Upper Extremity Function Assessment Quiz

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Questions and Answers

What is a key aspect of upper extremity (UE) function?

It is unrelated to self-care activities.

It is irrelevant for gross motor skills.

It contributes to fine motor skills. (correct)

It only involves hand movements.

What factors are integrated into the assessment of upper extremity function?

Emotional factors play a significant role.

Contextual factors such as environment and individual capabilities are integrated. (correct)

Only environmental factors are considered.

Only individual capabilities are assessed.

What is crucial for reaching, grasping, and manipulating tasks?

Physical strength alone.

Simple movement strategies.

Low attentional demands.

High attentional demands. (correct)

Which area typically requires recovery of function for motor control retraining?

Upper extremities. Signup and view all the answers

Which of the following describes the basis for upper extremity tasks?

Sensorimotor processing. Signup and view all the answers

What is primarily involved in feedback control of movement?

Somatosensation Signup and view all the answers

Which process takes advantage of previous experience to predict the outcome of movements?

Feedforward control Signup and view all the answers

Which aspect is crucial for efficient reaching strategies?

Both feedback and feedforward control processes Signup and view all the answers

What role do proprioceptive signals from eye muscles play in movement?

They contribute to localizing targets in space. Signup and view all the answers

What influences the velocity profile during reaching tasks?

Task constraints and goals set by the movement Signup and view all the answers

In the eye–head–trunk coordination process, what is the primary sensory input for locating objects?

Visual input Signup and view all the answers

Which control process reacts to disturbances causing deviations from a desired state?

Feedback control Signup and view all the answers

What kind of pathways are involved in transmitting visual information?

Both serial and parallel pathways Signup and view all the answers

Which pathway is responsible for shape and form recognition?

Ventral pathway to inferior temporal cortex Signup and view all the answers

What condition can result from damage to the temporal association area?

Prosopagnosia Signup and view all the answers

What does the posterior parietal cortex primarily mediate?

Spatial cognition Signup and view all the answers

What is a critical aspect of interventions for patients with visual guided reaching impairments?

Training both perceptual and action components Signup and view all the answers

What might result from damage to the lateral association of the parietal lobe?

Unilateral hemispatial neglect Signup and view all the answers

Which component is active during movement planning in the posterior parietal cortex?

Eye, head, trunk, and limb maps Signup and view all the answers

Which sensory information is crucial for feedforward control of reach and grasp?

Visual information Signup and view all the answers

What is a feature of sensory information in anticipatory control of movement?

Helps in determining the initial position and coordination of limb segments Signup and view all the answers

What role does postural support play during reaching and grasping?

It maintains upright orientation and alignment of body segments. Signup and view all the answers

What is the purpose of anticipatory postural adjustments?

To prepare the body for upcoming movements by maintaining balance. Signup and view all the answers

Which of the following grasp types involves force transmitted through the fingers and thumb?

Precision grip Signup and view all the answers

How does the nervous system adapt grip during grasping?

By anticipating the weight and surface characteristics of the object. Signup and view all the answers

What feature indicates that reach and grasp are kinematically coupled?

The timing of transport and hand opening is coordinated. Signup and view all the answers

What does reaction time (RT) measure in the context of movement?

The complexity of cognitive processing before a movement. Signup and view all the answers

Which tracts are associated with the grasp-manipulation element in motor control?

Medial spinal tracts and reticulospinal tracts. Signup and view all the answers

How do choice reaction times differ from simple reaction times?

Choice reaction times require more cognitive processing and are typically longer. Signup and view all the answers

What is a key characteristic of the power grip?

Thumb and fingers are positioned towards the palm to exert force. Signup and view all the answers

In what way does the cerebellum contribute to grasping tasks?

It helps predict necessary forces for maintaining a grip and adapts for slips. Signup and view all the answers

Which area is primarily responsible for the command of movements?

Primary motor cortex Signup and view all the answers

What is the function of the posterior parietal association area?

Planning intention and decisions Signup and view all the answers

Which structure integrates visual perception of the environment with the body's relationship to it?

Egocentric spatial frame Signup and view all the answers

Which area is involved in planning movements to accomplish environmental goals?

Dorsolateral frontal association Signup and view all the answers

What role does the cerebellum play in motor control?

Corrects movement errors and maintains grip force Signup and view all the answers

The integration of body movement in relation to the environment is best described by which spatial frame?

Egocentric spatial frame Signup and view all the answers

Which structure is primarily responsible for carrying motor commands to motor neurons?

Spinal cord Signup and view all the answers

What is one key function of the basal ganglia in motor control?

Judging grasp force and sequence Signup and view all the answers

What role does vision play in the accuracy of reaching movements?

Vision decreases accuracy when individuals cannot see their hands. Signup and view all the answers

Which system is primarily responsible for the execution of reaching movements?

Premotor and Primary Motor Cortex Signup and view all the answers

What is a key difference between the roles of the Premotor Cortex and the Posterior Parietal Cortex (PPC)?

PPC encodes in body reference while Premotor encodes in visual reference. Signup and view all the answers

What is the significance of sensory feedback in complex movement execution?

Sensory feedback is crucial for finely regulated movements. Signup and view all the answers

How does a corticospinal injury affect an individual's ability to grasp objects?

Transport ability remains intact, but grasping is impaired. Signup and view all the answers

Which pathways are involved in the proximal control of reaching movements?

Reticulospinal and rubrospinal tracts Signup and view all the answers

What is the relationship between motor development and reaching and grasping?

Reaching develops early while grasping develops later. Signup and view all the answers

Which sensory input is necessary for accurate grasp and hand manipulation control?

Somatosensory feedback from cutaneous and proprioceptive senses Signup and view all the answers

Study Notes

Neural Contributions to Reach, Grasp, and Manipulation

The course, DPT 425 Functional Neuroscience, covers the neural contributions to upper extremity (UE) functions, including reach, grasp, and manipulation.
The primary resource for the information is the Shumway-Cook and Woollacott Motor Control text, Chapter 17.
Upper-extremity (UE) function is fundamental to fine and gross motor skills and plays a key role in retraining motor control.
Contextual factors (environment and individual) influence upper-extremity function significantly.
UE function is integrated into daily activities such as self-care, work, and household tasks.

International Classification of Function (ICF)

The ICF framework categorizes health conditions, body structure and function, activities, and participation.
Body structure and function encompass neuromusculoskeletal and movement-related functions, including control of voluntary movements, visually directed movements, and eye-hand coordination.
Activities refer to mobility (carrying, moving, handling objects), and tasks like self-care and activities of daily living.
Participation involves activities in real-world situations

Sensorimotor Processing for Eye-Head-and-Hand Coordination

Individual constraints, task type, and environmental constraints influence sensorimotor processing.
The goal is to understand how an individual's CNS controls upper-extremity (UE) movements.

What is Going on in the Brain?

Visual cortex, posterior parietal association area, somatosensory cortex, prefrontal area, premotor cortex, primary motor cortex, basal ganglia, and cerebellum play roles in sensory and motor processing.
Spinal cord pathways (e.g., dorsal column/medial lemniscus) and sensory receptors (e.g., fingers and hand) support sensory processing.
Motor neurons activate hand and forearm muscles, transmitting motor commands from the CNS.

Hedmann's Model for Movement Observation Analysis

The model describes the stages of movement observation and analysis to evaluate motor performance.
The model categorizes factors in determining the outcome of a movement.
Includes segments for initial conditions, preparation, initiation, execution, and termination.

Motor Control Principles (SC&W PP 466)

Motor control involves feedforward (anticipatory) and feedback (reactive) control.
Motor program theory is discussed.
Visual system plays a key role in anticipatory control, while Somatosensation is heavily involved in feedback control.
Locating a target and reaching/grasping kinematics are significant components of movement control.

Feedforward versus Feedback Control of Movement

Efficient reaching involves both feedforward and feedback processes.
Feedforward (anticipatory) control uses prior experiences to predict sensory consequences.
Feedback control uses sensory input to compare actual movement to a reference signal.

Motor Control Diagrams

Feedforward control involves the feedforward controller that has memory and an anticipatory command. Disturbances happen at the same time.
Feedback control receives the signal from the comparator, where input processing amplifies and filters the feedback.

Locating a Target (Eye-Head-Trunk Coordination)

Vision guides hand movements, particularly in locating objects in far visual fields.
Eye and hand movements interact with and influence each other.
Proprioceptive signals from eye muscles contribute to locating targets in extrapersonal space.

Reach and Grasp Kinematics

Adapting reach is crucial for upper extremity function.
Task constraints and goals influence the reaching phase.
Velocity profiles of arm movements vary based on task goals (pointing vs. grasping).

Neural Control of Reach and Grasp

The brain regions involved in neural control of reach and grasp are detailed.
Key areas like the Frontal, Limbic, and Motor Association cortices are involved.

Association Cortices - Perceptions and Planning

Association cortices in the frontal, parietal, and temporal lobes are crucial for integrating movement with perception, including awareness and understanding of limbs in space and their location.
They are essential for planning movement and relating movements to the extrapersonal space around the body.

Sensory System

The sensory system helps understand surroundings and spatial awareness.
Sensory information (body position mapping using somatosensory information) is essential for movement planning and performing accurate movements.
Sensory feedback is essential to adjust the motor plan during movement, refining and correcting errors.

Visual Processing Pathways (Where and What Streams)

Visual information travels through serial and parallel pathways (Where and What streams).
Location in space and movement utilize the dorsal pathway to the parietal cortex.
Shape, form, and object recognition utilize the ventral pathway to the inferior temporal cortex.

Clinical Implications

Clinicians should assess perceptual and action components of visual-guided reaching.
Different neurological components are involved, and impairment might affect specific neural locations.
Understanding the crucial features of objects for grasping is vital for successful manipulation.

Posterior Association Areas

The posterior parietal area mediates spatial cognition and attention to one's surroundings.
Damage to the parietal lobe can cause neglect of one side of space.
Facial recognition is mediated by temporal association areas.

What is Happening in the Posterior Parietal Cortex?

The Posterior Parietal Cortex is active during sensorimotor activities.
Its functions include sensorimotor transformation, movement planning via internal maps of body parts (eye, head, trunk, limbs), and formation of internal models and coordinate transformations.

Role of Sensory Information in Anticipatory Control of Reach and Grasp

Vision helps locate and determine the direction of a reaching movement.
Sensory information (e.g., visual and somatosensory) aids in determining initial limb position and coordination for grip.

Role of Sensory Feedback to Reach and Grasp

Visual feedback is vital for fine-tuning movement accuracy, while somatosensory feedback is crucial for controlling complex movements.
Absence of visual feedback can lead to less accurate movements in most cases.
Continuous visual guidance helps regulate movements during complex manipulations, such as solving puzzles.

Motor System in Reach and Grasping: Execution of Movement

Premotor and primary motor cortices receive inputs from the posterior parietal cortex.
They process the intended movement, including target location-direction and hand formation-orientation.

Two Separate Descending Pathways for Reach and Grasp

Separate spinal pathways control reaching and hand movements.
“Transport” and “Grasp” components are controlled by distinct pathways, emphasizing that separate cortical and subcortical networks play distinct roles in controlling distinct elements of reach and grasp tasks.

Musculoskeletal Contributions

Neural and musculoskeletal systems interact.
Changes impact movement commands if range of motion or muscle tone changes.
Compensation occurs during reaching movements when limb capabilities are limited, such as reduced elbow extension when there is reduced range of movement.

Postural Support of Reaching and Grasping

Postural adjustments (anticipatory and reactive) maintain equilibrium and alignment while reaching and grasping.

Motor Control Elements

Posture, Reach, and Grasp-manipulation are the motor control elements controlled by their respective pathways.

Grasping Patterns

Grasping patterns, including power grips (e.g., for heavy objects) and precision grips (e.g., for delicate objects), vary in their characteristics/applications.

Anticipatory Control of Grasp and Lift

Anticipatory control is crucial for grip formation and maintaining grasp for stability.
The nervous system adjusts grips depending on the weight or surface of the object.

Coordination of Reach and Grasp

Reach and grasp movements are coupled kinematically, with consistent patterns.
Rules for movement (e.g., timing of transport and hand opening) are stored.
Other factors like direction, speed, and grasp types modify the patterns.

Reaction Time (RT)

Reaction time measures the time it takes to process sensory information and initiate a movement.
It is a basic research tool to understand discrete actions, such as reaching.
Reaction time increases when visual processing and motor response selections are complex.

Simple vs. Choice Reaction Time

Simple RT involves a single stimulus and response.
Choice RT involves multiple stimulus-response possibilities.
Choice RT generally takes longer due to increased processing time.

Fitt’s Law of Movement

Fitt's Law describes the trade-off between speed and accuracy in movements that involve reaching and grasping.
Movement time increases with increasing distance and accuracy demands.

Theories of Reaching Control

Distance and location programming theories describe how the CNS controls reaching movements.
Distance programming heavily relies on initial visual perception.
Muscle stiffness is adjusted based on the location/direction of a target to be reached.

Interference between Reaching and Cognitive Tasks

Dual-task paradigms demonstrate interference between cognitive and motor tasks that require reaching and grasping.
Completing a cognitive task while reaching leads to slower movement onset times.

Prefrontal Cortex and Limbic System Influence

Prefrontal cortex plays a key role in motivation, stopping actions, and higher-level motor planning.
The limbic system is involved in goal-directed behaviors.

Conceptual Mapping of Neural Control of Reach and Grasp

A conceptual map is suggested to integrate different concepts.

What Might Be the Elements of the Conceptual Map?

The brain regions (e.g., visual cortex, parietal cortex, prefrontal cortex), pathways, and processes involved in reaching and grasping are outlined.
Factors include target location, body schema, sensory processing (visual, somatosensory), and motor processing.

Extrapolate Reaching and Grasping Research

Research on reaching and grasping in the upper extremity impacts other similar complex movement tasks.

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Description

Test your knowledge on the key aspects of upper extremity (UE) function! This quiz covers important factors involved in assessing UE function, including motor control and rehabilitation. Discover what is crucial for tasks like reaching, grasping, and manipulating objects in everyday life.