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Direct and Indirect Motor Systems - Coggle Diagram
Direct and Indirect Motor Systems
Apraxia
Apraxia: Affect the ability to produce voluntary movements in the absence of muscle weakness/paralysis
Apraxia of Speech
affects the planning and sequencing of speech movements for the volitional production of speech
can occur developmentally (CAS)
can be acquired in older child or adult (acquired apraxia of speech)
Neurological basis of Apraxia
motor planning/programming of speech movement is controlled by a network of interacting structures/pathways
premotor area / SMA are connected to other regions (like broca's, basal ganglia, cerebellum, thalamus, limbic system)
Function of motor planning network
organize and activate a plan for motor execution
transform the abstract phoneme to a neuromotor code
neuromotor code specifies movement of specific muscles/muscle groups, movement duration and displacement, acceleration, deceleration, time to peak velocity, muscle stiffness, relative timing of speech events
Characteristics of Apraxia
phonemic errors (omission, substitution, distortion, addition, repetition)
groping
errors are highly inconsistent
automatic reactive speech is more accurate than volitional-purposive speech
Dysarthrias
Basal ganglia functions
subcortical structure near thalamus
chooses which type of motor signals need to be given a yes and which need to be given a no
facilitates to initiation and execution of voluntary movement
prevents unwanted muscle contractions
basal ganglia lesions
patient has no paralysis or weakness
etiology: CVA, TBI, tumor, infection, degenerative condition
characteristics: involuntary movement
parkinsonism: resting tremors, rigidity, bradykinesia/akinesia, postural abnormality
athetosis: slow continuous, writhing movements of the fingers, hands, face, and throat
chorea: intermittent jerking of limbs and trunk
Hypokinetic
difficulty initiating movements
minimal motor output
reduced rate and range of movement
akinesia: takes a lot of effort to move impaired excitatory signal
bradykinesia: slowness of movement; signals are not fast enough
rigidity: resistance to passive movement with increased muscle tone; like trying to move client's hand
Hyperkinetic
inhibition of unwanted movements is impaired
constant tremors
chorea: dance like rapid, jerky movements
athetosis: slow, writhing movement
Cerebellum
forms a feedback loop that originate from a specific cortical or subcortical region
info passes through the cerebellum and then returns to those same areas to update/inform
regulates skilled actions, planning/executing of complex spacial and temporal sequences of movements, gait, posture, eye/head/neck motion
influences descending motor systems of head/face/neck/limbs during real time movement execution
Lesions
no paralysis or muscular weakness
poor coordination of skilled motor acts
ataxia (difficulty with balance)
impaired gait and poor posture
intentional tremor
dysmetria: undershooting or overshooting; unable to gage distance