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Medicine - Year 1 > Block 5 - Musculoskeletal and Nervous System 2 > Flashcards

Block 5 - Musculoskeletal and Nervous System 2 Flashcards

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1
Q

What does the cerebellum do?

A 
Coordination and refining of movements by detecting motor errors
Motor memory (conscious and unconscious learned movements)
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2
Q

What does the basal ganglia do?

A

Selection and initiation of voluntary movements

Cognition, attention and working memory

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3
Q

What do the cerebellum and basal ganglia do together?

A

Increase the accuracy of movements by providing feedback loops to motor and sensory areas in the cortex to modify signals from UMN

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4
Q

What are the two pathways for signals to leave the cerebral cortex by?

A

Cerebral cortex - Brainstem - Spinal cord - Body - Movement

Cerebral cortex - Basal ganglia + Cerebellum - Thalamus - Cerebral cortex

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5
Q

Where is the cerebellum located?

A

In the hindbrain underneath the cerebral cortex

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6
Q

What is the structure of the dorsal surface?

What is this called?

A

Folded

Folia

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7
Q

What does damage of the cerebellum lead to?

A

Jerky, uncontrolled and inaccurate movements

IPSILATERAL (SAME SIDE)

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8
Q

What does damage of the basal ganglia lead to?

A

Uncontrolled and decreased movements at rest

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9
Q

What are the 3 parts of the cerebellum?
What do they do?
Where are they found?

A

Cerebrocerebellum: Inputs from the cerebral cortex; regulated high skilled movements and sequences
(2 SIDES)

Spinocerebellum: Input from the spinal cord
(MIDDLE)

Vestibulocerebellum: Inputs from the vestibular nuclei in the brainstem to coordinate movement, balance and posture. Made from foccules and nodules
(BOTTOM)

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10
Q

How is the cerebellum attached to the pons?

A

By peduncles

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11
Q

What are the three cerebellar peduncles?
Which pathways are they involved in?
Where do they project to?

A

Superior cerebellar peduncles: Efferent pathway - Midbrain
Middle cerebellar peduncles: Afferent pathway - Pons
Inferior cerebellar peduncles: Efferent and Afferent - Medulla + Spinal cord

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12
Q

What are two motor input pathways to the cerebellum?

Where do they decussate?

A

Cerebral cortex - Pontine nucleus (DECUSSATE) Cerebellum

Cerebral cortex - Red nucleus - Inferior olive (DECUSSATE) Cerebellum

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13
Q

What is the sensory input pathway to the cerebellum?

Does this pathway decussate?

A

Spinal cord/Vestibular nucleus - Inferior cerebellar peduncle - Cerebellum
Does NOT decussate

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14
Q

What is the output pathway from the cerebellum?

A

Cerebellum - Deep cerebellar nuclei (DECUSSATE in superior cerebellar peduncle) - Thalamus - Primary + premotor cortex

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15
Q

What are the deep cerebellar nuclei?

What do they do?

A

Output structures in the white matter

Relay corticol cerebellar information to the motor cortex and brainstem as a feedback mechanism to correct movement

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16
Q

What are the 2 output pathway for the vestibulocerebellum?

A

Fastigial nucleus - Medial descending systems - Motor execution
Vestibular nuclei - Balance and eye movements

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17
Q

What is the output pathway for the spinocerebellum?

A

Interposed nucleus - Lateral descending systems - Motor execution

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18
Q

What is the difference between lateral and medial descending systems?

A 
Lateral = LIMBS
Medial = TRUNK
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19
Q

What is the output pathway for the cerebrocerebellum?

A

Denate nucleus - Motor + premotor cortex - Motor planning

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20
Q

What are the 2 input pathways to the cerebellum?

A

Cerebral cortex, spinal cord and vestibular system –> Mossy fibres which synpase onto granule cells –> Parallel fibres which synapse with purkinje fibres

Inferior olive –> Climbing fibres which synapse with purkinje fibres

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21
Q

What is the output pathway from the cerebellum?

A

Purkinje fibres synapse onto neurones in the deep cerebellar nuclei –> GABA –> Thalamus and motor cortex

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22
Q

What are the interneurones in the cerebellum?

A

Granule, Satellite, Golgi and Basket cells

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23
Q

What happens if there is a lesion in the vestibulocerebellum?

A

Damage to balance and eyes

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24
Q

What happens if there is a lesion in the spinocerebellum?

A

Impaired gait and decreased smoothness of movement

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25
What happens if there is a lesion in the cerebrocerebellum?
Impairments in highly skilled sequences
26
What is sent to sensory neurones before you tickle yourself?
An efference copy
27
What does alcohol degenerate in the cerebellum? | Which limbs are affected?
The anterior cerebellum | Lower limbs affected
28
What is cerebellar ataxia?
Jerky, imprecise and uncoordinated movements
29
What is Dyssynergia?
Patients move joints separately, not simultaneously
30
What is Dysmetria?
The inability to judge distance
31
What is Dysdiadochokinesia?
You can't do rapid, alternating movements
32
What is an intention tremor?
A tremor when you're moving
33
What is ataxicdysarthria?
Slurred speech
34
Where is the basal ganglia? | What is it?
Underneath the cerebral cortex but outside the thalamus | A collection of functionally distinct nuclei
35
What is the input zone to the basal ganglia?
Caudate nucleus and putamen --> Striatum
36
What is the output zone to the basal ganglia?
Globus Pallidus and substantia nigra --> Pars Reticula
37
What excites and inhibits the basal ganglia?
Excities: Glutamate from the motor cortex Inhibits: Basal ganglia and feedback mechanisms
38
What are the three input pathways to the Basal Ganglia? | What neurotransmitter is involved with 2 of them?
Corticostriatal pathway: Cerebral cortex --> Striatum (Glutamate) Nigrostriatal pathway: Substantia Nigra --> Striatum (Dopamine) Medium spiny neurones: Inputs to the striatum
39
What are the two output pathways from the basal ganglia?
Striatum - Substantia Nigra - Superior colliculus - Eye movements Striatum - Globus pallidus - limb and trunk movements - thalamus - motor cortex
40
What does the globus pallidus do to the thalamus? | What does this mean for movement?
Globus pallidus inhibits the thalaus causing decreased excitation of the motor cortex and decreased movement
41
What happens when the substantia nigra release dopamine and it binds to D1 in the striatum? What pathway is this?
Removes inhibition of the globus pallidus Thalamus excites the motor cortex Movement occurs DIRECT PATHWAY
42
What 2 things happen when the substantia nigra release dopamine and it binds to D2 in the striatum? What pathway is this?
Decreases inhibition on the globus pallidus causes increased inhibition of the thalamus Decreased inhibition of the subthalamic nucleus leads to increased excitation of the subthalamic nucleus and increased inhibition of the thalamus Thalmus sends no signal to the motor cortex causing no movement INDIRECT PATHWAY
43
2 causes of Parkinson's disease?
Idiopathic | Genetic
44
What type of disorder is Parkinson's? | 4 symptoms?
``` Hypokinetic (can't initiate movement) T: Tremor of hands R: Rigidity of muscles A: Akinesia (no movement) P: Postural problems ```
45
What happens in Parkinson's disease?
Degeneration of neurones in the substantia nigra causes a decrease in dopamine Decreased excitation of the direct pathway Decreased inhibition of the indirect pathway Increased inhibition of the thalamus and decreased movement
46
2 types of surgery used to treat Parkinson's?
Stem cell transplant to the putamen | Brain surgery to inactivate or remove the globus pallidus or thalamus
47
What happens during Huntington's disease? 2 symptoms and the type of disorder What drugs are used?
Loss of output from neurones in the striatum Hyperkinesia: Excessive and uncontrolled movements Drugs to DECREASE dopamine levels
48
What happens in Hemiballismus? | 3 symptoms
Death of striatal inputs to to globus pallidus decreases inhibition of the subthalamic nucleus and decreases excitation of the globus pallidus causing inhibition of the thalamus Rapid, flinging and violent movements of the limbs
49
What are Gyri?
Mounds of the brain
50
What are Sulci?
Grooves in the brain
51
What are Folia?
Mounds on the cerebellum
52
What lobes does the central sulcus separate?
Frontal and partietal
53
What does the longitudinal fissue separate?
The right and left hemispheres
54
Which is motor and sensory: the precentral or postcentral gyrus?
PREcentral gyrus = MOTOR | POSTcentral gyrus = SENSORY
55
How many hemispheres does the cerebellum have?
2
56
What is the Flocculondular system involved in? | What does it project to?
Equilibrium and muscle tone | Projects to the vestibular system
57
Where is the Paleocerebellum? | What does it cause?
Anterior hemisphere and vermis | Propulsive and stereotyped movement
58
What does the Neocerebellum cause?
Coordination of skilled and voluntary movement
59
What do the medial, superior and lateral parts of the homunculus control?
Medial: Pelvis and lower limbs Superior: Trunk Lateral: Face and upper limbs
60
What is the anterior and posterior supply to the brain? What cerebral arteries do they form? Where do they join?
Anterior: Internal carotid artery --> Anterior and middle cerebral arteries Posterior: Vertebral artery --> Basilar artery --> 2 posterior cerebral arteries Join at the Circle of Willis
61
Which cerebral arteries supply the lower and upper regions of the body? How?
Anterior: Lower Middle and posterior: Upper By supplying areas of the homunculus
62
What does a lesion in the middle cerebral artery cause?
Contralateral upper limb weakness Hemiplegia (contralateral paralysis) Hemianaethesia
63
What does a lesion in the anterior cerebral artery cause?
Contralateral lower limb weakness Hemiplegia (contralateral paralysis) Cortical-type sensory loss
64
What does a lesion in the posterior cerebral artery cause?
Contralateral hemisensory loss | Hemiparesis (loss of vision fields)
65
What is the pathway of the Dentatorubrothalamocortical pathway? Does it decusate? What is its role?
Cerebellum - dendate nucleus - red nucleus - thalamus - motor and somatosensory cortex DECUSSATES To refine movement
66
How does the brain make a somatosensory map? | What is the somatosensory map of?
Through ascending tracts | Of what the limbs are doing
67
What is lost during disconnection syndromes?
White matter
68
How many regions of the brain are there?
49
69
How are the different regions of the brain distinguished between?
Histological differences
70
What fibres link the right and left side of the brain?
Commisural fibres
71
What fibres link the same side of the brain?
Associated fibres
72
Which area of the brain is the primary motor cortex in?
Area 4
73
Which area of the brain is the supplementary motor cortex in?
Area 6
74
Which ares of the brain is the somatosensory cortex in?
Areas 1, 2 and 3
75
Which areas of the brain is the associated areas of the somatosensory cortex in?
39 and 40
76
What do lesions in area 4 cause?
Contralateral flaccid paralysis | Babinski
77
What do lesions in area 6 cause?
Contralateral spasticity | Increase in deep tendon reflexes
78
What do lesions in area 8 cause?
Difficulty moving the eye to the opposite side | lesion in left = eye cannot move to the right
79
What do lesions in area 1,2 and 3 cause?
Contralateral loss of touch, pressure and proprioception | Decreased pain in sensory areas
80
What do lesions in area 40 cause?
Tactile and proprioceptive dystonia (can't tell what things are when you touch them) Contralateral loss of left to right discrimination Hemineglect Apraxia
81
What do lesions in area 39 cause?
Akesia Dyslexia Agraphia (can't write)
82
Which hemisphere is language controlled by?
Left
83
What is the dominant hemisphere involved with? - language - motor - maths - music - surroundings
``` Speech Skilled motor formation Analytical arithmitic Trained musical ability Following directions ```
84
What is the non-dominant hemisphere involved with? - language - motor - maths - music - surroundings
``` Emotion Spacial analysis and attention Estimation and lining up of numbers Untrained musical ability Spacial orientation ```
85
What could Karl Wernicke's patient do/not do? Where was the lesion? What condition did they have? What was their hearing, speech and understanding like?
- Hear and speak fluently but not understand - The lesion was at the junction of the temporal , parietal and occipital lobes - Receptive/sensory aphysis
86
What could Pierre Broca's patient do/not do? Where was the lesion? What condition did they have? What was their hearing, speech and understanding like?
- They could understand language, know how to respond and move but could not speak - Lesion in posteroinferior frontal lobe - Expressive/motor aphysis
87
What is agraphia?
Slow and laboured speech
88
Where is the site in the brain for hearing?
Primary auditory cortex in the lateral fissure next to the language perception area
89
What happens to hearing if there is a one sided lesion? | Why?
There is no hearing loss as hearing is bilateral
90
What are the 3 tracts in the prefrontal cortex?
Neocortex, thalamus and limbic system
91
What 6 things is the prefrontal cortex involved in?
Decision making, goal directed behaviour, planning, prioritising, sequencing, thinking
92
What does a lesion in the prefrontal cortex lead to?
Disinhibition Personality and concentration change Higher intelligence Less shy
93
What functions does the middle cerebral artery supply?
Speech, language and hearing | Also supplies the frontal eye fields
94
What area does the anterior cerebral artery supply?
Basal ganglia, internal capsule and prefrontal cortex
95
What function does the posterior cerebral artery supply?
Vision
96
What % of blood to the brain does the middle cerebral artery supply?
60-80%
97
What areas of the brain does the middle cerebral artery run to?
Basal ganglia, internal capsule and thalamus
98
What is Homohymous Hemianopia?
Loss of a field of view in both eyes
99
What is Global Aphasia?
A language disorder
100
What is contralateral hemineglect
You are unaware of the side of your body opposite to the lesion
101
What is Ipsilateral gaze preference
The eyes point towards the lesion
102
What is Anosognosia
A decrease in self awareness
103
How does the anterior cerebral artery supply the internal capsule and basal ganglia?
By the medial striate artery (of Heubner)
104
What function does the anterior cerebral artery supply?
Defecation
105
What is vision controlled by?
The medial surface of the occipital lobe | Perpendicular to the parieto-occipital sulcus near th calcarine sulcus
106
What is visual agonsia?
Loose half the field of view
107
What does the posterior cerebral artery receive information from?
From the posterior communicating artery and other brain areas
108
Where is a movement planned?
Prefrontal cortex
109
Where is a movement sequenced?
Motor cortex
110
Where is movement initiated?
Basal ganglia

Medicine - Year 1 (20 decks)

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