Parkinson's Disease Flashcards
1
Q
what are the parts of the basal ganglia
A
- caudate
- putamen
- globus pallidus
- Subthalamic nucleus
- substantia nigra
- striatum
2
Q
describe the direct pathway
A
- Turns up motor activity and due to disinhibition
- thinking about movement in cortex
- causes excitation in striatum
- which inhibits the inhibition of the globus pallidus on the motor thalamus
- the motor thalamus excites the motor cortex allowing for movement
3
Q
Describe the indirect pathway
in the basal ganglia
A
- the globus pallidus internus inhibits motor thalamus there for decreasing excitatory thalams input to cortext and TURNS DOWN motor activity
- subthalamic nucleus excites inhition of motor thalamus
- cortext excites striatum which inhibits the globus pallidus externus
- which inhibits the subthalamic nucleus which excites the globus pallidus internus
4
Q
Striatal interneurons cholinergic
A
- uses dopamine and ACh used within the basal ganglion
- ACh can be excitatory or inhibitory depending on receptor
- this turns down direct pathway and turns up indirect pathway = less motor activity
5
Q
Neurotransmitters that can affect the basal ganglia
A
- Glutamate (+)
- GABA (-)
- Dopamine (+/-)
- Acetlycholine (+/-)
6
Q
Thalamus
A
- reduced inhibition of motor nuclei of thalamus: you get voluntary movement
7
Q
Pedunculopontine Nucleus
A
- reduced inhibition increases activitiy of PPN
- directly stimulates LMN/involved with postural control
- gets information and sends it to motor cortex
- stimulates: reticulospinal tract, vestibulospinal tract, LMN for postural control
8
Q
Motor control of complex movements
A
- basal ganglia activated by sensorimotor assoication areas
- perception of environment used to make movement
- striatum stores movement programs for complex voluntary movements
- CPG may be stored in basal ganglion
- any motor circuits for tasks is stored in basal ganglia
9
Q
complex movements
A
- movement programs in striatum are modified by reciprocal connections
- striatum with substantia nigra
- globus pallidus with subthalamic nuceli
- all parts work together
10
Q
Basal ganglia disorders
generally cause what kinds of physiological issues
A
- loss of balance of excitation/inhibition
- loss of control exerted on striatum
- loss of control exerted on globus pallidus
- loss of control exerted on motor thalamus and PPN
11
Q
Parkinson’s disease what are symptoms related to
caused by/pathophysiology
A
- motor symptoms
- symptoms related to decreased in dopamine due to degeneration of neurons in substantia
nigra compacta - development of alpha-synuclein deposts, lewy body
- development of abnormal proteins that imped transmission (usually develop years before symptoms start)
12
Q
Parkinsons
Brain pathology stage
A
- stage 1: olfactory bulb, CN I, CN IX, CN X (changes in smell, vitals, orthostatic hypotension
- Stage 2: pons - CN 5-8 chewing, fascial expression, vestibular symptoms
- Stage 3: substantia nigra - start to see motor symptoms due to dopamine production
- Stage 4: hypothalamus, thalamus, cortex (thinking, weight control, BP)
- Stage 5: sensory assoication areas, prefrontal cortex (personality, execuative function)
- Stage 6: primary motor and sensory cortex
13
Q
Parkinson’s disease
symptoms
A
- hypokinesia: less movement/little movement
- akinesia: no movement
- bradykinesia: slow movement
- tremor: resting ususally
- abnormal postural adjustments
- rigidity: no spasticity, no velocty dependent and usually in both directions
14
Q
Parkinson’s disease
other signs/symptoms
A
- gait abnormalities (freezing/festinating gait)
- micrographia: writing gets really small
- swallowing impairments/dysphagia: thick liquids to give time to swallow
- speech impairments
15
Q
Parkin’s disease
non motor symptoms
A
- REM sleep: hard time falling/staying asleep
- cognition-related disorders: visual-perception impairments
- mood related disorders: depression, anxiety, apathy
- sensory dysfunction: loss of taste, smell, GI symptoms (fullness/consitpation)
- Dysautonomia: orthostatic hypotension
