13 - Spinal Cord: Motor Systems Flashcards

1
Q

Describe how skeletal muscle contraction is controlled

A

motor neurons originating in the primary motor cortex synapse with another motor neuron in the brainstem or the spinal cord

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2
Q

what is the corticospinal tract

A

connects primary motor cortex to the spine
- controls upper limb, trunk, lower limb via spinal nerves

cortex –> spine –> spinal nerve –> control structures in the body (upper limb, trunk and lower limb)

Motor neuron crosses over in the medulla (decussate) to corticospinal tract
Hand: would go to cervical ventral root
Foot: would go to lumbar ventral root

all axons are bundled together

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3
Q

What is the corticobulbar tract

A

connects primary motor cortex to the brainstem
- controls head and neck via cranial nerves

primary motor cortex –> brainstem –> out through cranial nerve –> controls muscles of the head and neck (face)

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4
Q

What would happen if there were a lesion in the cortex above the brainstem crossing (ex. stroke)

A

contralateral sign (signs on the opposite side to the side of the brain that is affected) - from underneath the brainstem crossing
- touch and pressure
- proprioception
- pain and temperature
- motor

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5
Q

What would happen if there were a lesion in the spinal cord

A

ipsilateral signs (deficits in the same side as lesion) - b/c sensory information can’t get past the break and motor information can’t come go down and past it
- touch and pressure
- proprioception
- motor
All information already crossed over = ipsilateral signs

contralateral signs - b/c information immediately crosses over at the top of the spinal cord
- pain and temperature

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6
Q

What is the direct motor pathway

A

primary motor cortex –> internal capsule (deep cortex) –> pyramidal tracts (brainstem) –> corticospinal tracts (spinal cord)

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7
Q

What is the lateral corticospinal tract

A

contains axons of upper motor neurons that control skeletal muscle in the distal part of limbs (upper and lower)

90% of axons already crossed

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8
Q

Anterior corticospinal tract

A

contains axons of upper motor neurons that control skeletal muscle in the proximal limb and trunk (midline, proximal to limb – hip, shoulders)

10% of axons uncrossed
only cross over at level they need to leave at

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9
Q

How are lower motor neurons of the ventral grey horn organized

A

kinda homonculus

lateral in grey matter –> more distal part of appendages
medial parts of body = more medial in grey matter

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10
Q

Describe white matter tracts

A

larger at the top of the spinal cord and become smaller as they descend

really big in cervical –> very small in sacral
(because they spread out as you go down)

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11
Q

Describe grey matter tracts

A

larger in the areas innervating the limbs (lumbar and sacral and cervical)

contains:
dorsal horn (sensory)
lateral horn (neuronal cell bodies of the sympathetic nervous system)
ventral horn (motor)

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12
Q

What does the thoracic segment include

A

includes a lateral grey horn (preganglionic sympathetic neuron)

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13
Q

What is the facial nerve

A

right facial nerve innervates muscles on the right side of your face
facial expression, blinking eye

Contains sensory and motor

Somatic: close mouth, occulair, obicullus
Sensory: taste sensations,
Parasympathetic: make tears to wash cornea (lacramal)

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14
Q

Upper motor neuron lesions

A

damage to soma in cortex or axon in coricospical tract
lower limb injury

results in spastic paralysis (muscle that you lost control over has muscle tone = very stiff)
- hypertonia = increase muscle tone
- hyperreflexia = better reflexes
- positive babinski = abnormal response to touch sensations (flexing foot when you should curl towards stimulus)
- clonus = repetetive muscle reflex (keeps repeating)

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15
Q

Lower motor neuron lesions

A

damage to spinal cord grey matter or peripheral nervous system (cranial or spinal nerve)
upper limb injury

results in flaccid paralysis: can’t control muscle, no muscle tone (need brace)
- hypotonia = reduction muscle tone
- hyporeflexia = muscle not activated, lower reflex
- fasciculations = bundle of muscle fibres contract on their own
- atrophy = wasting away (b/c can’t use the muscle)

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16
Q

What are the compartments that limbs are divided into

A

flexor and extensor

17
Q

Synergistic muscles

A

muscles activated within the same limb compartment
help each other out

18
Q

Antagonistic muscles

A

muscles activated in opposite limb compartments
to provide stability for joints

19
Q

What is the Brachial plexus

A

formed from c5-t1
formed by mixed spinal nerve from ventral ramus (stuff going to front)
innervate both proximal and distal large muscle groups in upper limb

20
Q

What is the purpose of the brachial plexus

A

1) to join at least 2 spinal levels
2) separate anterior flexor and posterior extensor divisions: flexors to the front of the limb, extensors to the back

21
Q

Myotoms

A

spinal levels innervating specific groups of muscles (lower motor neurons)

upper limb and lower limb myotomes

22
Q

What is the general rule for plexuses and myotomes

A

the further down the plexus, the more distal the myotome

23
Q

What is the lumbo-sacral plexus

A

innervates the lower lim (obturator nerve - adductors of hip)(femoral nerve - extensors of knee)

24
Q

What is the purpose of the lumbo-sacral plexus

A

1) to join at least 2 spinal levels
2) separate anterior flexor and posterior extensor divisions: flexors to the front of the limb, extensors to the back

Sciatic nerve: two nerves glued together that will seperate just about above knee
Fibular nerve: muscles associated with shin
Tibial nerve: muscles in calf

25
Q

Paresis

A

muscle weakness

with upper or lower motor neuron lesion

26
Q

Where are peripheral nerves derived from

A

nerve plexuses

27
Q

What is the peripheral nerve pathway

A

peripheral nerves are deep, give off their muscular branches/provide –> become superficial, giving off their cutaneous (sensory) branches/provide

ex. deep muscular branches –> cutaneous distribution of musculotaneous nerve

28
Q

What would happen if there were a lesion proximal to the brachial plexus

A

motor loss and sensory loss

29
Q

What would happen if there were a lesion distal to the brachial plexus

A

already given off muscular branches
sensory loss only