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NEUROLOGY > 1b Motor Cortical Control > Flashcards

1b Motor Cortical Control Flashcards

1
Q

What is meant by the hierarchical organisation?

A

high order areas of hierarchy are involved in more complex tasks, and lower level areas of hierarchy perform lower level tasks

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2
Q

What is meant by functional segregation?

A

Motor system organised in a number of different areas that control different aspects of movement

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2
Q

What do the cerebellum and the basal ganglia do in the motor system of heirarchy?

A

adjust the commands received from the other parts of the motor system

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3
Q

What are the two pyramidal descending tracts?

A

corticospinal
corticobulbar

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4
Q

Why are the pyramidal tracts called pyramidal?

A

because they pass through the pyramids of the medulla

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5
Q

What do the pyramidal descending tracts do?

A

voluntary movement of the body and face muscles

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6
Q

What are the extrapyramidal tracts?

A

descending tracts which do not pass through the pyramids of the medulla

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7
Q

Which descending tracts are responsible for the involuntary movements of balance, posture and locomotion?

A

Extrapyramidal

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8
Q

Where is the primary motor cortex located?

A

Anterior to the central sulcus

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9
Q

What does the primary motor cortex do?

A

Controls fine, discrete and precise voluntary movements

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10
Q

What does the premotor area do?

A

Involved in planning movements, by regulating externally cued movements

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11
Q

what does the supplementary motor area do?

A

Planning complex movements and becomes active prior to voluntary movements

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12
Q

Where does the lateral corticospinal tract decussate?

A

In the medulla

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12
Q

Where does the lateral corticospinal tract decussate?

A

In the medulla - innervates the limb muscles

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13
Q

Where does the anterior corticospinal tract decussate?

A

Spinal cord - innervates the trunk muscles

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14
Q

What is the principal motor tract for voluntary movement of the face and the neck?

A

Corticobulbar

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15
Q

What is the function of the vestibulospinal tract?

A

Stabilise head during body movements, or as head moves
Coordinate head movements with eye movements
Mediate postural adjustments

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16
Q

What is the function of the reticulospinal tract?

A

Most primitive descending tract - from medulla and pons
Changes in muscles tone associated with voluntary movement
Postural stability

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17
Q

What is the function of the tectospinal?

A

Orientation of the head and neck during eye movements

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18
Q

What is the function of the rubrospinal tract?

A

Innervate lower motor neurons of flexors of the upper limb

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19
Q

What is paresis?

A

graded weakness of movement

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20
Q

What are the three negative signs of an upper motor neuron lesion?

A

Loss of voluntary movement
Paresis
Paralysis = complete loss of voluntary muscle activity

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21
Q

What is spasticity?

A

Increased muscle tone

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22
Q

What is hyper-reflexia?

A

Exaggerated reflexes

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23
what is clonus?
Abnormal oscillatory muscle contraction
24
What are the positive signs of an upper motor neurone lesion ?
Increased abnormal motor function due to loss of inhibitory descending inputs Spasticity: increased muscle tone Hyper-reflexia: exaggerated reflexes Clonus: abnormal oscillatory muscle contraction Babinski’s sign
25
what is Apraxia?
disorder of skilled movement - patients lose information about how to perform skilled movements
26
Lesions to which areas can cause apraxia?
Frontal lobe and the inferior parietal lobe - premotor cortex, and supplementary motor area
27
What two diseases are the most common causes of apraxia?
Stroke and dementia
28
What is seen in patients with a lower motor neuron lesion?
Weakness Hypotonia Fibrillations Fasciculations Hyporeflexia Muscle atrophy
29
What is Fasciculations?
damaged motor units produce spontaneous action potentials, resulting in a visible twitch
30
What is the difference between fasciculations and fibrillations?
Fasciculations = damaged motor units producing twitching, Fibrillations = individual muscle fibres producing twitching
31
What is motor neurone disease also known as?
Amyotrophic Lateral Sclerosis
32
What are the upper motor neuron signs of motor neuron disease?
Spasticity (increased tone of limbs and tongue) Brisk limbs and jaw reflexes Babinski’s sign Loss of dexterity Dysarthria (difficulty speaking) Dysphagia (difficulty swallowing)
33
What are the lower motor neuron signs of motor neuron disease?
Weakness Muscle wasting Tongue fasciculations and wasting Nasal speech Dysphagia
34
What are the two nucleuses which make up the basal ganglia called?
Lentiform nucelus and caudate nucleus
35
What makes up the lentiform nucleus?
The putamen and globus pallidus
36
What is the function of the basal ganglia?
Making the decision to move Elaborating associated movements Moderating and coordinating movements Performing movements in order
37
What is parkinsons disease/
Degeneration of the dopaminergic neurons that originate in the substantia nigra and project to the striatum
38
What are the five associated symptoms of Parkinsons?
Bradykinesia Hypomimic face Akinesia Rigidity Tremor at rest
39
What is bradykinesia?
slowness of (small) movements (doing up buttons, handling a knife)
40
What is hypomimic face?
face - expressionless, mask-like (absence of movements that normally animate the face)
41
What is Akinesia?
difficulty in the initiation of movements because cannot initiate movements internally
42
What is rigidity?
muscle tone increase, causing resistance to externally imposed joint movements
43
What is a pill rolling tremor?
When the patients hands tremor as if they were polling a pill between two fingers, which with time can spread to other parts of the body
44
What is Huntington's disease?
Degeneration of GABAergic neurons in the striatum, caudate and then putamen
45
What causes Huntingtons disease?
CAG repeat on chromosome 4
46
What are some symptoms of Huntington's disease?
Choreic movements Rapid jerky movements - hands and face affect Speech impairement Difficulty swallowing Unsteady gait Cognitive decline and dementia
47
What is the most common cause of Ballism?
Stroke which affects the subthalamic nucleus
48
What is Ballism?
Contralateral, uncontrolled flinging of the extremities
49
What separates the cerebellum from the cerebrum?
The tentorium cerebelli
50
What is the function of the vestibulocerebellum?
Regulation of gait, posture and equilibrium Coordination of head movements with eye movements
51
What does damage to the vestibulocerebellum cause?
gait ataxia and tendency to fall (even when patient sitting and eyes open)
52
What is the function of the spinocerebellum?
Coordination of speech Adjustment of muscle tone Coordination of limb movements
53
What can cause degeneration and atrophy of the spinocerebellum?
chronic alcoholism
54
What does damage to the spinocerebellum cause?
Abnormal gait and stance (wide based)
55
What is the function of the cerebrocerebellum?
Coordination of skilled movements, cognitive function, attention and processing of language
56
What does damage to the cerebrocerebellum result in?
Affects arms (coordinated movments) and speech
57
What is Ataxia?
General impairments in movement coordination and accuracy. Disturbances of posture or gait: wide-based, staggering (“drunken”) gait
58
What is dysmetria?
Inappropriate force and distance for target-directed movements (knocking over a cup rather than grabbing it)
59
What is Dysdiadochokinesia?
Inability to perform rapidly alternating movements (rapidly pronating and supinating hands and forearms)
60
What is scanning speech?
Staccato speech, due to impaired coordination of speech muscles
61
What are the main signs of cerebellar dysfunction?
Ataxia Dysmetria Intention remor Scanning Speech Dysdiadochokinesia
62
What causes a fasciculation?
When the muscle fibres of a motor unit lose their nerve supply - they become denervated Axons of the remaining motor unit grow and reach out to the denervated muscle fibres - reinnervation takes place Therefore the resulting motor unit is larger and prone to ectopic generation of electrical stimuli in the distal axons which cause muscle contraction = fasciculation
63
What is the striatum?
Caudate + putamen
64
What is the lentiform nucleus?
Putamen + external globus pallidus
65
What is the result of a stroke affecting the subthalamic nucleus?
Ballism

NEUROLOGY (22 decks)

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