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NSB Lectures > Motor Learning and Neurological Syndromes > Flashcards

Motor Learning and Neurological Syndromes Flashcards

1
Q

Which part of the brain is responsible for voluntary movement?

A

Primary motor cortex

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2
Q

What is the pathway for voluntary movement messages?

A

Primary motor cortex of brain via upper motor neuron - synapsing in the anterior horn cells of the spinal cord with a lower motor neuron.

Lower motor neuron then synapses with muscle and innervates it.

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3
Q

Which spinal tract do upper motor neurons run in?

A

Corticospinal tract

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4
Q

Which Brodman area is the primary motor cortex?

A

4

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5
Q

Which Brodman area is the supplementary motor area?

A

6

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6
Q

Which Brodman area is the posterior parietal cortex?

A

5 & 7

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7
Q

What is a tumour of the meninges called?

A

Meningioma

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8
Q

What are the following signs of?
- Weakness
- Spasticity
- Brisk reflexes
- Babinski sign
- Patient maintains posture

A

Upper motor neuron disorder

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9
Q

What is the difference between spasticity and rigidity?

A

Both are forms of hypertonia.

Spasticity is characterized by a sudden increase in muscle tone, occurring at a threshold velocity, angle, or amplitude; while rigidity is characterized by a high muscle tone that remains throughout the range of movement of the joint.

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10
Q

What is the Babinski sign?

A

Stimulating the lateral border of the foot results in big toe curling upwards, and if severe fanning outwards of the toes.

Normal reaction would be for the big toe to curl inwards.

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11
Q

What is the most common cause of upper motor neuron problems?

A

Stroke

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12
Q

What are the following signs of:
- Weakness
- Wasting of muscles
- Fasciculations
- Reduction in tone
- Reduced reflexes

A

Lower motor neuron disorder

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13
Q

In planning a movement - which areas of the brain determine the following:

(1) What you are going to do (strategy)

(2) How you are going to do it (tactics)

(3) Doing it (execution of movement)

A

(1). Neocortex & Basal ganglia

(2) Motor cortex & Cerebellum

(3). Brainstem & spinal cord

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14
Q

How are the higher cortical regions involved in movement?

A

They plan the movement - so take in proprioceptive information, formulate a couse of action using memories and relay to the motor action systems to implement.

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15
Q

Which lobe stores our auditory & visual perceptions and memories?

A

Temporal lobe

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16
Q

Which part of the brain plans the movements?

A

Pre-frontal cortex

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17
Q

How do messages move from the pre-frontal cortex to the spinal tract?

A

They pass from the prefrontal cortex to the following:
- Premotor cortex
- Supplementary motor area
- Primary motor cortex
- Sends messages down the corticospinal tract

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18
Q

Which part of the brain is responsible for telling us where our body is in space and surroundings?

A

The posterior parietal cortex

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19
Q

Where does the posterior parietal cortex receive information from in terms of proprioception?

A

From
- Spinothalamic tract
- Dorsal columns via thalamus
- Visual afferents

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20
Q

Where does information from the posterior parietal cortex go to?

A

The pre-motor area (then to supplementary motor are followed by primary motor cortex).

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21
Q

How can you tell if a Patient has a posterior parietal cortex problem?

A

There is neglect of mental images - P is able to perceive but not attend to the information. (E.g. RHS lesion can neglect LHS in shapes - see photo).

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22
Q

What two areas is the premotor area (6) divided into?

A

Lateral premotor cortex (PMC)

Medial supplementary motor area (SMA)

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23
Q

What does the premotor area do?

A

Takes in information from posterior parietal cortex AND pre-frontal cortex - and then feeds this information to the motor region to allow activation of the correct neurons for the correct muscles.

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24
Q

What two areas does the lateral premotor cortex receive information from?

A

The posterior parietal cortex AND cerebellum

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25
Q

What is the lateral premotor cortex responsible for?

A

Important for movements requiring visual guidance

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26
Q

Where does output from the lateral premotor cortex go?

A

Either down descending spinal tracts OR to the primary motor cortex

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27
Q

Where does the medial supplementary motor area receive information from?

A

Basal ganglia AND posterior parietal cortex

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28
Q

What is the medial supplementary motor area responsible for?

A

Coordinating complex voluntary & planning movements

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29
Q

Where does output from the medial supplementary motor area go to?

A

To the primary motor cortex or down descending spinal tracts

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30
Q

What is the name of the condition where you are unable to carry out skilled movements but no paralysis exists?

A

Apraxia

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31
Q

What causes apraxia?

A

Damage to the premotor area

32
Q

What are the two different types of apraxia?

A

Ideational apraxia (cannot put together higher sequences to perform action)

Ideomotor apraxia (cannot use tools)

33
Q

What can a lesion in the prefrontal cortex or supplementary motor area cause?

A

Utilisation behaviour

34
Q

What is utilisation behaviour?

A

The inability to consider whether you need to do the action or not. The patient can do the action, but cannot weigh up and evaluate whether it is necessary to do it.

35
Q

The motor regions of the cerebral cortex send information to which parts of the brain?

A

Brainstem (nuclei)
Spinal cord
Basal ganglia
Cerebellum

36
Q

What does the cerebellum do?

A

Takes information from the motor cortex and processes it to allow “smooth” movements

37
Q

Where can the cerebellum send information to?

A

Either the motor regions of the cerebral cortex (via the thalamus)

OR

To the Brainstem (deep nuclei) to send information down the spinal cord

38
Q

What are the basal ganglia?

A

Nuclear groups in the basal forebrain and midbrain

39
Q

Name 4 different nuclear groups that comprise the basal ganglia

A

Striatum

Globus Pallidus

Subthalamic nucleus

Pigmented compact part of substantial nigra

40
Q

What makes up the striatum?

A

Caudate nucleus
Putamen
Nucleus accumbens

41
Q

What are the two parts of the globus pallidus?

A

External GP and Internal GP

42
Q

What is the role of the basal ganglia?

A

To control movements - information comes from the motor cortex, where it is refined, send via the thalamus and back to the motor cortex. They control lots of pathways at once to allow complex movement.

43
Q

Are the basal ganglia always active?

A

Yes - there is always activity going on in the basal ganglia.

Messages can increase or reduce this amount of activity, but cannot turn it off completely.

44
Q

What are the two motor loops via the basal ganglia?

A

The direct pathway

The indirect pathway

45
Q

What does the direct pathway do?

A

Promotes activity (on switch)

46
Q

What does the indirect pathway do?

A

Promotes inhibition (reduces but doesn’t completely inhibit)

47
Q

The basal ganglia receive excitatory or inhibitory input from the cortex via which NT?

A

Excitatory input

Uses Glutamergic

48
Q

The basal ganglia receive modulatory input from where using which NT?

A

From substantia nigra - dopamine

49
Q

Pathways within the basal ganglia are excitatory or inhibitory and use which NT?

A

Inhibitory - use GABA

50
Q

Output from the basal ganglia and thalamus is always on - what is this called?

A

Being tonically active

51
Q

Where do messages for the direct pathway of the basal ganglia initiate?

A

From the sensorimotor cortex

52
Q

Outline the course of the direct pathway

A

Sensorimotor complex - stimulates striatum (Glutamate)

Striatum sends inhibitory messages to the globus pallidus (GABA)

Globus pallidus reduces the number of inhibitory messages to the thalamus (GABA) = less inhibition of thalamus

Thalamus therefore stimulated to increase activity to Supplementary Motor Cortex and Motor Cortex.

53
Q
A
54
Q

Which part of the brain activates the indirect pathway for the basal ganglia?

A

The Supplementary Motor Cortex

55
Q

Outline the course the indirect pathway

A

Supplementary Motor Cortex sends excitatory messages to the striatum (Glutamate)

Striatum is excited to release GABA (inhibitory) onto the globus palludis externa.

Globus pallidus externa reduces the inhibitory input to the sub thalamic nucleus

Increased stimulation of the sub thalamic nucleus increases release of glutamate from it. This stimulates the globus pallidus interna.

Globus pallidus internal increases amount of GABA released which acts on thalamus to inhibit it - therefore reducing the output it has to the supplementary motor area & cortex.

56
Q
A
57
Q

What is the main role of motor loops in the basal ganglia?

A

To reinforce the wanted motor action

AND

Inhibit unwanted actions of other muscles

58
Q

Does the basal ganglia have its own homunculus?

A

Yes - there is somatotopic representation in the putamen and globus pallidus

59
Q

What other loops in the basal ganglia are involved in movement apart from the motor loops?

A

Cognitive loops
Limbic loops
Oculomotor loops

All have input onto our muscle movement

60
Q

What is the pathology behind Parkinson’s disease?

A

Degeneration of the dopaminergic neurons in substantial nigra = lack of stimulation in the direct pathway.

Therefore there is a reduced amount of dopamine found in the brain of Ps with Parkinsons.

61
Q

What are these symptoms indicative of?

Bradykinesia
Tremor
Rigidity

A

Parkinson’s Disease

62
Q

Give an example of a hypokinetic disorder affecting the basal ganglia

A

Parkinson’s Disease

63
Q

What are the types of disorders are the following:
- Reduction in movement
- Increase in movement

A

Reduction = hypokinetic disorder

Increase = hyperkinetic disorder

64
Q

What are the types of disorders are the following:
- Reduction in movement
- Increase in movement

A

Reduction = hypokinetic disorder

Increase = hyperkinetic disorder

65
Q

Give an example of a hyperkinetic disorder affecting the basal ganglia.

A

Huntington’s disease

Task specific dystonias

66
Q

What is the genetic deficit in Huntington’s disease?

A

Autosomal dominant Chromosome 4 - CAG repeats in gene for Huntingtin.

67
Q

How does Huntington’s present and why?

A

Presents as -
- Involuntary movements
- Chorea (writhing movements)
- Dementia

Is caused by a loss of inhibition from the basal ganglia = causes toxic gain in function

68
Q

What is task specific dystonia caused by?

A

Repeated use of muscles = abnormal contraction - due to disrupted processing probably by the basal ganglia.

69
Q

What is the function of the cerebellum?

A

Coordinating smooth, accurate movements - but not initiating movement or interpretation of sensory information.

Receives info from the cortex and coordinates it to give smooth movement

70
Q

What are the three peduncles which connect the cerebellum to the brainstem?

A

Inferior
Middle
Superior

71
Q

Which are the mainly afferent peduncles of the cerebellum?

A

Inferior & middle

72
Q

Which are the mainly efferent peduncles of the cerebellum?

A

Superior

73
Q

What is the internal structure of the cerebellum?

A

Outer layer of cerebellar cortex
White matter core
Deep nuclei

74
Q

Name 3 deep nuclei of the cerebellum.

A

Fastigial nuclei
Dentate nuclei
Interposed nuclei

75
Q

What are the three layers of the cerebellar cortex?

A

Molecular layer
Purkinje layer
Granule cell layer

NSB Lectures (48 decks)

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