Chapter 11 Workbook Questions

Question 1

List the structures classified as the basal ganglia circuit.

Answer 1

caudate nucleus, putamen, globus pallidus, subthalamic nucleus, substantia nigra reticularis, and substantia nigra compacta.

Question 2

List the five separate, parallel cortico-basal ganglia-thalamic loops and their functions.

Answer 2

(1) Motor loop: adjusts the activity of cortical upper motor neurons (corticospinal, corticobrainstem, and corticopontine tracts) and reticulospinal tracts
(2) Oculomotor loop: makes decisions about eye movements and spatial attention
(3) Executive loop: goal-directed behavior, including evaluating information for making perceptual decisions, planning, and choosing actions in context
(4) Behavioral flexibility and control: recognition of social disapproval, self-regulatory control, selecting relevant knowledge from irrelevant, maintaining
attention, and stimulus-response learning
(5) Limbic: Links limbic, cognitive, and motor systems; identifies value of stimuli; involved in reward-guided behaviors; monitors errors in predictions; concerned with seeking pleasure.

Question 3

How does motor information from the basal ganglia reach spinal lower motor neurons?
A. Neurons in the basal ganglia that have direct axonal connections directly to spinal lower motor neurons.
B. Neural connections with the cerebellum.
C. Output to the thalamus and pedunculopontine nucleus (PPN), which synapse with cortical and brainstem motor neurons that project to the spinal lower motor neurons.
D. Direct connections from the striatum to lower motor neurons.
E. Neurons from the subthalamic nucleus directly synapse with spinal lower motor neurons.

Answer 3

C: The motor output from the basal ganglia inhibits three structures: pedunculopontine nucleus, the midbrain locomotor region, and motor areas of the thalamus. Neurons from these three structures project to the reticulospinal tracts and motor areas of the cerebral cortex. So motor information from the basal ganglia reaches lower motor neurons via multisynaptic routes involving corticospinal and reticulospinal tracts and stepping pattern generators. There are no direct connections from the basal ganglia to spinal lower motor neurons. A direct connection would be a neuron that directly synapses with the lower motor neuron. Corticospinal neurons have direct connections with lower motor neurons.

Question 4

The cortico-basal ganglia-thalamus motor loop contributes to:
A. Regulation of muscle force
B. Sequencing of movements
C. Regulation of muscle tone
D. Selection and inhibition of specific motor synergies
E. All of the above

Answer 4

E: The cortico-basal ganglia-thalamus motor loop regulates muscle contraction, muscle force, multijoint movements, and sequencing of movements.

Question 5

Major roles of the cerebellum are to
A. Compare actual movement to intended movement.
B. Adjust movements to existing conditions.
C. Provide conscious awareness of proprioceptive information.
D. Both A and B
E. A, B, and C

Answer 5

D: The cerebellum compares actual movement to intended movement and adjusts movements to existing conditions. However, all cerebellar activity is subconscious.

Question 6

Flocculonodular lobe

What is this part of the cerebellums function?

Answer 6

Regulates eye movements and postural muscles associated with equilibrium.

Question 7

Vermis

What is this part of the cerebellums function?

Answer 7

Influences medial activation pathways and cranial nerves associated with muscles for speech.

Question 8

Paravermis

What is this part of the cerebellums function?

Answer 8

Influences lateral upper motor neuron pathways via input to brainstem nuclei.

Question 9

Lateral cerebellar hemispheres

What is this part of the cerebellums function?

Answer 9

Indirectly influences the cortical control of distal limb muscles.

Question 10

Hemiparesis

What area(s) of the nervous system is this disorder most associated with?

Answer 10

Lateral upper motor neurons

Question 11

Focal dystonia

What area(s) of the nervous system is this disorder most associated with?

Answer 11

Basal ganglia

Question 12

Alcohol-induced ataxia

What area(s) of the nervous system is this disorder most associated with?

Answer 12

Cerebellum

Question 13

Huntington’s chorea

What area of the nervous system is this disorder most associated with?

Answer 13

Basal ganglia

Question 14

Athetoid cerebral palsy

What area(s) of the nervous system is this disorder most associated with?

Answer 14

Basal ganglia

Question 15

Multiple systems atrophy

What area(s) of the nervous system is this disorder most associated with?

Answer 15

Basal ganglia, Cerebellum , and Lateral upper motor neurons

Question 16

Abnormal palmar grasp

What area(s) of the nervous system is this disorder most associated with?

Answer 16

Lateral upper motor neurons

Question 17

What is a visuoperceptive disorder?

Answer 17

The misperception that an object will obstruct movement, thereby causing a cessation of movement.

Question 18

Does excessive output from the basal ganglia inhibit or facilitate voluntary movement?

Answer 18

Excessive output of the basal ganglia inhibits the thalamus, reduces the excitation of the cortex, and inhibits voluntary movement.

Question 19

What is the clinical term used to describe rapid alternating movements?

Answer 19

Diadochokinesia is the term for rapid alternating movements. The prefix dys- is only used when the movements are abnormal.

Question 20

What is meant by the term parkinsonism?

Answer 20

The term parkinsonism is used to describe central nervous system (CNS) disorders with signs and symptoms common to Parkinson’s disease but having a different cause.

Question 21

Nystagmus, dysequilibrium, truncal ataxia

Where is the location of the lesion responsible for the sings/symptoms given?

Answer 21

Vestibulocerebellum

Question 22

Wide-based, staggering gait

Where is the location of the lesion responsible for the sings/symptoms given?

Answer 22

Spinocerebellum

Question 23

Dysarthria

Where is the location of the lesion responsible for the sings/symptoms given?

Answer 23

Vermis & Cerebrocerebellum

Question 24

Dysdiadochokinesia, dysmetria, and action tremor, and wide-based, staggering gait

Where is the location of the lesion responsible for the sings/symptoms given?

Answer 24

Cerebrocerebellum

Question 25

What are the three Parkinson-plus syndromes?

Answer 25

1. progressive supranuclear palsy
2. dementia with Lewy bodies
3. multiple system atrophy.

Question 26

In normally developing infants and people with extensive cerebral lesions, turning of the head elicits reflexive posturing of the limbs. Name the reflex and describe the position of the limbs when the head is turned to the right.

Answer 26

An asymmetric tonic neck reflex (ATNR) is elicited in normal infants and in people with extensive cerebral lesions. When the head is turned to the right, the ATNR produces extension of the limbs on the right and flexion of the limbs on the left.

Question 27

During posturographic testing, what is the purpose of having the platform tilt in response to changes in the client’s weight bearing? What is the purpose of having the visual surround sway referenced to the client?

Answer 27

The purpose of having the platform tilt in response to changes in the client’s weight bearing is to determine the effect of inaccurate proprioceptive information on postural control. The purpose of having the visual surround sway with the client’s postural sway is to determine the effect of inaccurate visual information on postural control.

Question 28

What is visual action stream?

Answer 28

Visual action stream is the flow of visual information used to guide movements.

Question 29

How does a lesion to the descending axons of the internal capsule affect flexor and extensor muscles of the lower limbs?

Answer 29

Lesions to the descending axons of the internal capsule interrupt the descending corticospinal regulation of reticulospinal tracts resulting in increased extension and decreased flexion of the contralateral lower limb.

Question 30

Dyskinesia is a side effect caused by prolonged use of which one of the following chemical agents for treatment of Parkinson’s disease?
A. Acetylcholinesterase
B. L-dopa
C. Botulinum
D. Baclofen
E. Gamma-aminobutyric acid (GABA) agonists

Answer 30

B: Prolonged use of L-dopa for treatment of Parkinson’s disease can cause dyskinesia because the drug L-dopa is converted to dopamine is converted to dopamine in the brain and an excess of dopamine in the striatal output pathway disinhibits the motor thalamus. In turn the motor thalamus overstimulates the motor areas of the cerebral cortex, producing involuntary movements.

Question 31

Deep-brain stimulation of which structure is safe and effective for reducing tremors in Parkinson’s disease?
	A. Putamen
	B. Caudate
	C. Thalamus
	D. Substantia nigra
	E. Red nucleus

Answer 31

C: Deep brain stimulation of the thalamus is safe and effective for reducing Parkinson’s disease tremors.

Question 32

Which of the following is/are associated with the emergence of focal hand dystonia?
A. Excessive repetition or overuse
B. Somatotopic degradation of somatosensory cortex
C. Central impairment of proprioception
D. Both A and B
E. A, B, and C

Answer 32

E: Excessive repetition or overuse of the hand causes somatotopic degradation of somatosensory cortex and central impairment of proprioception, leading to focal hand dystonia in genetically susceptible people.

Question 33

What type of testing is used to evaluate the following?

Strength of an individual muscle

Answer 33

Manual muscle test (MMT)

Question 34

What type of testing is used to evaluate the following?

Function of motor fibers in a peripheral nerve

Answer 34

Motor nerve conduction velocity (NCV)

Question 35

What type of testing is used to evaluate the following?

Possible myopathy or a denervated muscle

Answer 35

Diagnostic EMG

Question 36

What type of testing is used to evaluate the following?

Muscle tone

Answer 36

Passive range of motion (PROM)