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Neurology 2 > Deep Brain Structures 1 > Flashcards

Deep Brain Structures 1 Flashcards

1
Q

function of basal ganglia as a collective group

A

to refine movement

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2
Q

basal ganglia consist of:

A
  • caudate
  • putamen
  • globus pallidus
  • claustrum
  • amygdala
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3
Q

caudate + putamen =

A

striatum

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4
Q

putamen + GP =

A

lenticular system

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5
Q

caudate

A
  • lateral to lateral ventricles

- a circular nucleus

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6
Q

putamen

A
  • fuses w/ head of caudate

- the outside portion

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7
Q

amygdala

A
  • the end of the caudate

- related to emotion

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8
Q

internal capsule

A
  • mass of fibers between the GP/putamen and the caudate

- represents the ascending and descending fibers to and from cortex

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9
Q

basal ganglia afferents are from:

4 regions

A
  • cerebral cortex
  • substantia nigra
  • thalamus
  • subthalamic nucleus
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10
Q

where do the basal ganglia relay the afferent input that it receives?

A

GP

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11
Q

cerebral cortex as basal ganglia afferent

A
  • one of the largest projections

- excitatory to basal ganglia

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12
Q

substantia nigra as basal ganglia afferent

A
  • projects mainly to caudate but also to putamen
  • inhibitory via dopamine
  • excitatory via Ach
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13
Q

clinical correlation of substantia nigra being excitatory and inhibitory

A
  • Parkinson’s treament
  • it’s a loss of dopa so you get extra Ach
  • tx: anticholinergic
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14
Q

thalamus as basal ganglia afferent

A
  • the thalamus is sensory relay for everything except smell

- excitatory to basal ganglia

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15
Q

subthalamic nucleus as basal ganglia afferent

A

-excitatory to basal ganglia

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16
Q

what is considered the receptive portion of the basal ganglia?

A

-caudate and putamen

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17
Q

where do the caudate and putamen project to after receiving afferents?

A

GP

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18
Q

basal ganglia output is from?

A

GP

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19
Q

modality of GP

A

-ALL inhibitory

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20
Q

basal ganglia efferents go to:

3 regions

A
  • thalamus
  • subthalamus
  • red nucleus
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21
Q

basal ganglia efferent to thalamus

A
  • encourages everything to fire

- goes on to cortex

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22
Q

basal ganglia efferents to subthalamus

A

also gets back to the cortex

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23
Q

basal ganglia efferents to red nucleus

A

-goes to the spinal cord

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24
Q

what happens if you lose inhibition to the red nucleus (i.e a lesion above the red nucleus but below the basal ganglia)

A

-you’ll see a release of function
-red nucleus can fire at well
= decorticate posturing

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25
Q

since all of the basal ganglia efferents are inhibitory, what is the neurotransmitter?

A

GABA

26
Q

which of the basal ganglia project to the spinal cord?

A

NONE

27
Q

since basal ganglia don’t project to the SC, how is movement modulated?

A

it does so in the cerebral cortex and brainstem nuclei like the red nucleus

28
Q

GP effect on motor curcuits

A
  • GP exerts a continuous inhibitory effect on motor thalamocortical curcuits
  • acts as a “brake”
29
Q

what is the outcome if the basal ganglia inhibitory feedback loop (i.e the brake) is removed?

A

tremor/shake

“if you remove the brake you get a shake”

30
Q

tremor is aka

A

dyskinesias

31
Q

athetosis

A

slow, worm like, writhing of extremities or neck

32
Q

when is athetosis seen?

A

cerebral palsy

33
Q

choreaform dyskinesia

A

-quick, jerky, involuntary, distal extremity, tongue, face

34
Q

in general, dyskinesias are secondary to:

A
  • release phenomenon
  • i.e an inhibitor is gone so movement that it suppressed is now “released”
  • disinhibition
35
Q

what is less understood about dyskinesias?

A
  • there are also inhibition manifestions

- like in PD: flat affect and shuffling gait or in tardive dyskinesia

36
Q

tardive dyskinesia can be caused by:

A
  • psych meds that inhibit DA action in striatum

- ex: Haldol and prolixen

37
Q

basal ganglia issue in PD

A

dopa loss from the substantia nigra

38
Q

basal ganglia issue in Huntington’s

A

GABA loss from caudate

39
Q

Sydenham’s chorea

A
  • self limiting
  • seen in kids that were not treated for strep and develop rhuematic fever
  • get small hemorrhaged and develop st. vitas dance tremor
40
Q

hemiballism

A
  • unilateral lesion of the subthalamic nucleus
  • usually d/t stroke
  • causes huge flailing contralateral tremor
41
Q

if there are infarcts of small vessels, what is always the answer?

A
  • DM
  • HTN
  • smoking
42
Q

wilson’s disease

A
  • familial disorder of copper metabolism
  • lesions putamen and GP
  • aka hepatolenticular degeneration
43
Q

hallmark of wilson’s disease

A
  • Kayser-Fleischer rings

- flapping tremor

44
Q

internal capsule

A
  • contains motor fibers going out and sensory fibers going back up
  • has ant. and post limb
  • comes from all over brain but 90% are from 3 areas
45
Q

what are the 3 areas that make up 90% of the internal capsule?

A
  1. pre central gyrus
  2. post central gyrus
  3. premotor area
46
Q

anterior limb of the internal capsule

A

all connections b/w the basal ganglia and the thalamus

47
Q

posterior limb of internal capsule

A
  • descending and ascending input

- FAL and fal areas (face arm leg)

48
Q

FAL of internal capsule posterior limb

A

-location of motor fibers from pre central gyrus that give rise to the corticospinal tract

49
Q

fal of internal capsule posterior limb

A

-location of sensory info that is traveling back up to the post central gyrus

50
Q

striate arteries are branches of what artery?

A

middle cerebral a.

51
Q

middle cerebral a. supplies:

A

the dorsolateral surface of the brain

52
Q

outcome of stroke at the middle cerebral a.

A
  • motor AND sensory loss

- contralateral muscle weakness and parasthesia

53
Q

outcome of stroke at the striate arteries

A

-lose either motor or sensory but rarely both

54
Q

what is a stroke to the striate arteries called?

A

lacunar infarct

55
Q

brodemann’s areas

A

-numbers of areas in the brain that individually correspond to specific function

56
Q

brodemann area 4

A
  • pre central gyrus
  • principal motor area
  • contributes 1/3 of the corticospinal tract
57
Q

brodemann area 6

A

-pre motor area

58
Q

result of a lesion of area 6

A

loss of initiation of motor function

59
Q

area 3 2 1

A

postcentral principal sensory area

60
Q

anatomy of thalamus

A
  • one of each side of brain
  • related to 3rd ventricle
  • has hypothalamic sulcus and hypothalamus beneath it
61
Q

what is the structure called in some people who have a connected thalamus?

A

massa intermedia

62
Q

foramen monroe

A

opening of 3rd ventricle leading to the lateral ventricles

Neurology 2 (21 decks)

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