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Neuro Anat/Path > Thalamus And Basal Ganglia Lecture 7 Quiz 5 > Flashcards

Thalamus And Basal Ganglia Lecture 7 Quiz 5 Flashcards

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1
Q

What is the function of the internal capsule

A

Projection fibers from cortex
- motor
- somatosensory
- eye movement/vision

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2
Q

Blood supply of the thalamus

A

PCA
Posterior communicating arteries

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3
Q

Function of the thalamus

A

Relays and regulates all sensory info (except CN 1: olfactory) going to the cortex

Consciously detect, distinguish, and interprets all sensory info

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4
Q

Thalamus acts as ____ ?

A

Gateway to consciousness

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5
Q

What is the visual function of the thalamus

A

Eye
Thalamus
Primary visual cortex ( BA 17)
Secondary/associative cortices

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6
Q

What is the auditory function of the thalamus

A

Ear
Thalamus
Primary auditory cortex (BA 41)
Secondary/associative auditory cortex

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7
Q

What is the function of the somatosensory of the thalamus

A

Body
Thalamus
Primary somatosensory (BA 3,1,2)
Secondary/associative somatosensory cortex

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8
Q

What is the function of the basal ganglia and cerebellum of the thalamus

A

They BOTH relay motor info

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9
Q

What is the function of the limbic system of the thalamus

A

Relays info relating to fear, memory, learning and other human behavior/needs

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10
Q

What is the function of the reticular connection of the thalamus

A

Relays info that modify and regulate consciousness, sleep/wake cycle, alertness, and pain ect.

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11
Q

What are the 5 thalamic nuclei

A

Medial geniculate
Lateral geniculate
Ventral posterior medial
Ventral posterior lateral
Ventral lateral

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12
Q

What is the medial geniculate

A

Project to primary AUDITORY CORTEX (BA 41)
Relays auditory info FROM BRAINSTEM

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13
Q

What is lateral geniculate

A

Project to primary VISUAL cortex (BA 17)
Projects visual info from EYE

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14
Q

What is ventral posterior lateral

A

Project to primary SOMATOSENSORY cortex (BA 3,1,2)
Relays somatosensory info from the BODY

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15
Q

What is ventral posterior medial

A

Project to primary SOMATOSENSORY cortex ( BA 3,1,2)
Relays somatosensory info from CRANIAL NERVES (head)

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16
Q

What is ventral lateral (thalamic nuclei)

A

Project to primary AND premotor cortex (BA 4,6)
Relays motor info from BG and cerebellum

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17
Q

What is dejerine-roussy syndrome

A

Occurs in posterior thalamus and damages the SOMATOSENSORY pathways that transmit info from the cortex

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18
Q

What are other names for dejerine roussy syndrome

A

Thalamic pain syndrome

Lacunar stroke ?
Small vessel stroke ?

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19
Q

Symptoms of dejerine roussy syndrome

A

Contralateral loss of sensation of NEUROPATHIC PAIN

Burning
Shooting
Stabbing
Freezing
Cutting sensation
(Pretty much anything sharp)

Provoked by touch, movement, temp changes or stress

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20
Q

Nociceptive pain

A

Non-neural tissue damage
Originates from stimulation in peripheral nerve endings

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21
Q

Neuropathic pain

A

Pain caused by disease/injury
Originates from dysfunction of the damaged nervous system

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22
Q

What is the overview basal ganglia pathway

A

Anterior association area
Premotor/motor cortex
Basal ganglia
Thalamus
Premotor/ primary motor cortex

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23
Q

Lesion to the basal ganglia

A

Too much or too little movement
Hyperkinetic or hypokinetic

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24
Q

Lesion to cerebellum

A

Motor tone, balance/posture, and coordination (synergy) are impaired

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25
Where is the basal ganglia located
Diencephalon and midbrain (Mesencephalon)
26
What are the nuclei(s) of the basal ganglia
Caudate nucleus Nucleus accumbens Putamen Globus pallidus Subthalamic nuclei Substantia nigra CNPGSS Charles Never Passes Gas She Shits
27
Structure/location of the caudate nucleus
Large horn shaped structure that wraps around the other BG structures Amygdala is located near one end of caudate
28
Structure/location of the putamen
Oval shaped structure located lateral to the globus pallidus nuclei
29
Structure/location of nucleus accumbens
Located at the junction of caudate and putamen Plays role in pleasure/reward processing
30
Structure/location of the globus pallidus
External and internal Both medial to putamen Form triangular shape in a frontal slice view of the brain
31
Structure/location of the subthalamic nuclei
Located inferior to the thalamus
32
Structure/location of the substantia nigra
Located in midbrain of the brainstem
33
Blood supply of the basal ganglia
MCA aka lenticulostriate arteries Small portion of BG is ACA
34
Function of the basal ganglia
Responsible for initiating and executing movement
35
What are the 3 functional loops/pathways of the BG
Motor loop Association loop Limbic loop
36
What is the function of the motor loop
Modifies the motor plan to initiate (activates) and execute movement
37
Explain the motor loop pathway starting from the premotor cortex to the thalamus of the BG
1. Premotor/motor cortex sends the motor plan to the PUTAMEN 2. BG is going to analyze/adjust the motor plan to determine the best way to execute the movement 3. Gets sent to 2 different pathways (direct/indirect) 4. Globus pallidus internus packages it up and sends the final plan to the THALAMUS 5. Thalamus relays the final instructions to the motor cortex and appropriate muscles are activated for movement
38
Direct pathway of the basal ganglia
Putamen connects DIRECTLY to the GPi Promotes movement Dopamine stimulates Ach inhibits
39
Indirect pathway of the basal ganglia
Putamen connects INDRECTLY to the GPi Promotes Suppresses movement Dopamine inhibits Ach stimulates
40
What is the role of the substantia nigra in the motor loop pathway of the BG
Releases dopamine in the putamen Stimulates direct pathway and inhibits indirect Net effect= promote movements
41
What is the role of the putamen in the motor loop pathway in the BG
Release Ach Stimulates indirect and inhibits direct Net effect = suppress movement
42
What is hypokinetic disorder
Loss of dopamine and allows Ach to dominate Patient has difficulty initiating and executing movements
43
What is hyperkinetic disorder
Loss of Ach and allows dopamine to dominate Patient Patient experiences too much movement
44
What is bradykinesia
Slow movement
45
What is rigidity
Increased resistance to PROM Bi-directional and “non velocity or amplitude dependent” “Regardless of speed, there’s rigidity”
46
What is lead pipe rigidity
Resistance persists throughout the ROM
47
What is cogwheel rigidity
Periodic resistance at different points throughout the ROM
48
Rigidity vs spasticity
Rigidity IS NOT speed dependent Spasticity IS speed dependent
49
What are tremors
Rhythmic back and forth or oscillating involuntary movement
50
What are resting tremors
Oscillating movement occurs at rest in a postural position
51
What are intention tremors
Oscillating movement occurs as arm approaches “intended target” “Getting a coffee cup, tremors get more severe”
52
What is dystonia
Involuntary, sustained or intermittent, muscle contractions that cause twisting and repetitive movements, abnormal postures or both Slower than athetosis Can affect one muscle, or group, or entire body - cervical dystonia
53
What is athetosis
Slow, continuous, involuntary writhing movement that prevents maintenance of a stable posture Writhing twisting movement of limbs (hands/feet), trunk or face
54
What is chorea
Ongoing random appearing sequence of one or more discrete involuntary movements or movement fragments “Dance like” involuntary movements
55
What is ballismus (hemi-ballismus)
Flailing, flinging or rotary movements of the proximal limbs
56
Hemi-ballismus is associated with lesion to where?
Subthalamic nuclei SN is part of the indirect pathway = excessive movement
57
What are tics
Repeated individually recognizable, intermittent movements
58
What are motor tics
Face/neck Less frequent in extremities
59
What are vocal tics
Sounds (grunt, cough, howling, barking) Vocalizing (obscene words not uncommon)
60
What is myoclonus
Sequence of repeated, often non-rhythmic, brief SHOCK-LIKE JERKS due to sudden involuntary contraction or relaxation of one or more muscles “Short circuit” or “shock like”
61
What is clonus
Muscular spasm involving repeated, often rhythmic, rapid contraction/relaxation Often unidirectional (plantarflex contract followed by relax) Quick stretch or DTF may stimulate clonus if UMN lesion
62
What are the common findings of hypokinetic movement disorders
TRAP Tremors Rigidity Akinesia Postural instability
63
Symptoms of Parkinson’s disease
Bradykinesia Difficulty initiating movement Freezing Increased muscle tone Resting tremor Micrographia - slow writing Masked expression
64
Non-motor symptom of Parkinson’s disease
Cognitive dysfunction Dementia Psychosis and hallucinations Mood disorders = depression, anxiety, apathy Sleep disturbances Fatigue Pain/sensory dysfunction Olfactory, GI Seborrhea
65
Proteinopathy of Parkinson’s
Alpha synuclein Gliosis in the substantia nigra and other regions in the cortex Lewy bodies
66
Pathophysiology of Parkinson’s disease
Decrease in dopamine Lewy bodies found in the substantia nigra = atrophy/death of neurons that lead to dopamine deficiency in the putamen Parkinson’s dementia or Parkinson’s with Lewy bodies
67
What is the difference btw Lewy Body dementia and Parkinson’s disease
In LBD, patient has dementia symptoms without hypokinetic motor symptoms
68
What type of gait do people with Parkinson’s do
Marche a petitis pas
69
What are common findings of hyperkinetic movement disorders
Dystonia Athetosis Chorea Ballismus Myoclonus Tics Tremors Dumb Bitch Assholes Can’t Memorize Their Terms
70
Pathology of Tourettes syndrome
Not completely understood but elevated dopamine
71
Clinical criteria for diagnosis of Tourette’s syndrome
Presence of both motor and vocal tics Occurrence of tics every day through more than 1 year Without remission of tics greater than 3 months Symptoms are not due to meds or drugs
72
What is tardive dyskinesia
A dyskinesia characterized by involuntary uncontrollable writhing movement patterns Develops as a side effect of prolonged use of antipsychotic and other meds Drug holiday = 3-6 months Effects of meds can be tardive
73
What is Huntingtons disease
Inherited degenerative neurological disease that causes: Choreiform movement Dementia Behavioral changes
74
What is the prognosis of Huntington’s disease
Death within 10-30 years following symptoms onset Injuries related to fall lead to mortality Pneumonia leads to mortality
75
Proteinopathy of huntingtons disease
Huntingtin protein Causes neuron death in caudate and putamen in the BG
76
Pathophysiology of huntington’s disease
Caudate and putamen most affected and atrophy Ventricles enlarged Decrease Ach = too much movement Hyperkinetic disorder Less stimulation of indirect and more direct pathway
77
What are the final stages of Huntington’s disease
Patient is bedbound Unable to communicate Unable to eat.drink Severe chorea or extreme rigidity

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