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Year 3 Neuro > Motor Cortical Control > Flashcards

Motor Cortical Control Flashcards

1
Q

What are the negative affects of an upper motor neurone lesions?

A

Loss of voluntary motor function

Paresis: graded weakness of movements

Paralysis (plegia): complete loss of voluntary muscle activity

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2
Q

What is meant by negative?

A

Loss of function

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3
Q

What is meant by positive?

A

Unwanted gain of function

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4
Q

What are the positive affects of an upper motor neurone lesions?

A

Increased abnormal motor function due to loss of inhibitory descending inputs

Spasticity: increased muscle tone

Hyper-reflexia: exaggerated reflexes

Clonus: abnormal oscillatory muscle contraction

Babinski’s sign

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5
Q

What is apraxia?

A

Consequence of UMN lesion

disorder of skilled movement

Patients are not paretic but have lost information about how to perform skilled movements

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6
Q

What can cause apraxia?

A

Lesion of inferior parietal lobe, the frontal lobe

e.g. stroke and dementia

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7
Q

What are the symptoms of a lower motor neurone lesions?

A

Weakness

Hypotonia (reduced muscle tone)

Hyporeflexia (reduced reflexes)

Muscle atrophy

Fasciculations

Fibrillations

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8
Q

What are fasciculations?

A

damaged motor units produce spontaneous action potentials, resulting in a visible twitch

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9
Q

What are fibrillations?

A

spontaneous twitching of individual muscle fibres; recorded during needle electromyography examination

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10
Q

What is MND?

A

Motor Neuron Disease

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11
Q

What is motor neurone disease?

A

Progressive neurodegenerative disorder of the motor system

Affects UMN and LMN’s

Also known as Amyotrophic Lateral Sclerosis (ALS)

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12
Q

Which muscles are particularly affected by MND?

A

Tongue
Upperlimb
Intercostal muscles
Lower limb

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13
Q

What are the signs of upper motor neurone disease? in MND

A 
Spasticity (increased tone of limbs and tongue)
Brisk limbs and jaw reflexes 
Babinski’s sign
Loss of dexterity
Dysarthria (difficulty speaking)
Dysphagia
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14
Q

What are the signs of lower motor neurone disease? in MND

A 
Weakness
Muscle wasting
Tongue fasciculations and wasting
Nasal speech
Dysphagia
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15
Q

What disorders are associated with basal ganglia dysfunction?

A

Parkinson’s
Huntington’s
Ballism

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16
Q

What causes Parkinson’s?

A

Degeneration of the dopaminergic neurons that originate in the substantia nigra and project to the striatum

17
Q

What are the symptoms of Parkinson’s?

A 
Bradykinesia
Hypomimic face
Akinesia
Rigidity
Tremor at rest
18
Q

What is bradykinesia?

A

slowness of (small) movements (doing up buttons, handling a knife)

19
Q

What is hypomimic face?

A

expressionless, mask-like (absence of movements that normally animate the face)

20
Q

What is akinesia?

A

difficulty in the initiation of movements because cannot initiate movements internally

21
Q

What is rigidity?

A

muscle tone increase, causing resistance to externally imposed joint movements

22
Q

What are the main feature of the Parkinson’s tremor?

A

4-7 Hz, starts in one hand (“pill-rolling tremor”); with time spreads to other parts of the body

23
Q

What causes Huntington’s disease?

A

Degeneration of GABAergic neurons in the striatum, caudate and then putamen

Genetic neurodegenerative disorder
Chromosome 4, autosomal dominant
CAG repeat

24
Q

What are the symptoms of Huntington’s?

A 
Choreic movements 
Speech impairment
Difficulty swallowing
Unsteady gait
Later stages, cognitive decline and dementia
25
Q

What are choreic movements?

A

(chorea - dance)

rapid jerky involuntary movements of the body; hands and face affected first; then legs and rest of body

26
Q

What are the main signs of cerebellar dysfunction?

A 
Ataxia
Dysmetira
Intention tremor
Dysdiadochokinesia
Scanning speech
27
Q

What is ataxia?

A

General impairments in movement coordination and accuracy. Disturbances of posture or gait: wide-based, staggering (“drunken”) gait

28
Q

What is dysmetria?

A

Inappropriate force and distance for target-directed movements (knocking over a cup rather than grabbing it)

29
Q

What is intention tremor?

A

Increasingly oscillatory trajectory of a limb in a target-directed movement (nose-finger tracking)

30
Q

What is dysdiadochokinesia?

A

Inability to perform rapidly alternating movements (rapidly pronating and supinating hands and forearms)

31
Q

What is scanning speech?

A

Staccato, due to impaired coordination of speech muscles

32
Q

How is Parkinson’s diagnosed?

A

Clinical diagnosis
If unclear dopaminergic agent trial can be used
If symptoms improve the diagnosis can be confirmed

e.g. Levodopa

33
Q

What is the primary option of mild parkinson’s?

A

Levodopa

34
Q

What dopamine receptor agonists are used to treat parkinson’s?

A

Ropinirole

Procyclidine

35
Q

What is important re Levodopa?

A

Reduced effectiveness with time

Cannot stop abruptly

Year 3 Neuro (17 decks)

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