UMN and LMN Disorders

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UMN and LMN Disorders
2013-04-01 03:56:21
upper motor neurons lower disorders

disorders of UMN and LMN disorders
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  1. Disorders Associated with Upper Motor Neuron (UMN) Lesions
    Spastic Paralysis:  Too much muscle contraction.

    Hypertonia:  Too much muscle tone, resistance to movement

    Hyperreflexia:  Too much reflexis

    Positive Babinski reflex:  reflex presents to those in an infant.  Infant reflex goes away but Babinski reflex may present itself again w/ brainstem injury.
  2. Disorders Associated with Lower Motor Neuron (LMN) Lesions
    Denervation:  Muscle is deprived of blood supply.

    Hypotonia:  Not enough muscle tone.  Flaccid refers to loss of muscle tone.

    Atrophy:  When you don't have control of muscle, they waste away and lose mass.

    Fibrillations:  Twitching of a single muscle.

    Fasciculations;  the twitching (contraction) of a group of muscles.  Example:  ALS-tongue twitch first indication of ALS.

    Hypoflexia:  Decrease of reflexes

    Areflexia: Absence of reflexes
  3. Disorders of the Extrapyramidal System
    Dyskinesias:  Hyperkinesia, Hypokinesia

    Tremors:  Resting tremors, postural tremors, intention tremors.





    Tardive Dyskinesia

  4. Dyskinesias
    Dyskinesias are referred to as involuntary movement disorders.  Within these involuntary movements there are:

    Hyperkinesia:  Too much movement


    Hypokinesia:  Too little movement

    Ex:  Huntington's, Chorea: excessive movement

    Disorders of Extrapyramidal System
  5. What are the three kinds of tremors?
    Disorder of the Extrapyramidal System

    Lesion in a specific region in the extrapyramidal system

    Resting Tremors:  Tremors occurs when body is at rest or relaxed.  Often seen in Parkinson's Disease.  Tremors can affect a person's voice, resulting in dysarthria.

    Postural Tremors:  AKA static tremors.  No tremors when body is at rest but when held in a sustained position against gravity.  Example:  Can see in head & neck because it's constantly held up against gravity.

    Intention Tremors:  AKA Kinetic Tremors: Present or occur during purposeful movement.  Seen in Huntington's Disease
  6. Chorea
    Chorea is a disorder of the Extrapyramidal System.

    Refers to quick, random, hyperkinetic movements.
  7. Athetosis
    Athetosis is a Disorder of the extrapyramidal system.

    Opposite of chorea.  It's slower movements, described as irregular coarse movement.  Tend to have a more writhing (squirming) motion.  Consistent going/moving.

    Sometimes seen with people with Cerebral Palsy.
  8. Dystonia
    Disorder of the Extrapyramidal System.

    Refers to excessive tone in certain parts of the body causing distorted static posture of the limbs and/or vocal dystonia affects parts of the face, tongue, and neck.
  9. Myoclonus
    Disorder of the Extrapyramidal System

    Described as sharp, brief muscle contraction.  Muscles jerk.  Not uncommon with TBI.  Putting pressure to the muscles can temporarily release the jerking but it always comes back.
  10. Tardive Dyskinesia
    Disorder of the Extrapyramidal System

    Very rare/unique syndrome in which there is bizzare movement affecting the mouth, face and tongue.  Side effect of pyschotropic drugs (treatments for psychosis & neurosis)
  11. Dysarthria
    Disorders of the Extrapyramidal System

    Refers to weakness of the muscles, decreased range of motion, decreased coordination.

    Multiple forms of dysarthria exist.  The type is determined where the lesion is in the CNS.  If UMN, LMH, or cerebellum all cause a different type.  This means the presence of a dysarthria doesn't necessarily mean damage to the extrapyramidal system.

    Impact one's speech production by affecting articulators, respiration, and phonation.

    Some dysarthria associated with the extrapyramidal system would include ataxic  dysarthria: presents when there is damage to the cerebellar pathways.

    Might have hypokinetic  dysarthria--damage to the basal ganglia associated with Parkinson's Disease.

    Hyperkinetic dysarthria is damage to the basal ganglia in a different way--associated with Huntington's Disease (Chorea or Athetosis)
  12. Cerebellar Disorders (Nine of them)

    Decomposition of Movement






    Ataxic Dysarthria

    Diminished Muscles stretch reflexes
  13. Ataxia
    Cerebellar Disorder

    Refers to general incoordination.  May have a staggering gait--wide stance
  14. Decomposition of Movement
    "Robot-like" in nature.  So, in order to move you have to break down every movement in discrete parts.  Execute every movement
  15. Dysmetria
    Cerebellar Disorder

    Refers to an inability to gauge distances, speed, and power of movement.
  16. Adiadochokinesia
    Cerebellar disorder

    "puh-da-kah" inability to perform rapidly alternating movement.
  17. Hypotonia
    Cerebellar Disorder

    Flaccid muscle tone (weak muscle) when have LMN involvement or lack to get signals to LMN can lead to weak muscles.
  18. Nystagmus
    Cerebellar Disorder

    Oscillatory movement of the eye.  Eyeball moves either side to side, up and down, or rotary.  Occurs w/ obstruction to vestibulocular tract.
  19. Tremors
    Cerebellar Disorder

    Occurs with lesion of the nervous system & cerebellum  Lesion to the UMN & LMN can cause tremors.
  20. Ataxic Dysarthria
    Cerebellar Disorder

    Described as uncoordinated speech. Slow range of motion, decreased strength, and decreased coordination.
  21. Diminished Muscle Stretch Reflexes
    Cerebellar Disorder

    Like the knee= genu reflex or ac??es reflex.  Associated with lesion of the pathway that goes to the muscle.