Lower Motor Neuron Unit/Neuromuscular Disease Flashcards
where do lower motor neurons originate and where do they go? contrast with upper motor neurons
LMN originate from the spinal cord and innervate muscles in limbs;
UMN originate from the brain, they send the thoughts to move the limb (turn LMN on or off to move limbs)
how does an action potential travel down an axon?
the wave of depolarization travels in big hops (saltatory conduction); axons are myelinated by schwann cells except at nodes of ranvier; the AP jumps from one node to the other, traveling faster than if it ran down the entire length of the axon
what 3 things are required for saltatory conduction? what does this imply?
- sodium
- potassium
- ATP (from glucose or other energy sources)
this means that energy is required to establish an action potential, so an energy source is ESSENTIAL! if not getting neuromuscular transmission, check these 3
how is muscle contraction accomplished? (6)
- an impulse reaches the presynaptic terminal
- this causes an influx of calcium
- calcium binds to presynaptic vesicles that contain ACh
- ACh is exocytosed and released into neuromuscular junction
- ACh binds to the post-synaptic membrane (muscle) and depolarizes the muscle cell
- this depolarization causes actin/myosin interaction and muscle contraction
how is muscle contraction stopped?
acetylcholine esterase degrades ACh and recycles is back to the presynaptic terminal to get ready for the next action potential
what are the 3 ways to assess LMN function?
- reflexes
- muscle tone
- presence of atrophy
THIS IS THE MPST IMPORTANT PART OF THE NEURO EXAM
what are the 2 ways to assess reflexes? describe reliability
- myotactic (tendon reflexes)
- withdrawal reflex (flexor reflexes)
reliability varies by which reflex is being assessed
describe a monosynaptic reflex arc, give an example
there is one synapse involved int he reflex; composed of sensory component (afferent) that synapses with a LMN an efferent component out to cause a response
an example of this is the patellar reflex
compare and contrast extrafusal and intrafusal muscle fibers
muscle spindles are proprioceptive organs located throughout skeletal muscle (size and shape of a grain of rice) contained within a connective tissue capsule; these spindles are stretched when the muscle lengthens, causing the sensory neuron in the spindle to transmit an impulse to the spinal cord, where it will synapse with alpha motor neurons, determining the amount of contraction needed to overcome a certain resistance
muscle fibers within the spindle are called intrafusal; these provide sensory information on muscle length and change in length
muscle fibers outside the spindle are called extrafusal, make up the bulk of the muscle, run tendon to tendon or ligament to ligament, and are controlled by larger alpha motor neurons
what are the 4 parts of the lower motor neuron unit? describe how they are all related
- LMN cell body
- axon
- neuromuscular junction
- muscle
need all 4 components for a reflex, so a lesion in any part will look the same externally (absent or reduced reflex)
what are the 5 functional segments of the spinal cord? what is meant by functional?
- C1-C5: UMN only
- C6-T2: LMN to thoracic limbs
- T3-L3: UMN only to pelvic limb
- L4-S1: LMN to pelvic limb
- S1-3 to S5 +/- caudal segments
function means that a focal or a diffuse lesion in this area will look the same clinically
what are the spinal cord segments for lower motor neuron units?
thoracic limbs: C6-T2
pelvic limbs: L4-S1
what is an intumescence? what are the 2 kinds?
intumescence is a spinal cord swelling of the ventral horn where all cell bodies come together before leaving as a named nerve
cervical intumescence: cell bodies for nerves that innervate the thoracic limb;
this is located at spinal cord segment C6-T2, between vertebrae C5-T1
lumbar intumescence: cell bodies for nerves that innervate the pelvic limb; this is located at spinal cord segment L4-S1, between vertebrae L3-L6
what is found in spinal cord segment C6-T2? (3)
- cervical intumescence
- brachial plexus
- nerves of the thoracic limb
what is found in spinal cord segments L4-S1 and S1-S3 (S5)? (4)
- lumbar intumescence
- lumbar/lumbosacral plexus
- nerves of the pelvic limb
- nerves of the bladder/bowel
give the vertebral location of the end of the spinal cord in dogs, cats, ruminants, swine, and horses
dogs: L6-L7
cats: L7-S3
ruminants: L6-S1
swine: S1-S2
horses: S2
do myotactic and withdrawal reflexes rely on the nervous system cranial or caudal to their reflex arc? how does this help with localization?
no! reflexes just speak to their reflex arc (you can have these reflexes in recently amputated limbs)
this helps you localize, meaning that is the reflex is not normal, then the local LMN is the source of the lesion
how is the thoracic limb assessed? (3)
- withdrawal
- tone
- muscle mass
what reflex is used to assess the thoracic limb? what nerves does it asses?
withdrawal reflex; every animal has it and it is reliable!
assesses all peripheral nerves in thoracic limb
what does atrophy of the suprasinatus and infraspinatus muscles suggest?
damage to suprascapular nerve; located at spinal cord segments C5, C6, C7
what does atrophy of the biceps brachii!!, brachialis, or coracobrachialis suggest?
damage to the musculocutaneous nerve; located at spinal cord segments C6 and C7