23 Flashcards
(28 cards)
What aspects of movement does the cerebellum moderate?
Balance, coordination, and accuracy, important for tasks that require timing, important in acquiring new movement sequences
What aspects of movement do the basal ganglia moderate?
Important for force of movement, critical for learning new motor skills and organizing sequences
What are the two major pyramidal output tracts from the primary motor area? What is the difference between their functions?
Corticobulbar tracts: paths from the cerebral cortex to the pons and medulla that control facial movement
Corticospinal tracts: paths from the cerebral cortex to the spinal cord
Lateral corticospinal tract: controls movements in peripheral areas (hands and feet)
Medial (or anterior) corticospinal tract: Controls muscles of the neck, shoulders, and trunk; enables movement such as walking, bending, turning, standing up and sitting down
What is the difference between upper and lower motor neurons?
The upper motor neurons originate in the cerebral cortex and travel down to the brainstem or spinal cord, while the lower motor neurons begin in the spinal cord and go on to innervate muscles and glands throughout the body
What are the two corticospinal tracts we mentioned in class? What is the subdivision between the functions of the corticospinal tracts? What are extrapyramidal tracts?
Lateral corticospinal tract:
Controls movement in peripheral areas (hands and feet)
Medial (or anterior) corticospinal tract:
Controls muscles of the neck, shoulders, and trunk
Enables walking, turning, bending, standing up, and sitting down
Extrapyramidal tracts:
Motor pathways outside the corticospinal tracts; help regulate involuntary and postural movement
How are cortical motor disorders different from subcortical ones?
Cortical motor disorders:
Typically involves dysfunctions in the motor cortex, resulting in voluntary movement issues like paralysis or weakness
Subcortical motor disorders:
Involves the basal ganglia, cerebellum, or brainstem, affecting movement coordination, posture, and muscle tone.
Leads to disorders like tremors or rigidity (e.g., Parkinson’s, Huntington’s)
What is agrammatism? What is mutism?
Agrammatism: Agrammatism is a language production problem where grammatical elements are omitted or misused in speech and writing. It’s often associated with Broca’s aphasia and is characterized by simplified sentence structures, leaving out function words like articles and auxiliary verbs, and errors in grammatical morphemes like plural markers and tense indicators.
Mutism: Mutism refers to the inability or unwillingness to speak, regardless of whether it’s due to a physical cause, a psychological issue, or a conscious refusal
What two general types of problems are there with cerebellar disorders?
Motor coordination problems:
Difficulty in coordinating voluntary movements, leading to ataxia (uncoordinated movements)
Motor learning problems:
Difficulty learning or adaption motor skills
What is decomposition of movement?
The action is decomposed into parts.
What is intention tremor?
Intention tremor is a type of tremor that becomes more pronounced as a person attempts a purposeful, directed movement toward a target.
What is Parkinson’s disease? What is the proximate cause of PD?
Parkinson’s Disease:
Neurodegenerative disorder, primarily affecting movement
Proximate cause:
Degeneration of dopamine-producing neurons in the substantia nigra of the basal ganglia, impairing movement regulation
What is the incidence of the PD disease in people over 60?
Incidence: 1% of population older than 60 (estimates vary 15-300/100,000),
How much substantia nigra has usually been lost before the motor function impairments become noticeable? (60% of neurons, 80% of dopamine)
About 50% of the substantia nigra has usually been lost before motor impairments become noticeable
Explain the distinction between positive and negative symptoms?
Positive symptoms: resting tremor, rigidity, stoop, balance problems
People have these symptoms on top of normality, regular people do not have them
Negative symptoms: slow movement, hard to initiate movement, slow, festinating gait, no arm swing, lack of facial expression, slow, soft speech
They have less of something or slower than typical people
Recognize the positive motor symptoms in Parkinson’s disease
Tremor
Rigidity
Postural instability (balance issues)
Bradykinesia (slowness of movement)
Recognize the negative motor symptoms in Parkinson’s disease
Bradykinesia (slowness in initiating or completing movements
Hypomimia (reduced facial expressions)
Freezing (inability to start movement)
What is bradykinesia a synonym for (see book)? What is freezing in PD?
Bradykinesia: slowing down of voluntary movements
Freezing is the temporary, involuntary inability to move, often either while walking or starting to walk
Recognize non-motor symptoms for Parkinson’s disease.
Visuospatial deficits
Executive functioning deficits
Language difficulties (articulation, lack of emotional expression, word finding problems)
Mood (depression)
Dementia (age-related)
Which factors appear to protect against PD, what are risk factors for PD?
Environmental toxins risk increase
Cigarette smoking and coffee drinking risk decrease
What is the standard (primary) treatment for PD? What are some other treatments? What is the problem with L-dopa?
Primary Treatment:
L-Dopa
Other Treatments:
Deep brain stimulation and stem cell therapy,
Problem with L-Dopa:
Long-term use can cause motor fluctuations, such as on-off effects or dyskinesia (involuntary movements)
What is deep brain stimulation? When is deep brain stimulation not an option?
Deep Brain Stimulation:
Implanting electrodes in specific brain areas (e.g., subthalamic nucleus) to modulate neural activity and reduce symptoms of PD
Not an option:
If the patient has severe cognitive decline or psychological issues
How effective is stem cell therapy right at this point in time?
Stem cell therapy for Parkinson’s disease shows promise but is not yet a standard treatment. Early clinical trials have demonstrated safety and some improvement in motor function, but larger trials are needed to confirm its efficacy and long-term effects.
For which symptom of PD did we see deep brain stimulation used?
Motor symptoms, helps regain control of limbs. See above.
What is Huntington’s disease? (genetic, progressive, subcortical)
Associated with gradual and extensive brain damage especially in the caudate nucleus, putamen, globus pallidus, and the cerebral cortex.
More rare than PD - very little that can be done
Destruction of basal ganglia
Cortex is thinner, white matter shrunk - destruction of brain
