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Understanding Upper Motor Neurons

Aug 6, 2024

Upper Motor Neurons Lecture Notes

Introduction

  • Topic: Upper motor neurons
  • Difference from Lower Motor Neurons: Upper motor neurons control lower motor neurons

Lower Motor Neurons Recap

  • Somas Location: Brain stem or spinal cord
  • Axons Path: Peripheral nervous system → synapse on skeletal muscle cells
  • Function: Tell skeletal muscle cells when to contract
  • Control:
    • Spinal nerves → muscles of limbs and trunk
    • Cranial nerves → muscles of head and neck

Upper Motor Neurons Overview

  • Function: Control lower motor neurons
  • Somas Location: Cerebral cortex (outer surface of cerebrum)
  • Axons Path: Descend to synapse on lower motor neurons in brain stem or spinal cord
  • Information Flow: Cerebral cortex → axons → lower motor neuron somas → skeletal muscle cells

Upper Motor Neurons Pathways

Corticospinal Tract

  • Path: Cerebral cortex → spinal cord
  • Axons Travel: Down cerebral cortex → deep white matter → brain stem (midbrain, pons, medulla) → cross over → down opposite side of spinal cord → synapse on lower motor neurons
  • Function: Control skeletal muscle contraction
  • Dysfunction Effects:
    • Spinal cord dysfunction → same side muscle weakness
    • Brain dysfunction → opposite side muscle weakness

Corticobulbar Tract

  • Path: Cerebral cortex → brain stem
  • Axons Travel: Similar to corticospinal tract but terminate in brain stem
  • Function: Control lower motor neurons in brain stem (muscles of head and neck)
  • Wiring Complexity: One cerebral cortex side sends neurons to both sides of brain stem
  • Dysfunction Effects: Vary due to complex wiring

Dysfunction and Weakness

  • Causes: Both upper and lower motor neuron issues can cause weakness
  • Diagnosis: Determine if problem lies in upper or lower motor neurons

Upper Motor Neuron Signs

Hyperreflexia

  • Definition: Increase in muscle stretch reflexes (MSR)
  • Opposite of Hyporeflexia: Lower motor neuron sign
  • Example: Exaggerated knee-jerk reaction
  • Possible Cause: Lower motor neurons become super sensitive without upper motor neuron stimulation

Clonus

  • Definition: Rhythmic contraction of antagonist muscles
  • Examples: Rapid up-and-down foot movement when pulled up
  • Possible Cause: Hyperreflexia triggering antagonist muscle responses

Hypertonia

  • Definition: Increased tone of skeletal muscles
  • Opposite of Hypotonia: Lower motor neuron sign
  • Possible Cause: Related to hyperreflexia, but not fully understood

Extensor Plantar Response (Babinski Sign)

  • Definition: Abnormal extension of toes when bottom of foot is scraped
  • Normal Response: Flexion of toes (toes curl down)
  • Possible Cause: Unknown
  • Significance: Indicates upper motor neuron dysfunction

Conclusion

  • Summary: Understanding upper motor neuron pathways and signs helps diagnose the location of neurological issues and contribute to identifying underlying dysfunctions.