L5 UMNs Flashcards

1
Q

Medial Ventral horn

A

Most UMNs that project to the medial part also project to the intermediate zone, innervating the LMNs responsible for posture, balance, proximal muscles.

Pathways travel through the anteromedial white matter, they receive input from both sides of the brainstem

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2
Q

Lateral ventral horn

A

Most UMNs come from the motor cortex and travel in the lateral white matter and terminate in the lateral ventral horn

distal limbs, precise movements

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3
Q

Corticobulbar Axons

A

terminate bilaterally and contralaterally
ensures that loss in one side does not significantly impact the other side

terminate in the reticular formation before reaching the LMNs, meaning motor commands are refined before being created

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4
Q

Exceptions for Bilateral Innervation

A
  1. Hypoglossal nucleus: controls tongue muscles
  2. Trigeminal Motor Nucleus: chewing
  3. Facial Motor Nucleus: facial expressions
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5
Q

Primary Motor Cortex Organization

A
  1. Neurons located near each other are connected by local circuits. Allows for organization of movements. Instead of one action, a grouping/pattern can be completed
  2. Less specific then the somatosensory cortex, allows the M1 to be dynamic and flexible
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6
Q

Role of premotor cortex

A
  1. Indirectly: through connections with M1
  2. Directly: through axons projecting to corticobulbar and corticospinal pathways (over 30 %)
  3. Significant role in motor control
  4. Encode action goals oriented toward extrapersonal space/objects that are farther away
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7
Q

When do neurons in the preomotor cortex fire?

A

fire at the appearance of the cue, before we actually received a signal to make a movement

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8
Q

Ventrolateral subdivision of premotor cortex

A

active when individual prepares to perform specific movement but also when observing someone else doing a similar action

mirror motor neurons play out this mechanism, particularly when action involves a specific goal

plays a crucial role in understanding, encoding, imitating actions performed by others

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9
Q

Frontal lobe damage

A

patients have difficulty learning to select a movement in response to a visual cue

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10
Q

Medial Division of premotor cortex

A
  1. mediates selection of movements, specialized for initiating movements by internal cues
  2. Region is active when individual performs something from memory
  3. Example is the frontal eye fields, cingulate gyrus
  4. Damage reduces the amount of self initiated movements
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11
Q

Brainstem motor circuitry

A

contain circuits of UMNs
organize axial musculature of trunk and limbs
helps with balance, posture, visual gaze
can direct motor activities w/out higher motor centers in cortex

include vestibulospinal, medial vestibulospinal, tectospinal, pontine reticulospinal, and medullary reticulospinal tracts

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12
Q

Feedforward Control

A

create a motor plan to move body of limb from current location to its ultimate location

cannot adjust for unexpected events
works well in case feedback is delayed

reticular formation initiate, when they are inactive, you see a lack of postural responses

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13
Q

Feedback control

A

using information from environment to adjust the motor plan

works well when we need to be sensitive to change
does not work well when our feedback is slow or there are errors

uses muscle spindles and vestibular nuclei

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14
Q

What are S/S you would expect w/UMN involvement?

A

hyperflexia
sensory input is there, unable to create appropriate motor plan
upregulation
spasticity, clonus
fine motor impairment

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15
Q

Upper motor neuron syndrome

A

damage to internal capsule typically results in flaccid presentation to contralateral side

hypotonia = called spinal shock, due to decreased activity of spinal circuits. Resolves in a few days

Babinskis sign and clonus

more widespread distribution of impariment in body regions

mild or no atrophy develops

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16
Q

Visceral motor system

A

controls smooth muscle fibers, cardiac muscle, glands

17
Q

Visceromotor differences

A
  1. LMNs are located outside of CNS, located close to target organ
  2. Coordinated by ventral and medial parts of the forebrain and brainstem
  3. NMJs are less differentiated, tend to be highly branched
18
Q

What things only receive sympathetic innervation?

A

sweat glands
adrenal medulla
piloerector muscles of skin
arterial blood vessels

19
Q

Parasympathetic makeup

A

neurons are located in brainstem and sacral spinal cord
ganglia are located far from target organs

20
Q

Hypothalamus and visceral system

A

coordinate efferent activity
cardiac, bladder control, sexual function, respiration, vomiting

21
Q

Posterior insular cortex and visceral system

A

integrates visceral sensory with higher cognitive centers to process emotional experieneces

22
Q

Solitary nucleus and visceral system

A

Caudal: reflexive control
Rostral: gustatory relay/taste

23
Q

Bladder neural control

A

Sympathetic innervation for filling
Parasympathetic innervation for emptying
afferent sensory and brain centers
pontine micturition center

24
Q

Sympathetic innervation for filling

A

T10-L2, postganglionic
stimulation is caused by an increase in bladder pressure (b’c of urine), the bladder begins to fill without urine leakage

25
Q

Parasympathetic innervation for emptying

A

S2-S4 preganglionic
promotes bladder emptying by causing the bladder to contract and internal sphincter to relax

26
Q

Afferent sensory input and brain centers

A

mechanoreceptors convey sensory info about the state of the bladder

info is sent to the PAG, which assesses the risk (emotionally, social, bio) before initiating urination

27
Q

Pontine Micturition Center

A

activation = stronger contractions of bladder wall and inhibits external sphincter, causing urination

28
Q

Sphinchter Control

A

Internal = autonomic
External = Somatic

29
Q

To hold urine

A

sacral visceral motor outflow decreases
thoracolumbar motor outflow increases
internal sphincter contracts
detrusor relaxes
pelvic floor contracts

30
Q

To void urine

A

sacral visceral motor outflow increases
thoracolumbar motor outflow decreases
external sphincter contracts
detrusor contracts
pelvic floor relaxes