CNS Class 5 - Higher Motor Centres Flashcards
An HMC located in the rear portion of the frontal lobe, just before the central sulcus, that separates the frontal lobe from the parietal lobe.
Motor Cortex
The motor cortex is one of the brain areas most involved in controlling _________/intentional movements.
Voluntary
To carry out goal-directed movements, the _____ ______ must first receive various kinds of information from the various lobes of the brain.
Motor Cortex
Match the various kinds of information to the corresponding lobe.
1) Goal to be attained & appropriate strategy to attain it
2) Memories of past strategies
3) Body’s position in space
A) Parietal Lobe
B) Anterior Frontal Lobe
C) Temporal Lobe
1) Goal to be attained & appropriate strategy to attain it = B) Anterior Frontal Lobe
2) Memories of past strategies = C) Temporal Lobe
3) Body’s position in space = A) Parietal Lobe
T/F - The motor cortex releases command sequences for locomotor activities and is the primary issuer of command “packages” related to movement.
True
The key HMC in learning of new motor activities through visual observation, or as a part of a process of thought/imagination.
Motor Cortex
T/F - The motor cortex is still involved once a skill is learned.
False - The motor cortex is NO LONGER involved once a skill is learned.
The motor cortex is the primary HMC for _________ and fine motor control.
Dexterity
T/F - The cerebellum is the key HMC for functions that combine cognitive and fine motor functions, such as speech.
False - The MOTOR CORTEX is the key HMC for functions that combine cognitive and fine motor functions, such as speech.
The motor cortex plays a larger role when movements are complex, skillful and _________.
Bilateral
Since the motor cortex is constantly generating output, it contributes a significant amount of ________ motor system tone.
Baseline
T/F - Discrete full motor cortex lesions are virtually never seen clinically, however it can be affected in a larger context.
True
When the _____ ______ is injured, the most impaired functions include:
- Ability to learn new motor skills
- Motor functions heavily reliant on fine motor control
- Speech
- Thought-to-initiation voluntary activity
Motor Cortex
Refers to reduced tone in the motor system, creating a lower resting tone and weaker/slower recruitment of power.
Generalized Hypotonia
T/F - With generalized hypotonia, there are more noticeable performance issues with complex, small-scale skillful movements.
False - With generalized hypotonia, there are more noticeable performance issues with complex, LARGE-scale skillful movements.
An HMC located at the base of the posterior brain that is composed of a number of lobes and lobules. This increases the surface area of grey matter and provides this HMC with a very high density of neurons.
Cerebellum
T/F - The cerebellum accounts for only 10% of the brain’s total volume, but over 50% of its neurons.
True
The __________ first recieves information about the intended movement from the sensory and motor cortexes. Then it sends information back to the motor cortex about required direction, _____ and duration of this movement.
Cerebellum
Force
The loop involving the cerebellum operates in addition to a loop involving the _____ _______ to regulate the details of motor control.
Basal Ganglia
The cerebellum is the primary HMC for overall ____________, integration of elements within movement command packages.
Coordination
T/F - The motor cortex monitors incoming sensory information from external and internal body sources, especially visual and proprioceptive data, and integrates thus information into organizing effective/appropriate movements.
False - The CEREBELLUM monitors incoming sensory information from external and internal body sources, especially visual and proprioceptive data, and integrates thus information into organizing effective/appropriate movements.
The cerebellum is the key HMC for the body’s motor adjustments to the _______ and to gravity.
Horizon
The cerebellum is the primary HMC for sequencing/________ of commands, which is crucial to perfect movement, especially rapid/_______ actions.
Ordering
Complex
What does the acronym SSS represent, related to the cerebellum?
Speed
Sequencing
Synchronicity
T/F - The cerebellum has a role in learning, as it helps to mobilize motor command “packages” for newly learned/improved activities into and out of memory storage.
True
The cerebellum is responsible for ________ fine tuning of motor commands. It monitors motor cortex output and makes ___________, both while the commands are being issued and after. This improves continuous actions or learned skills.
Constant
Adjustments
T/F - The basal ganglia is responsible for suppression of tremor during purposeful body part activity, through counteracting surge-like qualities of motor cortex output.
False - The CEREBELLUM is responsible for suppression of tremor during purposeful body part activity, through counteracting surge-like qualities of motor cortex output.
A symptom of cerebellum dysfunction related to generalized incoordination.
Dyssynergia/Asynergia
A symptom of cerebellum dysfunction in which a body part(s) tremors during purposeful activity. The tremor initiates and/or intensifies as the activity proceeds.
Intention Tremor
A symptom of cerebellum dysfunction involving a failure to pinpoint, which is the inability to bring a body part in an accurate/efficient path to a target.
Dysmetria (aka. Pass-Pointing)
A symptom of cerebellum dysfunction which combines intention tremor and dysmetria pertaining to the eyes.
Nystagmus
T/F - With nystagmus, when attempting to focus on a visual target the eyes rapidly “shimmy” back and forth, usually vertically.
False - With nystagmus, when attempting to focus on a visual target the eyes rapidly “shimmy” back and forth, usually HORIZONTALLY.
A symptom of cerebellum dysfunction involving impaired ability to perform rapidly alternating movements, typically when requiring a mirrored pattern with matching limbs.
Dysdiadochokinesia
A symptom of cerebellum dysfunction where the person breaks the motor activity into component parts, doing them one at a time and requiring effort and focus.
Decomposition of Movement
A symptom of cerebellum dysfunction related to decomposition of speech. The person breaks words/phrases into syllables, speaks them slowly and deliberately one at a time, generally without inflection (monotonically) and normal punctuation breaks/shifts.
Scanning Speech
Symptoms of cerebellum dysfunction where the person has difficulty recalling/repeating previously learned motor activities.
Impairments of Motor Memory
A symptom of cerebellum dysfunction where there is hallucination of movement, either of the person’s body or of the external environment (or both).
Vertigo
T/F - Dizziness is the same as vertigo.
False - Dizziness is NOT the same as vertigo.
Symptoms of cerebellum dysfunction where there is impaired ability to maintain centre of gravity in static positions and when the body is moving.
Disorders of Balance & Equilibrium
A symptom of various cerebellum dysfunctions where the person walks with a “lurching” or “staggering” gait, typically with a wider stance than is normal.
Dystaxia/Ataxia (aka. Drunken Sailor’s Gait)
Some characteristics of _______ ________ gait include:
- Body parts do not work well together
- Equilibrium is poor
- Sensing of ground & objects in environment is off (e.g frequent bumping into things, frequent falls)
- Hallucinatory effects may be involved (e.g. ground/objects are moving)
- May include intention tremor in legs
Drunken Sailor’s Gait
As their name suggests, the _____ _______ consist of a set of neural structures buried deep inside the cerebrum that are tightly interconnected.
Basal Ganglia
The _____ _______ receive information from several different regions of the cerebral cortex, and once it has been processed, they return it to the motor cortex via the thalamus.
Basal Ganglia
The basal ganglia is known as the first _________, as it scans for incoming data and then “______” the other centres to the need for new command sequences to be issued.
Initiator
“Alerts”
The _____ _______ is a key HMC in oversight of reflexive relationships in the motor system, including:
- Agonist/antagonist/synergist relationships
- Postural reflexes (e.g. righting reflexes)
- “Background positioning” of trunk and limb girdles
- Inherent, automatic types of movement responses
Basal Ganglia
T/F - The cerebellum is responsible for error correction, as it monitors information coming into the motor system and suppresses automatic responses that are not correct for the situation.
False - The BASAL GANGLIA is responsible for error correction, as it monitors information coming into the motor system and suppresses automatic responses that are not correct for the situation.
The basal ganglia has a major role in the motor aspects of _______ expression, especially of reflexive/___________ facial expression.
Emotion
Involuntary
T/F - The basal ganglia plays a role in motor memory as it relates to creating and regulating stereotyped and reflexive components of repeated activities/skills.
True
The basal ganglia adds ____________ and efficiency to movement.
Gracefulness
T/F - The basal ganglia is involved in suppression of tremor in body parts not engaged in purposeful activity through counteracting surge-like qualities of motor cortex output.
True
A symptom of basal ganglia dysfunction in which a body part(s) tremors when not engaged in purposeful activity.
Resting Tremor
A symptom of basal ganglia dysfunction where movement is slow and effortful.
Hypokinesia
A symptom of basal ganglia dysfunction involving inability to initiate movement.
Akinesia
A symptom of basal ganglia dysfunction related to slow movement initiation. This includes difficulty getting started, changing course/adding a new component, modulating speed and/or stopping. The person may have moments of “freezing” while trying to do any of the above tasks.
Bradykinesia
Symptoms of basal ganglia dysfunction where routine activities are slow, clumsy and exhausting to perform. There is a lack of smoothness and fluidity.
Impairments of Efficiency & Gracefulness
Symptoms of basal ganglia dysfunction in which the person’s body and facial expressions do not reflect/represent their emotional state/experience. Often there is an appearance of indifference, even negativity.
Impaired Physical Expression of Emotion
A symptom of basal ganglia dysfunction where a body part(s) begins to tremor after holding a position for a short period of time.
Postural Tremor
T/F - There can be absence/impairment of postural reflexes with motor cortex dysfunction.
False - There can be absence/impairment of postural reflexes with BASAL GANGLIA dysfunction.
T/F - There can be improper synergistic stabilization of limb girdles and/or spine during motor activities with basal ganglia dysfunction.
True
A symptom of basal ganglia dysfunction where there is impaired reciprocal inhibition, meaning that simultaneous concentric contraction occurs and there is a failure of the agonist/antagonist relationship.
Rigidity
A type of rigidity in the limbs involving consistent movement resistance.
Leadpipe Rigidity
A type of rigidity in the limbs involving stop/start movement resistance.
Cogwheel Rigidity
A type of facial rigidity where the person does not make automatically responsive facial expressions.
Parkinsonian Mask (aka. Mask of Parkinsonism)
Rigidity causing impairments of reflexive cycling of ___________ actions, leads to:
- Apical breathing
- Dyspnea (especially with exertion/in specific positions)
- Poor mucociliary elevator function (more incidence of infections)
Respiratory
T/F - Impaired peristalsis, poor recruitment of reflexive components and atonic constipation corresponds with spasticity in the GI tract.
False - Impaired peristalsis and poor recruitment of reflexive components corresponds with RIGIDITY in the GI tract.
_________ refers to difficulty swallowing and _______ refers to inability to swallow.
Dysphagia
Aphagia
T/F - Choking in prone would be an RMT alert related to dysphagia and aphagia.
False - Choking in SUPINE would be an RMT alert related to dysphagia and aphagia.
A symptom of basal ganglia dysfunction often described as a “shuffling” gait, where the person has difficulty starting to walk and will often throw the upper body forward to create momentum.
Festination (aka. Festinating Gait)
A ___________ gait starts slowly but picks up speed and often cannot change course, slow down or stop effectively. It may include episodes of ________.
Festinating Gait
Freezing
Some characteristics of ___________ gait include:
- Lack of arm swing, knee lift and toe-off reflexes
- Straight-kneed and flat-footed
- General movement is flat and has an effortful/clunky appearance
- May include postural tremor
- Person fatigues easily
Festinating Gait
Symptoms of basal ganglia dysfunction that represent poor editing/inhibition of automatic/reflexive movements.
Involuntary Movements
An involuntary movement involving sudden sharp contractions, typically of a muscle or specific muscle group. Most often seen in the face, but can be in other body parts or even full body. Often occurs singly, but can happen in a series.
Tics
An involuntary movement involving a writhing (snake-like/worm-like) action that usually occurs bilaterally at the wrists, but can be the ankles or whole legs.
Athetosis
An involuntary, characteristic movement called a “dance” in which a sequence of movements travels along the affected body part(s) in the same pattern.
Chorea
An involuntary, large-scale and explosive sudden movement of a body part(s).
Ballsim
An involuntary movement involving a body part that migrates into an extreme position and “freezes” there for a period of time.
Dystonia
An involuntary movement involving a body part(s) that enacts a circular or cyclical “swaying” movement that is usually repeated in a “loop.”
Dyskinesia
