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Neuro > Motor system > Flashcards

Motor system Flashcards

1
Q

Primary motor area

A

Precentral gyrus
Pyramidal tracts
Simple fine movement e.g. hand

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2
Q

Premotor PMC (more ventral/caudal/to the side) and supplementary motor areas SMA (dorsal)

A

Programming of complex movement
Lies in the frontal lobe, immediately rostral to the primary motor area

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3
Q

Frontal eye field

A

Immediately rostral to the PMC
Saccadic eye movement to the opposite side
Right FEF - saccade to left

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4
Q

Anterior cingulate gyrus

A

Goal or emotion directed movement

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5
Q

Motor decussation of pyramidal tracts?

A

FORAMEN MAGNUM, MEDULLA OBLONGATA
Ventral - crosses later, TRUNK
Lateral corticospinal tracts LIMB

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6
Q

Pyramidal tract: corticospinal course

A
  1. Motor cortex
  2. Corona radiata
  3. Post. limb of internal capsule
  4. Cerebral peduncle
  5. Longitudinal pontine bundle
  6. Pyramid (medulla)
  7. lateral column in spinal cord
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7
Q

Pyramidal corticobulbar tract course

A
  1. Motor cortex
  2. Corona radiata
  3. GENU of internal capsule
  4. Cerebral peduncle
  5. Longitudinal pontine bundle
  6. Pyramid (medulla)
  7. lateral column in spinal cord
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8
Q

Extrapyramidal system

A

Basal ganglia
- Caudate
- Lenticular
- Subthalamic nucleus
- Substantia nigra

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9
Q

Which region of the substantia nigra atrophies in PD?

A

Pars compacta

(not pars reticularis)

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10
Q

Non-pyramidal motor pathways

A

NON-VOLUNTARY = parallel control of LMN
1. Red nucleus
2. Reticular formation
3. Vestibular nuclei

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11
Q

Rubrospinal tract

A

From red nucleus.
FLEXOR MUSCLES OF UPPER EXTREMITY

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12
Q

Medial reticulospinal tract

A

From pontine RF. IPSILATERAL CONTROL
EXTENSOR MUSCLES OF UPPER & LOWER EXTREMITIES.

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13
Q

Lateral reticulospinal tract

A

From medullary RF. CONTRALATERAL
Inhibits gamma motor neurons and
LOSS OF MUSCLE TONE

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14
Q

Vestibulospinal tracts

A
  1. Lateral tract = EXTENSOR MUSCLES OF UPPER & LOWER
  2. Medial tract = CONTRACTION OF NECK MUSCLES in response to postural changes
    Remark: balance is always ipsilateral
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15
Q

What is the main neuron in the cerebellum?

A

Purkinje = only output tract

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16
Q

Deep cerebellar nuclei from medial to lateral

A
  1. Fastigial nucleus
    2&3. Globose n., Emboliform n.
  2. Dentate nucleus
17
Q

Fxn of Flocculonodular lobe (vestibulocerebellum)

A

Vestibulo-ocular (VOR through MLF) and vestibulospinal reflexes (head & neck, muscle tone)

18
Q

Fxn of vermis (spinocerebellum)

A

Control muscle tone & postural control (upgrade from flocculonodular)
AFFERENT
1. Spinocerebellar
2. Cuneocerebellar
3. Vestibular nuclei

EFFERENT
1. Vestibulospinal tract
2. Fastigial nuclei sends signals to RF and then down the reticulospinal tract

19
Q

Cerebellar hemisphere / cerebro or pontocerebellum

A

Cortical motor areas sends signals to the cerebellar hemisphere through the pontine nucleus. These PONTOCEREBELLAR fibers decussate before reaching the cerebellum.

The DENTATE nucleus sends decussating fibers to the cortical motor area again through the thalamus.

The cerebellar hemispheres also work with the inferior olivary nucleus (RUBROSPINAL, RED NUCLEUS)

Remark: the multiple decussations are from attempts to keep the cerebellum controlling ipsilateral and cortex controlling contralateral.

20
Q

Inferior cerebellar peduncle

A

Mostly inputs
1. Spinocerebellar tract: mossy fibers
2. Inferior olive

21
Q

Middle cerebellar peduncle

A

Pontocerebellar fibers

22
Q

Superior cerebellar fibers

A
  1. Dentate To Thalamus
  2. INTERPOSED N. to red nucleus
  3. FASTIGIAL n. to vestibular n.
23
Q

Lesions above motor motor decussation (medulla, foramen magnum)

A

Contralateral hemiplegia

24
Q

Lesions below motor motor decussation (medulla, foramen magnum)

A

Ipsilateral hemiplegia

25
Q

LMN lesion, anterior horn cell disease

A

Flaccid (gamma) paralysis (alpha motor neuron)
Hyporeflexia
Severe muscular atrophy
Muscle fasciculation
Clonus negative
Babinski’s sign: flexor

26
Q

UMN lesion (specifically, Pyramidal tract lesion)

A

Weakness/paralysis
Atrophy of disuse
Clonus: positive or sustained
Babinski’s: extensor

27
Q

Decorticate rigidity vs decerebrate rigidity

A

Decorticate rigidity is due to a lesion above the brainstem whereas decerebrate rigidity is caused by a lesion between the midbrain and the pons.

Specifically, upon decerebrate rigidity, caused when a lesion in the midbrain, pons, or diencephalon. Decorticate rigidity occurs when lesions occur in the cortical white matter, internal capsule, thalamus, cerebral peduncle, and basal ganglia.

28
Q

Lewy body

A

Intraneuronal inclusion body composed of alpha-synuclein in Parkinson’s disease

29
Q

Extrapyramidal lesions

A
  • No paralysis or weakness
  • Abnormal muscle tone: RIGIDITY (dystonia)
  • Decreased movement
  • Increased involuntary movement
30
Q

Cogwheel rigidity

A

Parkinson

31
Q

Festinating gait, decreased arm swing, stooped posture, difficulty initiating gait

A

Parkinson

32
Q

Hemiballismus: ischemia of

A

Contralateral subthalamic n.

33
Q

Huntington’s disease

A

In Huntington disease, the caudate nucleus atrophies, the inhibitory medium spiny neurons in the corpus striatum degenerate, and levels of the neurotransmitters gamma-aminobutyric acid (GABA) and substance P decrease.

Huntington disease results from a mutation in the huntingtin (HTT) gene (on chromosome 4), causing abnormal repetition of the DNA sequence CAG, which codes for the amino acid glutamine. The resulting gene product, a large protein called huntingtin, has an expanded stretch of polyglutamine residues, which accumulate within neurons and lead to disease via unknown mechanisms. The more CAG repeats, the earlier the onset of disease and the more severe its expression (phenotype). The number of CAG repeats can increase with successive generations when the father transmits the mutation and, over time, can lead to increasingly severe phenotypes within a family (called anticipation).

34
Q

chorea

A

Involuntary jerking or writhing movements

35
Q

Deep brain stimulation of GPi or subthalamic n. may help with

A

Hyperkinetic disorders or Parkinson’s disease

36
Q

Vermis lesion in cerebellum

A

Trunkal ataxia
Wide-based gait
Nystagmus

37
Q

Cerebellar hemisphere lesion

A

Dysdiadochokinesia
Dysmetria
Intention tremor
Rebound phenomenon
Dysarthria

38
Q

Lateral reticulospinal tract lesion or injury

A

SPASTICITY
HYPERREFLEXIA

Neuro (18 decks)

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