Motor Systems Flashcards
What are the pathways descending from the brain?
Corticobulbar and corticospinal
What are the clinical features of an injury to corticospinal fibers in the internal capsule?
corticospinal = posterior limb of internal capsule
Contralateral hemiparesis
Various CN signs
What is the main clinical feature of an injury to corticospinal fibers rostral to the decussation of pyramids?
Contralateral hemiplegia
What is the main clinical feature of an injury to corticospinal fibers in the decussation of pyramids with a lesion in the rostral pons?
Bilateral paresis of upper limbs
What is the main clinical feature of an injury to corticospinal fibers in the decussation of pyramids with a lesion in the caudal pons?
Bilateral paresis of lower limbs
What are the clinical features of a unilateral cervical spinal cord injury to corticospinal fibers?
Ipsilateral hemiplegia of upper and lower extremities
Features of UMN lesion
What is the clinical feature of bilateral damage to the cervical spinal cord above C4 or C5?
Quadriplegia
What is the clinical feature of unilateral injury to the thoracic spinal cord to corticospinal fibers?
Ipsilateral monoplegia of lower extremity
What is the clinical feature of bilateral injury to the thoracic spinal cord to corticospinal fibers?
Paraplegia
What do corticobulbar fibers control?
Where do they originate?
Cranial nerve motor nuclei Frontal eye fields (A6 & 8) - caudal anterior limb of internal capsule Precentral gyrus (A4) - genu of internal capsule Postcentral gyrus (A3, 1, 2) - rostral posterior limb of internal capsule
What cranial nerves are not innervated bilaterally by corticobulbar fibers?
How are they innervated?
CN VII - contralateral for lower quadrants of face
Motor nucleus of CN XII - contralateral to tongue
CN XI - ipsilateral for SCM and trapezius
How would an UMN lesion to CN XII present?
Tongue deviated away from affected side
How would an UMN lesion to CN XI present?
Inability to turn head away from affected side or raise shoulder on affected side
How would an UMN lesion to CN X present?
Uvula deviated towards affected side
How would an UMN lesion to CN VII present?
Supranuclear palsy
Loss of voluntary control to lower half of opposite side of face (compensation for upper half)