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Neuro II > Motor tracts > Flashcards

Motor tracts Flashcards

1
Q

a lesion in what location is implicated by spasticity?

A

upper motor neuron lesion

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2
Q

a lesion in what location is implicated by rigidity

A

basal ganglia

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3
Q

a lesion to what structure may cause hyper reflexia

A

upper motor neuron

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4
Q

what is babinski sign and what causes it

A

inverted plantar reflex

upper motor neuron lesion

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5
Q

what pathways are lost in an upper motor neuron lesion

A

corticospinal tract

indirect brainstem motor control (via collaterals of the CST)

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6
Q

a lesion to what structure is associated with flaccid paralysis, muscle wasting, hyporeflexia and fasciculations

A

lower motor neuron lesion

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7
Q

which part of the corticospinal tract innervates the axial/postural muscles?

A

medial corticospinal tract

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8
Q

which part of the corticospinal tract innervates the muscles of the extremities

A

lateral corticospinal tract

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9
Q

are cranial nerves upper or lower motor neurons

A

LOWER MOTOR NEURONS

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10
Q

what are the UMNs going to cranial nerves called?

A

cortioconuclear/corticobulbar tract

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11
Q

where do the fibers innervating skeletal muscle of the extremities decussate

A

at the pyramids of the medulla

lateral corticospinal tract

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12
Q

where do the fibers innervating axial skeletal muscle decussate

A

at the ventral grey horn of the spinal level that they exit

medial corticospinal tract

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13
Q

what is the target of gamma motor neurons

A

intrafusal fibers

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14
Q

what is the target of alpha motor neurons

A

extrafusal fibers

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15
Q

what is the function of the indirect motor pathways

A

modulate movement

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16
Q

what are the major structures through which fibers of the direct pathway of the CST pass?

A

posterior limb of internal capsule =>
cerebral peduncles of the midbrain
anterior pons =>
pyramids

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17
Q

which portion of the motor cortex controls voluntary movement of the face

A

lateral 1/3

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18
Q

how do the paths of the lateral and medial CSTs differ

A

lateral - decussates in the inferior medullary pyramids

medial - continues ipsilaterally until it reaches spinal level

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19
Q

what is the target of the corticobulbar tract

A

muscles innervated by cranial nerves

EXCEPT PERIORBITAL MS

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20
Q

does the corticobulbar tract innervate ipsilateral or contralateral muscles

A

contralateral

** CN XI is an exception and innervates on the ipsilateral side

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21
Q

how does the path of the corticobulbar tract differ from that of the lateral corticospinal tract

A

UMN cell body is more lateral within the primary motor cortex=>
descends through GENU of internal capsule

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22
Q

how are lower motor neurons of the CST organized functionally within the spinal cord

A

neurons innervating extensors lie VENTRAL

neurons innervating flexors lie DORSAL

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23
Q

what are the two lateral UMN indirect tracts

A

rubrospinal

lateral reticulospinal

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24
Q

what are the four medial UMN indirect tracts

A

tectospinal
medial reticulospinal
medial AND LATERAL vestibulospinal

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25
Q

what is the function of the lateral vestibulospinal tract

A

extension against gravity

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26
Q

where is the lateral vestibular nucleus and to where do its axons extend

A

dorsal pons

extends to all spinal levels

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27
Q

where is the medial vestibular nucleus and to where do its axons extend

A

dorsal pons

to cervical and thoracic spinal levels

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28
Q

what is the function of the medial vestibular spinal tract

A

muscle tone/posture of the neck and shoulders

coordination of head movements

29
Q

what indirect pathway originates at the red nucleus

A

rubrospinal

30
Q

where is the red nucleus

A

anteromedial midbrain

31
Q

what is the function of the rubrospinal tract

A

UE flexion

32
Q

where do the medial and lateral reticulospinal tracts originate

A

M: reticular formation of the PONS
L: reticular formation of the MEDULLA

33
Q

what is the target of the medial reticulospinal tract

A

ipsilateral LMNs of the postural ms. and limb extensors

34
Q

what is the function of the of the lateral reticulospinal tract

A

inhibition of extensor LMNs

facilitation of flexor LMNs

35
Q

what tract is responsible for your head turning towards what you are looking at or loud noises

A

tectospinal

36
Q

where is the origin of the tectospinal tract

A

superior colliculus

37
Q

what pathways are lost in UMN syndrome

A

direct pathway of CST and indirect pathways supplied by it’s collateral branches

38
Q

what tract is implicated in loss of sensation of the face

A

trigeminal

39
Q

what tract is implicated in facial paralysis

A

corticobulbar

40
Q

will a lesion of a LMN illicit sxs on the same or opposite side (of the lesion)

A

same side

41
Q

will a lesion of an UMN above the medulla illicit sxs on the same or opposite side (of the lesion)
to what tracts does this apply?

A

opposite side

CST AND PCMLS

42
Q

will a lesion of an UMN below the medulla illicit sxs on the same or opposite side (of the lesion)

A

same side

43
Q

what is decorticate posture

A

hands in fists, elbows flexed, forearms pronated, LE internally rotated

44
Q

what causes decorticate posture

A

lesion above the red nucleus

45
Q

what is decerebrate posture

A

UE pronated, UE and LE extended

46
Q

what causes decerebrate posture

A

lesion between red nucleus and above the vestibulospinal/reticulospinal nuclei

47
Q

in a complete transection of the spinal cord, where would anesthesia begin and why

A

1-3 levels below the lesion b/c of overlapping dermatomes

48
Q

where would upper- and lower- motor neuron signs be present in a complete transection of the SC

A

UMN signs below the lesion

LMN signs at the level of the lesion

49
Q

what sensation would be lost from the CONTRALATERAL side in the case of a hemisection of the spinal cord

A

pain and temperature

2-3 dermatomes below lesion

50
Q

In a SC hemisection, why is there an area at the level of the lesion where all sensation and voluntary movement would be lost? Is this section ipsilateral or contralateral to the lesion?

A

because the DRG was severed

ipsilateral to the lesion

51
Q

what lesion is associated with Brown-Sequard’s syndrome

A

spinal cord hemisection

52
Q

what tract/sense is usually first affected by syringomyelia

A

ALS/pain and temperature

53
Q

occlusion of what artery causes anterior cord syndrome

A

anterior spinal a

54
Q

in anterior cord syndrome, are LMN sxs contralateral or ipsilateral

A

ipsilateral

55
Q

what are two causes of central cord syndrome

A

syringomyelia

cervical hyperextension

56
Q

does central cord syndrome ever effect the PCMLS

A

NO

57
Q

what three structures are lesioned in medial medullary syndrome

A

pyramids
medial lemniscus
CN XII nucleus

58
Q

occlusion of what artery causes medial medullary syndrome

A

anterior spinal artery

59
Q

what sxs are associated w/ medial medullary syndrome

A

contralateral UMN sxs
contralateral loss of proprioception, vibration, discriminative touch
tongue deviation towards lesion

60
Q

central seven palsy is caused by a lesion to what tract

A

corticobulbar tract

61
Q

what is the hallmark of central seven palsy

A

lower face drooping with intact muscles of the upper face (pt can wrinkle forehead)

62
Q

where is the lesion in central 7 palsy

A

contralateral lower pons

63
Q

why does innervation to the upper face remain intact when there is a lesion to the corticobulbar tract

A

the muscles of the upper face have bilateral innervation

64
Q

what is the dx for a lesion to the cerebral peduncle

A

weber syndrome

65
Q

what nervous structures are effected in weber syndrome

A

CST
corticobulbar
CN III, X, XI, XII

66
Q

what pattern of sensory impairment is associated with polyneuropathy

A

stocking/glove distribution

67
Q

what neurons are destroyed in amyotropic lateral sclerosis (ALS)

A

somatic motor neurons

68
Q

What artery supplies the posterior limb of the internal capsule

A

Lenticulostriate arteries and anterior choroidal a

69
Q

What is the blood supply to the nucleus ambiguous

A

PICA

Neuro II (16 decks)

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