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Structure And Function 2 Test 3 > Norden - Extrapyramidal Motor System > Flashcards

Norden - Extrapyramidal Motor System Flashcards

1
Q

Involved in motor “programs” (arm swing when you walk), habitual behaviors, and in the modulation of movement

A

Extrapyramidal system

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2
Q

Involved in balance, equilibrium, posture, tone; the proper timing and coordination of learned, skilled motor movement and the correction of movement errors during on-going movement

A

Cerebellum

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3
Q

Neither the _ nor the _ project to the spinal cord, rather they have connections which influence firing of UMN’s in the corticospinal tract

A

Extrapyramidal system

Cerebellum

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4
Q

The major output division of the globus pallidus

A

GPi (glous pallidus internal portion)

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5
Q

Central players of the extrapyramidal system

A

Caudate and putamen

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6
Q

Hypo-kinetic disorders of the extrapyramidal motor system

A

Parkinson’s disease

Parkinsonism

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7
Q

Hyper-kinetic disorders of the extrapyramidal motor system

A

Huntington’s Chorea

Ballismus

Dystonia

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8
Q

• A family of disorders involving an abnormal posturing of the trunk or
extremity, caused by a sustained contraction and hypertrophy of muscles
involved
• Can be generalized or focal; most common focal are torticollis and
blepharospasm
• Etiology unknown; lentiform nucleus abnormalities have been found
• Can be primary (idiopathic) or secondary (called symptomatic)

A

Dystonia

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9
Q

Hyperkinetic extrapyramidal disorder • Due to lesions of the subthalamic nucleus • Results in violent, uncontrollable movements (contralateral to lesion) • Can be a fatal disorder

A

Ballismus

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10
Q

• ETIOLOGY: Autosomal dominant disorder with genetic anticipation linked
to an abnormal expansion in the length of a CAG triplet repeat sequence;
chromosome 4; hyperkinetic extrapyramidal disorder
• PATHOLOGY: A neurodegenerative disorder characterized by loss of the
medium-spiny neurons that are involved in the indirect pathway; overall
effect is to decrease inhibition of the thalamus (VA, VL) and thus
abnormally excite UMNs in cortex – leading to abnormal, uncontrollable
motor movements
• Also involves loss of other cortical neurons (prefontal cortex,
hippocampus)
• Results in chorea, mental changes

A

Huntington’s Chorea

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11
Q

this is the system that plans and initiates a voluntary motor movement (direct corticospinal) and maintains background tone in muscle that allows the movement to be made (indirect corticospinal

A

Pyramidal motor system

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12
Q

Plays a primary role in the execution of motor “programs”, habitual learning, and in the modulation of movement

A

Extrapyramidal motor system

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13
Q

Monitoring of on-going movement, proper timing and coordination of learned, skilled motor movement and the correction of movement errors during on-going movement

A

Cerebellum

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14
Q

Medium spiny neurons are prominent where ?

A

Neostriatum (caudate and putamen)

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15
Q

Medium spiny neurons are prominent in the neostriatum (caudate and putamen) and use ____ as a neurotransmitter

A

GABA

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16
Q

What are the excitatory neurons of the neostriatum ?

A

Aspiny neurons, excitatory, use acetylcholine

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17
Q

The pars compacta’s melanin containing neurons provide ______ input to the neostriatum

A

Domapinergic

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18
Q

The extrapyramidal motor system consists of ?

A

The neostriatum
Globus pallidus
Subthalamic nucleus
Substantia nigra

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19
Q

The 3 major afferent projections to the neostriatum are?

A

Cerebral cortex (cortico-striate)

Thalamus (thalamo-striate)

Substantia nigra (nigro-striate)

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20
Q

What Is the major neurotransmitter in cortico-striate and thalamo-striate projections?

A

Glutamate

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21
Q

Where do many of the cortico-striate axons come from?

A

A lot of them are collaterals from the cortico - spinal tract .

(This allows for the extrapyramidal system to “know” what movement is expected to be made)

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22
Q

What type of neurotransmitter does the pars compacta send to the striatum?

A

Dopamine.

Either + or -

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23
Q

What determines whether the dopamine that is used in the nigro-striate pathway is inhibitory or excitatory?

A

The type of postsynaptic dopamine receptor involved.

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24
Q

What are the major efferents out of the neostriatum ?

A

Globus pallidus and substantia nigra?

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25
Q

What neurotransmitter is used in efferent projections to the globus pallidus and substantia nigra out of the neostriatum ?

A

GABA

26
Q

Where do the nuclei of the extrapyramidal motor system ultimately project to ?

A

The motor cortex .

NOT tHE SPINAL CORD

27
Q

What thalamic nuclei does the neostriatum ( extrapyramidal motor system) project to ?

A

Ventral anterior nuclei (VA)

Ventral lateral nuclei (VL)

28
Q

How does the extrapyramidal system modulate motor movement?

A

By providing feedback to the motor cortex that influences the firing of cortical UMN’s of the direct and indirect corticospinal tracts

29
Q

At rest. Medium spiny neurons are ?

A

Quiescent

30
Q

In the direct pathway, the dopaminergic projection from the substantia nigra to the neostriatum is ?

A

Exitatory

31
Q

In the indirect pathway, there is ____ inhibition of the the thalamus.

(This is regarding the extrapyramidal motor system)

A

Increased

32
Q

In the indirect pathway (extrapyramidal) the dopaminergic projection from the substantia nigra to the neostriatum is ?

A

Inhibitory

33
Q

Disorder involving extrapyramidal motor system where the primary dysfunction is a decrease and slowing of movement

A

Hypokinetic disorders

34
Q

Hypokinetic disorders include?

A

Parkinson’s disease

Parkinsonianism

35
Q

What type of disease are huntington’s chorea, ballismus, and dystonia?

A

Hyperkinetic disorders

36
Q

Extrapyramidal dz in which the major clinical manifestation is abnormal involuntary movement

A

Hyperkinetic disease

37
Q

Parkinson’s Disease is caused by ?

A

Idiopathic, cause unknown. (90%) of cases

38
Q

Parkinsonism -

A

Parkinson’s in which there is a known etiologic agent/cause.

39
Q

Cause of parkinsons’ disease?

A

Loss of melanin-containing neurons of the pars compacta of the substantia nigra. 80-85%of substantia nigra must be lost to start seeing symptoms

40
Q

What does the loss of melanin containing neurons of the substantia nigra do?

A

Loss of dopaminergic input to the neostriatum

This causes a decrease in the activity of the direct path (extrapyramidal motor loop) and and increase in the activity of the indirect pathway.

41
Q

Dementia and then parkinsonism

A

Lewy body dementia

42
Q

Parkinsonism then lewy body then dementia?

A

Parkinson, (50-80% of pts develop dementia)

43
Q

Causes an increased incidence of both parkinsons and alzheimers

Occurs second to swine flu.

Lethargy, due to the reticular formation’s involvement

A

Encephalitis lethargica

44
Q

Where can strokes occur that could cause the development of Parkinson’s disease?

A

Branches of the ACA, PCA, and anterior choroidal, which all supply the striatum.

Branches of the posterior cerebral artery which supply the substantia nigra

45
Q

What can happen with people who have long, chronic exposure to low levels of CO or who attempt suicide by CO poisoning?

A

Increased incidence of parkinson’s disease

46
Q

What are some known insults that can cause parkinson’s disease?

A

Encephalitis lethargica (2nd to swine flu)
Stroke of branches of PCA, ACA, MCA, and ant choroidal
CO exposure

Herbicides and pesticides

Toxic manifestation of some prescription drugs

Long term Meth use.

47
Q

Why is drooling a symptom of parkinson’s disease?

A

Swallowing is impaired

48
Q

What gene is errant in Huntington’s chorea?

A

Gene 4.

Has expansion in the length of a CAG triplet repeat sequence

49
Q

A neurodegenerative disease characterized by the loss of medium spiny neurons in the caudate and putamen. These normally project to the GPe in the indirect pathway.
Overall effect of loss of neurons is decrease in inhibitory output to the thalamus. Results in abnormal activation of UMN’s

A

Huntington’s chorea

50
Q

motor disturbance characterized by non-rhythmic continuous involuntary
movements, particularly of the distal extremities, face and tongue a. In advanced stages, the patient is never at rest; the patient has no control; it can involve
all parts of the body, can be unilateral or bilateral

A

Chorea

51
Q

early in the disorder, the patient characteristically tries to hide the
movements (tries to work them into normal movements)
a. As the disease progresses, there is severe mental deterioration and usually marked
paranoia

A

Mental changes associated with huntington’s disease

52
Q

What neurological disease has the highest patient suicide rate, at about 10%?

A

Huntington’s chorea

53
Q

Occurs with lesions of the subthalamic nucleus; lesions effectively remove excitatory input
to GPi thereby decreasing the inhibitory outflow of extrapyramidal motor system nuclei; this leads to an abnormal activation of UMNs (resulting in violent movements)

A

Ballismus

54
Q

Most common form of focal dystonia.

Involves cervical neck muscles

A

Torticollis

55
Q

Focal dystonia; orbicularis oculi

A

Blepharospasm

56
Q

Focal dystonia involving vocal apparatus

A

Spasmodic dysphonia

57
Q

Focal dystonia involving upper extremity only when writing

A

Writer’s cramp

58
Q

Where are lesions in ballismus?

A

Subthalamic nucleus

59
Q

Where is problem of huntingtons disease

A

Medium spiny neurons in caudate and putamen that project to GPe degenerate

60
Q

Where is degeneration in Parkinson’s disease?

A

Substantia nigra

61
Q

Dystonia can be caused by lesions in the?

A

Lentiform nucleus

Structure And Function 2 Test 3 (21 decks)

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