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Clinical neuroscience > Lecture 8 Brainstem and motor disorders > Flashcards

Lecture 8 Brainstem and motor disorders Flashcards

1
Q

Ears

A

Cerebral peduncles

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2
Q

Eyebrows

A

Substantia nigra that releases dopamine

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3
Q

Eyes

A

Red nucleus

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4
Q

Tears

A

Ascending sensory pathways

  • medial lemniscus pathway - dorsal column
  • spinothalamic tract
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5
Q

Nose

A

Occulomotor nucleus
Edinger Westphal nucleus
Motor nucleus

  • for accommodation reflex
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6
Q

Mouth

A

Cerebral aqueduct connecting the third and fourth ventricle

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7
Q

Around the mouth

A 
Peri-aqueductal grey matter 
Function:
- pain perception 
- contains progesterone receptors that alter pain tolerance during menstruation
- urinary continence
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8
Q

Double chin

A

Tectum of the midbrain contains colliculi for vision and hearing

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9
Q

Lentiform nucleus

A

Putamen and globus pallidus

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10
Q

Striatum

A

Putamen and caudate nucleus

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11
Q

What shape in the caudate nucleus

A

C shaped due to the lateral ventricles which are also C shaped due to the temporal horn that goes into the temporal lobe

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12
Q

Parts of the cerebellum

A

Cerebellar peduncles - connects the cerebellar to the brain stem

  • superior - midbrain
  • middle - pons
  • inferior - medulla

Vermis - midline structure between the cerebellar hemispheres that control the trunk

Cerebellar tonsil - can compress the medulla during a rise in intracranial pressure

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13
Q

Basal ganglia function

A

Decide the most appropriate set of movements from a motor plan provided by the prefrontal cortex

Act via:

  • Direct pathway
  • Indirect pathway
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14
Q

Direct pathway

A

Causes excitation of the cerebral cortex to facilitate motor movements

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15
Q

Indirect pathway

A

Inhibits the cerebral cortex to inhibit motor movements

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16
Q

Role of dopamine

A

Acts as a kick starter

  • acts on D1 receptors of the direct pathway which causes excitation of the direct pathway
  • acts on D2 receptors of the indirect pathway which inhibits the indirect pathway
17
Q

Role of the cerebellum

A

Using proprioception input via the spinocerebellum tract, determines an appropriate sequence to conduct the motor plan

18
Q

Parkinson’s disease triad

A

Tremor - pill rolling tremor
Lead pipe rigidity - resistance to full range of movement
Bradykinesia

+/- psychiatric features such as depression
Micrographia - small handwriting
Hypophonia
Dementia (Lewy body)

19
Q

Bradykinesia

A

Slowness of movement
Mask like face
Trouble stopping and starting with destinations gait
Walk slow

20
Q

Cause of Parkinson’s disease

A

Degeneration of the substantia nigra therefore less dopamine release

Decreased inhibition of the indirect pathway therefore increased movements

Decrease stimulation of the direct pathway

21
Q

Causes of huntington’s disease (chorea)

A

Decreased activity of the indirect pathway therefore decreased inhibition of the globus pallidus external segment resulting in increased movements

22
Q

Chorea

A

Abnormal involuntary movement does order

23
Q

Features of Huntington’s disease

A

Autosomal dominant

  • choreiform movements
  • dystonia
  • incoordination
  • psychiatric features
24
Q

Dystonia

A

Uncontrollable muscle contraction causing twisting, abnormal posture or repetitive movements

25
Q

Hemiballismus

A

Destruction of subthalamic nucleus therefore less excitation of the globus pallidus internal segment

Causes increased movement
- ballistic movements on one side

26
Q

Ballistic movements

A
  • no one side

- rotating

27
Q

Basal ganglia lesions

A

Affects the contralateral side

28
Q

Cerebellar lesions

A

Affects the ipsilateral side

29
Q

Symptoms of cerebellar lesions

A 
Dysdiadochokinesis 
Ataxia
Nystagmus 
Intention tremor 
Slurred speech (dysarthria)
Hypotonia
30
Q

Lesion in the vermis

A

Affect the trunk e.g. trunk ataxia

When sitting down, one falls to one side

31
Q

Dysdiadochokinesis

A

Difficulty with rapidly alternating movements

32
Q

Nystagmus

A

Flickering movements of the eyes that are fast phase towards the side of the lesion

33
Q

How to test for intention tremor

A

Finger nose test

- past pointing - go beyond finger

34
Q

Cerebellar pathway

A
  1. Proprioception receptors in the muscle spindle send afferent a to the ipsilateral cerebellar hemisphere viabthe dorsal spinocerebellar pathway
  2. Motor innervation from the precentral gyrus has efferents that travel to the pontine nucleus via the corticospinal pathway
  3. From the pontine nucleus where is synapses, it desuccates to the CONTRALATERAL cerebellar hemisphere
  4. Collating the data, the cerebellum sends axons to the CONTROLATERAL primary motor cortex via the cerebellum-thalamo- cortical pathway but first synapses at the thalamus
  5. Motor efferent are sent to the effector muscle via the corticospinal pathway after decussating

Clinical neuroscience (20 decks)

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