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Nervous System & Neuropsychiatry > Motor Disorders > Flashcards

Motor Disorders Flashcards

1
Q

Where is the cerebellum located within the cranium?

A

Posterior cranial fossa

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2
Q

How is the cerebellum separated from the occipital and parietal lobes?

A

By the tentorium cerebelli

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3
Q

How is the cerebellum separated by the pons?

A

4th ventricle

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4
Q

The cerebellum consists of the _____ and two _________ ___________

A

Vermis

Lateral hemispheres

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5
Q

The Vermis regulates which structures?

A

Trunk musculature

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6
Q

Lateral cerebral hemispheres regulate which structures?

A

Distal structures i.e. limbs

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7
Q

Are tracts in the cerebellum contralateral or ipsilateral?

A

Ipsilateral

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8
Q

Which structure attaches the cerebellum to the midbrain?

A

Superior cerebellar peduncle

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9
Q

Which structure attaches the cerebellum to the pons?

A

Middle cerebellar peduncle

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10
Q

Which structure attaches the cerebellum to the medulla?

A

Inferior cerebellar peduncle

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11
Q

Midline cerebellar lesions can cause what clinical presentations?

A

Truncal ataxia

Abnormal gait

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12
Q

Extension of cerebellar midline lesions can cause what?

A

4th cranial nerve lesions

Ipsilateral arm tremors

Compression of 4th ventricle

Obstruction of CSF flow—> Hyrdocephalus

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13
Q

Do cerebellar lesions cause ipsilateral or contrlateral symptoms?

A

Ipsilateral symptoms

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14
Q

What are the 6 symptoms of cerebellar pathology?

A

Disdiadochokinesis - abnormal repetitive movement

Ataxia - abnormal movement

Intention tremor

Slurred speech

Hypotonia- decreased muscle tone compared to normal, floppy

“DANISH”

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15
Q

What is the name of the area of the brain known to be involved in motor function?

A

Basal Ganglia

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16
Q

Name three important overall structures of the basal ganglia.

A

Caudate

Lentiform nucleus

Substantia nigra

17
Q

The lentiform nucleus is made up of what?

A

Putamen

Globus pallidus externa

Blobus pallidus interna

18
Q

Substantia nigra can be separated into which two parts?

How do they differ?

A

Pars compacta - dorsal, dopaminergic nerurones

Pars reticularis - ventral

19
Q

Output of the basal ganglia is to the cerebral cortex via _________.

A

The thalamus

20
Q

The caudate nucleus and the putamen make up what?

A

Striatum

21
Q

What is the overall net effect of direct and indirect pathways in the basal glanglia with regard to the motor cortex.

A

Thalamic stimulation of the motor cortex

22
Q

Disorders will present in the same or different side of the body to the affected basal ganglia?

A

Same side as the abnormal basal ganglia

23
Q

What 4 features might imply disorders of the basal ganglia?

A

Abnormal motor control

Altered posture

Muscle tone

Dyskinesia

24
Q

What is Parkinson’s disease?

How is the disease characterised (triad of features)?

A

Chronic, progressive movement disorder characterised by a triad of bradykinesia, tremor and rigidity

25
Q

Parkinson’s disease is caused by what?

A

Degeneration of substantia nigra pars compacta which causes deficiency in dopamine production

26
Q

Using reference to both the direct and the indirect pathways, explain why Parkinson’s disease presents as it does when the substantia nigra pars compacta is degenerated.

A

Without dopamine, the direct pathway is stimulatory and therefore inhibits the thalamus—> Causes bradykinesia

Without dopamine, the indirect pathway is inhibitory and therefore—> Further causes bradykinesia

27
Q

Besides the three cardinal signs, what are some other associated features of Parkinson’s disease

A

Hypophonia

Reduced facial expression

Micrographia

Dementia

Depression

28
Q

What is Huntington’s disease?

At what age does it usually present?

A

An autosomal, dominant, progressive disorder

Associated with cell loss within the basal ganglia and cortex 30-50 years

29
Q

Give some defining symptoms of Huntington’s disease.

A

Chorea - abnormal, jerky movements of the body

Dystonia - repetitive muscle cramping

Incoordination

Cognitive decline

Behavioural difficulties

30
Q

Describe the pathogenesis of Huntington’s disease.

A

Loss off GABAergic neurones from the putamen of the basal ganglia.

Lose inhibiton of globus pallidus externa which in turn leads to less inhibtion of the subthalamic nucleus —> less stimulation of the globus pallidus interna.

The globus pallidus interna is usually responsible for inhibition of the thalamus, loss of this inhibition.

This explains the excessive, jerky, uncoordinated movements.

31
Q

The cerebellum can be divided into how many functional lobes?

A

3

  • Anterior
  • Posterior
  • Flocculonodular
32
Q

Give some examples of conditions that may cause cerebellar signs.

A

Posterior fossa tumour

Alcohol

MS

Trauma

Rare

Inherited

Epilepsy medication

Stroke

“PASTRIES”

33
Q
A

Nervous System & Neuropsychiatry (17 decks)

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