BSN 266 HESI V2 Questions with Verified Answers |
Latest 2024/2025 Grade A- Nightingale.
__________________________________________________________________________________________
Categories of neurological impairment
Weakness
Abnormal muscle tone
Sensory and perception dysfunction
Lack of coordination
Balance dysfunction
Weakness impairment
Due to MSK injury
Due to neuromuscular pathology
Over or under recruitment
Over recruitment
Occurs when additional neurons fire and shore up declining brain structures that are inefficient
Under recruitment
Occurs when neuronal firing is limited when the brain is activated
Treatment for a weakness impairment
Strength program
Isometrics
Bands, weights, more
Neuro-physiological rational/function of weakness treatment
1|Page
,Resetting the spindle
Reciprocal inhibition
Alpha and gamma neurons
UMN vs LMN vs motivation
Motor pathways involved
Muscle spindle
A sensory receptor located in a muscle that senses its tension
When a muscle is stretched, the spindle loses its spiral shape and stretches, which signals the muscle to
contract. This process is called the stretch reflex and helps protect the muscle from being overstretched
Eccentric contraction lengthens this
Intrafusal
Sensory fibers that detect stretch of the muscle
Resetting the muscle spindle
Proprioceptive Neuromuscular Facilitation (PNF) stretching
Static stretching
Strength training
Reciprocal inhibition
The simultaneous contraction of one muscle and the relaxation of its antagonist to allow movement to take
place
Alpha neurons
Major Motor Neurons
Small
Quick conduction
2|Page
,Responsible for
voluntary and reflexive movements of the head, trunk and extremities
Gamma neurons
Adjust the tension in the muscle spindle fibers so they can accurately detect a stretch
Regulate the gain of the stretch reflex by adjusting the level of tension in the intrafusal muscle fibers of the
muscle spindle
Upper motor neuron
Motor neurons that project from the cortex down to the spinal cord or brainstem
Originates in cerebral cortex or brainstem and terminates on a lower motor neuron
First neuron in the motor command pathway with its cell body in the cerebral cortex that synapses on the
lower motor neuron in the spinal cord
In the CNS
Lower motor neuron
Lower motor neurons (LMNs) originate in the spinal cord and brainstem, and are part of a two-neuron circuit
with upper LMNs: the cell bodies of lower MNs are located in the ventral horn of the spinal cord's gray matter
or located in the motor nuclei of the cranial nerves
Formed when UMNs synpase onto the LMNs which are in the anterior horns of the central gray matter
Second neuron in the motor command pathway that is directly connected to the skeletal muscle
Can be a peripheral nerve
Motor pathways involved in muscle weakness
Alpha or gamma motor neurons
Neuromuscular junction (NMJ)
Corticospinal tract (CST)
Lower motor neurons
3|Page
, Neuromuscular junction
Point of contact between a motor neuron and a skeletal muscle cell
Corticospinal tract (CST)
This tract is responsible for voluntary refined movements of distal extremities
Begins in the primary motor cortex
Pathway of upper motor neurons from the motor cortex (UMN) to the lower motor neurons (LMN) in the
contralateral spinal cord
Abnormal tone impairment
Increased
Decreased
Hypertonicity
Rigidity vs abnormal tone
Increased muscle tone
Hypertonia/hypertonicity
Decreased muscle tone
Hypotonia
Rigidity
The physical property of being stiff and resisting bending
Increased resistance to passively imposed muscle stretch; resistant is not velocity dependent and the same
resistance is felt throughout the ROM
Rigidity is caused by abnormal processing of sensory afferents and possibly overactive descending
retoculospinal pathways
Rigidity vs abnormal tone
Rigidity is constant
Treatment for abnormal tone
4|Page
Latest 2024/2025 Grade A- Nightingale.
__________________________________________________________________________________________
Categories of neurological impairment
Weakness
Abnormal muscle tone
Sensory and perception dysfunction
Lack of coordination
Balance dysfunction
Weakness impairment
Due to MSK injury
Due to neuromuscular pathology
Over or under recruitment
Over recruitment
Occurs when additional neurons fire and shore up declining brain structures that are inefficient
Under recruitment
Occurs when neuronal firing is limited when the brain is activated
Treatment for a weakness impairment
Strength program
Isometrics
Bands, weights, more
Neuro-physiological rational/function of weakness treatment
1|Page
,Resetting the spindle
Reciprocal inhibition
Alpha and gamma neurons
UMN vs LMN vs motivation
Motor pathways involved
Muscle spindle
A sensory receptor located in a muscle that senses its tension
When a muscle is stretched, the spindle loses its spiral shape and stretches, which signals the muscle to
contract. This process is called the stretch reflex and helps protect the muscle from being overstretched
Eccentric contraction lengthens this
Intrafusal
Sensory fibers that detect stretch of the muscle
Resetting the muscle spindle
Proprioceptive Neuromuscular Facilitation (PNF) stretching
Static stretching
Strength training
Reciprocal inhibition
The simultaneous contraction of one muscle and the relaxation of its antagonist to allow movement to take
place
Alpha neurons
Major Motor Neurons
Small
Quick conduction
2|Page
,Responsible for
voluntary and reflexive movements of the head, trunk and extremities
Gamma neurons
Adjust the tension in the muscle spindle fibers so they can accurately detect a stretch
Regulate the gain of the stretch reflex by adjusting the level of tension in the intrafusal muscle fibers of the
muscle spindle
Upper motor neuron
Motor neurons that project from the cortex down to the spinal cord or brainstem
Originates in cerebral cortex or brainstem and terminates on a lower motor neuron
First neuron in the motor command pathway with its cell body in the cerebral cortex that synapses on the
lower motor neuron in the spinal cord
In the CNS
Lower motor neuron
Lower motor neurons (LMNs) originate in the spinal cord and brainstem, and are part of a two-neuron circuit
with upper LMNs: the cell bodies of lower MNs are located in the ventral horn of the spinal cord's gray matter
or located in the motor nuclei of the cranial nerves
Formed when UMNs synpase onto the LMNs which are in the anterior horns of the central gray matter
Second neuron in the motor command pathway that is directly connected to the skeletal muscle
Can be a peripheral nerve
Motor pathways involved in muscle weakness
Alpha or gamma motor neurons
Neuromuscular junction (NMJ)
Corticospinal tract (CST)
Lower motor neurons
3|Page
, Neuromuscular junction
Point of contact between a motor neuron and a skeletal muscle cell
Corticospinal tract (CST)
This tract is responsible for voluntary refined movements of distal extremities
Begins in the primary motor cortex
Pathway of upper motor neurons from the motor cortex (UMN) to the lower motor neurons (LMN) in the
contralateral spinal cord
Abnormal tone impairment
Increased
Decreased
Hypertonicity
Rigidity vs abnormal tone
Increased muscle tone
Hypertonia/hypertonicity
Decreased muscle tone
Hypotonia
Rigidity
The physical property of being stiff and resisting bending
Increased resistance to passively imposed muscle stretch; resistant is not velocity dependent and the same
resistance is felt throughout the ROM
Rigidity is caused by abnormal processing of sensory afferents and possibly overactive descending
retoculospinal pathways
Rigidity vs abnormal tone
Rigidity is constant
Treatment for abnormal tone
4|Page
