Basal Ganglia Flashcards

1
Q

What is the basal ganglia

A
  • group of gray matter nuclei in cerebrum, diencephalon, & midbrain: (located deep within white matter)
  • 5 Nuclei =Caudate, Putamen, Globus Pallidus, Subthalamic Nucleus, Substantia Nigra
  • caudate, putamen and globus pallidus are in the cerebrum
  • influnce function of movemetn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the non motor circuits of the basal ganglia

A
  • Goal directed or executive circuit
  • Social-behavioral
  • emotion or limbic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Goal Directed or Executive circuit function

A
  • decision-making loop regarding goal directed behavior (Ex: late-yellow light. Brake or accelerate?);
  • puts actions in context (Same example-at same light, but not in a hurry, ease gas, etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Social Behavioral circuit function

A

recognition of

  • social disapproval,
  • self-regulatory control,
  • selecting relevant knowledge from irrelevant,
  • maintaining attention,
  • stimulus-response learning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Emotional or limbic circuit

A
  • links limbic, cognitive, and motor systems
  • involved in reward-guided behavior;
  • concerned with seeking pleasure;
  • involved with facial expression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Motor circuits of the basal ganglia

A

Oculomotor circuit
motor circuit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Oculomotor circuit

A

makes decisions about eye movement and spatial attention; initiation of fast eye movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Motor circuit of basal ganglia

A

circuit-regulates

  • muscle contraction,
  • muscle force,
  • multi-joint movements,
  • sequencing of movements;
  • movement selection and action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Caudate nucleus

A

c-shaped and adjacent to the lateral ventricle

  • Head=Anterior
  • Body=participates in motor control-part of the oculomotor loop
  • Posterior=tail=successful learning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anterior portion of the caudate nucleus importance

A
  • Executive function/goal directed behavior Loop
  • evaluates info for making perceptual decisions, planning, and choosing actions in context
  • NOT involved with controlling movement
  • active in learning and changes its activity before the cortex when reward contingencies are reversed;
  • caudate head is first to learn new contingency=executive function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lentiform nucleus

A
  • putamen + Globus Pallidus
  • coordinates small, precise muscle movements
  • Putamen-forms lateral portion of basal ganglia
  • Globus pallidus-”pale globe”-many myelinated fibers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the putamen do

A

Putamen receives input from premotor and motor cortex-forms lateral portion of basal ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the globus pallidus do

A

Globus pallidus sends output to motor areas of the cerebral cortex (maintains muscle tone)=motor circuit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the striatum

A
  • Caudate + putamen
  • contributes to motor control-virtually all inputs to the basal ganglia arrive via striatum
  • Join anteriorly=ventral striatum= limbic/Emotion circuit
  • role in emotions and motivation
  • acts as a link between the limbic, cognitive, and motor system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Neurotransmitters of the basal ganglia

afferent

A
  • glutamate from cerebral cortex=excitatory
  • glutamate and ACh from PPN=excitatory
  • Serotonin from dorsal raphe nuclei=inhibitory

go into the basal ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Neurotransmitters of the basal ganglia as efferent signals

A
  • Efferent signals leaving the basal ganglia=GABA-inhibits thalamus, PPN, and reticular formation
  • Dopamine from substantia nigra to the striatum adjusts signals to output nuclei so these nuclei provide the appropriate level of inhibition to target cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Basal ganglia pathways

A
  • “the Go pathway disinhibits the motor thalamus, thereby facilitating specific movements.” (direct pathway)
  • “No-Go pathway activity is suppression of unwanted movements.” (Indirect pathway)
    With dysfunction, movement is either insufficient(akinesia) or excessive due to lack of inhibition (tremor, postural instability)
18
Q

Motor control from the internal globus pallidus

A
  • motor thalamus => motor areas of cortex => corticospinal tracts => LMNs voluntary movement (Glutamate excitatory)
  • pedunculopontine nucleus => (GABA) reticulospinal tracts => LMNs of posutral (Glutamate)
  • Midbrain locomotor region => (acH) reticulospinal tracts => (glutamate) stepping pattern generator
19
Q

Blood supply to caudate

A

anterior cerebral
anterior choroidal

20
Q

blood supply

putamen

A

Lenticulostriate branches of middle cerebral

21
Q

blood supply

Substantia nigra

A

Basilar, posterior cerebral, superior cerebellar

22
Q

blood supply to

subthalamic nucleus

A

posterior cerebral

23
Q

Basal ganglia disorders

A

hypokinetic
hyperkinetic

Result from dysfunction in the motor pathways within the basal ganglia and in the PPN

24
Q

Basal ganglia disorders

hypokinetic

A
  • Too little movement
  • Excessive basal ganglia inhibition of the motor thalamus, PPN, and midbrain locomotor region (MLR)
25
Q

Basal ganglia disorders

hyperkinetic

not specific examples

A
  • Excessive movement
  • Inadequate inhibition of the motor thalamus, PPN, and MLR
26
Q

Parkinsons disease

A
  • Hypokinetic
  • Related to decrease in dopamine
  • dopamine lost in substantia nigra
27
Q

PD

symptoms

A
  • Bradykinesia/
  • akinesia
  • Tremor-unilateral, resting
  • Postural instability
  • rigidity
  • gait abnormalitis (freezing, shuffling)
  • visual perceptive impairments (diffculty with doorways or changes)
  • masked fascial expression
28
Q

PD

types

A
  1. tremor dominant
  2. postural instability/gait diffculty
29
Q

PD non motor dysfunction

symptoms

A
  • depression
  • Psychosis=visual hallucinations
  • Dementia=deterioration of intellectual function (planning, goal direction, decision making) vs. memory with Alzheimer’s
  • Autonomic=constipation, orthostasis
30
Q

Parkinsons treatment

A
  • Medications (not a complete list)
  • Increase dopamine levels via levadopa (L-dopa/ Sinemet)
  • Other meds
  • Mirapex (Dopamine agonists)
  • Comtan (Prolongs effects of levodopa)
  • Amantadine (short term mild symptoms or to enhance leva dopa)
31
Q

Dyskinesia

A

Involuntary, erratic, writhing movements of the face, arms, legs or trunk (too much Sinemet)

32
Q

Goal of PD medications

A
  • goal is to increase on time and decrease off time (symptoms)
  • keep side effects at bay
33
Q

Other treatments for PD

A
  • Surgery: deep brain stimulation pallidotomy and thalamotomy, fetal tissue transplant
  • PT, OT, Speech therapy…multidisciplinary approach
  • Moderate to high intensity-PWR, LSVT
  • Tai Chi, wellness exercise, boxing, dance

Pallidotomy/Thalamotomy-liquid nitrogen or lasers used destroy a small precise region of the thalamus(tremor) or globus pallidus (akinesia). For treatment of dyskinesia and tremor

34
Q

Atypical presentation of PD

A
  • multple system atrophy
  • progressive supranuclear palsy
  • dementia with lewy bodies
  • corticobasal degeneration
35
Q

Secondary parkinsonism

A
  • results from another disease or event
  • traumatic
  • toxic
  • infectious
  • drug-induced
36
Q

Red flags with possibel PD case

A
  • early postural instability
  • rapid progression,
  • respiratory dysfunction,
  • abnormal postures,
  • emotional lability,
  • cerebellar signs,
  • voluntary gaze dysfunction
37
Q

Progressive supranuclear palsy (PSP)

A

PSP-Corticobrainstem tract –motor function on eyes=downward gaze palsy

38
Q

Atypical PD

Multi system atrophy

A
  • Akinetic/rigid syndrome
  • Cerebellar signs: uncoordinated speech and ataxia
  • Autonomic dysfunction:
  • Corticospinal tract dysfunction
  • Decreased goal-directed cognition and difficulty with attention
  • progressive degenerative disease
  • Cause unknown
  • affects the basal ganglia and cerebellar and autonomic systems; the peripheral nervous system; and the cerebral cortex.
39
Q

Atypical PD

Dementia with lewy bodies

A
  • EARLY, generalized cognitive decline
  • Visual hallucinations
  • Postural instability
  • Gait dysfunction
40
Q

Atypical PD

Corticobasal degeneration

A
  • progressive atrophy of the cerebral cortex and basal ganglia.
  • Motor signs similar to PD
  • visuospatial and cognitive impairments, apraxia, dysphagia, speech hesitancy, and myoclonus.
41
Q

Hyperkinetic disorders

huntington’s disease

A
  • Genetic disorder
  • “hyperkinetic” disorder
  • Symptoms: chorea, athetosis, possible dementia
  • Degeneration: ↓activity in output nuclei; Disinhibition of thalamus & PPN
  • ↑ activity in lateral tracts

Chorea-literal meaning=dance. Continuous involuntary movements that have a jerky/fluid quality (low amplitude might be mistaken for fidgeting)

42
Q
A