NMS
5/17/99

Upper Motor Neuron
1.	pyramidal (Corticospinal)
2.	extrapyramidal
•	neuron is completely in the CNS
•	cranial nerves leave the cord and the brain--therefore a LMN
-Motor Neuron--Lower Motor Neuron
•	homonymous annulospiral--sensory input from a muscle spindle in a muscle coming in goes to the LMN that goes to the same muscle --releases a neurotransmitter that will facilitate the muscle (+)
•	homonymous GTO--inhibits the muscle (-)
•	pyramidal--facilitates the muscles 
•	antagonistic annulospiral (from the opposite muscle)--inhibition
•	agonistic annulospiral--comes from a muscle of similar function, facilitates
•	extrapyramidal--inhibit
•	pain fibers--facilitates the muscle, creates spasm to protect the injured area, can come from visceral areas also
•	summation--takes all of the pluses and minuses and decide if it should facilitate the muscle
•	normal tone (tonus)--result of the summation, allows for full ROM at a joint
1.	increase output
•	increase (+)--in a healthy state--tap on the tendon, stimulate the muscle spindles
•	consciously decide to use the muscle (precentral gyrus in the frontal lobe)--Betz is the cell body of the corticospinal tract which decussates at the pyramids 
•	pain fibers--SA/VA (somatic afferent/visceral afferents) VA-SE (visceral afferent-somatic efferent)
2.	decrease (-)
•	lesion in extrapyramidal system--UMN lesion lose the (-)
•	CVA in precentral gyrus
•	Lose pyramidal--conscious control 
•	Internal capsule--can disrupt the pyramidal and not affect the extrapyramidal
•	In normal situation lose extrapyramidal also
•	Corticospinal = strength
•	Extrapyramidal = tone
•	Weakness on same side gives (+) Babinski = decreased pyramidal
•	Parkinson's Disease
•	Extrapyramidal disease--inhibitory signal--allows for movement at joints
•	Muscle tone increases--joints are rigid
•	Still has sensory perception
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