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Applied Neuroanatomy: Motor Tracts for Occupational Therapy Practice

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1.  Alex was recently involved in a motor vehicle accident, which left her with whiplash and fractures to her right humerus and clavicle. Although she did not have any major damage to structures below her elbow, she is no longer able to extend her wrist or fingers. Which spinal motor tract did Alex injure? Rubrospinal tract Corticospinal tract Spinothalamic tract Vestibulospinal tract

2.  You have a patient with left-sided stroke, and you suspect there is damage to their Corticospinal tract. What is the best tool to use to assess the patients voluntary motor functioning? Timed Up and Go Functional Reach Test Hydraulic hand dynomometer Fugl-Meyer Assessment

3.  Which intervention is most appropriate for addressing damage to the Vestibulospinal tract? Use neuro-reeducation techniques, such as PROM and AROM exercises, to maintain mobility of joint and improve movement and strength. Introduce adaptive equipment, such as a sock donning aide and long-handled sponge, to compensate for the loss of motor control. Practice using these tools and other adaptive techniques during functional skills training. Begin all activities in upright, neutral alignment. Challenge seated and standing balance by performing activities that require weight shifting, such as sorting laundry, making the bed, and emptying the dishwasher Create a splint to prevent wrist-drop as the tract heals. Use this splint during treatment sessions to practice skills such as grasping and releasing objects, opening containers, and performing self-care activities.

4.  Your patient has a loss of voluntary motor control on the contralateral (opposite) side following a left sided stroke. Which tract is most likely affected? Lateral Vestibulospinal tract Lateral Corticospinal tract Ventral Corticospinal tract Reticulospinal tract

5.  Which of the following types of movement is NOT associated with the Reticulospinal tract? Postural control Bilateral motor control Head stabilization Overall muscle tone

6.  Which of the following compensatory strategies is most appropriate for an individual with an impaired lateral Corticospinal tract? Introduce adaptive techniques to compensate for one-sided weakness, including one-handed sock donning and hemiplegic dressing techniques. Pair these strategies with adaptive equipment to increase independence in self-care activities. Make recommendations for seating and positioning aids to help the patient maintain appropriate posture while eating at the kitchen table. Introduce a walker or a cane to compensate for poor postural control and irregular stepping pattern when moving around the home. Modify the home environment using high-contrast materials to improve the patient's ability to navigate the space. For example, use dark placemats with white dinnerware so she can easily see where her plate is at dinner.

7.  An occupational therapist is evaluating a patient who cannot independently maintain an upright posture when seated at edge of bed. In addition, the OT is concerned about his risk for falls because he was only able to reach forward 5 inches on the Functional Reach Test without losing his balance. What tract is most likely affected? Corticospinal tract Vestibulospinal tract Rubrospinal tract Reticulospinal tract

8.  Which of the following is the major function of the Rubrospinal tract? Extends shoulder and elbow Voluntary motor control Postural control and muscle tone Extends wrist and fingers

9.  What is NOT a treatment technique for a patient who lacks overall muscle tone and bilateral gross motor control due to a damaged Reticulospinal tract? Promoting proper posture and positioning by using a seating aid or bolster Range of motion exercises to reduce risk of contractures Introducing a walker or mobility aid and modifying the environment so it is more accessible Core and lower extremity strengthening exercises

10.  The Berg Balance Scale is most useful in assessing which spinal motor tract? Reticulospinal tract Ventral Corticospinal tract Vestibulospinal tract Spinocerebellar tract