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Neurology Ch 11
Motor System
| Term | Definition |
|---|---|
| Neuraxial | Brain and Spinal Cord |
| Six Neuraxial* Levels of Motor system | 1. Spinal Cord 2. Brainstem 3. Cerebellum 4. Diencephalon 5. Basal Ganglia 6. Cerebral Cortex |
| Functional Levels of spinal cord (lower level of the Neuraxial | -Simple -Reflexes -Regulation of Higher Skilled or Patterned Movements |
| Functional Levels of the upper level of the Neuraxial | -Initiation (deciding to standup), Inhibition (stopping muscles from working) or Facilitation (When running) of Motor Functions that are within your control -Voluntary Motor Movements |
| Size of the spinal cord | 43.5 cm long (fluctuates with height of person), 1cm in diameter (Average) |
| Five Spinal Segments and nerves | -Cervical (8) -Thoracic (12) -Lumbar (5) -Sacral (5) -Coccygeal (1-3 b/c some have fused together some have not) |
| Conus Medullaris | -End of Spinal Cord at L2 -Vertebral Column Longer Than Spinal Cord. Spine itself does not travel the length of the vertebral column. |
| Cauda Equina (Horse’s Tail) | -Stretched nerve root fibers from L3 to S5 -After spinal cord nerves will continue through Vertebral Column |
| Filum Terminale | Where Stretched Spinal Cord ends and remnant is attached to Coccyx |
| Lumbosacral Cistern | -Fluid Filled Space for Spinal Puncture (where they do spinal taps and give epidurals) |
| Function of spinal nerves | Carry info from CNS TO PNS -Is part of the PNS |
| Meninges of the spinal column | Pia mater-Arachnoid mater -Duramater |
| Dentate Ligaments | -Group of Ligaments That Connect Arachnoid and Pia Mater Layers |
| Internal Structure of spinal cord | -White Matter – outer parts of the cord -Gray Matter Horns and Commissures – the internal sections -Varies in Shape With Level of Spinal Segment Dorsal Root and Ventral Root |
| Intervertebral Foramina | Holes on side of vertebrae where nerves exit |
| Make up of Spinal | Made of: -Dorsal Roots - Sensory Information -Ventral Roots- Motor Information -Dorsal and Ventral Rami fuse to make up the Spinal Nerve |
| Dorsal Root Ganglia | House cell bodies for sensory nerves |
| Plexi | -Neural nets in motor pathways that innervate multiple muscles to be excited -NOT found in T-2 and T-11 |
| Brachial Plexus | -From C5 to T1 -Plexi (Net of nereves) that innervate the shoulder and arm |
| Brachial Plexus palsy | -Usually occurs in children at birth if some kind of complication and child is pulled out of birth canal with force causing this to tear. |
| Lower Motor Neuron | -Path for Efferent Impulses (away from CNS) and start of PNS -Final common pathway to muscles -Exit spinal column to activate muscles. |
| Four Components of the Motor Unit | 1)Motor Cell body (in spinal column) 2)Efferent Fiber (exits spinal column) 3)Myoneural-Neuromuscular Junction (where nerve innervates the muscle) 4)Muscle Fibers Innervated by Axon |
| Three Major Bundles in the spinal cord | -Dorsal Column -Lateral Column -Ventral Column |
| Dorsal Column | -Ascending (sensory) fibers -located in back of spinal cord |
| Lateral Column | -Ascending (sensory) and Descending (motor) Fibers -located on the sides of the spinal cord |
| Ventral Column | -Ascending (sensory) and Descending (motor) Fibers -Located on the front of the spinal cord |
| Pyramidal system | -aka upper motor neuron -made up of Anterior cortical spinal tract and lateral cortical spinal tract - Goes straigt from cortex to spinal column |
| Extrapyramidal system | Consist of: 1)Rubrospinal tract 2)Madulary reticulospinal tract 3)vestibular spinal tract 4)Tectospinal tract 5)Pontine recticulospinal tract Goes from cortex to other stations where info is modified before going to the spinal column. |
| Pyramedial decussation | 90% Occurs at level of Medulla 10% decussate in the spinal collumn |
| Path of the Pyramidal system | -Starts at precentral gyrus of the motor cortex -Through Internal Capsule and Pes Pedunculi -Into the Pontine Nuclei -Pyramidal Decussation (medulla) 90% decussate -Spinal Cord |
| Path of the Extrapyramidal system | -Not directly from motor or premotor cortex. Come from areas like cerebellum and basil ganglia. Come from areas that have done some modification of movements. |
| Autonomic Pathways | -Pathways from thalamus to spinal cord and brainstem – regulates motor functions of the sympathetic and parasympathetic systems (breathing, vomiting, and coughing reflexes) |
| Lateral Corticospinal Tract | -Pyramedial Tract Control of Skeletal Muscle (Fingers, Toes, Forearm) -Skilled Manipulations I.e. writing, tie shoes, brushing teeth) -90% Decussate at medulla and Form Alpha Fibers in Ventral Horn |
| Alpha nerves | Important for skilled movement |
| Anterior Corticospinal Tract | -8-10% Fibers That Did Not Cross Midline (in Medulla) -Decussates at Spinal Horn Control Axial and Girdle Muscles –responsible for axial movement of head and trunk |
| Tectospinal Tract | -Extrapyramidal Tract -Response to Visual Stimulation - Goes from Superior Colliculus to Cervical Spinal Cord |
| Rubrospinal Tract | -Extrapyramidal Tract -Starts in Midbrain at the Red Nucleous -Regulation of Muscle Tone Against Gravity -Goes from Red N. To Motor Nerve Cells in Ventral Horn |
| Vestibulospinal Tract | -Reflexive Adjustment of Body and Limbs -Goes fromVestibular N. at the brainstem To Spinal Cord |
| Reticular Descending Tract | Alteration of Muscle Tone |
| Anterior Motor Neurons | – exit at the ventral horns -Alpha and Y (Gamma) Motor Nerve Cells -Lower Motor Neurons (Below 2nd Level in Neuronal Pathway) |
| Interneurons | -Association Cells Connecting Sensory and Motor Neuron Pools -Often Part of Reflexive Action -30 Times More Than Motor Neurons -Filter of Sensory and Motor Function |
| Alpha Neurons | -Major Motor Neurons -Responsible for Voluntary and Reflexive Movements of Head, Trunk and Extremities -One Fiber Can Innervate 200 Muscles FIBERS |
| Y(Gamma)-Motor Neurons | -Smaller and Fewer -Controlled by Reticular and Vestibular Systems -Automatic functions |
| Two Types of Muscle Receptors | 1)Muscle Spindle 2)Golgi Tendon Organs |
| Muscle Spindle | -Detects and Maintains Muscle Tension (how much it contracts and stretches) |
| Golgi Tendon Organs | -Monitors Degree of Muscle Tension During Contraction -Stretch to Prevent Too Much Tension |
| Stretch Reflex i.e. knee reflex | -Tap Patella causing tendon change (y motor neuron) -Muscle spindles stimulate alpha motor neuron response, and muscle contracts -Occurs at the L3 level |
| Withdrawal (Flexor) Reflex i.e. Touching Hot Stimulus | -Protective Response to pain -Flexion of leg or arm |
| Crossed (Intersegmental) Extensor Reflex | -Protective response -Involves both sides of the body -As one arm is withdrawn, the other arm is extended -Multisynaptic because it involves opposite body parts |
| Neuro-Transmitters of motor system CNS | -Epinephrine -orepinephrine -Serotonin |
| Neuro-Transmitters of motor system PNS | Acetylcholine |
| Symptom of Upper Motor Neuron Problem | -Hyper Quality of Movement (Spastic movement) |
| Symptom of Spinal or Spinal Nerve Level - Lower Motor Neuron problem | -Hypo Quality of Movement -Flaccid Paralysis- limp limbs |
| What does absent of reflexes indicate | Atrophy or Muscle Wasting |
| Complete Spinal Transection (cutting of spinal column) | -Dislocations, tumor, myelitis (inflimation of the spinal column) -Function lost below the lesion -After a period of time, reflexes may become spastic in nature |
| Brown-Sequard Syndrome- | -Lesion on ipsilateral half of body, ipsilateral sensory loss, contralateral pain and temperature sensation loss depending on where the lesion is |
| Syringomyelia | -Rare developmental condition: cyst formation within spinal cord with loss of sensation and muscle control â usually starts between ages 25-40 |
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aramos139
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