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Motor control Flashcards

1
Q

In terms of motor control, what is meant by hierarchical organisation?

A

High order areas of hierarchy are involved in more complex tasks (programme and decide movements, coordinate muscle activity), lower level areas perform lower level tasks (execution of movement)

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2
Q

In terms of motor control, what is meant by functional segregation?

A

Motor system organised in as number of different areas that control different aspects of movement

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3
Q

In terms of motor control, what is meant by the motor system hierarchy?

A

Different parts of the brain interact with each other in order to bring out voluntary or involuntary movement

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4
Q

What are the three broad principles of motor control?

A

Hierarchical organisation, functional segregation and motor system hierarchy

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5
Q

What are the two types of major descending tracts associated with motor control?

A

Pyramidal tracts and extrapyramidal tracts

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6
Q

What are the two major descending pyramidal tracts?

A

The corticospinal (movement from the neck down) and corticobulbar tracts (movement of the head and neck)

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7
Q

Why are pyramidal tracts called pyramidal tracts?

A

Pass through the pyramids of the medulla, whereas the extrapyramidal tracts do not

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8
Q

Outline the path of the major descending pyramidal tracts

A

Motor cortex to spinal cord or cranial nerve nuclei in brainstem

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9
Q

What is the function of the major descending pyramidal tracts?

A

Voluntary movements of the body and face

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10
Q

What are the 4 major descending extrapyramidal tracts?

A

Vestibulospinal, tectospinal, reticulospinal, rubrospinal

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11
Q

Outline the path of the major descending extrapyramidal tracts

A

Brainstem nuclei to spinal cord

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12
Q

what is the function of the major descending extrapyramidal tracts?

A

Involuntary movements for balance, posture and locomotion

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13
Q

What is the function of the premotor area?

A

Involved in the planning of movements, regulates externally cued movements

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14
Q

The premotor area is located where?

A

Anterior to primary motor cortex

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15
Q

What is the function of the supplementary motor area?

A

Planning complex movements, becomes active prior to voluntary movement

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16
Q

Where is the supplementary motor area located?

A

Anterior and medial to the primary motor cortex

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17
Q

Outline the pathway of the corticobulbar tract

A

Upper motor neurones in the primary motor cortex synapse with brainstem nuclei to provide voluntary movement of the face and neck

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18
Q

Outline the pathway of the corticospinal tract

A

Upper motor neurones in the primary motor cortex descend and converge to form the corona radiata. The fibres then pass through the midbrain, the pons, into the medulla. The majority of fibres dessucate in the medulla forming the lateral tract, both tracts run along the spinal cord synapsing with lower motor neurones.

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19
Q

What is the function of the Vestibulospinal tract?

A

Stabilise head during body movements, coordinate head movements with eye movements. Mediate postural adjustments.

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20
Q

What is the function of the reticulospinal tract?

A

Changes in muscle tones associated with voluntary movement. Postural stability

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21
Q

What is the function of the tectospinal tract?

A

Orientation of the head and neck during eye movements

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22
Q

What is the function of the rubrospinal tract?

A

Mainly taken over by corticospinal tract, innervates lower motor neurones of flexors of the upper limb

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23
Q

What path does the reticulospinal tract take?

A

From medulla to pons

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24
Q

Where does the tectospinal tract originate?

A

From superior colloculus of midbrain

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25
Where does the rubrospinal tract originate?
From red nucleus of midbrain
26
Outline the negative signs associated with a upper motor neurone lesion
Loss of voluntary motor function. Paresis (graded weakness of movements). Plegia of voluntary muscle activity
27
Outline the positive signs associated with an upper motor neurone lesion
Increased abnormal motor function due to loss of inhibitory descending inputs. Spasticity. Hyper-reflexia. Clonus. Babinskis sign.
28
What is spasticity?
Where a muscle is over-active
29
What is hyper-reflexia?
Exaggerated reflexes
30
What is clonus?
Abnormal oscillatory muscle contraction
31
What is babinskis sign?
Abnormal Dorsi flexion of toes with plantar stimulation
32
What is apraxia?
Disorder of skilled movement. Patients are not paretic but have lost information about how to perform skilled movements
33
Why does a lower motor neurone lesion result in hypotonia and not spasticity?
No signal from brain for contraction
34
What are the causes of apraxia?
Lesion of inferior parietal lobe, the frontal lobe. Stroke and dementia are the most common causes
35
What are the signs of a lower motor neurone lesion?
Weakness, hypotonia, hyporeflexia, muscle atrophy, fasciculations, fibrillations
36
What is hypotonia?
Reduced muscle tone
37
What is hyporeflexia?
Reduced reflexes
38
What are fasciculations?
Damaged motor units produces spontaneous action potentials resulting in a visible twitch
39
What are fibrillations?
Spontaneous twitching of individual muscle fibres, recorded during needle electromyography examination
40
What is motor neurone disease?
Progressive neurodegenerative disorders of the motor system.
41
What are the signs associated with upper motor neurone disease?
Spasticity, brisk limbs and jaw reflexes, babinskis sign, loss of dexterity, dysarthria, dysphagia,
42
What is dysarthria?
Difficulty speaking
43
What is dysphagia?
Difficulty swallowing
44
What are the signs associated with lower motor neurone disease?
Weakness. Muscle wasting. Tongue fasciculations and wasting. Nasal speech. Dysphagia
45
What is the function of the basal ganglia?
Makes decision to move, elaborating associated movements, moderating and coordinating movements, performing movements in order
46
What are the major structures located in the basal ganglia? (CPGTAccAmAc)
Caudate nucleus, putamen, globus pallidus, thalamus, nucleus accumbens, Amyglada, anterior commisure
47
What is Parkinson’s disease?
Degeneration of the dopaminergic neurones that originate in the substantia nigra and project to the striatum
48
What are the symptoms associated with Parkinson’s disease?
Bradykinesia, tremor at rest, rigidity, hypomimic face, akinesia
49
What is bradykinesia?
Slowness of small movements
50
How does a tremor develop in Parkinson’s?
Starts as a ‘pill-rolling tremor’ in one hand then spreads to other parts of the body
51
In Parkinson’s, what is meant by rigidity as a symptom?
Muscle tone increase causing resistance to externally imposed joint movements
52
What is a hypomimic face?
Expressionless, mask-like face
53
What is akinesia?
Difficulty in the initiation of movements because cannot initiate movements internally
54
What is huntingtons disease?
Degeneration of GABAergic neurons in the striatum, caudate and putamen.
55
What signs and symptoms are associated with Huntingtons disease?
Choreic movements, speech impairment, dysphagia, unsteady gait, cognitive decline and dementia
56
What is the cause of Huntington’s disease?
Is a genetic neurodegenerative disorder caused by autosomal dominant CAG repeats of chromosome 4
57
What is Ballism?
Sudden uncontrolled flinging of the extremities
58
What usually causes Ballism?
A stroke affecting the subthalmic nucleus, symptoms occur contralaterally
59
Where is the cerebellum located?
Posterior cranial fossa, separated from the cerebrum by tentorium cerebelli
60
What is the function of the cerebellum?
Coordination and prediction of movement
61
What are the three functional regions of the cerebellum?
Vestibulocerebelum, spinocerebelum, cerebrocerebelum
62
what is the function of the vestibulocerebellum?
regulation of gait, posture, and equilibrium. coordination of head and eye movements.
63
what occurs as a result of damage to the vestibulocerebellum?
gait ataxia, and tendency to fall
64
what is the function of the spinocerebellum?
coordination of speech, adjustment of muscle tone, coordination of limb movements.
65
what occurs as a result of damage to the spinocerebellum?
affects mainly the legs, causes abnormal gait and stance (wide-based)
66
what would be the most likely cause of damage to the vestibulocerebellum?
tumour
67
what would be the most likely cause of damage to the spinocerebellum?
degeneration and atrophy associated with chronic alcoholism
68
what is the function of the cerebrocerebellum?
coordination of skilled movements, cognitive function, atention, processing of language. emotional control
69
what occurs as a result of damage to the cerebrocerebellum?
affects mainly arms and skilled coordinated movements causing tremor and abnormal speech
70
when are the main signs of cerebellar dysfunction most present?
apparent only on movement
71
What are the five cardinal signs of cerebellar dysfunction? (ADIDyS)
ataxia, dysmentria, intention tremor, dysdiadochokinesia, scanning speech Dysmetria is the inability to control the distance, speed, and range of motion necessary to perform smoothly coordinated movements.
72
what is ataxia?
general impairments in movement coordination and accuracy. disturbances of posture or gait
73
what is dysmetria?
innapropriate force and distance for target-directed movements
74
what is intention tremor?
increasing oscillatory trajectory of a limb in a target-directed movement
75
what is dysdiadochokinesia?
inability to perform rapidly alternating movements
76
what is meant by 'scanning speech'?
speaking in short, choppy sentences due to impaired coordination of speech muscles
77
What are alpha motor neurones?
the lower motor neurons of the brainstem and spinal cord
78
what do alpha motor neurones innervate?
the extrafusal muscle fibres of the skeletal muscles
79
what results as alpha motor neurons are activated?
muscle contraction
80
what is a motor unit?
a single motor neuron along with all the muscle fibres it innervates
81
what is the name of the smallest motor unit able to produce force?
a motor unit
82
what happens when a motor unit is stimulated?
contraction of all muscle fibres in that unit
83
what are the three types of motor unit?
Slow (S, type 1), fast fatigue resistant (FR, type 2a), fast fatiguable (FF, type 2B)
84
what is the difference between slow and fast type motor units?
slow = smallest diameter cell bodies, small dendritic trees, thinner axons, slowest conduction velocity
85
which type of motor unit produces the most force in response to a single motor neuron action potential?
type 2b (fast fatiguable)
86
what are the two mechanisms by which the brain regulates the force that a single muscle can produce?
recruitment and rate coding
87
In terms of motor control, what is recruitment?
smaller units are recruited first, as more force is required, more units are recruited, this allows for fine control
88
which of the two regulatory mechanisms for muscle force allows for fine control?
recruitment
89
in terms of motor control, what is rate coding?
a motor unit can fire at a range of frequencies, as the firing rate increases, the force produced by the unit increases
90
when does summation occur?
when units fire at frequency too fast to allow the muscle to relax between arriving action potentials
91
what are neurotrophic factors?
growth factor that prevents neuronal death and promotes growth of neurons after injury
92
What muscle fibre switch could you expect to see following training?
type 2B to 2A
93
what muscle fibre switch would you expect to see following severe deconditioning or spinal cord injury?
type 1 to type 2
94
what switch in muscle fibres occurs with aging?
preferential loss of type 2 fibres, larger proportion of type 1 fibres in aged muscle
95
Define reflex
automatic, stereotyped response to a peripheral stimulus resulting in involuntary coordinated pattern of muscle contraction and relaxation without reaching the level of consciousness
96
what is the Jendrassik manoeuvre?
pulling against locked fingers when having a patellar tendon tapped makes the reflex larger
97
explain the role of the CNS in reflex movement
higher centers of CNS exert inhibitory and excitatory regulation upon the stretch reflex. inhibitory control dominates in normal conditions, decerebration reveals the excitatory control from supraspinal areas
98
what are the five pathways that make up the descending control of reflexes?
activating alpha motor neurons, activating inhibitory interneurons, activating propiospinal neurons, activating gamma motor neurones, activating terminals of afferent fibres
99
What is hyper-reflexia?
overeactive reflexes with loss of descending inhibition, associated with upper motor neurone lesions

Y2 NEUROLOGY (10 decks)

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