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Nervous System > Lecture 8.1: Motor Cortex, Cerebellum and Basal Ganglia > Flashcards

Lecture 8.1: Motor Cortex, Cerebellum and Basal Ganglia Flashcards

1
Q

What parts of nervous system are involved in active moving? (4)

A

Motor cortex –> thalamus –> Pyramidal system –> Lateral corticospinal tract

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2
Q

What part of the brain is involved in coordination of movement?

A

Cerebellum

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3
Q

What part of the brain differentiates between correct vs incorrect mechanisms of moving?

A

Basal Ganglia

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4
Q

Cycle of Planning Movement in Brain (4)

A
  • Posterior Cortex provides sensory information to
    frontal cortex
  • Prefrontal cortex plans movements
  • Premotor cortex organises movement sequences
  • Motor cortex produces specific movements
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5
Q

Pyramidal vs Extra-Pyramidal Tracts

A
  • Pyramidal tracts: Conscious control of muscles from
    the cerebral cortex to the muscles of the body and
    face
  • Extrapyramidal tracts: Originate in the brainstem,
    carrying motor fibres to the spinal cord
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6
Q

What is the Basal Ganglia?

A

A group of subcortical nuclei responsible primarily for motor control, as well as other roles such as motor learning, executive functions and behaviours, and emotions

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7
Q

What structures are included in the Basal Ganglia?

A
  • Caudate
  • Putamen
  • Globus pallidus
  • Substantia nigra (midbrain)
  • Subthalamic nuclei (ventral thalamus)
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8
Q

Do Basal Ganglia project directly to the spinal cord?

A

They do not project directly to the spinal cord

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9
Q

How does the Basal Ganglia influence activity movement?

A

By regulating activity of UMNs

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10
Q

What can happen if there are defects in the basal ganglia? (3)

A
  • Cause inability to control movement
  • Problems when switching between commands
  • Problems initiating and terminating movements
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11
Q

The Cerebellum is also know as the…?

A
  • ‘Little Brain’
  • Hindbrain
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12
Q

How does the Cerebellum influences movements?

A

By interaction with UMNs rather than projecting directly to LMNs

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13
Q

The Cerebellum is involved in feedback loops with …..?

A

the motor cortex and brain stem nuclei

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14
Q

Where is the Cerebellum found?

A

Found infratentorial below the tentorium cerebelli in the posterior fossa

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15
Q

How does the Cerebellum connect to the brainstem (pons and medulla)?

A

Via 3 peduncles – superior, inferior and middle

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16
Q

What is the Structure of the Cerebellum?

A
  • Consists of 2 hemispheres joined in the middle by
    the vermis
  • Has an outer cerebellar cortex and subcortical
    cerebellar nuclei
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17
Q

What is the white matter of the Cerebellum called?

A

Arbor vitae

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18
Q

What are the predominant cell types in the Cerebellum? (2)

A

Purkinje and Granule Cells

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19
Q

Role of Cerebellum? (4)

A
  • Coordinates smooth skeletal muscle movements
  • Balance
  • Learning and memory
  • Processes sensory information to monitor the
    course of movement/feedback
20
Q

Inputs to the Cerebellum (3)

A
  • Cerebral Cortex
  • Brainstem
  • Ascending Pathways – JPS, muscle length/tension
21
Q

Outputs to the Cerebellum (3)

A
  • Brain Stem Nuclei
  • Thalamus
  • Cerebral Cortex
22
Q

What is Dysdiadochokinesis?

A

The inability to perform and sustain a series of repeated movements

23
Q

What is Ataxia?

A
  • Gross incoordination of movements
  • Gait / rebound
24
Q

What is Nystagmus?

A

Repetitive, involuntary oscillation of the eyes

25
Q

What is Intention Tremor

A

A wide tremor when performing voluntary movements

26
Q

What is Slurred Speech?

A

Speech may be imprecise slow and distorted

27
Q

What is Hypotonia?

A

The patient may have muscle weakness

28
Q

What is Pass Pointing (Dysmetria)?

A

The patient overshoots when touching the examiners finger

29
Q

Pyramidal Tracts

A
  • Corticospinal & corticobulbar tracts
  • Travel through the pyramids of the medulla
    oblongata
  • Chief organiser and executor of motor function
30
Q

Extrapyramidal Tracts

A
  • Rubrospinal/ vestibulospinal/ reticulospinal/
    tectospinal/ basal ganglia/cerebellum
  • Essentially beyond voluntary control
31
Q

Signs of Extrapyramidal Lesions (5)

A
  • Impair the regulation of voluntary movement
    without affecting strength
  • Absence of UMN signs
  • Abnormal, involuntary movements - hyperkinesia
  • Reduced movements – hypokinesia
  • Tremor – a rhythmic oscillatory movement
32
Q

Signs of Extrapyramidal Lesions (7)

A
  • Chorea
  • Hemiballismus
  • Dystonia
  • Bradykinesia
  • Tics
  • Athetosis
  • Tardive Dyskinesia
33
Q

What is Chorea?

A
  • Rapid irregular, unpredictable, involuntary muscle
    jerks
  • Nearly always abnormal
34
Q

What is Hemiballismus?

A

Unilateral, usually violent, chorea

35
Q

What is Dystonia?

A

Excessive or inappropriate muscle contractions/ spasm

36
Q

What is Bradykinesia?

A
  • Slowness of movement
  • Can go onto akinesia (absence of movement)
37
Q

What is Tics?

A
  • Fleeting purposeless actions
  • Can be normal (stress, childhood)
38
Q

What is Athetosis?

A

Involuntary slow writhing movements hands or face

39
Q

What is Tardive Dyskinesia?

A
  • An iatrogenic cause of parkinsonism-like effects
  • Oral grimaces, sucking, chewing
40
Q

Signs of UMN Lesions (5)

A
  • Weakness / spastic paralysis
  • Increased tone - spasticity
  • Increased tendon reflexes
  • Hyperreflexia
  • Extensor plantars (Babinski reflex)
41
Q

Signs of LMN Lesions (5)

A
  • Weakness / flaccid paralysis
  • Reduced tone (flaccidity)
  • Loss of tendon reflexes
  • Wasting
  • Fasciculations
42
Q

What is Multiple Sclerosis (MS)?

A

Chronic central nervous system demyelinating disease

43
Q

Pathophysiology of MS

A
  • Autoimmune disease caused by myelin-reactive T cells in the peripheral circulation that become activated by a trigger
  • Invade the central nervous system and cause
    destruction of myelin and axons directly and by
    initiating the release of various inflammatory
    mediators
  • There is often ineffective or no repair of damage
44
Q

How does MS Present Clinically? (6)

A
  • Visual: loss, dim, blurred (49%)
  • Oculomotor: impaired eye movements, nystagmus
    (42%)
  • Paresis: unilateral, mono-, paraparesis (42%)
  • Incoordination: extremity, gait, tremor (23%)
  • GU/bowel: incontinence, retention (10%)
  • Cerebral: cognitive impairment (4%)
45
Q

Treatment of MS Exacerbations (3)

A
  • Methylprednisolone 500-1000mg qd x 5 +/- oral
    taper Oral high dose steroids
  • Plasma exchange
  • Intravenous immunoglobulin
46
Q

Treatment of MS: Refractory Relapsing Remitting Disease (4)

A
  • High dose methylprednisolone pulse therapy
  • IVIG –intravenous immunoglobulin
  • Plasma exchange
  • Immunosuppressives (mitoxantrone,
    cyclophosphamide, azathioprine, methotrexate)
47
Q

What Disease Modifying Agents can be used to treat MS?

A
  • INTERFERONS: (Beta interferon-1a: Avonex, Rebif
    Beta interferon-1b: Betaseron)
  • GLATIRAMER ACETATE: Copaxone

Nervous System (18 decks)

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