movement + thalamus (<50% have question, not priority) + basal ganglia

Question 1

reflex to test C5 nerve root

Answer 1

biceps

Question 2

reflex to test C7 nerve root

Answer 2

triceps

Question 3

reflex to test L4 nerve root

Answer 3

patellar

Question 4

reflex to test S1 nerve root

Answer 4

achilles

Question 5

dorsiflexion of large toe + fanning of other toes with plantar stimulation

Answer 5

+ babinksi sign (plantar reflex)

if in adults: suggests UMN lesion

Question 6

let go of baby and baby abducts/extends limbs and then draws together

Answer 6

moro reflex

Question 7

stroke cheek and baby moves head toward one side

Answer 7

rooting reflex

Question 8

roof of mouth is touched and suck in response

Answer 8

sucking reflex

Question 9

curling of fingers when palm is stroked

Answer 9

palmar reflex

Question 10

baby is face down (ventral position) and stroke along one side of the spine causes lateral flexion of lower body toward stimulated side

Answer 10

galant reflex

Question 11

what thalamic nuclei relays this information:
SENSORY signals from body (via medial lemniscus: proprioception, light touch + spinothalamic tract: pain + temp of body) → summate information to sensory somatosensory cortex

Answer 11

ventral posterolateral nucleus (VPL)

VPL: very painful LEGS (spinothalamic)

Question 12

what thalamic nuclei relays this information:

trigeminothalamic (pain + temp of face) and taste signals → somatosensory cortex

Answer 12

ventral posteromedial nucleus (VPM)

VPM: very painful MOUTH (trigeminothalamic)

Question 13

what thalamic nuclei relays this information:

retina (visual, CN II) → occipital lobe

Answer 13

lateral geniculate nucleus (LGN)
optic tracts arise from LGN
lateral: visual

Question 14

what thalamic nuclei relays this information: 
inferior colliculus (auditory) → 1° auditory cortex

Answer 14

medial geniculate nucleus (MGN)

medial: auditory

Question 15

what thalamic nuclei relays this information:

mammillothalamic tract → cingulate gyrus (part of Papez circuit)

Answer 15

anterior nucleus (part of limbic system)

Question 16

what thalamic nuclei relays this information:
communications with prefrontal cortex
memory loss results if destroyed

Answer 16

medial dorsal nucleus

Question 17

what thalamic nuclei relays this information:

cerebellum (dentate nucleus) and basal ganglia → motor cortex

Answer 17

ventral lateral (VL) nucleus

Question 18

what thalamic nuclei relays this information:

basal ganglia → prefrontal, premotor, orbital cortices

Answer 18

ventral anterior nucleus

Question 19

viruses and diseases that damage the anterior horn cells of LMNs

Answer 19

poliovirus
west nile virus
spinal muscular atrophy: werdnig-hoffmann disease
ALS (affects UMN (spasticity) + LMNs (weakness), spares sensory tracts)

Question 20

deep nuclei of cerebellum ( integrates signals of cerebellum) from medial to lateral

Answer 20

FAST Gerbals Exercise Daily
Fastigial
Globose
Emboliform
Dentate
interposed nuclei = globose + emboliform

Question 21

information that helps you to maintain balance

Answer 21

proprioception in legs (consider if can’t stand with eyes open)
vision
vestibular apparatus (consider if can’t stand with eyes open)

Question 22

romberg test

Answer 22

close eyes (remove visual input, can only rely on proprioception of legs (dorsal column) and vestibular apparatus)
if either damaged: fall (+ romberg test)
DOESN’T TEST CEREBELLAR FUNCTION

Question 23

3° syphilis affects

Answer 23

dorsal columns of proprioception

+ positive rhomberg

Question 24

tremor occurs at rest, disappears with voluntary movements

Answer 24

resting tremor

Question 25

associated with Parkinson disease

Answer 25

resting tremor

Question 26

tremor appears with voluntary movements only

Answer 26

intention tremor

Question 27

associated with cerebellar damage (cerebrocerebllum - lateral hemisphere)

Answer 27

intention tremor

Question 28

tremor occurs with movement and at rest

Answer 28

essential tremor

Question 29

associated with family history of tremor

Answer 29

essential tremor

Question 30

rapid fine tremor of head, hands, arms, and/or voice
occurs with movement + rest
50% have family history of tremor

Answer 30

essential tremor

Question 31

treatment of essential tremor

Answer 31

B blocker (propranolol): DOC
primidone (anticonvulsant)
clonazepam (BZD)
alcohol (self-medicate)

Question 32

lesion of substantia nigra pars compacta of basal ganglia

Answer 32

hypokinesis: Parkinson Disease

Question 33

lesion of subthalamic nucleus of basal ganglia

Answer 33

hemiballismus of CONTRALATERAL extremity: lacunar stroke

Question 34

neurodegenerative movement disorder
intracellular inclusion of Lewy Bodies inside neurons of substantia nigra pars compacta → lose dopaminergic neurons → can’t make dopamine

Answer 34

parkinson disease

Question 35

depigmentation of substantia nigra

Answer 35

parkinson disease
lose dopaminergic neurons → not making dopamine → stop making melanin (dopa is precursor): provides pigmentation of dopaminergic neurons

Question 36

neurodegenerative movement disorder
hypokinesis
bradykinesia
akinesia
postural instability
festinating gait: problem initiating walking, problem stopping so shuffle gait
resting tremor “pill rolling”
cogwheel rigidity: passively move arm and have rigidity
mask-like facies (hypokinesia of face, frozen)

Answer 36

parkinson disease

Question 37

chemical that can cause parkinsonian features

Answer 37

process of synthesizing meperidine creates MPTP → metabolized to MPP → destroys dopaminergic cells in substantia nigra→ ↓ dopamine

Question 38

treatment of parkinson disease

Answer 38

BALSA
Bromocriptine (ergot dopamine agonist), pramipexole, ropinirole (both non-ergot dopamine agonist)
Amantadine
Levodopa + carbidopa + talcapone (DOC)
Selegiline, rasagiline
Antimuscarinics (benztropine): treat rigidity, tremor (not bradykinesia)

Question 39

treatment for MPTP exposure

Answer 39

selegiline

Question 40

non-drug treatment of parkinson disease

Answer 40

deep brain stimulation

lesion of subthalamic nucleus →↑ movement

Question 41

wild, flailing motion of unilateral arm or leg

Answer 41

hemiballismus

Question 42

normal function of subthalamic nucleus

Answer 42

inhibits movement

Question 43

normal function of substantia nigra pars compacta

Answer 43

facilitates movement

Question 44

brief, purposeless, NON-repetitive jerks of individual muscles “dancing”

Answer 44

chorea

Question 45

brief, sudden muscle contraction (like muscle spasm)

can be repetitive

Answer 45

myoclonus

Question 46

slow, writhing, snake-like movements in hands + fingers

Answer 46

athetosis

Question 47

compulsion (choosing) to move

Answer 47

akathisia: SE of some anti-psychotic drugs

Question 48

AD trinucleotide repeat disorder

Answer 48

huntington disease

Question 49

huntington disease presentation

Answer 49

CAG trinucleotide repeat
Chromosome Cuatro (4)
Cuarenta (40 yo)
Chorea
Cognitive decline: dementia + depression, psychosis
Caudate atrophy + putamen (part of BG called the neostriatum)

Question 50

neurodegenerative disorders of BG

Answer 50

parkinson disease: pars compacta substantia nigra

huntington disease: caudate + putamen atrophy

Question 51

excessive glutamate excitation (NMDA receptors) → kills neurons in caudate + putamen of BG
↑ dopamine: excessive movements
↓GABA: lose inhibition
↓Ach

Answer 51

huntington disease

Question 52

treatment of huntington disease

Answer 52

tetrabenazine: (inhibit VMAT → block dopamine packaging + release): treat chorea
olanzapine, haloperidol (neuroleptics - dopamine antagonists): treat chorea + psychosis

Question 53

normal function of globus pallidus interna

Answer 53

inhibit movement