Exam #3: Lesions III Flashcards Preview

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Flashcards in Exam #3: Lesions III Deck (25):
1

What are the four general functions of the basal ganglia?

1) Inhibiting involuntary movement at rest
2) Disinhibiting voluntary movement
3) Accelerating voluntary movements
4) Stopping movements upon completion

2

Once you have identified that there is a basal ganglia deficit, accompanied by behaviroal deficit, what structure is implicated?

Head of the caudate

3

What are the MRI signs of Huntington's Disease?

- Atrophy of the Head of the Caudate with enlarged lateral ventricles
- Loss of corticostriatal fibers that leads to cortical atrophy

4

What is the name for the pathognmenoic presentation of Huntington's Disease?

Chorea

****Note that patients also have:
- Dystonia
- Torticolis
- Blepharospasm
- Athetosis
- Hemiballismus

5

What is dystonia?

Constant contraction of a muscle

6

What is Torticolis?

"Twisted neck"

7

What is a blepharospasm?

Involuntary blinking and holding of the eyes shut

8

What type of tremor is seen in PD?

"pill-rolling"

9

What are the characteristics of PD?

- Pill-rolling tremor
- Difficulty initiating movement
- Reptilian stare--lack of blinking

10

What is the general sequence of structures in the basal ganglia?

Cortex
Striatum
Pallidum
Thalamus

11

What is a surgical intervention for PD?

Pallidotomy

12

What are the major functions of the cerebellum?

1) Integration of equilibrium & locomotion
2) Integration of head & eye movements (MLF)
3) Coordinating voluntary movements

13

What tract sends cortical information to the cerebellum (via the pons)?

Corticopontocerebellar pathway

14

What pathway runs from the cerebellum to the cortex?

Dentorubrothalamic tract

15

What are the tracts that make adjustments to ongoing movements?

Vestibulospinal
Rubrospinal

16

What type of deficits are seen in cerebellar lesions?

IPSILATERAL deficits

17

Where does the corticopontocerebellar tract cross-over?

Pons

18

If you lesion the cerebellum directly in the midline, which direction will the patient fall?

Equal amount of chance to fall to EITHER side

19

What arteries supply the cerebellum?

AICA
PICA

20

What part of the brain must AICA go around?

Pons

*****AICA sends a few arteries to the pons (laterally) as it goes around it--at the pontomedullary junction

21

What part of the brain must PICA go around?

Brainstem

****PICA sends a few arteries to the brainstem (laterally)

22

Where does the superior cerebellar artery send bracnhes?

Midbrain

- Supplies the superior cerebellum, but as it travels to the cerebellum, it also supplies the midbrain

23

What type of lesion should you suspect if you see mixed brainstem & cerebellar signs?

Infarct of the superior cerebellar artery

24

What are the hallmarks for SCA Syndrome?

- Ipsilateral Dysmetria
- Contralateral pain & temperature loss
- Contralateral superior oblique paralysis
- Ipsilateral Horner's Syndrome

25

What are the symptoms of Horner's Syndrome?

- Upper lid ptosis
- Constricted pupil
- Flushed, dry face