NMS
5-13

Proprioception
1.	dorsal column
2.	spinocerebellar—coordinates muscles—ataxia—inability to control muscles
•	eyes can send information back to the cerebellum
•	w/eyes open or closed will experience ataxia w/ a cerebellum lesion
•	intension tremor—early sign of cerebellum lesion (no tremor at rest, but when move have the tremor)
•	essential tremor—occurs even at rest, a tremor that is just there (no one knows why)
•	Parkinson's—pill rolling tremor—go away w/certain meds
•	Dysdiadochokinesia—inability to perform rapid alternating movement—early indicator to show loss of muscle control
•	Dysmetria—passed pointing
•	Hypotonia results on the affected side
•	Lesion is ipsilateral to side affected (right cerebellar lesion, problems on the right side)
•	Agnosia—discriminate sensation
•	Aphasia—inability to communicate
•	Ataxia—difficulty controlling muscular activity

•	Cord lesion w/functioning cerebellum
•	Have trouble getting info to cerebellum
•	May show some signs
•	Strange gait
•	Eye sight w/help compensate
•	Pronator sign—arm falls down

•	Romberg Sign
•	Pt stands w/arms out and close eyes
•	Swaying increases—cord lesion (eyes compensate)
•	Increased ataxia w/eyes closed

3.	DTR
•	Most primitive
•	Maturity controls these reflexes
•	When lose control of DTR, UMN lesion—hyper-reflexia
•	Muscle spindle initiates the reflex
•	Transmit on the annulospiral
•	Synapses on MN
•	Extrapyramidal pathway inhibits this reflexes
•	Cortical and Pyramidal are the same thing—voluntary motion
•	Extrapyramidal:  tectospinal, rubrospinal (motor pathways)—inhibition, maintaining normal control over activity—keeps the reflexes under control
•	Only to motor pathways in CNS is pyramidal and extrapyramidal