CH04: Movement and Posture

Question 1

caudate nucleus + putamen

Answer 1

STRIATIUM

Question 2

main receptive part of the basal ganglia

Answer 2

PUTAMEN

Question 3

(2) output nuclei of the basal ganglia

Answer 3

MEDIAL PALLIDUM + PARS RETICULATA

Question 4

sample of drug that can induce Parkinsonism

Answer 4

Phenotiazine

Question 5

most pervasive role neurotransmitter but can act as excitatory or inhibitory

Answer 5

Dopamine

Question 6

areas with richest dopamine

Answer 6

(1) Cell bodies of Pars Compacta (2) Termination fibers in Striatum

Question 7

Location D1 and D2 receptors

Answer 7

STRIATIUM

Question 8

Location D3 receptor

Answer 8

Nucleus accumbens

Question 9

Location D4 receptor

Answer 9

Frontal cortex, limbic structures

Question 10

Location D5 receptor

Answer 10

Hippocampus and limbic system

Question 11

D1- like class

Answer 11

D1 and D5 subtypes

Question 12

D2- like class

Answer 12

D2, D3, D4

Question 13

Intermediate precursor of dopamine that crosses the blood-brain barrier

Answer 13

L- Dopa

Question 14

Addition of this enzyme in the catabolism of Dopamine

Answer 14

dopadecarboxulase

Question 15

Why add LDopa and CDopa

Answer 15

Minimize the systemic side effects

Question 16

(T/F) Psychological stress and anxiety worsen the abnormal movements in the EPS

Answer 16

TRUE

Question 17

tendency for the voluntary movement to adopt the frequency of a coexistent tremor

Answer 17

Entrainment

Question 18

A gentle push on the sternum or tug on the shoulders may cause a fall or start a series of small corrective septs that the patient cannot control

Answer 18

Festination

Question 19

Rhythmically interrupted, ratchet- like resistance

Answer 19

Cogwheel phenomenon

Question 20

Unable to relax a group of muscles on request

Answer 20

Paratonia

Question 21

Encompasses all the active movement phenomena that are a consequence of disease of the basal ganglia, implying an element of dystonia

Answer 21

Dyskinesia

Question 22

Chorea and myoclonus differ in what aspect

Answer 22

Myoclonic jerks is much faster and may involve single muscles

Question 23

Chorea after Streptococcal infection

Answer 23

Syndenham chorea

Question 24

(2) Paraneoplastic chorea antibodies

Answer 24

anti- CRMP, anti- Hu

Question 25

involuntary movements involve proximal limb muscles and are of wide range and flinging ni the nature

Answer 25

Hemiballismus

Question 26

Term stems from Greek word "unfixed"

Answer 26

Athetosis

Question 27

Idiopathic dystonia responding to extremely small doses of L- dopa

Answer 27

Segawa Disease

Question 28

A characteristic, almost diagnostic, example of the acute drug- induced dystonias

Answer 28

Retrocolis

Question 29

Give (3) drugs that can induce dystonias

Answer 29

L- Dopa, CCB, AEDs

Question 30

Surgery in these structures yielded positive but unpredictable results in dystonia

Answer 30

Pallidum, ventrolateral thalamus

Question 31

Numerous brief attacks of dystonia or CA provoked by sudden movement, startle, hyperventilation

Answer 31

Paroxysmal kinesigenic choreoathetosis

Question 32

Treatment for paroxysmal kinesigenic choreothetosis

Answer 32

Phenytoin and Carbamazepine

Question 33

Precipitated by ingestion of alcohol or coffee or fatuge

Answer 33

Second' nonkinesigenic choreoathetosis

Question 34

Treatment for nonkinesigenic choreoathetosis

Answer 34

Benzodiazepine

Question 35

Third type of paroxysmal choreoathetosis precipitated by prolonged exercise

Answer 35

Mount- Reback type VARIANT

Question 36

Treatment for Mount- Reback type VARIANT paroxysmal choreoathetosis

Answer 36

Acetazolamide

Question 37

involuntary rhythmic oscillatory movement produced by alternating or irregularly synchronous contractions

Answer 37

Tremor

Question 38

Tremor vs other involuntary movement distinguishing factor

Answer 38

Rhythmicity

Question 39

Tremor vs myocolonus and asterixis

Answer 39

Oscillatory nature

Question 40

Frequency of tremors

Answer 40

8- 13 Hz

Question 41

Commonest type of tremor

Answer 41

Essential (Familial) Tremor

Question 42

Essential tremor of non- alternate beat type can be supressed by this in 75% of cases

Answer 42

Alcohol

Question 43

Antibody associated with tremor of polyneuropathy

Answer 43

Anti- MAG

Question 44

coarse, rhythmic tremor with a frequency of 3-5 Hz characterized by bursts of activity that alternate between opposing muscle groups

Answer 44

Parkinsonian Tremor

Question 45

ratchet- like interruption perceived by the examiner on passive movement of an extremity

Answer 45

Negro sign

Question 46

sign when patient engages the opposite limb tracing circles in the air

Answer 46

Froment sign

Question 47

constant frequency, variable amplitude

Answer 47

Parkinsonian Tremor

Question 48

meperidine analogue that destroys neurons of the substantia niagri pars compacta (p. 96)

Answer 48

MPTP

Question 49

wide- ranging, rhythmic 2- 5 Hz "wing beating tremor" (p. 97)

Answer 49

Rubral tremor

Question 50

strong familial episodic trmor disorder of the chin and lower lip that begins in childhood and may worsen with age (p. 97)

Answer 50

Geniospasm

Question 51

chromosome involved with the mutation that causes geniospasm

Answer 51

Chromosome 9

Question 52

Tremor occuring during quiet standing and its cessation almsot immediately on walking (p. 97)

Answer 52

Orthostatic tremor

Question 53

Loading the limb exaggerates this tremor (p. 98)

Answer 53

Psychogenic and tremor by polyneuropathy

Question 54

arrhythmic lapses of sustained posture that allow gravity of the inherent elastocotu of muscles produce a sudden movement which the patient corrects (p. 99)

Answer 54

Asterixis

Question 55

sharp wave, probably generated in the motor cortex, immediately preceding a period of EMG silence (p. 99)

Answer 55

Asterixis

Question 56

rapid, shock-like contractions of group of muscles, irregular in rhythmn and amplitude (p. 99)

Answer 56

Myoclonus

Question 57

myoclonus associated with atypical petit mal and akinetic seizure (p. 101)

Answer 57

Lennox- Gastaut Syndrome

Question 58

stimulus sensitive (reflex) myoclonus autosomal recessive disease (p. 101)

Answer 58

Lafora- body disease

Question 59

myoclonus disease asociated with loss of Purkinje cells but NO inclusion bodies (p. 101)

Answer 59

Baltic variety of myoclonic epilepsy

Question 60

give (3) drugs taht can cuase myoclonus (p. 101)

Answer 60

Haloperidol, lithium, amphatemines

Question 61

T/F Action myoclonus is almost always associated with cerebellar ataxia (p. 102)

Answer 61

TRUE

Question 62

repeated stimuli may recruit a series of incremental myoclonic jerks that culminate in a generalized convulsion (p. 102)

Answer 62

Unverricht- Lundberg Syndrome

Question 63

most common mutation in startle syndromes (p. 103)

Answer 63

1- subunit of GLRA1

Question 64

act of flexing the neck and bringing hte arms close to teh torso decring the intensity of attackes of Startle syndromes (p. 103)

Answer 64

Vigevano maneuver

Question 65

gene associated with generalized torsion dystonia (p. 104)

Answer 65

DYT-1 mutation

Question 66

most frequent form of restricted dystonia (p. 104)

Answer 66

Torticolis

Question 67

percent of tortiolis with oral, mandibular or hand dystonia (p. 106)

Answer 67

15%

Question 68

percent of torticolis with blepharospasm (p. 106)

Answer 68

10%

Question 69

percent of torticolis with no relief with Botox injection (p. 106)

Answer 69

10%

Question 70

Blepharospasm with forceful opening of the jaw, retraction of the lips, spasms of the plastysma, protrusion of tongue (p. 107)

Answer 70

Meige syndrome

Question 71

treatment for tardive dyskinesia (p. 109)

Answer 71

Reserpine and Tetrabenazine

Question 72

main identifying features of tics and habit spasm (p. 109)

Answer 72

Stereotypy and irresistibility

Question 73

inner feeling of restlessness, inability to sit still, compulsion to move about (p. 111)

Answer 73

Akithisia