OT Game

Parkinson's Disease

100

Decreased range of active motion in face

What is mask-like expression? Higher Centers of Motor Control Basal Ganglia & Cerebellum

200

True or false: Rhythm strategies in therapy can help control pill-rolling tremors.

What is false- pill-rolling is a resting tremor. These are INVOLUNTARY rhythmic shaking contractions of antagonist muscles. Higher Centers of Motor Control Basal Ganglia & Cerebellum

300

True or false: A person with PD will most likely have difficulty controlling their chorea and dementia (in relation to memory).

What is False 1) chorea: involuntary, jerky, rapid movements. These are associated with Huntington's Disease. 2) Dementia in PD is NOT related to memory. It is related to goals, planning, and decision making. Higher Centers of Motor Control Basal Ganglia & Cerebellum

400

Name 3 specific treatments for PD

What is 1) Drugs: L-Dopa 2)Invasive procedures: deep brain stim., neuronal transplant, other surgical options (thalamotomy, pallidotomy) Higher Centers of Motor Control Basal Ganglia & Cerebellum

500

What is PD?

What is the degeneration of the nigrostriatal dopaminergic pathway resulting in inhibition of movement. Death of DA- producing cells in substantia nigra, death of ACh producing cells in PPN, 80% cell death occurs when symptoms show. Higher Centers of Motor Control Basal Ganglia & Cerebellum

Basal Ganglia

100

What is the main function?

What is to initiate (the idea of) movement up until completion of movement. Higher Centers of Motor Control Basal Ganglia & Cerebellum

200

True or False: BG does not directly influence the cortex, but holds important position in motor control loops.

What is False: BG does not directly influence the SPINAL CORD, but holds important positions in motor control loops. Higher Centers of Motor Control Basal Ganglia & Cerebellum

300

True or false: Ganglia are found only in the peripheral nervous system.

What is false: Basal GANGLIA are the only exception. Higher Centers of Motor Control Basal Ganglia & Cerebellum

400

True or false: some nuclei receive information and some send out information; many internal circuits between the 6 nuclei.

What is false: 5 nuclei. Caudate, putamen, globus pallidus, subthalamic nucleus, and substantia nigra. Higher Centers of Motor Control: Basal Ganglia & Cerebellum

500

Name 3 disorders of the Basal Ganglia.

1) Parkinson's Disease- degeneration of the nigrostriatal pathway/ Reduction of DA / Slowly progressive resting tremor, cogwheel rigidity, akinesia, bradykinesia, postural reflex impairment. 2) Huntington's Disease- degeneration of GABA-ergic nuerons and cholinergic neurons / Reduction of GABA & choline acetyl transferase / Progressive with dementia chorea 3) Tardive Dyskinesia- alteration of dopaminergic receptors causes hypersensitivity to DA / (no chem change) / Abnormal involuntary movements in face and tongue (disorder due to long term treatment with antipsychotic drugs). Handout 7/28/10

Polio

100

What is the etiology?

Viral illness- transmitted primarily through the ingestion of material contaminated with fecal matter Introduction to Motor Control LMN

200

What are the two types of Polio?

Asymptomatic polio: no symptoms (90-95% of cases) Symptomatic polio: symptoms are mild to severe - spinal polio- LMN cell bodies attacked - bulbar polio- CN (motor) cell bodies attacked *you can have a combination: bulbospinal Introduction to Motor Control LMN

300

True or false: When LMN cell bodies are attacked and undergo retrograde degeneration, cell bodies from the ventral horn of the SC begin axonal sprouting to reinnervate the denervated muscle fibers.

False- Wallerian degeration False- CNS does not regenerate- cell bodies do not undergo axonal sprouting. LMN that have survived undergo axonal sprouting. Introduction to Motor Control LMN

400

Name the 3 theories for post polio syndrome

1) "use it = lose it" 2) virus lies dormant and becomes reactivated 3) typical old age that presents at a greater degree Introduction to Motor Control LMN

500

Draw the SC, LMNs, sarcolemma/muscle, and show how post polio syndrom occurs. Describe the process from 'beginning to end.'

Introduction to Motor Control LMN

Reflexes

100

This receives information about muscle lengthening/ tonic stretch.

What Ia and II. Quick stretch/lengthening is only Ia. Reflexes, Spinal Cord, SCI

200

True of false: When the muscle fiber quickly lengthens, 1b afferents help to signal gamma fibers to contract the GTO. This is what allows the muscle fiber from going 'slack'

False. 1) Fiber lengthens --> shortens -->contract the muscle spindle --> muscle spindle 2)1b afferents --> Ia --> alpha MN to contract the agonist --> allows for protectvie mechanism / homeostasis 3)gamma fibers * refer to answer for 1). 4)GTO 5)muscle fiber- slack Reflexes, Spinal Cord, SCI

300

True of false: During the deep tendon reflex, the LMNs that innervate the extrafusal fibers contract the antagonist with such speed and force that it also contracts the intrafusal fibers within; ultimately the GTO sensory organ activates during this period.

False LMNs innervate both agonist and antagonist, but only the agnist contracts; ultimately Ia afferent fibers detect stretching. Reflexes, Spinal Cord, SCI

400

You are walking in your dark hallway and can't see your surrounding. As your right foot touches the ground you feel something sharp poke the bottom of your foot. Identify the reflex and describe what occurs.

What is Crossed extension. At the rt- flexion At the lt- extention Reflexes, Spinal Cord, SCI

500

You decide to assess your client's deep tendon patellar reflex. You 'tap tap' their patellar tendon and nothin happens. You repeat it and nothing happens. You decide to do a bilateral comparison on the other knee, and still, nothing happens. Explain why you think there is no response. Hint: Lecture handouts for 7/27/10

There must be a complete lesion within the SC at L3 (knee extensors). Damage at the lesion results in AREFLEXIA. Reflexes, Spinal Cord, SCI; UMN; handouts.

OT Treatments

100

You have a client dx'd with post polio syndrome. Describe a treatment you would do with your client.

Client centered care in treatment- taking into account their preferences as well as occupational history and goals. - education "use it = lose it" - cardio vs strength exercises - home modification - adaptive devices - compensatory strategies Lecture 9- Introduction to Motor Control LMN Lab handout Robert Hathaway

200

Your client has been suffering from PD for some time now. You have a conversation with him and he begins to talk about "the good old days playing texas hold 'em" with his friends. He sits down and begins to weep. You ask him if he wants to play a game with cards and he refuses. Identify various internal factors involved in this situation. How and what would you focus on in therapy?

300

You have a client who is has recently begun to recover from a stroke. The occupational history shows that she was previously working as a fashion designer and that she enjoyed hand sewing her own clothes. However, the medical chart shows that her right side of the body was affected and that she had lost some of her vision. What do you think has happened to the client? What would you do for therapy?

400

Your client walks up to you and you share a conversation for some time. They ask about what they should do with their medication (L-DOPA). Several family and friend birthdays are coming up and they want to make sure that they can attend them without any problem. In fact, there are 10 parties planned every week and they will all last throughout the day. What would you do as a therapist in this situation?

500

Identify 3 important things to consider each time you plan/carryout an OT treatment.