Neuro!!!! - Basal Ganglia and Movement disorders

Question 1

Important in voluntary movements and making postural adjustments

Answer 1

Basal ganglia

Question 2

Regulates amount of movement, receives cotical input and provides negative feedback to cortex to modulate movement

Answer 2

BAsal ganglia

Question 3

Contains the putamen (motor) and caudate (cognitive)

Answer 3

(Neo) Striatum

Question 4

Contains the putamen and globus pallidus

Answer 4

Lentiform

Question 5

Action of dopamine in basal ganglia

Answer 5

D1 - stimulates excitatory pathway; D2 inhibits inhibitory pathway == MOTION!!

Question 6

Lewy bodies composed of alpha synuclein, loss of dopaminergic neurons (depigmentation) of substantia nigra pars compacts

Answer 6

Parkinson’s

Question 7

Symptoms of Parkinson’s

Answer 7

Resting tremor, cogwheel rigidity, akinesia or bradykinesia, postural instability, gait problems, trouch getting started, falling foward, fenistating gait

Question 8

AD trinucleotide CAG repeat on Chrom 4 associated with chorea, aggression, dpression and dementia with atrophy of striatal nuceli (the main inhibitors of moevment)

Answer 8

Huntington’s disease

Question 9

CAG =

Answer 9

Caudate loses ACh and GABA

Question 10

Rx for Huntingtons to inhibit DA

Answer 10

haloperidol, olanzapine

Question 11

Rx for Huntintons to inhibit release of DA

Answer 11

tetrabenazine

Question 12

Sudden wild flailing of 1 arm +/- ipsilateral leg lesion location

Answer 12

Hemiballismus - lesion in C/L subthalamic nucleus (lacunar stroke)

Question 13

Sudden, jerky, purposeless movements lesion location

Answer 13

Chorea - Lesion in basal ganglia (Huntington’s)

Question 14

Slow, writhing movements; especially seen in fingers lesion location

Answer 14

Athetosis - Lesion in basal ganglia (Huntinton’s)

Question 15

Sudden, brief, uncontrolled muscle contraction cause

Answer 15

Myoclonus - Jerks, hiccups; common in metabolic abnormalities such as renal and liver failure

Question 16

Sustained, involuntary muscle contractions examples

Answer 16

Dystonia - writer’s cramp; blepharospasm (sustained eyelid twitch)

Question 17

Action tremor; exacerbated by holding posture/limb position

Answer 17

Essential tremor (postural tremor) - Genetic predisposition. Patients often self-medicate with EtOH, which decreases tremor amplitude

Question 18

Proper treatment of an essential tremor

Answer 18

Beta-blockers, Primidone

Question 19

Uncontrolled movement of distal appendages (most noticeable in hands) tremor alleviated by intentional movement

Answer 19

Resting tremor - seen in Parkinson’s disease “pill rolling tremor”

Question 20

Slow, zigzag motion when pointing/extending toward a target; when moving

Answer 20

Intention tremor - cerebellar dysfunction

Question 21

Dancing in place, compulsion to move

Answer 21

Akathisia - voluntary - olanzepine