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108 Cards in this Set
- Front
- Back
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Damage to the pupillary response (CN-) and extraocular eye movement (CN-) is due to a lower motor neuron problem in which part of the brain
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Pupillary- CN II, III
Extraocular- CN III IV VI both are LMNs of Midbrain |
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Damage to facial sensation, mastication muscles (CN?) along with facial expression/taste (CN?)
where is the LMN for these |
Face Sensation/Chewing CN V
Expression/Taste CN VII both from LMN in Pons |
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Damage to the lower motor neurons in the medulla could cause these symptoms
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Palate elevation/gag reflex problem (CN IX, X)
Articulation (CN V, VII, IX, X, XII) Tongue (CNXII) |
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Patient has difficulty articulating words ,sticking out tongue , and palate elevation is diminished.
what region is the lesion? |
Lower Motor Neuron of Medulla
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Define Positive Motor Sign
Give 3 examples |
involuntarily increased frequency of muscle activity
chorea, tics, tremor |
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Define Negative Motor Sign
3 examples |
Insufficient muscle activity or insufficient control
paralysis, ataxia, apraxia |
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What kind of neuron exerts the final control over muscle and where are they located
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Alpha Motor Neuron (also called lower motor neuron, final common pathway)
located in brainstem and spinal cord |
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Spinal Circuits are Controlled by ____ Pathways that originate in ____
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Medial and Lateral Descending pathways
Cerebral Cortex and Brainstem |
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The Lateral Descending Pathway includes these 2 tracts
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Corticospinal tract and Rubrospinal stract
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T or F
Basal Ganglia and Cerebellum plan and organize movements that are projected directly to lower motor neurons |
False.
BC and C plan/organize but cannot communicate directly because they are not executive motor areas |
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What are executive motor areas and which regions of the brain apply
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Structures that can project directly to a motor neuron
Cerebral cortex and Brainstem |
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Most Brain structures represent which side of the body? The major exception to the rule:
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Most represent Contralateral Side of Body
Cerebellum represents Ipsilateral |
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Precentral Gyrus is the ___
Postcentral Gyrus is the___ |
Precentral- Primary Motor Cortex
Postcentral- Primary Somatosensory Cortex |
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On the Motor and sensory cortex the lower limb is represented on the ____ surface while the upper limb and face are on the ___ surface
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Legs on Medial Surface
Arms/Face on Lateral surface |
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Blood supply to most of the lateral cortical surface
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Middle Cerebral Artery
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Blood supply to most of the medial cortical surface-
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Anterior Cerebral Artery
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A flexor posturing after a lesion has these clinical features
Arms ___ and legs___ explain why |
Arms Flexed, Legs Extended
Cortical or CST damage Red Nucleus is released, exciting upper limb flexors Reticulo and vestibulospinal tract released exciting leg extensors |
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An extensor posturing occurs after lesion to____
Arms ___, Legs ___ explain why |
Midbrain or Upper Pons lesion
arms and legs extended Upper brainstem damage release of reticulo and vestibulospinal that excited both upper and lower limb extensors |
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Pathological Babinski Sign is
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Extension (Dorsiflexion) when bottom of foot is scraped becase a lesion of the CST fails to suppress dorsiflexion
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Do babies with a positive Babinski sign have an Upper Motor Neuron Injury?
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No. this is normal. the descending UMN axons are not yet myelinated at birth
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Brainstem Nuclei that serve as executive motor areas (3)
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Superior Colliculus
Vestibular Nucleus Reticular Formation |
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The Lateral System commands proximal or distal?
Terminates Ipsi or Contra? Many or Few Segments? Motor Neurons or Interneurons? |
Distal
Contra Few Motor and Interneurons |
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The Medial System is made of these 4
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Anterior Corticospinal tract
Superior Colliculus Vestibular N. Reticular Formation |
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Medial System controls ___ musculature? Terminates Ipsi or Contra? Many or few Segments? Motor or Interneurons?
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Axial and Proximal Musculature
Both Ipsi and Contralateral Many Segments Terminates on Interneurons |
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Termination of Lateral Systems are in the ___ horn and ___ zone
they are always unilateral or bilateral? |
Dorsolateral Ventral Horn and Intermediate Zone
Always unilateral |
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Termination of the medial system are in the ___ horn and __ zone
they are always unilateral or bilateral? |
Ventromedial Ventral Horn and Intermediate Zone
Always bilateral |
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Medial Descending Path
Reticulospinal- travels ___ Tectospinal- Vestibulospinal- travels___ |
Reticulo- travels ipsilateral
Tecto- decussates near origin Vestibulo- travels bilaterally |
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Describe the Tectospinal fibers
arise from___ decussate___ descend____ innervate where on spinal cord |
arise from Superior Colliculus
Cross immediately in midbrain Descend ventral medial B.S. Spinal Cord Innervate medial ventral horn of both sides |
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Describe Vestibulospinal fibers
arise from innervate where on spinal cord |
arise from 2 vestibular nuclei
innervate medial ventral horn on both sides |
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Describe Reticulospinal tract
arises from descend on innervates |
arises from reticular formation in pons and medulla
descends on ventral cord innervate medial ventral horn on both sides |
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Region of the Reticular Formation and areas that give rise to reticulospinal tracts
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it runs through the core of the brainstem, caudal pons and medulla
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This is involved in postural adjustments like coarse movements of head, trunk, and proximal limbs
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Reticular Formation
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Visual influences of movements like tracking objects in space use this tract whose major influence is on neck and upper trunk
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Tectospinal tract
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Sense of balance and movement of head for posture is based in this tract
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Vestibulospinal Tract
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The Motor Cortex contributes this to the medial descending system ___
it is unilateral or bilateral? decussates with travels in |
Anterior Corticospinal tract
bilateral decussates with other corticospinal fiber travels in anterior columns |
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Anterior Corticospinal tract innervates what part of spinal cord
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Medial Ventral Horn on both sides
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This is the only brainstem nucleus to contribute to the lateral descending system
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Red Nucleus
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Slow twitch fibers are type ___ and colored ___
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Type 1, red
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Fast Twitch fibers are type ___ and colored ___
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2, white
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Slow twitch stain for
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oxidative enzymes like NADH-TR and myoglobin
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Fast twitch fibers are rich in ___ and do not stain darkly for __ and are lower in__
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rich in glycogen and not stain for oxidative enzymes and low in myoglobin
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This type of muscle is fatigable quickly and has the most force on contraction
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type 2B
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These type of fibers produce the lowest force
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Type 1 fibers
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Type 2A vs Type 2 B
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2A are fast moderatly fatigue resistant w some aerobic capacity
2B are largest diameter most anaerobic fast fatigable |
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These fibers type important for postural control or standing
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Slow fibers type 1
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Each muscle cell is innervated by how many neurons
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One
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Alpha motor neurons innervate-
Gamma Motor Neurons innervate- |
Alpha- Skeletal
Gamma- Muscle spindle intrafusal |
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Aalpha sensory fibers are for
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super fast muscle stretch receptors from muscle spindles and muscle tension information from Golgi Tendon Organs
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A Beta fibers are
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mechanoreceptors and very fast muscle stretch receptors
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A gamma sensory fibers are associted with
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fast pain
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C sensory Fibers are associated with
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second pain
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Motor Neurons are clustered in pools of cells in the ____ horn of the spinal cord
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ventral
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The intermediate zone of the spinal cord typically contains what kind of neurons
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interneurons
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Motor Neurons in the distal side of the ventral horn of spinal cord most likely innervate
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distal muscles like fingers
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Define Motor Unit
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The motor neuron and the muscle fiber it innervates
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Is atrophy common with UMN injury or LMN injury? why
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LMN injury because the muscle denervated loses trophic factors released by nerves with APs
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What is tetanus
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higher freqency of sustained contractions without stretch
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Muscle contraction force or tension is regulated by
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the frequency of LMN firing
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In the stretch reflex the afferent fiber synapses on
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a motor neuron
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The afferent leg of the stretch reflex projects to ___ and excites___
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projects to spinal cord, somatosensory cortex and cerebellum, excited alpha motor neurons
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Muscle spindles contain a set of muscle fibers called ____ that are innervated by special sensory endings and gamma motor neurons
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intrafusal muscle fibers
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Sensory fibers of the intrafusal muscle fiber are type___ and what is that important
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Type A alpha because they have the most myelin and travel really fast to CNS
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Type A beta axons vs Type A Alpha axons
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type A Beta- fire at very sensitive stretch at onset of load
Type A alpha fire only when heavier load but they are faster and respond best during the stretch |
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Intrafusal fibers have their own motor innervation by
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gamma motoneurons
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2 types of intrafusal muscle fibers name them and tell their sensory endings
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Nuclear bag- with primary wrapped around (AAlpha)
Nuclear chain with secondary tail Alpha Beta |
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Level of spinal cord tested by reflexes
Biceps Brachiodorsalis Triceps Patellar Achilles |
C5,6
C6 C7 L4 S1 |
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When a cortical UMN lesion occurs the reflex is___ and this is due to influence of intact
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hyperreflexive
loss of inhibition from UMN and the intact reticulo and vestibulospinal path |
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Define Clonus
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Rhythmic sustaind muscular contraction brought about by stretching
series of agaonist and atagonist contraction |
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Clomus usually indicates an UMN or LMN lesion?
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UMN
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Golgi tendon organs are located in
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dense regular connective tissue where muscle connects to tendon
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GTO measures ___
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muscle contraction by measuring how hard muscle is pulling tendon
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Describe circuitry of inverse stretch reflex
originates- has what kind of synpase prevents excites |
originates in GTO
has disynaptic inhibition of homonymous muscle prevents tension overload excites antagonist muscle |
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Information from the GTO ascends or descends? Where
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Ascends in dorsal columns and spinocerebellar tracts
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GTO is innervated by
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Alpha beta sensory axons
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GTO can inhibit __ to control tension
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alpha motor neuron
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What do renshaw cells do? They use ___ as a neurotransmitter
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Inhibit motoneurons to dampen firing
GABA |
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The felxion reflex is activated by painful stimuli from ___ fibers
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C and A delta fibers
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Circuitry of flexion reflex includes
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crossed innervation of flexors and extensors
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Is ataxia contralateral or ipsilateral to a cerebellar lesion
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ipsilateral
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Compare clinical signs of midline and lateral lesions in the cerebellum
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Midline- unsteady gait, eye movement abnormalities, intense vertigo
Lateral- ataxia of the limbs |
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Among Superior Middle and Inferior which carry outputs and which carry inputs
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Superior- outputs
Middle - inputs from pons Inferior- inputs form spinal cord and brainstem |
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Name the function of these regions in cerebellum
Lateral Hemisphere- Intermediate Hemisphere Vermis and flocculonodular lobe |
Lateral- motor planning for extremities
Intermediate- distal limb coordination Vermis/Floccu- balance and reflexes |
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Does the cerebellum project directly to LMNs?
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No it goes through the thalamus first
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Name deep cerebellar nuclei from lateral to medial
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Dentate, Emboliform, Globose, Fastigal
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All of the output of the cerebellar cortex is through- Molecular layer, Purkinje Cell Layer, or Granule Cell layer?
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Purkinje Cell layer
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Spinocerebellar tracts travel along the median or periphery of the spinal cord?
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periphery
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Name cerebellar outputs of Dentate nucleus
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parvocellular red
VL thalamus |
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Cerebellar outputs of interposed nuclei
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reticular formation
VL thalamus red nucleus |
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Cerebellar outputs of fastigial nuclei
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reticular formation
vestibular hypothalamus |
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In the cerebellum name the function and nuclei for the lateral hemisphere
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Motor planning and Dentate
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For the cerebellum name the function and nuclei for the paravermis
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Distal limb coordination and Interposed N
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For the Vermis of the cerbellum name the function and Nuclei
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Proximal limb and trunk coordination, Fastigial N
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For the FN lobe and inferior vermis of cerbellum name the function and nuclei
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equilibrium balanca, VOR, uses the Fatigial and Vestibular N.
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Which artery do you hit to cause lateral medullary syndrome?
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PICA
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Which artery do you hit to cause lateral pontine syndrome?
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AICA
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Wide, unsteady gait, difficulty with tandem gait, inability to stand with feet together most likely involves the cerebellum in a lesion of the Vermis and Anterior Lobe or the Paravermis and Lateral hemisphere?
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Vermis and Anterior Lobe
these are medial motor systems |
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Ataxia in the limbs, loss of check, and an intention tremor most likely hit the vermis and anterior lobes or the paravermis and lateral hemisphere?
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Paravermis and Lateral Hemisphere
these are lateral motor systems |
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Lateral medullary stroke can involve the inferior cerebellar peduncle. What are the clinical signs?
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Ipsilateral ataxia
nystagmus due to involvement of the vestibular nuclei |
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Is a Romberg sign an indication of cerebellar dysfunction or a loss of proprioception?
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Loss of proprioception
NOT a cerebellar sign |
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Does the vestibular nucleus project to the contra or ipsilateral abducens nucleus?
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Contralateral
|
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List the HEAL functions of the hypothalamus
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Homeostasis
Endocrine Function Autonomic Limbic |
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Describe origins of anterior and posterior pituitary
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Anterior- from ectodermal epithelium at roof of mouth
Posterior- from the diencephalon |
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2 exceptions to the hypothalamus receiprocal rule
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Pituitary
Retina |
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Warm sensitive nuclei are located where
and activate what response |
Preoptic and Anterior nuclei of the hypothalamus
parasympathetic to cool body |
|
Cold sensitive neurons are located where and evoke what response
|
Posterior hypothalamus
sympathetic to warm body/ conserve heat |
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Lateral or Medial Hypothalamus
Name the region that increases appetite and the one that suppresses appetite |
Lateral- increases appetite
Medial-suppresses appetite |
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Only peptide on the list that increases feeding behavior
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Ghrelin
|
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Preoptic and Ventromedial hypothalamus
which is involved in male and which in female sexual behavior |
Preoptic-Male
Ventromedial-Female |
