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Clinical Neuroscience > Motor System & Motor Disorders > Flashcards

Motor System & Motor Disorders Flashcards

1
Q

Name the 3 main descending motor pathways.

A

1) lateral corticospinal tract
2) corticobulbar tract
3) ventral corticospinal tract

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2
Q

What is the difference between a pyramidal tract and an extrapyramidal tract?

A

Pyramidal - UMN cell body in cortex.

Extrapyramidal - UMN cell body in brainstem.

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3
Q

What is the internal capsule?

A

A white matter bi-directional pathway between the lentiform nucleus and thalamus.

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4
Q

Describe the monosynaptic reflex arc.

A

When patellar tendon is hit, muscle spindle senses stretch and sends impulse to spinal cord. Spinal cord excites LMN supplying quadriceps and sends inhibitory interneurone to LMN supplying hamstrings. Quadriceps contract and antagonistic hamstrings relax.

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5
Q

What is the Babinski reflex? How would babies and adults react differently?

A

Stroke up along plantar surface of foot.
Babies - extensor plantar reflex (extend toes) due to immature inhibition of LMN.
Adults - flexor plantar reflex (flex toes).

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6
Q

Name 4 UMN lesion signs.

A
  • weakness
  • hypertonia
  • hyper-reflexia
  • extensor-plantar reflexes
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7
Q

What is spasticity?

A

Contraction of muscles that causes stiffness and rigidity.

Upper limb is flexed as flexors are stronger, lower limb is extended as extensors are stronger.

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8
Q

What is spinal shock?

A

Immediately after an UMN lesion, LMN have reduced activity so there is initially hypotonia and hyporeflexia. After a few days this converts to the classic UMN lesion.

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9
Q

Name 5 LMN lesion signs.

A
  • weakness
  • muscle wasting
  • hypotonia
  • areflexia
  • fasciculations/fibrillations
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10
Q

What causes fasciculations in LMN lesions?

A

Upregulation of nAChrs.

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11
Q

In a lesion of the left facial nerve at the brainstem, what findings would be present?

A

Weakness on one 1/2 of face on ipsilateral side to lesion.

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12
Q

In a lesion of the left cerebral hemisphere, what findings would you have in terms of facial weakness, and why?

A

Weakness of lower 1/2 of face on contralateral side of face - only lower 1/2 because upper 1/2 receives UMNs from both sides of the face.

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13
Q

What is clasp knife rigidity?

A

When you push a spastic and rigid limb and it suddenly gives way.
Commonly seen in UMN lesions.

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14
Q

What is the basal ganglia?

A

Collection of nuclei sitting deep in the grey matter of the cerebral hemispheres.

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15
Q

What makes up the neostriatum?

A

Caudate nucleus and putamen.

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16
Q

What makes up the lentiform nucleus?

A

Globus pallidus and putamen.

17
Q

What is the function of the basal ganglia?

A

Enables us to select the most appropriate way to carry out a task i.e. Refines cortical activity.

18
Q

Name the 2 pathways that enable communication between the basal ganglia and motor cortex.

A

Direct and indirect pathways.

19
Q

What is the nucleus accumbens?

A

The most rostral aspect of the neostriatum where the putamen and caudate nucleus join.

20
Q

What is the difference between the direct and indirect pathways?

A

Direct pathway stimulates the motor cortex.

Indirect pathway inhibits the motor cortex.

21
Q

What is the action of dopamine?

A

Stimulates the direct pathway via D1 receptors, inhibits the indirect pathway via D2 receptors.

22
Q

What is cogwheeling?

A

Feature of Parkinson’s where there is both tremor and rigidity.

23
Q

Name the triad of Parkinsonian symptoms.

A

Tremor (pill-rolling)
Rigidity (cogwheeling)
Bradykinesia

24
Q

Name 4 less obvious symptoms of Parkinson’s.

A
  • hypophonia - quietly spoken due to weakness of laryngeal muscles
  • micrographics - small writing due to slowness of movement
  • mash-like facies - poor facial expression due to slowness of muscles of facial expression
  • dementia
25
Q

What is Huntington’s disease?

A

An autosomal dominant disorder caused by loss of inhibition of the indirect pathway.

26
Q

What is the main symptom of Huntington’s disease?

A

Chorea/choreiform movements (jerky, involuntary movements).

27
Q

What is hemiballismus?

A

Hyperkinetic disorder caused by damage to the sub-thalamic nucleus.

28
Q

Name some cerebellar signs.

A 
D - dysdiadokinesia
A - ataxia
N - nystagmus
I - intention tremor
S - slurred speec
H - hypotonia

Clinical Neuroscience (10 decks)

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