Chapter 39 Flashcards
1
Q
- The initiation of movements by the basal motor nuclei depends on projections from the ______________ ________ to the striatum (putamen and caudate).
A
substantia nigra
2
Q
- If the neurons in the substantia nigra die, it will be extremely difficult to __________ _____________.
A
initiate movements
3
Q
- Death of neurons in the substantia nigra makes it so hard to ___________ movement in the facial muscles that the patient doesn’t move the facial muscles.
A
initiate
4
Q
- Immobility of the ________ __________ creates the mask-like face typical of Parkinson’s disease.
A
facial muscles
5
Q
- Parkinson’s disease is due to death of neurons in the ______________ _________.
A
substantia nigra
6
Q
- Exposure to broad-spectrum herbicides such as paraquat injures neurons in the substantia nigra and increases the risk of ________________ _______.
A
Parkinson’s disease
7
Q
- Several ______________, of which the most widely used is paraquat, cause Parkinson’s disease in susceptible individuals.
A
herbicides
8
Q
- Caffeine and estrogen protect neurons in the substantia nigra so that male _________ drinkers have half as much risk of Parkinson’s disease as non-drinkers.
A
coffee
9
Q
- Caffeine, certainly, and other components of _________, probably, protect the substantia nigra.
A
coffee
10
Q
- The __________ in ________ and ______ has a neuroprotective effect that halves the risk of getting Parkinson’s disease.
A
caffeine
coffee
tea
11
Q
- The performance of dying, but not dead, neurons in the _____________ ________ can be improved by supplying them with l-dihydroxyphenylalanine (L-DOPA), the immediate precursor of dopamine
A
substantia nigra
12
Q
- The immediate precursor of dopamine is _____________.
A
L-DOPA (or l-dihydroxyphenylalanine
13
Q
- Death of neurons in the substantia nigra eliminates the ________ pathway through the lenticular nucleus and allows the ___________ pathway to become overactive.
A
direct
indirect
14
Q
- The overactive indirect pathway causes the medial globus pallidus to inhibit the stimulation of the premotor cortex by the _________ ___________ _________ of the ___________.
A
ventral anterior nucleus thalamus
15
Q
- The symptoms of Parkinson’s disease are due to an overactive ________ ________ ___________.
A
medial globus pallidus
16
Q
- The symptoms of Parkinson’s disease can be lessened by deep brain stimulation which uses implanted electrodes to decrease the activity of the _________ ________ ___________.
A
medial globus pallidus
17
Q
- The most common treatments for Parkinson’s disease are _______ _________ _____________ and _________ .
A
deep brain stimulation
L-DOPA
18
Q
- Activity of the medial globus pallidus reduces the output of the ventral anterior nucleus to the ___________ ________.
A
premotor cortex
19
Q
- It is very difficult for the primary motor cortex (Brodmann area 4) to _________ movement without input from the premotor cortex (Brodmann area 6).
A
initiate
20
Q
- Death of neurons in the substantia nigra makes it an effort to ________ each step when walking.
A
start (or initiate
21
Q
- The delay between steps in _______________ disease leads to the upper body getting ahead of the feet, a symptom called anterograde walking.
A
Parkinson’s
22
Q
- Walking with a pronounced forward lean is called _______________ walking.
A
anterograde
23
Q
- Anterograde walking and mask-like face are symptoms of ________________ ___________.
A
Parkinson’s disease
24
Q
- There is a lack of activity in the ventral anterior nucleus leads to a lack of activity in the ___________ ________ and ___________ ________ _________.
A
premotor cortex
primary motor cortex
25
Q
- Lack of stimulation of the premotor cortex by the _________ ____________ _________ causes bradykinesia (Greek: brady=slow, kinesia=movement).
A
ventral anterior nucleus
26
Q
- Bradykinesia is a symptom of _______________ _________.
A
Parkinson’s disease
27
Q
- Greatly reduced input from the __________ _______ ________ leads to spontaneous activity in lower motor neurons, especially in the region of the brachial plexus.
A
primary motor cortex
28
Q
- Spontaneous activity in the ________ _______ __________ of the brachial plexus causes a fidgeting movement of the fingers called “pill rolling.”
A
lower motor neurons
29
Q
- “Pill rolling” is a symptom of ________________ __________.
A
Parkinson’s disease
30
Q
- James Parkinson called the disease he described “paralysis agitans” because it combined near ______________ of the facial muscles with _______ ____________ of the fingers.
A
paralysis ]
“pill-rolling”
31
Q
- In addition to “pill rolling” and _______-like face, Parkinson’s disease includes _________________
and _______________ walking.
A
mask
bradykinesis
anterograde
32
Q
- Just as excess activity of the medial globus pallidus inhibits desired movement, insufficient activity of the medial globus pallidus causes ____________ ______________.
A
unwanted movement
33
Q
- The activity of the medial globus pallidus would be most sharply decreased by removal of all stimulation by a stroke in the ______________ __________.
A
subthalamic nucleus
34
Q
- A stroke in the _____________ _________ causes large-scale unwanted movements called hemiballismus.
A
subthalamic nucleus
35
Q
- Because the basal motor nuclei modulate the activity of the motor cortex whose output crosses in the lower medulla, a stroke in the subthalamic nucleus causes _______________ in the ______________ limbs.
A
hemiballismus
contralateral (or opposite)
36
Q
- The net effect of release of dopamine at synapses in the putamen is to ____________ movement.
A
facilitate
37
Q
- An overdose of DOPA is liable to cause ____________ ____________.
A
unwanted movement
38
Q
- Unwanted movement caused by treating Parkinson’s disease with ________ is called Parkinson’s dyskinesia. (Greek: dys=bad, kinesia=movement.)
A
L-DOPA
39
Q
- Unwanted movement due to an overdose of L-DOPA is ________________ _____________.
A
Parkinson’s dyskinesia
40
Q
- Blocking too many dopamine receptors in the putamen with dopamine receptor blocking tranquillizers would have the same effect as loss of neurons in the _____________ ________.
A
substantia nigra
41
Q
- An overdose of a dopamine-receptor-blocking tranquillizer causes symptoms similar to those of ________________ _________.
A
Parkinson’s disease
42
Q
- The bradykinesia, anterograde walk, and immobile face caused by antipsychotic ____________ ___________ __________ are called “drug induced Parkinsonism.”
A
dopamaine receptor blockers
43
Q
- Neurons respond to overstimulation and understimulation by seeking their basal activity by deleting receptors from their cell membranes during prolonged ___________________ and adding receptors to their cell membranes during prolonged ____________________.
A
inactivity
activity
44
Q
- Neurons in the putamen respond to the prolonged inactivity induced by dopamine-receptor-blocking tranquilizers by __________ dopamine receptors.
A
adding
45
Q
- After prolonged use of dopamine-receptor-blocking tranquillizers, neurons in the putamen have so many _______________ _____________that they are hypersensitive to _______________ from the substantia nigra.
A
dopamine receptors
dopamine
46
Q
- Hypersensitivity to endogenous dopamine causes _____________ ____________.
A
unwanted movement
47
Q
- Unwanted movement due to __________________ to endogenous ______________ as a result of prolonged use of dopamine-receptor-blocking tranquillizers is called “tardive dyskinesia.” (Greek: tardive=delayed.)
A
hypersensitivity dopamine
48
Q
- Tardive dyskinesia occurs after _____________ use of ______________ __________ ___________ _______________.
A
prolonged dopamine-receptor-blocking
tranquilizers
49
Q
- __________ is Greek for delayed, and dyskinesia is Greek for ______ _____________.
A
Tardivebad movement
50
Q
- The popularity of dopamine-receptor-blocking tranquillizers (haloperidol, metoclopramide, etc.) makes ___________ ______________ a common disorder of movement.
A
tardive dyskinesia
51
Q
- Drug induced Parkinsonism, which mostly affects the limbs, is an order of magnitude less common than _________ _____________, which mostly affects the facial muscles.
A
tardive dyskinesia
52
Q
- The first sign of tardive dyskinesia is twitching of the ________ ___________.
A
facial muscles
53
Q
- Whereas Parkinson’s disease is caused by death of neurons in the ______________ ________, Huntington’s disease (or Huntington’s chorea) is caused by death of neurons in the putamen..
A
substantia nigra
54
Q
- If the indirect circuit neurons (D2) in the putamen die, the neurons in the lateral globus pallidus will ___________ the neurons in the subthalamic nucleus, and the neurons in the subthalamic nucleus will not _______________ the neurons in the medial globus pallidus.
A
inhibit
stimulate
55
Q
- If the direct circuit neurons (D1) in the putamen die, the neurons in the medial globus pallidus will
______ ____ _____________.
A
not be inhibited
56
Q
- If the medial globus pallidus is neither stimulated nor inhibited, it will have only the very small inhibitory effect on the ________ ____________ nucleus due to its own spontaneous activity.
A
ventral anterior
57
Q
- Thus, death of the putamen will result in a small amount of spontaneous activity in the slightly inhibited ________ ___________ _________ of the __________.
A
ventral anterior nucleus
thalamus
58
Q
- The death of the putamen in Huntington’s disease results in small unwanted ________________.
A
movement
59
Q
- Huntington’s disease caused by an autosomal dominant gene that causes death of neurons in the __________ and, much later, in the rest of the brain.
A
putamen
60
Q
- Because the Huntington’s disease gene is ______________, either parent can pass the gene on to a child of either gender.
A
autosomal
61
Q
- The symptoms of Huntington’s disease appear in middle age after one has already had a 50% chance of passing on the ____________ _____________ ________.
A
autosomal dominant gene
62
Q
- Huntington’s disease is characterized by many ________ ____________ ______________.
A
small unwanted movements
63
Q
- The unwanted movements in _______________ _________ are smaller in scale than the unwanted movements in hemiballismus because the net stimulatory effect of the direct circuit neurons on the ventral anterior nucleus is still present in hemiballismus.
A
Huntington’s disease
64
Q
- If the putamen is sick rather than dead, the ____________ _____________ will be smoother than in Huntington’s disease and they will disappear when the putamen ____________.
A
unwanted movements
recovers
65
Q
- Sydenham’s chorea (Greek: chorea=dance) is temporary unwanted movement due to suppression of activity in the ____________ by scarlet fever.
A
putamen
66
Q
- Sydenham’s chorea may last for a year after a bout of __________ ________.
A
scarlet fever
67
Q
- The unwanted movement in ______________ ________ is smooth and dance-like.
A
Sydenham’s chorea
68
Q
- Sydenham’s chorea is an uncommon sequel of _________ _______; Huntington’s disease is a rare and fatal ____¬_______ disorder.
A
scarlet fever
hereditary
69
Q
- Patients usually recover from ________________ _________, they always die from _____________ ___________.
A
Sydenham’s chorea
Huntington’s disease
70
Q
- The cholinergic neurons in the putamen have the net effect of ____________ movement.
A
inhibiting
71
Q
- A deficiency of cholinergic neurons in the putamen or caudare leads to ___________ ____________.
A
unwanted movement
72
Q
- Tourette’s syndrome is vocal and facial tics due to a hereditary deficiency of ______________ _________ in the head of the caudate nucleus.
A
cholinergic neurons
73
Q
- The unintended vocalizations in _______________ syndrome are due to a hereditary deficiency of cholinergic neurons in the ________ of the ___________ ___________ which controls vocalization.
A
tourettes
head of the caudate nucleus
74
Q
- The tics in Tourette’s syndrome are exacerbated by activation of the direct basal motor circuit and suppression of the indirect circuit by ________________.
A
dopamine
75
Q
- ______________ syndrome involves tics, mostly of the facial muscles, and unwanted vocal outbursts while awake.
A
tourettes
76
Q
- Since the coincidence of Tourette’s syndrome in identical twins is only 75%, the genes that cause it require _______________ factors for expression.
A
environmental
77
Q
- Tourette’s syndrome is caused by several ________ with variable penetrance.
A
genes
78
Q
- Restless legs syndrome (a.k.a. Willis-Ekbom disease) is the only hyperkinetic disorder of movement that is not due to malfunction of the _________ __________ ___________.
A
basal motor nuclei
79
Q
- Restless legs syndrome is due to ________________ in the pontine reticular formation due to a common hereditary defect in the D3 receptor.
A
hyperactivity
80
Q
- The defective ____ receptor fails to inhibit leg extensions when dopamine levels fall during sleep.
A
D3
81
Q
- Although the defective _____ ________ is recessive, it is common enough to make restless legs the most common disorder of movement.
A
D3 gene
82
Q
- There are 3 hereditary disorders of movement: _________________ ___________, ______________ _____________, and ____________ _______ _____________. All are hyperkinesias.
A
Tourette’s syndrome, Huntington’s chorea, and restless legs syndrome
83
Q
- _________________ __________ is progressive and fatal.
A
Huntington’s chorea
84
Q
- _________________ ____________ produces facial and vocal tics while awake.
A
Tourette’s syndrome
85
Q
- ___________ ______ ____________ produces kicks during sleep.
A
Restless legs syndrome
86
Q
- ______________ _________ is an uncommon sequela of scarlet fever.
A
Sydenham’s chorea
87
Q
- Sydenham’s chorea usually disappears in about ___ _______, but antibiotics are usually given to prevent recurrence.
A
1 year
88
Q
- Huntington’s chorea and Sydenham’s chorea are due to failure of a damaged ___________ to prevent _____________ ___________.
A
putamen
unwanted movement
89
Q
- Huntington’s chorea and Sydenham’s chorea are due to insufficient activity of _____ neurons in the _____________.
A
D2
putamen
90
Q
- Parkinson’s disease is due to excessive activity of _____ neurons in the ____________.
A
D2
Putamen
91
Q
- Parkinson’s disease is due to failure of the _________________ neurons in the substantia nigra to inhibit the ____ neurons in the ____________.
A
dopaminergic
D2
putamen
92
Q
- Tardive dyskinesia is due to the _____________ receptive neurons in the ___________ becoming hypersensitive to ______________ as they habituate to _____________ receptor blockers.
A
dopamine
putamen
dopamine
dopamine
93
Q
- Hemiballism is usually due to a stroke affecting the _____________ __________.
A
subthalamic nucleus
