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Clinical Neuroscience > Upper Motor Neuron Syndrome > Flashcards

Upper Motor Neuron Syndrome Flashcards

1
Q

What is the following a defintion of?

Clinical condition of signs and symptoms arising from upper motor neuron lesions

A

Upper motor neuron syndrome

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2
Q

What are some causes of UMN lesions?

A
  • Stroke
  • Spinal Cord injury
  • abnormal development
  • neurogenerative disorders
  • anoxic brain injury
  • traumatic brain injury
  • tumor
  • infections
  • infalmmatory disorders
  • metabolic disoders
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3
Q

What is the following a definition of?

Sudden onset of neurologic deficits due to disruption of the blood supply in the brain which damages neural tissue disrupting connections between cortex, subcortical structures, brainstem, cerebellum and spinal cord

A

Stroke

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4
Q

What is the following a defintion of?

Complete sever of all ascending and descending axons, prevent spinal cord below the level of injury from converying signals to or from the brain

A

Spinal cord injuries

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5
Q

What is the following a defintion of?

Motor deficits arise from damage to the corticospinal, corticoreticular, and corticobrainstem tracts during perinatal period

A

Spastic cerebral palsy

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6
Q

What is the following a defintion of?

Demyelination of the CNS UMN which can occur anywhere in the brain and spinal cord

A

Multiple Sclerosis

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7
Q

Where can UMN be damaged?

A

anywhere along its route

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8
Q

Damage to UMN can be catagorized as what?

A

loss of function or gain of function

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9
Q

is the following loss or gain of function?

Absence of a feature that is normally present

A

Loss of function

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10
Q

is the following loss or gain of function?

Presence of a feature that is not normally present

A

Gain of function

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11
Q

What is an upper motor neuron sign that can be both loss or gain of function?

A

Abnormal muscle tone

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12
Q

What are the signs of loss of function in UMN syndromes? (4)

A
  • paresis
  • paralysis
  • impairted selective motor control
  • absent or decreased muscle tone
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13
Q

What are the signs of gain of function in UMN syndomes? (8)

A
  • spasticity
  • myoplasticity
  • hyperreflexia
  • excess reticulospinal drive
  • abnormal synergies
  • rigidity
  • abnormal reflexes
  • compensatory and pathologic cocontraction
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14
Q

What are the structures involved in UMN syndromes?

A
  • cerebral hemisphere
  • brainstem
  • spinal cord
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15
Q

What are the pathologies of UMN syndromes?

A
  • cerebral palsy
  • spinal cord injury
  • traumatic brain injury
  • MS
  • medial cerebral artery stroke
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16
Q

What are the voluntary movements of UMN syndromes?

A
  • impaired or absent
  • Obligatory abnormal muscle syergies in traumatic brain injury, MS, spastic cerebral palsy or medial cerebral artery stroke
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17
Q

If there is a lateral corticospinal tract lesion above decussation what happens?

A

Contralateral loss

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18
Q

If there is a lateral cortiocspinal tract lesion below decussation what happens?

A

Ipsilateral loss

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19
Q

If there is medial UMN damaged in the brainstem what happens?

A

Ipsilateral loss expect for bilateral loss of reticulospinal influence

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20
Q

If there is medial UMN damaged in the spinal cord what happens?

A

Ipsilateral loss

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21
Q

What happens to muscle tone in UMN syndromes?

A

Increased: velocity-dependent hypertonia (spasticity)

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22
Q

What is the following a definition of?

not as severe as neurogenic atrophy
type of muscle bulk sign in UMN syndromes

A

Disuse atrophy

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23
Q

In spastic cerebral palsy what does abnormal motor development cause?

A

Reduced muscle volume

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24
Q

What is the following a defintion of?

resistance to stretch in resting muscle

A

Muscle tone

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25
Q

What type of muscle tone is this?

  • type of hypertonia
  • velocity-independent increase in resistance to stretch
  • excess resistance that does not change with speed of stretch
  • occurs in basal ganglia disorders and severe lesions affecting midbrain or structures above it
  • diect UMN facilitation of alpha LMN
A

Rigidity

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26
Q

What type of muscle tone is this?

  • type of hypertonia
  • velocity-dependent increase in resistance to stretch
  • excess resistance that increases with increasing speed of movement
  • chronic UMN lesions
  • neuromuscular overactivity and/or myoplasticity
A

Normal muscle tone

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27
Q

What type of muscle tone is this?

  • abnormally low musuclar resistance to passive stretch
  • less than normal resistance during passive stretch
  • developmental disorders: decreased descedning facilitation resulting in fewer weak actin-myosin bonds; excessive muscle length; decrease tone due to abnormal brain development
  • LMN disorders: decreasd LMN input to skeletal muscles
  • acute UMN lesions that cause CNS shock: spinal or cerebral shock, disrupts descending motor commands that affect LMN and temporarily inactive due to edema
A

Hypotonia

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28
Q

What type of muscle tone is this?

  • compelte loss of muscle tone
  • no resistance during passive stretch
  • LMN disorders: severe spina bifida, floppy infant syndrome, loss of LMN input to skeletal muscle
A

Flaccidity

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29
Q

UMN lesions cause paresis whe some descending UMN remain intact which does what to LMN?

A

provides inadquate facilitation to LMN

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30
Q

What is the following a defintion of?

weakness affecting one side of the body

A

Hemiplegia

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31
Q

How it hemiplegia caused?

A

Interruption of the corticobrainstem and medial and lateral corticospinal tracts in one cerebral hemisphere

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32
Q

What does paraplegia affect?

A

affects body below the arms

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33
Q

What does tetraplegia affect?

A

Affects all four limbs

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34
Q

What does the suffix -“plegia” refer to?

A

paralysis

35
Q

What does the suffix “-paresis” refer to?

A

weakness/partial paralysis due to neurological issue

36
Q

What does interruption to the lateral corticospinal tract cause?

A

Prevents selective motor control in the limbs

37
Q

Why cannot specific muscles be activated independently?

A

B/c only the corticospinal neurons synapse with LMN to a single muscle & activate inhibitory interneurons to prevent unwanted motor neuron activity

38
Q

What does lateral corticospinal loss affect?

A

Distal function

39
Q

What is the following a definition of?

  • delayed effects of decreased movement
  • type of hypertonia where excessive resistance to stretch of a muscle is dependent on velocity of movement
A

Spasticity

40
Q

What is spasticity produced by?

A

overactive neural input to muscles and changes in muscle of myoplasticity

41
Q

What is the following a defintion of?

adaptatin for immobility where adapative changes occur within muscle in response to prolonged positioning in a shortened range and to changes in neuromuscular activity level

A

Myoplasticity

42
Q

What are some myoplastic changes?

A
  • muscle contracture
  • increased number of actin-myosin bonds
  • muscle disuse atrophy
43
Q

What is the following a defintion of?

Adaptive shortening and stiffening of muscle caused by a loss of sarcomeres by connective tissue thickening and loss of elasticity

A

Muscle contracture

44
Q

What is the following a defintion of?

adaptation from paresis and paralysis

A

neural overactivity

45
Q

Excess neural input to muscle elicits excess muscle contraction via what 2 mechanisms?

A

Hyperflexia and excess reticulospinal drive to LMN

46
Q

Where does hyperreflexia occur?

A

Spinal lesions

47
Q

Where does excess reticulospinal drive occur?

A

Cerebral lesions

48
Q

What develops after spinal cord lesions?

A

Phastic stretch hyperreflexia

49
Q

What is the following a defintion of?

brief excessive muscle contraction when muscle spindles are stretched, caused by excessive firing of LMN

A

Phasic stretch hyperreflexia

50
Q

When lession interputs UMN in spinal cord what happens to the disinhibited interneurons and LMN below the lesion?

A

Develop enhanced excitability causing hyperrflexia

51
Q

What does hyperrelfexia interfere with?

A
  • postioning
  • mobility
  • hygiene
  • comfort
  • sleep
52
Q

What is the purpose of triggering muscle contraction during hyperreflexia?

A

To help maintain muscle mass preventing muscle atrophy and assisting venous return

53
Q

What type of stretch reflex is continued as long as stretch is maintained and does not occur in normal neuromuscular systems during typical veloctites of stretch?

A

Tonic stretch reflex

54
Q

What is fired during a maintained stretch of the spindle?

A

Central region fires the spindle sensory endings and multiple interneurons

55
Q

loss of what allows stretch of central spindle to elicit continual muscle contractions via the tonic stretch reflex

A

Loss of presynaptic inhibition

56
Q

What does the tonic stretch reflex contribute to in a spinal cord injury?

A

Spasticity at all velocities of stretch

57
Q

What does corticoreticular lesions diminish?

A

Cortical drive to the contralateral reticulospinal tract

58
Q

Intact ipsilateral corticoreticular tract increases it drive to what tract?

A

The ipsilateral reticulospinal tract

59
Q

Involunary muscle contractions produced by excess reticulospinal drive to LMN is called what?

A

UMN dystonia

60
Q
A
61
Q

What does UMN dystonia contribute to?

A

spasticity

62
Q

In absence of corticospinal control the reticulospinal tract provides voluntary control of what?

A

Paretic limb muscles

63
Q

What is the following a defintion of?

Activation of muscle groups that are unable to acheive the desired movement outcomes

A

Abnomral muscle synergies

64
Q

Why do abnormal muscles synergies occur?

A

B/c of lesions that interrupt the corticopsinal tract also interrupt the corticoreticular tract

65
Q

What doe the reticulospinal tract provide signals to?

A

LMN that elicit abnormal synergy

66
Q

What is the following a defintion of?

Type of hypertonia where excessive resistance to stretch of a muscle is independent of the velocity of movement

A

Rigidity

67
Q

What is the reason as to why rigidity cuases increased resistance to movement in skeletal muscle?

A

excessive UMN facilitation of alpha LMN producing the active muscle contractions

68
Q

What type of rigidity is this?

constant increase in muscular tone and stiffness of affected muscles

A

Leadpipe rigidity

69
Q

What type of rigidity is this?

coexistence of rigidity with tremor producing stiffness and a ratchet-like jerkiness when a body part is manipulated

A

Cogwheel rigidity

70
Q

What type of rigidity is this?

Consists of rigid expression of the limbs and trunk, internal rotation of the upper limbs and ankle PF

A

Decerebrate rigidity

71
Q

When does decerebrate rigidity occur?

A

Injury of brainstem between midbrain and pons

72
Q

What is cocontraction?

A

simulatneous contraction of agnoist and antagnoist muscles

73
Q

Why does compensatory cocontraction occur?

A

As a compensations for weakness and is used to fulfull the movement goals

74
Q

What is the following type of cocontraction?

loss of selective recruitment of physiologically antagnoistic muscles

A

pathologic cocontraction

75
Q

What are the primary problems that interfere with functional movements in UMN syndromes?

A

Paresis or paralysis

76
Q

What conditions have these symptoms?

Complete injury causes paralysis and thus selective motor control is absent no impaired

A

complete spinal cord injury

77
Q

What conditions have these symptoms?

impaired selective motor control and excess retculospinal drive

A

cerebral UMN syndrome

78
Q

What conditions have these symptoms?

muscle stretch hyperreflexia contributes to movement dysfunction

A

chronic complete spinal cord injury

79
Q

What conditions have these symptoms?

excess brainstem UMN drive overactivity, pathologic cocontraction, hyperreflexia, & abnormal muscle development

A

Spastic cerebral palsy

80
Q

What conditions have these symptoms?

muscle force and selectivity and inadequate to achieve tasks; weak actin-mysoin bonds, contracture, hyperreflexia, and excess reticulospinal drive

A

UMN syndrome

81
Q

What conditions have these symptoms?

contracture, incresed number of weak actin-myosin bonds

A

Chronic UMN syndromes

82
Q

What is the following a defintion of?

UMN syndrome wehre there is CNS demyelinate involving damage to the myelin sheaths in the brain and spinal cord

A

Multiple sclerosis

83
Q

What is the effect of demyelination of CNS system neurons in MS?

A

slowed or blocked transmission of signals

Clinical Neuroscience (22 decks)

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