Which tract damaged uncoordinated movements

A trach may not be permanent. If you are not on a ventilator, you will be encouraged to cough and deep breathe hourly while awake to help keep the lungs healthy and prevent infection. You may also be asked to use an incentive spirometer, a plastic breathing device. You can see on the device how much air is being taken into the lungs. The nurse or therapist will help you to set goals for using this breathing device.

Families are welcomed to be involved in helping you use the incentive spirometer. The brain normally controls blood pressure and heart rate. Signals from the brain send messages through the spinal cord to constrict blood vessels and raise the heart rate to keep the blood pressure and heart rate normal.

When these signals cannot get through, a person can have low blood pressure and slow heart rate. Blood pressure may drop when the head of the bed is raised suddenly because blood vessels below the level of injury are dilated. They cannot constrict fast enough to prevent low blood pressure. This is called orthostatic hypotension. To lessen your risk of this, the head of the bed is gradually raised, and an abdominal binder may be used.

A person may not be able to sweat or make goose bumps below the level of injury. The body cannot adjust its temperature. A person may feel cold and need blankets, then later, feel hot and need a fan or to be uncovered.

People at highest risk for this condition are those with SCIs above T6. This tends to happen after the spinal shock phase. Autonomic hyperreflexia happens because nerve messages that used to go up the spinal cord to the brain are blocked.

Autonomic hyperreflexia is a serious condition and needs to be treated right away. Prevention and looking for signs are very important. Stroke, heart attack, or seizures can happen if this is not treated. This is a condition that may happen throughout the rest of your life. A DVT is a blood clot that can develop in the legs and arms. It is often caused by a lack of movement. A blood thinning medicine may be used, or a filter may be placed in a blood vessel. Regular exercise of the arms and legs, and turning will be done to help prevent DVTs from forming.

Sometimes after an SCI, the stomach and intestine will stop working for a short time. This is called an ileus. Even though the stomach may not be working, it still makes acid. The acid may damage the stomach lining and cause stomach ulcers if it is not removed. A nasogastric NG tube may be placed through the nose into the stomach.

This tube will be used to help remove stomach acids. Medicines may also be given to help prevent stomach ulcers.

Higher cervical injuries may make it harder to swallow. If this happens, an NG tube may be needed for nutrition and medicines. The tube is placed through the nose into the stomach. Liquid formula will be given either continuously or several times a day. The hospital dietitian helps the health care team choose a formula based on your calorie and fluid needs.

If long term tube feeding is needed, a gastric tube G-tube or PEG tube may be placed surgically through the wall of the abdomen into the stomach. Changes in bowel control may happen after an injury. A person may have constipation or diarrhea. A bowel training program including diet, medicines, and digital stimulation may be used. Digital stimulation means to touch inside the rectum to help the bowels move. Developing a bowel training program takes time, but it can be successful.

SCI may also cause the messages between your bladder and brain to be changed. Normally, when the bladder gets full, nerves in the bladder send a message up the spinal cord to the brain signaling the need to urinate pee. The message to the brain may be lost after an injury.

Coordination disorders often result from malfunction of the cerebellum, the part of the brain that coordinates voluntary movements and controls balance. Often, people cannot control their arms and legs, making them take wide, unsteady steps when they walk. Doctors base the diagnosis on symptoms, family history, magnetic resonance imaging of the brain, and often genetic testing. The cause is corrected if possible, and if it cannot be, treatment focuses on relieving symptoms.

See also Overview of Movement Disorders Overview of Movement Disorders Every body movement, from raising a hand to smiling, involves a complex interaction between the central nervous system brain and spinal cord , nerves, and muscles. Damage to or malfunction The cerebellum is the part of the brain most involved in coordinating sequences of movements.

It also controls balance and posture. Anything that damages the cerebellum can lead to loss of coordination ataxia. However, Many other disorders can also cause loss of coordination. Less commonly, other disorders, such as an underactive thyroid gland hypothyroidism Hypothyroidism Hypothyroidism is underactivity of the thyroid gland that leads to inadequate production of thyroid hormones and a slowing of vital body functions. Facial expressions become dull, the voice In developed countries, the cause is usually an absorption disorder.

Some infants are born with vitamin It may originate in the brain or have spread metastasized to the brain from another part of the body Some hereditary disorders, such as Friedreich ataxia Friedreich ataxia Coordination disorders often result from malfunction of the cerebellum, the part of the brain that coordinates voluntary movements and controls balance. The cerebellum malfunctions, causing Rarely, in people with cancer especially lung cancer , the immune system malfunctions and attacks the cerebellum—an autoimmune reaction.

This disorder, called subacute cerebellar degeneration Neurologic syndromes Paraneoplastic associated with cancer—see also Overview of Cancer syndromes occur when a cancer causes unusual symptoms due to substances that circulate in the bloodstream. These substances Certain drugs such as antiseizure drugs Antiseizure drugs In seizure disorders, the brain's electrical activity is periodically disturbed, resulting in some degree of temporary brain dysfunction.

Many people have unusual sensations just before a seizure In such cases, the disorder may disappear when the drug is stopped. Loss of coordination prevents people from being able to control the position of their arms and legs or their posture. Thus, when they walk, they take wide steps and stagger and make broad, zigzag movements with their arms when they reach for an object.

Ataxia: Coordination is lost. People may be unsteady when they walk and take wide steps. They may need to hold onto furniture and walls to move about. Dysmetria: People cannot control the range of body movements. For example, in attempting to reach for an object, people with dysmetria may reach beyond the object. Dysarthria Dysarthria Dysarthria is loss of the ability to articulate words normally. Speech may be jerky, staccato, breathy, irregular, imprecise, or monotonous, but people can understand language and use it correctly Movement of the muscles around the mouth may be exaggerated.

Scanning speech: People speak in a monotone with a tendency to hesitate at the beginning of a word or syllable. In nystagmus, the eyes repeatedly move rapidly in one direction, then return a little more slowly to their original position.

Tremor Tremor A tremor is an involuntary, rhythmic, shaking movement of part of the body, such as the hands, head, vocal cords, trunk, or legs. Tremors occur when muscles repeatedly contract and relax. Friedreich ataxia is a hereditary disorder. The basal ganglia are responsible for voluntary motor control, procedural learning, and eye movement, as well as cognitive and emotional functions.

The basal ganglia or basal nuclei are a group of nuclei of varied origin in the brains of vertebrates that act as a cohesive functional unit. They are situated at the base of the forebrain and are strongly connected with the cerebral cortex, thalamus, and other brain areas. The basal ganglia are associated with a variety of functions, including voluntary motor control, procedural learning relating to routine behaviors or habits such as bruxism and eye movements, as well as cognitive and emotional functions.

Currently popular theories hold that the basal ganglia play a primary role in action selection. Action selection is the decision of which of several possible behaviors to execute at a given time. Experimental studies show that the basal ganglia exert an inhibitory influence on a number of motor systems, and that a release of this inhibition permits a motor system to become active.

The behavior switching that takes place within the basal ganglia is influenced by signals from many parts of the brain, including the prefrontal cortex, which plays a key role in executive functions.

For both of these disorders, the nature of the neural damage is well-understood and can be correlated with the resulting symptoms. It is noteworthy that, although both diseases have cognitive symptoms, especially in their advanced stages, the most salient symptoms relate to the ability to initiate and control movement. Thus, both are classified primarily as movement disorders. A different movement disorder, called hemiballismus, may result from damage restricted to the subthalamic nucleus.

Hemiballismus is characterized by violent and uncontrollable flinging movements of the arms and legs. One of the most intensively studied functions of the basal ganglia is their role in controlling eye movements. Eye movement is influenced by an extensive network of brain regions that converge on a midbrain area called the superior colliculus SC. The SC is a layered structure whose layers form two-dimensional retinotopic maps of visual space.

A bump of neural activity in the deep layers of the SC drives eye movement toward the corresponding point in space. Although the role of the basal ganglia in motor control is clear, there are also many indications that it is involved in the control of behavior in a more fundamental way, at the level of motivation.

These patients have occasionally been observed to show a phenomenon called kinesia paradoxica, in which a person who is otherwise immobile responds to an emergency in a coordinated and energetic way, then lapses back into immobility once the emergency has passed. The role in motivation of the limbic part of the basal ganglia—the nucleus accumbens NA , ventral pallidum, and ventral tegmental area VTA —is particularly well established.

Numerous things that people find rewarding, including addictive drugs, good-tasting food, and sex, have been shown to elicit activation of the VTA dopamine system. In most regions of the brain, the predominant classes of neurons use glutamate as the neurotransmitter and have excitatory effects on their targets. In the basal ganglia, however, the great majority of neurons uses gamma-aminobutyric acid GABA as the neurotransmitter and have inhibitory effects on their targets.

The inputs from the cortex and thalamus to the striatum and subthalamic nucleus are glutamatergic, but the outputs from the striatum, pallidum, and substantia nigra pars reticulata all use GABA. Thus, following the initial excitation of the striatum, the internal dynamics of the basal ganglia are dominated by inhibition and disinhibition.

Other neurotransmitters have important modulatory effects. Dopamine is used by the projection from the substantia nigra pars compacta to the dorsal striatum and also in the analogous projection from the ventral tegmental area to the ventral striatum nucleus accumbens.

Acetylcholine also plays an important role, as it is used both by several external inputs to the striatum and by a group of striatal interneurons. Although cholinergic cells make up only a small fraction of the total population, the striatum has one of the highest acetylcholine concentrations of any brain structure. Main circuits of the basal ganglia : This diagram shows the main circuits of the basal ganglia.

Two coronal slices have been superimposed to include the involved basal ganglia structures. Green arrows refer to excitatory glutamatergic pathways, red arrows refer to inhibitory GABAergic pathways and turquoise arrows refer to dopaminergic pathways that are excitatory on the direct pathway and inhibitory on the indirect pathway. The cerebellum is important for motor control—specifically coordination, precision, and timing—as well as some forms of motor learning.

The cerebellum is a region of the brain that plays an important role in motor control. It may also be involved in some cognitive functions such as attention and language, and in regulating fear and pleasure responses, but its movement-related functions are the most solidly established. The cerebellum does not initiate movement, but it contributes to coordination, precision, and accurate timing.

It receives input from sensory systems of the spinal cord and from other parts of the brain, including the cerebral cortex, and integrates these inputs to fine-tune motor activity.

Because of this fine-tuning function, damage to the cerebellum does not cause paralysis, but instead produces disorders in fine movement, equilibrium, posture, and motor learning. The cerebellum differs from most other parts of the brain, especially the cerebral cortex, in regards to the ability of signals to move unidirectionally from input to output. This feedforward mode of operation means that the cerebellum cannot generate self-sustaining patterns of neural activity, in contrast to the cerebral cortex.

However, the cerebellum can receive information from the cerebral cortex and processes this information to send motor impulses to the skeletal muscle. Cerebellum : View of the cerebellum from above and behind.

Cerebellum cells : View of the cerebellum from above and behind. In terms of anatomy, the cerebellum has the appearance of a separate structure attached to the bottom of the brain, tucked underneath the cerebral hemispheres.

The surface of the cerebellum is covered with finely spaced parallel grooves, in striking contrast to the broad irregular convolutions of the cerebral cortex. These parallel grooves conceal the fact that the cerebellum is actually a continuous thin layer of tissue the cerebellar cortex , tightly folded in the style of an accordion. Within this thin layer are several types of neurons with a highly regular arrangement, the most important being Purkinje cells and granule cells.

This complex neural network gives rise to a massive signal-processing capability, but almost all of its output is directed to a set of small, deep cerebellar nuclei lying in the interior of the cerebellum.