Control of Postural Movement PDF

Summary

This document provides an overview of postural control, including definitions, types of posture, and different postural tasks. It details the physiology and motor systems involved in postural control, along with pathways and reflexes. The document is from NEAR EAST UNIVERSITY and intended for postgraduate studies.

Full Transcript

12/29/20 Definitions Control of postural movement 3 Assist. Prof. Dr. Cenk Serhan ÖZVEREL [email protected] Types of Posture • Postural control: Controlling bodies position in space for dual purposes of stability and orientation. • Posture: Biochemical alignment of body and orientatio...

12/29/20 Definitions Control of postural movement 3 Assist. Prof. Dr. Cenk Serhan ÖZVEREL [email protected] Types of Posture • Postural control: Controlling bodies position in space for dual purposes of stability and orientation. • Posture: Biochemical alignment of body and orientation of body to the environment. • Postural stability: Ability to control centre of mass in relationshi to the base of support. Framework of postural control • Static posture: • Body and body segments are aligned and maintained in certain positions. • Dynamic Posture: • Refers to postures in which body or body segments are moving 1 12/29/20 Types of postural TASKS Feedforward vs feedback postural control • Steady State Balance: Stability underlying sitting or standing quietly à Static balance • Reactive balance control: Movement strategies in response to brief displacements of supporting surfaces. • Proactive (anticipatory) balance control: A preprogrammed force based on anticipation of what the task requires based on previous experiences by the CNS. Physiology behind postural control: Motor Systems in postural control: • Depends on: • Motor system à Generation of coordination of appropriate muscles. à control bodys position and movement in space. • Motor / Somatosensory • Visual System • Vestibular system • Motor systems include: • High level planning àFrontal and motor cortex • Coordination à Brainstem, cerebellum and basal ganglia • Generation of forces à Motor neurons and muscles 2 12/29/20 Cortical Areas involved in Motor control Descending Pathways from the motor cortex • Corticospinal pathway / Pyramidal Tract • Corticobulbar Pathway • Extrapyramidal Pathway • Cerebellum • Basal Ganglia Corticospinal Tract Corticobulbar pathway • They are descending tracts of voluntary motor activities of body. • Also known as Corticonuclear tract • Also known as pyramidal tracts of spinal cord. • 2 neuron • White matter motor pathway • There are 2 corticospinal tracts: • 1-Anterior corticospinal tract • 2-Lateral corticospinal tract • Connects motor cortex in cerebral cortex to medullary pyramids 3 12/29/20 • Functions: • Muscle of face • Head • Neck • Innervates cranial nerve 5,7,11 and 12 • Also innervates the motor part of cranial nerve 10. Role of Extrapyramidal Pathway • Adjust body posture • Provides stable background for movement • Concerned with grosser movements and posture 4 12/29/20 Role of Cerebellum Role of Basal Ganglia • Regulates postural reflexes by Modifying muscle tone. • They are scattered masses of gray matter submerged in subcortical substance of cerebral hemisphere. • It facilitates the gamma motor neur ons in the spi nal cord via cerebell ovestibulo-s pinal ne urons in th e spinal cord and cerebellreticulp-spinal tracts. • Gamma motor neurons reflexly modify the activity of alpha motor neurons thus regulate the muscle tone. • Has 3 components: • 1-Corpıs striatum • 2- Substantia nigra • 3-Subthalamic nucleus of luys • Thus, cerebellum forms important li nkage of alpha-gamma systems responsible for muscle tone. Control of posture by BASAL GANGLIA Role of Brainstem • Controls the muscle tone • Red nucleus of brainstem ***** • In fact, gamma motor neurons are responsible for development of muscle tone. • Important in maintaining posture • Reflex muscular activities, particularly visual and labyrinthine reflexes are important in maintaining posture. • Basal gangliaà Coordination and integration of impulses for these reflex activities. • Red nucleus is a large oval or round mass of gray matter, extending between superior colliculus and hypothalamus. • Pathways: • The Ventromedial Pathway • The Lateral Reticulospinal Tract • The Rubrospinal Tract 5 12/29/20 1- Ventromedial Pathway • Vestibulospinal Tract: • Info from vestibular nucleus for reflex control of equilibrium. • Tectospinal Tract: • Originates in tectum for control of head and eye movements • Medial Reticulospinal Tract: • Originates in reticular formation for maintaining posture by activation of extensors. 2- Lateral Reticulospinal Pathway 3- The Rubrospinal Pathway • Originates in reticular formation for maintaining posture by activation of flexors. • The rubrospinal tract begins in the magnocellular red nucleus. • Terminates in the cervical segments of the spinal cord • So, it only innervates upper limbs. • à Arm swinging while walking 6 12/29/20 Role of Visual Pathway • The visual proprioceptive system has neurons that are specialized in responding movement of the retinal image across retina. Role of Vestibular Apparatus: • Labyrinth (Inner ear) • Vestibular apparatus is a part of labyrinth or inner ear. • Consist of 2 structures • Important role in maintaining posture and equilibrium through statokinetic reflexes. • 1- Bony labyrinth • 2-Membranous labyrinth 7 12/29/20 • Semicircular Canals: • Tubular structures at right angles to each other. • 1-Anterior or Superior Canal • 2-Posterior Canal • 3-Lateral or horizontal or external canal • Mechanism of semi-circular canals: • Superior Semicircular Canal: • Gives response to rotation anteroposterior plane (transverse axis), EX:front to back movements of head while saying ’YES-YES’ • Horizontal Semicircular Canal: • Gives response to rotation in horizontal plane (Vertical axis): EX: Side to Side movements of head while saying ‘No- NO’ Posture • Posterior Semicircular Canal • Gives response to rotation in vertical plane (anteroposterior axis) by which head is rotated from shoulder to shoulder. • Maintained by 2 main factors • 1-Muscle tone • 2-Postural reflexes 8 12/29/20 Muscle Tone • State of continuous and passive contraction of muscle with certain vigor and tension. • It is also called tonus. • It is also defined as resistance offered by muscle to stretch Postural Reflexes: • Help to maintain the body in upright and balanced position • Efferent pathways à alpha-motor neurons supplying skeletal muscles (Effector organs) • REFLEX ARC • Afferent pathways come from EYES, the vestibular apparatus and the proprioceptors. • Integrating centers are formed by neuronal networks in brain stem and spinal cord. 9 12/29/20 Types of Postural Reflexes • 2 types • 1- Static Reflexes • Both Static and Statokinetic reflexes are integrated at various levels in CNS from spinal cord to cerebral cortex. They are largely affected by pyramidal pathways. • Elicited by gravitational pull and involve sustained contraction of muscles. • 2- Statokinetic Reflexes • Also called phasic reflexes. • Elicited by acceleratory displacement of body. • They maintain stable postural background for voluntary activity. Maintenance of posture: • Decision for particular posture à occurs in CORTEX • ,In a standing posture • Centre of gravity pulls body to fall forward • Planning and programming à BASAL GANGLIA and CEREBELLUM • Information comes down through PYRAMIDAL TRACT to MOTOR NEURONS supplying muscles. • So antigravity muscles like extensors of neck, back, lip and legs etc. should be in contracted state 10 12/29/20 • In normal standing posture, • Upper limbs are slightly flexed • The flexor group of muscles are antigravity muscles in the upper limb • Vestibular receptors, proprioreceptors, visualreceptors etc. have important roles in maintaining posture. • In the standing posture, • Impulse coming through vestibulospinal tract and reticulospinal tract also plays important role. • If there is a change in head position, receptors in the utricle and saccule are stimulated. à Some group of muscles contract and head is held erect or in particular posture. 11 12/29/20 The End 12

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