Motor Pathways; Corticol Motor System, Basal Ganglia & Cerebellum Flashcards

1
Q

Describe the Functional segregation of motor control

A

Motor systems are organised in a number of different areas that control different aspects of MOVEMENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the Hierarchical organisation of motor control

A

HIGHER ORDER AREAS involved in more complex tasks (i.e. programme movements, coordinate muscle activity)

than LOWER LEVEL AREAS (execution of movement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the hierarchical levels of motor control?

A

Level 4 (highest) - association cortex

Level 3 - motor cortex (precentral gyrus)

Level 2 - brain stem & cerebellum (refines motor cortex inputs)

Level 1 (lowest) - basal ganglia & spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 main areas of the motor cortex?

A
  1. Primary Motor Cortex (M1)
  2. Premotor Cortex
  3. Supplementary Motor Area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Primary Motor Cortex location?

A

Precentral gyrus

i.e. ANTERIOR to the CENTRAL SULCUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Primary Motor Cortex function?

A

o Control FINE, discrete, precises VOLUNTARY MOVEMENT

o provide DESCENDING signals to execute movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which cells are found in the primary motor cortex?

A

Betz cells!

Pyramidal cells located in LAYER V of the grey matter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the somatotopic organisation of the Primary Motor Cortex

A

Penfields Motor Homunculus (ONENOTE!!)

Different areas of the cortex control different areas of the body
E.G. face & hands have large area as they have more fine control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which tracts provides innervation to the arms, legs & axial structures (trunk & abdomen)?

A

Corticospinal tract

from Primary Motor Cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Passage of Lateral Corticospinal tract and what does it innervate?

A
  1. R-hemisphere of cortex
  2. Internal capsule
  3. Midbrain - cerebral peduncle
  4. Medulla - decussation at the pyramids!
  5. Ventral horn of SC - synpase w. LMN
  6. Innervate distal muscles

Distal muscles of limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Passage of Anterior Corticospinal tract and what does it innervate?

A
  1. R-hemisphere of cortex
  2. Internal capsule
  3. Midbrain - cerebral peduncle
  4. Medulla
  5. Ventral horn of SC - synpase w. LMN & decussation at spinal level
  6. Innervate proximal limbs & trunk muscles

Proximal limbs & trunk muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which tracts provides innervation to the facial muscles?

A

Corticobulbar Tract

from Primary Motor Cortex - head region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Passage of Corticobulbar Tract and what does it innervate?

A
  1. Head region on Primary Motor Cortex
  2. Internal capsule
  3. Medulla - synpases at a CRANIAL NERVE NUCLEI (within brainstem)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

NT associated with UMNs & LMNs?

A

Upper to LMN = GLUTAMATE

LMN to muscles fibres = ACH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Location of Premotor Cortex?

A

Frontal Lobe - ANTERIOR to M1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Function of the Premotor Cortex?

A

PLANNING of movements

o regulates externally cued movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Location of the Supplementary Motor Area?

A

Frontal Love - ANTERIOR to M1 MEDIALLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Function of the Supplementary Motor Area?

A

o Planning COMPLEX movements
o Programming SEQUENCING of movements

regulates internally driven movements e.g. speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When does the Supplementary Motor Area become active?

A

When THINK about a movement BEFORE actually executing it

i.e. all about PRE-movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define the Association Cortex

A

Brain areas NOT strictly motor areas
AS
their activity does NOT correlate with motor output/act

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

2 cortical areas that make up the association cortex?

A

o Posterior Parietal Cortex

o Prefrontal Cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Posterior Parietal Cortex?

A

Part of Association Cortex

o ensures MOVEMENTS are TARGETED accurately to objects in EXTERNAL SPACE

i.e. motor learning & planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Prefrontal Cortex?

A

Part of Association Cortex

o involved in SELECTION of APPROPRIATE MOVEMENTS for a particular course of action

i.e. personality input into a movement (e.g. if touch hot plate, avoid it again)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define LMN & UMN

A

LMN:
o SC - ventral horn
o Brainstem - bulbar

UMN:
o Corticospinal
o Corticobulbar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Define Pryamidal & Extrapyramidal
Pyramidal: o LATERAL corticospinal tract Extrapyramidal: o Basal Ganglia o Cerebellum
26
Difference between pyramidal and extrapyramidal?
The pyramidal tracts (corticospinal tract and corticobulbar tracts) may directly innervate motor neurons of the spinal cord or brainstem (anterior (ventral) horn cells or certain cranial nerve nuclei), WHEREAS the extrapyramidal system centers on the modulation and regulation (indirect control) of anterior (ventral) horn cells.
27
What are the NEGATIVE signs associated with UMN Lesions?
LOSS OF FUNCTION o Paresis - graded weakness of movements o Paralysis (plegia) - complete loss of muscle activity
28
What are the POSITIVE signs associated with UMN Lesions?
INCREASED ABNORMAL MOTOR FUNCTION - due to LOSS of INHIBITORY DESCENDING INPUTS o Spasticity - increased muscle tone o Hyper-reflexia -- exaggerated reflexes o Clonus - abnormal oscillatory muscle contraction o Babinski's Sign - extensor plansar response
29
Define Apraxia?
Disorder of SKILLED movement - patient is NOT paretic but HAS lost info. about how to preform skilled movements
30
Why does Apraxia arise?
Due to UMN lesions of either the: o Inferior parietal lobe o Frontal lobe (PMC & SMA) Stroke & dementia are the most common causes
31
Signs of LMN lesions?
OPPOSITE of UMN lesions o Weakness o Hypotonia (REDUCED muscle tone) o Hyporeflexia (REDUCED reflexes) o Muscle atrophy (as muscles loose innervation) o Fasciculations - produce spontaneous APs = visible twitch o Fibrillations - spontaneous twitching of INDIVIDUAL muscle fibres
32
What is MND?
Motor Neurone Disease Affects BOTH UM & LM neurones (normally die due to respiratory musculature NO longer working)
33
Examples of MND?
Progressive neurodegenerative disorder E.g. ALS (amyotrohpic lateral sclerosis)
34
MND signs - for UMN?
``` o Increased muscle tone o Brisk limbs & jaw reflex o Babinski's Sign o Loss of dexterity o Dysarthria - difficult/inacrticulate speech o Dysphagia ```
35
MND signs - for LMN?
``` o Weakness o Muscle wasting o Tounge fasciculations & wasting o Nasal speech o Dysphagia ```
36
What is required for the 3 main motor cortical areas to work (PMC, PM & SMA, AC)?
Side-loop structures (SLS) This includes: o Basal ganglia o Cerebellum
37
Structure of the Basal ganglia? | ONENOTE for more images!!!
Extrapyramidal o Striatum: - Caudate nucleus - Lentiform nucleus (putamen + external globus pallidus) [separated from nucleus via. internal capsule] o Subthalamic nucleus (beneath thalamus) o Substantia nigra (in midbrain BUT project to B.G) ``` o Globus pallidus internia o Ventral pallidum o Claustrum o Nucleus Accumbens o Nucleus basalis of Meynert ```
38
Functions of the Basal ganglia?
o Elaborates associated movements (e.g. swinging arms when walking) o Moderates & coordinates movement (whilst suppressing unwanted movements) o Performs movements in order
39
Basic Basal Ganglia circuitry?
1. PC thinks of a movement 2. SPA imagines/generates sequence for movement 3. PMC generates impulse 4. Send it to basal ganglia 5. Which sends it to the thalamus and to the PMC 6. Which then sends it to the muscles
40
2 main circuit pathways into the basal ganglia?
1. DIRECT pathway o NO projection to STN o Overall EXCITATORY effect on motor cortex 2. INDIRECT pathway o PROJECT to STN o Overall INHIBITORY effect on motor cortex Normal functioning relies on balance between these 2 pathways
41
Which side does the basal ganglia mediate its function for?
Ipsilateral cortex!
42
2 different classes of syndromes caused by damage to the basal ganglia?
1. HYPOkinetic disorders o DECREASED movements o e.g. Parkinson's 2. HYPERkinetic disorders o INCREASED movements o e.g. Huntington's
43
Pathophysiology of Parkinson's?
Neurodegeneration of the DOPAMINERGIC neurones that originate in the: o STN and project to the striatum
44
What does the pathophysiology of Parkinson's cause?
LOSS of DA neurones = loss of NIGRA-STRIATAL PATHWAY (Onenote!!!!) and so DISRUPTS the fine balance of EXCITATION & INHIBITION = reduction of excitation in the motor cortex
45
Main Motor Signs of Parkinson's?
o Bradykinesia - slow movements o Hypomimic face - expressionless o Akinesia - difficult in initiation of movements o Rigidity - muscle tone increases o Tremor at rest - starts in one hand o Gait & posture 0 walk slow, small shuffling steps, reduces arm swing, head bent forward & down
46
Pathophysiology of Huntington's?
Autosomal dominant - Chr4 Denegeration of GABA neurones in straitum (caudate nucleus, followed by putamen)
47
What does the pathophysiology of Huntington's cause?
Disrupts fine balance SO motor cortex gets EXCESSIVE EXCITATORY INPUT so sends continous, INVOLUNTARY commands to the muscles
48
Main Motor Signs of Huntington's?
o Choreic movements (chorea) - rapid, jerky involuntary movements of the body; hand & face affected first, then legs and rest of body o Speech impairment o Difficulty swallowing o Unsteady gait o Cognitive decline & dementia
49
Location of Substantia Nigra?
In the MIDBRAIN BUT projects to basal ganglia (DA neurones) so considered part of its circuitry
50
What does the cerebellum sit in?
Posterior Cranial Fossa
51
Cerebellum structure when cut horizontally?
Divided into 3 lobes! 1. Anterior 2. Posterior 3 Flocculonodular (LUDLEY!!!)
52
Cerebellum structure when cut sagittaly?
Divides into 3 zones! 1. Vermis (middle) 2. Intermediate hemisphere (either side of 1.) 3. Lateral hemisphere (either side of 2.)
53
Connections with the cerebellum and NTs?
Connections w. the cerebellum at with the: o SAME side of the body o OPPOSITE cerebral hemispheres Glutamate (+) GABA (-)
54
3 divisions of the cerebellum?
Vestibulocerebellum Spinocerebellum Cerebrocerebellum
55
Vestibulocerebellum?
Regulates: o gait o posture o equilibrium o coordinates head movements with eye movements
56
Spinocerebellum?
Coordination of: o speech o limb movements o adjusts muscle tone
57
Which parts do the afferents of the spinocerebellum project?
Spinal afferents from: o axial body, trigeminal, auditory & visual inputs = project VERMIS o limbs = project to INTERMEDIATE hemisphere
58
Cerebrocerebellum?
o coordination of skilled movements o cognitive function, attention, processing of language o emotional control
59
Functions of the Cerebellum?
o Maintenance of balance & posture o Coordination of voluntary movements (coordinates muscle groups to produce smooth body movements) o Motor learning (adapting & fine-tuning motor programmes) o Cognitive functions i.e. language
60
Vestibulocerebellar Sydndrome?
Damage (tumour) causes syndrome leading to: o gait ataxia o tendency to fall
61
Spinocerebellar Syndrome?
Damage (from degeneration & atrophy due to alcoholism) affects LEGS, causing: o abnormal gait o wide-based stance
62
Cerebrocerebellar Syndrome?
Damage affects mainly: o arms/skilled coordinated movements (tremor) o speech
63
Another word for Cerebrocerebellar Syndrome?
Lateral Cerebellar Syndrome
64
Main signs of cerebellar dysfunction?
Deficits apparent ONLY UPON MOVEMENT o Ataxia o Dysmetria - inappropriate force & distance for target-directed movements o Intention tremor - only upon movement o Dysdiadochokinesia - inability to perform rapidly alternating movements o Scanning speech - staccator due to impaired coodination of speech muscles
65
What are the BG and Cerebellum responsible for?
Monitoring & coodrination of movements BY modifying the output from the motor cortex