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  • SDR Neuron Motor Central

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    rak3u
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    This document summarizes the central motor pyramidal syndrome. It begins by explaining the origin is the frontal cortex, specifically the primary motor areas and supplementary motor areas. It then describes the somatotopy of the motor homunculus and consequences of cortical lesions such as partial, asymmetric deficits. Next, it describes the corticospinal and corticonuclear tract pathways from the cortex to the spinal cord and brainstem nuclei. It outlines the clinical features of a pyramidal syndrome including types of motor deficits based on affected limbs. It also describes tests to assess upper and lower limb weakness. Finally, it discusses factors like muscle tone and spasticity, reflexes, and pathological signs. It emphasizes the importance

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    This document summarizes the central motor pyramidal syndrome. It begins by explaining the origin is the frontal cortex, specifically the primary motor areas and supplementary motor areas. It then describes the somatotopy of the motor homunculus and consequences of cortical lesions such as partial, asymmetric deficits. Next, it describes the corticospinal and corticonuclear tract pathways from the cortex to the spinal cord and brainstem nuclei. It outlines the clinical features of a pyramidal syndrome including types of motor deficits based on affected limbs. It also describes tests to assess upper and lower limb weakness. Finally, it discusses factors like muscle tone and spasticity, reflexes, and pathological signs. It emphasizes the importance

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    © All Rights Reserved
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    263 views21 pages

    SDR Neuron Motor Central

    Uploaded by

    rak3u
    This document summarizes the central motor pyramidal syndrome. It begins by explaining the origin is the frontal cortex, specifically the primary motor areas and supplementary motor areas. It then describes the somatotopy of the motor homunculus and consequences of cortical lesions such as partial, asymmetric deficits. Next, it describes the corticospinal and corticonuclear tract pathways from the cortex to the spinal cord and brainstem nuclei. It outlines the clinical features of a pyramidal syndrome including types of motor deficits based on affected limbs. It also describes tests to assess upper and lower limb weakness. Finally, it discusses factors like muscle tone and spasticity, reflexes, and pathological signs. It emphasizes the importance

    Copyright:

    © All Rights Reserved
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    of 21

    Sindromul de neuron motor

    central
    - piramidal -

    Origine: cortex frontal


    aria motorie principala = 4 50%
    arii motorii suplimentare = 6, 8 + 3,1,2

    Origine: cortex frontal


    Somatotopie:
    homunculus motor
    Consecinta:
    Leziune corticala:
    deficit parcelar,
    asimetric
    + lez corticale
    invecinate

    Traiect
    Fascicol cortico-spinal:
    MS catre cornul
    anterior: sinapsa cu
    pericarionul neuronului
    motor periferic
    Decuseaza (75%) la
    jonctiunea bulbo-spinala

    Fascicol corticonuclear: sinapsa cu


    nucleii motori ai nn
    cranieni din trunchiul
    cerebral

    Sindrom piramidal:
    1. deficit motor
    Numai miscarea voluntara
    topografie extinsa:

    1 membru = monopareza
    mb sup + mb inf = hemipareza
    ambe membre sup = dipareza
    ambe membre inf = parapareza
    toate = tetrapareza

    Sindrom piramidal:
    1. deficit motor
    Probe pareza mb superior:
    proba bratelor intinse

    probe pareza membrul


    inferior:
    Vasilescu
    Mingazini
    Barre

    Intensitatea deficitului motor

    scala British Medical Research


    Council (BMRC):
    0 = nici o contractie
    1 = contractie musculara vizibila
    subcutanat
    2 = miscare posibila ce deplaseaza
    segmente in acelasi plan, nu
    antigravitational
    3 = miscare posibila antigravitational,
    nu contrarezistentei
    4 = miscare posibila contra unei
    rezistente usoare / medii
    5 = forta normala
    Intensitate:
    2 - 4 = pareza
    0-1 = plegie

    Tonusul muscular
    Inspectie: relief
    Palpare: consistenta
    Probe pasive

    2. Tonus muscular
    Initial: (+/-) hipotonie =
    diaschizis (leziune
    cerebrala) / soc spinal
    (leziune spinala)
    Hipertonie piramidala =
    spasticitate:
    pred flexori + pronatori - mb
    sup
    pred extensori + rotatori
    interni - mb inf
    cedeaza in lama de briceag =
    opozitie initiala
    elastica = revine in postura
    dominanta

    2. Tonus
    muscular
    Mers + postura
    caracteristice

    3. ROT
    Vii:
    ample
    rapide
    repetate

    ROT

    3. R cutanate
    Abdominale:
    T5 - mamelon
    T10 - ombilic
    T12 - inghinal
    = abolite / dimin
    plantare: extensie

    4. Semne patologice
    Sincinezii: imitatie, coordonare, globale
    clonus
    semne patologice
    linie mediana: oculo-palpebral, Toulouse
    mb sup: Marinescu-Radovici, Hoffmann
    mb inf: Gordon, Schaeffer, Chadock, Babinski
    Mendel-Bechtereev, Rossolimo

    Diagnostic
    topografic
    Topografia deficit
    semne asociate:
    corticale
    nn cranieni
    sensibilitate

    Cortical

    cortical: hemipareza controlaterala asimetrica +


    afazie, tulb camp vizual
    capsula interna: hemiplegie egal distribuita

    Subcortical

    TC: sindrom altern = pyr controlat +


    nn cran ipsilat
    ex.: Millard - Gubler (pyr + VII)

    Spinal

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