Motor systems Flashcards

0
Q

Spinal cord anatomy

A

Neurons/grey matter in middle
- dorsal horn - sensory, integration
- ventral horn - motor - A-alpha (fast!), gamma (slower, fewer)
- interneurons - activate patterns of alpha (excite one muscle, inhibit antagonist)
- smaller caudally
- cervical, lumbar enlargements - sensory and motor neurons for limb
Nerves - dorsal root and ventral root -> spinal nerve -> branches
- includes branches to SNS chain (T1-L2) from lateral horn

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1
Q

Overview of motor systems

A

Descending
- cortex - planning, initiating, voluntary
- brainstem - basic movements, posture
- basal ganglia -> cortex, (brainstem) - initiation
- cerebellum -> cortex, brainstem - coordination
Spinal cord
- input from cortex -> interneurons (most common, patterns), alpha (rapid, skilled)
- sensory input to interneurons (pain, stretch, tension)
- interneurons - patterns -> excite/inhibit muscle groups via alpha
- alpha/”lower motor” neurons -> all output to motor units

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2
Q

Fiber types

A

Alpha - A-alpha -> extrafusal (normal) muscle fibers
- 80-120 m/s (big diameter)
Gamma - A-gamma -> intrafusal (spindle) fibers
- 4-24 m/s (smaller)

Sensory
- Spindle (Ia) and golgi tendon (Ib) both A-alpha (fat, 80-120 m/s)

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3
Q

Organization of motor neurons

A

Motor pool - all neurons to same muscle
- clustered over several spinal segments (-> mult spinal nerves)
- surrounded by interneurons that control
Topography
- distal (hand) - lateral; axial - medial
- flexors - dorsal; extensors - ventral
- tracts mirror - lateral funiculus = limbs, anterior funiculus = axial

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4
Q

Recruitment of motor fibers

A

Motor unit - all fibers innervated by single neuron
- always activated together
Contraction - increase in firing rate -> recruit additional units
- max firing rate = 20 AP/sec

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5
Q

Muscle fiber types

A

Type I - red, aerobic (glycogen), small, weak, endurance
Intermediate - white, fast, powerful, resist fatigue
Type II - white, anaerobic (creatinine phos), large, fast, strong

Fiber type is determined by neuron contacting fiber
- ex small alpha neuron -> induces red Type I fibers
- can’t be changed via exercise (can strengthen differentially)
Contraction always begins with Type I -> recruit II for more power

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6
Q

Muscle spindle

A

Sensory organ - modified skeletal muscle fiber
Mechanical stretch -> annulospiral sensory nerve fiber -> 1A afferent (fastest!)

Innervated by gamma neuron (highly innervated)

  • > only ends of fiber contract (nucleus is in middle)
  • > new set point after muscle contraction (alpha, gamma together)

Respond to muscle stretch or contraction (-> stretch)
Not enough power to actually contract muscle

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7
Q

Muscle stretch reflex

A

Annulospiral/muscle spindle stretch (ie hitting tendon with hammer) -> A-alpha fiber ->

Synapses

  • > direct to same muscle (quad contracts)
  • > interneuron -> inhibits antagonist (hamstring relaxes)

Depends on level of excitability
Function - stabilizes, prevent unintended movement (hitting back of knee, pouring liquid into cup)
Super fast! (all A-alpha fibers)

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8
Q

Gamma loop

A

Efficient mechanism for slow, routine movements

Activate small group of gamma neurons

  • > spindle senses stretch
  • > activates spinal reflex
  • > contraction of muscle, relaxation of antagonists

Once muscle spindles are set -> resist change from this length

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9
Q

Spasticity

A

Overactive response of gamma neurons

  • due to absence of descending inhibitory input (brainstem)
  • > excessive response to stretch
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10
Q

Golgi tendon organ

A

At junction of fiber and connective tissue

“Inversion myostatic”
Contraction -> tension -> 1B fiber (very fast, slightly slower than spindle)
-> interneurons -> relaxation of muscle, contract antagonist
-> also to cerebellum for coordination

Passive stretch - most absorbed by muscle fibers -> little activity
- active only at limits of compliance (protective)
Spasticity -> “clasp knife” - gives way under stretch

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11
Q

Flexion reflex

A

aka withdrawal

Pain -> type IV fibers ->
- flexion of limb
- extension of contralateral limb
Reciprocal/bilateral response
Mediated by interneurons (complex, multisynaptic)
Overactive = Babinski (extension of big toe)

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12
Q

Interneuron patterns

A

Interneurons can activate patterns (vs direct cortical control)
- ex walking
Also reflexes (cough, sneeze, cornea), many voluntary movements
- bilateral and vertical coordination
- both excitatory and inhibitory
- integrate sensory and cortical input

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13
Q

Topography of motor tracts

A

Mirrors topography of motor neurons
Anterior funiculus (medial) - axial, bilateral, gross movements
Lateral funiculus - limbs, detail, unilateral

Medial -> lateral

  • medial vestibulospinal
  • anterior/ventral corticospinal
  • tectospinal
  • pontine reticulospinal
  • lateral vestibulospinal (anterior to pontine)
  • medullary reticulospinal
  • rubrospinal
  • corticospinal
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14
Q

Medial motor systems

A
Tectospinal (adjacent to MLF)
Medial vestibulospinal (MLF)
Pontine reticulospinal (MLF)
Anterior corticospinal - voluntary control of axial
(Lateral vestibulospinal)
(Medullary/lateral reticulospinal)

Terminate bilaterally in upper torso
-> neck and trunk movements
Most from MLF -> anterior/ventral funiculus

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15
Q

Tectospinal tract

A

Superior colliculus ->
decussates in midbrain (“dorsal tegmental decussation”) ->
adjacent to MLF -> anterior funiculus
cervical, upper thoracic (bilateral)

Sudden stimuli -> head and neck movements

16
Q

Medial vestibulospinal tract

A

Medial vestibular nucleus (vestibular input) ->
medial to MLF -> descends -> anterior funiculus ->
cervical, upper thoracic

Vestibular stimuli, movement -> head and neck tone

17
Q

Pontine reticulospinal tract

A

aka medial reticulospinal

Para-median pontine reticular formation (PPRF)
-> MLF -> anterior funiculus -> cervical, upper thoracic

Lateral eye movement -> head turning
Can function as indirect cortico-spinal tract (for gross movements)

18
Q

Lateral vestibulospinal tract

A

Lateral vestibular nucleus ->
anterior portion of lateral funiculus (ipsilateral) ->
extensors at all spinal levels

Vestibular righting reflex (tip head to right -> extension on right)

19
Q

Medullary reticulospinal tract

A

aka lateral reticulospinal tract

Medulla -> anterior part of lateral funiculus -> all spinal levels
inhibits interneurons -> activates gamma loop

Gross movements, muscle tone
Can be activated by cortico-bulbar tract (fx as indirect cortico-spinal tract for gross movements)

20
Q

Lateral motor systems

A

Rubrospinal
Corticospinal

Control limbs, detailed movements

Anterior part of lateral funiculus (not technically lateral)

  • medullary reticulospinal
  • lateral vestibulospinal
21
Q

Rubrospinal tract

A

Red nucleus (midbrain) ->
decussates in midbrain (ventral tegmental decussation) ->
lateral funiculus ->
interneurons

Proximal flexor muscles -> crawling
Can be indirect corticospinal tract

22
Q

Corticospinal tract

A

Most important motor tract

Motor cortex (topography, pyramidal/Betz/upper motor neurons)

  • > internal capsule (head at genu, arms, legs posterior)
  • > cerebral peduncles (small area/percentage of fibers)
  • > base of pons -> medullary pyramids
  • > pyramidal decussation (90% of fibers cross)
  • > lateral funiculus

Most to interneurons (pattern activation)
- some direct to alpha motor (fast, highly skilled, distal limbs)
- few to dorsal horn (sensory transmission, reflexes)
Uncrossed fibers -> anterior funiculus -> gross axial
Isolated lesion -> weakness of distal, not effect on reflexes

23
Q

Cortical motor areas

A

Amount of cortex corresponds to complexity of movement
Precedes muscle movement (20 ms upper limb, 30 ms lower)

Motor - homonculus, simple movements (finger tapping)
- neurons are specific for direction of movement (not muscle or motor unit)
Premotor - preparation, rehearsal
Supplementary (SMA) - part of premotor
- deciding between movements, initiating
- lesion -> abulia (difficulty initiating)

24
Q

Corticobulbar tracts

A

Cerebral cortex -> brain stem

Multiple functions
- majority pontine -> cerebellum
- motor cranial nerve nuclei (facial, eye)
- indirect corticospinal pathways
(corticotectal -> superior colliculus, corticoreticular -> reticular)
- sensory transmission
- autonomic

25
Q

Facial control

A
Motor cortex (lateral)
 -> lower face = strictly crossed
  (unilateral "supranuclear" lesion -> contralateral deficit)
 -> upper face = bilateral
  (unilateral lesion -> no deficit)
Facial nucleus - receives cortical input -> ipsilateral nerve
  (unilateral lesion -> complete ipsilateral deficit)
Unilateral lesion ->
 lower face (most), tongue/swallow (some), upper face (little), jaw (none)

Anterior cingulate -bilateral, limbic (direct)> emotional movements
- can have hyperactive emotional responses if preserved (hypermimia, “pseudobulbar” affect)

26
Q

Indirect cortico-spinal tracts

A

Muscle tone and stabilization
- ex flexing calf before pulling up on lever

Cortico-reticulo-spinal pathway

  • premotor/supplementary motor -> medulla -> medullary reticulospinal pathway
  • inhibitory (lesion -> overactive reflexes)