Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology Clinical > Clinical signs and Patterns of Motor Control Impairment > Flashcards

Clinical signs and Patterns of Motor Control Impairment Flashcards

1
Q

Where are motor movements controlled in the cortex

A

Frontal lobe executes movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What areas are involved in frontal love execution of movement and what is each area responsible for

A

1- Primary motor cortex ( M1 ) : large pyramidal neurons that travel down spinal cord and synapse with motor neurons

2- premotor cortes : organizes and sequences movements

3- Prefrontal and orbitofrontal : abstract planning and selecting a goal to tell premotor cortex the steps required to reach that goal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the lower motor neurons

A

Cell bodies within the anterior horn of spinal cord / brainstem.
Alpha motor neurons : voluntary muscle contraction, myosatic stretch reflex

OR

Gamma motor neurons: regulate muscle tone , maintain proprioception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The descending motor pathway can be divided into which two groups

A

1- Pyramidal tracts ( Direct )

2- Extrapyramidal tracts ( Indirect )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Explain the descending Pyramidal Corticospinal motor pathway ( 6 steps )

A

1- Corticospinal tract begins at cortex and receives input from primary , premotor and supplementary areas

2- Neurones descend through internal capsule ( between he thalamus and basal ganglia )

3- Neurone then passes through the crus cerebra of midbrain, the pons and into the medulla

4- in the inferior part ( caudal ) of the medulla and then divides into 2 tracts

5- Lateral corticospinal tract crosses over at the medulla and then descends into spinal cord.
Anterior corticospinal tract stays ipsilateral and descends in the spinal cord.

6- Lateral tracts terminates at ventral horn and then synapses with lower motor neurons. Anterior tract terminates at ventral horn of Cervical and upper thoracic levels.

7- signals carried to musculature of the body except face and neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the clinical importance of the internal capsule of the pyramidal motor pathway

A

Internal capsule susceptible to compression from haemorrhage bleeds ( capsular strokes ) which could result in lesion of descending tracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain he Corticobulbar tract motor pathway

A

1- Arises from lateral aspect of primary motor cortex

2- receive same input as the corticospinal tract

3- pass through internal capsule to the brainstem

4- neurons terminate on motor nuclei of cranial nerves

5- synapse with lower motor neurones that carry signals to face and neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where do the extrapyramidal tracts originate

A

Brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are extrapyramidal tracts responsible for

A

involuntary and automatic control of musculature ex: muscle tone, balance, posture , locomotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are pyramidal tracts responsible for

A

Voluntary control of the musculature of the body and face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 4 extrapyramidal tracts

A

1- Vestibulospinal
2- Reticulospinal
3- Rubrospinal
4- Tectospinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain the Vestibulospinal tract motor pathway

A
  • 2 pathways : medial and lateral.
  • arise from vestibular nuclei that receive input from organs of balance
  • remains ipsilateral and tract conveys balance info to spinal cord

Control balance and posture by innervating anti-gravity muscles via lower motor neurons ( arm flexors/leg extensors )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Explain the Reticulospinal tract motor pathway

A

2 tracts
Medial : arises from pons & facilitates voluntary movement and increase muscle tone

lateral: arises form medulla & inhibits voluntary movements and reduces muscle tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Explain the Rubrospinal tract motor pathway

A
  • Originates from red nucleus ( midbrain )
  • Fibres cross over when they emerge and descend spinal cord ( contralateral innervation )

Role in fine control of hand movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Explain the tectospinal tract motor pathway

A
  • begins at colliculus of the midbrain , receives input form optic nerves
  • neurons cross over and enter spinal cord , terminating at cervical levels
  • function: coordinate head movements in relation to vision stimuli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where do the Motor pathway tracts receive inhibitory signals form

A

Cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A movement to ensure stability is usually done before or after anticipated movement

A

Usually the Brain will ensue postural stability BEFORE anticipated movement ex: gastrocnemius contracting before biceps do when pulling on handle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define paraparesis

A

weakness of legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define paraplegia

A

complete weakness of legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define paraesthesia

A

abnormal sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define Quadra/tetraparesis

A

Weakness of arms and legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define Hemiparesis

A

weakness of half of body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define prefix Mylo

A

something of the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define prefix Radiculo

A

something of the nerve roots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define ataxia

A

lack of coordination of limb movements and or gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Damage above the medulla will result in what

A
  • Contralateral hemiplegia

- pattern of flexed ULs & extended LLs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Damage below the medulla will result in what

A

Spinal cord syndrome

  • Cervical sc = quadriplegia
  • thoracic or lumbar sc = paraplegia
  • hemisection of cord - Brown-sequard syndrome
28
Q

What is Brown-sequard syndrome

A

neurological condition due to a hemisection lesion of spinal cord. Results in hemiparaplegia of one side of body and hemianesthesia on the opposite side

29
Q

Define hemianestehesia

A

loss of sensation on side of body

30
Q

What will and UMN lesion result in terms of stretch reflex

A

Hyperexcitability of the stretch reflex due to loss of inhibitory control.
Since stretch is applied quickly contraction is stronger ( increased tone ) = clasp knife

31
Q

List the signs of UMN lesions

A 
1- Hypertonia 
2- Hyperreflexia 
3- Clonus ( involuntary, rhythmic contractions ) 
4- Babinski sign ( extensor plantar )
5- muscle weakness
32
Q

How would hemiparesis look

A

1- Adducted + flexed UL
2- Extended LL
3- plantar flexed + inverted

33
Q

If there is spastic paraperesis of all 4 limbs the lesion must be above …

A

C5

34
Q

Define spastic paraparesis

A

Weakness in limbs ( with muscle spasms )

35
Q

How would a lesion in the cervical spinal cord usually present as

A

1- Spastic paraperesis of 4 limbs if lesion above C5

If lesion complete
1- complete paralysis below lesion
2- loss of all sensory modalities below lesion
3- loss of bowel,bladder, sexual function

36
Q

How would a lesion in the thoracic or lumbar spinal cord usually present as

A

1- Spastic paraparesis in legs but normal arms
2- lesion will be below T1

Lesions often incomplete
3- bilateral leg weakness , not complete paralysis
4- impaired sensory function
5- defective bowel, bladder, sexual function

37
Q

If there’s posterior column spinal cord lesion will there be UMN signs in the legs and why

A

No because the pyramidal tracts would be sparred since they are lateral

38
Q

Will the bladder be affected in a posterior column spinal cord lesion ? if not what type of lesion would affect it ?

A

Bladder will probably be intact , usually affected by anterolateral lesions

39
Q

Which conditions can cause UMN signs

A 
1- Brain tumour 
2- ischaemic stroke 
3- ICH 
4- Post head injury 
5- multiple sclerosis 
6- spinal cord stenosis 
7- prolapsed disc
40
Q

What does a LMN lesion mean ( damage where ? )

A

Damage to the peripheral nervous system :

  • motor neuron in anterior horn
  • nerve roots / plexus
  • peripheral nerve
  • muscle
  • neuromuscular junction
41
Q

What are the signs of LMN signs

A

1- Muscle wasting and flaccid tone
2- Waddling gait
3- Fasciculations
4- hyporeflexia

42
Q

What are patterns of LMN

A

1- Flaccid areflexic paraplegia
2- primal weakness ( difficulty rising ,stairs, hair washing )
3- distal weakness : focal or widespread ( phone , writing )
4- fatiguable weakness ( worse with repeated effort )

43
Q

what is Flaccid areflexic paraplegia

A

weakness or paralysis and reduced muscle tone due to trauma affecting nerves associated with muscle

44
Q

Define plexopathy

A

Disorder of brachial or lumbosacral plexus of nerves

45
Q

Define radiculopathy

A

symptoms due to pinching of nerve in spinal column

46
Q

What drops are seen with LMN lesions

A 
1- Foot drop 
 - can't dorsiflex foot 
 - floppy ankle 
2- wrist drop 
 - can't extend wrist 
 - hand hangs flaccidly
47
Q

What could cause a wrist drop

A

radial nerve lesion due to penetrating trauma , extrinsic compression , humeral fracture or Motor neuron disease

48
Q

What could cause a foot drop

A 
Lesion to 
- deep/common perineal nerve 
- sciatic nerve 
- lumbosacral plexus 
= L5 nerve root
49
Q

What are common LMN diseases in out-patients

A 
1- foot drop ( perineal ) 
2- bells palsy ( facial )
3- peripheral neuropathy ( diabetic? ) 
4- ocular myasthenia gravis
5- muscular dystrophy 
6- radiculopathy due to prolapsed disc
50
Q

What is ocular myasthenia gravis

A

muscles moving eyes and eyelids are fatigued and weakened.

Presenting with Dropping eyelids or double vision

51
Q

What are common LMN diseases in ward patients

A 
1- Motor neurone disease 
2- cauda equina syndrome 
3- Traumatic plexopathy 
4- Guillain-barre syndrome 
5- CIDP 
6- Cristial illness neuropathy 
7- Mysasthenia gravis 
8- Inflammatory Myopathies
52
Q

What is Guillain-barre syndrome

A

Rare neurological condition affecting feet, hands and limbs causing weakness, numbness and pain

53
Q

What is CIDP

A

Chronic inflammatory demyyelinating polyradiculoneuropathy

rare autoimmune disorder causing body to attack myelin sheaths

54
Q

What if patient presents with both UMN & LMN signs

A

Suspect damage to anterior horn in spinal cord. Could cause tract and segmental signs due to spinal cord lesion and still cause LMN signs due to lower motor neurons being affected .

Could be MND

55
Q

Fasiculations and atrophy are lesion in ?

A

LMN

56
Q

Brisk reflexes and extensor plantar are lesion in ?

A

UMN

57
Q

What is the pathology of a basal ganglia problem

A

1- movements are fragmentary , incomplete and staccato
2- Hypokinesis
2- Hyperkinesis

58
Q

What is Hypokinesis

A

Too little movement

  • rigidity
  • resisting tremor
  • bradykinesia : deceased speed and amplitude of movement
59
Q

What is hyperkinesis

A

too much movement

  • essential tremor
  • chorea
  • ballism
  • myoclonus
  • dystonia
60
Q

What is the purpose of basal ganglia in extrapyramidal tracts

A

Sequencing and smooth control of movement. gives fluidity to movement

61
Q

Parkinson’s disease is an example of problem in ?

A

Basal ganglia

62
Q

What is the purpose of the cerebellum

A

Coordinates muscle activity during learner movement and receives input from proprioceptors, inner ear and cortex

63
Q

Signs of cerebellar dysfunction

A 
1- Nystagmus 
2- dysarthria 
3- intention tremor / dysmetria 
4- dysdiadochokinesia 
5- wide based unsteady gait
6- truncal sway
64
Q

Left cerebellar hemisphere lesion will cause what

A

Left sided ataxia

65
Q

What are examples of extrapyramidal and cerebellar diseases in out patients

A 
1- Parkinson's disease 
2- essential tremor 
3- thyrotoxic tremor 
4- Huntington's chorea 
5- tics 
6- wry neck ( torticollis )
66
Q

What are examples of extrapyramidal and cerebellar diseases in ward patients

A

1- asterixis ( liver flap )
2- anaesthesia induced myoclonus
3- alcohol related ataxia
4- viral cerebellitis ( in kids )

Neurology Clinical (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions