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BB 2 > Motor systems 2 > Flashcards

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
Q

Result of stroke damage to motor thalamus?

A

Severe paralysis

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26
Q

What structure does the corticobulbospinal tract course through

A

Internal capsule

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27
Q

Where does the corticobulbar component of the corticobulbospinal tract terminate

A

Various cranial nerve nuclei
Pontine nuclei
Reticular formation
Red nucleus

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28
Q

Where is the red nucleus found

A

In the midbrain next to oculomotor nuclei

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29
Q

Where does the corticospinal component of tract cross

A

Lower medulla

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30
Q

What does the corticospinal tract form once its decussated

A

Large lateral tract

Small medial tract

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31
Q

Where does motor decussation happen

A

Upper spinal cord and lowest part of medulla

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32
Q

Where does sensory decussation happen

A

Rostral medulla

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33
Q

If the brain is injured above the spinal cord is the motor deficit on the same or opposite side

A

Opposite

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34
Q

If the spinal cord is injured is motor deficit on same or opposite side

A

Same

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35
Q

Where does the lateral corticospinal tract run

A

In the dorsolateral cord

36
Q

Where does the anterior corticospinal tract run

A

In the medial ventral cord

37
Q

What does the corticospinal tract have monosynaptic connections with

A

Motor neurones of thumb and digits

38
Q

How does the corticospinal tract initiate movements in muscles it doesn’t synapse directly onto

A

Via spinal interneurones

39
Q

Where does the anterior/ ventral corticospinal tract terminate

A

Cervical cord

40
Q

What does the cervical cord control

A

Voluntary movement of neck and shoulder

41
Q

Damage to the corticospinal tract in the spinal cord causes what

A

Loss of control of hands and fingers

42
Q

What other motor system mediates motor functions of posture locomotion and gait

A

Extrapyramidal system

43
Q

Name 3 major extrapyramidal tracts

A

Lateral vestibulospinal tract
Reticulospinal tract
Rubrospinal tract

44
Q

Where does the lateral vestibulospinal tract originate

A

Vestibular nuclei in upper medulla/ lower pons

45
Q

What is the function of the lateral vestibulospinal tract

A
  • Posture and balance
  • Nucleus projects ipsilaterally to antigravity muscles
  • Tonically active when upright
46
Q

Where does the reticulospinal tract arise from

A

Reticular formation of pons and medulla

47
Q

What is the function of the reticulospinal tract

A

Autonomic conrtol
Drive to respiration
General arousal of spinal cord

48
Q

What is the function of the rubrospinal tract

A

Carries cerebellar commands to spinal cord

49
Q

Where does the rubrospinal tract arise from

A

Red nucleus in the brainstem

50
Q

What 2 things does the red nucleus give rise to

A

Rubrospinal tract

Large ascending projection to motor thalamus

51
Q

Name 2 minor extrapyramidal tracts

A

Tectospinal tract

Medial vestibulospinal tract

52
Q

What is the function of the tectospinal tract

A

Coordinates voluntary head and eye movements in response to visual/ auditory stimuli

53
Q

Where does the tectospinal tract originate from

A

Superior colliculus

54
Q

Where does the superior colliculus project to

A

Contralateral cervical spinal cord

55
Q

Where does tectospinal tract terminate

A

rexed laminae VI, VII and VIII

56
Q

What is the medial vestibulospinal tract a continuation of

A

Medial longitudinal fasciculus

57
Q

Function of the medial vestibulospinal tract

A

Mediates coordination of head and neck muscles with extraocular eye muscles to maintain objects in view despite body movement

58
Q

Define spasticity

A

Abnormally increased muscle tone

59
Q

What is spasticity characteristic of

A

Upper motorneurone lesions

60
Q

What is clonus

A

Series of jerky contractions following sudden stretching of the muscles

61
Q

What is hyperreflexia

A

Abnormally/ pathologically brisk tendon reflex seen in one or more muscle

62
Q

What does decorticate posturing indicate

A

Damage to corticospinal tract in midbrain

63
Q

What does decerebrate posturing indicate

A

Damage at level of brainstem including damage to corticospinal and rubrospinal tracts

64
Q

Describe decorticate posturing

A

Arms adducted and flexed
Wrists and fingers flexed on chest
Legs may be internally rotated and stiffly extended
Plantar flexion of feet

65
Q

Describe decerebrate posturing

A

Arms adducted and extended
Wrists pronated and fingers flexed
Legs internally rotated and stiffly extended
Plantar flexion of feet

66
Q

Is decorticate or decerebrate posturing favourable

A

Decorticate

67
Q

Explain the mechanism thought to underly decerebrate posturing

A
  • 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
Q

How can recovery occur after lesions to motor cortex

A

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
Q

What is hemiplegic dystonia

A

Persistent flexion of arms and extension of legs following lesion to motor cortex

70
Q

What reflex is characterised of chronic cerebral motor lesions

A

Clasp knife

71
Q

What is spinal shock

A

Clinical condition occuring after acute damage to spinal cord including damage to descending tracts

72
Q

What is the acute effect of spinal shock

A

Paralysis/ paresis

Reduced reflex response in all muscles below injury

73
Q

What are the chronic effects of spinal shock

A

Weak monosynaptic reflexes
Crossed extensor reflexes may recover
May be exaggerated and hyerpactive
Babinski sign present

74
Q

What symptoms of spinal injury can be attributed to reticulospinal tract (4)

A

Loss of bladder/ bowel control
Poor gait, loss of walking
Loss of temp regulation
Loss of BP regulation

75
Q

What symptoms of spinal injury can be attributed to corticospinal tract

A

Paralysis/ weakness voluntary movement

Hyperactive tendon reflexes

76
Q

What symptoms of spinal injury can be attributed to vestibulospinal tract

A

Loss of ability to stand/ balance

Poor gait, loss of ability to walk

77
Q

Common causes of upper motor neuron lesion

A

CVA, trauma, MS, ALS

78
Q

Common cause of lower motor neuron lesion

A

CVA, polio, tumour, alcoholism, diabetes

79
Q

What structures are involved in UMN lesion?

What is the distribution?

A

MOtor cortex/ corticospinal tract/ other tracts

Never just individual muscle, always groups

80
Q

What structures are involved in LMN lesion?

What is distribution?

A

Spinal or brainstem a-motor neurones or peripheral motor aons
Limited to muscle innervated by damaged motorneurones

81
Q

What is the effect of UMN lesion on voluntary movement

A

Parlysis or paresis

82
Q

What is the effect of LMN lesion on voluntary movement

A

Paralysis

83
Q

What is the effect of UMN lesion on muscle tone

A

Increased

84
Q

What is the effect of LMN lesion on muscle tone

A

Decreased

85
Q

What is the effect of UMN lesion of reflexes

A

Myotactic reflexes will be hyperactive

Some cutaneous reflex abnormalities (babinkski)

86
Q

What is the effect of LMN lesion on reflexes

A

Decreased or absent

87
Q

What is the classical description of UMN lesion and LMN lesion

A 
UMN= spastic paralysis
LMN= flaccid paralysis

BB 2 (28 decks)

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