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Cerebral motor control Flashcards

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1
Q

What is the definition of functional segregation?

A

Different areas that control particular aspects of movements

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2
Q

What type of tracts are the corticospinal and corticobulbar tracts?

A

Pyramidal tracts (major descending)

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3
Q

What is the corticospinal tract responsible for?

A

The corticospinal tract is a motor pathway that carries efferent information from the cerebral cortex to the spinal cord. It is responsible for the voluntary movements of the limbs and trunk.

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4
Q

Where are the first order neurones located in terms of the corticospinal tract?

A

Primary motor cortex

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5
Q

What is the function performed by the corticobulbar tract?

A

Provides voluntary movements of body and face

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6
Q

What are the four types of extrapyramidal tracts?

A

1) Vestibulospinal
2) Tectospinal
3) Reticulospinal
4) Rubrospinal

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7
Q

Where is the primary motor cortex located?

A

Resides within the precentral gyrus anterior to the central sulcus.

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8
Q

What is the function performed by the primary motor cortex?

A

Such a cortex is responsible for controlling fine, discrete, precise voluntary movements and transmits descending signals to execute movements.

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9
Q

What is the function performed by the premotor cortex?

A

Concerned with movement planning and regulates externally cued movements

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10
Q

What area is responsible for planning internally cued movements?

A

Supplementary motor area

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11
Q

What structure is included in the midbrain?

A

Cerebral peduncles

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12
Q

Where do the majority of descending motor fibres decussate?

A

Medulla

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13
Q

What tract is formed from decussated upper motor neurone fibres?

A

Lateral corticospinal tract

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14
Q

What tract is formed from the ipsilateral upper motor neurone fibres?

A

Anterior corticospinal tract

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15
Q

Which muscles are innervated by the anterior corticospinal tract?

A

Trunk (axial) muscles

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16
Q

Which muscles are innervated by the lateral corticospinal tract?

A

Limb muscles

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17
Q

Who is the primary motor cortex arranged?

A

Somatopically

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18
Q

Which brainstem cranial nuclei are responsible for innervating the extra-ocular muscles?

A

Oculomotor, trochlear and abducens nerve

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19
Q

Where do the upper motor neurones synapse within the corticobulbar tract?

A

Synapse within the brainstem cranial nuclei

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20
Q

What structures are innervated by the facial nerve?

A

Muscles of the face

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21
Q

What structure is innervated by the hypoglossal nerve?

A

Tongue

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22
Q

What structures are innervated by the trigeminal nerve?

A

Muscles of mastication

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23
Q

Where are the lower motor neurones located within the extrapyramidal tracts?

A

Within the brainstem nuclei

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24
Q

Which extrapyramidal tract is responsible for stabilising the head during body movements, and coordinates with eye movements?

A

Vestibulospinal tract

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25
What is the function of the vestibulospinal tract?
Stabilises head during body movements or as head moves. Coordinate head movements with eye movements and mediates postural adjustments.
26
What is the function of the reticulospinal tract?
Most primitive descending tract – from medulla and pons. Changes in muscles tone associated with voluntary movement and concerned with postural stability.
27
What is the function of the tectospinal tract?
From superior colliculus of midbrain. Orientation of head and neck during eye movements.
28
Where within the midbrain are the lower motor neurones arise from for the tectospinal tract?
Superior colliculus
29
Where do the lower motor neurones arise from for the rubrospinal tract?
Red nucleus of the midbrain
30
What is the function of the rubrospinal tract?
Innervates lower motor neurones of flexors of the upper limb. The corticospinal tract dominates rubrospinal activity.
31
What are the negative signs for a patient with an upper motor neurone lesion?
There is a loss of voluntary motor function Paresis (graded weakness of movements) Paralysis (plegia): Complete loss of voluntary muscle activity
32
What are the four main positive signs of an upper motor neurone lesion?
Spasticity: Increased muscle tone Hyperreflexia: Exaggerated reflexes Clonus: Abnormal oscillatory muscle contractions Babinski's sign
33
What is apraxia?
A disorder of skilled movement, patients are not paretic however lost information regarding how to perform skilled movements
34
Which cerebral lobe lesions are commonly associated with apraxia?
``` Lesion of inferior parietal lobe. Frontal lobe (premotor cortex and supplementary motor area) ```
35
Which motor areas are affected in apraxia?
Supplementary motor area (SMA) and premotor cortex
36
What are the most common causes of apraxia?
Strokes and dementia
37
Why do positive signs occur in an upper motor lesion?
Increased abnormal motor function due to loss of inhibitory descending inputs
38
Where do lower motor neurones reside?
Within cranial nuclei to corticobulbar tracts or within spinal cord for innervating limb muscles
39
What are the 6 main signs of a lower motor neurone lesion?
1) Weakness 2) Muscle wasting (atrophy) 3) Tongue fasciculations and wasting 4) Hypotonia (reduces muscle tone) 5) Hyporeflexia (reduced reflexes) 6) Fibrillations
40
What are fasciculations?
Damaged motor units produce spontaneous action potentials resulting in a visible twitch.
41
What are fibrillations?
Spontaneous twitching of individual muscle fibres; recorded during electromyography examination
42
What is another term used to describe motor neurone disease?
Amyotrophic lateral sclerosis
43
What is motor neurone disease?
Progressive neurodegenerative disorder of the motor system (upper and lower motor neurones)
44
What are the upper motor neurone signs in motor neurone disease?
* Spasticity (Increased tone of limbs and tongue). * Brisk limbs and jaw reflexes * Babinski’s sign: Palmar extension of the toes upon stimulation is indicative of a corticospinal tract lesion, a typical response is concerned with palmar flexion. * Loss of dexterity * Dysarthria (Difficulty speaking) * Dysphagia (Difficulty swallowing).
45
What is Babinski's sign?
Palmar extension of the toes upon stimulation is indicative of a corticospinal tract lesion, a typical response is concerned with palmar flexion.
46
Muscle atrophy is an example of what type of motor neurone lesion?
Lower motor neurone
47
Fasciculations is an example of what type of motor neurone lesion?
Lower motor neurone
48
Babinski's sign is an example of what type of motor neurone lesion?
Upper motor neurone
49
What are the 7 main structures of the basal ganglia?
``` Caudate nucleus Putamen External globus pallidus thalamus nucelus accumbens amygdala anterior commisure ```
50
The subthalamic nucleus is associated with which other basal ganglia structure?
Globus pallidus
51
Which type of neurones are affected in Parkinson's disease?
Dopaminergic neurones
52
Which basal ganglia structure is predominantly affected in Parkinson's disease?
Substania nigra
53
The dopaminergic neurones originating in the substantia nigra project to which structure?
Striatum
54
What are the 5 main clinical presentations of Parkinson's disease?
``` Bradykinesia Hypomimic face Akinesia Rigidity (muscle tone increases, causing resistance to externally imposed joint movements) Tremor at rest ```
55
What is bradykinesia?
Slowness of small movements
56
What is a hypomimic face?
Expressionless (absence of movements that normally animate the face).
57
What is akinesia?
Difficulty in the initiation of movements because cannot initiate movements internally
58
What type of neurones are affected in Huntington's disease?
GABAergic neurones
59
Which basal ganglia structures are affected in patients with Huntington's disease?
Striatum Caudate Putamen
60
What is the inheritance pattern of Huntington's disease?
Autosomal dominant
61
What type of mutation is inherited in a patient with Huntington's disease?
CAG repeat
62
What are the presenting symptoms in a patient with Huntington's disease?
Choreic movements (chorea)- rapid jerky involuntary movements of the body hands and face a Speech impairment Difficulty swallowing (dysphagia) Unsteady gait Later stages, cognitive decline and dementia
63
Which part of the body is affected first by choreic movements?
Hands and face affected first, then legs
64
Which basal ganglia structure is associated with Ballism?
Subthalamic nucleus
65
What is ballism?
Sudden uncontrolled flinging of the extremities, symptoms occur contralaterally
66
Where is the cerebellum located?
Posterior cranial fossa
67
Which structure separates the cerebrum from the cerebellum?
Tentorium cerebelli
68
What is the main function of the cerebellum?
Coordinator and predictor of movement
69
Which cerebellum structure is associated the regulation of gait, posture and equilibrium?
Vestibulocerebellum
70
A tumour to the vestibulocerebellum can cause what type of symptoms?
Symptoms of vestibular disease leading to gait ataxia and tendency to fall
71
What is the function of the spinocerebellum?
Coordination of speech Adjustment of muscle tone Coordination of limb movements
72
A lesion to the spinocerebellum can lead to what?
Causes abnormal gait and stance (wide-based) | Affects mainly legs
73
Chronic alcoholism affects which part of the cerebellum?
Spinocerebellum
74
Which cerebellar region is the most lateral?
Cerebrocerebellum
75
What is the function of the cerebrocerebellum?
Coordination of skilled movements Cognitive function, attention, processing of language Emotional control
76
A lesion to the cerebrocerebellum affects what?
Mainly affects arms/skilled coordinated movements (tremor) and speech.
77
What are the main signs of cerebellar dysfunction?
``` Ataxia Dysmetria Intention tremor Dysdiadochokinesia Scanning speech ```
78
What is dysmetria?
Inappropriate force and distance for target directed movements
79
What is intention tremor?
Increasingly oscillatory trajectory of a limb in a target-directed movement
80
What is dysdiadochokinesia?
Inability to perform rapidly alternating movements (rapidly pronating and supinating hands and forearms)

BRS 2 (62 decks)

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