxia: inability to draw, construct, or copy simply configurations/shapes -Ideational/conceptual apraxia: inability to understand concept/idea [ex: putting in shoes then socks] -Ideomotor apraxia: deficits in ability to plan or complete tasks that rely on sematic memory [can explain, but can't do it - ex: "show me how to brush your teeth"]

Structures involved with motor PLANNING: [7]

-Primary motor cortex: programming volitional movement -caudate: controls conscious contraction of certain skeletal muscles -putamen: movement control -glubus pallidus: regulate muscle tone for intentional movement -subthalamus: involved in ballistic movements -Substantia nigra: balance between dopinergic inhibition and cholinergic excitation of striatal output (GABA) -Thalamus: part of the motor planning & communicates with basal ganglia

Secondary circuits -Striatum to GPe: -GPe to subthalamic nucleus: -Subthalamic nucleus to Gpi: -Striatum to substantia nigra: -Substantia nigra to striatum:

-Striatum to GPe: GABA (-) -GPe to subthalamic nucleus: GABA (-) -Subthalamic nucleus to Gpi: glutamate (+) -Striatum to substantia nigra: GABA (-) -Substantia nigra to striatum: dopamine (-) or (+) - has the effect to either excite more or inhibit

Deficits of each structure -primary motor: -caudate: -putamen: -globus pallidus: -subthalamus: -substantia nigra:

-primary motor: inability to perform purposeful movement even though there is no paralysis -caudate: negative actions or positive actions -putamen: positive and negative signs -globus pallidus: positive and negative signs -subthalamus: hemiballismus -substantia nigra: muscle tremors and rigidity

Functional zones of cerebellum -spinocerebellar: -cerebrocerebellar: -vestibulocerebellar:

-spinocerebellar: somatosensory info from the extremities -cerebrocerebellar: motor planning -vestibulocerebellar: balance and eye movement

Task considerations [4]

1. body action - stability vs. mobility 2. UE manipulation 3. organization - discrete vs. continuous 4. open vs. closed

Motor strategies used to respond to a threat to balance [3]:

1. characteristics of perturbation (direction and magnitude] 2. biomechanical constraints 3. environmental conditions [space available, surface, etc.]

Ankle: vs. Hip:

Ankle: distal to proximal Hip: proximal to distal

hallmark of pathology within cerebellum [2 ish]

Ataxia or discoordination of voluntary movement direction and extent [dysmetria] including limb and gait

Body righting [part of righting reactions]

Body righting: movement around the body axis which are necessary for anti-gravity positions

stepping strategy is used when ______

COM is moved outside BOS

Basal ganglia 2 parallel loops:

Caudate and putamen

What are CPGs?

Central pattern generator - patterns that live withing spinal network for control of movement without conscious control [walking, running, skipping, swimming, breathing, wing flapping]

Main function of cerebellum

Coordination

Reflex theory identified these things (3)

Interaction of excitatory and inhibitory processes, sensory receptors (nociceptors and muscle spindles), proprioception

In the optic chiasm, axons from the nasal retina [L] ________, and axons on the R _____

L: Cross over R: Do not cross over

paresis is part of ______ syndrome

LMN syndrome

Motor unit =

Motor unit = alpha motor neuron + fibers it innervates

myotatic reflexes: Long-loop reflexes: Triggered reactions:

Myotatic: stretch reflex - spindles, gamma loop, and same muscle Long-loop reflexes: spindles, SC interneurons, cortex/cerebellum, same muscles Triggered reactions: various receptors, higher centers and associated musculature

function of caudate loop: process _____ motor tasks/circuits

NEW [modulates multiple sensory inputs from association cortex & Processes information through circuit → frontal lobe]

Open vs. closed skill

Open = changing environment, more variability Closed= less variability, controlled/constant

types of mechanoreceptors [4]

Pacinian corpuscle [deep pressure], Merkle's disks/Ruffini ending/ Meissner corpuscle [light touch]

Dorsal stream = ______ lobe

Parietal lobe

death of dopamine neurons in the substantia nigra-pars compacta = _______

Parkinson's

Primary versus secondary effects

Primary: primary impairment affecting motor, sensory/perceptual, and/or cognitive/ behavioral systems - CNS lesion Secondary: do not result from CNS lesion directly from as a result of original problem

Motor control theory refuted the idea that...

REFUTED THE IDEA THAT MOVEMENTS WERE CONDITIED REFLEXES

Hick's Law

RT increased by 150 ms for each doubling of S-R choice & training is possible to decrease RT (more options are available to a person, the longer it will take for him or her to make a decision about which option is best)

Response Time

Reaction time + Movement Time

Rods = Cones =

Rods = night vision Cones = daylight/color

Sign: Symptom:

Sign: objective finding from a physical examination Symptom: pt reported, subjective finding

Simple RT task: Choice RT task: Go/No Go RT task:

Simple RT task: 1 button, 1 light Choice RT task: 4 buttons, 4 corresponding lights Go/No Go RT task: 2 buttons, 1 corresponding light

Classes of motor units

Slow fatigue: small, sustained contraction for posture fast fatigue: somewhat fatigable, twice the power as slow fast fatigable: large burst of power

Posterior parietal function general terms:

Talk to prefrontal about planning

Movement is the interaction between (3)

Task, environment, individual

spasticity is part of _____ syndrome

UMN syndrome

Sensitivity

a test detecting dysfunction when it is present [true positive rate] - SNOut

Specificity

a testing detecting no dysfunction when not present [true negative rate] - SPIn

Anticipatory postural control [proactive]:

ability to activate muscles in legs/trunk for balance in advance of potentially destabilizing voluntary movements

Adaptive postural control: ability to modify ______ and ______ systems in response to changing task and environmental demands; maintain postural control while __________

ability to modify sensory and motor systems in response to changing task and environmental demands; maintain postural control while moving through space

Reactive postural control:

ability to recover a stable position following an unexpected perturbation

Individuation:

ability to selectively activate a muscle allowing isolated joint motion

impaired individuation leads to _________

abnormal coupling between related muscles

Construct validity

accurately measures a construct [abstract variable] (ex: QoL)

Positive signs:

actions that the pt does not want - over excitation Ex: hypertonicity, tremors, chorea (jerky), athetosis, ballismus and tics [Huntington's]

Negative signs:

actions that the pt wants to perform but can't - inhibition Ex: akinesia and abnormal postural adjustments [Parkinson's]

Response-programming

after selecting response, need to convert it to a coordinated action

Correlation of coefficient

amount of shared associated that exists between 2 data sets [no causation]

Equilibrium reactions:

balance when the center of gravity is disturbed o Counter rotations the head and trunk away from the direction of displacement and use of extremities

discrete: Serial: Continuous:

beginning and end discrete strung together no beginning and end

CPG: Circuits remain intact _______ level of lesion

below

Medial motor system is ______ or _______

bilateral or ipsilateral

Parts of basal ganglia [5]:

caudate nucleus, putamen, globus pallidus, subthalamic nucleus, and substantia nigra

caudate: _______ tasks vs. putamen: _______ tasks

caudate: new motor tasks putamen: previous motor tasks

Main idea of motor control theory

central motor program can be elicited wither with sensory stimulation or through central processes

______ and ______ act directly on LMN

cerebral cortex and brainstem

Muscle stiffness = ________ / _______

change on tension divided by change in length

Lateral motor system is located in ______ and _____ from site of orgin

contralateral spinal cord cross over from site of origin

Optic ataxia

correctly identify but do not know how to use it

Giving a constant foreperiod ______ RT

decreases

Function of secondary circuits:

decreases excitability of the thalamus to decrease excitability in motor cortex [opposite of direct loops]

Agnosia

deficit in ability to identify objects

Function of muscle spindles

detect absolute muscle length [static] and change in muscle length [dynamic]

Limitations to hierarchical theory

does not explain why adults have reflexive behavior in certain situations [such as flexor withdrawal] which is a result of bottom-up control

Motor performance

efficient control of motor processes, the execution of movement [skill]

Variable Error

error relative to performer's consistency

Constant Error

error relative to target

Anticipatory adjustments are influenced by [3]:

expectations, anticipation, and practice

Limitations of motor programming theory

fails to account for influence of MSK and environment for motor control

higher intensity stimulus = _______ processing

faster

Basal ganglia and cerebellum are part of __________ from the thalamus

feedback loops [do not act directly on LMN]

reactive postural control includes [2]:

fixed support strategies and change in support strategies

CPG do not change ______

force

Temporal anticipation uses a ______

foreperiod [1,2,3, GO!]

Location and function of joint receptors

found in joint receptors and fire at extreme ends of range

Saccadic eye movement helps keep _________

fovea on information

Limitations of reflex theory

goal directed movement is possible without somatic sensation even if vision is occluded

high variable error = low variable error =

high variable error = performance is inconsistent low variable error = scores are similar/ less variation

Precision/resolution

how much a measurement tool will pick up on subtle changes

Optic ataxia is an issue with the _______ lobe

issue with dorsal stream [parietal lobe]

agnosia is a problem with the ______ lobe

issue with ventral stream/temporal lobe

COP moves around constantly to _____

keep COM within BOS

Clinical implication of stimulus-response compatibility

keep it simple to have a better RT

high CE= low CE =

less accurate performance accurate performance

Neuroanatomy

levels of control, spinal bord, brainstem, etc.

Location of golgi tendon organ

located at muscle and tendon junction

Function of gamma motor neurons:

maintain tension

Number of muscle spindles depends on:

mass of muscle and muscle that require precise control

Vailidity

measuring what we think it is measuring

3 types of cutaneous receptors

mechanoreceptors, thermoreceptors, nociceptors

Ecological theory main idea

motor control evolved so we can cope with the environment & accomplish goal-oriented movement

Apraxia

motor disorder caused by damage to posterior parietal cortex or corpus collosum - difficulty motor planning when ASKED

Basal ganglia is involved in:

movement control [especially higher-level and internally generate movements], learning [reward-based], and cognition/memory/affect

Main idea of dynamic systems theory

movements are active a goal-oriented and not conditioned reflexes, CNS is not solely responsible for movement but biomechanical characteristics too

- Within synergies, _______ has a weighting factor

muscle

Type of receptors

muscle [muscle spindle & Golgi Tendon], joint, and cutaneous [mechano-, thermo-, and nociceptors]

Gamma motor neurons bring info from CNS to ______

muscle spindle [efferent]

Muscles spindle maintain

muscle stiffness

Synergies

muscles linked together to form movement [adaptive and dynamic]

3 neurological reflexes

myotatic, long-loop reflexes, and triggered reactions

Types of paresis:

o Hemiplegia: weakness of 1 side of body o Paraplegia: weakness of lower extremities o Tetraplegia: weakness of all 4 limbs

example of reflex-reversal phenomenon:

o Hitting your foot on unexpected object leads to tibialis posterior to cause DF o Placing your foot on ground, despite stimulus, does not cause tibialis anterior burst

Reactive postural control - medial-lateral strategies require [2]:

o Requires adduction of one leg and abduction of the other o Loading and unloading of limbs are mirror images

Objectivity

observers get the same result with evaluating the same thing [if not, then it is subjective]

Somatosensory

perception of sensory stimuli from skin and internal organs

Limitations to dynamic systems theory

place less importance on role of CNS, increased emphasis on body mechanics and mathematical concepts

Direct circuits utilize ______ feedback loops

positive

other sx of Parkinson's [2]

postural instability and gait disturbances

Protective reactions:

prevent injury if the equilibrium reactions are unable to restore balance [ex: putting arm out when falling]

function of putamen loop:

primarily concerned with movement o Input from sensory areas and motor/premotor areas of cortex

Postural control: process of the CNS controlling the body's _________ for purposes of ______ & _______

process of the CNS controlling the body's position in space for purposes of orientation and stability

According to motor control theory, 4 pieces of info that are stored in memory

proprioception, force & speed, feeling of movement, and outcome

Function of medial motor system:

proximal, axial, and girdle muscles in postural control

Lateral motor system is essential for:

rapid, dexterous movement and individual digit/joint movement

what 2 schemas is information abstracted in

recall [motor] & recognition [sensory]

3 types of anticipation in feedforward

receptor: detect using senses effector: anticipate how long the movement will take and body positions (ex: swinging a bat) perceptual: internal rhythm (ex: running)

Neurophysiology

receptors, synapses, reflexes, neural networks, brain & spinal physiology

Reflex theory main idea

reflexes are the basis for all movement & complex movement is the result of chained reflexes - sensory input is necessary for movement

environment regulatory features: environment non-regulatory features:

regulatory features: shape of movement itself [weight, size, shape of object, type of walking surface] non-regulatory features: affect performance [background noise, distractions]

Hallmark symptoms of Parkinson's [3]

resting tremor, bradykinesia, and rigidity

Treatment of Parkinson's

restore dopamine levels [L-Dopa] and balance overactive BG circuit

Motor skill

result of learning, producing a planned movement with certainty and maximum efficiency

Postural reactions include [3]:

righting reactions, equilibrium, and protective reactions

cerebellar dysfunction will appear on _______ side of cerebellar lesion

same

Stimulus-Response compatibility

same side as hand = high SR compatibility opposite side as hand = low SR compatibility

Function of golgi tendon organs

senses tension and inhibit agonist and excites antagonist so tension doesn't get too high [muscle protection] - role in fatigue

Coactivation

simultaneous activation of additional muscles during functional movements, present in neurologically intact individuals just learning a skill and individuals with neurological pathology

Location of muscle spindles

skeletal muscle

2 forms of hypertonia

spasticity: velocity dependent rigidity

Conditions that require anticipatory adjustments [3]:

speed, weight of load to be removed, and support

3 parts of Control of locomotion:

spinal preparation, decerebrate preparation, and decorticate preparations

CPGs require ______ to start movement but not to maintain movement

stimulus [electrical, pharm]

Monosynaptic stretch reflex loop

stretched muscle → excited 1a afferent → CNS

Caudate + putamen = ________

striatum

Righting reactions

supporting positioning of the head vertically in space

Ventral stream = _______ lobe

temporal lobe

Clinical implications for hierarchical theory

test reflexes, prevent primitive reflexes [grasping, rooting], normalize muscle tone/reduce hyperactive stretch, and facilitate normal patterns of movement

issue with direct circuit would result in inhibition of _______

thalamus

Skill

the ability to bring about some end result with maximum certainty and minimum outlay of energy, or of time and energy

Motor Control

the ability to regulate or direct the mechanisms essential to movement - result of complex interaction between individual, task, and the environment

Concurrent validity

the instrument agrees with other instruments - "gold standard"

Realibility

the measurement is able to be reproduced

Subtractive method key principle

the time is takes to perform a task depends on the number and types of mental stages involved

Reaction time

time from beginning of stimulus to beginning of response

Fitt's Law

time to complete a targeted movement depends on the distance to the target and the width of the target - as movement becomes more difficult the speed and accuracy are compromised

Hierarchical theory main idea

top-down CNS organization of motor control, sensory feedback needed to control movement, and reflexive movement is only seen after CNS damage

True or false: in hierarchical theory, higher levels control lower levels

true

example of impaired individuation

trying to isolate elbow flexion but get shoulder ABD/ flexion and wrist flexion - unable to isolate

Spatial anticipation uses _______

use spatial cutes to predict [ex: goalie looks at foot placement to predict]

Feedback concept

uses sensory information, more for first time movement

Sensory feedback (part of feedback system) uses (2)

vision and somatosensory

3 systems used for sensory-perceptual systems

vision, somatosensory, vestibular

Gamma motor neurons are activated at the same time as _________

voluntary contraction

Example of adaptive postural control

walking on grass -> walking on gravel

When fovea is straight ahead, and stimulus is on the L - projected on L _____ and R _____

when stimulus is on the L, NASAL L and TEMPORAL R