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2nd year > anatomy - movement and control > Flashcards

anatomy - movement and control Flashcards

1
Q

upper motor neurone lesion

A

hypertonicity - spasticity after a couple of days
spasticity
paralysis of movement rather than individual muscles
hopping rabbit posture
moderate muscle wasting
babinski sign
hyperreflexia

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2
Q

lower motor neurone lesion

A

paralysis of individual muscles
hypotonicity - flaccidity
muscle wasting
tendon reflexes are absent

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3
Q

what supplies the internal capsule?

A

middle cerebral artery

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4
Q

function of basal ganglia

A

initiation and termination of movement
initiation and termination of some cognitive functions - attention, memory, planning, emotions and cognition via projections to cortical and limbic systems

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5
Q

damage of basal ganglia

A

leads to spontaneous and inappropriate movement

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6
Q

what is the anatomy of the basal ganglia?

A

collection of nuclear masses in forebrain
caudate nucleus
putamen
globus pallidus
amygdala - part of limbic system
2 midbrain structures = substantia nigra and subthalamus

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7
Q

caudate nucleus

A

most superior part of basal ganglia
above and lateral to thalamus
medial to internal capsule

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8
Q

putamen and globus pallidus

A

together = lentiform nucleus

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9
Q

putamen and caudate nucleus

A

functionally related

form corpus striatum

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10
Q

what makes up the limbic system?

A 
hippocampus
amygdala
thalamus
hypothalamus
their connections
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11
Q

what is the role of the limbic system?

A 
initiation and termination
neuroendocrine
motivation 
mood 
attention 
planning 
focus 
concentration 
emotional function
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12
Q

what is the amygdala?

A

part of limbic system

where movement and cognitive/ emotional abilities are linked

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13
Q

substantia nigra

A

dopaminergic neurones to basal ganglia
pigmented dopaminergic neurones projecting to corpus striatum of basal ganglia
largest nuclei in midbrain
black due to melanin

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14
Q

what is ballismus?

A

severe chorea with thrashing motions

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15
Q

what is athetosis?

A

involuntary writhing movements of limbs and neck - twisting anf turning

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16
Q

pneumonic for cerebellar problems

A

DANISH

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17
Q

DANISH

A 
Dysdiadokokinesis
Ataxia
Nystagmus
Intention tremor
Speech disturbance
Hypotonia
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18
Q

non- corticospinal motor pathways

A

originate from subcortical groups of motor neurons/ nuclei
control posture and balance
control coarse movements of proximal muscles
coordinate head, neck and eye movements in response to visual stimuli/ targets
project back to cortical motor regions and circuits in the spine

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19
Q

what is the trunk?

A

body minus head and limbs

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20
Q

what is the torso?

A

the trunk

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21
Q

what is the back?

A

spine

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22
Q

what is the spine

A

starts at inferior border of skull and ends at tip of coccyx

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23
Q

what is the role of the spine?

A
  • protects spinal cord and spinal nerves
  • carries the superior portion of body
  • allows resistance to gravity
  • absorbs shocks through curves and intervertebral discs
  • allows limited movement of trunk and neck
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24
Q

vertebra of the spine?

A

33 vertebrae

24 separate bones

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25
what are the regions of the spine?
``` cervical thoracic lumbar sacral coccygeal ```
26
sacral spine
5 vertebrae fused together
27
coccygeal spine
4 vertebrae all fused together - represented with Co not C
28
shape of cervical spine
lordosis
29
shape of thoracic spine
kyphosis
30
shape of lumbar spine
lordosis
31
formation of cervical lordosis
3 months when baby lifts head
32
lumbar lordosis formation
10 months - 1 year when baby begins to walk
33
exaggerated lumbar lordosis
common in pregnant women
34
exaggerated thoracic kyphosis
common in elderly
35
what are the different types of spina bifida?
spina bifida occulta closed spinal dysraphism meningocele myelomeningocele
36
spina bifida occulta
closed asymptomatic neural tube defect in which some of the vertebrae are not completely closed
37
closed spinal dysraphism
deficiency of at least 2 vertebral arches | can be covered with a lipoma
38
meningocele
protrusion of meninges filled with CSF through defect in skull or spine
39
myelomeningocele
open spinal cord | with a meningeal cyst
40
innervation of anterior 2/3 of tongue
hypoglossal = motor facial = special sensory (taste) trigeminal mandibular branch via lingual nerve = general sensory vagus nerve = motor to palatoglossus
41
innervation of posterior 1/3 tongue
glossopharyngeal nerve = general and special sensory
42
intrinsic muscles tongue
superior longitudinal inferior longitudinal transverse vertical
43
extrinsic muscles of tongue
hypoglossus styloglossus genioglossus palatoglossus
44
embryological origin of the tongue
pharyngeal arches | each one has its own cranial nerve supply
45
locked jaw
dislocation of temporomandibular joint/ TMJ - head of mandible moves past articular tubercle - caused by opening mouth too wide - physical relocation required
46
what are the phases of swallowing?
voluntary oral phase involuntary pharyngeal phase involuntary oesophageal phase
47
voluntary oral phase
controlled by cerebral cortex via cranial nerves
48
involuntary pharyngeal phase
rapid controlled by sensory receptors and swallowing centre in medulla triggers reflex arc respiration is momentarily stopped
49
involuntary oesophageal phase
peristaltic movement involves vagus and accessory nerves sympathetic fibres
50
what cranial nerves are involved in swallowing?
``` trigeminal facial glossopharyngeal vagus controlled by cerebral cortex and brainstem ```
51
other controls of swallowing
common integration area brainstem cranial nerve nuclei
52
common integration area
integrates sensory information about food, size, temperature and texture from mouth, pharynx and larynx makes decision whether to swallow and sends orders to reflex muscles of mastication which close the larynx and epiglottis
53
deglutition reflex arc
1. sensory receptors in oropharynx send signal to deglutition centre in brainstem 2. initiates motor activity mediated by cranial nerves 3. effects muscle contraction to: - elevate soft palate to close the nasopharynx - move the epiglottis and elevate it to close off the larynx - initiates peristalsis of pharynx and oesophagus 4. respiration is temporarily stopped during the pharyngeal phase
54
what is the role of the gag reflex?
protection of GI tract
55
gag reflex
1. glossopharyngeal nerve – tactile sensation from posterior 2/3 tongue 2. brainstem – sensory nucleus of trigeminal nerve 3. brainstem – nucleus ambiguous of vagus and hypoglossal nuclei 4. vagus and glossopharyngeal nerves – efferent pathway to muscles 5. innervation of muscles of soft palate, pharynx, upper part of oesophagus and stylopharyngeus (innervated by glossopharyngeal nerve)
56
prevalence of back pain
10%
57
lifetime prevalence of back pain
80%
58
disease burden of back pain
psychological problems lots of people off work leading cause of disability globally
59
causes of back pain
- scoliosis - herniated/ prolapsed disc - cancer - sciatica - trauma - pregnancy - mechanical – heavy lifting etc. - pathological fractures - ankylosing spondylitis - nerve compression - kyphosis - bad posture - HIV - depression - trauma - fragility fractures - stress fracture - infection – intervertebral disc - sclerosis - cauda equina syndrome – compression of cauda equina - arthritis
60
red flags for back pain
``` unexplained weight loss urinary retention young age new pain PMH of cancer bladder symptoms lumps thrombocytopenia neurological deficit sexual dysfunction saddle anaesthesia fever recent travel fatigue thoracic back pain ```
61
cauda equina syndrome
compression of cauda equina urinary retention saddle anaesthesia
62
causes of referred back pain
``` kidney stones pyelonephritis MI menstrual pain endometriosis duodenal ulcers pancreatitis abdominal aortic aneurysms thoracic aortic aneurysms ```
63
mechanical back pain
97% of back pain
64
imaging for back pain
MRI is gold standard if concerned about cord progression or neurological symptoms X-ray not normally needed in absence of red flag symptoms
65
what age is back pain most concerning?
<20 year olds = very concerning | >55 year olds back pain = higher risk of serious causes such as AAA or cancer
66
vertebral artery
runs through transverse foramen of cervical vertebrae carries blood supply to posterior of brain - brainstem, cerebellum and posterior cerebral cortex elderly can occlude this
67
C1
no vertebral body
68
C2
has dens/ peg
69
C7
spinous process = prominent and palpable
70
body of cervical vertebrae
small wide side to side
71
spinous process of cervical vertebrae
short bifid | projects posteriorly
72
vertebral foramen of cervical vertebrae
contains vertebral artery | triangular
73
transverse process of cervical vertebrae
contain foramina
74
movements of cervical vertebrae
flexion extension lateral flexion rotation
75
body of thoracic vertebrae
larger than cervical heart-shaped 2 costal demifacets
76
spinous process of thoracic vertebrae
long sharp projects inferiorly
77
vertebral foramen of thoracic vertebrae
circular
78
transverse process of thoracic vertebrae
facets for ribs - except T11 and 12
79
Movements of thoracic vertebrae
rotation limited lateral flexion due to ribs flexion and extension prevented
80
body of lumbar vertebrae
massive | kidney shaped
81
spinous process of lumbar vertebrae
short blunt projects posteriorly
82
vertebral foramen of lumbar vertebrae
triangular
83
transverse process of lumbar vertebrae
thin and tapered
84
movements of lumbar vertebrae
flexion extension some lateral flexion rotation prevented
85
intervertebral disc
between vertebra | degenerates over time causing height loss
86
structure of intervertebral discs
centre = nucleus pulposus | outer layer = annulus fibrosis
87
what happens in a herniated disc?
rupture of annulus fibrosis and nucleus pulposus seeps out | can cause compression of spinal nerve
88
caudal epidural
given through sacral hiatus
89
interlocking vertebrae
superior and inferior articular processes form the joint | intervertebral foramen between the 2 vertebrae
90
intervertebral foramen
where spinal nerve leaves spinal cord
91
arthritis
can cause compression of spinal nerve
92
what are the ligaments of interlocking vertebrae
``` supraspinous interspinous ligamentum flavum anterior longitudinal posterior longitudinal ```
93
where does the spinal cord end?
L1 | extends more inferiorly in babies and shorter people
94
lesion of cauda equina
causes lower motor neuron lesion signs
95
L4
vertebra is level with iliac crest | level for lumbar puncture as this is where the cauda equina is so won't cause damage
96
where does the subarachnoid space end?
S2
97
test for scoliosis
bend over | one side will go lower than the other
98
caudal epidural injections
used during birth process

2nd year (48 decks)

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