Peripheral Nervous System
Are peripheral nerve injuries considered a UMN or LMN injury?
Lower Motor Neuron (LMN)
True or False: Pain can occur without stimulation of nociceptors
True
What functions maintain Gaze Stabilization?
The learner begins to refine movement and correct errors with practice
What is neuroplasticity?
The brain’s ability to reorganize its structure and function in response to experience or injury
True or False: Cranial nerves are considered a part of the CNS
True
What causes referred pain?
When pain signals from two different areas share the second 2nd order neuron in SC or Thalamus leading to central sensitization
Describe the first and second order neurons of sight
1st Neuron - Retina - optic nerve, chiasm, tract - Lateral Geniculate Nucleus
2nd Neuron - Lateral Geniculate Nucleus - Primary Visual Cortex via optic radiation (conscious awareness)
Which form of feedback involves a PT allowing a patient to sense and correct a movement error through self-evaluation and internal cues?
Intrinsic feedback
What is the functional changes of Long Term Potentiation regarding ESPS and AMPA receptors?
Enhanced EPSPs and increased AMPA receptor expression?
What are peripheral nerves made of?
Parallel bundles of axons surrounded by connective tissue (endoneurium, perineurium, epineurium, mesoneurium)
What neurotransmitters are involved with the descending perception of pain, producing an analgesic effect?
Norepinephrine & Enkephalin
Compare visual agnosia vs ataxia
Visual agnosia - inability to recognize objects w/ normal vision
Visual ataxia - inability to coordinate motor with vision
A PT is retraining gait in a patient recovering from TBI. Which of the following best supports long-term retention and adaptability of the walking pattern?
A) Repeated walking at the same speed and surface
B) Practicing walking on varied surfaces with changing speeds
C) Providing continuous verbal cues for each step
D) Massed practice on a treadmill without variability
B) Practicing walking on varied surfaces with changing speeds
Which principle applies to this scenario: "A child learns to rise from the floor by practicing it repeatedly in therapy, which later helps them climb stairs more confidently"
Transference
What are the three main divergent pathway?
1) Spinomesencephalic (pain modulation - PAG)
2) Spinoreticular (poorly localized pain, sleep/wake)
3) Spino-emotional (pain, emotion)
Compare fast and slow pain signals
Fast - Sharp, localized, lateral spinothalamic tract to conscious brain, A-delta fibers, cutaneous (skin)
Slow - Dull/throbbing, poorly localized, divergent pathway, C fibers, bone/muscle/ligament/organs
Retina - Optic Nerve (CNII) - Optic Chiasm - Optic Tract - LGN - Optic Radiation - Primary Visual Cortex
Which practice structure is best for enhancing skill transfer in a patient at the autonomous stage?
A) Blocked practice with immediate feedback
B) Random practice with variable contexts
C) Massed practice in a quiet environment
D) Constant practice on a stable surface
B) Random practice with variable contexts
During acute inpatient rehabilitation after stroke, a therapist orients a patient upright early in recovery. What neuroplastic principle is this strategy targeting?
Time matters
What is Analgesia, Hyperalgesia, Allodynia Paresthesias and Dysesthesias
Analgesia - Loss of pain sensation
Hyperalgesia - Exaggerated sensitivity to pain
Allodynia - Painful sensitivity to a normal stimulus
Paresthesias - Pins & Needles, burning (extremities)
Dysesthesias - Burning, prickling, aching (chronic nerve conditions)
Compare the medial and lateral pain systems
Medial - Emotional/cognitive responses, cerebral cortex (insula, cingulate cortex, prefrontal), Amygdala, hypothalamus, midline/intralaminar nuclei, PAG, reticular formation, ventral medulla
Lateral - Location/intensity, somatosensory cortex, insula, Thalamus VPL/VPM
PT Implication:
A physical therapist is treating a patient with central vestibular dysfunction following a cerebellar stroke. The patient demonstrates impaired smooth pursuit, poor balance, and cannot tolerate VOR exercises. What is the most appropriate early intervention strategy?
A) Initiate VOR x2 exercises with background distraction
B) Begin habituation exercises using graded exposure to head motion
C) Emphasize strength training and gait speed
D) Delay vestibular rehab until spontaneous compensation occurs
B) Begin habituation exercises using graded exposure to head motion
PT Implication: A patient with bilateral vestibular loss is undergoing vestibular rehab. The PT introduces walking tasks in dim lighting and on uneven surfaces to challenge compensation. Which principle of motor learning is most directly being applied?
A) Variable practice
B) Massed practice
C) Blocked practice
D) Knowledge of results
Variable practice
A physical therapist is designing a treatment plan for a patient recovering from a left-sided MCA stroke affecting motor function. The therapist selects task-specific training (e.g., reaching to grasp a cup), uses frequent repetitions, and increases challenge over time. Which three neuroplasticity principles are most directly guiding this approach?
A) Use it or lose it, specificity, transference
B) Repetition matters, specificity, intensity matters
C) Salience matters, interference, age matters
D) Time matters, learned non-use, transference
B) Repetition matters, specificity, intensity matters