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OTDV 528 > Motor System Lesions > Flashcards

Motor System Lesions Flashcards

1
Q

major sources of motor disruption

A
  • peripheral motor connections
  • cortical connections
  • basal ganglia
  • cerebellum
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2
Q

Motor disorders involving the peripheral nervous system can involve disruptions of

A
  • The neuromuscular junction
  • peripheral nerves
  • spinal nerve roots
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3
Q

produce motor disruption by altering the connections between motor axons and muscle (neurotransmission)

A

Neuromuscular Junction Disease (NMJ)

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4
Q

Neuromuscular Junction Disease (NMJ) involves

A
  • motor axon
  • the neurotransmitter (acetylcholine)
  • neurotransmitter receptors on the muscle or the metabolism of the neurotransmitter
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5
Q

autoantibodies are formed to acetylcholine receptors where the antibodies can block neuromuscular transmission

A

Myasthenia Gravis

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6
Q

Can have weakness mainly in skeletal muscles innervated by cranial nerves with ocular weakness and bilateral ptosis

A

Myasthenia Gravis

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7
Q

treatment for Myasthenia Gravis

A

cholinesterase inhibitors, which prevent the breakdown of acetylcholine after it is released by the nerve

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8
Q

one of a group of toxins from a bacterium (clostridium botulinum, one type of food poisoning) that irreversibly blocks the release of acetylcholine by binding to the presynaptic membrane in neuromuscular junctions and at preganglionic autonomic terminals

A

Botulinum Toxin

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9
Q

Nerve terminals fully disrupted by botulinum toxin must regrow or “sprout” locally for function to be restored

A

Botulinum Toxin

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10
Q

with Botulinum Toxin what type of muscles are affected?

A

Both smooth and skeletal muscle

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11
Q

with Botulinum Toxin you typically have weakness in

A

cranial nerve muscles and then in the limbs

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12
Q

dry mouth, abdominal cramping, vomiting and diarrhea because of an absence of peristalsis are symptoms of what

A

autonomic symptoms of Botulinum Toxin

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13
Q

Peripheral Nerve [Lesions- axons] can include damage to

A
  • Dorsal roots
  • Ventral roots
  • And /or a spinal nerve
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14
Q

deficits usually associated with a particular spinal segment or restricted to particular muscles/groups that can be attributed to the functions of a single nerve

A

Mononeuropathy

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15
Q

in Mononeuropathy sensory loss is often used to identify what?

A

the nerve or root involved

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16
Q

Flaccid paralysis followed relatively rapidly (weeks to months) by atrophy of the muscle is what?

A

Peripheral Motor System Lesions

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17
Q

Hypotonia is what?

A

decreased muscle tone

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18
Q

Hyporeflexia, areflexia is what?

A

weakening or absence of tendon reflexes

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19
Q

Fibrillations or fasciculations of motor units as a result of denervation due to what?

A

Peripheral Motor System Lesions

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20
Q

Disseminated

A

result from metabolic diseases

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21
Q

Onset of what may be very slow and almost unnoticed (e.g. diabetes) or very rapid in some autoimmune neuropathies

A

Disseminated

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22
Q

typical pattern is the “stocking” or “glove” like deficits in limbs that usually involve both motor and sensory problems in what

A

Disseminated

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23
Q

isolated sensory or motor deficits is the compression of nerve roots as they leave the spinal cord

A

Nerve Compression at Spinal Roots - Radiculopathies

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24
Q
  • Compressions of sensory roots are usually painful, or produce paresthesias
  • Motor roots can also be selectively disrupted resulting in weakness of muscles innervated by the spinal root
A

Nerve Compression at Spinal Roots - Radiculopathies

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25
Q

symptoms of what type of lesion can be more complex and dependent upon the structure(s) damaged

A

Central Nervous System Motor Lesions

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26
Q
  • paralysis or paresis with muscles that are initially weak and flaccid followed by (Spasticity, Hypertonia, Hyperreflexia, altered cutaneous reflexes including the Babinski sign (or Hoffmann sign) , and Clonus and a clasp knife response may also be present)
  • Basal ganglia disturbances
  • Cerebellar disturbances
A

Central Nervous System Motor Lesions

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27
Q

what lesion can produce upper motor neuron signs to varying degrees

A

Primary Motor Cortex Lesions

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28
Q

what lesion causes effects on movement

A

Primary Motor Cortex Lesions

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29
Q

lesions restricted to what produce disruptions of fine motor control such as finger movements

A

Primary Motor Cortex Lesions

30
Q

typical upper motor neuron signs from more severe injuries result in

A

part from the loss of cortical influences (often inhibitory) on tracks originating in the brainstem

31
Q

posturing or decorticate rigidity in humans results from brainstem sections above the superior colliculus that leaves the red nucleus and the influence of the rubrospinal tracts in place

A

Decortication

32
Q

the upper limb is flexed, while the lower limbs remain extended

A

Decortication

33
Q

produce a higher flexor tone in the upper limb (flexor activation is generally stronger than extensor)

A

Decortication

34
Q

​​what results in unopposed extensor muscle activity in all four limbs or decerebrate rigidity

A

Brainstem Spinal Influences Lesions

35
Q

when there is a Brainstem Spinal Influences Lesions what does it interrupt?

A

the lower midbrain interrupts the corticospinal and rubrospinal tracts

36
Q

what produces motor processing problems

A

motor cortical areas outside of primary motor cortex

37
Q

what is expressed as the inability to use the affected body part to perform voluntary or learned movements in spite of the lack of spasticity, paralysis or altered tone in the muscles

A

Apraxias

38
Q

Lesions of premotor cortex usually result in

A

apraxias

39
Q

Lesions of premotor cortex can affect

A

the ability to coordinate action on the two sides of the body, particularly in relation to learned movements

40
Q

integration and processing of important feedback information from muscle spindles and other sensory receptors that can be used to guide motor activities

A

feedback control in the cerebellum

41
Q

information to motor areas of cortex, not only to monitor and correct motions in progress but what

A

provide appropriate cues for subsequent actions

42
Q

precise coordination of movement rather than the initiation or control of movement is what

A

Cerebellar Dysfunction- Motor Disruption

43
Q

when there is a motor disruption what aspect of movements can be affected?

A

posture, gait, speech, and eye movements

44
Q

when posture, gait, speech, and eye movements are affected what region is the damage in?

A

cerebellar region

45
Q

tests show a lack of coordination of motor tasks, but not a problem with initiating and actually performing the movement

A

Resembles a sobriety test

46
Q

poor walking, unsteady

A

Ataxia (cerebellar)

47
Q

past point sign-unable to gage distance in motor tasks

A

Dysmetria

48
Q

unable to perform rapid alternating movements

A

dysdiadochokinesia

49
Q

oscillations during directed movement

A

Intention tremor

50
Q

a slow / thick speech

A

scanning speech

51
Q

Lesions of the cerebellum will disrupt the feedback to the what

A

motor cortex on the opposite side of the midline

52
Q

when there is a lesion in the cerebellum the symptoms are?

A

on the same side of the midline (ipsilateral) to the lesion site

53
Q

what lesion result in a variety of movement disorders that include involuntary movements (dyskinesias) to rigidly contracted muscles (dystonias)

A

Basal Ganglia Lesions

54
Q

what diseas is a major hallmarks of the basal ganglia disease are involuntary movements and alteration of muscle tone

A

Parkinson disease

55
Q

arise from lesions to a balanced system of excitatory and inhibitory influences on movement

A

extrapyramidal symptoms

56
Q

what disorder is characterized by a paucity of movement and rigidity- increased muscle tone throughout the range of motion that does not vary with passive acceleration

A

Hyperkinetic disorders

57
Q

what is the most common hypokinetic disorder?

A

Parkinson’s Disease

58
Q

Parkinson disease will begins what?

A

unilaterally and slowly progress to the opposite side

59
Q

Parkinson can effect what?

A

postural instability may result in total disability

60
Q

hereditary disorder with an trinucleotide expansion on chromosome 4

A

Huntington Chorea

61
Q

onset of Huntington Chorea is?

A

around age 40

62
Q

movements on one side of the body and hypotonus associated with a unilateral (contralateral ) destruction of the subthalamic nucleus is what?

A

Hemiballismus

63
Q

what creates and imbalance in basal ganglia circuitry that results in loss of inhibition

A

Hemiballismus

64
Q

slow loss (possibly decades) of neurons in the substantia nigra pars compacta (pigmented, dopaminergic)

A

Parkinsonism (paralysis agitans)

65
Q

what is a Hypokinetic Movement disorder?

A
  • lack of movement
  • reduced amplitude of movements
  • slow movement
  • rigidity
66
Q

sustained muscle contractions that may be focal or broadly distributed

A

Dystonia

67
Q

if dystonia is drug induced dystonias it is usually from?

A

dopaminergic agents

68
Q

what percent is responsive to L-Dopa

A

5-10%

69
Q

slow writhing movements-generally associated with broad pathological changes in cortex and neostriatum

A

Athetoid Movements

70
Q

an immaturity of the organization of movement

A

Developmental Coordination Disorder (Developmental Dyspraxia)

71
Q

Developmental Coordination Disorder (Developmental Dyspraxia) affects ___ of people an ___ severely

A

10%; 2%

72
Q
  • not exclusively motor
  • poor short term memory
  • cognitive problems
  • difficulty with language skills
A

Developmental Coordination Disorder (Developmental Dyspraxia)

OTDV 528 (11 decks)

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