Abcn Week 6

Front 1

What is the vermis

Back 1

Midline of the cerebellum

Front 2

Functions of lateral hemispheres of the cerebellum

Back 2

Motor planning for extremities

Front 3

Functions of intermediate hemispheres of cerebellum

Back 3

Distal limb coordination

Front 4

Functions of vermis and flocculonodular lobe of cerebellum

Back 4

Proximal limb and trunk coordination, balance and vestibulo-ocular reflects

Front 5

Deficits in coordination occur (ipsilateral or contralateral) to cerebellar lesion?

Back 5

Ipsilateral, due to double-crossing of fibers

Front 6

Lesions of cerebellar vermis cause:
A. Unilateral, ipsilateral deficits
B. Unilateral, contralateral deficits
C. Bilateral deficits

Back 6

Bilateral

Front 7

Name the three branches of the vertebrobasilar arteries that supply the cerebellum

Back 7

Posterior interior cerebellar artery (PICA)
Anterior inferior cerebellar artery (AICA)
Superior cerebellar artery (SCA)

Front 8

What is ataxia

Back 8

"Lack of order." Lack of normal coordination between movements at different joints. Irregular, wavering couse that seems to consist of continuous overshooting and overcorrecting. Includes dysmetria and dysrhythmia

Front 9

What is dysrhythmia

Back 9

Abnormal timing of movements

Front 10

What is dysmetria

Back 10

Abnormal trajectories through space

Front 11

Describe truncal ataxia

Back 11

Wide-based, drunklike gait

Front 12

Describe appendicular ataxia

Back 12

Ataxia on movement of the extremities

Front 13

What is dysdiadochokinesia

Back 13

Abnormalities with rapid alternating movements

Front 14

Name the main components of the basal ganglia

Back 14

Caudate, putamen, globus pallidus, subthalamic nucleus, substantia nigra

Front 15

What makes up the striatum?

Back 15

Caudate, putamen

Front 16

What makes up the lentiform nucleus?

Back 16

Globus pallidus, putamen

Front 17

Name the four major inputs to the basal ganglia

Back 17

Cerebral cortex, substantia nigra pars compacta, intralaminal nuclei, raphe nuclei

Front 18

Two types of movement disorders

Back 18

Hyperkinectic, hypokinetic

Front 19

What is hemiballismus and what would cause it?

Back 19

Unilateral wild flinging movements of the extremities contralateral to a lesion in the BG, typically the subthalamic nucleus

Front 20

Physiologically, what can cause bradykinetic movement disorders?

Back 20

Increased inhibitaory BG output to thalamus

Front 21

What is the difference between spasticity & rigidity?

Back 21

Spasticity refers to UMN lesions in corticopsinal tract while rigidity caused by BG is more continuous.

Front 22

What is cogwheeling

Back 22

Rathchetlike interruptions in tone that can be felt as limb is bent

Front 23

What is dystonia?

Back 23

Abnormal, often distorted positions of the limbs, trunk, or face. Can be generalized, unilateral, or focal

Front 24

What is athetosis?

Back 24

Writhing movement

Front 25

What is Wilson's disease?

Back 25

Autosomal recessive disorder of biliary copper excretion that cuases degeneration of the liver and basal ganglia. Manifestations include: Gradual onset of dysarthris, dystonia, rigidity, tremor, choreoathetosis, psychiatric disturbances

Front 26

What is chora?

Back 26

"Dance." Nearly continuos involuntary movements that are fluid or jerky, constantly varying.

Front 27

What can cause chorea?

Back 27

Huntington's disease, systemic lupus erythematosus (SLE), side effect of levodopa or antipsychotic medications

Front 28

What are two types of tics?

Back 28

Motor, vocal

Front 29

Describe Tourette's Syndrome

Back 29

4 times more common in boys, typically starts in late childhood, associated with ADHD and OCD, symptox wax and wane, characterized by persistent motor and vocal tics

Front 30

What i myoclonus?

Back 30

Rapid muscular jerk that can be focal, unilateral, or bilateral.

Front 31

Types of tremor

Back 31

Resting, postural (essential, action, static, kinetic), intention (ataxic, action)

Front 32

Type of tremor seen in PD

Back 32

Resting, pill-rolling

Front 33

Describe a postural tremor

Back 33

Prominent when limbs are actively held in a position, and disappears at rest. MAy increase with stress. Can be improved by beta-adrenergic antagonists such as propranolol. Severe cases may beneffit from ventrolateral thalamotomy or thalamic stimularion

Front 34

Describe intention tremor

Back 34

Associated with cerebellar disorders. Occurs when patient attempts to move limb towards a target.

Front 35

Describe PD

Back 35

- Onset age 40-70
- 1% of people over 65 have it
- Generally no familial tendency
- Characterized by triad of bradykinesia, resting tremor, cogwheel rigidity, accompanied by posutal instability that can cause unsteady gait.
- Starts unilaterally, becomes bilateral.
- NEARLY ALWAYS improves with levodopa
- Course is typically 5 to 15 years and can elad to eath or severe disability
- OTher characteristics: Masked facies, hypophonic voice, slow saccades and impaired smooth pursuit, micrographia, festinating gait, en bloc turning, bradyphrenia, depression, anxiety
- Dementia can occur later in the couse (15-40% or more)

Front 36

Describe progressive supranuclear palsy

Back 36

Degeneration of multiple structures around midbrian-diencephalic junction including superior colliculus, red nucleus, dentate nucleus, subthalamic nucleus, globus pallidus. Vertical eye movement limited, waxy rigidity, bradykinesia, numerous falls

Front 37

Describe dementia with Lewy bodies

Back 37

Prominent psychiatric symptoms early on, including visual hallucinations

Front 38

Describe corticobasalganglionic degerneration

Back 38

Parkinsonism together with cortical features such as apraxia

Front 39

Describe Huntington's disease

Back 39

Genetic disorder marked by progressive choreiform movement, dementia, psychiatric disturbances.
- PRogressive atrophy of striatum, especially caudate nucleus
- Abnormal of body movements, eye movements, emotions, and cognition
- 4-5 per 1 million
- Onset 30-50 years
- Psych can include depression, anxiety, mania, OCD, occasionally psychosis
- Median survival is 15 years
- Usually die from respiratory infections

Front 40

Pallidotomy can provide improvements with what?

Back 40

Bradykinesia, rigidity, medication-related dyskinesias

Front 41

Thalamotomy can provide improvement with what?

Back 41

Debilitating tremor

Front 42

Parkinson symptoms are a result of what?

Back 42

Dopamine deficiency

Front 43

Part of BG that appears to be associated with psychiatric symptoms

Back 43

Caudate

Front 44

Part of BG most associated with motor pathways dysfunction

Back 44

Putamen