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Exam 1 (Motor) Flashcards

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1
Q

4 Main Functions of CSF?

A

1) Reduces traction on nerves and blood vessels by floating the brain and sc
2) Cushioning effect
3) Removes metabolites from CNS
4) provides stable ionic environment for CNS

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2
Q

Layers Head from outside to inside

A
  1. skull
  2. dura mater (meningeal layer)
  3. Arachnoid space (meningeal layer)
  4. Sub-arachnoid space
  5. Pia mater
  6. Cerebral cortex
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3
Q

BBB Components

A
  1. Astrocytic Process (creates tight junctions)
  2. Capillary Cell Membrane
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4
Q

CSF Circulation

A

Produced in choroid plexus and lateral 4th ventricle, then to arachnoid space via arachnoid villa, then superior sagittal sinus, then to venous system

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5
Q

What does the central sulcus divide?

A

Pre and Post cntral gyrus

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6
Q

What does the lateral sulcus divide?

A

Parietal and frontal lobes from temporal lobe

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7
Q

What is the body’s central stress response system?

A

Hypothalmic-pituitary adrenal axis (HPA axis)

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8
Q

Limbic System Componenets

A

Hippocampus, amygdala, thalamus, hypothalamus, frontal cortical areas

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9
Q

Hippocampus

A

-Librarian of the brain/ memory center
- CONSCIOUS memory about emotion

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10
Q

Amygdala

A

-Threat detector
- UNCONSCIOUS emotional memory

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11
Q

Pre-frontal cortex (PFC)

A

emotional regulation and inhibitory control

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12
Q

Limbic System function

A

Process sensory info and prepare the body to act

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13
Q

List the lateral descending pathway tracts

A
  1. Corticospinal
  2. Lat. Corticospinal
  3. Corticobulbar
  4. Rubrospinal
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14
Q

Lateral Descending Pathway Functions (General)

A
  • voluntary movement
  • distal muscles
  • flexors
  • more fine motor skills oriented
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15
Q

Lateral Corticospinal tract Function

A
  • distal muscles
  • fine motor movements
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16
Q

Corticobulbar Tract Function

A
  • muscles of head and face
  • movements of tongue (speech)
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17
Q

CN 7 (Facial) innervation to face

A
  • upper face is bilateral
  • lower face is contralateral (opp. side)
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18
Q

Lateral Pathway Tracts origin/termination

A

1) Corticospinal/Lat. Corticospinal:
- origin: cerebral cortex
- termination: grey matter of sc (synapse on alpha motor neurons or intenuerons)
2) Corticobulbar:
-origin: cortex
-termination- nuclei of CN 5, 7, and 12
3) Rubrospinal:
-origin: red nucleus in brainstem
-terminates: grey matter in sc (internuerons)

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19
Q

Rubrospinal Tract Function

A
  • maintain muscle tone in flexors of UE
  • contralateral control of flexors in UE
  • distal control
  • NO INVOLVEMENT IN LE
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20
Q

Medial Pathway Tracts Functions

A

1) Anterior Corticospinal:
- axial and proximal limb control
2) Vestibulospinal:
- maintains upright position
- posture and balance
- reflex adjustment of head (medial division)
3)Reticulospinal:
- integrated vestibular, sensory info. with commands from cortex
- bilateral control
- extensors of proximal muscles
- reflexes (origin allows for homeostasis bc medulla inhibits reflexes while pontine facilitates reflexes)
4) Tectospinal:
- reflex control of head and neck movements to visual and auditory stimuli

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21
Q

Parkinsons

A

Hypokinetic, hypertonic

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22
Q

Pyramidal vs. Extrapyramidal Signs and Symptoms

A

1) Pyramidal (ex: stroke):
- Clasp knife effect (spasticity)
- hypertonicity in UE flexors and LE extensors (flexor synergy)
- Increased DTR/ positive Babinski sign
- dystonia (involuntary mvmnt that is non-rhythmic)
-paralysis of voluntary movements

2) Extrapyramidal (ex: Parkinsons):
- cogwheel rigidity
- hypertonicity in flexors of limb and trunk (bilateral)
- involuntary mvmnt presents as tremor (rhythmic)
- negative babinski sign

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23
Q

Motor Neuron Pool (MNP) vs. Motor Unit

A

MNP: cell bodies of motor neurons that innervate ONE specific muscle and the associated spinal level (ex: biceps at C5-C6)
* 1 MNP contains MANY motor units*

Motor Unit: a motor neuron, its axon, and the muscle fibers it innervates

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24
Q

Lesions to Lat. Corticospinal Tract

A
  • In Brainstem: affect opposite side (side it will cross over to)
  • In SC: affect same side (bc it has already crossed)
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25
Lesion to Corticobulbar Tract
Impact CN 5, 7, and 12
26
Primary Motor Cortex (M1) Function and Somatotopical arrangement
- Function: Force/torque, movement direction - UE and face: lateral - LE: medial
27
M1 inputs/outputs
- Inputs: S1, all premotor areas, PPC -Outputs: corticospinal tract neurons (use of direct and indirect connections)
28
Dorsal and Ventral Premotor Cortices (PMd and PMv) Functions
- Movements triggered by external stimuli - action selection - establishment of new motor plan/modification of existing one
29
Damage to Supplementary Motor Area may impair what?
Can impair ability to plan movement
30
Posterior Parietal Cortex Function
Guides movement using tactile stimuli and visual feedback (ex: looking at something and then reaching for it)
31
UMN Lesion characteristics
- hypertonic - increased DTR (hyperreflexive) (ex: stroke)
32
LMN Lesion characteristics
- hypotonic - atrophy - loss of all reflexes (ex: Bells Palsy)
33
Components of Neuromuscular Junction (NMR)
1) Axon Terminal 2) Synaptic Cleft (Ach released into and catabolized) 3) Post Synaptic Membrane (muscle membrane) 4) Motor Unit
34
Role of Ach and Ca+ in NMJ
· Ach- only neurotransmitter released from nerve fibers and binds to nicootinic Ach (gated receptor), Na released into cell, K eventually released, action potential generated and penetrates deep into fibers then into sarcoplasmic reticulum · Ca+: released from sarcoplasmic reticulum into cells and sets off muscle contraction
35
Major Functions of Cerebellum
- motor coordination - motor learning (via trial and error) - state estimaiton - cognition
36
Cerebellum input/output
Input: - somatosensory, visual, auditory, vestibular, motor - mossy fibers (to granule cells, to parallel fibers, to purkinje fibers) - climbing fibers Output: purkinje fibers to deep nuclei of cerebellum to brainstem/cerebral cortex/sc thus resulting in modification of movement
37
What allows the cerebellum to adjust things on an ongoing basis?
feedback loop between vestibular nuclei within the Flocculus
38
Zones of cerebellum and function
1) Flocculus- eye movement (stabilize gaze), balance, VOR 2)Medial - posture of proximal muscles, locomotion (balance with walking), gaze 3) Intermediate- rapid movements (agonist/antagonist), distal limb control 4) Lateral- multi joint movement, state estimation, conscious assessment of movement errors, cognitive functions
39
Zones of Cerebellum and associated deep nuclei
1) Medial - fastiguis 2) Intermediate- Interpositus 3) Lateral- dentate
40
Cerebellar Damage Signs
- Ataxia - Postural disturbances (wide BOS, fall to lesion side) - Hypotonia - Action or Intention tremor (low frequency, high amplitude) - Lack of check (difficulty turning off agonist/antagonist) - dysmetria (under/overshooting target) - dyssynergia (poor ability coordinating muscle groups) - Dysdiadochokineasia ( difficulty performing alternating movements) - gaze disturbances - Decomposition of Movement (multi-joint task turned into individual movement/ staggered)
41
Basal Ganglia (parkinsons) vs Cerebellar Movement Dysfunction
· Basal Ganglia (Parkinsons)- - high freq, low amp tremor - shuffling - narrow BOS - slow limb movements · Cerebellar- - low freq, high amp - drunken gait - wide BOS - uncoordinated/nonsymmetrical limb movements
42
Spasticity (pyramidal) vs Rigidity (extra-pyramidal) (hypertonia)
Spasticity- resistance to movement in one DOF/direction but not the other (ex: during elbow flexion but not ext.) Rigidity- resistance throughout entire movement
43
Basal Ganglia Communication steps
1) Cerebral cortex sends excitatory signals to Thalamus 2) Thalamus relays signals to basal ganglia 3) basal ganglia sends minor inhibitory signals back to thalamus 4) Thalamus relays signal to Cerebral Cortex
44
Neurotransmitters of Basal Ganglia
· Excitatory: - Glutamate - Dopamine (D1, facilitates movement, disinhibits thalamus) · Inhibitory: - GABA - Dopamine (D2, inhibits movement, increased inhibition to thalamus)
45
Where does neostriatum recieve info from?
1) Cerebral cortex sends glutamate to it 2) Substantia Niagra pars compacta sends dopamine to it
46
Terminology for Hypokinetic Basal Ganglia Movement Disorders
- Bradykinesia- slowness - Akinesia- lack of movement - Rigidity- increased tone causing stiffness across joints in flexors and extensors
47
Terminology for Hyperkinetic Basal Ganglia Movement Disorders
- Hyperkinesia- excessive motor activity including involuntary movements and hypotonia - Hypotonia - Chorea- uncontrolled and jerky movements of the distal extremities and face - Ballism- involuntary and large proximal limb movements - Dystonia- sustained muscle contractions causing slow and repetitive movements
48
Basal Ganglia Type of Control
Bilateral with contralateral control
49
Reflex Circuit Components
1) Sensory receptor (in the muscle) 2) Afferent neuron 3) CNS connection 4) Efferent neuron 5) Effector muscle
50
Knee Jerk reflex
- Monosynaptic (1 synapse only between muscle afferent and motor neuron) - dorsal horn
51
Disynaptic Reflex
- 2 synapses (1 on interneuron and 1 on motor neuron of antagonist muscle) -Relaxation of antagonist muscle (ex: HS during knee jerk reflex)
52
Polysnaptic Reflex
- Flexor Withdrawal reflex (ex: stepping on tack) - Crossed Extensor reflex (part of Flexor Withdrawal) (ex: after stepping on tack, other leg extensors contract to maintain posture)
53
Sensory Receptor that detects stretch
- Muscle spindles in muscle belly (Alpha-gamma coactivation) - spindles do homonymous excitation
54
Intrafusal vs Extrafusal Fibers
1) Intrafusal- sensory, within muscle spindle (ex: gamma motor) 2) Extrafusal- motor neurons, provide force during muscle contraction (ex: alpha motor)
55
Golgi Tendon Organ (GTO)
- detects force - homonymous inhibition
56
Sites for modulation of the stretch reflex
1) Alpha motor neurons 2) Interneurons 3) presynaptic terminals of afferent fibers
57
Proprioceptive Reflexes Purpose
protection from injury
58
Motor Learning Trifecta
1) Individual 2) Task 3) Environment (and learner's motivation)
59
Clinical Implications for Operant Conditioning (associative learning/implicit bias)
· Operant conditioning is based on trial and error · CNS involved- cerebellar nuclei, amygdala, dorsal lateral premotor cortex
60
Hyperreflexia
gamma motor neuron hyper-excitability resulting in decreased inhibition
61
Motor Control Theories
1) Reflex - reflexes are the building blocks of complex behavior - Charles Sherrington 2) Hierarchical -Top down control (prefrontal> medulla) - Limitation- doesnt explain spontaneous/voluntary behavior - James Hughlings Jackson 3) Motor Planning - mvmnt without a stimulus - Bernstein -Limitations- CPG and gravity 4) Systems Theory (Eventually became Dynamic Systems theory) - Many systems cooperat to acheive movement - Bernstein 5) Dynamic Sytems - variability is normal 6) Ecological Theory -James Gilbert - Limitation- underemphasis on the CNS 7) Internal Model
62
What function is the lateral zone of cerebellum associated with?
State estimation
63
Major output cells of cerebellar cortex
Purkinje
64
Control Systems Theory
· 2 Models- Forward and Inverse - Forward Model- predicts sensory consequences of actions from efference copies of motor commands - Inverse- calculates necessary motor commands to accomplish desired task ·2 Types of control- Feedback and Feedforward - Feedback- uses output of system to adjust performance - Feedforward- predicts, control that operates without direct sensory input * Limitation- underemphasis on the environment

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