Basal Ganglia Flashcards

1
Q

The basal ganglia is used to designate an area known to be involved in the control of ___.

A

movement

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2
Q

What are the three parts of the striatum?

A
  1. caudate nucleus
  2. nucleus accumbens
  3. putamen
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3
Q

What two structures make up the lenticular nucleus?

A
  1. putamen

2. globus pallidus (external and internal)

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4
Q

What are the four main structures that make up the basal ganglia?

A
  1. striatum
  2. globus pallidus
  3. subthalamic nucleus
  4. substantia nigra
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5
Q

What structures make up the substantia nigra?

A
  1. compact part (SNc)

2. reticular part (SNr)

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6
Q

What structure is C-shaped with 3 parts (head, body and tail) that make up part of the wall of the lateral ventricle?

A

Caudate

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7
Q

The ___ coincides with the insula.

A

putamen

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8
Q

The ___ ___ has an extensive basal ganglia output to the thalamus.

A

globus pallidus

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9
Q

Basal ganglia related movement disorders create involuntary movements with ____ disorders (chorea, athetosis, ballismus). These patients have difficulty in ___ (starting/stopping) movement and a perturbed muscle tone is noted.

A

hyperkinetic; starting

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10
Q

The ___ part of the substantia nigra has densely packed ___ (pigmented/non-pigmented) neurons and it provides diffuse, modulatory ___ projections to the striatum.

A

compact; pigmented; dopaminergic

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11
Q

The reticular part of the substantia nigra is closer to the ___ ___ and contains ___ (pigmented/non-pigmented) neurons. It is considered a basal ganglia ___ (input/output) nucleus.

A

cerebral peduncle; non-pigmented; output

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12
Q

The subthalamus is part of the ___.

A

diencephalon

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13
Q

The ___ has fibers that travel from the cortex to the caudate.

A

corticostriate

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14
Q

The ___ has fibers that travel from the globus pallidus to the thalamus.

A

pallidothalamic

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15
Q

What does the anterior limb of the internal capsule separate?

A

caudate from the lenticular nucleus

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16
Q

What does the posterior limb of the internal capsule separate?

A

globus pallidus from the thalamus

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17
Q

T/F. The nucleus accumbens receives input from the amygdala, hippocampus, and limbic cortex.

A

True.

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18
Q

What part of the substantia nigra has basal ganglia output?

A

reticular part

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19
Q

What is the source of striatonigral fibers?

A

compact part

20
Q

Inputs to the basal ganglia involve what structure?

A

cortical afferents to the striatum (& subthalamus)

21
Q

What structures carry output fibers?

A

globus pallidus interna and substantia nigra reticular

22
Q

Basal ganglia excitatory connections use ___ and inhibitory connections use ___.

A

glutamate; GABA

23
Q

T/F. The basal ganglia can influence the motor cortex directly.

A

False, it cannot

24
Q

Special staining (enkephalin) shows that the striatum is divided into matrix territories and discrete patches known as ___.

A

striosomes

25
Q

In the direct pathway, ___ (excitatory/inhibitory) corticostriate fibers activate ___ (excitatory/inhibitory) neurons in the striatum. The striatum ___ (excites/inhibits) GPi which leads to the ___ (excitation/disinhibiton) of the thalamus. The thalamus then ___ (activates/inhibits) the cortex and cortical output is ___ (increased/decreased).

A

excitatory; inhibitory; inhibits; disinhibition; activates; increased

26
Q

If the GPi receives more inhibiton from the striatum it becomes ___ (more/less) active.

A

less

27
Q

When the GPi is less active, the inhibition on the thalamus is ___ (increased/decreased) leading to ___ (increased/decreased) thalamic excitation to the cortex (more cortical output).

A

decreased; increased

28
Q

It the GPi is more active then there is ___ (increased/decreased) inhibition on the thalamus. This leads to ___ (increased/decreased) thalamic excitation to the cortex (less cortical output).

A

increased; decreased

29
Q

In huntington’s disease, there is degeneration of the striatum, moreso in the ___ than the ___.

A

caudate; putamen

30
Q

A 55 year old man presents with chorea, rigidity and cognitive disturbances. His movements are continuous, rapid movements in the face and distal limbs. Genetic testing reveals an autosomal dominance with trinucleotide repeats in the DNA. What diagnosis would you give?

A

Huntington’s disease

31
Q

In the indirect pathway, what structure is involved in output?

A

globus pallidus externa

32
Q

Decreased GPe output leads to ___ (increased/decreased) thalamic inhibition followed by ___ (increased/decreased) cortical output.

A

increased; decreased

33
Q

The indirect pathway can send signals through the striatum or subthalamus.

A

True.

34
Q

What happens if there is a loss of subthalamic fibers?

A

loss of disinhibition of the thalamus, increase in cortical outputs resulting in involuntary movements (hemiballismus)

35
Q

An 89 year patient recently suffered from a cerebrovascular accident involving a branch of the posterior cerebral artery. They present with dramatic flailing and rotatory limb movements on one side of their body. What you be the appropriate diagnosis?

A

Hemiballismus

36
Q

What are the main outputs from the substantia nigra?

A

SNr and GPi

37
Q

What is needed to diagnosis a patient with Parkinson’s disease?

A

2 or 3 cardinal features:

  • bradykinesis
  • resting tremor
  • rigidity
38
Q

How old are most patients who develop Parkinson’s disease?

A

60

39
Q

What histological finding is noted in the compact part of the substantia nigra of Parkinson’s patients?

A

Lewy bodies

40
Q

Decreases in ___ lead to more ___ (excitation/inhibition) from the striatum to GPe, which results in decreased ___ (excitation/inhibition) to the subthalamus. As a result, there is more activation of GPi leading to increased ___ (excitation/inhibition) of the thalamus and subsequent decreased cortical output.

A

dopamine; excitation; inhibition; inhibition

41
Q

T/F. Parkinson’s patients note the bradykinesa and lack of arm movements while walking. They also notice the face lacks expressive features and they experience a tremor at rest.

A

True.

42
Q

How does Levodopa work?

A

It replaces dopamine lost due to degeneration of nigrostriatal fibers

43
Q

T/F. Dopamine can cross the BBB.

A

False, it cannot.

44
Q

In the pallidotomy, the ___ is destroyed leading to less inhibition of the thalamus and more cortical output.

A

GPi

45
Q

During a pallidotomy, what structure is a risk for damage?

A

internal capsule

46
Q

T/F. The basal ganglia fibers cross the midline.

A

False, the basal ganglia does not cross the midline

47
Q

___ (Ipsilateral/Contralateral) pallidotomy controls the left GPi which sends signals to the left motor cortex. This would affect the right hand causing a resting tremor on the right.

A

Contralateral