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Neuroanatomy > Chapter 39: Disorders of the Basal Motor Nuclei > Flashcards

Chapter 39: Disorders of the Basal Motor Nuclei 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
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2
Q

If the neurons in the substantia nigra die, it will be extremely difficult to _____.

A
  • Initiate movements
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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
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4
Q

Immobility of the _____ creates the mask-like face typical of Parkinson’s disease.

A
  • Facial muscles
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5
Q

Parkinson’s disease is due to death of neurons in the _____.

A
  • Substantia nigra
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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
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7
Q

Several _____, of which the most widely used is paraquat, cause Parkinson’s disease in susceptible individuals.

A
  • Herbicides
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8
Q

Caffeine protects neurons in the substantia nigra so that _____ drinkers have half as much risk of Parkinson’s disease as non-drinkers.

A
  • Coffee
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9
Q

Caffeine, certainly, and other components of _____, probably, protect the substantia nigra.

A
  • Coffee
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10
Q

The _____ in _____ and _____ has a neuroprotective effect that halves the risk of getting Parkinson’s disease.

A
  • Caffeine
  • Coffee
  • Tea
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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
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12
Q

The immediate precursor of dopamine is _____.

A
  • L-DOPA (l-dihydroxyphenylalanine)
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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

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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

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15
Q

The symptoms of Parkinson’s disease are due to an overactive _____.

A
  • Medial globus pallidus
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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
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17
Q

The most common treatments for Parkinson’s disease are _____ and _____.

A
  • Deep brain stimulation

- L-DOPA

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18
Q

Activity of the medial globus pallidus reduces the output of the ventral anterior nucleus to the _____.

A
  • Premotor cortex
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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
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20
Q

Death of neurons in the substantia nigra makes it an effort to _____ each step when walking.

A
  • Start
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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
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22
Q

Walking with a pronounced forward lean is called _____ walking.

A
  • Anterograde
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23
Q

Anterograde walking and mask-like face are symptoms of _____.

A
  • Parkinson’s Disease
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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

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25
Q

Lack of stimulation of the premotor cortex by the _____ causes bradykinesia (Greek: brady=slow, kinesia=movement).

A
  • Ventral anterior nucleus
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26
Q

Bradykinesia is a symptom of _____.

A
  • Parkinson’s Disease
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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
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28
Q

Spontaneous activity in the _____ of the brachial plexus causes a fidgeting movement of the fingers called “pill rolling.”

A
  • Lower motor neurons
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29
Q

“Pill rolling” is a symptom of _____.

A
  • Parkinson’s Disease
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30
Q

James Parkinson called the disease he described “paralysis agitans” because it combined near _____ of the facial muscles with _____.

A
  • Paralysis

- “Pill-rolling”

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31
Q

In addition to “pill rolling” and _____-like face, Parkinson’s disease includes _____
and _____ walking.

A
  • Mask
  • Bradykinesia
  • Anterograde
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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
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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
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34
Q

A stroke in the _____ causes large-scale unwanted movements called hemiballismus.

A
  • Subthalamic nucleus
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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

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36
Q

The net effect of release of dopamine at synapses in the putamen is to _____ movement.

A
  • Facilitate
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37
Q

An overdose of DOPA is liable to cause _____.

A
  • Unwanted movement
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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
  • Dopamine 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
  • Tardive

- Bad 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
  • Tourette’s
  • Head
  • 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
  • Tourette’s
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
  • Restless Leg 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 Leg 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

Neuroanatomy (21 decks)

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