UMN and LMN Disorders

Spastic Paralysis:  Too much muscle contraction.

Hypertonia:  Too much muscle tone, resistance to movement

Hyperreflexia:  Too much reflexis

Positive Babinski reflex:  reflex presents to those in an infant.  Infant reflex goes away but Babinski reflex may present itself again w/ brainstem injury.

Denervation:  Muscle is deprived of blood supply.

Hypotonia:  Not enough muscle tone.  Flaccid refers to loss of muscle tone.

Atrophy:  When you don't have control of muscle, they waste away and lose mass.

Fibrillations:  Twitching of a single muscle.

Fasciculations;  the twitching (contraction) of a group of muscles.  Example:  ALS-tongue twitch first indication of ALS.

Hypoflexia:  Decrease of reflexes

Areflexia: Absence of reflexes

Dyskinesias:  Hyperkinesia, Hypokinesia

Tremors:  Resting tremors, postural tremors, intention tremors.

Chorea

Athetosis

Dystonia

Myoclonus

Tardive Dyskinesia

Dysarthria

Dyskinesias are referred to as involuntary movement disorders.  Within these involuntary movements there are:

Hyperkinesia:  Too much movement

and 

Hypokinesia:  Too little movement

Ex:  Huntington's, Chorea: excessive movement

Disorders of Extrapyramidal System

Disorder of the Extrapyramidal System

Lesion in a specific region in the extrapyramidal system

Resting Tremors:  Tremors occurs when body is at rest or relaxed.  Often seen in Parkinson's Disease.  Tremors can affect a person's voice, resulting in dysarthria.

Postural Tremors:  AKA static tremors.  No tremors when body is at rest but when held in a sustained position against gravity.  Example:  Can see in head & neck because it's constantly held up against gravity.

Intention Tremors:  AKA Kinetic Tremors: Present or occur during purposeful movement.  Seen in Huntington's Disease

Chorea is a disorder of the Extrapyramidal System.

Refers to quick, random, hyperkinetic movements.

Athetosis is a Disorder of the extrapyramidal system.

Opposite of chorea.  It's slower movements, described as irregular coarse movement.  Tend to have a more writhing (squirming) motion.  Consistent going/moving.

Sometimes seen with people with Cerebral Palsy.

Disorder of the Extrapyramidal System.

Refers to excessive tone in certain parts of the body causing distorted static posture of the limbs and/or vocal dystonia affects parts of the face, tongue, and neck.

Disorder of the Extrapyramidal System

Described as sharp, brief muscle contraction.  Muscles jerk.  Not uncommon with TBI.  Putting pressure to the muscles can temporarily release the jerking but it always comes back.

Disorder of the Extrapyramidal System

Very rare/unique syndrome in which there is bizzare movement affecting the mouth, face and tongue.  Side effect of pyschotropic drugs (treatments for psychosis & neurosis)

Disorders of the Extrapyramidal System

Refers to weakness of the muscles, decreased range of motion, decreased coordination.

Multiple forms of dysarthria exist.  The type is determined where the lesion is in the CNS.  If UMN, LMH, or cerebellum all cause a different type.  This means the presence of a dysarthria doesn't necessarily mean damage to the extrapyramidal system.

Impact one's speech production by affecting articulators, respiration, and phonation.

Some dysarthria associated with the extrapyramidal system would include ataxic  dysarthria: presents when there is damage to the cerebellar pathways.

Might have hypokinetic  dysarthria--damage to the basal ganglia associated with Parkinson's Disease.

Hyperkinetic dysarthria is damage to the basal ganglia in a different way--associated with Huntington's Disease (Chorea or Athetosis)

Ataxia

Decomposition of Movement

Dysmetria

Adiadochokinesia

Hypotonia

Nystagamus

Tremors

Ataxic Dysarthria

Diminished Muscles stretch reflexes

Cerebellar Disorder

Refers to general incoordination.  May have a staggering gait--wide stance

"Robot-like" in nature.  So, in order to move you have to break down every movement in discrete parts.  Execute every movement

Cerebellar Disorder

Refers to an inability to gauge distances, speed, and power of movement.

Cerebellar disorder

"puh-da-kah" inability to perform rapidly alternating movement.

Cerebellar Disorder

Flaccid muscle tone (weak muscle) when have LMN involvement or lack to get signals to LMN can lead to weak muscles.

Cerebellar Disorder

Oscillatory movement of the eye.  Eyeball moves either side to side, up and down, or rotary.  Occurs w/ obstruction to vestibulocular tract.

Cerebellar Disorder

Occurs with lesion of the nervous system & cerebellum  Lesion to the UMN & LMN can cause tremors.

Cerebellar Disorder

Described as uncoordinated speech. Slow range of motion, decreased strength, and decreased coordination.

Cerebellar Disorder

Like the knee= genu reflex or ac??es reflex.  Associated with lesion of the pathway that goes to the muscle.