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Y2 LCRS Neuro Fwong HR > Motor pathways: Cortical motor function, basal ganglia and cerebellum > Flashcards

Motor pathways: Cortical motor function, basal ganglia and cerebellum Flashcards

1
Q

What is the difference in function between the higher and lower cortical areas of the brain?

A

Higher areas program and coordinate tasks, lower order areas execute tasks

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2
Q

What is the pyramidal tract composed of?

A

Corticospinal tract

Corticobulbar tract

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3
Q

What makes up the extrapyramidal tract?

A

Cerebellum

Basal ganglia

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4
Q

Where is the M1?

A

Pre-central gyrus

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5
Q

What is the function of M1?

A

Fine, discrete, precise voluntary movement

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6
Q

Describe the layers of M1

A

6 layers

Layer 5 has Betz cells = very large pyramidal cells

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7
Q

Explain the mapping of M1 and the relevance to stroke

A

Somatotopic - Penfield’s homunculus
Stroke affecting MCA –> upper limb dysfunction
Stroke affecting ACA –> lower limb dysfunction

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8
Q

Recall the pathway taken by 90% of descending motor neurons

A 
M1 
internal capsule
cerebral capsules
pyramids
decussation
lateral corticospinal tract
ventral horn
*synapse with alpha neuron*
ventral root
spinal nerve
musculature
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9
Q

Recall the pathway taken by descending motor neurons that do not decussate in the medulla

A 
M1 
internal capsule
cerebral capsules
pyramids
anterior corticospinal tract
ventral horn
*synapse with alpha neuron*
*cross side* 
ventral root
spinal nerve
AXIAL musculature
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10
Q

What is the main difference between the corticospinal and corticobulbar tracts?

A 
Corticobulbar = CRANIAL nerves
Corticospinal = spinal nerves
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11
Q

What is the function of the premotor cortex and where is it located?

A

Anterior to M1, regulates externally cued movements

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12
Q

What is the role of the supplementary motor cortex? Recall 3

A
  1. Planning of complex movements
  2. Movement sequences
  3. Speech mechanics
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13
Q

Recall the 2 association motor cortices

A
  1. Posterior parietal

2. Prefrontal

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14
Q

What is the function of each of the association motor cortices?

A
  1. PP = ensures movements are targeted accurately to objects in external space
  2. PF = selects appropriate movements for particular course of action
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15
Q

Recall 2 negative signs of an upper motor neuron lesion

A

Paresis

Plegia

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16
Q

Recall 5 positive signs of an upper motor neuron lesion

A
  1. Babinski’s sign
  2. Clonus
  3. Increased muscle tone (spasticity)
  4. Hyper-reflexia
  5. Apraxia
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17
Q

What is clonus?

A

Abonormal oscillatory muscle contraction

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18
Q

What are the most common causes of apraxia?

A

Stroke or dementia

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19
Q

Dysfunction of which lobes are most likely to result in apraxia

A

Inferior parietal or frontal

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20
Q

What is apraxia?

A

Disorder of skilled movement

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21
Q

How does the presentation of a lower motor neuron lesion differ from that of an UMN lesion?

A
  1. Decreased tone and reflex speed
  2. Muscle atrophy
  3. Fasciculations
  4. Fibrillations
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22
Q

What is a fasciculation?

A

Visible twitch due to motor unit damage

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23
Q

By what other name is motor neuron disease known?

A

Amyotrophic lateral sclerosis

24
Q

Recall 6 upper motor neuron signs of ALS

A
  1. Increased muscle tone and spasticity
  2. Hyper-reflexIia
  3. Babinski’s sign
  4. Dysarthria
  5. Dysphagia
  6. Loss of dexterity
25
Recall 5 lower motor neuron signs of ALS
1. Myopathy 2. Atrophy 3. Tongue fasciculations 4. Nasal speech 5. Dysphagia
26
Recall the 8 key component structures of the basal ganglia
1. Caudate nucleus 2. Lentiform nucleus 3. Subthalamic nucleus 4. Substantia nigra 5. Ventral pallidum 6. Claustrum 7. Nucleus accumbens 8. Nucleus basilis of Meynert
27
What is the striatum of the BG made up of?
Caudate and lentiform nuclei
28
What is the lentiform nucleus made up of?
Putamen and external globus pallidus
29
How can neurosurgeons cure tremor in Parkinson's patients?
Moddification of subthalamic nucleus
30
What is the function of the nucleus accumbens?
Underlies reward and addiction behaviours
31
What is the main function of the nucleus basilis of Meynert?
Memory
32
Where is the caudate nucleus?
Lateral wall of lateral ventricle
33
Recall 3 functions of the basal ganglia
1. Elaborating associated movements 2. Suppressing unwanted movements 3. Sequencing movements
34
Recall the progression of neuron breakdown in Huntingdon's
GABAergic neuron breakdown First caudate nucleus Second GP in LN
35
What sort of neurons are broken down in Parkinson's?
Dopaminergic
36
What is the black substance that makes up the substantia nigra?
Neuromelanin- released from dopaminergic cells
37
Where is the substantia nigra?
Midbrain
38
Recall 6 presentations of Parkinson's
1. Bradykinesia 2. Hypomimic face 3. Micrographia 4. Akinesia 5. Rigidity 6. Tremor at rest
39
At what frequency is a Parkinson's tremor?
4-7Hz
40
Describe the inheritance of Huntingdon's disease
Chromosome 4 Autosomal dominant CAG repeats - >35 = almost certain
41
What are chorea?
Rapid, jerky involuntary movements
42
Describe the progression of chorea in Huntingdons's disease
First affects hands and face and then legs and rest of body
43
Recall 5 signs of Huntingdon's
1. Chorea 2. Unsteady gait 3. Speech impairment 4. Dysphagia 5. In later stages, cognitive decline and dementia
44
Recall the 3 divisions of the cerebellum
1. Vestibulocerebellum 2. Spinocerebellum 3. Cerebrocerebellum
45
What is the main function of the vestibulocerebellum?
Gait and posture regulation
46
What are the 3 main functions of the spinocerebellum?
Speech coordination Coordination of limb movements Adjustment of muscle tone
47
WHat are the 4 main functions of the cerebrocerebellum
1. Language processing 2. Coordination of skilled movements 3. Motor learning 4. Some emotional control
48
Recall 2 symptoms of vestibular disease
Gait ataxia | Tendency to fall
49
What is the most common cause of spinocerebellar syndrome?
Chronic alcoholism
50
Recall 5 signs of cerebellar dysfunction
1. Ataxia 2. Dysmetria 3. Intention tremor 4. Dysdiadochokinesia 5. Scanning speech
51
What is ataxia?
Really drunken-looking gait
52
What is dysmetria?
Inappropriate force and distance for targeted movements
53
What is an intention tremor?
Tremor when asked to perform a motor command
54
What is dysdiachokinesia?
Inability to perform rapidly alternating movements
55
What is scanning speech and what causes it?
Staccato speech | Causes by laryngeal muscle dysfunction in cerebellar syndromes

Y2 LCRS Neuro Fwong HR (17 decks)

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