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Neuro Block 4 > Motor Cortex > Flashcards

Motor Cortex Flashcards

0
Q

What are some characteristics of stellate cell?

A

Receive cortico information
Granular cortex is a bunch of these
A lot around sensory tissue
Look like sand in stain

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1
Q

What is motor cortex?

A

Anatomically: 6 layers, 4 cells, two types, stellate cells in the 4th layer, pyramidal cells everywhere else. Small layer 4 big layer 5
Physiologically:

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2
Q

Where are pyramidal cells projecting in layers 5 and 6?

A

Subcortically

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3
Q

What are Betz cells?

A

Large pyramidal cells
In the 5th layer
Only in layer 5

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4
Q

What is area 4?

A

Motor cortex

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5
Q

What is area 6?

A

Premotor cortex and supplementary motor cortex

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6
Q

Where is the frontal eye fields?

A

In front of area 8

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7
Q

What does the frontal eye fields do?

A

Gaze:
VOR
Fixation
Optokinetic response

Saccades
Smooth pursuit
Vengeance
Cancellation of VOR

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8
Q

Where is the horizontal gaze center?

A

Paramedian pontine reticular formation

PPRF

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9
Q

Where is the vertical gaze center?

A

Rostral interstitial nucleus of the medial longitudinal fasciculus

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10
Q

What does the PPRF project to?

A

Ipsilateral abducens

Contralateral CN III (via MLF)

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11
Q

What do the frontal eye fields do?

A

Select visual targets

Initiate Saccades and smooth pursuit

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12
Q

Where does the frontal eye field project?

A

The PPRF directly

And through the superior colliculus

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13
Q

Where is the PPRF?

A

The pons

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14
Q

What is the path of selecting eye targets?

A

Frontal eye field –> superior colliculus –> contralateral PPRF –>

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15
Q

What controls the rightward movement?

A

The left frontal eye field and the right PPRF

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16
Q

What happens when you get injury to the FEF?

A

Loss of voluntary Saccades to the contralateral side

Loss ability to move gaze away from a stimulus. Stuck involuntarily

Deviation of eyes to the side of the lesion

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17
Q

What are the three cortical motor areas?

A

SMA
Primary motor cortex
Premotor cortex

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18
Q

What does stimulus of an area of the motor cortex do?

A

Stimulates movement of a body part not a muscle

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19
Q

What does the M1 region do?

A

Direction, force among others

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20
Q

What are the inputs to M1?

A
  • Proprioception info: mostly contralateral via dorsal column and VP nucleus of the thalamus.
  • Tactile information from the hands
  • other cortical area: S1, premotor, cingulate, parietal lobe
  • cerebellum and basal ganglion
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21
Q

How is the premotor cortex functionally organized?

A

Dorsal - reaching

Ventral - grasping, cognitive control

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22
Q

Where does the premotor cortex receive input?

A 
SMA
Cingulate motor area
Prefrontal cortex (planning and learning)
Posterior parietal 
Cerebellum and basal ganglion
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23
Q

What does the premotor cortex do?

A

Gives complex multi joint movement
Eating

Sensorimotor transformation: transforming sensory cues into motor actions - externally driven

Way before the action, mirror neurons

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24
Q

What are mirror neurons?

A

Responds if the monkey were doing an action but the monkey is actually just watching someone do something

Signals intent
Learning by watching

Behavioral context - why we are doing what we do

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25
Q

What happens if there is a lesion in the premotor cortex?

A

Inability to properly respond to stimuli, plan movements based on circumstances, learn new sensory-motor associations, steer arm directly

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26
Q

What is the functional organization of the SMA?

A

Homunculus (leg, arm, face caudal to rostral)

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27
Q

What does SMA stimulation do?

A

Movement in multiple joints

More than M1 but less than premotor
Postural changes

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28
Q

Where does the SMA receive input?

A

M1
Prefrontal cortex
Posterior parietal cortex
Basal ganglion and cerebellum

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29
Q

What is the function of the SMA?

A

Internal generation of movement

Activity is linked to learning sequences of movements, performing them, mental rehearsal

Piano playing learning

Suppresses premotor planning when inappropriate

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30
Q

What happens when a movement becomes a habit?

A

SMA becomes less and the M1 assumes control

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31
Q

What happens when there is a lesion in the SMA?

A
  • Cannot learn new complex sequences
  • loss internal drive for movements
  • loss of suppression of motor programs triggered by visual stimuli: alien hand syndrome, utilization behavior
  • neglect of affected limb
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32
Q

What is alien hand syndrome?

A

Lesion in the SMA

Contralateral semi-purposeful movements that are outside the patients volitional control

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33
Q

What is utilization behavior?

A

Caused by a lesion in the SMA

Use of objects in an inappropriate setting

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34
Q

When is premotor and SMA active?

A

Premotor: when visual cue without prior learning, responds to external
SMA: when there is prior learning, responds to internal

Premotor is not active when the sequence has been learned

SMA is not active when a sequence has not been learned

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35
Q

What are the paths of the corticospinal and corticobulbar tracts?

A

M1, premotor, SMA, somatosensory –> internal capsule –> cerebral peduncle (base of midbrain)
–> through the pons –> pyramidal tracts on the ventral side of the medulla

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36
Q

Where does the corticobulbar tract projects and how?

A

Motor cranial nerves

Mostly bilateral

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37
Q

What is normal facial expressions controlled by?

A

Corticobulbar

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38
Q

What controls emotional facial expression?

A

The cingulate

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39
Q

What is the voluntary control of facial expression?

A

Contralateral of lower face

Bilateral of low face

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40
Q

Where does the corticospinal tract project?

A

Collateral to red nucleus and reticular formation

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41
Q

What is the function of the 10% of the corticospinal tract fibers that do not decussate?

A

Ventral corticospinal tract (medial)

Collateral sac cross the midline

Primarily innervates axial and proximal limb muscles (medial)

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42
Q

What does the corticospinal tract contact?

A
  • Alpha-motor neurons

- Interneurons that are connected to alpha-motor neurons allowing for coordination

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43
Q

Where is most of the direct contact of the corticospinal tract and the alpha-motor neurons?

A

Forearm and hand areas

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44
Q

What is the rubrospinal tract associated with?

A

The red nucleus?

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45
Q

Where is the red nucleus?

A

The upper midbrain

By the superior colliculi

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46
Q

What are the two components of the red nucleus?

A
  • Magnocellular

- Parvocellular

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47
Q

What is the input and output of the magnocellular part of the red nucleus?

A

Input: motor cortex
Output: spinal cord

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48
Q

What is the input and output of the Parvocellular part of the red nucleus?

A

Input: cerebellum
Output: inferior olive

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49
Q

Where does the axons of the red nucleus decussate?

A

Almost immediately

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50
Q

What is the function of the rubrospinal tract?

A

Primary motor pathway in lower vertebrates

Terminates in upper half of spinal cord (cervical or thoracic)

Controls arms

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51
Q

Where does the vestibulospinal tract receive input?

A

The cerebellum and vestibular organs

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52
Q

What is the function of the medial VN and where does it terminate?

A

Regulates head position

Terminates bilaterally in the medial ventral horn of the spinal cord

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53
Q

What is the function of the lateral VN?

A

Activates physiological extensor muscles that work against gravity with deviations from posture

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54
Q

What are the two nuclei of the reticulospinal “nuclei”?

A

Pontine and medullary (rostral and caudal)

Coordinate movements of the trunk and proximal limbs

Really just continuous formation with little organization

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55
Q

What measures your intended output and readjusts?

A

Cerebellum

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56
Q

How is posture maintained?

A

By primary physiological extensors

Through the tonic activity of alpha-motor neurons

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57
Q

How do you increase alpha-motorneuron activity thereby tone?

A

Directly - corticospinal neuron, vestibulospinal, reticulospinal (descending tracts) (gamma as well)

Indirectly - stretch receptors (gamma motor activity) reflex.

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58
Q

How are adjustments are made on the fly?

A

Feedforward - anticipate, includes reticulospinal

Feedback - includes vistibulospinal tract (random)

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59
Q

What does the vestibulospinal tract contact?

A

Alpha and gamma motorneurons

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60
Q

What do the vestibulocollic and vestibulospinal reflexes do respectively?

A
  • act on neck muscles to adjust the head

- adjust limb

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61
Q

What are the three things that help you maintain balance?

A

Vision, proprioception, and the vestibular system

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62
Q

What provides central control of posture?

A

The corticospinal, rubrospinal, and reticulospinal tracts

Adjust reflex sensitivity

Enable Feedforward adjustments for self-generated movements (planning)

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63
Q

What allows for Feedforward (anticipatory) adjustments?

A

The corticoreticular and reticulospinal tracts

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64
Q

What is the pathway of Feedforward adjustments?

A

Cortex –> corticoreticular tract –> reticular formations –> reticulospinal tracts –> alpha and gamma motorneurons

65
Q

What does the pontine reticular formation do?

A

Excites gamma-motorneurons

Is inhibited by the cortex
Action

66
Q

What does the medullary reticular formation do?

A

Inhibits gamma-motorneurons

Excited by the cortex

67
Q

How does the cortex affect gamma-motorneurons?

A

Dampens gamma-motorneurons activity

Mechanism for modifying tone

68
Q

What happens when there is a lesion of pyramids?

A

Well the pyramids becomes the corticospinal tract

Loss of fine voluntary movements of the hands

The other descending projects can compensate for this
Hands are specifically innervating the hands, that is special, other things are compensated for

69
Q

What happens when you have a spinal cord transection?

A

You take out all descending tracts

No input to alpha or gamma neurons –> loss of muscle and reflexes

However afterward 2months you get hypertonia (more tone and reflex)

70
Q

Why do you get hypertonia and hypereflexia after a spinal cord cut?

A

Denervation sensitivity (increased) of receptors of motorneurons

Local axons fill the synaptic void (more input)

No longer inhibition of gamma-MN or excitation of the medullary reticular formation. So increased gamma-MN activity and increased tone.

71
Q

What is characteristics of upper motor neuron syndrome (motor cortex or internal capsule)?

A
  • initially, weakness (spinal shock)
  • a few days, babinski’s reflex(spinal cortical tract), clonus, clasp-knife rigidity (hard, resistant, and them it collapses)
72
Q

Where does the rubrospinal tract project?

A

The cervical spinal cord
Flex ion of upper limbs

From the red nucleus

73
Q

How does the cortex affect the reticulospinal tract?

A

Generally inhibits gamma-MN activity

Inhibits pontine reticular formation (less gamma-MN)

Excites the medullary reticular formation (less gamma-MN)

74
Q

How can you interrupt the cycle of UMN hypertonia and clonus?

A

By cutting the primary afferent, (dorsal root)

Cures spasms

75
Q

What is decorticate posture?

A

UMN lesion

Upper extremities in flexion
Lower in extension
Brainstem centers intact, no input from cortex, above the red nucleus

76
Q

What is decerebrate posture?

A

Progressive decorticate posture

All limbs in extension, no longer have red nucleus doing flexion of upper extremities

A lot of brain damage.

77
Q

What happens when decerebrate posture progresses?

A

As it progresses further past the red nucleus it hits the vestibulo and reticulospinal tracts –> flaccidity (likely death)

78
Q

What is the vermis?

A

The middle of the cerebellum

79
Q

Where is the para vermis?

A

Lateral to the vermis

80
Q

What are the divisions of the cerebellum?

A

Lobes, lobules, and folia

81
Q

What is the function of the cerebellum?

A

Correcting or preventing motor mistakes

Ensuring accurate and smooth movements

Associative learning system

82
Q

How does the cerebellum learn?

A

Receives a lot of sensory and motor input and associates sensory input with actual movements with intended motor output

Modulates motor output to match expected sensory input

Coordination

Contributes to learn new motor skills specifically with respect to timing

Automatic reactions

83
Q

What are the other functions of the cerebellum besides motor?

A

Language and cognition

84
Q

What is the function of the vermis?

A 
Midline movements (structures that are on midline)
-gait, speech, posture, stance, visceral function
85
Q

What part of the cerebellum controls appendicular movements like reaching and grasping?

A

The paravermis

86
Q

What do the lateral hemispheres of the cerebellum do?

A

Reciprocal connections with the cortex

Spatially and temporally complex movements requiring synergistic coordination

Cognition

87
Q

What part of the cerebellum deal with cognition?

A

Lateral hemispheres

88
Q

What makes up the spinocerebellum

A

The vermis and paravermis

Output to the spinal cord

89
Q

What composes the cestibularcerebellum

A

The floccularnodular region

Coordinates vestibular function

90
Q

What are the four nuclei of the deep cerebellum?

A

(Lateral to medial)
Don’t eat green frogs

Dentate (largest)
Emboliform (interposed)
Globus (interposed)
Fastigial

91
Q

What does the vermis project to?

92
Q

What does the paravermis project to?

A

The interposed nuclei (emboliform and globus)

93
Q

What do the lateral hemispheres project to?

A

The Dentate nucleus

94
Q

What is the main function of the cortex of the cerebellum?

A

Input

Learning new complex stuff

95
Q

What is the function of the deep cerebrallar nuclei?

A

Receive input from the cortex and direct input

Provide output

Provide ongoing monitoring of movements

96
Q

What are the layers of the cerebellum from inner to outer?

A

White matter –> granular layer –> purkinje layer

–> molecular layer

97
Q

What is significant of the purkinje cells?

A

Large cell bodies
Large number of dendrites
Broad one direction, thin in the other plane

98
Q

What are the most numerous cell types in the brain?

A

Granule cells

99
Q

Where do the granule cells project?

A

Into the molecular layer where they bifurcate

100
Q

How do you get integration of information in the cerebellum?

A

Each parallel fiber contacts up to 200K purkinje cells

Each purkinje cell receives contact from tens of thousands of parralell fibers

101
Q

What does the purkinje cell project to?

A

Out of the cortex to the deep cerebellar nuclei

102
Q

What are the two inputs to the deep nuclei?

A

Mossy fibers - nuclei and granule cells

Climbing fibers - nuclei and purkinje cells

103
Q

What are mossy fibers?

A

From the spinocerebellum
Gets info from spinal cord, auditory, vestibular, visual

And from the vestibulocerebellum
- vestibular nerve and nuclei

And from the cerebrocerebellum
- cortex via the pontine nucleus

Tons, input
Excite the deep nuclei and granule cells

104
Q

What takes in ipsilateral input from the dorsal and rostral spinocerebellar tracts and the cuneocerebellar tract?

A

The inferior cerebellar peduncle

Mossy

105
Q

What is the input front the middle cerebellar peduncle?

A

Massive contralateral input from the pontine nucleus

Mossy

106
Q

What is passing through the superior cerebellar peduncle?

A

Mostly output

Input from the ventral spinocerebellar tract

Mossy

107
Q

Where do climbing fibers originate?

A

Contralateral inferior olive

108
Q

Where does the inferior love receive input from?

A

Parvocellular red nucleus
Reticular formation
Spinal cord

109
Q

Where do climbing fibers enter the cerebellum?

A

The inferior peduncle

110
Q

What do climbing fibers contact?

A

Purkinje cells (1:1)

Climb then, wrap around

111
Q

What are climbing fibers critical for?

A

Detecting error in motions

Needed for motor learning

112
Q

What is the function of the purkinje cells?

A

Inhibitory to the deep nuclei

113
Q

What happens when purkinje cells are activated?

A

Stop movement just as you reach your target so you don’t go too far

114
Q

What is reafference?

A

Sensory from the periphery about motions actually occurring

Enables the system to identify unexpected conditions

115
Q

What enables the cerebellar system to identify unexpected conditions?

A

Reafference - sensory information about what is actually happening

116
Q

What is efference copy (corollary discharge)?

A

Neural copy of motor commands

117
Q

What do reafference and efference allow?

A

These inputs are compared and future motions are corrected

118
Q

How is properioceptive info received into the cerebellum?

A

Ipsilateral from muscles
Spinocerebellar mossy fibers

  1. Dorsal spinocerebellar tract C8 and below via clerked column
  2. Cuneocerebellar tract rostral to C8 via accessory cuneate nucleus
  3. Mesencephalic nucleus, face
119
Q

Where does the cerebellum receive motor information from?

A

Mossy fibers from:

  1. Ventral spinocerebellar tract, crosses midline in spinal cord, enters through superior CP,macros see again in cerebellum
  2. Rostral spinocerebellar tract, starts I’m cervical spinal cord, stays ipsilateral
120
Q

What is the cerebellum in relation to the body?

A

Ipsilateral, same side lesion

121
Q

What are the spinocerebellar outputs of the vermis?

A

Vermis –> fastigial nucleus –>

1a. Superior CP –> thalamus VL –> M1 –> ventral corticospinal tract
1b. Superior CP –> Superior colliculus –> tectospinal tract

2a. Inferior CP –> reticular nuclei –> reticulospinal tract
2b. Inferior CP –> vestibular nuclei –> vestibulospinal tracts

Overall it does posture, orienting, and gait

122
Q

Where does the paravermis project?

A

Interposed nuclei

  1. –> VL thalamus –> M1 –> lateral corticospinal tract
  2. –> magnocellular red nucleus –> rubrospinal tract

Overall, reaching and grasping

123
Q

Where are the Parvocellular and magnocellular parts of HHS red nucleus projecting?

A

Parvocellular - inferior olive

Magnocellular - rubrospinal tract

124
Q

What happens if you get a lesion in the vermis?

A

Gait ataxia

Spinocerebellar ataxia (SCA)
Collection of genetic disorders
125
Q

What happens with chronic alcohol abuse?

A

Deterioration of the anterior division of the cerebellum

126
Q

What happens with a lesion in the paravermis?

A

Action tremor

Timing disorders

No longer adapt

127
Q

What happens with damage to the lateral hemispheres?

A

Bad motor learning

Cognition

  • language defects after PICA stroke
  • behavioral
  • developmental loss of purkinje cells in autism
128
Q

What does the basal ganglia do?

A 
Mutually exclusive movements
- promote one and suppress another
- can work at different levels
- info contributing to choice
   - efference copy
   - associate memories and emotions
Importance or urgency of possible action (bear)
129
Q

What is the function of the corpus striatum?

A

Input zone of the basal ganglion

Composed of putamen and caudate nucleus

130
Q

What is the input some of the basal ganglion?

A

The corpus striatum

Caudate and putamen

131
Q

What is the output of the basal ganglion?

A

The pallidum (globus pallidus and substantia Nigra pars reticulata (SNr))

132
Q

What part of the BG receives striatal output?

A

The pallidum

133
Q

Where is the input into the corpus striatum from?

A
  1. Ipsilateral cortex (widespread and somatotopic)
  2. SN pars compacta
  3. Subcortical structures via intralaminar nuclei of the thalamus
134
Q

What inputs into the BG besides the striatum?

A

Subthalamic nucleus

Inputs outnumber outputs

135
Q

What makes up 90% of the neurons in the BG?

A

Medium spiny neurons

136
Q

What are medium spiny neurons?

A

GABAergic - inhibitory

  1. Substance P
  2. Enkephalins
137
Q

What movement does the caudate nucleus do?

A

Eye movement

138
Q

What does the putamen do?

A

Limb movement

139
Q

What is the default of the BG?

A

To do nothing

Active is inhibit

140
Q

What are the three main pathways of the BG?

A

Direct - dis inhibits selected actions, allowing them to occur

Indirect - inhibits actions selected against

Hyperdirect - purely inhibits

141
Q

What is topically active?

A

The globus pallidus

NOT the striatum

142
Q

What does he globus pallidus do?

A

Inhibits the thalamus –> prevents excitation of motor cortex

143
Q

What does the striatum do?

A

Inhibits Gpi and Gpe

144
Q

What excites the Gpi?

A

Subthalamic nucleus therefore inhibiting motion

145
Q

What is the hyper direct pathway?

A

Suppresses motion by the cortex exciting the STN, therefore increases GPi and inhibiting the thalamus

146
Q

What type of medium spiny neuron projects to the direct pathway?

A

GABA/substance P
–> GPi and SNr

Excitatory response to DA

D1

147
Q

What medium spiny neurons project to the indirect pathway?

A

GABA/enkephalin
–> GPe

D2 receptors

Inhibitory response to DA

148
Q

What is D1 and D2?

A

Excitatory and inhibitory respectively

149
Q

What does the SNc do?

A

Is dopaminergic

Projects to striatum

150
Q

What is the firing of the SNc to the striatum?

A

Tonic

Also in bursts to unexpected events

151
Q

What happens of you get rid of STN?

A

Reduces inhibition

Get flailing

152
Q

What causes Parkinson’s?

A

Degeneration of the SNc

No dopamine release

153
Q

What are common symptoms of Parkinson’s?

A

Hypokinesia/akinesia

  • placidity of movements
  • lack of facial expression

Bradykinesia: slow movements

Shuffling gait
Rigidity (lead pipe or cogwheel)
Postural instability
Tremor at rest

154
Q

What areas of the brain are stimulated for Parkinson’s treatment?

A

GPi
STN
VIM (part of VL)

155
Q

What is the pallidum composed of?

A

Globus pallidus (internal and external)

SNr

156
Q

What is the treatment of Parkinson’s?

A

L-DOPA/carbidopa
Deep brain stimulation
Treatment of non motor symptoms

157
Q

What degenerates in Huntington disease?

A

Caudate and putamen

Also frontal temporal cortices

158
Q

What is the inheritance pattern and cause of Huntington disease?

A

Autosomal dominant

Expansion of CAG repeats in Huntington

159
Q

What are symptoms of Huntington disease?

A

Rapid jerky movements (choreiform)
Hypokinesia
Later the pallidum and SN degenerate

160
Q

What are the tracts?

A

Pic inserts

161
Q

What is the treatment for Huntington?

A

Cannot change course of disease

Treat early symptoms of hyperkinesia and psychiatric disturbances

Neuro Block 4 (13 decks)

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