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Pathophys II MHM - Exam 3 > Neuro Module 3 > Flashcards

Neuro Module 3 Flashcards

(69 cards)

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1
Q

What does the diencephalon consist of?

A
  • Epithalamus
  • Subthalamus
  • Hypothalamus
  • Thalamus
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2
Q

What is the thalamus and what does it do?

A
  • Gateway to the cortex

- Relays sensory input to cortex (EXCEPT CN 1)

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3
Q

Describe sensory input to the thalamus

A

ALL sensory must pass through thalamus (EXCEPT CN 1)

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4
Q

How does motor info pass through the thalamus?

A

Via basal ganglia

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5
Q

How does the limbic system relate to the thalamus?

A

Limbic connects to thalamus

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6
Q

Describe output from the thalamus

A
  • Most fibers project to the cortex (some to limbic areas and basal ganglia)
  • Somatosensory input to the thalamus “enters consciousness”
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7
Q

Anatomy of the thalamus

A
  • Oval shaped cluster of nuclei

- Comprises 80% of diencephalon

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8
Q

Nuclei functions of the thalamus

A
  1. RELAY NUCLEI - send specific info to a certain location in cortex
  2. ASSOCIATION NUCLEI - regulatory inputs from cortex project to these nuclei which project back to cortex
  3. INTRALAMINAR and MIDLINE NUCLEI - basal ganglia and limbic system project to these which go back to cortex
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9
Q

Define central pain

A

Sensation of pain (nociception) that originates in CNS

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10
Q

Define peripheral pain

A

Sensation of pain that originates in peripheral nerve

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11
Q

Define thalamic pain

A

Light somatosensory stimulus (or none at all) generate pain sensation due to thalamic damage (posterior)

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12
Q

Thalamic pain syndrome

A
  • Caused by thalamic stroke in posterior thalamus
  • Pain and loss of sensation
  • AKA Dejerine-Roussy, Posterior Thalamic syndromes
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13
Q

What is the internal capsule?

A
  • Bundle of fibers (white matter) located between thalamus/caudate nucleus and lenticular nucleus
  • Almost all neural connections pass to/from the cortex through the internal capsule
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14
Q

Function of the internal capsule?

A

Almost all neural connections pass to/from the cortex through internal capsule

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15
Q

What is corona radiata?

A
  • Part of internal capsule

- Broad expanse of white matter spanning up and out to the cortex

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16
Q

5 parts of the internal capsule

A
  1. Anterior limb
  2. Genu
  3. Posterior limb
  4. Retrolenticular part
  5. Sublenticular part
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17
Q

Posterior limb of internal capsule contains:

A
  • Thalamus to cortex pathway
  • Corticospinal and cotricobulbar tracts
  • VPL (input from body)/VPM (input from face) of thalamus project somatosensory fibers up to somatosensory cortex
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18
Q

What is the genu of the internal capsule?

A

Transition area between anterior and posterior limbs

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19
Q

Retrolenticular part of internal capsule contains:

A

Fibers connecting thalamus to posterior lobes of cerebral cortex including:
-Optic radiation (thalamus to visual cortex)

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20
Q

Sublenticular part of internal capsule contains:

A
  • Some fibers of optic radiation (like retrolenticular part)

- Auditory radiation (thalamus to auditory cortex)

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21
Q

What is a lacunar stroke?

A

“Small vessel stroke”
Blood supply to internal capsule:
-Lenticulostriate arteries of MCA
-Perforating arteries of ACA

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22
Q

Pathology of lacunar stroke

A
  • Micro deposits of CT or fatty tissue

- Necrotic tissue is then removed by macrophages leaving “holes” (for a few months)

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23
Q

What is the MC form of lacunar stroke?

A

Pure motor

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24
Q

Pure motor stroke

A
  • MC form of lacunar stroke
  • Posterior limb of internal capsule
  • Contralateral hemiparesis/plegia
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25
Types of lacunar stroke
1. Pure motor 2. Ataxic hemiparesis 3. Mixed motor and sensory 4. Pure sensory
26
Ataxic hemiparesis lacunar stroke
- Pons, posterior internal capsule and other areas - Site of lesion includes cerebellar AND motor pathways - Homolateral ataxia and crural paresis - Leg symptoms more than arms
27
Mixed motor and sensory lacunar stroke
- Infarct of posterior limb and thalamus | - Contralateral hemiparesis/paresthesia
28
Pure sensory lacunar stroke
- Least common type | - Lacunar stroke in thalamus
29
Define basal ganglia
Group of nuclei located bilaterally deep in telenchephalon, diencephalon, midbrain
30
Function of basal ganglia
Modify motor control (initiation and execution of)
31
5 major nuclei of basal ganglia
- Putamen - Caudate nucleus - Nucleus accumbens - Globus pallidus - Other: substantia nigra (midbrain), subthalamus (diencephalon)
32
How are basal ganglia classified?
- Lentiform nuclei (putamen and globus pallidus) - Striatum (putamen, caudate nucleus and nucleus accumbens) - Corpus striatum (all 3 - putamen, globus pallidus, caudate nucleus)
33
What do the basal ganglia stimulate the thalamus to do?
Either increase or decrease thalamic drive to the motor cortex
34
What happens with too much thalamic drive to motor cortex?
Excessive unwanted movement (hyperkinesis)
35
What happens with too little thalamic drive to motor cortex?
Not enough movement (hypokinetic)
36
Basal ganglia normal tone is:
Inhibition to thalamus
37
What does sum total direct and indirect pathways of basal ganglia determine?
Amount of thalamic inhibition
38
Direct pathway of basal ganglia
Cortex - striatum - GP - SNr - thalamus - cortex
39
Function of basal ganglia direct pathway
- Decreases inhibition - Results in HIGH thalamic drive - Facilitates movements
40
Indirect pathway of basal ganglia
Cortex - striatum - GP - STh - GP - thalamus - cortex
41
Function of basal ganglia indirect pathway
- Increases inhibition - Results in LOW thalamic drive - Blocks unwanted movements
42
Hypokinetic movement disorders
- Absence or difficulty w/intended movements | - Bradykinesia and rigidity
43
Hyperkinetic movement disorders
- Extraneous unwanted movements | - Chorea, athetosis, ballismus
44
Disorders of basal ganglia are classified as:
Hyper or hypokinetic
45
Define chorea
Involuntary, constant, rapid, complex body movements that flow from one part to another
46
Define choreiform
Resembling chorea (involuntary dance like movement of limbs)
47
Define athetosis
Slow, writhing movements of fingers and hands (sometimes toes)
48
Define ballismus
Violent, flailing movements
49
What causes hemiballismus?
Damage to subthalamic nuclei of basal ganglia
50
Define dystonia
Persistent spasm/posture of a body part which can result in grotesque movements and distorted positions of the body
51
Define tremor
Rhythmic, involuntary, oscillatory movements
52
Resting vs. postural tremor
- Resting tremor decreases with activity | - Postural increases with action
53
Essential tremor
- MC form - Occurs in a person who is moving or trying to move - Familial, no cause identified - Worsened by stress, fatigue, fear, anger, caffeine, cigs
54
What is the MC form of tremor?
Essential
55
What is a common cause intentional tremor?
Cerebellar pathology
56
Define bradykinesia
Slowing of voluntary movement
57
Define lead-pipe rigidity
Increased muscle tone (resistance) persists through ROM of a particular joint
58
Define cogwheel rigidity
Periodic muscle resistance at different points throughout ROM
59
Rigidity vs. spasticity
- Spasticity is speed dependent (moving slow can move limb through ROM) - Rigidity is NOT influenced by speed (moving fast or slow but still can't move through ROM)
60
Describe Parkinson's
- Hypokinetic disorder - Increased rigidity, resting tremor - Destruction of substantia nigra (reduced dopamine production) - Decreased thalamic drive to motor cortex
61
Causes of Parkinson's
- Genetic | - Environmental (pesticides, MPTP, trauma like boxing)
62
Describe Huntington's
- Hyperkinetic disorder - Choreiform movement, dementia, behavior changes - Onset at middle age - Increased thalamic drive to motor cortex
63
Pathology of Parkinson's
-Inhibits DIRECT pathway -Allows INDIRECT to dominate (Decreased thalamic drive)
64
Pathology of Huntington's
-Inhibits INDIRECT pathway | Increased thalamic drive to cortex
65
Define tardive dyskinesia
- Delayed onset of symptoms - Dyskinesia w/involuntary uncontrollable movements - Mouth, tongue, trunk, limbs
66
What causes tardive dyskinesia ?
Side effect of prolonged use of antipsychotics or dopamine antagonists
67
Define tic
Rapid and repeated and stereotyped involuntary movements
68
Tourette's syndrome
- Hyperkinetic - Motor and vocal tics - Pathology not completely understood (elevated dopamine considered significant)
69
Criteria to diagnose Tourette's syndrome?
- Presence of both motor and vocal tics - Multiple tics nearly every day through a period of more than 1 year and w/o a remission of tics for greater than 3 consecutive months - Symptoms cause distress or impairment in functioning - Age of onset less than 18 - Symptoms not due to meds or drugs or other medical condition

Pathophys II MHM - Exam 3 (5 decks)

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