Podcast
Questions and Answers
A lesion in the motor-hand area would primarily cause what deficit?
A lesion in the motor-hand area would primarily cause what deficit?
- Weakness of the hand on the same side of the lesion.
- Weakness of the leg on the same side of the lesion.
- Weakness of the leg on the opposite side of the lesion.
- Weakness of the hand on the opposite side of the lesion. (correct)
Which artery primarily supplies the motor-hand area?
Which artery primarily supplies the motor-hand area?
- Anterior communicating artery
- Middle cerebral artery (correct)
- Posterior cerebral artery
- Anterior vertebral artery
Where is the area for the legs and feet located in the precentral gyrus (PCG)?
Where is the area for the legs and feet located in the precentral gyrus (PCG)?
- Anterior to the motor-hand area.
- Near the motor-hand area, towards the vertex. (correct)
- In between the motor-hand area and the trunk area.
- Posterior to the motor-hand area.
Which of the following describes the location of the superior frontal gyrus?
Which of the following describes the location of the superior frontal gyrus?
The superior frontal sulcus forms what, in conjunction with the precentral sulcus, when trying to locate the motor-hand area?
The superior frontal sulcus forms what, in conjunction with the precentral sulcus, when trying to locate the motor-hand area?
What is the visible appearance of cerebrospinal fluid (CSF) in a T1-weighted MRI scan?
What is the visible appearance of cerebrospinal fluid (CSF) in a T1-weighted MRI scan?
Which area of the precentral gyrus is primarily responsible for controlling movements of the mouth and tongue?
Which area of the precentral gyrus is primarily responsible for controlling movements of the mouth and tongue?
Which motor fibers are the most direct to internal capsule without any obstacle course?
Which motor fibers are the most direct to internal capsule without any obstacle course?
What is the centrum semiovale mainly formed by?
What is the centrum semiovale mainly formed by?
Which of the following best describes the spatial arrangement of the motor fibers?
Which of the following best describes the spatial arrangement of the motor fibers?
Where do the face and tongue motor fibers primarily target?
Where do the face and tongue motor fibers primarily target?
What anatomical structure must face and tongue motor fibers arch to reach the internal capsule?
What anatomical structure must face and tongue motor fibers arch to reach the internal capsule?
What becomes black in a T1 weighted MRI scan?
What becomes black in a T1 weighted MRI scan?
What consequence may occur if blood pressure gets high in the area described?
What consequence may occur if blood pressure gets high in the area described?
Which area is allocated for the arms and legs according to the description?
Which area is allocated for the arms and legs according to the description?
What types of tracts are described for the arms and head?
What types of tracts are described for the arms and head?
What is noted about the distribution of motor functions among individuals?
What is noted about the distribution of motor functions among individuals?
What is the significance of the fibers twisting in the internal capsule?
What is the significance of the fibers twisting in the internal capsule?
What happens to the muscle controlled by a destroyed lower motor neuron?
What happens to the muscle controlled by a destroyed lower motor neuron?
Where is the oculomotor nucleus complex located?
Where is the oculomotor nucleus complex located?
What is a plausible cause of the electric fan propeller not spinning if no external damages are visible?
What is a plausible cause of the electric fan propeller not spinning if no external damages are visible?
Which cranial nerve nucleus is responsible for motor control of the tongue?
Which cranial nerve nucleus is responsible for motor control of the tongue?
What anatomical structure denotes the diamond shape at the level of the pons?
What anatomical structure denotes the diamond shape at the level of the pons?
Which anatomical structure is responsible for both pain perception and balance?
Which anatomical structure is responsible for both pain perception and balance?
What is the primary function of the diencephalon in relation to the nervous system?
What is the primary function of the diencephalon in relation to the nervous system?
Lesions interrupting long tracts will have different effects depending on their location. Which location will likely affect visual perception?
Lesions interrupting long tracts will have different effects depending on their location. Which location will likely affect visual perception?
Which statement regarding decussation is correct?
Which statement regarding decussation is correct?
Which region is responsible for autonomic functions such as swallowing and phonation?
Which region is responsible for autonomic functions such as swallowing and phonation?
What is the consequence of a lesion occurring before the decussation of long tracts?
What is the consequence of a lesion occurring before the decussation of long tracts?
Which of the following observations is essential in assessing an unconscious patient?
Which of the following observations is essential in assessing an unconscious patient?
In the context of neurological lesions, what does Occam's razor suggest about diagnosis?
In the context of neurological lesions, what does Occam's razor suggest about diagnosis?
What is the primary function of the corticospinal tract?
What is the primary function of the corticospinal tract?
Where does the majority of the corticospinal tract fibers decussate?
Where does the majority of the corticospinal tract fibers decussate?
What percentage of corticospinal fibers descend uncrossed?
What percentage of corticospinal fibers descend uncrossed?
In which portion of the body are the arm fibers located relative to the leg fibers in the corticospinal tract?
In which portion of the body are the arm fibers located relative to the leg fibers in the corticospinal tract?
Which structure is part of the lower motor neuron pathway impacted by the corticospinal tract?
Which structure is part of the lower motor neuron pathway impacted by the corticospinal tract?
What type of movements does the lateral corticospinal tract primarily control?
What type of movements does the lateral corticospinal tract primarily control?
Why is it important for the corticospinal tract to have a degree of redundancy?
Why is it important for the corticospinal tract to have a degree of redundancy?
What should be assessed when evaluating problems in muscle function?
What should be assessed when evaluating problems in muscle function?
Which part of the corticospinal fibers descends as the anterior corticospinal tract?
Which part of the corticospinal fibers descends as the anterior corticospinal tract?
Which type of muscle activity is least likely to be paralyzed due to corticospinal tract control?
Which type of muscle activity is least likely to be paralyzed due to corticospinal tract control?
Flashcards
Superior Frontal Gyrus
Superior Frontal Gyrus
Located in the frontal lobe, in front of the precentral sulcus, this gyrus is responsible for higher-order cognitive functions like planning, working memory, and decision-making.
Superior Frontal Sulcus
Superior Frontal Sulcus
A deep groove that separates the superior frontal gyrus from the middle frontal gyrus. This sulcus helps divide the frontal lobe into different functional areas.
Motor-Hand Area
Motor-Hand Area
This area of the brain is responsible for controlling voluntary movements of the hand. Damage to this region can result in weakness or paralysis of the hand on the opposite side of the body.
Precentral Sulcus
Precentral Sulcus
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Lesions in the Motor-Hand Area
Lesions in the Motor-Hand Area
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Precentral Gyrus (Mouth and Tongue Motor Control Area)
Precentral Gyrus (Mouth and Tongue Motor Control Area)
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Internal Capsule
Internal Capsule
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Centrum Semiovale
Centrum Semiovale
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Corona Radiata
Corona Radiata
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Motor Homunculus
Motor Homunculus
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Face and Tongue Motor Fibers
Face and Tongue Motor Fibers
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Hand Motor Fibers
Hand Motor Fibers
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Corticobulbar Tract
Corticobulbar Tract
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Motor Cortex
Motor Cortex
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Corticospinal Tract
Corticospinal Tract
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Motor Cortex Vulnerability
Motor Cortex Vulnerability
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Lower Motor Neuron Lesions: Flaccid Paralysis
Lower Motor Neuron Lesions: Flaccid Paralysis
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Lower Motor Neurons (LMNs): The Final Common Pathway
Lower Motor Neurons (LMNs): The Final Common Pathway
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Broken Electric Fan Analogy for Lower Motor Neuron Lesions
Broken Electric Fan Analogy for Lower Motor Neuron Lesions
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Lower Motor Neuron Lesions: Muscle Atrophy
Lower Motor Neuron Lesions: Muscle Atrophy
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Lower Motor Neuron Lesions: Decreased Reflexes
Lower Motor Neuron Lesions: Decreased Reflexes
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What does the corticospinal tract do?
What does the corticospinal tract do?
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How are the fibers of the corticospinal tract organized?
How are the fibers of the corticospinal tract organized?
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What happens to the corticospinal tract at the cervicomedullary junction?
What happens to the corticospinal tract at the cervicomedullary junction?
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What are some of the muscles controlled by the corticospinal tract?
What are some of the muscles controlled by the corticospinal tract?
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What is the lateral corticospinal tract?
What is the lateral corticospinal tract?
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What is the anterior corticospinal tract?
What is the anterior corticospinal tract?
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What is the significance of the anterior corticospinal tract?
What is the significance of the anterior corticospinal tract?
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What type of neuron pathway is the corticospinal tract?
What type of neuron pathway is the corticospinal tract?
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What can happen if the corticospinal tract is damaged?
What can happen if the corticospinal tract is damaged?
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What is a key consideration when evaluating a patient with a movement disorder?
What is a key consideration when evaluating a patient with a movement disorder?
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Decussation
Decussation
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Exclusively Intracranial Lesion
Exclusively Intracranial Lesion
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Occam's Razor
Occam's Razor
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Localization Approach to the Unconscious
Localization Approach to the Unconscious
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Lesion Interrupting Long Tracts
Lesion Interrupting Long Tracts
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Proprioception
Proprioception
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Triangulating Neurological Lesions
Triangulating Neurological Lesions
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Study Notes
Overview of Motor Cortex Anatomy
- The corticospinal and corticobulbar tracts originate in the sensorimotor cortex, located on the banks of the central sulcus.
- 55% of the fibers originate in the frontal lobe, and 35% from the parietal lobe.
- The precentral gyrus (PCG) has a 1:1 representation of body muscles.
- Fine motor movements involve more neurons than gross movements.
- More important movements have more neurons assigned.
- The PCG is part of the frontal lobe, responsible for voluntary muscle activation and connected to the corticospinal tract.
- It runs transversely from the brain's apex towards the Sylvian fissure.
- The central sulcus is a helpful landmark for identifying the PCG.
- The motor-hand area is often seen as a "knob" or bump within the PCG (an inverted omega).
- The shape of the PCG can vary between individuals (inverted omega or epsilon shaped).
Corticospinal and Corticobulbar Tracts
- Corticospinal tracts contain upper motor neuron axons controlling arm and leg muscles. They end in the spinal cord.
- Corticobulbar fibers originate in the sensorimotor complex (face, eye, mouth, tongue areas) and end on brainstem motor nuclei.
- Corticobulbar fibers control muscles in the head and neck.
- Approximately 50% of corticobulbar fibers decussate, synapsing on the opposite side lower motor neurons in the brainstem.
- The remaining 50% stay ipsilateral.
- Corticospinal fibers decussate (cross) at the cervicomedullary junction to form the lateral corticospinal tract (controlling limbs).
- 10% of corticospinal fibers descend uncrossed as the anterior corticospinal tract (controls axial muscles).
Lower Motor Neurons
- Lower motor neurons are organized, with specific nuclei controlling specific muscles.
- Brainstem nuclei include the oculomotor (eye), trochlear (superior oblique), abducens (lateral rectus), hypoglossal (tongue), and ambiguus (swallowing) nuclei.
- Different spinal cord areas control different movement types: medial columns for posture and axial muscles; lateral columns for finer movements in the limbs.
- Damage to lower motor neurons results in flaccid paralysis.
Lesions and Clinical Correlations
- Damage to specific areas can cause weakness in corresponding body parts.
- Upper motor neuron lesions result in contralateral weakness or paralysis.
- Lower motor neuron lesions result in ipsilateral weakness.
- Strokes in different artery regions affect different body parts.
- Anterior cerebral artery stroke affects legs, middle cerebral artery stroke affects face and hands.
- Stroke localization is crucial for determining the cause of weakness or paralysis.
- Assessment of reflexes (hyporeflexia, hyporeflexia, or areflexia) is important in diagnosing upper/lower motor neuron issues.
Tracts and Pathways
- Corticospinal and corticobulbar axons follow specific pathways (centrum semiovale, corona radiata, internal capsule, cerebral peduncles) to reach their target muscles.
- These pathways' arrangement maintains a spatial representation of the body (homunculus).
- Lateral ventricles, caudate nucleus, putamen, and globus pallidus are important structures for corticospinal tract fibers.
- Leg fibers are furthest back in the internal capsule; hand fibers are middle; and face and tongue fibers are closest to the genu and more medial.
- There are "back-up" fibers in these tracts, which may help recovery from some types of damage.
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