Motor learning and neurological symptoms Flashcards

1
Q

Describe the simple motor pathway

A

Motor cortex in the brain
Upper motor neuron
Lower motor neuron
Muscle

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2
Q

Describe the motor control of hierarchy and state the structures involved

A

High - function: strategy - Association areas of the neocortex and basal ganglia
Middle - Function: tactics - Motor cortex and cerebellum
Low - Function: Execution - brainstem, spinal cord

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3
Q

What is the purpose of the decending motor pathways

A

These use sensory information about balance, body position and the visual environment to reflexively maintain balance and posture.

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4
Q

Describe the pyramidal/corticospinal tract

A

Pyramidal tract derives its name from decussation in
medullary pyramids

Only cortical tract to directly synapse with motor neurons

Predominantly derived from cells in layer V
(not exclusively Betz cells)
Brodmans Area 4 (and 6)

90% fibres crossed in lateral CST but individual variation
may account for different deficits in strokes

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5
Q

What is the rubrospinal tract used for?

A

Unclear to what extend this pathway is involved in humans.

Predominantly innervates the flexor muscles in the upper limbs.

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6
Q

Describe the vestibulospinal tract

A

Originate in the vestibular nuclei of the medulla which relay sensory information from the vestibular labyrinth in the inner ear.

Medial vestibulospinal pathways projects down to the spinal cord and activates the cervical spinal circuits that control neck and back muscle guides and thus guide head movements.
Therefore it helps to keeps the eyes stable as the body is moved.

Lateral vestibulospinal projects ipsilaterally as far down as the lumbar spinal cord. Helps us maintain an upright and balanced posture by facilitating the extensor motor neurons of the legs.

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7
Q

Describe the tectospinal tract

A

Originates in the superior colliculus in the midbrain which receives direct input from the retina.
The superior colliculus receives information from the retina and the visual cortex. This is used to construct a map of the world around us.
Allows us to direct the head and eyes to move so that the appropriate point of space is imaged on the fovea.

The projections decussate immediately and lie close to the midline into the cervical regions of the spinal cord where they help to control the muscles of the neck, upper trunk and shoulders.

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8
Q

What is the reticulospinal tract?

A

The pathway runs from the brainstem. The reticular formation is just under the cerebral aqueduct and fourth ventricle. It is a complex meshwork of neurons.
It descends in two separate pathways, pontine (medial) and medullary (lateral) .
Both facilitate the extension of the limbs.

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9
Q

Which tracts control head and neck movements?

A

Tectospinal and medial vestibulospinal

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10
Q

Which tracts activate extensor muscles in arms and legs?

A

Lateral vestibulospinal and reticulospinal

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11
Q

Which tracts Activates flexor muscles in arms.

A

Rubrospinal

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12
Q

If the lesion is above the red nucleus which posture is present?

A

Decorticate posturing - flexion of arm muscles

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13
Q

If the lesion is below the red nucleus which posture is present?

A

Decerebrate posturing - extension of all 4 limbs

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14
Q

Describe the typical posture of a patient with damage to the motor cortex and corticospinal tract

A

some preserved upper limb flexion and lower limb extension
Increased tone (spasticity), Brisk Reflexes,
Extensor Plantar/Babinski reflex, Clonus

But patient maintains posture

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15
Q

Describe loss of descending inhibition

A

Altered excitability of spinal inhibitory interneurons
Brisk reflexes
increased tone to rapid passive muscle stretching= spasticity

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16
Q

Describe the motor homunculus

A

The amount of brain matter devoted to any particular body part represents the amount of control that the primary motor cortex has over that body part. This disproportionate map of the body in the motor cortex is called the motor homunculus. This map may not be fixed and may be malleable.

17
Q

How are parts of the body represented in the primary motor cortex arranged?

A

arranged somatotopically – the foot is next to the leg which is next to the trunk which is next to the arm and the hand

18
Q

Describe the effect of a proximal middle cerebral artery occlusion

A

Proximal lesion affects internal capsule

Complete hemiparesis

19
Q

Describe the effect of a distal middle cerebral artery occlusion

A

Distal lesion may spare leg area of motor cortex

though secondary swelling and ischaemia may compromise function

20
Q

What is Abulia?

A

Loss or impairment of the ability

to make decisions or act independently

21
Q

What does the anterior cerebral artery supply?

A

Supplies medial part of frontal lobes

including leg area of motor cortex

22
Q

What is area 5 in the posterior parietal cortex used for?

A

somatosensory afferents

23
Q

What is area 7 in the posterior parietal cortex used for?

A

visual pathway afferents

24
Q

What is the function of the posterior parietal cortex?

A

Mental body/ environment image
Damage results in neglect
(can perceive but do not attend)

Exploratory movements
Eg turning object in hand
(looking and feeling)

25
Q

What is the function of the premotor area (PMA)?

A

Importance in control of

Visually guided movements

26
Q

What is activated in finger flexion?

A

M1 only

27
Q

Which areas are activated in a sequence of complex finger movements?

A

M1 and SMA

28
Q

Which areas are activated in rehearsal of finger movements?

A

Only SMA

29
Q

What is apraxia?

A

Damage to wide interconnections between sensory and motor association areas

Inability to carryout purposeful movements in the absence of paralysis or paresis.

Great difficulty in the sequencing and execution of movements.

30
Q

Name the types of apraxia

A

Ideational (parietal)

Ideomotor (SMA)

31
Q

What is ideational apraxia?

A

unable to report the sequence

32
Q

What is ideomotor apraxia?

A

unable to use the tool

33
Q

Describe task specific dystonias?

A

Repeated and extended use of the hand results
in changes in the functional organisation of brain
areas related to sensory processing and motor control.

Can be altered by ‘sensory tricks’

Although the manifestation is motor, the primary
abnormality is likely to be disrupted sensory processing
probably mediated by the basal ganglia

34
Q

What is a dystonia?

A

sustained muscle contractions, usually producing

twisting and repetitive movements or abnormal postures or positions

35
Q

What is the function of the basal ganglia?

A

Positive feedback loop with the cortex to select wanted movements and deselect unwanted movements.

36
Q

What is the function of the cerebellum?

A

Coordination of muscles in order to make smooth movements.
Balance
Motor learning