BS Flashcards

1
Q

Babinski sign

A
  • Upturning toes indicates pathological upper motor neuron lesion
  • Corticospinal tract
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2
Q

Corticospinal tract

A
  • Voluntary mvmt of body
  • 80% Cross over at medulla
  • Originate in cerebral cortex
  • Form pyramids of medulla
  • Upper motor neurons
  • Synapse with interneurons
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3
Q

Deep tendon reflexes

A
  • Stretch reflex, direct response from spinal cord
    -Hyporeflexia- Lower motor neuron
    Hyperreflexia- Upper motor neuron, pyramidal tract
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4
Q

Flaccid paresis

A
  • Lower motor neuron
  • Weakness, hypotonia, hyporeflexia
  • GBS, encephalopathy, botulism
  • Inability to contract muscles
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5
Q

Hemiparesis

A
  • Injury above medulla cause contralateral hemiparesis

- Injury below medulla cause ipsilateral hemiparesis

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6
Q

Hyperreflexia

A
  • Upper motor neuron involvement

- Can be DTRs or superficial

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7
Q

Superficial reflex

A
  • Sensory signal must ascend to brain

- Interruption of pathway between brain and spinal cord

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8
Q

Hypertonia

A
  • Upper motor lesion
  • Anterior horn of spinal cord
  • Reticulospinal tract
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9
Q

Hyporeflexia

A
  • Lower motor neuron issue
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10
Q

Hypotonia

A
  • Diminished resistance to passive movement

- Lower motor neuron disease

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11
Q

Internal capsule

A
  • Ascending and descending motor neurons
  • Corticospinal tract travels through
  • Going to and coming from cerebral cortex
  • Primary motor cotrex- hemiparesis and hemiplegia
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12
Q

Lateral corticospinal tract

A
  • Fine mvmt of ipsilateral limbs
  • Largest part of corticospinal tract
  • Descending motor neuron
  • Decussates in pyramid of medulla
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13
Q

Pyramidal tract

A
  • Originate in cerebral cortex
  • Carry motor fibers to brainstem, spinal cord
  • Voluntary control of musculature
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14
Q

Extrapyramidal tract

A
  • Originate in brainstem
  • Motor fibers to spinal cord
  • Involuntary control of musculature
  • Tone, balance, posture and locomotion
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15
Q

Primary motor cortex

A
  • Organized somatotopically
  • Dorsal potion of frontal lobe
  • Excites lower motor neuron, inhibits reflexes, tone
  • Betz cells
  • Anterior to central sulcus
  • Activates contralateral side of body
  • Posterior limb of internal capsule
  • Cross over at medulla
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16
Q

Premotor cortex

A
  • Frontal lobe, anterior to primary motor cortex
  • Timed individual mvmts via direct and indirect stimulation
  • Excites groups of neurons
  • Spatial and sensory guidance of tasks
  • Visually cued conditional tasks
  • Projects to spinal cord
  • Trunk muscles
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17
Q

Reticular formation

A
  • Brainstem
  • Interconnected nuclei, motor integration
  • Behavioral arousal and consciousness
  • CV control
  • Pain modulation
  • Habituation
  • Sleep and consciousness
  • Raphe, red and parvocellular nuclei
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18
Q

Ventral corticospinal tract

A
  • Descending
  • Cerebral cortex to spinal cord
  • Ends in mid thoracic region
  • Cross at anterior white commissure
  • Voluntary motor impulses to precentral gyrus
19
Q

Ventral horn of spinal cord

A
  • Motor neurons of axial muscles
  • Corticospinal tract runs through
  • Intact sensation but weakness with lesion
20
Q

Vestibular nuclei

A
  • Medulla
  • Input from CN VIII
  • Lateral and medial nucleus to cerebellum
  • Vestibulospinal tract- coordinate head and trunk movements
21
Q

Vestibulospinal tract

A
  • Extrapyramidal system
  • Motor commands
  • Alter muscle tone, extend and change position of limbs and head
  • Maintain posture and balance
  • Medial pathway, anterior horn cells
  • Funiculus
  • Righting reflex
22
Q

Lateral tracts

A

Precise movement of distal limbs

23
Q

Medial tracts

A

Gross movement of proximal limbs and trunk

24
Q

Muscle tone

A
  • Continuous, passive contraction of muscles
  • Hypertonia = UMN
  • Hypotonia = LMN
25
Neuromuscular junction
- Very large synapse, contact points | - LMN to skeletal musc
26
Nicotinic acetylcholine receptor blockers
- Paralysis of muscle, can't sense ach - Inhibit effect of acetylcholine - Immobilization of pts
27
Acetylcholine agonists
- Nicotine is mild agonist - Activation of cholinergic system- BP, addiction - Stimulates muscle and doesn't allow reexcition- exhaustion of muscle
28
Acetylcholinesterase blockers
- Build up of acetylcholinesterase at neuromusc jxn - Tx myasthenia gravis - Indirectly provided cholinergic action - Prolongation of muscle activity
29
Stretch reflex arc
- Activated by DTRs - Direct activation of LMN - Stretch -> afferent signal -> spinal cord -> efferent reflex -> activate musc, inhibit antagonist - Protective measure - Responsible for muscle tone
30
Lateral funiculus motor systems
- Contralateral corticospinal and spinothalamic tracts - Ventral horn - Activate lateral musculature (forearms) - Internal capsule - Inhibition from ventral horn
31
Primary motor cortex
- Precentral sulcus of central lobe - Analogus to primary somatosensory cortex - Fine motor control areas larger
32
Corticospinal tract
- Limbs, head and trunk
33
Corticobulbar tract
Face, neck, throat
34
Lesion of lateral corticospinal tract
- Ipsilateral deficit, weakness - Loss of fine motor movement in distal extremities - Hypertonia/ spasticity and clonus - Exaggerated babinski sign
35
Unilateral destruction at dorsal column- C4
Ipsilateral proprioception loss
36
Proprioception sensation
- DCML | - Decussates at caudal medulla
37
Unilateral destruction at dorsal root ganglion- C4
- Ipsilateral proprioceptive sensation loss
38
Unilateral destruction at anterolateral system- C4
- Unaffected
39
Unilateral destruction at lateral primary sensory cortex
Contralateral proprioception | - Loss of face
40
Unilateral destruction at medical somatosensory cortex
Contralateral proprioception | - Loss of limbs
41
Reticular activating system
- Within reticular formation - Interconnected nuclei - Regulates activity in cerebral cortex - Auditory and temperature activation - Avoidance of pain, smells
42
Paresthesia
- Odd, unnatural sensation - Peripheral neuropathy, - Damage to relay nucleus, nerve or primary cortex
43
Dysthesias
Unpleasant or painful sensations produced by stimulus