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Pathophysiology 2 > Exam 4 - Thalamus and Cerebellum > Flashcards

Exam 4 - Thalamus and Cerebellum Flashcards

1
Q

Shape of the Thalamus? Percent of diencephalon?

A

Oval shape cluster of nuclei. 80% of diencephalon.

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2
Q

Function of Thalamus? Where does the info come from? Exception?

A

Somatosensory input from spinal cord. Relays, modifies, and projects all sensory input to cortex, except for CN1.

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3
Q

Role of Relay Nuclei? Send to what?

A

Nuclei in Thalamus which send sensory input from body to cerebral cortex.

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4
Q

Gate Keeper role of Thalamus?

A

Decision maker for which type of info projected to cerebral cortex for processing.

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5
Q

Sensory input from body sent to which nuclei in the Thalamus then to the cerebral cortex?

A

Relay nuclei

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6
Q

Cortex/Limbic/Olfactory sensory info sent to which nuclei in thalamus? AKA? Then where to?

A

Thalamic Nuclei. AKA Association Nuclei. To cerebral cortex.

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7
Q

Basal Ganglia and Limbic System to cerebral cortex through which two nuclei?

A

Intralaminar and Midline nuclei

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8
Q

Role of Limbic System?

A

Survival, core levels, learning and experiences

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9
Q

Basal Ganglia involved in what?

A

Involved in motor output

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10
Q

Describe Central Pain. What causes it?

A

Sensation of pain (“nociception”) originating from CNS. No obvious injury. CNS pathology can cause central pain.

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11
Q

Describe Peripheral Pain. Cause?

A

Nociception originating in peripheral nerve. Due to actual injury.

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12
Q

Describe Thalamic Pain. Cause?

A

Nociception due to posterior thalamic damage. No or light somatosensory stimulus.

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13
Q

Describe Thalamic Pain Syndrome. Cause?

A

Pain and loss of sensation. D/T stroke in posterior thalamus.

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14
Q

Describe the Internal Capsule

A

Conduit and bundle of myelinated white matter between Thalamus/Caudate Nucleus and Lenticular Nucleus. Almost all neural connections to and from cortex go through Int Capsule.

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15
Q

What are the two limbs of the Internal Capsule? Jobs

A

Anterior Limb=diffuse sensory input to 3,1,2 Primary Somatosensory Area
Posterior Limb=Ascending (sensory) input, Descending (motor) output

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16
Q

What connects Thalamus to Cerebral Cortex?

A

Ascending and Descending tracts of the Posterior Limb of Int Capsule

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17
Q

What is the Genu?

A

“Transition” area between Anterior Limb and Posterior Limb of Internal Capsule

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18
Q

Job of the Retrolenticular and Sublenticular Parts of the Internal Capsule? Connect Thalamus to which lobes?

A

Retrolenticular=Optical Radiation. Thalamus to Parietal and Occipital lobes

Sublenticular=Auditory and Optical Radiation. Thalamus to auditory cortex on Temporal lobe

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19
Q

Stroke of the Internal Capsule called what? What is it not caused by?

A

“Lacunar Stroke”. Not an atherosclerotic stroke.

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20
Q

Describe Pure Motor Stroke of Int Capsule. Where lesion and what presentation?

A

Most common 50-60%. On Posterior Limb. Contralateral Hemiparesis/Hemiplegia on face/arms/hands/legs WITHOUT sensory deficits

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21
Q

Describe Ataxic Hemiparesis of Int Capsule. Where lesions and what presentation?

A

2nd most common type of Lacunar Stroke. Cerebellar/Motor symptoms. On Pons and Posterior Int Capsule.

Ipsilateral motor deficits. Clumsiness of leg.

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22
Q

Describe Mixed Motor and Sensory Input Lacunar Stroke of Int Capsule. Where lesions and what presentation?

A

On Posterior Limb and Thalamus. Contralateral hemiparesis and hemiparasthesia on face/arm/leg/trunk.

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23
Q

Describe Pure Sensory Stroke. Where lesions and what presentation?

A

Least common type 6-7%, lacunlar stroke in Thalamus, contralateral parasthesia in limbs (more) and trunk (less)

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24
Q

What and where are the Basal Ganglia?

A

Group of nuclei located bilaterally deep in the telencephalon, diencephalon, and midbrane.

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25
Q

What does the Basal Ganglia start and executes? Acts as what?

A

Starts and executes motor activity. Acts as governor switch to smooth out motor action.

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26
Q

The Basal Ganglia stimulates the Thalamus to do what?

A

Increase or decrease Thalamic Drive

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27
Q

Thalamic Drive is stimulated by what?

A

The Basal Ganglia

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28
Q

Increased Thalamic Drive due to what from motor cortex? Which pathway of Basal Ganglia? Inhibition?

A

Increased output from motor cortex stimulates Thalamus. Direct Pathway, reduced inhibition on Thalamus.

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29
Q

Decreased Thalamic Drive does what to motor cortex? Which pathway of Basal Ganglia? Inhibition?

A

Inhibits drive to motor cortex.

Indirect Pathway, increased inhibition on Thalamus.

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30
Q

Increase Thalamic drive does what to movement?

A

Excessive unwanted movement. Hyperkinetic.

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31
Q

Decreased Thalamic drive does what to movement?

A

Not enough movement. Hypokinetic.

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32
Q

Huntington is a disorder of which BG pathway and drive?

A

Direct Pathway, increased Thalamic Drive. Hyperkinetic.

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33
Q

Parkinson’s is a disorder of which BG pathway and drive?

A

Indirect Pathway, decreased Thalamic Drive. Hypokinetic.

Decreased thalamic drive to motor cortex from inhibitied direct pathway

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34
Q

Hyperkinetic disorders due to which BG pathway and Thalamic drive?

A

BG Direct Pathway. Decreased inhibition=Increased Thalamic Drive.

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35
Q

Hypokinetic disorders due to which BG pathway and Thalamic drive?

A

Increased inhibition=Decreased Thalamic Drive.

36
Q

Parkinson etiology?

A

Reduced substantia nigra resulting in decreased dopamine production.

Causes decreased thalamic drive to motor cortex from inhibitied direct pathway

37
Q

Huntington etiology?

A

Severe degeneration of striatum and frontal cortex.

Increased Thalamic Drive. Direct and Indirect Pathways involved.

38
Q

Tardive Dyskinesia presentation and etiology?

A

Involuntary uncontrollable movements of mouth, tongue, and limbs from prolonged use of antipsychotics and dopamine antagonists. Continues after stopping meds.

39
Q

Tics (Tourette’s Syndrome) presentation and etiology?

A

Rapid and repeated sterotyped involuntary movement. Motor and vocal tics more than 3 months. Onset under 18 y/o.

Unknown etiology. Not due to meds or other medical conditions.

40
Q

Cerebellum percent of brain volume and percent of neurons total?

A

10% of volume, 50% of neurons

41
Q

4 functions of the cerebellum?

A
  1. Maintain balance and posture
  2. Coordinate voluntary movement
  3. Motor learning
  4. Cognitive functions
42
Q

The cerebellum integrates what two things?

A

Sensory perception with motor output

43
Q

Cerebellar lesions affect which side? What happens to motor and sensory?

A

Ipsilateral (same side). No motor or sensory loss, but uncoordinated.

44
Q

Are lesions on the cerebellum easy to pinpoint based on signs and symptoms?

A

Very difficult to pinpoint exact location.

45
Q

Disequilibrium definition and due to lesion where?

A

Lesion on cerebellum. Loss of coordinated activity.

46
Q

Dyssynergia definition and due to lesion where?

A

Lesion on cerebellum. Loss of coordinated activity.

47
Q

Dysarthria definition and due to lesion where?

A

Slurring, slowing, “scanning” speech. Random volume, emphasis on wrong syllables. Lesion on cerebellum.

48
Q

Dystaxia definition and due to lesion where?

A

Lack of coordination in execution of learned voluntary movement such as gait. Lesion on cerebellum.

49
Q

Dysmetria definition and due to lesion where?

A

Overshooting target, inability to stop muscular movement at right space-time point. Finger to nose. Lesion on cerebellum.

50
Q

Intention Tremor definition and due to lesion where?

A

Oscillating tremor that is worse with precise voluntary movement. Lesion on cerebellum.

51
Q

Dysdiadocokinesia definition and due to lesion where?

A

Can’t perform rapid alternating or repetitive movement such as supination and pronation. Difficulty with timing and sequence. Lesion on cerebellum.

52
Q

Nystagmus definition and due to lesion where?

A

Ocular dysmetria. Rhythmic oscillation of eyeballs. Lesion on cerebellum.

53
Q

Decomposition of Movement definition and due to lesion where?

A

Breakdown of smooth muscle activity into jerky, awkward fragments w/poor timing. Lesion on cerebellum

54
Q

Rebound definition and due to lesion where?

A

Inability to adjust to changes in muscle tension. Arm pull test hits self in chest. “Three stooges.” Lesion on cerebellum.

55
Q

What separates the Right and Left Hemispheres of the Cerebellum? What is along the inferior surface?

A

Vermis.

Flocculondular Lobe.

56
Q

Where are the cerebellar nuclei located?

A

Subcortical “deep” region of cerebellum

57
Q

What are the three Cerebellular Peduncles and their input/output and connections?

A

Superior=Efferent from deep nuclei. Cerebellum to Midbrain
Middle=Afferent. Major motor input from cerebral cortex. Cerebellum to Pons.
Inferior=Both afferent and efferent. Cerebellum to Medulla.

58
Q

Cerebellar (Afferent) Input to Cerebellar Cortex via what?

A

Via Climbing or Mossy Fibers, to Purkinje Fibers in Cerebellar Cortex.

59
Q

Cerebellar Cortex to Deep Nuclei via what?

A

Purkinje Fibers

60
Q

Deep Nuclei to Cerebellar (Efferent) Output via what?

A

Superior and Inferior Peduncles

61
Q

Acute EtOH on Cerebellum?

A

Impaired signaling between Golgi Cells to Granule Cells, and Climbing Fibers to Purkinje Fibers

62
Q

Chronic EtOH on Cerebellum?

A

Degeneration of Purkinje Fibers and Granule Cells. Apoptosis of Granule Cells, overall cerebellar atrophy/hypoplasia.

63
Q

The Vestibulocerebellar (Archicerebellum), Spinocerebellum (Paleocerebellum), and Pontocerebellum/Cerebrocerebellum (Neocerebellum) make up what?

A

Phylogenic subdivisions of the cerebellum

64
Q

Direction of newest to oldest in Phylogenic Subdivisions of Cerebellum?

A

Lateral (newest), Medial (oldest)

65
Q

Vestibulocerebellum (Archicerebellum) age? Lobe? Reflex and control?

A

Oldest part. Flocculobar lobe. Visual reflexes and posture control.

66
Q

Vestibulocerebellum (Archicerebellum) input and output? Which peduncle?

A

Inferior Peduncle.
Afferent input=CN 8 and vestibular nuclei.
Efferent output=to vestibular nuclei

67
Q

Does the Vestibulocerebellum (Archicerebellum) have deep nuclei? What does lesion cause?

A

No deep cerebellular nuclei.

Lesion=Dysequilbrium, hypotonia, nystagmus, altered visual reflex

68
Q

Spinocerebellum (Paleocerebellum) function? Which peduncles?

A

“Real time” correction and coordination of ipsilateral motor control on extremities and trunk. Inferior and Superior Peduncles.

69
Q

Spinocerebellum (Paleocerebellum) Afferent Input and Efferent Output via?

A

Afferent Input=Inferior Peduncle

Efferent Output=Superior Peduncle to vermis and paravermis

70
Q

Lesion of Spinocerebellum (Paleocerebellum)?

A

Rebound overshooting; ataxia of gait, trunk, leg, arm; hypotonia

71
Q

Pontocerebellum aka Cerebrocerebellum (Neocerebellum) age and info?

A

Newest and largest functional subdivision of cerebellum

72
Q

Pontocerebellum aka Cerebrocerebellum (Neocerebellum) peduncle and afferent/efferent connections?

A

Middle peduncle entering cerebellum.
Afferent Input=Via pontine nuclei
Efferent Output=via thalamus

73
Q

Pontocerebellum aka Cerebrocerebellum (Neocerebellum) function and lesion?

A

Planning, learning, and timing of skilled voluntary movements; cognitive and emotional learning, congnitive speech.

Lesion=Dyssynergia, loss of coordinated movement

74
Q

Dentate Nuclei is a deep cerebellar nuclei responsible for what?

A

Motor learning. Connection to motor cortex. Newest.

75
Q

Interposed Nuclei is a deep cerebellar nuclei responsible for what?

A

Fine tuning motor coordination. Pick up coffee cup without spilling.

76
Q

Fastigial Nuclei is a deep cerebellar nuclei responsible for what?

A

Oldest. Vestibular function. Stance, walk, antigravitational muscles.

77
Q

Putamen, Caudate Nucleus, and Nucleus Accumbens makes up what?

A

Striatum

78
Q

Putamen, Globus Padillus, and Caudate Nucleus make up what?

A

Corpus Striatum

79
Q

Violent, flailing movements d/t damage from Subthalamic Nucleus and Basal Ganglia called what?

A

Ballismus (go ballistic!)

80
Q

Parkinsons Disease inhibits which pathway and allows which pathway?

A

Inhibits direct, allows indirect.

81
Q

Putamen and Globus Pallidus called what?

A

Lentiform nuclei

82
Q

Rigidity vs Spacticity?

A

Rigidity not influenced by speed, Spacticity influenced by speed

83
Q

Lead-pipe vs Cogwheel?

A

Lead-pipe=entire ROM

Cogwheel=portion of ROM

84
Q

What is the role of the Basal Ganglia?

A

Stimulates Thalamus to increase or decrease Thalamic drive to motor cortex.

85
Q

Increased Thalamic Drive leads to what?

A

Increased motor output from Motor Cortex. Too much=hyperkinesia

86
Q

Decreased Thalamic Drive leads to what?

A

Decreased motor output from Motor Cortex. Hypokinesia=too little

Pathophysiology 2 (15 decks)

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