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Motor systems 2 Flashcards

1
Q

The more anterior the structure…

A

The more abstract its role in movement

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2
Q

What is area 4 of the brain called

A

Primary motor cortex

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3
Q

What is the result of a lesion in the primary motor cortex

A

Paralysis of muscle groups

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4
Q

Result of medial lesion to primary motor cortex

A

Loss of leg function

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5
Q

Result of lateral lesion to primary motor cortex

A

Loss of arm function

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6
Q

What is area 6 called

A

Premotor cortex

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7
Q

What is area 8 called

A

Supplementory motor cortex

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8
Q

What happens if there is damage to areas 6/8

A

Apraxia

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9
Q

What is apraxia

A

Reflexes and muscle strength normal, but there is a difficult in performing complex motor tasks

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10
Q

What is ideational apraxia

A

Unable to plan motor tasks so can’t carry out multistep tasks– can’t explain how one would do that task

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11
Q

What is ideomotor apraxia

A

Unable to complete tasks that rely on semantic memory but can explain how to do it

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12
Q

What are areas 9/10 called

A

Dorsolateral prefrontal cortex

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13
Q

What is the role of areas 9/1-

A 
Planning of movements
Executive function (problem solving a judging)
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14
Q

What does it suggest if extra perseverance is seen when patient does the Winconsin card sorting test

A

Lesion to areas 9/10

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15
Q

What happens if there is bilateral damage to frontal eye fields

A

Oculomotor apraxia

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16
Q

What is oculomotor apraxia

A

Unable to follow objects
Absence of fast phase nystagmus
People move head instead of eyes

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17
Q

What is area 11 called

A

Orbitofrontal cortex

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18
Q

What is the function of area 11

A

Control/ inhibition of motor function associated with limbic system

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19
Q

What are areas 1,2,3 called

A

Somantosensory cortex

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20
Q

What % of the corticobulbar tract arises from somatosensory cortex

A

40

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21
Q

Role of somatosensory cortex in movement

A

Modulate sensory input and reflexes

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22
Q

What are the motor symptoms of strokes involving occlusion of MCA

A

Produce severe motor disability in all parts of contralateral body apart from lower limb (this is supplied by anterior cerebral artery)

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23
Q

As well as the motor cortex, what other important structure does MCA stroke affect

A

Blood supply to basal ganglia via lenticulostriate arteries

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24
Q

What structure in an important route for motor commands from the basal ganglia and the cerebellum into corticospinal tract

A

Motor thalamus (VL thalamic nucleus)

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25
Result of stroke damage to motor thalamus?
Severe paralysis
26
What structure does the corticobulbospinal tract course through
Internal capsule
27
Where does the corticobulbar component of the corticobulbospinal tract terminate
Various cranial nerve nuclei Pontine nuclei Reticular formation Red nucleus
28
Where is the red nucleus found
In the midbrain next to oculomotor nuclei
29
Where does the corticospinal component of tract cross
Lower medulla
30
What does the corticospinal tract form once its decussated
Large lateral tract | Small medial tract
31
Where does motor decussation happen
Upper spinal cord and lowest part of medulla
32
Where does sensory decussation happen
Rostral medulla
33
If the brain is injured above the spinal cord is the motor deficit on the same or opposite side
Opposite
34
If the spinal cord is injured is motor deficit on same or opposite side
Same
35
Where does the lateral corticospinal tract run
In the dorsolateral cord
36
Where does the anterior corticospinal tract run
In the medial ventral cord
37
What does the corticospinal tract have monosynaptic connections with
Motor neurones of thumb and digits
38
How does the corticospinal tract initiate movements in muscles it doesn't synapse directly onto
Via spinal interneurones
39
Where does the anterior/ ventral corticospinal tract terminate
Cervical cord
40
What does the cervical cord control
Voluntary movement of neck and shoulder
41
Damage to the corticospinal tract in the spinal cord causes what
Loss of control of hands and fingers
42
What other motor system mediates motor functions of posture locomotion and gait
Extrapyramidal system
43
Name 3 major extrapyramidal tracts
Lateral vestibulospinal tract Reticulospinal tract Rubrospinal tract
44
Where does the lateral vestibulospinal tract originate
Vestibular nuclei in upper medulla/ lower pons
45
What is the function of the lateral vestibulospinal tract
- Posture and balance - Nucleus projects ipsilaterally to antigravity muscles - Tonically active when upright
46
Where does the reticulospinal tract arise from
Reticular formation of pons and medulla
47
What is the function of the reticulospinal tract
Autonomic conrtol Drive to respiration General arousal of spinal cord
48
What is the function of the rubrospinal tract
Carries cerebellar commands to spinal cord
49
Where does the rubrospinal tract arise from
Red nucleus in the brainstem
50
What 2 things does the red nucleus give rise to
Rubrospinal tract | Large ascending projection to motor thalamus
51
Name 2 minor extrapyramidal tracts
Tectospinal tract | Medial vestibulospinal tract
52
What is the function of the tectospinal tract
Coordinates voluntary head and eye movements in response to visual/ auditory stimuli
53
Where does the tectospinal tract originate from
Superior colliculus
54
Where does the superior colliculus project to
Contralateral cervical spinal cord
55
Where does tectospinal tract terminate
rexed laminae VI, VII and VIII
56
What is the medial vestibulospinal tract a continuation of
Medial longitudinal fasciculus
57
Function of the medial vestibulospinal tract
Mediates coordination of head and neck muscles with extraocular eye muscles to maintain objects in view despite body movement
58
Define spasticity
Abnormally increased muscle tone
59
What is spasticity characteristic of
Upper motorneurone lesions
60
What is clonus
Series of jerky contractions following sudden stretching of the muscles
61
What is hyperreflexia
Abnormally/ pathologically brisk tendon reflex seen in one or more muscle
62
What does decorticate posturing indicate
Damage to corticospinal tract in midbrain
63
What does decerebrate posturing indicate
Damage at level of brainstem including damage to corticospinal and rubrospinal tracts
64
Describe decorticate posturing
Arms adducted and flexed Wrists and fingers flexed on chest Legs may be internally rotated and stiffly extended Plantar flexion of feet
65
Describe decerebrate posturing
Arms adducted and extended Wrists pronated and fingers flexed Legs internally rotated and stiffly extended Plantar flexion of feet
66
Is decorticate or decerebrate posturing favourable
Decorticate
67
Explain the mechanism thought to underly decerebrate posturing
- Excessive activity (disinhibtion) of extrapyramidal system esp vestibulospinal tract - Vestibulospinal tract usually under tonic inhibition by corticobulbospinal tract and red nucleus - If red nucleus damaged may lead to this posture
68
How can recovery occur after lesions to motor cortex
Because of plasticity | After a lesion to face area, face cells may be driven by cells from different part of cortex and homonculus is changed
69
What is hemiplegic dystonia
Persistent flexion of arms and extension of legs following lesion to motor cortex
70
What reflex is characterised of chronic cerebral motor lesions
Clasp knife
71
What is spinal shock
Clinical condition occuring after acute damage to spinal cord including damage to descending tracts
72
What is the acute effect of spinal shock
Paralysis/ paresis | Reduced reflex response in all muscles below injury
73
What are the chronic effects of spinal shock
Weak monosynaptic reflexes Crossed extensor reflexes may recover May be exaggerated and hyerpactive Babinski sign present
74
What symptoms of spinal injury can be attributed to reticulospinal tract (4)
Loss of bladder/ bowel control Poor gait, loss of walking Loss of temp regulation Loss of BP regulation
75
What symptoms of spinal injury can be attributed to corticospinal tract
Paralysis/ weakness voluntary movement | Hyperactive tendon reflexes
76
What symptoms of spinal injury can be attributed to vestibulospinal tract
Loss of ability to stand/ balance | Poor gait, loss of ability to walk
77
Common causes of upper motor neuron lesion
CVA, trauma, MS, ALS
78
Common cause of lower motor neuron lesion
CVA, polio, tumour, alcoholism, diabetes
79
What structures are involved in UMN lesion? | What is the distribution?
MOtor cortex/ corticospinal tract/ other tracts | Never just individual muscle, always groups
80
What structures are involved in LMN lesion? | What is distribution?
Spinal or brainstem a-motor neurones or peripheral motor aons Limited to muscle innervated by damaged motorneurones
81
What is the effect of UMN lesion on voluntary movement
Parlysis or paresis
82
What is the effect of LMN lesion on voluntary movement
Paralysis
83
What is the effect of UMN lesion on muscle tone
Increased
84
What is the effect of LMN lesion on muscle tone
Decreased
85
What is the effect of UMN lesion of reflexes
Myotactic reflexes will be hyperactive | Some cutaneous reflex abnormalities (babinkski)
86
What is the effect of LMN lesion on reflexes
Decreased or absent
87
What is the classical description of UMN lesion and LMN lesion
``` UMN= spastic paralysis LMN= flaccid paralysis ```

BB 2 (28 decks)

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