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IMF-028-01-0001-en	How do the contributions of the basal nuclei and the cerebellum to movement differ?	The basal nuclei select and scale actions, whereas the cerebellum predicts consequences, compares intended with actual performance, and drives adaptation.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0002-en	How does motor-unit size relate to function, and by what two means does muscle force rise?	Small units permit fine control and large units generate power; force rises by increasing motor-neuron firing and recruiting progressively larger units.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0003-en	Why is neuromuscular transmission normally reliable, and what can expose its failure?	A safety factor normally ensures transmission, but receptor loss, impaired release, toxins, drugs, or repeated activity can erode it and reveal failure.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0004-en	What clinically distinguishes neuromuscular-junction disease from primary muscle disease?	Junction disease causes fatigable weakness without sensory loss, with reflexes varying by mechanism; muscle disease often causes symmetric proximal weakness with sensation and reflexes relatively preserved until advanced loss.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0005-en	How do Ia afferents from a stretched muscle spindle act on the agonist and its antagonist?	They excite alpha motor neurons supplying the same muscle and inhibit antagonists through interneurons.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0006-en	Why is alpha-gamma coactivation needed during muscle contraction?	Gamma motor neurons adjust spindle tension as the muscle shortens, so the spindle keeps its sensitivity to length and stretch during contraction.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0007-en	How do Golgi tendon organs differ from muscle spindles in arrangement and in what they sense?	Tendon organs lie in series with muscle and sense tension through Ib afferents, whereas spindles lie in parallel and detect length and rate of stretch.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0008-en	Why is the tendon tap a probe of far more than one spinal segment?	The reflex depends on the afferent nerve, spinal segment, motor neuron, neuromuscular junction, muscle, and descending modulation, so a fault anywhere can alter it.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0009-en	How do reflexes change over time after spinal cord injury, and why?	They may first disappear during spinal shock, then become exaggerated as descending control reorganises.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0010-en	Why can spinal central pattern generators not produce human walking on their own?	They generate rhythmic output, but human walking also requires descending initiation and sensory adjustment, with brainstem and cerebellum keeping equilibrium and cortex handling obstacles.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0011-en	Why does a corticospinal lesion above the lower medulla weaken skilled movement on the opposite side?	Most corticospinal fibres cross in the lower medulla to form the lateral corticospinal tract, which controls contralateral distal skilled movement.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0012-en	Why does a hemispheric lesion spare the forehead while a peripheral facial lesion does not?	Many cranial motor nuclei receive bilateral corticobulbar input but the lower face has contralateral predominance, whereas a peripheral facial lesion weakens the entire ipsilateral face.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0013-en	What distinguishes the roles of the reticulospinal, vestibulospinal, and tectospinal pathways?	Reticulospinal tracts influence tone, automatic posture, locomotion, and anticipatory adjustments; vestibulospinal pathways stabilise head and body against gravity; tectospinal circuits orient head and neck toward salient stimuli.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0014-en	How is spasticity distinguished from rigidity on passive movement?	Spasticity is velocity-dependent because it reflects exaggerated stretch responses, whereas rigidity is not velocity-dependent and affects agonists and antagonists more evenly.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0015-en	What distinguishes the contributions of premotor cortex and supplementary motor areas to action?	Premotor cortex uses external cues and integrates posture with action, whereas supplementary motor areas contribute internally generated sequences and bimanual coordination.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0016-en	How does an efference copy of the motor command support movement control?	It allows the predicted sensory consequences of a command to be compared with actual feedback, so discrepancies can be detected.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0017-en	In the repeated cerebellar cortical circuit, what roles do climbing fibres and Purkinje cells play?	Climbing fibres provide powerful teaching signals, and Purkinje cells inhibit the deep nuclei, which provide major cerebellar output.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0018-en	Why do cerebellar hemispheric lesions usually cause ipsilateral limb signs?	After its pathway crossings, cerebellar influence effectively returns to the same side of the body.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0019-en	How is sensory ataxia distinguished from cerebellar limb incoordination?	Sensory ataxia accompanies impaired proprioception and worsens markedly with eye closure.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0020-en	In the simplified basal-nuclei model, how does dopamine promote movement through the two pathways?	Via D1 effects it boosts the direct pathway, which reduces inhibitory output to facilitate selected action, and via D2 effects it reduces the indirect pathway, which would suppress competing action.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0021-en	Why does dopamine replacement help parkinsonism, and which adverse effects limit it?	Parkinsonism reflects reduced dopamine, so replacement improves many features, but it can cause nausea, hypotension, hallucinations, dyskinesia, and fluctuations.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0022-en	Why is quiet standing described as active, and what reduces postural reserve?	Vestibular, visual, and proprioceptive signals continually estimate body motion and ankle, hip, and stepping strategies restore the centre of mass; ageing, neuropathy, weakness, sedatives, poor vision, and cognitive load erode reserve.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0023-en	How do parkinsonian, cerebellar, and frontal gait disorders differ?	Parkinsonian gait is short-stepped with reduced arm swing and freezing, cerebellar gait is broad and irregular, and frontal gait disorders impair initiation despite adequate power.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending
IMF-028-01-0024-en	Why can reducing spasticity sometimes worsen function?	Some patients use their stiffness for support, so lowering tone can worsen transfers; treatment is therefore justified by pain, contracture, hygiene difficulty, or impaired function.	Integrated Medical Foundations; chapter 28, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 81e6bfa0967282eb931e703dab670b3a3a80fb02b5facc6fb097cc5b73890c5e; editorial review pending	imf lang::en chapter::028 module::028-01 review::pending