Exam 3 ppt 2 Movement Disorders Flashcards
What are three parts of the CNS that influence voluntary movement?
- Corticospinal Tract
- Basal Ganglia
- Cerebellum
what is the center of motor cordination?
the cerebellum
In general, what does the cerebellum do in regards to voluntary movement?
Cerebellum- center of motor coordination
- Complex interaction to ensure smooth, purposeful movement without extraneous muscular contractions
Describe the system that are usually involved in movement disorders (because they are part of motor control)?
- •Pyramidal tracts- pass through the medullary pyramids
- –Connect cerebral cortex to brain stem and SC lower motor centers
- •Extrapyramidal system- Basal ganglia
- –Caudate nucleus, putamen, globus pallidus, subthalamic nucleus and substantia nigra
- –Deep to the forebrain, direct output rostrally through thalamus to cerebral cortex
- –Movement disorders typically occur in this system
Dr. Shappy basically skipped over this slide. She said When we have Disordered movement, we are looking at movement disorders that are cause by problems in this system (didn’t specify if she meant both or one or the other)
Describe Pyramidal tracts and what they do
•Pyramidal tracts- pass through the medullary pyramids
- –Connect cerebral cortex to brain stem and SC lower motor centers
More from wikipedia:
The pyramidal tracts (pyramides)[citation needed] include both the corticospinal and corticobulbar tracts. These are aggregations of upper motor neuron nerve fibres that travel from the cerebral cortex and terminate either in the brainstem (corticobulbar) or spinal cord (corticospinal) and are involved in control of motor functions of the body.
The corticobulbar tract conducts impulses from the brain to the cranial nerves.[1] These nerves control the muscles of the face and neck and are involved in facial expression, mastication, swallowing, and other functions.
The corticospinal tract conducts impulses from the brain to the spinal cord. It is made up of a lateral and anterior tract. The corticospinal tract is involved in voluntary movement. The majority fibres of the corticospinal tract cross over in the medulla, resulting in muscles being controlled by the opposite side of the brain. The corticospinal tract also contains Betz cells (the largest pyramidal cells), which are not found in any other region of the body.
The pyramidal tracts are named because they pass through the pyramids of the medulla.
http://en.wikipedia.org/wiki/Pyramidal_tracts
Describe extrapyramidal system and what it does
•Extrapyramidal system- Basal ganglia
- –Caudate nucleus, putamen, globus pallidus, subthalamic nucleus and substantia nigra
- –Deep to the forebrain, direct output rostrally through thalamus to cerebral cortex
- –Movement disorders typically occur in this system
I found this confusing without explanation, so below is a helpful section from wikipedia:
In anatomy, the extrapyramidal system is a neural network that is part of the motor system that causes involuntary reflexes and movement, and modulation of movement (i.e. coordination). The system is called “extrapyramidal” to distinguish it from the tracts of the motor cortex that reach their targets by traveling through the “pyramids” of the medulla. The pyramidal pathways (corticospinal and some corticobulbar tracts) may directly innervate motor neurons of the spinal cord or brainstem (anterior (ventral) horn cells or certain cranial nerve nuclei), whereas the extrapyramidal system centers on the modulation and regulation (indirect control) of anterior (ventral) horn cells.
Extrapyramidal tracts are chiefly found in the reticular formation of the pons and medulla, and target neurons in the spinal cord involved in reflexes, locomotion, complex movements, and postural control. These tracts are in turn modulated by various parts of the central nervous system, including the nigrostriatal pathway, the basal ganglia, the cerebellum, the vestibular nuclei, and different sensory areas of the cerebral cortex. All of these regulatory components can be considered part of the extrapyramidal system, in that they modulate motor activity without directly innervating motor neurons.
The extrapyramidal system is very old and three of the four tracts of the human extrapyramidal system are clearly present in salamanders.[1][2]
The extrapyramidal tracts include parts of the following:[3]
rubrospinal tract
pontine reticulospinal tract
medullary reticulospinal tract
lateral vestibulospinal tract
tectospinal tract
http://en.wikipedia.org/wiki/Extrapyramidal_system
What are three classifications of movement disorders?
and some examples
- •Hypokinetic disorders- Decreased or slow movement
- –Parkinson’s disease
- •Hyperkinetic disorders- Increased movement
- –Tremors, myoclonus, dystonia, chorea, hemiballismus, athetosis, tics
- •Overlap
- like tremors in Parkinson’s disease
Shappy said all of these terms were defined in last class.
what is dystionia?
symptoms?
Dystonia: Sustained involuntary muscle contractions of antagonistic muscle groups
Symptoms: Abnormal posturing or jerky, twisting, intermittent spasms
Dystonia: diagnosis
Diagnosis by Exclusion of other diseases, such as:
- •Tardive dyskinesia
- •Basal ganglia and other CNS infections
- •Neck infections or tumors
what is Tardive dyskinesia?
Wikipedia:
Tardive dyskinesia /ˈtɑrdɨv ˌdɪskɨˈniːʒə/ is a difficult-to-treat and often incurable form of dyskinesia, a disorder resulting in involuntary, repetitive body movements. In this form of dyskinesia, the involuntary movements are tardive, meaning they have a slow or belated onset.[1] This neurological disorder most frequently occurs as the result of long-term or high-dose use of antipsychotic drugs,[Note 1] or in children and infants as a side effect from usage of drugs for gastrointestinal disorders.[Note 2][2]
Three Treatments for Dystonias
- –Physical measures
- –Botulinum toxin injections or medication
- –Surgery to release (like in dorsal rhizotomy)
will most movement disorders show up on scans?
Can we treat them if they dont?
A lot of these conditions will not show up on scans until they are very severe.
Too hard to test in the basal nuclei down to the neuron level (to see it degenerating). Most of these disorders are identified post mortem.
So we may not have a specific diagnosis, but we can treat the symptoms
Dystonia Pathophysiology
Progressive neuron degeneration of the basal nuclei and cerebellum
What does degeneration of the neuron mean?
- •Something wrong with the synapse
- •She listed several things that could go wrong at the synapse (I think it is from previous lectures)
- •Not in the synapse
- •Demyelination
- •Progressive degenerative process that causes abnormal responses
- •Death of neuron
- •Louie bodies
- •Build up of protein and eosinophil
- •Common in Alzheimer’s and Parkinson’s
- •Louie bodies
- •Demyelination
What two ways the neuron can degenerate?
- Something wrong in the synapse
- Problem not in the synapse
What are ways neurons can degenerate at the synapse?
why is it important to know what is wrong?
Problems with:
- receptors,
- reuptake,
- neurotransmitter production (amount of neurotransmitters)
if you know what is wrong, then you can give the correct meds to help with the synapse
Neuron degeneration: what are some problems that can occur outside of the synapse?
•Demyelination is the main one
- •Progressive degenerative process that causes abnormal responses
what can both demyelination and synaptic degeneration lead to?
•Death of neuron
- •Louie bodies
- •Build up of protein and eosinophil
- •Common in Alzheimer’s and Parkinson’s
what are Lewy Bodies?
Wikipedia:
Lewy bodies are abnormal aggregates of protein that develop inside nerve cells in Parkinson’s disease (PD), Lewy body dementia, and some other disorders. They are identified under the microscope when histology is performed on the brain.
Lewy bodies appear as spherical masses that displace other cell components. The two morphological types are classical (brain stem) Lewy bodies and cortical Lewy bodies. A classical Lewy body is an eosinophilic cytoplasmic inclusion consisting of a dense core surrounded by a halo of 10-nm-wide radiating fibrils, the primary structural component of which is alpha-synuclein. In contrast, a cortical Lewy body is less well defined and lacks the halo. Nonetheless, it is still made up of alpha-synuclein fibrils. Cortical Lewy bodies are a distinguishing feature of dementia with Lewy bodies (DLB), but may occasionally be seen in ballooned neurons characteristic of Pick’s disease and corticobasal degeneration,[1] as well as in patients with other tauopathies.[2] They are also seen in cases of multiple system atrophy, particularly the Parkinsonian variant.[3]
http://en.wikipedia.org/wiki/Lewy_body
what is Fragile X?
Who and what structures it affects
Transmission
Signs and symptoms
Diagnostic testing
Treatment
It is a genetic Disorder (involves the X chromosome), and the most common intellectual disability in males. Affects cerebellar peduncles, but may impact other areas- need more research. May occur before school age, so IEP (individualized education plan) are developed for education in the school setting.
Carrier is the female (daughters of males who have the disease) . dad can be symptomless, but pass it on to the daughter who will then give to her sons who will show the symptoms
s/s: Progressive neural dysfunctional diseases: tremors, dystonia, mood issues (impatience, hostility), autonomic nervous system issues (sweating, bowel, bladder, ect), Parkinson like, and eventually dementia
Diagnostic testing: Genetic testing can identify it, MRI, EKG can show the deficiencies in the brain.
Treatment: There are some med that can help, but only slow the progression/ does not fix (behavioral, speech, balance, etc). IEPs fdeveloped for education at school
Fragile X:
Who and what structures it affects
It is a genetic Disorder (involves the X chromosome), and the most common intellectual disability in males. Affects cerebellar peduncles, but may impact other areas- need more research. May occur before school age, so IEP (individualized education plan) are developed for education in the school setting.
Carrier is the female (daughters of males who have the disease) . dad can be symptomless, but pass it on to the daughter who will then give to her sons who will show the symptoms
Fragile X:
Transmission
Transmission:
Carrier is the female (daughters of males who have the disease) . dad can be symptomless, but pass it on to the daughter who will then give to her sons who will show the symptoms
Fragile X:
Signs and symptoms
Signs and symptoms:
s/s: Progressive neural dysfunctional diseases: tremors, dystonia, mood issues (impatience, hostility), autonomic nervous system issues (sweating, bowel, bladder, ect), Parkinson like, and eventually dementia
Fragile X:
Diagnostic testing
Diagnostic testing:
Diagnostic testing: Genetic testing can identify it, MRI, EKG can show the deficiencies in the brain.
Fragile X:
Treatment
Treatment:
There are some med that can help, but only slow the progression/ does not fix (behavioral, speech, balance, etc). IEPs fdeveloped for education at school
