Movement Disorders

Question 1

what artery mainly supplies the Basal ganglia?

Answer 1

MCA

Question 2

what part of the basal ganglia is adjacent to the lateral ventricleS?

Answer 2

caudate nucleus

Question 3

what is adjacent to the caudate nucleus on lateral side?

Answer 3

internal capsule

Question 4

what is lateral to the internal capsule?

Answer 4

globus pallidus

Question 5

what is lateral to the globus pallidus that is part of the basal ganglia

Answer 5

putamen

Question 6

D1 is of the direct pathway in the BG and leads to excitatory or inhibitory synapses?

Answer 6

excitatory dopamine synapses

Question 7

D2 is of the indirect pathway and leads to excitatory or inhibitory synapses in the BG?

Answer 7

inhibits the indirect pathway to increase movement

Question 8

what portion of the BG forms dopamine?

Answer 8

pars compacta of the substantia nigra

Question 9

in addition to GABA and dopamine, what other Nt is involved in the striatum of the BG?

Answer 9

cholinergic neurons

Question 10

what is the effect of the chilinergic neurons in the BG?

Answer 10

opposite of dopamine…excite indirect pathway and inhibit direct pathway…limit movement

Question 11

what are the two types of hypokinesia to know?

Answer 11

bradykinesia and rigidity

Question 12

what is bradykinesia?

Answer 12

slow movement

Question 13

what is akinesia?

Answer 13

no movement at all

Question 14

what is rigidity?

Answer 14

stiffness and resistance to movement

Question 15

what is the type of rigidity seen in parkinsons?

Answer 15

cogwheel rigidity

Question 16

what is parkinsons disease an issue with?

Answer 16

substantia nigra destroyed

Question 17

what does substantia nigra destruction lead to?

Answer 17

more inhibition of the thalamus and movement than excitation

Question 18

what are the four motor features of parkinsons?

Answer 18

tremor
rigidity
bradykinesia
postural instability

Question 19

what are the non motor symptoms of parkinsons?

Answer 19

depression
dementia
constipation
orthostatic hypotension

Question 20

what accumulates in parkinsons and where does it accumulate?

Answer 20

alpha synuclein accumulates in neuronal cell bodies

Question 21

how does alpha synuclein appear in neuronal cell bodies in parkinsons?

Answer 21

round lamellated eosinophilic cytoplasmic inclusions

Question 22

what are the round lamellated eosinophilic cytoplasmic inclusions called in parkinsons?

Answer 22

Lewy bodies

Question 23

what is chorea?

Answer 23

irregular random semi directed smooth movements

Question 24

what is athetosis?

Answer 24

continuous writhing movements

Question 25

what is ballismus?

Answer 25

sudden vigorous forceful movements involving a whole limb

Question 26

what is dystonia?

Answer 26

sustained contraction of opposing muscle groups causing abnormal posture and twisting

Question 27

what is myoclonus?

Answer 27

sudden brief shock like movements

Question 28

what are the three types of tremors?

Answer 28

cerebellar physiologic essential

Question 29

when does cerebellar tremor occur/

Answer 29

at end of purposeful moevemtns

Question 30

what is an essential tremor?

Answer 30

postural and intention tremor

Question 31

where does essential tremor occur usually?

Answer 31

arms and head

Question 32

what is rx for essential tremo?

Answer 32

beta blockers and mysoline

Question 33

what relieves essential tremor?

Answer 33

booze

Question 34

when does parkinsons tremor occur?

Answer 34

at rest

Question 35

are essential tremors symmetric?

Answer 35

yes

Question 36

are parkinsons tremors symmetric?

Answer 36

no

Question 37

what is rx for dystonia?

Answer 37

botulinum toxin

Question 38

what is chorea a common feature of?

Answer 38

huntingtons

Question 39

what drugs can cause chorea?

Answer 39

antipsychotics...tardive dyskinesia

Question 40

what is an infection that leads to chorea?

Answer 40

streptococcal infection

Question 41

name systemic disease that can have chorea?

Answer 41

lupus `

Question 42

what stage in life can lead to chorea?

Answer 42

pregnancy...chorea gravidarum

Question 43

what is inheritance of huntingtons

Answer 43

AD

Question 44

what is genetic change in huntingtons

Answer 44

CAG trinucleotide expansion

Question 45

what is affected in the brain in huntingtons ?

Answer 45

atrophy of caudate nucleus

Question 46

with atrophy of caudate in huntingtons what else happens?

Answer 46

dilation of lateral ventricles

Question 47

when does huntingtons onset?

Answer 47

4th-5th decade of life

Question 48

tics are often part of what triad?

Answer 48

tics, OCD ADHD

Question 49

tourettes has what in diagnosis?

Answer 49

multiple motor tics and one vocal tic

Question 50

where is lesion in hemiballismus?

Answer 50

subthalamic nuclei

Question 51

what is cause of lesion in subthalamic nuclei that leads to hemiballismus?

Answer 51

vascular