Lesson 9 - Descending Pathways Flashcards

1
Q

Descending systems modify all the activity of ————– systems, and are prominent in controlling conscious and reflex responses to stimuli

A

ascending

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2
Q

Motor areas:

  • ————- ———- of frontal lobe
  • Primary ——– ——- directs voluntary movements
A

Precentral gyrus
motor cortex

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3
Q

Sensory Areas:
- Postcentral gyrus of ———- lobe
- Primary sensory cortex:
receives somatic sensory information (touch, pressure, pain, vibration, taste, and temperature)

A

parietal

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4
Q

Functional Organisation
of the CNS:
(Primary Motor Cortex)

Functionally the ——— —— is known as the primary motor cortex.

A

precentral gyrus

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5
Q

Functional Organisation
of the CNS:
(Primary Motor Cortex)

Stimulation of the primary motor cortex elicits contraction of discrete muscle groups on the ———– side of the body.

The function of this region is the control of voluntary, skilled movements sometimes referred to as ———— movements.

A

opposite

fractionated

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6
Q

Functional Organisation
of the CNS:
(Primary Motor Cortex)

30% of ———– and ———- fibres arise from neurons of the primary motor cortex while 3% originate from giant ————— cells

A

corticospinal and corticobulbar
pyramidal cells

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7
Q

Functional Organisation
of the CNS:
(Primary Motor Cortex)

The principal subcortical afferents to the primary motor cortex originate from the ventral lateral nucleus of the thalamus which in turn receives input mainly from the ——- ———– of the cerebellum and from the ——– ——— of the basal ganglia.

A

dentate nucleus
globus pallidus

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8
Q

The ————- ———— represents either the motor or the sensory distributionalong the cerebral cortex of the brain.

A

cortical homunculus

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9
Q

The ———– ———is a topographic representation of the body parts and its correspondents along the precentral gyrus of the frontal lobe.

A

motor homunculus

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10
Q

The ———— homunculus is a topographic representation of the body parts along the postcentral gyrus of the parietal lobe.

A

sensory

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11
Q

Within the cortex of the precentral gyrus the contralateral half of the body is represented in a precise ———– fashion.

A

somatotopic

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12
Q

The Cortical Homunculus:

The representation of the body is inverted with the head area located in the most inferior part of the precentral gyrus just above the ———– fissure. Progressing superiorly successive areas of cortex represent the digits hand arm shoulder and trunk.

A

lateral

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13
Q

The Cortical Homunculus

The lower limb is represented on the medial surface of the hemisphere above the ——— ——-

A

corpus callosum.

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14
Q

The Cortical Homunculus

The area of cortex devoted to a particular body part is ————- not to its size but to the degree of precision with which movements can be executed therefore the larynx, tongue, face and digits of the hand are represented by relatively large regions period

A

proportional

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15
Q

Functional Organisation of the CNS (Premotor Cortex):

The region immediately anterior to the ——— ——– cortex is known as the premotor cortex.

A

primary motor

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16
Q

Functional Organisation of the CNS (Premotor Cortex):

On the ———- surface of the hemisphere, this includes the posterior portions of the superior, middle and inferior frontal gyri.

A

lateral

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17
Q

Functional Organisation of the CNS (Premotor Cortex):

On the ——— surface of the hemisphere, the premotor cortex includes a region referred to as the supplementary motor cortex.

A

medial

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18
Q

Functional Organisation of the CNS (Premotor Cortex):

Stimulation of premotor cortical areas induces movements that are less focused than those elicited from the ———- ———– cortex and that involves groups of functionally related muscles.

A

primary motor

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19
Q

Functional Organisation of the CNS (Premotor Cortex):

Movements evoked from the supplementary motor cortex tend to be postural in nature involving ———– and ———– musculature.

A

axial and proximal

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20
Q

Functional Organisation of the CNS (Premotor Cortex):

Premotor cortical areas are thought to function in the programming of and preparation for movement and in the control of ———

A

posture

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21
Q

Functional Organisation of the CNS (Premotor Cortex):

The premotor cortex exerts its actions partly via the primary motor cortex with which it is connected by short ———— fibres and partly via corticospinal and corticobulbar fibres.
~ 30% of the corticospinal and corticobulbar fibres originate in the premotor cortex.

A

association

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22
Q

Functional Organisation of the CNS (Premotor Cortex):

The principal subcortical input to premotor cortical regions is the ventral anterior nucleus of the thalamus. This in turn receives fibres from the ——- ———- and ——– ———

A

globus pallidus and substantia nigra

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23
Q

Functional Organisation of the CNS (Frontal eye field, motor speech area and prefrontal cortex):

Immediately in front of the premotor cortex on the lateral surface of the hemisphere are located two other important regions;

1) In the middle frontal gyrus lies the ——– —- ——. This region controls voluntary conjugate deviation of the eyes as occurs when scanning the visual field.

2) In the inferior frontal gyrus of the dominant hemisphere (usually the left) lies the motor speech area also known as ——–s area. ———-s area has important interconnections with parts of the ipsilateral temporal, parietal and occipital lobes that are involved in language function.

3) The extensive regions of the cortex of the frontal lobe that lie anterior to premotor areas are referred to as prefrontal cortex. The prefrontal cortex has rich connections with parietal, temporal and occipital cortex through long association fibers running in the subcortical white matter. Subcortical afferents arise mainly in the medial ——— dorsal and ——– nuclei of the thalamus. The prefrontal cortex has cognitive functions of a high order e.g. intellect, judgment, predictive faculties and the planning of behavior.

A

frontal eye field
broca
medial dorsal and anterior nuclei

24
Q

Gross Anatomy of Motor Pathways

  1. ———- fibres: connect cortices of cerebral hemispheres.

The largest bundle forms the c——– ————.

A

Commissural
Corpus callosum

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Gross Anatomy of Motor Pathways 2. -------------- Fibres: connect regions of the cerebral cortex with one hemisphere. - Short ----------- fibres (arcuate) connect adjacent gyri - Long ------------ fibres (longitudinal) connect distant gyri (different lobes)
Association association association
26
Gross Anatomy of Motor Pathways 3. Projection Fibres: fibres that leave the cerebral white matter - Form the --------- capsule - Two categories of projection fibres are: A. ------------: terminate in the basal nuclei, brainstem, or spinal cord; B. ---------------: typically originate in thalamus and terminate in cerebral cortex Motor projection fibres travel through the --------------- ---------- and the internal capsule
internal Corticofugal Corticopedal corona radiata
27
Motor Systems Expression of the activity in the CNS depends on ----------- or skeletal muscles Muscles are innervated by: 1. Motor neurons in the ----------- horn 2. Motor nuclei of cranial nerves The concept of upper and lower nueron function is fundamental to the clinical description of the effects of lesions in the motor system
somatic ventral
28
-----------er motor neurons are the neurons which control the activity of lower motor neurons and do not transmit impulses directly to muscles. Their cell body originates in the ------ ----------- or brainstem. Also known as -------- --------- neurons. They form a number of descending tracts that run through the brainstem and spinal cord. Among the most important of these are the corticospinal and corticobulbar tracts.
Upper cerebral cortex first-order
29
Lower motor neurons are those motor neurons that directly innervate -------- muscle. Their cell bodies originate in the grey matter of the spinal cord, brain stem or cranial nerve nuclei. They constitute the so-called ‘final ----------- pathway’ by which the nervous system controls movement. Also known as ---------- -order neurons.
skeletal common second
30
Lower Motor Neurons - the spinal arc: Not all transduction of sensory nerve fibres signals ---------- action via the brain
muscular
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Lower motor neurons – the spinal reflex arc: A -------- is a rapid involuntary pre-programmed response that activates muscles to help us avoid potential or in this case with the iron further damage/injury. Must be fast, therefore by-passes the brain and goes from site of stimulus into spinal cord and straight back out again; In summary, a ------------ picks up a stimulus (e.g. pain from hot iron) > Sensory neuron sends afferent signal to the Integration centre (interneuron) in spinal cord > Lower motor neuron then sends an efferent signal > effector (muscle to move hand away from hot iron)
reflex receptor
32
Corticospinal and corticobulbar tracts originate partly from neurons in the motor area of the --------- ----------. Axons pass through the --------- capsule and into the brainstem where most of them decussate to the other side. This means that movement of one side of the body are controlled by the opposite ------------- ------------
cerebral cortex internal cerebral cortex
33
------------ fibers control the activity of motor neurons located in cranial nerve nuclei which innervates skeletal muscles of the head and neck through the cranial nerves.
Corticobulbar
34
---------------- fibers control the activity of motor neurons in the spinal cord which innervate trunk and limb muscles.
Corticospinal
35
The place where ------------ fibres crossover to the other side of the nervous system can be seen on the ventral aspect of the medulla and is known as the decussation of the pyramids. Because of this the -------------- tract is also known as the ------------ tract.
corticospinal x2 pyramidal
36
Pyramidal Tracts (Corticospinal or corticobulbar tracts) Most of the cell bodies of the pyramidal tracts are located on the ----------- gyrus of the frontal lobe: AKA primary motor cortex Input from supplementary motor area, the premotor cortex fibres, parietal lobe, and ---------- gyrus C------------- tract: brain to spinal cord C--------------: brain to cranial nerves
precentral cingulate Corticospinal Corticobulbar
37
Corticospinal Tract: Originate from layer ? of cortex internal layer, contains large pyramidal neurons Input from motor neurons and premotor cortical areas: somatosensory cortex, ---------- lobe, and cingulate gyrus Travel through internal capsule to the cerebral -----------s and then come to lie on ventral surface of the medulla (i.e. the pyramids)
5 parietal peduncles
38
Corticospinal Tract: Anterior/Ventral Corticospinal Tracts - Controls central axial and proximal muscles involved in ------------ control - Fibres decussate in the ---------- ---------
postural spinal cord
39
Corticospinal Tract: Lateral Corticospinal Tracts - Controls ------------ muscles for fine movement of ipsilateral limbs - Fibres ------------- in the pyramids
appendicular decussate
40
Corticobulbar (Corticonuclear) tract The corticobulbar tract carries upper motor neuron input to motor nuclei of trigeminal, facial, glossopharyngeal, vagus, accessory, and ---------- nerves. The motor component of trigeminal nerves supplies muscles of -----------------. The facial nerve supplies the muscles of facial -----------.
hypoglossal mastication expression
41
Corticobulbar (corticonuclear) tract: Initially follows the same pathways as the --------------- tracts Synapse with the motor nuclei of the cranial nerves beginning at the level of the upper ------- Some decussate and some do not Responsible for --------- movement of the muscles of the face (CN VIII), head and neck (CN XII) Also involved in -----------, swallowing, and facial expression (CN VII and IX)
corticospinal pons voluntary phonation
42
Upper and Lower Motor Neuron Lesions: Recall the concept of upper and lower motor neurons, this is important for clinical applications.
???
43
Upper Motor Neuron Lesion: Causes --------- ---------- (muscles become tight, stiff and contracted; hypertonia) In the absence of UMN control, the LMN exhibits ----------------
spastic paralysis hyperactivity
44
Lower Motor Neuron Lesions (LMN): Causes -------- paralysis (muscles are limp and lack firmness; hypotonia) Loss of reflexes Muscle ---------- (later symptom)
flaccid atrophy
45
Give an example of Lower Motor Neuron lesion?
bulbar lesion of the facial nerve
46
Bulbar lesions: injuries to the cranial nerve nuclei or axons of the glossopharyngeal, vagus and/or hypoglossal nerve The paralysis that they cause is called -------- ------------ Nucleus of the glossopharyngeal or vagus nerve (pharyngeal muscle weakness and posterior 1/3 of tongue, i.e. issues swallowing) Nucleus of the ---------- nerve (progressive loss of speech and tongue muscle atrophy i.e. dysathria) Caused by lesions to the LMN Most common cause is brainstem ---------- or tumor
bulbar palsy hypoglossal stroke
47
Name a pyramidal disorder
Amyotrophic lateral sclerosis or Lou Gehrig's Disease - Upper and lower motor neuron disease - In about 10% of cases, ALS is caused by a genetic defect. In the remaining cases, the cause is unknown. - Leads to muscle weakening, twitching, and inability to move the arms, legs, and body. - The condition slowly gets worse. - When the muscles in the chest stop working, it becomes very hard to breath on one's own - ALS affects approximately 5 out of every 100,000 people worldwide - Breathing or swallowing muscles may be the first muscles affected - As the disease gets worse, more muscle groups develop problems - No known cure for ALS
48
Extrapyramidal tracts Function: - involuntary and autonomic control of movements, posture and muscle tone - more control over muscles in the midline than those in the periphery i.e. gross motor movements rather than fine control Structures involved include: - basal ganglia - red nucleus - substantia negra - reticular formation - cerebellum Four tracts: - vestibulospinal - reticulospinal - ------------------ - tectospinal
rubrospinal
49
Extrapyramidal tracts (unconscious) 1. ------------------- - from vestibular nuclei - conveys balance information to spinal cord, ipsilateral 2. -------------- - reticular formation of the pons - medial fibres excite voluntary movements - lateral fibres inhibit voluntary movements 3. --------------- - red nuclei - contralateral, plays a role in fine control of the hand 4. ------------- - superior colliculli - receives input from optic nerves, coordinates head movements in relation to visual stimuli
1. Vestibulospinal 2. Reticulospinal 3. Rubrospinal 4. Tectospinal
50
Vestibulospinal tract: - Vestibulospinal tract axons arise from vestibular ---------- located in the pons and medulla - The medial vestibular nucleus gives rise to the medial vestibulospinal tract, which projects bilaterally to thoracic regions of the spinal cord - The lateral vestibular nucleus gives rise to the lateral vestibulospinal tract, which descends -----------rally through the entire length of the spinal cord to synapse on interneurons in the anterior horn grey matter - Vestibular nuclei receive sensory input from the inner ear and cerebellum - Tract facilitates activity of extensor/antigravity muscles and inhibits activity of flexor muscles to maintain an --------- posture - E.g. the change in head position during tripping initiates extension of the upper limb and/or lower limb to prevent oneself from falling forward.
nuclei ipsilatelaterally upright
51
Rubrospinal tract - Cell bodies of upper motor neurons in this pathway begin in the ------ nucleus of the midbrain - After leaving the ---- nucleus, the axons cross the midline as the ventral tegmental decussation and descend as the rubrospinal tract through the brainstem and lateral column of the spinal cord white matter - These axons only descend to cervical regions of the spinal cord, and axons synapse with ----------s in the anterior horn gray matter to facilitate flexor muscle activity and inhibit extensor muscle activity of the upper limb.
red x2 interneurons
52
Tectospinal Tract: - Tectospinal tract axons arise from cell bodies located in the superior colliculus of the dorsal midbrain - These axons decussate in the dorsal tegmental decussation shortly after leaving the nucleus to form the tectospinal tract along the midline of the brainstem - The tectospinal tract continues through the brainstem near the medial longitudinal ---------- and into cervical regions of the spinal cord near the anterior median fissure. Within the cervical spinal cord, axons project bilaterally to synapse on cell bodies of interneurons in the anterior horn gray matter. - Superior colliculus recieves --------input - It is believed that the tectospinal tract modulates reflex postural movements in response to visual stimuli
fasiculus visual
53
Reticulospinal Tract: - Reticulospinal tract axons from the reticular formation in the pons and medulla - The axons of the pontine and medullary reticulospinal tracts descend ipsilaterally through the length of the spinal cord in the anterior white matter and synapse with interneurons in the anterior horn ------- matter - Believed to function in regulating voluntary movements in relfex activity and a--------- outflow
gray autonomic
54
Clinical context: extrapyramidal syndromes and diseases
Parkinson's disease Huntington's Chorea Tourettes Syndrome
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