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Neurology > Movement Disorders > Flashcards

Movement Disorders Flashcards

(51 cards)

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1
Q

homology to Glopus Pallidum interna

A

Substantia Nigra pars reticularis

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2
Q

homology to Glopus Pallidum interna

A

Substantia Nigra pars reticularis

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3
Q

Direct Pathway in BG

A

Excitatory cortical neurons —>
Putamen —> inhibitory on GPi
GPi —> inhibits Thalamus

Total: Disinhibition of Thalamus —> more motor activity from Thalamus to cortex facilitating movement!

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4
Q

Indirect Pathway BG

A

Excitatory cortical neurons —>
Putamen —> inhibition of GPe —>
GPe —> inhibits STN
—> totaling in disinhibition of the STN!

STN —> excitation of GPi
—> by this GPi is excited and inhibits Thalamus

Total: indirect pathway is inhibiting the thalamo-cortical pathway = cortical inhibition: less movement

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5
Q

SN to Putamen

A

D1 = activating (excitatory) direct pathway

D2 - inhibiting indirect pathway

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6
Q

Loss of SN neurons

A

1) less excitation of direct pathway = less facilitation of thalamo cortical movement
2) less inhibition of the indirect pathway (D2)

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7
Q

Huntingtons BG physiology

A

loss of indirect pathway neurons: less suppression of movement

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8
Q

medium spiny neurons in direct pathway from GPi to thalamus: Biochemistry

A

GABA
substance P
Dynorphin

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9
Q

indirect pathway GABA neurons

A

Enkephalin colocalized

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10
Q

Which neurons contain Acetylcholine in the BG?

A

Large Aspiny Striatal Interneurons

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11
Q

Dopamine receptors with adenylate cyclase

A

D1

D5

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12
Q

Migraine serotonin pharmacology:

A

1) Serotonin agonists for 5-HT1B agonists
- - sumatriptan, rizatriptan, and naratriptan
- migraine and cluster

2) 5-HT1D agonist: vasoconstriction of blood vessels in the brain.

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13
Q

5-HT1A

A

Azapirones such as buspirone, gepirone, and tandospirone are 5-HT1A agonists marketed primarily as anxiolytics, but also recently as antidepressants.

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14
Q

5HT1B

A

Serotonin agonists for 5-HT1B agonists

    • sumatriptan, rizatriptan, and naratriptan
  • migraine and cluster
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15
Q

Hoehn and Yahr

A

I - unilateral only, minimal or no functional impairment

II - Bilateral or midline involvement without impairment of balance

III - mild to moderate disability

IV - fully developed severely disabling disease; still able to walk and stand

V - confined to bed or wheelchair

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16
Q

Pathology of PD

A

1) SN: neuronal loss, gliosis, cytoplasmic inclusions: Lewy bodies pale halo
2) Lewy bodies also in locus coeruleus, dorsal motor nucleus of vagus,
3) intermediolateral column spine
4) Myenteric intestinal neurons show Lewy bodies

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17
Q

Braak and Braak staging

A

1&2: presymptomatic: Lewy bodies in medulla oblongata and olfactory bulb
3:&4: SN and other ncl
5&6: telencephalic cortex

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18
Q

Effect of anticholinergics in PD:

A

trihexyphenidyl, benztropine: muscarinic antagonists
Tremor reduction
rigidity reduction

no effect on bradykinesis

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19
Q

L-Dopa Side Effects

A

nausea, vomiting, orthostatic hypotension, sedation, confusion, sleep disturbances, alterations of dream phenomen, hallucinations, dyskinesia

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20
Q

Thalamic DBS in PD effect:

A

1) 75% reduction in Tremor
2) small effect on rigidity
3) no effect on bradykinesia

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21
Q

MSA pathology

Study These Flashcards
A

neuronal loss and gliosis:
striatum, SN, locus coeruleus, inf olive, pontine nuclei, purkinje, intermediolateral cell column, Onuf nuclei in sacral cord,

Glial intracellular inclusions: alpha synuclein

22
Q

Onuf nucleus

Study These Flashcards
A

sacal cord lamina IX resposnible for micturition and defacation

23
Q

MSA wheelchair bound

24
Q

Granulovacuolar Degenration

Study These Flashcards
A

1) in AD in hippocampus

2) in PSP in Brain stem

25
Granulovacuolar Degenration
1) in AD in hippocampus | 2) in PSP in Brain stem
26
Direct Pathway in BG
Excitatory cortical neurons ---> Putamen ---> inhibitory on GPi GPi ---> inhibits Thalamus Total: Disinhibition of Thalamus ---> more motor activity from Thalamus to cortex facilitating movement!
27
Indirect Pathway BG
Excitatory cortical neurons ---> Putamen ---> inhibition of GPe ---> GPe ---> inhibits STN ---> totaling in disinhibition of the STN! STN ---> excitation of GPi ---> by this GPi is excited and inhibits Thalamus Total: indirect pathway is inhibiting the thalamo-cortical pathway = cortical inhibition: less movement
28
SN to Putamen
D1 = activating (excitatory) direct pathway | D2 - inhibiting indirect pathway
29
Loss of SN neurons
1) less excitation of direct pathway = less facilitation of thalamo cortical movement 2) less inhibition of the indirect pathway (D2)
30
Huntingtons BG physiology
loss of indirect pathway neurons: less suppression of movement
31
medium spiny neurons in direct pathway from GPi to thalamus: Biochemistry
GABA substance P Dynorphin
32
indirect pathway GABA neurons
Enkephalin colocalized
33
Which neurons contain Acetylcholine in the BG?
Large Aspiny Striatal Interneurons
34
Dopamine receptors with adenylate cyclase
D1 | D5
35
Migraine serotonin pharmacology:
1) Serotonin agonists for 5-HT1B agonists - - sumatriptan, rizatriptan, and naratriptan - migraine and cluster 2) 5-HT1D agonist: vasoconstriction of blood vessels in the brain.
36
5-HT1A
Azapirones such as buspirone, gepirone, and tandospirone are 5-HT1A agonists marketed primarily as anxiolytics, but also recently as antidepressants.
37
5HT1B
Serotonin agonists for 5-HT1B agonists - - sumatriptan, rizatriptan, and naratriptan - migraine and cluster
38
Hoehn and Yahr
I - unilateral only, minimal or no functional impairment II - Bilateral or midline involvement without impairment of balance III - mild to moderate disability IV - fully developed severely disabling disease; still able to walk and stand V - confined to bed or wheelchair
39
Pathology of PD
1) SN: neuronal loss, gliosis, cytoplasmic inclusions: Lewy bodies pale halo 2) Lewy bodies also in locus coeruleus, dorsal motor nucleus of vagus, 3) intermediolateral column spine 4) Myenteric intestinal neurons show Lewy bodies
40
Braak and Braak staging
1&2: presymptomatic: Lewy bodies in medulla oblongata and olfactory bulb 3:&4: SN and other ncl 5&6: telencephalic cortex
41
Effect of anticholinergics in PD:
trihexyphenidyl, benztropine: muscarinic antagonists Tremor reduction rigidity reduction no effect on bradykinesis
42
L-Dopa Side Effects
nausea, vomiting, orthostatic hypotension, sedation, confusion, sleep disturbances, alterations of dream phenomen, hallucinations, dyskinesia
43
Thalamic DBS in PD effect:
1) 75% reduction in Tremor 2) small effect on rigidity 3) no effect on bradykinesia
44
MSA pathology
neuronal loss and gliosis: striatum, SN, locus coeruleus, inf olive, pontine nuclei, purkinje, intermediolateral cell column, Onuf nuclei in sacral cord, Glial intracellular inclusions: alpha synuclein
45
Onuf nucleus
sacal cord lamina IX resposnible for micturition and defacation
46
MSA wheelchair bound
5 years
47
PSP pathology
- midbrain atrophy - sylvian aqueduct dilated - SN depigmented orange shrunk - locus coreuleus (less prominent tan other PD) - frontal lobe, STN, sup cerebellar peduncle, - eriaqueductal grey neurofibrillary tangles Granulovacuolar Degenrations in Brain stem
48
Granulovacuolar Degenration
1) in AD in hippocampus | 2) in PSP in Brain stem
49
Corticobasal Degeneration Pathology
brain atrophy tau positive neuron and glial astrocytic plaques median survival 7 years
50
CBD PET scan
asymetrical hypometabolism thalamus and motor cortex
51
Guardeloupean PD
``` french west indies levodopa unresponsive PD postural instability early falls pseudobulbar palsy PSP like ``` RETICULINE and COREXIMINE mitochondrial toxin in soursoup/corossol/guanbana/graviola

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