2217 – Motor system Somatic – striated muscle Autonomic – smooth muscle, cardiac muscle,...

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2217 – Motor system Somatic – striated muscle Autonomic – smooth muscle, cardiac muscle, glands Upper and lower motor neurons (final common path) Segmental (reflexes) and suprasegmental control Pyramidal vs ‘extrapyramidal’ systems

Transcript of 2217 – Motor system Somatic – striated muscle Autonomic – smooth muscle, cardiac muscle,...

  • 2217 Motor systemSomatic striated muscleAutonomic smooth muscle, cardiac muscle, glands

    Upper and lower motor neurons (final common path)Segmental (reflexes) and suprasegmental controlPyramidal vs extrapyramidal systems

  • Reflexes

  • Descending PathwaysPyramidal systemExtrapyramidal systembasal ganglia, thalamusred nucleussubthalamic nucleisubstantia nigrareticular formationvestibulo-spinal?tecto-spinal?cerebellum?

  • Pyramidal TractsPyramidal cells in the primary motorcortexA major tract in primatesMainly for fine motor controlHomunculus in primary motor cortex

  • From cortex (only about 50% from primary motor cortex)

    Passes through the posterior limb of the internal capsule in somatotopic order

    Passes through cerebral peduncles

    Sends branches off to bulbar nuclei (both ipsi and contra)

    At pyramids 85% cross midline

    50-55% end in cervical cord

    5-10% direct on motor neurons

    Damage effects not as bad as might be expected from its size

    cortico-bulbarcortico-spinal

  • Extrapyramidal pathwaysTectospinalRubrospinalReticulospinalVestibulospinal

  • Extra-pyramidal tractsTegmento-spinal(7) Rubro-spinal(8)Medial long. Fasc.(10)Tecto-spinal(9)Reticulo-spinal(6,5)Vestibulo-spinal(4)

  • The basal ganglia

  • Basal Ganglia

  • StriatumCaudatePutamenGlobus pallidusBasal ganglia = caudate nucleus and lenticular (lentiform) nucleus

    Lenticular nucleus = Globus pallidus + putamen

  • Kandel et al

  • Basal ganglia problemsInvoluntary movement at restHypokinesiaA mask like faceRigidity

    Typical of Parkinsons diseaseTreated by L-DopaExperimentally by fetal grafts (stem cell grafts ??) Globus pallidus, subthalmic nucleus lesions

  • Cerebellum

  • CEREBELLUM

  • Cerebellar Movement DisordersDysmetria - over-reaching (test by touching your nose) DISTANCEDisdiadochokinesia - disjointed movement, poor timing (touch fingers in order) TIMINGDyssynergia - disjointed force (touch examiners finger) FORCEAtaxia - poor coordination (all the above)Clonus - contraction in response to stretchParesis - weakness, partial paralysis

  • Movement deficits associated with large cerebellar lesionsDisruption of spatial accuracy and temporal coordination of movements