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OT 441: Neuroscience - Summer 2017 > Higher Centers of Motor Control - Descending Pathways (11) EXAM 3 Material > Flashcards

Higher Centers of Motor Control - Descending Pathways (11) EXAM 3 Material Flashcards

1
Q

Primary Motor Cortex, aka:

A

Precentral Gyrus

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2
Q

Which part of the frontal lobe controls contralateral voluntary movements?

A

Primary Motor Cortex (precentral gyrus)

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3
Q

Controls fine movements of hands and face (hand, foot and lower face are entirely contralateral)

A

Primary Motor cortex (precentral gyrus)

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4
Q

What part of the frontal lobe controls motor planning and trunk and girdle muscles of the body?

A

Premotor cortex

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5
Q

What part of the frontal lobe controls motor planning, initiation of movement, orientation of eyes and head, and planning bimanual and sequential movements?

A

Supplementary Motor Cortex

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6
Q

What two arts of the frontal lobe are important in motor planning?

A

Premotor cortex and supplementary motor cortex

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7
Q

Where do the motor cortices receive info from?

A

Secondary association areas, somatosensory areas, basal ganglia and cerebellum

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8
Q

What type of organization is the primary motor cortex (precentral gyrus)

A

Somatotopic (motor homunculus)

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9
Q

What does the homunculus of the primary motor cortex have the greatest representation of?

A

Hand and lower face (NOT rigidly fixed)

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10
Q

Where does the primary motor cortex (precentral gyrus) receive info from?

A

Thalamus

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11
Q

Dorsolateral Tracts: control

A

Limb flexion and fine movement (buttoning a button)

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12
Q

Dorsolateral Tracts:

A
  1. Lateral corticospinal tract
  2. Rubrospinal tract
  3. Corticobulbar Tract
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13
Q

Which tracts control limb flexion and fine movements?

A

Dorsolateral tracts

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14
Q

Which tracts control trunk and limb muscles?

A

Ventromedial System

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15
Q

Ventromedial System Tracts:

A
  1. Ventral/Anterior corticospinal tract
  2. Medial vestibulospinal tract
  3. Lateral vestibulospinal tract
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16
Q

Lateral corticospinal tract: What system?

A

Dorsolateral system

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17
Q

Lateral corticospinal tract: Function:

A

Voluntary control of distal muscles needed for precise movement
(Fractionation)

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18
Q

Fractionation Definition (part of which tract and what group)

A

Ability to activate individual muscles independently of other muscles
ex: Mr Burns in simpsons - evil villain / buttoning button
Lateral Corticospinal tract
Dorsolateral System

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19
Q

Pathway of Lateral corticospinal tract:

A
  1. Originates in primary motor, premotor and supplementary motor cortex
  2. Decussation at pyramids of medulla
  3. Travels through the lateral funiculus (white matter (in the SC
  4. Most fibers terminate by contacting interneurons in the spinal cord; some synapse directly with LMNs
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20
Q

Lateral corticospinal tract: How many neurons?

A

ONE long neuron, NOT a chain

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21
Q

Ventral/Anterior Corticospinal Tract: What system?

A

Ventromedial system

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22
Q

Ventral/Anterior corticospinal tract: function

A

Control of neck, shoulder and trunk muscles

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23
Q

Ventral/Anterior corticospinal tract pathway:

A
  1. Descends ipsilaterally
  2. Travels through anterior funiculus of the SC
  3. Can have a bilateral projection at the level of the SC
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24
Q

Corticobulbar tract: part of what system?

A

Dorsolateral system

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25
Q

Corticobulbar tract: function

A

Voluntary control of face muscles (precise movement)

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26
Q

Corticobulbar tract: Pathway

A
  1. Originates in motor areas of cortex
  2. Projects to and terminates on cranial nerve nuclei in the brainstem
  3. Some projections terminate contralaterally and others bilaterally.
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27
Q

What plays an important role in regulating posture and equilibrium?

A

Brainstem

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28
Q

Brainstem nuclei act reflexively to what?

A

Stimuli and in response to descending info from cortex and cerebellum

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29
Q

What two ways do descending links from the brainstem affect muscle tone?

A
  1. Links to alpha motor neurons

2. Links to gamma motor neurons

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30
Q

Function of descending tracts from brainstem:

A

Postural control; control axial and proximal muscles

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31
Q

Medial and Lateral Vestibulospinal Tracts: Part of which system?

A

Vestibulospinal tracts (ventromedial system)

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32
Q

What is the function of the medial and lateral vestibulospinal tracts?

A

Medial: Neck and upper back movement, facilitates extensors (bilateral)
Lateral: Lumbar, trunk, facilitates extensors (ipsilateral)

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33
Q

Reticulospinal tracts: function

A

Facilitates bilateral LMNs innervating postural and gross limb movement muscles (coordinates all 4 limbs while walking)

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34
Q

Rubrospinal tract: part of which system:

A

Dorsolateral system

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35
Q

Rubrospinal tract: Function

A

Works closely with LCT (lateral corticospinal tract) to control distal musculature (primarily upper limb flexor muscles)

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36
Q

Works closely with LCT (lateral corticospinal tract) to control distal musculature (primarily upper limb flexor muscles)

A

Rubrospinal Tract

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37
Q

Rubrospinal Tract: Pathway

A
  1. Originates in red nucleus of the midbrain
  2. IMMEDIATELY Decussates
  3. Descends to SC to synapse on LMNS (turn off reflex arc)
38
Q

Which tracts originate in the cortex?

A
  1. Lateral corticospinal tract
  2. Anterior corticospinal tract
  3. Corticospinal tract
39
Q

Which tracts originate in the brainstem?

A
  1. Medial and Lateral vestibulospinal tracts
  2. Reticulospinal tract
  3. Rubrospinal tract
40
Q

Just like some reflexes are mediated at the spinal level, some reflexes are mediated where?

A

At the brain stem

41
Q

What are brain stem reflexes concerned with?

A

Posture, alignment of the head and body with respect to gravity

42
Q

Brain stem reflexes are not neurologically intact when?

A

In children and adults

43
Q

When are brain stem reflexes exhibited typically?

A

Developing infants

44
Q

Can brain stem reflexes be seen in older children/adults?

A

Yes, but it accounts for atypical neurology or following neurological trauma when info from cortex does not reach the brainstem to modulate this reflex

45
Q

What inhibits brain stem reflexes?

A

Higher centers

46
Q

Asymmetric Tonic Neck Reflex (ATNR): Stimulus

A

Head turned (to right or left)

47
Q

Asymmetric Tonic Neck Reflex (ATNR): Response (if head is turned right)

A

Right arm ABducted and extended, Left arm ADducted and flexed at the elbow

48
Q

When should ATNR be inhibited by?

A

6 months of age in walking state

49
Q

If ATNR is active in a child at a later age, it can affect:

A
  1. Hand-eye coordination
  2. Ability to cross midline
  3. Bilateral integration (cutting, clapping, jumping)
50
Q

Symmetrical Tonic Neck Reflex (STNR): Stimulus

A

Head flexion or extension

51
Q

Symmetrical Tonic Neck Reflex (STNR): Response to head flexion

A

Arms flex and legs extend

52
Q

Symmetrical Tonic Neck Reflex (STNR): Response to head extension

A

Arms extend and legs flex

53
Q

What is STNR a precursor to?

A

Crawling on hands and knees

54
Q

When is STNR present until typically?

A

8-11 months of post-natal life

55
Q

If STNR remains present in an older child, it can affect:

A
  1. Integration of upper and lower portions of body (swimming)
  2. Sitting posture
  3. Poorly developed muscle tone
  4. Poor hand-eye coordination
56
Q

UMN descend to synapse where?

In order to convey what?

A

LMNs and/or interneurons in the brainstem or spinal cord in order to convey commands for movement

57
Q

Where do UMN cell bodies originate?

A

Higher regions of brain (cortex or brainstem)

58
Q

What adjusts the activity of the descending (UMN) tracts?

A

Control circuits

59
Q

What is considered an UMN lesion?

A

Lesion in cortex, hemisphere, brainstem or spinal cord area which controls ventral horn cells

60
Q 
UMN or LMN motor neuron lesion? 
Brain damage (stroke)
A

UMN

61
Q

UMN or LMN motor neuron lesion?

Damage to peripheral nerve

A

LMN (talk to muscles)

62
Q

UMN or LMN motor neuron lesion?

Damage to descending tract

A

UMN

63
Q

UMN or LMN motor neuron lesion?

Damage to motor neuron inside SC; damage to ventral root; damage to nerve

A

LMN

64
Q

UMN or LMN motor neuron lesion?

Damage to descending tract, synapsing on a motor neuron

A

UMN

65
Q

What happens immediately following an UMN lesion?

A

Cerebral shock

the LMNs become temporarily inactive due to loss of descending facilitation and edema in area of lesion

66
Q

What happens following shock recovery in UMN lesion?

A

Interneurons and LMNs resume activity, but are no longer modulated by UMNs

67
Q

UMN Lesion: Clinical Correlations:

A
  1. Paresis/paralysis
  2. Loss of fractionation movement
  3. Atypical reflexes
68
Q

Atypical Reflexes: Muscle Stretch Hyperflexia

A

Unmediated stretch reflex

69
Q

Atypical Reflexes: Babinski Reflex

A

Typical in infants, pathological in adults

Abnormal (positive) reflex: big toe extends, toes fan out

70
Q

Atypical Reflexes: Clonus

A

Involuntary repeating, rhythmic contractions of a single muscle group

71
Q

Atypical Reflexes: Clasp-Knife response

A

When a paretic (weak) muscle is slowly and passively stretched, resistance drops at a specific point in the ROM
(this is when a therapist would be moving the muscle)

72
Q

Cerebral Palsy: Definition

A

Movement and postural disorder caused by permanent, non-progressive damage to a developing brain

73
Q

Cerebral Palsy: Etiology

A

Maternal or fetal infection, hypoxia, trauma, fetal stroke

74
Q

Cerebral Palsy: Classified by:

A

Type of motor dysfunction of by area of body affected

75
Q

Cerebral Palsy: T or F, many have no additional medical disorders?

A

True

76
Q

Cerebral Palsy: Associated Problems (5 things)

A
  1. Seizures
  2. Cognitive deficits
  3. Language impairments
  4. Visual problems
  5. Spinal deformities
77
Q

What is one of the most common forms of cerebral palsy and what age group is it often seen in?

A 
Spastic Diplegia (Spastic - increased resistance to passive stretch)
Premature Infants
78
Q

In spastic diplegia, what extremities are more involved?

A

Bilateral lower extremities more involved (affected), upper extremities are less affected

79
Q

What form of cerebral palsy usually results from a lesion in the motor cortex (contralateral side)?

A

Hemiplegia

80
Q

Hemiplegia Cerebral Palsy is often caused by:

A

Head trauma at birth or stroke

81
Q

Hemiplegia Cerebral Palsy: What extremities are most affected?

A

Unilateral; upper extremity more involved than lower

82
Q

What is the most severe form of cerebral palsy?

A

Complex/Spastic Tetraplegia

83
Q

Which form of cerebral palsy has spasticity bilaterally in all extremities?

A

Complex/Spastic Tetraplegia

84
Q

Less/More affected areas in diplegia (in pictorial representation):

A 
Legs more affected
Higher area (trunk, arms) less affected
85
Q

Less/More affected areas in hemiplegia (in pictorial representation):

A 
One side leg and arm more affected
One side (same as leg and arm side) trunk area less affected
86
Q

Less/More affected areas in Quadriplegia (in pictorial representation)

A

Both legs and arms more affected

Trunk area less affected

87
Q

Constraint-Induced therapy for Cerebral Palsy:

A

Less affected upper limb is restrained during session that demand use of the paretic upper limb

88
Q

How is botox used to treat cerebral palsy?

A

Reduces the rigidity of muscles or unwanted spasms in a specific muscle

89
Q

What is baclofen?

A

A drug used to treat cerebral palsy. It is a muscle relaxant that relieves the stiffness caused by spasticity.

90
Q

What is a treatment for cerebral palsy that is only done in SUPER severe cases?

A 
Dorsal Rhizotomy
(cuts overactive dorsal roots)
91
Q

What type of cerebral palsy is dorsal rhizotomy most often used for>

A

Spastic Diplegia and other spastic forms of cerebral palsy

OT 441: Neuroscience - Summer 2017 (11 decks)

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