Motor system III Flashcards

1
Q

Which part of brain causes the execution of movements?

A

primary motor cortex

(although almost all cortical areas input)

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2
Q

These cells are from which motor tract? [1]

A

Primary motor cortex –> corticospinal tract

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3
Q

Define hemiplagia [1]

A

loss of voluntary movements on the contralateral side of the body

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4
Q

What makes a region a watershed region in the brain? [1]

A

Region supplied by both the MCA and ACA: means that if stroke occurs can compensate

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5
Q

Which artery supplies most of the lateral surface of the frontal, parietal and temporal lobes? [1]

A

MCA

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6
Q

Which arteries do the arrows point to? [1]

A

Lenticulostiate arteries

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7
Q

Label 5, 6 & 7

A

1 - superior temporal gyrus;
2 - inferior frontal gyrus; 3 - insular cortex;
4 - temporal stem;
5 - internal capsule;
6 - thalamus;
7 - lentiform nucleus (the internal and external globus pallidus and the putamen)
8 - frontal horn;
9 - superior circular sulcus;
10 - inferior circular sulcus.

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8
Q

The MCA is divided into different segments. Label A-C that depicts this.

A

A: M1: horizontal section

B: M3: cortical section

C: Sylvian section

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9
Q

Middle cerebral artery:

Describe the difference between an occlusion in M1 v M3

A

M1: supplies blood supply to the basal ganglia via the lenticulostriate arteries & motor cortex. Causes a very bad lesion

M3: Only supplies motor cortex alone - Less bad lesion

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10
Q

Which part of the body would an occlusion to the MCA not effect and why? [2]

A

Lower limbs are not affected: supplied by ACA

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11
Q

How is the the somatosensory cortex involved in motor control?

A

40% of corticospinal and corticobulbar tract axons arise from somatosensory cortex; can modulate somatosensory input (e.g. supress nocicpetive pain)

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12
Q

FYI summary

A
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13
Q

Where does the corticospinal tract cross decussate in the body? [1]

On the way to the brainstem, which structure does the cortiospinal tract pass through? [1]

A

Decussates in upper spinal cord: C1-C5

Goes through the internal capsule on way to brainstem

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14
Q

Describe an overview of the corticospinal tract [3]

A
  • Primary motor cortex on l/r signal: upper motor neuron travels in brain to medulla where the lateral corticospinal tract decussates; the ventral corticospinal tract will decussate in the spinal cord just before they synapse with lower motor neurons.
  • The lateral corticospinal tract controls distal fine muscle movement.
  • The ventral corticospinal tract controls axial movement
  • After synapsing at the ventral horn, becomes lower motor neuron. leaves spinal cord to innervate muscle motor
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15
Q

The corticobulbar tracts provide innervation to the musculature of which region of the body?

Head and neck

Upper limbs

Lower limbs

Neck

A

The corticobulbar tracts provide innervation to the musculature of which region of the body?

Head and neck

Upper limbs

Lower limbs

Neck

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16
Q

A lesion of the CST above the decussation of the pyramids will result in deficits on the [] side.

A lesion of the CST below the decussation of the pyramids will result in deficits on the [] side.

A

A lesion of the CST cranial to the decussation of the pyramids will result in deficits on the contralateral side.

A lesion of the CST caudal to the decussation of the pyramids will result in deficits on the ipsilateral side.

17
Q

Which part of the body does CST have monosynaptic connections with? [2]

Explain why [1]

How does the CST control movement in other muscles? [1]

A

Monosynaptic connections with thumb and digits

Creates a greater degree of precision of movement

Other muscles are controlled via CST synapsing on interneurons: modulates spinal reflexes

18
Q

Which tract controls the movement of the face? [1]

A

Corticobulbar tract

19
Q

Explain why forehead sparing can occur from lesion in the UMN of the corticobulbar tract but does not in a LMN lesion.

A

Forehead has bilateral innervation from the corticospinal tract; if lesion occurs in UMN then the contralateral side can still innervate

Lower part of face is only innervated by one (contralateral nerve): LMN lesion causes contralateral upper and lower paralysis

20
Q

Extrapyramidal tracts:

What is the role of the reticulospinal tract [1]

A

Responsible for autonomic control of the sympathetic preganglionic neurons (eg heart rate, circulation, breathing, respiratory rate)

Also provides drive to the respiration via the phrenic nerve)

21
Q

Extrapyramidal tracts:

Desribe the path of the medial and lateral reticulospinal tracts [2]

A

Medial Reticulospinal Tract (Pontine): Descends ipsilaterally

Lateral Reticulospinal tracts (Medullary): Descends bilaterally

21
Q

Extrapyramidal tracts:

Desribe the path of the medial and lateral reticulospinal tracts [2]

A

Medial Reticulospinal Tract (Pontine): Descends ipsilaterally

Lateral Reticulospinal tracts (Medullary): Descends bilaterally

22
Q

Extrapyramidal tracts:

What is the role of the lateral vestibulospinal tract? [1]

A

Controls posture and balance

23
Q

Extrapyramidal tracts:

Describe the course of the lateral vestibulospinal tract

A

Fibres descend ipsilaterally though the anterior funiculus of the same side of the spinal cord, synapsing on the extensor antigravity motor neurons

24
Q

Extrapyramidal tracts:

Desribe the function and path of medial vestibulospinal tract

A

Function: Performs the synchronization of the movement of the eyes with the movement of the head so that eyes do not lag behind when the head moves to one side

Pathway: Descends bilaterally in the medial longitudinal fasciculus. Synapses with the excitatory and inhibitory neurons of the cervical spine

25
Q

Describe the function and path of the rubrospinal tract [2]

A

Function: Controls muscle tone in flexor muscle groups; Inhibits extensor tone

Path:
- Arises from the red nucleus in the brainstem
- crosses at medulla
- terminates primarily in the cervical and thoracic portions of the spinal cord

26
Q

Path and function of tectospinal tract? [2]

A

Coordinates voluntary head and eye movements

Involved in both auditory and visual cues, it is primarily understood to orient our eyes and head towards both auditory and visual stimuli. For example, if you were sitting in a quiet room and all of a sudden heard a noise to your right, you would subconsciously turn your head in that direction and orient your eyes towards the direction of the sound, attempting to find the source.

Path:
Originates in the superior colliculus
Projects to the contralateral cervical spinal cord to terminate in Rexed laminae VI, VII, and VIII

27
Q

Spasticity:

Effect on muscle tone and reflexes ? [1]

Lesion usually occurs where in body? [1]

A

Spasticity:
* Increased muscle tone and reflexes
* UMN damage

28
Q

Clonus

Describe the characteristic movements associated with clonus [1]

UMN or LMN lesion? [1]

A

Lots of jerky contractions followed by a suddent stretch of muscle

UMN lesion

https://www.google.com/search?q=clonus&rlz=1C5CHFA_enGB760GB761&hl=en&sxsrf=AJOqlzUkXZhV4TRE-1FXesUfy9LnZqP-NA:1674751896001&source=lnms&tbm=vid&sa=X&ved=2ahUKEwi-jOT-2OX8AhWuRUEAHcBgBmwQ_AUoAXoECAEQAw&cshid=1674751960915393&biw=714&bih=732&dpr=1#fpstate=ive&vld=cid:596e37d4,vid:4SrhgjGIZ30

29
Q

Describe how rigidity occurs [1]

A

If have a lesion above the pons occurs, the inhibitory system is lost; extrapyramidal system becomes hyperactive

30
Q

Describe the how a patient would present with:

Decorticate posturing [4]

Decerebrate posturing [3]

A

Decorticate posturing:
* plantar flexed
* internally rotated legs
* flexed hands and elbows
* adducted arms

Decerebrate posturing:
* Plantar flexed
* Pronated hands
* Extended arms

31
Q

Where would damage occur for the following:

Decorticate posturing [1]

Decerebrate posturing [1]

A

Decorticate posturing:
* Damage to the corticospinal tract above or in midbrain

Decerebrate posturing
* Damage to the corticospinal tract at the level of upper brainstem, including corticospinal and rubrospinal tracts