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31 Cards in this Set
- Front
- Back
Hemiballismus
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-contralateral subthalamic nucleus
-lacunar stroke -wild flail of arm or leg |
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Chorea
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-sudden jerky purposless movment
-basal ganglia -huntingtons |
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Athetosis
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-slow writhing movment - esp fingers
-basal ganglia -hintingtons |
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Myoclonus
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- sudden brief uncontrolled muscle contraction
- jerks, hiccups - common in renal and liver faiure |
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dystonia
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-sudden sustained contraction
-writer's cramp; eyelid twitch (blepharospasm) |
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Essential tremor
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-aka postural tremor
-action tremor, exacerbated by holding posture -genetic predisposition - tx: etoh, b-blocker, primidone |
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Resting tremor
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-uncontrolled movement of distal appendages
-tremor relieved by intentional movement -pill-rolling -Parkinsons |
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intention tremor
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-tremor when pointing
-cerebellar dysfunction |
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Basal ganglia: function and structure
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-voluntary movment and postural adjustment
-receives cortical input, provides negative feedback to cortex to modulate movement -striatum: putamen (motor) + caudate (cognitive) -lentiform: putament + globus pallidus |
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BG Excitatory
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-cortical input → stim striatum
-releases GABA -Disinhibits thalamus (via Globis pallidus interus and SNr -Increase motion |
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BG Inhibitory
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-cortical input → stim striatum
-disinhibits sub thalamic nucleus (via GPexterus) -STN stimulates GPi/SNr → inhibit thalamus -Dec motion |
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BG Dopamine
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-D binds to D1 → excitatory path → increase motion
-D binds to D2 → inhibit inhibitory path → increase motion |
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Right parietal lobe lesion
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-spatial neglect of contralateral side
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Kluver Bucy syndrome lesion
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-amygdala bilateral lesion
-hyperorality -hypersexuality -disinhibited -HSV-1 association |
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Reticular activating system (midbrain) lesion
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-dec arousal, wakefulness
-coma |
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Cerebellar hemisphere lesion
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-intention tremor
-limb ataxia -ipsilateral defects - fall toward lesion |
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Cerebellar vermis lesion
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-truncal ataxia
-dysartheria |
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Paramedian pontine Reticular Formation (PPRF) lesion
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-eyes look away from lesion
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Frontal eye fields lesion
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-eyes look toward lesion
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Broca
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-CAN understand
-Nonfluent aphasia – cant make words -Inferior frontal gyrus of frontal lobe |
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Wernicke’s
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-fluent aphasia – can make words
-CANNOT understand -Superior temoral gyrus of temporal lobe |
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Cerebral perfusion
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-Primarily driven by PCO2 --> adjusted until PCO2 > 90
-hypoxemia increases cerebral perfusion pressure only when PO2 < 50 |
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Basal ganglia lesion
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-may result in tremor at rest, chorea, or athetosis
-Parkinson's |
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Subthalamic nucleus lesion
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- contralateral hemiballismus
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Hippocampus lesion
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anterograde amnesia
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global aphasia
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both wernike and broke
nonfluent aphasia |
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conduction aphasia
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poor repetition but fluent
intact comprehension damage to arcuate fasiculus |
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Parkinson's disease:
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-Lewy bodies - made of a-synuclein intracellular inclusions
-loss of dopamine in S.Nigra -TRAP: Tremor, Rigidity, Akinesia, Postural instability |
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Huntington's
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- CAG repeats
- Xsome 4 - Anticipation - Caudate loses ACh and GABA - Chorea, aggression, depression **Neuronal death via NMDA-R binding and glutamate toxicity** **atrophy of striatal nuclei** |
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superior colliculi lesion
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paralysis of upward gaze
parinaud's syndrome |
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central pontine myelinolysis
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- acute paralysis, dysarthria, dysphagia
- diplopia - LOC - Locked in syndrome - axonal demyelination in pons - d2 rapid correction of NA levels |