Motor control: descending commands and clinical eval

Question 1

where does planned movement begin

Answer 1

premotor and supplementary motor cortex

Question 2

what can be measured to see planned movement and where

Answer 2

B-potential before movement happens in the pre-motor area

Question 3

what are the 4 descending motor pathways and which are in stem

Answer 3

1. corticospinal
2. rubrospinal - stem
3. vestibulospinal - stem
4. reticulospinal - stem

Question 4

what are 4 ways the brain controls movement

Answer 4

1. control reflex gain
2. select motor program
3. activate groups of M-neurons
4. activate indiv. muscles

Question 5

what is special about fine finger movements

Answer 5

in humans there is a monosynaptic control from the cortex

Question 6

5 signs of UMn lesions

Answer 6

1. paralysis
2. incr. reflexes (clonus and spastcity)
3. clasp knife rigidity ( incr. tone)
4. babinski response

Question 7

5 signs of LMN lesion

Answer 7

1. atrophy
2. fasiculations
3. decreased tone (not really)
4. decresed reflexes
5. no babinski

Question 8

2 disorders of tone

Answer 8

1. spasticity - increased velocity dependent tone with exageratted stretch reflexes
2. clonus - rapid succession of stretch reflexes, best felt at ankle

Question 9

what is sign in stroke UMN

Answer 9

upper body flexor and lower body extensor

Question 10

2 aspects of exaggerated stretch reflexes

Answer 10

1. increased amplitude

2. increased briskness

Question 11

what is clasp knife phenomenon

Answer 11

mixed spacticity and altered flexion reflex

Question 12

pharma and non pharm treatment of spactisicy

Answer 12

pharma - weaken muscles - botox or reduce transmission between affert and motoneuron - baclofen
non-pharm - PT, stretch