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fine motor
notes from fine motor lecture
113
Anatomy
Graduate
04/18/2012

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Term
what are fine motor movements
Definition
movements produced by smaller muscle groups, often referring to hand movements
Term
what are the 2 functions of the hands
Definition
sensory/perceptual tool; motor/executive tool
Term
touch - what is it and what does it do
Definition
the sensation that defines the limits of the body and provides information about places and objects in our environment
Term
what is perceptoin
Definition
sensory information with meaning attached to it
Term
what is stereognosis
Definition
the ability to use touch alone to identify objects
Term
what is it called when you feel and find something in your purse without having to look at it
Definition
stereognosis
Term
what is prehension
Definition
the ability to use our hands and upper limbs effectively
Term
is prehension a strong determinant of functional independence?
Definition
yes
Term
what does prehension include
Definition
visual regard, reach and grip formation, grasp, manipulation, release
Term
what is visual regard
Definition
visual attention held on an object
Term
what is reach and grip formation
Definition
directing and grading arm position and preshaping hand to match object
Term
what is grasp
Definition
the act of closing and stabilizing the hand on an object
Term
what is manipulation
Definition
movement of an object while it is being held
Term
what is release
Definition
manner in which an object leaves the hand
Term
what 2 types of postural control are used for prehension
Definition
proactive and reactive
Term
what is proactive postural control
Definition
contracting muscles and making anticipatory postural adjustments to prepare the body for movement
Term
what is reactive postural control
Definition
muscles responses to perturbations
Term
why is postural control important for visual exploration and functional reachign
Definition
prevents undesired movement, allows for adjustment of COG as upper limb moves through space, provides stability for completion of a task
Term
give an example of how visual perception plays an important role in reach, grasp, and manipulation
Definition
visual perception is needed for depth perception and for figure ground
Term
what is figure ground
Definition
ability to pick out an object from everything else that's surrounding it.
Term
what is visual motor control
Definition
ability to use visual information for precise guidance of movement
Term
does peripheral vision aid in reaching or in grasp and manipulation
Definition
reachign
Term
does central vision aid more in reaching or in grasp and manipulation
Definition
grasp and manipulation
Term
when visual input is not available, what else can be relied on
Definition
proprioceptive and tactile cues or visual memory
Term
what part of the upper extremity is involved in reach and grip formation
Definition
entire upper extremity
Term
what is the shoulder's function in reach and grip formation
Definition
moves hand in space over a wide area
Term
what is the elbow's function in reach and grip formation
Definition
places hand closer to or further from body
Term
what is the wrist and forearm function in reach and grip formation
Definition
position hand before grasp or initiation of weightbearing
Term
what is the finger and thum function in reach and grip formation
Definition
adjust position to accommodate the perceived spatial properties of the object
Term
what determines the way you approach/grip an object that you want to pick up
Definition
the size and shape of the object
Term
what does grasp pattern depend on
Definition
location, size, shape of object
Term
describe power grasps
Definition
forcible movements of thumb and fingers that act against the palm to transmit a force to an object
Term
3 examples of power grasps
Definition
cylindrical, spherical, hook grip
Term
describe precision and pinch grasps
Definition
forces are directed between the thumb and fingers, not against the palm
Term
what are some examples of precision/pinch grasps
Definition
pad to pad prehension, tip to tip prehension, pad to side prehension
Term
what type of muscular contractions does sustained grasp require
Definition
isometric
Term
what is a static grasp
Definition
any form of grasp in which the object does not move within the hand, although proximal joint movement may occur
Term
what is a dynamic grasph
Definition
object manipulation within the hand
Term
is holding a key using a lateral pinch static or dynamic?
Definition
static
Term
is rolling a needle between fingers to locate the eye of the needle static or dynamic?
Definition
dynamic
Term
what allows us to grade the force used during grasp
Definition
anticipatory control
Term
at what wrist position are manipulative tasks best performed
Definition
20-30 deg extension, 10 deg ulnar deviatino.
Term
why is 20-30 deg wrist extension and 10 deg ulnar deviation the best position for manipulative tasks
Definition
finger flexors are at useful length-tension range; thumb moves into a plane of opposition in relation to the fingers.
Term
what determines whether you sustain your grip/pinch?
Definition
somatosensory receptors, experience for the development of internal representations, anticipatory control or planning
Term
what are the 3 types of in-hand manipulation
Definition
shift, rotation, translation
Term
what is shift?
Definition
movement of an object on the finger pads or a mong the fingers
Term
what is rotation
Definition
movement of an object around its axis using the fingers
Term
what is translation
Definition
movement of an object from fingers to palm of from palm to fingers
Term
what is crude release
Definition
open hand and let go
Term
what is graded and cntrolled release
Definition
intentional, controlled release
Term
what is symmetrical bimanual coordination
Definition
tasks in which there is a strong coupling between limbs, such as catching a ball
Term
what is asymmetrical bimanual coordination
Definition
tasks in which one hand stablizes an object while the other manipulates the object
Term
what is an example of asymmetrical bimanual coordination
Definition
one hand stabilizes paper while the other hand writes on it
Term
at what gestational age do limb buds apper
Definition
26 days
Term
by what gestational age are upper limbs in appropriate position with defined fingers
Definition
end of 7th week
Term
are upper limbs fully developed at bifth
Definition
yes
Term
describe prenatal upper extremity movements
Definition
varied but not random; movements are targeted precursors to future movements, such as bringing hand to mouth
Term
what strongly influences the development of upper limb and hand movements in infancy?
Definition
visual regard
Term
describe early reaching
Definition
fling or thrust
Term
describe reaching at 4 months
Definition
visually guided and anticipatory
Term
what influences the delopment of reaching along with visual regard
Definition
postural control
Term
at what age are adult-like reaching patterns displayed
Definition
2 years
Term
describe the progression of anticipatory grip formation
Definition
develops in infancy but does not become adultlike until childhood
Term
describe the progression of grasp and manipulation
Definition
voluntary grasp develops in the first 6 months as hand reflexes integrate.
Term
when does thumb function in grasp and manipulation begin to initiate
Definition
3-12 months
Term
when do grasp patterns become more adult like
Definition
1 year
Term
for the next questions, list the age of the described stage of object manipulation in infancy
Definition
ok
Term
rotation of held objects
Definition
2 months
Term
translation of grasped objects
Definition
3 months
Term
vibrations/shaking of held objects
Definition
4 months
Term
bilateral hold of 2 objects
Definition
4.5 months
Term
2 handed hold of a single object
Definition
4.5 months
Term
hand to hand transfer of an object
Definition
4.5 months
Term
coordinated action with object in which one hand holds and other manipulates
Definition
5-6.5 months
Term
coordinated action with 2 objects
Definition
6-8.5 months
Term
deformation of objects (ripping, tearing, shredding)
Definition
7-8.5 months
Term
instrumental sequential actions
Definition
7.5-9.5 months
Term
when does the ability for voluntary release progress
Definition
as voluntary control of wrist, finger, and thumb extensors develop
Term
when does voluntary release emerge
Definition
7-9 months
Term
when does graded/controlled release emerge
Definition
12-15 months
Term
describe initial bimanual coordination
Definition
initial lack of dissociation of one hand from the other
Term
at what age is hand dissociation refined
Definition
8-10 months
Term
when is significant complexity of bimanual coordination reached
Definition
2 years
Term
describe prehensile skills and eye-hand coordination skills in preschool child
Definition
refined and practiced
Term
describe reach and grip formation in preschool child
Definition
adult like but continue to be refined through late childhood
Term
describe grasp and manipulatoin in a preschool child
Definition
utilized frequently. Use variety of grasps and manipulations
Term
by what age is hand preference for prehension well established
Definition
4-6 years
Term
how does pencil grip change from 1- 4+ years
Definition
palmar with supination, controlled by shoulder movement => digital grasp with pronated wrist, controlled by shoulder movement => static tripod, controlled by shoulder movement => dynamic tripod, moved by wrist and stabilized by upper arm
Term
list some additional fine motor skills achieved by 5 years
Definition
pours drink from pitcher; places pegs in small holes; strings small beads; manages buttons/zippers/snaps; puts key in lock and turns; dresses self; draws and copies shapes
Term
by what age is hand dominance with consistent use of one hand over the other established
Definition
6-7 years
Term
by what age do children demonstrate mastery of pencil grip and handwriting
Definition
school-age
Term
describe early catchgin
Definition
little force absorption, trap against chest, successful catching depends on skill of thrower, may turn away face and close eyes
Term
describe proficient catching
Definition
absorb forces, catch with hands, body moves to accommodate ball's location, appropriate hand orientation
Term
what things influence catching
Definition
task and environmental constraints: ball size, ball shape, location and speed of throw
Term
does catching require anticipatoin
Definition
yes
Term
for how long is prehension function maintained
Definition
through middle adulthood
Term
what affects prehension skills in adults
Definition
occupational choices
Term
how does prehension change in adulthood
Definition
hand strength declines, performance time increases, manual performance declines
Term
what do prehension changes in older adulthood reflect
Definition
adaptations to changes in visual, nervous, somatosensory, and musculoskeletal systems
Term
what causes hemiparetic cerebral palso
Definition
neurological insult before, during, or after birth that results in sensory and motor impairment on one side of the body
Term
is the upper or lower extremity more often involved in hemiparetic cp
Definition
upper
Term
what does the unaffected side do in hemiparetic cp
Definition
compensates for affected side
Term
what is a common cause of brachial plexus injuries in children
Definition
compression or traction injury from difficult childbirth
Term
what part of the brachial plexus is damaged in erb's palsy
Definition
C5-6
Term
what part of the brachial plexus is damaged in klumpke's palsy
Definition
C7-T1
Term
what symtoms are associated with brachial plexus injuries
Definition
motor and sensory impairmnent on involved side
Term
what determines severity of effects of brachial plexus injury?
Definition
extent of damage to the nerves
Term
what is the initial treatment of brachial plexus injury
Definition
immobilization for 7-10 days, followed by specific ROM, precauations, and positioning
Term
what is a stroke
Definition
disruption of blood flow to the brain with resultant brain tissue damage
Term
what is an ischemic stroke
Definition
artery blockage
Term
what is a hemorrhagic stroke
Definition
leakage or bursting of a blood vessel
Term
what is a transient ischemic attack
Definition
temporary disruption of bloodflow to the brain
Term
what does treatment of stroke involve
Definition
focus of return of upper extremity function; protection and support of paretic upper extremity; CIMT, ADL training
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