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49 Cards in this Set

  • Front
  • Back
What is the Central Pattern Generator?
-Basic Locomotor Pattern of Each Limb
-Require: Sensory Input Local Spinal Cord Circuitry, Motor Output
What are the Major Nuclei of the Basal Ganglia?
-Caudate
-Putamen
-Globus Pallidus (Internal and External)
-Substantia Nigra
-Subthalamic Nucleus (Pars Compacta and Pars Reticulata)
What does the term Striatum or Neostriatum refer to?
Caudate + Putamen
What does the term Paleostriatum refer to?
Globus Pallidus (GPe and GPi)
What does the term Lenticular Nucleus refer to?
Putamen + GPe + GPi
What divides the Caudate and Putamen?
Internal Capsule
Where does the Nucleus Accumbens sit?
Between the Caudate and Putamen
What Nucleus sits between the Caudate and Putamen?
Nucleus Accumbens
What major function does the Hippocampus serve? What will a Lesion to the Hippocampus result in?
-Memory
-Amnesia
What are the Major Functions of the Basal Ganglia?
-Planning and Maintaining Motor Activities
-Procedural Learning (Habits)
-Inhibiting Competing Motor Activities
-Controlling Eye Movements
-Additional Cognitive Roles Including Regulating Though Patterns
What is the Direct Pathway? What does it do? What results?
-Releases Thalamic Activity
-Increases Motor Output
What is the Indirect Pathway? What does it do? What results?
-Decreases Thalamic Activity
-Decreases Motor Output
Describe the Direct Pathway. Nuclei, NTs, and Effects.
-Cortex (Glutamate)
-(+) Striatum (Caudate and Putamen) - GABA and Substance P
-(-) SNr + GPi - GABA
-(Disinhibition) Thalamus - Releases Motor Inhibition
-Increased Motor Activity
What is the Thalamus's Normal Effect on Cortical Motor Output?
Excitatory
What is the Normal Effect of SNr and GPi on the Thalamus? Why?
-Inhibitory
-NT = GABA
How does the Striatum act on the GPi and SNr in the Direct Pathway? What results? How?
-GABA and Substance P are released
-Inhibit the GPi and SNr
-GPi and SNr Normally Inhibit the activity of the Thalamus - Now we have Disinhibition
-Thalamus Increases Activity
-Increased Motor Output
Describe the Indirect Pathway. Nuclei, NTs, and Effects.
-Cortex (Glutamate)
-(+) Striatum (Caudate and Putamen) - GABA and ENK
-(Disinhibition) GPe - GABA
-(+) STN - Glu
-(+) SNr and GPi - GABA
-(-) Thalamus
-Decreased Motor Output
What is the Normal Effect of the STN on the SNr and GPi in the Indirect Pathway? Why?
-Excitatory
-NT = Glu
How does Inhibiting the GPe in the Indirect Pathway lead to Decreased Motor Output?
-GPe Releases GABA and Inhibits the STN
-The STN Releases Glu and Excites the SNr and GPi which release GABA to Inhibit the Thalamus and Motor Activity
-If the GPe is Inhibited, it will have less of an Inhibitory Effect on the STN, thus Decreasing Motor Output
What are some disorders that result from Increased Motor Output?
-Dyskineasias
-Ballismus
-Choriform
-Athetoid
-Dystonia
-Huntington's Disease?
What are some disorders that result from Decreased Motor Output?
-Bradykinesia
-Rigidity
-Akinesia
-Masked Face
-Parkinson's?
What is TRAPD? What might you expect if a patient shows these symptoms?
-TRAPD - Resting Tremor, Rigidity, Akinesia, Postural Instability, Dementia
-Parkinson's
What is the pathology behind Parkinson's and its effects?
Loss of Dopaminergic Neurons in the Substania Nigra-Striatal Pathway
A Patient comes in with Cogwheel Rigidity, they have difficulty getting out of a chair, no arm swing when they walk, and take short shuffling steps. What do you suspect?
Parkinsons
What role does the SNc play in the Direct and Indirect Pathway?
-Regulatory
-Releases Dopamine on the Striatum
What is Bradykinesia?
Slowness of Movement
What is Dystonia?
Involuntary Muscle Contractions
What is Athetosis?
-"Writhing"
-Inability to Maintain a Fixed or Sustained Posture
-Constant Slow, Sinuous, Purposeless Movements
A patient comes in doing all of the following: What are they exhibiting?
-"Writhing"
-Inability to Maintain a Fixed or Sustained Posture
-Constant Slow, Sinuous, Purposeless Movements
Athetosis
What is Chorea?
-Involuntary, Arrhythmic Movements which are Forceful, Rapid, and Jerky
-May be Complex but never combined into a Coordinated Act
-Often Superimposed on Voluntary Movements
A patient comes in doing all this shit: What is this called?
-Involuntary, Arrhythmic Movements which are Forceful, Rapid, and Jerky
-May be Complex but never combined into a Coordinated Act
-Often Superimposed on Voluntary Movements
Chorea
What are some treatments for Parkinsons?
-Levodopa and Dopamine Agonists
-Amantidine
-MAO-B Inhbitors
-Deep Brain Stimulation - STN and GPi
What is Essential Tremor? Describe its characteristics?
-Upper Extremity Tremor with Posture and/or Action
-Bilateral, Usually Roughly Symmetric
-Typically of Long-Standing Duration
What is Myclonus? Describe its characteristics?
-Not a Termor
-Sudden, Shock-like Muscle Contractions
-May be Regular and Rhythmic but usually Irregular and Jerky
-Epileptic or Non-Epileptic
What are some possible causes of Chorea?
-Medications - Haldol, reglan
-Huntington's Disease
-Hemiballism (Stroke)
-Post-Infectious (Strep Infection)
-Pregnancy
-Other Disorders
What is Cogwheel Rigidity?
-Special Form of Rigidity that Exhibits a Rhymic Resistance that is Ratchet-like in Character
-Seen when the Limb is Passively Stretched
What is Lead-Pipe Rigidity?
-Hypertonus is Uniform throughout the movement of the muscle
-No Initial Free Interval as seen in Spasticity
What is Huntington's Diseaes? What is it Characterized by? How does it result?
-Inherited Disease of the CNS
-Progressive Dementia, Involuntary Choreic Movements
-Result from Degeneration of the Caudate and Putamen
What is Akathisia?
-Motor Restlessness with a "Desire to Move"
-Difficult for Patients to Describe
What is Ataxia? What can cause it?
-Symptomatic Interruption of Cerebellar Pathways
-Lesions to almost anywhere
What is Ballismus? What causes it? What is it called if only one side is affected?
-"Jumping About"
-Characterized by Violent Flinging of the Limbs
-Usually a Stroke to the STN
-Hemi-Ballismus - More Common
What is Wilson Disease?
-Disorder of Copper Metabolism
-Affects Brain and Liver
-Hallmark - Kayser-Flischer (Copper Colored) Ring around the the Cornea
A patient comes in with a Copper-Colored ring around their eyes, why might they're problem be?
Wilson's Disease
How can Dementia result in Huntington's Disease?
From Loss of Cortical and Subcortical Cells
What is Tardive Dyskinesia?
-Iatrogenic Disorder
-Antipsychotics Block D2 Receptors
-Relieves Schizophrenia, Cause Movement Disorder
A patient has a lesion to the STN. What is this called? What results?
Ballismus
What is Dysmetria?
Poor targeting of planned movments
What is Intention Tremor?
Rhythmic Tremor at the end of a planned movement
What types of Disorders are Dysmetria, Intention Tremor, and Ataxia?
Cerebellar Movement Disorders