Download 1 Pyramidal tract

METHODICAL INSTRUCTIONS
FOR INDIVIDUAL WORK OF THE STUDENTS
IN PREPARATION FOR PRACTICAL CLASSES
Subject
NEUROLOGY
Topic
Pyramidal tract. Corticomuscular tract. The symptoms of central
and peripheral paralyses. Pathological reflexes
Year
IV
Faculty
Medical
1. Topicality: Motor system abnormalities happen in the damage of nervous system by many
different factors and represent great importance for the diagnostics of the nosologic form of a
disease. Motor abnormalities represent one of the main reasons of the life activity damages of the
sick, loss of working ability, which has a great social importance. Among motor abnormalities,
the loss of the accidental moves ability (paralysis, paresis) is the most widely spread and
connected with the damage of a corticomuscular tract. The knowledge of the motor
abnormalities connected with the damage of a corticomuscular tract is of great importance in
diagnostics of nervous diseases.
2. Specific purposes:
- to interpret accidental moves realization
-to be able to diagnose paralysis (paresis)
- to explain the symptoms central and peripheral paralyses ( pareses)
-to be able to distinguish between central and peripheral paralyses
Basic level of knowledge and skills:
№
1.
Subject
Anatomy
Information to learn
The CNS structure, the anatomy of the cerebral cortex, the
anatomy of the cerebral column, the anatomy of the spinal cord
2.
Physiology
The principles of the CNS functioning. The physiology of the
motor analyzer. Pyramidal system. Corticomuscular tract.
3.
Pathophysiology
Manifestations of the corticomuscular tract lesions.
4.
Histology
The peculiarities of the nervous tissues structure. Nervous
system development. Nervous system cells: neurons, neuroglia
cells.
4. Assignments for individual work during preparation for the classes:
The list of basic terms, characteristics, which students must learn during the preparation
for the classes:
-motor trench, “Penfield man”, Betz cells
-internal capsule, genu of internal capsule, limb of internal capsule
-corona radiata
-central (spastic) paresis (paralysis, plegia)
-peripheral (flaccid, atonic) paresis (paralysis)
-combined paresis (paralysis)
-Vernike-Mann position (gait)
- fasciculation, fibrillation
-Barret’s test
The list of theoretical questions:
1. Accidental moves realization . Pyramidal system.
2. Сorticonuclear and corticospinal tracts.
3. Corticomuscular tract.
4. Central and peripheral motor neurons.
5. Central (spastic) paralysis symptoms .
6. Pathophysiology of muscular hypertonia, hyperrerflexia, pathological reflexes, abdominal reflexes
decrease.
7. Peripheral (flaccid) paralysis symptoms. Pathophysiology of atony, areflexia, atrophy.
8. A notion of a combined paralysis.
The list of practical skills that are to be mastered at the classes:
1. Examination of the active and passive moves volume.
2. Methodic of the muscular tonus evaluation.
3. Methodic of the muscle strength evaluation (5-rate scale).
4. Examination of muscular trophism.
5. Examination of the tendinous, periosteal, dermal reflexes (stylocarporadial, biceps,
triceps, patellar, Achilles, abdominal).
6. Methodic of the activation of pathological reflexes (extensor ones of Babinsky,
Oppenheim, Gordon, Shiffer; flexor ones of Rossolimo, Bekhterev, Zhukovsky etc)
7. Conducting of a Barret’s test
8. Methodic of the activation of clonus and defense reflexes.
9. Fasciculation exposure.
5. Students’ self-preparation curriculum:
1. To learn theoretical questions of the topic 3 (see the list of the theoretical questions and
information sources).
2. To know the methodic of examination of motor system.
3. To see the tests and situational tasks (the collection of tests and tasks, the “Reflex Motor
Sphere” chapter).
6. Materials for self-control
Tests and situational tasks (the collection of tests and tasks – module 1, topical module 1, the
“Reflex Motor Sphere” chapter)
Information Sources
Lecture.
1. Shcrobot S.I., Hara I.I. Neurology in lecture (Selected lectures) . Ternopil, TSMU,
«Ukrmedknyha», 2008. 319 p.
2. Reinhard Rohkamm. Color Atlas of Neurology © 2004 Thieme. 440 p.
3. Crash course Neurology by Anish Bahra and Katia Cikurel. Copyright 2006, Elsevier,
Inc. 244 p.
4. Adams and Victors. Principles of neurology. © 2005 McGraw-Hill . Medical Publishing
Division.
5. Mayo Clinic Internal Medicine Review 2006-2007. Chapter 18. Editor-in-Chief Thomas
M. Habermann, MD