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Questions and Answers
What type of synapse is the Neuromuscular Junction (NMJ)?
What type of synapse is the Neuromuscular Junction (NMJ)?
What is the primary neurotransmitter released at the NMJ?
What is the primary neurotransmitter released at the NMJ?
What is the function of the synaptic cleft at the NMJ?
What is the function of the synaptic cleft at the NMJ?
What is the primary function of the motor end plate?
What is the primary function of the motor end plate?
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Where are nicotinic acetylcholine receptors located at the NMJ?
Where are nicotinic acetylcholine receptors located at the NMJ?
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What is the role of acetylcholinesterase (AChE) at the NMJ?
What is the role of acetylcholinesterase (AChE) at the NMJ?
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What is the role of alpha gamma coactivation in muscle spindle function?
What is the role of alpha gamma coactivation in muscle spindle function?
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What type of reflex is the phasic stretch reflex?
What type of reflex is the phasic stretch reflex?
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What is the primary mechanism by which nicotinic acetylcholine receptors initiate muscle contraction?
What is the primary mechanism by which nicotinic acetylcholine receptors initiate muscle contraction?
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Which of the following receptors are NOT found at the NMJ?
Which of the following receptors are NOT found at the NMJ?
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What is the primary sensory receptor involved in the phasic stretch reflex?
What is the primary sensory receptor involved in the phasic stretch reflex?
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What effect does the activation of the Ia Inhibitory Interneuron have on the antagonist muscle?
What effect does the activation of the Ia Inhibitory Interneuron have on the antagonist muscle?
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Which of the following is NOT a characteristic of the tonic stretch reflex?
Which of the following is NOT a characteristic of the tonic stretch reflex?
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Which type of nociceptor is activated by intense pressure to the skin?
Which type of nociceptor is activated by intense pressure to the skin?
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Which of the following best describes the function of pain?
Which of the following best describes the function of pain?
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Which type of nerve fiber transmits pain signals faster?
Which type of nerve fiber transmits pain signals faster?
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What is the primary reason why individuals without pain sensation have a shorter lifespan?
What is the primary reason why individuals without pain sensation have a shorter lifespan?
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Which of the following types of stimuli can activate polymodal nociceptors?
Which of the following types of stimuli can activate polymodal nociceptors?
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What is the primary role of interneurons in pain processing?
What is the primary role of interneurons in pain processing?
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Which of the following best describes how chemicals released by traumatized tissues indirectly activate nociceptors?
Which of the following best describes how chemicals released by traumatized tissues indirectly activate nociceptors?
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Which of the following is NOT a characteristic of C-fibers?
Which of the following is NOT a characteristic of C-fibers?
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Which of the following statements accurately describes the location of nociceptors?
Which of the following statements accurately describes the location of nociceptors?
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Which of the following best describes the role of nociceptors in pain processing?
Which of the following best describes the role of nociceptors in pain processing?
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Which of the following statements accurately describes the function of muscle spindles?
Which of the following statements accurately describes the function of muscle spindles?
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Which of the following is NOT a characteristic of the Ia afferent fibers of muscle spindles?
Which of the following is NOT a characteristic of the Ia afferent fibers of muscle spindles?
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What is the primary function of gamma motor neurons?
What is the primary function of gamma motor neurons?
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Which of the following is a key difference between Ia and II afferent fibers in muscle spindles?
Which of the following is a key difference between Ia and II afferent fibers in muscle spindles?
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What is the primary role of the Golgi tendon organ (GTO) in muscle function?
What is the primary role of the Golgi tendon organ (GTO) in muscle function?
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Which of the following is NOT a type of reflex triggered by muscle spindles?
Which of the following is NOT a type of reflex triggered by muscle spindles?
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The co-activation of alpha and gamma motor neurons during voluntary movement is essential for:
The co-activation of alpha and gamma motor neurons during voluntary movement is essential for:
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What is the primary afferent input to alpha motor neurons that triggers the stretch reflex?
What is the primary afferent input to alpha motor neurons that triggers the stretch reflex?
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Which of the following is a characteristic of the Golgi tendon organ (GTO) reflex?
Which of the following is a characteristic of the Golgi tendon organ (GTO) reflex?
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Which of the following accurately describes the structure of muscle spindles?
Which of the following accurately describes the structure of muscle spindles?
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Which of the following best describes the type of information provided by the Ia afferent fibers of muscle spindles?
Which of the following best describes the type of information provided by the Ia afferent fibers of muscle spindles?
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Which of the following conditions is primarily associated with dysfunction of muscle spindles?
Which of the following conditions is primarily associated with dysfunction of muscle spindles?
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Gamma motor neurons play a critical role in maintaining muscle spindle sensitivity during muscle contraction. Which of the following statements accurately describes how gamma motor neurons achieve this?
Gamma motor neurons play a critical role in maintaining muscle spindle sensitivity during muscle contraction. Which of the following statements accurately describes how gamma motor neurons achieve this?
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Which of the following scenarios would most likely lead to an increase in the firing rate of Ia afferent fibers from a muscle spindle?
Which of the following scenarios would most likely lead to an increase in the firing rate of Ia afferent fibers from a muscle spindle?
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Which of the following statements accurately describes the relationship between muscle spindles and Golgi tendon organs?
Which of the following statements accurately describes the relationship between muscle spindles and Golgi tendon organs?
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Which of the following statements best describes the role of proprioception in movement?
Which of the following statements best describes the role of proprioception in movement?
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Which of the following is NOT a possible reason for increased insertional activity in an EMG signal?
Which of the following is NOT a possible reason for increased insertional activity in an EMG signal?
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Which of the following factors is NOT a primary consideration when choosing muscles for an EMG examination?
Which of the following factors is NOT a primary consideration when choosing muscles for an EMG examination?
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What is the typical duration of insertional activity in a normal muscle during an EMG examination?
What is the typical duration of insertional activity in a normal muscle during an EMG examination?
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Why is it important to interpret EMG data in the context of all other clinical data?
Why is it important to interpret EMG data in the context of all other clinical data?
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Which of the following is NOT a component of a standard EMG examination?
Which of the following is NOT a component of a standard EMG examination?
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Which of the following is NOT a feature of the sympathetic nervous system in chronic pain?
Which of the following is NOT a feature of the sympathetic nervous system in chronic pain?
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Which of these is the primary hormone released by the adrenal gland in response to stress, as described in the text?
Which of these is the primary hormone released by the adrenal gland in response to stress, as described in the text?
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What is a potential consequence of persistently high levels of cortisol, as mentioned in the text?
What is a potential consequence of persistently high levels of cortisol, as mentioned in the text?
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Which of these is a common misconception about pain, as described in the text?
Which of these is a common misconception about pain, as described in the text?
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What is a potential danger of relying solely on manual therapies for chronic pain management?
What is a potential danger of relying solely on manual therapies for chronic pain management?
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Which of these phrases describes a potential warning sign of centralized pain, as discussed in the text?
Which of these phrases describes a potential warning sign of centralized pain, as discussed in the text?
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In the context of chronic pain, what does the text refer to by "catastrophizing pain"?
In the context of chronic pain, what does the text refer to by "catastrophizing pain"?
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Which of these cognitive patterns might contribute to the development of persistent pain?
Which of these cognitive patterns might contribute to the development of persistent pain?
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What is the key message of the text regarding the treatment of persistent pain?
What is the key message of the text regarding the treatment of persistent pain?
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How does the text suggest limiting the duration of "nociceptive barrage" in patients with acute pain?
How does the text suggest limiting the duration of "nociceptive barrage" in patients with acute pain?
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Flashcards
Neuromuscular Junction (NMJ)
Neuromuscular Junction (NMJ)
The synapse between a motor neuron and a muscle fiber, facilitating communication.
Acetylcholine (ACh)
Acetylcholine (ACh)
A neurotransmitter released by motor neurons at the NMJ, always excitatory for muscles.
Synaptic Cleft
Synaptic Cleft
The small gap (20-30 nm) between the neuron and muscle cell where neurotransmitters diffuse.
Motor End Plate
Motor End Plate
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Nicotinic ACh Receptor
Nicotinic ACh Receptor
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Acetylcholinesterase (AChE)
Acetylcholinesterase (AChE)
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Junctional Folds
Junctional Folds
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Muscarinic ACh Receptors
Muscarinic ACh Receptors
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Alpha Gamma
Alpha Gamma
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Phasic Stretch Reflex
Phasic Stretch Reflex
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Ia Afferent Neurons
Ia Afferent Neurons
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Ia Inhibitory Interneuron
Ia Inhibitory Interneuron
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Tonic Stretch Reflex
Tonic Stretch Reflex
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Sympathetic Nervous System
Sympathetic Nervous System
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Adrenaline Release
Adrenaline Release
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Parasympathetic Nervous System
Parasympathetic Nervous System
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Cortisol
Cortisol
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Pro-inflammatory Cytokines
Pro-inflammatory Cytokines
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Centralized Pain
Centralized Pain
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Cognitive Aspects of Pain
Cognitive Aspects of Pain
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Catastrophizing
Catastrophizing
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Avoidance Behaviors
Avoidance Behaviors
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Maladaptive Changes in CNS
Maladaptive Changes in CNS
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Neural Pathways of Pain
Neural Pathways of Pain
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A-delta Fibers
A-delta Fibers
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C Fibers
C Fibers
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Interneurons
Interneurons
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Nociceptors
Nociceptors
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Thermal Nociceptors
Thermal Nociceptors
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Mechanical Nociceptors
Mechanical Nociceptors
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Polymodal Nociceptors
Polymodal Nociceptors
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Function of Pain
Function of Pain
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Consequences of Lack of Pain
Consequences of Lack of Pain
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Clinical EMG Examination
Clinical EMG Examination
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Insertional Activity
Insertional Activity
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Normal EMG Signals
Normal EMG Signals
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Interpretation Context
Interpretation Context
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Muscle Pathologies
Muscle Pathologies
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Myasthenia Gravis (MG)
Myasthenia Gravis (MG)
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Muscle Spindle
Muscle Spindle
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Golgi Tendon Organ (GTO)
Golgi Tendon Organ (GTO)
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Proprioception
Proprioception
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Intrafusal Muscle Fibers
Intrafusal Muscle Fibers
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Ia Afferent Fibers
Ia Afferent Fibers
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II Afferent Fibers
II Afferent Fibers
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Gamma Motor Neurons
Gamma Motor Neurons
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Alpha Motor Neurons
Alpha Motor Neurons
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Joint Receptors
Joint Receptors
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Spinal Reflex Circuit
Spinal Reflex Circuit
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Kinesthesia
Kinesthesia
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Autogenic Inhibition
Autogenic Inhibition
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Study Notes
Lower Motor Neurons and the Neuromuscular Junction
- Lower motor neurons are located in the gray matter of the spinal cord ventral horn.
- They are also called alpha motor neurons.
- Lower motor neuron cell bodies are grouped into clusters called motor neuron pools.
- Each pool innervates a specific muscle; axons in a pool project to the same muscle.
- Axial muscles are located more medially in the spinal cord.
- More distal muscles (dexterity muscles) are located more laterally.
- Motor neurons' dendrites and cell bodies are in the spinal cord.
- Their axons leave the spinal cord via the ventral root.
- Axons travel in bundles through segmental nerves and peripheral nerves.
- Terminal endings of motor neurons branch to many muscle fibers in a muscle, forming a motor unit.
- The fibers are scattered throughout the muscle, not clustered.
Motor System Organization
- Muscle activation occurs by lower motor neuron (LMN) activation.
- Lower MNs are activated by sensory neurons (reflexes) and upper MNs.
- Local circuits of interneurons also play a role, such as in stepping.
- Descending pathways, such as from the motor cortex, influence voluntary movements.
- Basal ganglia and cerebellum coordinate movement initiation and execution.
Motor Unit Types
- Motor units vary in size.
- Small motor units innervate small "red" muscle fibers and are slow (fatigue-resistant) motor units. These are good for sustained contractions.
- Large motor units innervate large, pale muscle fibers, often with few mitochondria.
- Such units are fast, fatigable units.
- Medium units have properties between small and large units (fast, fatigue-resistant).
Precision of Control
- Motor unit size correlates with level of precision of muscle control.
- Fine control uses small motor units with limited force.
- Gross control uses large motor units for large force.
Neuromuscular Junction (NMJ)
- The NMJ is a synapse between a motor neuron and a muscle fiber.
- Electrical signals are passed through the release of a chemical messenger.
- Acetylcholine (ACh) is the key neurotransmitter released at the NMJ.
- ACh is always excitatory for muscles.
- ACh diffuses across the synaptic cleft (a very tiny gap).
- The muscle cell membrane exhibits junctional folds that increase the surface area for ACh receptors.
- Receptors are called nicotinic ACh receptors.
- The enzyme acetylcholinesterase (AChE) breaks down ACh.
- Muscarinic ACh receptors are found in the brain and smooth muscle.
Activation of Muscle Fibers by ACh
- ACh binds to receptors, triggering the opening of chemically gated cation channels.
- A graded depolarization results in an end-plate potential (EPP).
- A larger EPP will lead to greater depolarization in the muscle fibers leading to an action potential.
- EPPs must reach a certain threshold to trigger the muscle fiber action potential, for a safety factor.
Definition of a Motor Unit
- A motor unit consists of a single motor neuron and all the muscle fibers it innervates.
- Each muscle fiber is innervated by only one motor neuron.
- The muscle fibers within a motor unit are usually dispersed throughout the muscle.
- When a motor neuron is activated, all its fibers contract in unison.
Motor Neuron Pathways
- Dendrites and cell bodies are located in the spinal cord.
- Axons travel the length of the cord in bundles (ventral root).
- The axons enter peripheral nerves.
- The terminal endings of axons branch to many muscle fibers within the entire muscle.
Muscles of the Head and Neck
- Muscles of the head and neck often have motor neurons originating in the brainstem.
- The nerves carrying these axons are "cranial nerves."
Damage to Lower Motor Neurons
- Damage leading to paralysis, loss of reflexes, decreased muscle tone or atrophy.
Diseases of the Lower Motor Neurons
- Poliovirus can impact lower motor neurons.
- Acute flaccid myelitis (AFM) is rare and can damage lower motor neurons, causing weakness.
- Amyotrophic lateral sclerosis (ALS) is a degenerative disease, impacting both lower and upper motor neurons.
Disease of the NMJ
- Myasthenia gravis (MG) is an autoimmune disease that impacts the NMJ.
- Antibodies impair ACh receptors, leading to reduced strength of muscle contraction.
Muscle Spindles and Proprioception
- Muscle spindles are sensory receptors within muscle tissue.
- They are arranged in parallel with the muscle fibers.
- Muscle spindles provide the CNS with length and rate information of muscles.
- Contain sensory nerve endings, and motor gamma neurons that alter responsiveness.
- Different types of sensory endings are stimulated based on the length and rate of stretch, providing information about muscle position and movement.
- Gamma motor neurons help maintain sensitivity during muscle contraction.
- Muscle spindles help us sense position and movement, as well as causing reflexes.
Golgi Tendon Organs (GTOs)
- GTOs are sensory receptors in tendons (arrange in series with fibers).
- GTOs are sensitive to changes in muscle contraction; provide information about force and tension.
- Trigger inhibitory interneurons.
Autogenic Inhibition (Inverse Myotactic Reflex)
- GTOs are sensitive; during active contraction; activate interneurons, preventing further contraction of the same muscle
- GTO activates inhibitory responses to prevent over-contraction.
Joint Receptors
- Joint receptors help maintain movement and provide a protective function.
- Different types of joint receptors are sensitive to different joint motions. (e.g., Golgi-Mazzoni, Ruffini, etc)
Proprioception pathways
- Includes information from muscles (sensory endings in muscles), and joints.
- Conscious proprioception pathways project to higher cortical centers.
- Unconscious pathways go to the cerebellum.
Use of Proprioceptive Information in Central Processing
- Cerebellum acts in co-ordination of movement; learns skills such as typing and sports.
- Information gathered by proprioception is vital for proper movement planning and execution, particularly at extremes of range of motion.
Acute vs. Persistent Pain
- Acute pain is a warning signal during tissue damage and is essential for survival.
- Persistent pain results when nociceptors remain triggered inappropriately, or there are changes in CNS processing.
- Peripheral and central sensitization may lead to chronic pain.
Nociceptive Pain
- Nociceptors are activated by actual or potential tissue damage.
- Nociceptors and nerve fibers convey pain stimuli to the spinal cord.
- Different types of nociceptors exist, responding to different types of stimuli.
- Pain information converges upon specific neurons, and is conveyed to higher brain regions.
- Pain processing can be modified by other inputs and systems (e.g., gate control mechanisms, descending pain pathways).
Pain Neuromatrix
- The neuromatrix is a distributed network of neurons that contribute to the perception of pain.
- It is affected by sensory inputs from the body, cognitions, and emotions.
- Inputs and outputs influence the perception of pain (and the affective-motivational response to pain).
Mechanisms of Persistent Pain
- Persistent pain may occur even after tissue is repaired.
- Sensitization of the nervous system at peripheral and spinal cord levels occurs.
- Central sensitizations can change higher level pain centers to process input differently.
- Increased sensitization and decreased inhibiting neural systems contribute to persistent pain.
Changes to the CNS with Chronic Pain
- Structural and functional changes can occur with chronic pain.
- Brain activity and response to stimuli can alter in response to chronic pain.
Other Changes Related to Chronic Pain
- Sympathetic, parasympathetic and endocrine systems can be altered by chronic pain states.
- Cytokines can contribute to chronic pain.
- Cognitive factors (thoughts and feelings) play a significant role in processing pain.
Electromyography (EMG)
- EMG involves recording electrical activity from muscles.
- A motor unit is comprised of a motor neuron and the fibers it innervates.
- Various factors can affect EMG signals, including electrode placement and cross-talk.
Nerve Conduction Velocity (NCV) Testing
- NCV assesses the speed of nerve impulse transmission from stimuli to innervated muscles.
- Testing different portions of the nerve can detect if there is damage with NCV.
H-Reflexes and F-Waves
- The H-reflex measures the strength of monosynaptic stretch reflexes; assesses the integrity of the pathways; detects possible spinal compression.
- The F-wave, a different response, assess axon health and speed in a second portion of the peripheral nerve.
Summary of Techniques
- Various techniques may differ in their use.
- Clinical evaluation of NCV, and H-reflex data can help clinicians locate specific areas of concern.
- EMG, NCV, H-reflex and F-wave results are interpreted in the context of patient history and other clinical data.
Additional Information
- Various conditions can cause abnormal responses to testing.
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Description
Test your knowledge on the neuromuscular junction (NMJ) with this informative quiz. Explore topics such as synapse types, neurotransmitters, and reflexes involved in muscle contraction and response. Perfect for students studying physiology or related disciplines.