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NEUROLOGY phase 1b > 1b Motor Cortical Control > Flashcards

1b Motor Cortical Control Flashcards

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1
Q

What is meant by the hierarchical organisation?

A

high order areas of hierarchy are involved in more complex tasks, and lower level areas of hierarchy perform lower level tasks

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2
Q

What do the cerebellum and the basal ganglia do in the motor system of heirarchy?

A

adjust the commands received from the other parts of the motor system

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3
Q

What are the two pyramidal descending tracts?

A

corticospinal
corticobulbar

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4
Q

Why are the pyramidal tracts called pyramidal?

A

because they pass through the pyramids of the medulla

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5
Q

What do the pyramidal descending tracts do?

A

voluntary movement of the body and face muscles

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6
Q

What are the extrapyramidal tracts?

A

descending tracts which do not pass through the pyramids of the medulla

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7
Q

Which descending tracts are responsible for the involuntary movements of balance, posture and locomotion?

A

Extrapyramidal

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8
Q

Where do pyramidal tracts travel from and to?

A

Motor cortex to spinal cord or cranial nerve nuclei in brainstem

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9
Q

Where do extrapyramidal tracts travel from and to?

A

Brainstem nuclei to spinal cord

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10
Q

Where is the primary motor cortex located?

A

Anterior to the central sulcus

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11
Q

Where does the lateral corticospinal tract decussate?

A

In the medulla - innervates the limb muscles

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12
Q

Where does the anterior corticospinal tract decussate?

A

Spinal cord - innervates the trunk muscles

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13
Q

What is the principal motor tract for voluntary movement of the face and the neck?

A

Corticobulbar

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14
Q

What is the function of the vestibulospinal tract?

A

Stabilise head during body movements, or as head moves
Coordinate head movements with eye movements
Mediate postural adjustments

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15
Q

What is the function of the reticulospinal tract?

A

Most primitive descending tract - from medulla and pons
Changes in muscles tone associated with voluntary movement
Postural stability

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16
Q

What is the function of the tectospinal?

A

Orientation of the head and neck during eye movements

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17
Q

What is the function of the rubrospinal tract?

A

Innervate lower motor neurons of flexors of the upper limb

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18
Q

What is paresis?

A

graded weakness of movement

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19
Q

What are the three negative signs of an upper motor neuron lesion?

A

Loss of voluntary movement
Paresis
Paralysis = complete loss of voluntary muscle activity

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20
Q

What is spasticity?

A

Increased muscle tone

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21
Q

What is hyper-reflexia?

A

Exaggerated reflexes

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22
Q

what is clonus?

A

Abnormal oscillatory muscle contraction

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23
Q

What are the positive signs of an upper motor neurone lesion
?

A

Increased abnormal motor function due to loss of inhibitory descending inputs
Spasticity: increased muscle tone
Hyper-reflexia: exaggerated reflexes
Clonus: abnormal oscillatory muscle contraction
Babinski’s sign

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24
Q

what is Apraxia?

A

disorder of skilled movement - patients lose information about how to perform skilled movements

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25
Lesions to which areas can cause apraxia?
Frontal lobe and the inferior parietal lobe - premotor cortex, and supplementary motor area
26
What two diseases are the most common causes of apraxia?
Stroke and dementia
27
What is seen in patients with a lower motor neuron lesion?
Weakness Hypotonia Fibrillations Fasciculations Hyporeflexia Muscle atrophy
28
What is Fasciculations?
damaged motor units produce spontaneous action potentials, resulting in a visible twitch
29
What is the difference between fasciculations and fibrillations?
Fasciculations = damaged motor units producing twitching, Fibrillations = individual muscle fibres producing twitching
30
What is motor neurone disease also known as?
Amyotrophic Lateral Sclerosis
31
What are the upper motor neuron signs of motor neuron disease? less power more tone more reflex
Spasticity (increased tone of limbs and tongue) Brisk limbs and jaw reflexes Babinski’s sign Loss of dexterity Dysarthria (difficulty speaking) Dysphagia (difficulty swallowing)
32
What are the lower motor neuron signs of motor neuron disease? less power less tone less reflex
Weakness Muscle wasting Tongue fasciculations and wasting Nasal speech Dysphagia
33
What makes up the basal ganglia?
C - caudate nucleus P – putamen G – (external) globus pallidus T - thalamus Acc – nucleus accumbens Am – amygdala AC – anterior commisure
34
What makes up the lentiform nucleus?
The putamen and globus pallidus
35
What is the function of the basal ganglia?
Making the decision to move Elaborating associated movements (swinging arms while walking and changing facial expression to match emotions) Moderating and coordinating movements Performing movements in order
36
What is parkinsons disease?
Degeneration of the dopaminergic neurons that originate in the substantia nigra and project to the striatum
37
What are the five associated symptoms of Parkinsons?
Bradykinesia Hypomimic face Akinesia Rigidity Tremor at rest
38
What is bradykinesia?
slowness of (small) movements (doing up buttons, handling a knife)
39
What is hypomimic face?
face - expressionless, mask-like (absence of movements that normally animate the face)
40
What is Akinesia?
difficulty in the initiation of movements because cannot initiate movements internally
41
What is rigidity?
muscle tone increase, causing resistance to externally imposed joint movements
42
What is a pill rolling tremor?
When the patients hands tremor as if they were polling a pill between two fingers, which with time can spread to other parts of the body
43
What is Huntington's disease?
Degeneration of GABAergic neurons in the striatum, caudate and then putamen
44
What causes Huntingtons disease?
CAG repeat on chromosome 4
45
What are some symptoms of Huntington's disease?
Choreic movements Rapid jerky movements - hands and face affect Speech impairement Difficulty swallowing Unsteady gait Cognitive decline and dementia
46
What is the most common cause of Ballism?
Stroke which affects the subthalamic nucleus
47
What is Ballism?
Contralateral, uncontrolled flinging of the extremities
48
What separates the cerebellum from the cerebrum?
The tentorium cerebelli
49
What is the function of the vestibulocerebellum?
Regulation of gait, posture and equilibrium Coordination of head movements with eye movements
50
What does damage to the vestibulocerebellum cause?
gait ataxia and tendency to fall (even when patient sitting and eyes open)
51
What is the function of the spinocerebellum?
Coordination of speech Adjustment of muscle tone Coordination of limb movements
52
What can cause degeneration and atrophy of the spinocerebellum?
chronic alcoholism
53
What does damage to the spinocerebellum cause?
Abnormal gait and stance (wide based)
54
What is the function of the cerebrocerebellum?
Coordination of skilled movements, cognitive function, attention and processing of language
55
What does damage to the cerebrocerebellum result in?
Affects arms (coordinated movments) and speech
56
What is Ataxia?
General impairments in movement coordination and accuracy. Disturbances of posture or gait: wide-based, staggering (“drunken”) gait
57
What is dysmetria?
Inappropriate force and distance for target-directed movements (knocking over a cup rather than grabbing it)
58
What is Dysdiadochokinesia?
Inability to perform rapidly alternating movements (rapidly pronating and supinating hands and forearms)
59
What is scanning speech?
Staccato speech, due to impaired coordination of speech muscles
60
What are the main signs of cerebellar dysfunction?
Ataxia Dysmetria Intention remor Scanning Speech Dysdiadochokinesia
61
What causes a fasciculation?
When the muscle fibres of a motor unit lose their nerve supply - they become denervated Axons of the remaining motor unit grow and reach out to the denervated muscle fibres - reinnervation takes place Therefore the resulting motor unit is larger and prone to ectopic generation of electrical stimuli in the distal axons which cause muscle contraction = fasciculation
62
What is the striatum?
Caudate + putamen
63
What is the lentiform nucleus?
Putamen + external globus pallidus
64
What is the result of a stroke affecting the subthalamic nucleus?
Ballism
65
Where does the lateral corticospinal tract decussate?
In the medulla
66
What is meant by functional segregation?
Motor system organised in a number of different areas that control different aspects of movement

NEUROLOGY phase 1b (13 decks)

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