Chapter 15

Question 1

Functions of BG

Answer 1

Refinement of cortically initiated motor activity

By suppression of competing movements extraneous to the target motor activity

Regulation of associated automatic motor movements

Contributes to species specific learned motor control and built in reflex control for highly skilled movements

Plays roll in skilled movements, higher mental functions, memory, emotion, cognitive, linguistic function

Question 2

BG is NOT involved with

Answer 2

Movement initiation

Direct protections to LMN

UMN symptoms

Lesions induced paralysis

Spinal motor neuron activity or cranial

Question 3

BG lesions cause

Answer 3

Inhibitory control

Involuntary movements

Dyskinesia, bradykinesia, hypokinesia, akinesia, dystonia

Question 4

BG lesions

Answer 4

BG nuclei communicate to and from motor cortex on ipsilateral side

Symptoms would be contralateral

Question 5

Structures of BG

Answer 5

Caudate nucleus, putamen, and globus pallidus

Functionally relates nuclei- subthalamus, substantia nigra

Question 6

Primary BG neurotransmitters

Answer 6

Glutamate

Dopamine

GABA

Acetylcholine

Substance P

Enkephalin

Question 7

BG First loop

Answer 7

Projections from sensorimotor and prefrontal cortex to neostriatum, GP, thalamus, and MC

Incorporation of integrated BG projections to neocortex

Most central

Motor impulses from sensorimotor and prefrontal to cn and putamen and GP int & ext
From here projection travel back to cortex after passing through VL and VANT thalamus

Question 8

BG loop 2

Answer 8

Bidirectional projections connecting striatum to substantial nigra

Question 9

BG loop 3

Answer 9

GP ext projections to sunthalamic nucleus and projections back to GP int

Question 10

BG loop 4

Answer 10

Intralaminar and pontoreticular projections to striatum

Question 11

Striatum

Answer 11

Caudate nucleus and putamen

Question 12

BG is important for

Answer 12

Cognition

Personality

Refining motor activity

Question 13

BG diseases cause

Answer 13

Loss of precision and inhibitory control

Loss of adequate inhibitory control on MC leading to involuntary motor behavior

Dyskinesia, bradykinesia, chorea, tremor, and impaired postural positions

Question 14

Signs of BG dynfunctioming

Answer 14

Athetosis

Buccofacial muscles

Hemiballism

Chorea

Tremor

Dystonia

Question 15

Athetosis

Answer 15

Sow involuntary twisting of axial and speech muscles with hypertonic

Question 16

Hemballism

Answer 16

Forceful swinging her key and sudden movements of arms and legs

Subthalamic nucleus- suspected site for BG dysfuntionjng

Question 17

Chorea

Answer 17

Rhythmic quick and graceful looking involuntary movements

Question 18

Sydenham chorea

Answer 18

Post infections condition appearing in childhood between ages 5-13 years after streptococcal infection and fever

Question 19

Huntington chorea

Answer 19

Progressive neurologic condition with dementia, dysarthric speech, and personality change

Caudate degeneration leading to depletion of striatal cholingeric and GABAergic neurons

Disinhibition induced involuntary motor movements of chorea

Caudate nucleus and protein gal cortical atrophy suspected sites

Autosomal dominant disease

Adult onset

50% chance inheritance

Question 20

Caudate nucleus

Answer 20

Suspected site BG dysfunctioning chore

Question 21

Tremor

Answer 21

Constantly alternating motor activity in one or more part of body

Question 22

Resting tremor

Answer 22

Degenerative changes in substantial nigra PD

Question 23

Intention tremor

Answer 23

Approaching voluntary movements (cerebellar lesions)

Question 24

Associated symptoms with tremor (BG Dysfunctioning)

Answer 24

Masked face

Infrequent blinking

Slow
Movements

Disequilibrium

Stopped posture

Dysarthria

Dysphasia

Question 25

Dystonia

Answer 25

Torticollis- lateral fixation of neck Musculorum deformAns- sustained involuntary movements of axial and limb muscles Tics- common dyskinesia behaviors like throats clearing, sniffling, excessive blinking Gilles de lA Tourette syndrome- hypersensitive dopMinergic receptors

Question 26

Lesion of globus pallidus and corpus striatum (putamen)

Answer 26

Athetosis Toxicity, striatAl degeneration, and hypoxia owning to carbon monoxide poisoning

Question 27

Subthalamic nucleus lesion

Answer 27

Ballism Stroke or denervation

Question 28

Striatum lesion

Answer 28

Chorea Huntington chorea

Question 29

Substantial nigra lesion

Answer 29

Dyskinesia Akinesia Bradykinesia Hypokinesia Tremor Parkinson's

Question 30

BG diseases

Answer 30

Parkinson's Resting tremor Cogwheel muscular rigidity Bradykinesia Loss of postural reflexes Paucity of facial expressions Shuffling gait

Question 31

BG disease treatment

Answer 31

L-dopa Deep brain stimulation Pallidotomy

Question 32

Deep brain stimulation

Answer 32

Intralaminar or subthalamic stimulation

Question 33

Pallidotomy

Answer 33

Or STN stimulation to reduce inhibitory output from GPM thereby facilitating movement

Question 34

Tardive dyskinesia

Answer 34

Involuntary movements of facial and lingual muscles from psychotropic drugs Drugs used to treat mental illness

Question 35

Wilson disease

Answer 35

Hepatolenticular degeneration Progressive disease (10-25 years onset) Metabolism Degeneration of BG cirrhosis of liver Muscular rigidity, tremor dynarthria and progressive dementia Treatment- diet and medication

Question 36

Progressive Supra unclear palsy- brain stem cellular degeneration

Answer 36

Symptoms- initial- gaze palsy and imbalance Late- bradykinesia m, impaired Gait control, facial grimaces, dysarthria, and dysphasia Personality changes- socially withdrawn with possible cognitive impairments Treatment- l-dopa

Question 37

BG and psychiatric disorders

Answer 37

Neurotransmitter dysfunctions in associated psychiatric illness High incidence of depression Parkinsonsims High depression and suicide Depression and altered personality Altered dopaminergic protections- Tourette and schizophrenia