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Neurology and Neuroscience > Motor Control > Flashcards

Motor Control Flashcards

1
Q

What is hierarchical organisation?

A

Higher orders do higher level of tasks which are more complicated and lower orders do lower tasks

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2
Q

What is functional segregation?

A

Motor system organised in a number of different areas that control different conckecst of movement

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3
Q

What are the pyramidal tracts and why are they called pyramidal tracts?

A

Pass through the pyramids of the medulla

  • Corticospinal
  • Corticobulbar

Go from motor cortex to the spinal cord or cranial nerve nuclei in brainstem

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4
Q

What are the Extrapyramindal tracts?

A

Do not pass through the pyramids of medulla

  • Vestibulospinal
  • Tectospinal
  • Reticulospinal
  • Rubrospinal

Brainstem nuclei to spinal cord

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5
Q

What does the primary motor cortex control?

A

Controls fine, discrete, precise voluntary movements

Descending signals to execute movements

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6
Q

What are premotor area control?

A

Involved in planning movements

Externally cued movement e.g. seeing and apple and reaching for it

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7
Q

What does the supplementary motor area do?

A

Planning complex movements which are internally cued e.g. speech

  • becomes active prior to voluntary movement
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8
Q

What percentage of fibres from corticospinal tract is responsible for trunk muscles?

A

10-15% uncrossed fibres = anterior corticospinal tract

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9
Q

What do the motor nerves from the corticobulbar tract do?

A

Synapse with brainstem cranial nerve nuclei

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10
Q

What is the corticobulbar tract responsible for?

A

principle motor pathway for voluntary movements of face + neck

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11
Q

What does vestibulospinal tract control?

A

head movement with eye movement coordination
Stablise head during body movements

postural adjusting

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12
Q

What does reticulospinal tract control?

A

arises from medulla and pons

changes muscle tone with voluntary movement
+
postural stability

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13
Q

What does the tectospinal tract control?

A

arises from superior colliculus of midbrain

head and neck orientation during eye movements

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14
Q

What does the rubrospinal tract control?

A

Arises from red nucleus of midbrain

mainly taken over by corticobulbar tract

Innervate lower motor nuerones of flexors of upper limb

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15
Q

What negative signs are seen with upper motor neuron lesions? (3)

A

Loss of : voluntary movement

Paresis : graded weakness of movements

Paralysis : complete loss of voluntary muscle activity = plegia

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16
Q

What are the positive signs seen with upper motor nueron tract? (4)

A 
- increased function abnormally
Spasticity = increased muscle tone
- Hyper-reflexia
- Clonus
- Babinski's sign
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17
Q

Why is increased motor function seen in upper motor neurone lesions?

A

Less descending inhibition inputs

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18
Q

What is clonus? Why is this relevent?

A

Abnormal oscillatory muscle contraction :

seen in upper motor neurone lesions

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19
Q

What is Apraxia?

A

A consequence of U.M.N.L

disorder of skileld movements

Meaning px will not have paralysis but lost information about how to perform skilled movements

20
Q

What are common causes of apraxia?

A

Stroke and dementia

21
Q

What symptoms and signs are seen in lower motor neurone lesions? (6)

A
  • Weakness
  • Hypotonia
  • Hyporeflexia
  • Muscle atrophy
  • Fasciculations
  • Fibrillations
22
Q

Why do fasciculations result in a twitch?

A

Damaged motor units produce spontaneous APs at NMJ = twitch

23
Q

What are fibrillations and how can we record these?

A

Spontaneous twitching of individual muscle fibres

  • use needle electromyography examination
24
Q

What is Motor neuron disease - MND and what is it also known as?

A

Progessive neurodegenerative disorder of motor system

ALS = amyotrophic lateral sclerosis

Affects both upper and lower neurones

Can cause a spectrum of disorders affecting intercostal muscles, lower and upper limb muscles, tongue

25
Q

Why can ALS cause death?

A

Over time it gets worse

- affects respiration due to muscles

26
Q

What are the UMN signs in ALS/MND?

A
  • Spasticity (increased tone of limbs and tongue)
  • Brisk limbs and jaw reflexes
  • Babinski’s sign
  • Loss of dexterity
  • Dysarthria (difficulty speaking)
  • Dysphagia (difficulty swallowing)
27
Q

What are the LMN signs in ALS/MND?

A
  • Weakness
  • Muscle wasting
  • Tongue fasciculations and wasting
  • Nasal speech
  • Dysphagia
28
Q

What structures are found in the basal ganglia?

A
  • Caudate nucleus
  • Lentiform nucleus ( made of putamen and external pallidus ) *together caudate and putamen are known as striatum
  • Nucleus accubens
  • Subthalamic nuclei
  • Substantia nigra (midbrain)
  • ventral pallidum, claustrum, nucleus basalis ( of meynert )
29
Q

What is the function of the basal ganglia?

A

Make the decision to move

Elaborating associated movements e.g. swinging arms when walking, changing facial expressions to match emotions

Suppressing unwanted movements

Performing movements in order

30
Q

What abbreviation is used to remember the parts of the basal ganglia?

A 
C - caudate nucelus
P - putamen
G - external Globus pallidus
T - Thalamus
Acc - nucelus accumbens
Am - Amygdala
Ac - Anterior commisure
31
Q

Why are there so many complications with the basal ganglia?

A

A big circulitry with many input and output paths (slide 20)

32
Q

What is Parkinson’s caused by?

A

Degeneration of the dopamingergic nuerones that orginate in the substania niagra and project to the striatum

33
Q

What are the signs and symptoms of parkinsons?

A

Bradykinesia - slowness of (small) movements (doing up buttons, handling a knife)
Hypomimic face - expressionless, mask-like (absence of movements that normally animate the face)
Akinesia - difficulty in the initiation of movements because cannot initiate movements internally
Rigidity - muscle tone increase, causing resistance to externally imposed joint movements
Tremor at rest - 4-7 Hz, starts in one hand (“pill-rolling tremor”); with time spreads to other parts of the body

34
Q

What is Huntingtons disease caused by?

A

Denegeration of GABAergic neurons in the striatum, caudate and putamen

It is a chromosome 5 authosomal dominent CAG repeat disorder

35
Q

What are the signs and symptoms of Huntingons disease?

A

Choreic movements (chorea - dance)
rapid jerky involuntary movements of the body; hands and face affected first; then legs and rest of body
Speech impairment
Difficulty swallowing
Unsteady gait
Later stages, cognitive decline and dementia

36
Q

What is Ballism?

A

Sudden uncontrolled flinging of the extremties

Symptoms occur contralaterally

37
Q

What is Ballism caused by?

A

usually from stroke affecting subthalamic nucelus

38
Q

Where is the cerebellum located?

A

Posterior cranial fossa

Sepreated from cerebrum above by tentorium cerebelli

It is the coordinator and predictor of movement

39
Q

What is the vestibulocerebellum ?

A

Regulation of gait, posture and equilibrium

Coordination of head movements with eye movements

40
Q

What does a damage such as tumour affecting the vestibulocerebellum do to the px?

A

Damage (tumour) causes syndrome similar to vestibular disease leading to gait ataxia and tendency to fall (even when patient sitting and eyes open

41
Q

What is the spinocerebellum?

A

Coordination of speech
Adjustment of muscle tone
Coordination of limb movements

42
Q

What does damage to the spinocerebellum do to a px?

A

affects mainly legs, causes abnormal gait and stance (wide-based)

43
Q

Why may the spinocerebellum be damaged?

A

Degeneration and atrophy associated with chronic alcoholism

44
Q

What does the cerebrocerebellum do?

A

Coordination of skilled movements
Cognitive function, attention,
processing of language
Emotional control

45
Q

What does damage to the cerebroccerebellum do to the px?

A

affects mainly arms/skilled coordinated movements (tremor) and speech

46
Q

What are the mains signs of cerebellar dysfunction? (5)

A

These are apparanet only on movement:

Ataxia
General impairments in movement coordination and accuracy. Disturbances of posture or gait: wide-based, staggering (“drunken”) gait
Dysmetria
Inappropriate force and distance for target-directed movements (knocking over a cup rather than grabbing it)
Intention tremor
Increasingly oscillatory trajectory of a limb in a target-directed movement (nose-finger tracking)
Dysdiadochokinesia
Inability to perform rapidly alternating movements (rapidly pronating and supinating hands and forearms)
Scanning speech
Staccato, due to impaired coordination of speech muscles

Neurology and Neuroscience (21 decks)

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