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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
what is the function of the lateral vestibulospinal tract
extension against gravity
26
where is the lateral vestibular nucleus and to where do its axons extend
dorsal pons | extends to all spinal levels
27
where is the medial vestibular nucleus and to where do its axons extend
dorsal pons | to cervical and thoracic spinal levels
28
what is the function of the medial vestibular spinal tract
muscle tone/posture of the neck and shoulders | coordination of head movements
29
what indirect pathway originates at the red nucleus
rubrospinal
30
where is the red nucleus
anteromedial midbrain
31
what is the function of the rubrospinal tract
UE flexion
32
where do the medial and lateral reticulospinal tracts originate
M: reticular formation of the PONS L: reticular formation of the MEDULLA
33
what is the target of the medial reticulospinal tract
ipsilateral LMNs of the postural ms. and limb extensors
34
what is the function of the of the lateral reticulospinal tract
inhibition of extensor LMNs | facilitation of flexor LMNs
35
what tract is responsible for your head turning towards what you are looking at or loud noises
tectospinal
36
where is the origin of the tectospinal tract
superior colliculus
37
what pathways are lost in UMN syndrome
direct pathway of CST and indirect pathways supplied by it's collateral branches
38
what tract is implicated in loss of sensation of the face
trigeminal
39
what tract is implicated in facial paralysis
corticobulbar
40
will a lesion of a LMN illicit sxs on the same or opposite side (of the lesion)
same side
41
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?
opposite side | CST AND PCMLS
42
will a lesion of an UMN below the medulla illicit sxs on the same or opposite side (of the lesion)
same side
43
what is decorticate posture
hands in fists, elbows flexed, forearms pronated, LE internally rotated
44
what causes decorticate posture
lesion above the red nucleus
45
what is decerebrate posture
UE pronated, UE and LE extended
46
what causes decerebrate posture
lesion between red nucleus and above the vestibulospinal/reticulospinal nuclei
47
in a complete transection of the spinal cord, where would anesthesia begin and why
1-3 levels below the lesion b/c of overlapping dermatomes
48
where would upper- and lower- motor neuron signs be present in a complete transection of the SC
UMN signs below the lesion | LMN signs at the level of the lesion
49
what sensation would be lost from the CONTRALATERAL side in the case of a hemisection of the spinal cord
pain and temperature | 2-3 dermatomes below lesion
50
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?
because the DRG was severed | ipsilateral to the lesion
51
what lesion is associated with Brown-Sequard's syndrome
spinal cord hemisection
52
what tract/sense is usually first affected by syringomyelia
ALS/pain and temperature
53
occlusion of what artery causes anterior cord syndrome
anterior spinal a
54
in anterior cord syndrome, are LMN sxs contralateral or ipsilateral
ipsilateral
55
what are two causes of central cord syndrome
syringomyelia | cervical hyperextension
56
does central cord syndrome ever effect the PCMLS
NO
57
what three structures are lesioned in medial medullary syndrome
pyramids medial lemniscus CN XII nucleus
58
occlusion of what artery causes medial medullary syndrome
anterior spinal artery
59
what sxs are associated w/ medial medullary syndrome
contralateral UMN sxs contralateral loss of proprioception, vibration, discriminative touch tongue deviation towards lesion
60
central seven palsy is caused by a lesion to what tract
corticobulbar tract
61
what is the hallmark of central seven palsy
lower face drooping with intact muscles of the upper face (pt can wrinkle forehead)
62
where is the lesion in central 7 palsy
contralateral lower pons
63
why does innervation to the upper face remain intact when there is a lesion to the corticobulbar tract
the muscles of the upper face have bilateral innervation
64
what is the dx for a lesion to the cerebral peduncle
weber syndrome
65
what nervous structures are effected in weber syndrome
CST corticobulbar CN III, X, XI, XII
66
what pattern of sensory impairment is associated with polyneuropathy
stocking/glove distribution
67
what neurons are destroyed in amyotropic lateral sclerosis (ALS)
somatic motor neurons
68
What artery supplies the posterior limb of the internal capsule
Lenticulostriate arteries and anterior choroidal a
69
What is the blood supply to the nucleus ambiguous
PICA

Neuro II (16 decks)

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