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Neuro Boards > Basal Ganglia and Cerebellum > Flashcards

Basal Ganglia and Cerebellum Flashcards

1
Q

Basal Ganglia Roles

A

multiple roles in the nervous system and include fine-tuning movements, reward functions, cognition, and memory

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2
Q

Basal Ganglia Regions

A

subcortical regions, including the putamen, caudate, nucleus accumbens, globus pallidus (interna and externa), the subthalamic nucleus, and substantia nigra

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3
Q

Basal Ganglia - other terminologies for regions

A

striatum: caudate, nucleus accumbens, and putamen
lenticular nucleus: putamen, globus pallidus (has the external and internal segments)

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4
Q

striatum

A

caudate, nucleus accumbens, and putamen

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5
Q

lenticular nucleus

A

putamen, globus pallidus (external and internal segments)

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6
Q

Basal ganglia image

A
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7
Q

Direct Pathway Net Effect

A

increase (or initiate and maintain) movement
DISINHIBITS the thalamus, which facilitates the EXCITATORY thalamocortical pathway

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8
Q

Direct Pathway - primary neuron receptors

A

D1 receptors

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9
Q

Direct Pathway

A

cortex projections travel to the putamen which sends inhibitory projections to the globus pallidus interna (GPi) and substantia nigra reticulatum (SNr). The GPi/SNr, in turn, sends inhibitory outflow to the thalamus

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10
Q

Indirect Pathway - net effect

A

suppress movement.
activity from indirect pathway excites the GPi/SNr which INHIBITS the thalamocortical pathway

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11
Q

Indirect Pathway primary neuron receptor

A

D2 receptors

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12
Q

Indirect Pathway

A

cortex projections travel to the putamen, which sends inhibitory projections to the globus pallidus externa (GPe), where inhibitory projections then extend to the subthalamic nucleus (STN), with the result of disinhibiting the STN. STN, in turn, has excitatory projections to the GPi

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13
Q

Hypokinetic movement disorders

A

due to REDUCED activity in the DIRECT pathway

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14
Q

hyperkinetic movement disorders

A

due to REDUCED activity in the INDIRECT pathway

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15
Q

Parkinson’s disease presentation

A

rigidity, masked facies, and resting pill-rolling tremor due to loss of dopaminergic neurons in the substantia nigra

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16
Q

lesions to substantia nigra

A

can cause parkinsonism

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17
Q

hemiballismus

A

rapid violent uncontrolled flailing movements of an extremity (usually the arm), classically associated with lesions of the subthalamic nucleus

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18
Q

lesions of subthalamic nucleus caused by

A

hemiballismus

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19
Q

loss of dopaminergic neurons in substantia nigra cause

A

parkinson’s disease

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20
Q

chorea

A

described as “dancing”
typically more proximal

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21
Q

number of layers in the cerebellar cortex

A

3

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22
Q

athetosis

A

described as “snake-like”
usually more distal

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23
Q

layers of the cerebellar cortex

A

granule layer
Purkinje cell layer
molecular layer

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24
Q

Granular layer

A

innermost layer containing tightly packed small granule cells that provide excitatory output to other cerebellar cells via parallel fibers

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25
Q

Purkinje layer

A

the middle layer, containing the cell bodies of Purkinje cells which provide inhibitory input to the deep cerebellar nuclei

26
Q

Molecular layer

A

outermost later, contains the dendrites and axons of interneurons (Golgi, basket, and stellate cells)

27
Q

basket and stellate cells

A

receive excitatory input from granule cells via parallel fibers and inhibit Purkinje cells

28
Q

Golgi cells

A

receive excitatory inputs from granule cell parallel fibers and provide feedback inhibition to granule cells

29
Q

number of layers in cortical tissue

A

6

30
Q

only cells to inhibit deep cerebellar nuclei

A

Purkinje cells

31
Q

cerebellum macroscopic anatomy

A

2 lateral hemispheres and a midline vermis
dorsal to the pons and medulla and separated from the occipital lobe via the tentorium

32
Q

folia

A

cerebellar hemispheres’ marked infoldings

33
Q

atrophy of the folia seen in

A

patients with chronic alcohol use

34
Q

mass lesions, swelling, or elevated intracranial pressure causes

A

cerebellum can herniate through the foramen magnum and compress the brainstem

35
Q

cerebellar peduncles

A

connect cerebellum to other brain structures via 3 paired major white matter tracts

36
Q

superior cerebellar peduncle

A

mostly EFFERENT/output fibers that relay to the thalamus and spinal cord

37
Q

middle cerebellar peduncle

A

contains INPUT from various regions of the cerebral cortex

38
Q

inferior cerebellar peduncle

A

contains INPUT from the spinal cord and lower brainstem

39
Q

deep cerebellar nuclei

A

located in cerebellar white matter
from lateral to medial: dentate, emboliform, globose, and fastigial nuclei
main output centers of the cerebellum, efferent fibers exiting via superior cerebellar peduncle

40
Q

cerebellar nuclei mnemonic

A

“Don’t Eat Greasy Food”
Dentate, Emboliform, Globose, Fastigial

41
Q

dentate nucleus

A

largest
dysfunction can lead to hiccups or palatal myoclonus as it is part of Mollaret’s triangle

42
Q

Mollaret’s triangle

A

ipsilateral red nucleus
ipsilateral inferior olivary nucleus
contralateral dentate nucleus

43
Q

emboliform and globose nuclei

A

sometimes called interposed nuclei
help with initiating movements and keeping movements smooth

44
Q

fastigial nuclei

A

receive inputs from the vermis and help with walking and stability while standing

45
Q

cerebellar lesion symptoms

A

input/output fibers “double-cross” with a net result of having ipsilateral symtpoms

46
Q

climbing fibers

A

originate from the contralateral inferior olivary nucleus
enter cerebellum via inferior and middle cerebellar peduncles
provide excitatory input to the granule and Purkinje cells

47
Q

mossy fibers

A

originate from several locations throughout the cortex, vestibular nuclei, and spine
enter cerebellum via inferior and middle cerebellar peduncles
provide excitatory input to the granule and Purkinje cells

48
Q

vascular supply to the cerebellum

A

three main arteries: posterior inferior cerebellar artery (PICA), anterior inferior cerebellar artery (AICA), and the superior cerebellar artery (SCA)

49
Q

cerebellum vascular territories

A
50
Q

posterior inferior cerebellar artery (PICA)

A

arises from the vertebral artery
largest vascular supply to the cerebellum

51
Q

PICA supplies

A

lateral medulla and most of the posterior and inferior portions of the cerebellum

52
Q

PICA strokes

A

high risk for cerebellar herniation due to large vascular territory
most common cerebellar stroke

53
Q

PICA stroke presentation

A

vomiting, vertigo, horizontal ipsilateral nystagmus, and truncal ataxia
if other PICA-supplied structures are affected, can present with lateral medullary syndrome

54
Q

head impulse test

A

can help differentiate posterior circulation stroke from peripheral vertigo. a normal head impuse testing in the setting of vertigo, nausea, and vomiting are more suggestive of brainstem insult. peripheral vertigo will have significant lag with corrective saccades with movement in one horizontal direction only

55
Q

head impulse test peripheral vertigo

A

significant lag with corrective saccades with movement in one horizontal direction only

56
Q

head impulse test brainstem insult

A

stroke from peripheral vertigo. a normal head impuse testing in the setting of vertigo, nausea, and vomiting

57
Q

anterior inferior cerebellar artery (AICA)

A

supplies the inferior lateral pons, the middle cerebellar peduncle, and a strip of the anterior cerebellum between the territories of the PICA and SCA

58
Q

AICA strokes

A

very rare
vessel occlusion leads to sudden dysmetria and vertigo, and ipsilateral sensorineural hearing loss

59
Q

labyrinthine/internal acoustic artery

A

branch of the AICA, which supplies the inner ear
occlusion contributes to hearing loss

60
Q

superior cerebellar artery (SCA)

A

supplies the upper lateral pons, superior cerebellar peduncle, and most of the superior half of the cerebellar hemisphere including the deep cerebellar nuclei

61
Q

SCA stroke

A

ataxia, nystagmus, and dysarthria

Neuro Boards (10 decks)

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