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BB CC > Motor Systems II > Flashcards

Motor Systems II Flashcards

1
Q

Motor tract origin

A

Corticospinal tract

Corticobulbar tract- to brainstem, movement of face

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2
Q

Primary motor cortex

A

Area 4

Immediately Anterior to central sulcus

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3
Q

Primary motor cortex lesion

A

Paralysis
Paresis of specific muscle groups
Some recovery of function may occur due to cortical plasticity
Damage depends on part of human homunculus involved

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4
Q

Stroke brain regions

A

Always involve multiple cortical areas

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5
Q

Stroke involving occlusion of MCA

A

Affect almost all of one side of frontal lobe

Severe motor disability in all parts of contralateral body except for lower limb (supplied by ACA)

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6
Q

Infraction of proximal M1 segment of MCA

A

Affect blood supply of basal ganglia via lenticulostriate arteries
Affects blood supply to motor cortex
More disabling than stroke that affects motor cortex (M3) alone

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7
Q

The more proximal an infarction…

A

The more problems arise

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8
Q

Premotor and Supplementary motor cortex Damage

A

Areas 6 and 8
Motor Apraxia –> normal reflexes + no muscle weakness, but difficulty performing complex motor tasks
Impair motor response to visual or other sensory cues
Damage to 1 side –> minimal as contralateral side can take over

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9
Q

Posterior parietal cortex

A

Areas 7 and 19
Damage can lead to sensory apraxia –> difficulty performing complex motor tasks when triggered by sensory input
More a difficulty in linking a sensory input to the motor system

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10
Q

Damage to Broca’s area

A

Motor aphasia
Difficulty generating speech motor outputs
Difficulty linking word strings into complex sentences
–> can’t construct meaningful word sequences

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11
Q

Damage to Frontal Eye Fields

A

Oculomotor Apraxia (OMA)
Difficulty moving eyes horizontally + moving them quickly to follow moving object
Patient have to turn head to compensate
Interferes with motor programmes controlling voluntary eye movements
Can appear to have perception problems, but acc just have difficulty with eye movement motor programmes

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12
Q

Sensory apraxia

A

Damage to connections from posterior parietal lobe to premotor cortex

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13
Q

40% of Corticobulbospinal tract axons arise from..

A

Anterior parietal lobe (somatosensory cortex), which lies immediately posterior to central sulcus

  • -> axons command down to spinal cord that modulate sensory input
  • -> modulate reflexes
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14
Q

Dorsolateral prefrontal cortex

A

Areas 9 and 10
Planning of movement
Evaluate future actions
Problem solving and judgement

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15
Q

Dorsolateral prefrontal cortex lesions

A

Apathy
Personality changes
Lack of ability to plan or to sequence actions or tasks
Left hemisphere damage- poor working memory for verbal information
Right hemisphere damage- poor working memory for spatial information

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16
Q

Wisconsin Card Sorting test

A

Test for frontal lobe function

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17
Q

Orbitofrontal cortex

A

Area 11
Control (inhibition) of motor responses with limbic system
Responses to hunger, thirst, sexual drive

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18
Q

Orbitofrontal cortex damage

A

Pseudopsycopathic behaviour- impulsiveness, puerility, jocular attitude, sexual disinhibition, complete lack of concern for others

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19
Q

Motor thalamus

A

VL + VA thalamic nuclei
Only route for motor commands from basal ganglia + cerebellum to be fed into corticospinal tract
Basal ganglia + cerebellum project to motor thalamus –> motor cortex

20
Q

Corticobulbospinal tract

A

Passes through internal capsule on way to brainstem

Vulnerable to stroke in this area

21
Q

Corticobulbar tract- terminates on which cranial nerve nuclei

A

V + VII for cortical control of muscles of head
Oculomotor nuclei (III, IV + VI) for control of eye movements
Cells on pontine nuclei
Reticular formation
Red nucleus

22
Q

Red nucleus

A

Large round nucleus in midbrain next to oculomotor nuclei

23
Q

Corticospinal tract

A

Decussates in medullary spinal junction- to opposite side

Forms lateral corticospinal tract and small medial corticospinal tract

24
Q

Motor decussation

A

Upper spinal cord C1-5
If brain injured above spinal cord/medulla junction, motor deficit on other side
If spinal cord injured, motor deficit on same side

25
Q

CST effects

A

Monosynaptic connections- motor neurones of thumbs + digits

Motor actions initiated in other muscles by CST are mediated by actions of CST on spinal interneurones

26
Q

CST damage

A

Loss of control of hands and fingers

27
Q

Extrapyramidal system

A

Originate from groups of cell bodies in brainstem
Lateral vestibulospinal tract (2c)
Reticulospinal tract (2b)

28
Q

Lateral vestibulospinal tract (2c)

A

Origin- vestibular nuclei in upper medulla/lower pons
Nucleus projects ipsilaterally to antigravity muscles
Tonically active during upright posture
Controls posture + balance

29
Q

Reticulospinal tract (2b)

A

Arises in reticular formation of pons + medulla
Projects bilaterally down spinal cord
Responsible for autonomic control (drives preganglionic symp. neurones)
Drive to respiration (phrenic)
General arousal of spinal cord

30
Q

Rubrospinal tract (2a)

A

Vestigial in humans
Origin- red nucleus in brainstem
Red nucleus receives main input from cerebellum
Carries cellular commands to spinal cord
Plays role in control of movement velocity
Plays role in transmitting motor commands from cerebellum to musculature

31
Q

Red nucleus

A

Large nucleus in midbrain
Gives rise to rubrospinal tract + large ascending projection to motor thalamus
Activation- excitation of flexor muscles, inhibition of extensor muscles

32
Q

Rubrospinal tract lesion

A

Slowness in movement

33
Q

Minor extrapyramidal tracts

A

Tectospinal tract

Medial vestibulospinal tract

34
Q

Tectospinal tract

A

Coordinates voluntary head and eye movements
Activates reflex movements of head in response to visual + auditory stimuli
Originates in superior colliculus
Receives afferents from retina
Terminates in laminae VI, VII and VIII

35
Q

Medial vestibulospinal tract

A

Continuation of medial longitudinal fasciculus
Reflex co-ordination of head + neck muscles
Extraocular eye muscles- maintain objects in view despite movement

36
Q

UMN act on

A

Most on interneurones

Only ones to directly act on LMNs are those driving muscles of thumb + fingers

37
Q

Spasticity

A

Abnormally increased muscle tone
Increased tendon reflexes
UMN lesion

38
Q

Clonus

A

Series of jerky contractions of a particular muscle following sudden stretching of muscle

39
Q

Hyperreflexia

A

Abnormally brisk tendon reflex in 1 or more muscles

40
Q

Decorticate posturing

A

Damage to corticospinal tract in midbrain

  • -> Arms adducted and flexed
  • -> Wrists + fingers flexed on chest
  • -> legs internally rotated + stiffly extended
  • -> Plantar flexion of feet
41
Q

Decerebrate posturing

A

Severe injury to brain at level of brainstem, including damage to corticospinal + Rubrospinal tract

  • -> arms abducted and extended
  • -> Wrists pronate and fingers flexed
  • -> legs externally rotated + stiffly extended
  • -> plantar flexion of feet
42
Q

Decerebrate posture MOA

A

Excessive activity (disinhibition) in extrapyramidal system
Damage to red nucleus
Only in unconscious

43
Q

Decorticate posture MOA

A

Damage to CST
More favoured than decerebrate
Unconscious usually
Unilateral or bilateral

44
Q

Hemiplegic dystonia

A

Persistent flexion of arms + extension of legs

45
Q

Spinal shock- acute effects

A

Paralysis or paresis + reduced reflex responses in all muscles below region of injury

46
Q

Spinal shock- chronic effects

A

Eventually wears off- days, weeks, months depending on severity
Exaggerated + hyperactive reflex
Clonus
Babinski sign

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