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Medicine 2 > Week 3 - Movement disorders > Flashcards

Week 3 - Movement disorders Flashcards

(48 cards)

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1
Q

What symptoms are associated with upper motor neuron damage?

A

Muscle weakness / stiffness

+ muscle tone

+ stretch reflexes

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2
Q

What symptoms are associated with lower motor neuron damage?

A

Muscle weakness

Decreased muscle tone

Inhibited stretch reflexes

Spontaneous firing

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3
Q

What is aphasia?

What are the two types?

A

Disruption of speech

Broca’s = failure to formulate

Wernicke’s = failure to comprehend

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4
Q

What are the 4 stages of motor neuron disease?

What occurs in each?

A

Amyotrophic lateral sclerosis - degeneration of MNs

Primary lateral sclerosis - slow corticospinal tract degeneration

Pseudobulbar palsy - corticobulbar tract degeneration (facial paralysis)

Progressive muscular atrophy - degeneration of LMNs

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5
Q

What is multiple sclerosis and what are the symptoms?

A

Autoimmunity against myelin

Leg tingling, fatigue, balance issues, blurred vision, dysphagia

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6
Q

What are 4 ways of measuring sleep?

A
  • Polysomogram
  • Electro-encephalogram
  • Electro-myogram
  • Electro-oculogram
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7
Q

What are the stages of sleep?

A
  • REM
  • Non-REM 1
  • Non-REM 2
  • Non-REM 3
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8
Q

Why do we sleep?

A
  • Reset body
  • Tau accumulates in brain during day and is cleared during sleep
  • Tau forms tangles if it accumulates
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9
Q

What happens to the body during sleep deprivation?

A
  • Increased sleep propensity
  • Decreased glucose metabolism
  • Increased tau
  • Mood changes
  • High level cognitive functioning
  • Perceptual changes
  • Increase in risky behaviours
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10
Q

What are the 3 types of insomnia?

A

Transient = 2-3 days

Short-term = < 1 month

Long-term = undewrlying psychiatric illness

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11
Q

What is the circadian rhythm?

A
  • Controlled by suprachiasmatic nucleus in hypothalamus
  • Melatonin produced when its dark, inducing tiredness
  • SCN releases cortisol in daylight, causing wakefulness
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12
Q

What is the role of ACh in sleep?

A

Active during wakefulness and REM

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13
Q

What is the role of NA in sleep?

A

Generates arousal

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14
Q

What is the role of histamine in sleep?

A

Promotes wakefulness

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15
Q

What is the role of 5HT in sleep?

A

Promotes wakefulness and supresses REM

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16
Q

What is the role of DA in sleep?

A

Exerts potent wake promoting effects

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17
Q

What causes restless leg syndrome?

A
  • Dopamine dysfunction
  • Genetics
  • Medications
  • Chronic illness
  • Vitamin deficiency
  • Pregnancy
  • Sleep deprivation
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18
Q

What drugs are used to treat sleep disorders?

A
  • Benzodiazepines
  • Antihistamines
  • Sedative antidepressants
  • Valerian
  • Melatonin receptor antagonists
  • Z drugs (bind to benzodiazepine binding sites)
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19
Q

WHat is executive function?

A

Description of psychological processes underlying flexible goal directed behaviour

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20
Q

What are the causes of Huntington’s disease?

Study These Flashcards
A
  • Genetics
    • Autosomal dominant on chromosome 4
    • Trinucleotide repeat disorder
    • HD gene codes for Huntingtin protein (HTT)
21
Q

What are the clinical features of Huntington’s disease?

Study These Flashcards
A
  • Chorea, dystonia, dysarthria, dysphagia
  • Dementia of frontal lobe, loss of empathy, lack of insight, loss of verbal fluency
  • Depression, anxiety, psychosis
  • High metabolic rate, weight loss
22
Q

How is Huntington’s managed?

Study These Flashcards
A
  • Dopamine blockers for chorea
  • Psychiatric medications
  • Speech and swallowing assessments
  • Fortified diet
  • Feeding tube?
23
Q

What triplet repeat causes Huntington’s?

24
Q

What is anticipation in regards to triplet repeats?

Study These Flashcards
A

When triplet repeats become unstable

Therefore more likely to expand

Therefore increased chance of developing condition

25
What is the parent of origin effect for maternal transmission?
* Larger CTG expansion occurs only on maternal transmission * Female carriers more likely to have children with expanded gene
26
What is the parent of origin effect for paternal transmission?
* Large CAG expansion repeats occur almost only on paternal transmission * Male carriers more likely to have children with expanded gene
27
What is incomplete penetrance?
When not everyone who inherits the mutation develops the disease
28
WHat are the 2 types of stroke and their subtypes?
* Ischaemic * Thrombotic * EMbolic * Lacunar occlusion * Large vessel occlusion * Haemorrhagic * Intracerebral * Subarachnoid
29
What are the symptoms of a haemorrhagic stroke?
* Thunderclao headache * Seizures * Nausea * Unilateral weakness
30
What are the symptoms of a anterior circulatory stroke?
* Hemiplegia * Hemisensory loss * Hemianopia * Dysphasia * Aphasia
31
What are the symptoms of a posterior circulatory stroke?
* Bilateral sensory deficits * Dis-conjugate eye movement * Cerebellar dysfunction * Isolated hemianopia
32
What happens in a lacunar infarction?
* Small stroke in penetrating arteries * Clinically silent * Motor hemiplegia syndrome
33
How do you treat a haemorrhagic stroke?
* Pain management * Surgery * Lower BP
34
How do you treat an ischaemic stroke?
* Thrombolysis with alteplase within 3 hours * Thrombectomy within 6 hours
35
What are the penumbra and core of a stroke?
Penumbra = area of potentially salvageable tissue Core = irreversibly damaged tissue
36
What happens during excitotoxicity stage of stroke?
* Failure of ion pumps * Cell depolarisation * Na+, Ca2+, H2O influxe * K+ efflux * GLutamate release and receptor activation
37
What happens in the later stages of a stroke cellularly?
* Microglia, astrocytes, blood vessels * BBB breakdown * Influx of leukocytes
38
When do strokes lead to dementia?
When there is major vascular cognitive impairment
39
How do the basal ganglia and cerebellum assist one another for movement?
_Basal ganglia:_ - Receives sensory and motor cortical information - Plans movement _Cerebellum:_ - Assists with dynamic coordination of movement, balance, and posture
40
What is the basal ganglia?
* Group of subcortical greay matter structures * Plan movement to cortex via thalamus * Prevents unwanted movement * Injury = involuntary movements * Caudate nucleus, lentiform nucleus (putamen + globus pallidus), substantia nigra, subthalamic nucleus
41
What is the role of the striatum?
* Receives input from glutamatergic afferents and dopaminergic afferents * Composed of 90% inhibitory GABAergic medium spiny neurons
42
What are upper motor neurone disorders?
* Stroke * Multiple sclerosis * Amyotrophic lateral sclerosis
43
What are lower motor neuron disorders?
* Peripheral neuropathy * Myasthenia gravis
44
What is Parkinson's disease?
* Neurodegeneration of extrapyramidal system * Poor movement, rigidity, mask like expression, tremor * Depression, dementia, endocrine dysfunction in late stages * Loss of striatal dopamine * Loss of pigmented neurons in substantia nigra
45
How do you treat Parkinson's disease?
* Dopamine replacement therapy * Dopamine agonists * Drugs preventing dopamine metabolism * Muscarinic receptor antagonists
46
What are the causes of Parkinson's disease?
* Oxidative stress * Immediate relative with disease * Genetic * Drug-induced neurodegeneration * Drug-induced * Viral encephalitis
47
What is Huntington's disease?
Disorder affecting basal ganglia Loss of GABA but not dopamine ENlarged lateral ventricles Reduced putamen and caudate nucleus
48
What is tourettes and how is it treated?
* Altered basal ganglia function * Dopamine receptor antagonists = treatment

Medicine 2 (29 decks)

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