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Neuro3 Motor System
Neuro3 Motor System IV
Question | Answer |
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2 ways proprioception reaches the ICP? | 1.Spinocerebellar Tract (lower Ext via Dorsal Nuclei of Clark). 2.Fasciculus Cuneatus (Upper Ext via accessory Nucleus). |
How will the patient present with ICP damage? | 1.Sensory-Type Ataxia. 2.Normal Awareness of body position. |
What is Sensory-type Ataxia | If the cerebellum loses group 1 fiber input, they WONT be Ataxic until they are deprived of either the vestibular system or the eyes. **close eyes, ataxia sets in. |
How will the patient present with ML damage in terms of proprioception? | 1.No ataxia. 2.No Awareness of Body Position. **Cant locate their limb with their eyes closed |
How will the patient present with a complete loss of Group 1 fibers? (tertiary syhpillis) | 1.Sensory-type Ataxia. 2.No awareness of body position. **If they close their eyes, they will fall to the floor (Rhomberg's sign). |
What structure passes through the Pontocerebellar angle and Cistern? | CN VIII. **Common place to develop CN VIII schwannoma. |
How can pushing the cerebellum towards the foramen magnum kill someone? | B/c the Tonsils will attempt to herniate out of the foramen magnum which will compress the medulla and stop breathing. |
What is the function of Purkinje cells in there cerebellum? | Integrate info and project onto the Deep Nuclei. **usually inhibitory output. |
Describe the 3 main zones of the cerebellum and their respective deep nuclei that their purkinje cells project to | 1.Lateral Zone (Neocerebellum): Projects to Dentate Nuc. 2.Paramedian Zone (Gap b/w the vermis and lateral hemisphere): Projects to the Interposed Nuc. 3.Median Zone (Vermis): Projects to the Fastigeal Nuc. |
Where does the Flocculonodular zone's purkinje cell's project to? | Vestibular Nuc. **Controls & coordinates head and neck movement. |
Where does most of the info from the torso end up in the cerebellum? | Projected down the Vermis (media Zone) to the Fastigeal Nuc. |
Where does most of the info from our limbes end up in the cerebellum? | Projected down the Paramedian zone to the Interposed Nuc. |
Are the feet registered in the Ant Cerellum? | NO, posterior. |
Decribe the Input, deep nuclei, output, and type of ataxia if damaged associated with the Floccularnodular lobe (Vestibulo-cerebellum) | 1.Input: Vestibular apparatus. 2.Deep Nuc: Vest Nuc. 3.Output: MLF & Vestibulospinal tracts. 4.Ataxia: head & neck (dizziness, vertigo, nystagmus). |
Decribe the Input, deep nuclei, output, and type of ataxia if damaged associated with the Vermis portion of the Spinocerebellum | 1.Input: Spinal cord. 2.Deep Nuc: Fastigial Nuc. 3.Output: Reticular formation (RST) & Vestibular Nuc (VST). 4.Ataxia: Trunkal (cant sit unassisted). |
Decribe the Input, deep nuclei, output, and type of ataxia if damaged associated with the Paramedian portion of the spinocerebellum | 1.Input: Spinal Cord. 2.Deep Nuc: Interposed Nuc. 3.Output: Red Nuc & Thalamus/Cortex (CST). 4.Ataxia: Limb (Finger to nose, heel to shin, tandem walking). |
Is limb ataxia usually proximal or distal? | Proximal. |
Decribe the Input, deep nuclei, output, and type of ataxia if damaged associated with the Neocerebellum (Lateral Zone) | 1.Input: Cerebral Cortex (via pontocerebellar fibers). 2.Deep Nuc: Dentate Nuc. 3.Output: Thalamus & cortex. 4.Ataxia: Fine Movement (No dexterity in fingers, cant do repid alternating movements). |
What is Athentosis? Where is the stroke? | It is a slow writhing/distonic movement that results from a stroke in the BASAL GANGLIA on the contralateral hemisphere. **Either damage to Globus Pallidus or its fibers as they pass through the internal capsule of thalamus. |
How will Athentosis initially present? | Weakness, but it will improve exposing the Athentosis. |
What are the 2 clinical manifestations of cerebellar disease | 1.Ataxia. 2.Hypotonia. |
What are the 3 different Forms that ataxia can present as with Cerebellar diseae? | 1.Dysmetria (Past-pointing: cant touch finger to the nose). 2.Dyssynergia (Decomposition of movements). 3.Disdiadokokinesia (Breakdown in rapid alternating movements). |
What are Choreic Movements? Describe the progression | Random, jerky (brief and sudden) purposeless movements about a joint complex. 1.Early on: one involved joint (hand and wrist). 2.Then progresses to entire extremity. 3.Then progresses to axial part of the body. **will also see a dance-like gait. |
Describe the 2 different types of Huntington's Chorea | 1.With Choreic movements. 2.Rigid Huntingon's Chorea (degeneration of GABA/SubP cell in corpus striatum cause Inc GABA secretions from Globus Pallidus Internus): Produces Parkinson's like akinesia w/ rigidity to passive ROM. |
What is Hemiballism? What is it a result of? | Unilateral ballism involving involuntary movements of the arm and leg (usually a continuous, rotatory nature). **Results from an infarct to the basal ganglia (Subthalamic Nuc & its radiations). |
List the 5 Clinical manifestations of Basal Ganglia disorder | 1.Akinesia. 2.BradyKinesia. 3.Athetosis. 4.Chorea. 5.Hemiballism/ ballism. |
What is the root cause of Parkinsonism? | Loss of dopaminergic neurons from the Substantia Niagra. |
What are the 4 cardinal manifestations of Parkinsonism | 1.Tremor. 2.Akinesia. 3.Rigidity. 4.Postural Embarrasment |
Parkinsonism: Tremor | 1.Alternating agonistic & antagonistic movements about a joint. 2.Present at rest. 3.Improved (decreased) during purposefull movement. |
Parkinsonism: Akinesia | 1.Masked face. 2.Lack of associated movements (no arm swing w/ walking). **Difficulty initiating action leads to small shuffling gate |
Parkinsonism: 2 different types of Rigidity | 1.Lead pipe form: feels like bending a lead pipe. 2.Cog Wheel form: feels like your bending their joint over a cog wheel (rhythmic jerky motion). 2. |
Parkinsonism: Postural Embarrassment | No postural reflexes when threatenend. **Retropulsive steps when pushed backwards. |