umn vs lmn revisi
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FACULTY OF MEDICINE UPH
VS
By:
Dr. Vonny F. Goenawan, Sp. S
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NERVOUS SYSTEM
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TERMS
UPPER MOTOR NEURONS cortical neurons that innervate lower motor
neurons
axons contained within the pyramidal system,which is the corticospinal (pyramidal) andcorticobulbar tracts.
LOWER MOTOR NEURONS neurons that directly innervate skeletal muscle
the cell bodies are located within the ventralhorns of the spinal cord and within brainstem
motor nuclei.
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UPPER MOTOR NEURON
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UPPER MOTOR NEURON
(UMN)
UMN conveying impulses for voluntary
motor activity
Tracts
Corticospinal
Corticobulbar
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Corticobulbar tract
axons homologous to corticospinal fibers
terminate in the motor nuclei of cranial nerves in the
brain stem e.g., nuclei V ,VII, IX, X, XI and XII
lower motor neurons of the brain stem receive bilateralcorticobulbar input.
two exceptions:
Facial nerveThe neurons that innervate the muscles of the
lower face (below the forehead) receive mainly crossed input
from the opposite motor cortex.
Hypoglossal nerveThe neurons that innervate the
genioglossus muscle receive mainly crossed input from the
opposite motor cortex
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Corticobulbar tract
CORTICOBULBARTRACT
CAPSULA
INTERNA
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Loss of dexterity, voluntary skillful movements
Stiffness, slowness, and clumsiness, in particular,
rapid repetitive motions.
Spasticity is hallmark of the UMN diseaseSpasticity is a state of sustained increase in
muscle tension in response to muscle
lengthening, in particular, with passive
movements.
Hyperreflexia.
Babinskis sign (pathology reflex)
positive
SIGNS & SYMPTOMS
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UMN SIGN
UMN Syndrome Increased Deep Tendon Reflex
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UMN SIGN - TONE
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LOWER MOTOR NEURON
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LOWER MOTOR NEURON
(LMN)
LMNlower motor neuron
Lower motor neurons (LMN) directly innervate
the skeletal muscle In both CNS and PNS
Cell bodies in CNS (brainstem and spinal cord)
Cranial and spinal nerves in PNS (anterior horn cell)
Motor unit=LMN & muscle fibers innervated by it
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Anterior horn cell
Muscle
Neuromuscular juntion
Peripheral nerve
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These stations are
The anterior (ventral) horn cell
The peripheral nerve ( ventral and dorsal nerve
roots ie radiculopathy or nerve ie neuropathy) The neuromuscular junction
The muscle (ie myopathy)
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SIGNS & SYMPTOMS
Weakness:
Denervation as well as decreased number of
functional LMN units reduces overall muscles
strength. Muscle atrophy & Hyporeflexia
Muscle hypotonicity & flaccidity
Fasciculations
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LMN SIGN
MUSCULAR ATROPHY
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UMN VS LMN
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UMN VS LMN
SIGNS UMN LMN
Atrophy - +++
Fasciculations - +++
Tone +++ -
Distribution Regional Segmental
Tendon
reflexes+++ -/--
Babinskis sign + -
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UMN DISORDERS
Stroke
Brain tumor
Multiple sclerosis (MS)
Mielitis
etc
Multiple sclerosis (MS)
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LMN DISORDERS
Poliomyelitis
Guillain-Barr syndrome
(GBS)
Multifocal Motor
Neuropathy
Poliomyelitis
http://www.ibiblio.org/herbmed/eclectic/thomas/pics/poliomyel-2.jpg -
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Where could the lesion be??
Medulla?
Pons?Midbrain?
Cortex?
Which side??
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THANK YOU
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