S3_L2: Basal Ganglia and Diencephalon Flashcards
_______ is a collective term for the caudate nucleus and lentiform nucleus
Corpus striatum
(1)_______ is composed of the caudate nucleus and putamen, while (2)_______ is the collective term for the globus pallidus and putamen.
- Striatum/Neostriatum
- Lentiform nucleus
TRUE OR FALSE: The basal ganglia cannot move without the cerebrum. In normal individuals, the direct and indirect pathways act alternatively.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
C. Only the 1st statement is true
NOTE: It acts act simultaneously.
The following are inhibitory in nature, EXCEPT:
A. Globus Pallidus Internus
B. Globus Pallidus Externus
C. Subthalamic Nucleus
D. Substantia Nigra pars Reticulata
E. None of the above
C. Subthalamic Nucleus
The following do NOT release, EXCEPT:
A. Substantia Nigra Pars Compacta
B. Cerebrum
C. Striatum
D. Thalamus
E. None of the above
C. Striatum
Match the following descriptions to its corresponding pathway.
- Decrease movement
- Cerebral cortex releases glutamate to striatum
- Uses D1 neurotransmitter
- Initiate motor activity
- Inhibit unwanted motor movements
A. Direct Pathway
B. Indirect Pathway
C. Both
D. Neither
- B
- C
- A
- A
- B
FILL IN THE D1 PATHWAY FLOW.
Cortex → striatum → (1)_______ → thalamus (VL & VA nuclei) → (2)_______
- globus pallidus (internus)
- cerebral cortex
FILL IN THE D1 PATHWAY FLOW.
Cortex → striatum → (1)_______ → (2)_______ → (3)_______ → thalamus (VA and VL nuclei) → cortex
- globus pallidus (externus)
- subthalamus
- globus pallidus (internus)
The D1 pathway is (1)_______ type of pathway, the D2 pathway is (2)_______.
- Facilitatory/ excitatory
- Inhibitory
Underactivity of direct pathway leads to?
decreased movement
TRUE OR FALSE: Underactivity of indirect pathway leads to increased movement.
True
Overactivity of direct pathway leads to?
Increased movement
Overactivity of indirect pathway leads to?
decreased movement
Bradykinesia is a result of:
A. Underactivity of direct pathway
B. Overactivity of direct pathway
C. Underactivity of indirect pathway
D. Overactivity of indirect pathway
E. All of the above
D. Overactivity of indirect pathway
Tremors are a result of:
A. Underactivity of direct pathway
B. Overactivity of direct pathway
C. Underactivity of indirect pathway
D. Overactivity of indirect pathway
E. All of the above
C. Underactivity of indirect pathway
Parkinson’s Disease may be a result of:
A. Underactivity of direct pathway
B. Overactivity of direct pathway
C. Underactivity of indirect pathway
D. Overactivity of indirect pathway
E. All of the above
E. All of the above
NOTE: Either overactivity of direct and underactivity of indirect OR overactivity of indirect and underactivity of direct. It is not all at once.
Postural instability is a result of:
A. Underactivity of direct pathway
B. Overactivity of direct pathway
C. Underactivity of indirect pathway
D. Overactivity of indirect pathway
E. All of the above
D. Overactivity of indirect pathway
______ gait is combination of hypokinesia and bradykinesia
Parkinsonian
This is a movement disorder with features of both chorea and athetosis
Choreoathetosis
Match the following basal ganglia pathology to its definition and details.
- Slow, sinuous, involuntary, writhing, twisting, “wormlike/snake-like” movements
- Usually seen in the late stages of Parkinson’s disease which can experience “freezing episodes”
- Decreased amplitude and velocity of voluntary movement
- Difficulty in initiating and performing new movements
- Inability to initiate movement
A. Akinesia
B. Athetosis
C. Bradykinesia
- B
- A
- C
- C
- A
Match the following basal ganglia pathology to its definition and details.
- Rapid jerky + wormlike movement
- Sustained involuntary, palpable contractions of agonist and antagonist muscles
- Consists of frequent, maintained contractions of hypertonic muscles, leading to bizarre postures
- Affectation of the putamen & globus pallidus (lentiform)
- Involuntary, rapid, irregular, jerky movements involving multiple joints
A. Chorea
B. Choreoathetosis
C. Dystonia
- B
- C
- C
- B
- A
Match the following basal ganglia pathology to its definition and details.
- Abnormally increased muscle activity or movement
2.Exhibits a Parkinsonian gait - Large-amplitude sudden, violent, flailing motions of the arm and leg of one side of the body
4..Exhibits a Choreiform gait - Decreased motor response especially to a specific stimulus
A. Hemiballismus
B. Hyperkinesis
C. Hypokinesis
- B
- C
- A
- B
- C
Match the following basal ganglia pathology to its definition and details.
- Noted in UE in the form of “pill-rolling” movement
- Gait presents with short steps & is often unable to stop
- Involuntary, rhythmic, oscillatory movement observed at rest
- Manifests stoop posture in standing & arms flexed
- Increase in muscle tone causing greater resistance to passive movement
A. Tremor (resting)
B. Rigidity
C. Postural Disturbance
- A
- C
- A
- C
- B
Match the following basal ganglia pathology to its definition and details.
- Results from degeneration of nigral cells
- Primarily involved axial and proximal muscles
- Can cause repetitive or twisting movements
- Lesion of contralateral subthalamic nucleus
- Occurs with lesions of the lentiform nucleus
A. Hypokinesis
B. Dystonia
C. Hemiballismus
- A
- C
- B
- C
- B
TRUE OR FALSE: A person with akinesia cannot move their muscles, even if they try. This pathology is most often described and seen in late stages of Parkinson’s Disease.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
TRUE OR FALSE: Athetosis has a greater involvement in the distal LEs.
False.
It affects the distal UEs more.
Determine the basal ganglia pathology.
Degeneration of globus pallidus with breakdown of circuitry involving basal nuclei and cerebral cortex
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Choreoathetosis
B. Athetosis
Determine the basal ganglia pathology.
The movements are slow, the face is expressionless, and the voice is slurred and unmodulated.
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Choreoathetosis
C. Bradykinesia
Determine the basal ganglia pathology.
Commonly seen in pts. with Huntington’s Disease, rheumatic fever, lyme disease, meningitis
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Choreoathetosis
E. Choreoathetosis
Determine the basal ganglia pathology.
Loss of ability to move your muscle voluntary or the absence of both spontaneous movement and associated movement
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
A. Akinesia
Determine the basal ganglia pathology.
This condition happens when there are lesions of the corpus striatum and cannot be voluntarily inhibited
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
D. Chorea
Determine the basal ganglia pathology.
Often seen in basal ganglia damage of Huntington’s Syndrome
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
B. Athetosis
Determine the basal ganglia pathology.
Is an extrapyramidal syndrome
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
E. Hyperkinesis
Determine the basal ganglia pathology.
Type of hyperkinetic movement disorder which may or may not occur during sleep
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
D. Chorea
Determine the basal ganglia pathology.
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
Determine the basal ganglia pathology.
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
Determine the basal ganglia pathology.
Has a dance-like appearance due to the random and flowing quality of the movement
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
D. Chorea
Determine the basal ganglia pathology.
Usually a characteristic of Parkinson’s disease and observable slow shuffling gait
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
C. Bradykinesia
Determine the basal ganglia pathology.
Decreased or lost arm swing during walking, slow steps regardless of step size
A. Akinesia
B. Athetosis
C. Bradykinesia
D. Chorea
E. Hyperkinesis
C. Bradykinesia
Most common clinical manifestation of dystonia?
cervical dystonia → stiff neck or spasmodic torticollis
Determine the kind of rigidity.
Uniform, constant resistance as limb is moved through ROM
A. Lead pipe
B. Cog-Wheel
A. Lead pipe
Determine the kind of rigidity.
series of brief relaxation or “catches” as extremity is passively moved
A. Lead pipe
B. Cog-Wheel
B. Cog-Wheel
Determine the kind of rigidity.
interrupted and with tremor
A. Lead pipe
B. Cog-Wheel
B. Cog-Wheel
Determine the kind of rigidity.
more common
A. Lead pipe
B. Cog-Wheel
A. Lead pipe
Bradykinesia and akinesia has a normal (1)____ movement when walking, but has difficulties in (2)______ movements
- straight line/planar
- rotatory
What are the cardinal symptoms of Parkinson’s Disease.
Tremor, Rigidity, Akinesia, Postural instability
NOTE: Akinesia may be bradykinesia
Phantom pillow posture presents with (1)_____ spine posture, (2)_____, and (3)______
- Flexed
- Rigidity
- Bradykinesia/ akinesia
TRUE OR FALSE: Tests for the cerebellum can also be used to test for Basal Ganglia Pathology.
True
How do you test for rigidity on the wrist?
- PT holds the hand of the patient above the wrist with one hand and keep it fixed.
- With other hand, he grasps the fingers and the palm and then slowly rotate along the long axis of the hand.
Determine the tests for the following basal ganglia pathology.
- Pronation Supination Test
- BRAIN test
- Fixation or position holding
A. Akinesia
B. Bradykinesia
C. Tremor (Resting)
D. Athetosis
E. Postural Disturbance
F. Rigidity
- B
- A
- E
Determine the tests for the following basal ganglia pathology.
- Hands on Knees
- Hands Above the Head
- Finger Tapping/Mass Grasp Test
A. Akinesia
B. Bradykinesia
C. Tremor (Resting)
D. Athetosis
E. Postural Disturbance
F. Rigidity
- D
- C
- B
Determine the tests for the following basal ganglia pathology.
- Handwriting
- Finger-to-nose Test
- Perturbation
A. Akinesia
B. Bradykinesia
C. Tremor (Resting)
D. Athetosis
E. Postural Disturbance
F. Rigidity
- B
- B
- E
Determine the tests for the following basal ganglia pathology. You may choose 2 or more.
Walking
A. Akinesia
B. Bradykinesia
C. Tremor (Resting)
D. Athetosis
E. Postural Disturbance
F. Rigidity
B. Bradykinesia
and
C. Tremor (Resting)
Determine the tests for the following basal ganglia pathology. You may choose 2 or more.
Observation during functional activities
A. Akinesia
B. Bradykinesia
C. Tremor (Resting)
D. Athetosis
E. Postural Disturbance
F. Rigidity
C. Tremor (Resting)
and
F. Rigidity
Determine the tests for the following basal ganglia pathology. You may choose 2 or more.
Observation of resting posture/s
A. Akinesia
B. Bradykinesia
C. Tremor (Resting)
D. Athetosis
E. Postural Disturbance
F. Rigidity
F. Rigidity
Computerized alternating finger tapping test for assessing Parkinson’s disease
Which basal ganglia pathology test fits this description?
Bradykinesia-Akinesia Incoordination (BRAIN) Test
- Pt is told to touch PT’s fingertip using index finger from an arm’s length distance.
- Then, pt is told to touch their nose using their index finger.
Which basal ganglia pathology test fits these description?
Finger-to-nose Test
Instruct pt “as big as you can and as fast as you can” for at least 10 reps
Which basal ganglia pathology test fits this description?
Finger Tapping/Mass Grasp Test
Ask patient to rest their hand on their knee
Which basal ganglia pathology test fits this description?
Hands on Knees Test
This is the relay station for limbic, sensory, and motor information and sending these information to the cerebral cortex
Thalamus
Match the following thalamic nuclei to its function.
- Involved in visual pathway
- Relays common sensations to consciousness
- Receives spinal and medial lemnisci
A. Lateral Geniculate Body
B. Medial Geniculate Body
C. Ventral Posteromedial Nucleus
D. Ventral Posterolateral Nucleus
- A
- C
- D
Match the following thalamic nuclei to its function.
- Facial sensations
- Involved in auditory pathway
- Relays common sensations consciousness
A. Lateral Geniculate Body
B. Medial Geniculate Body
C. Ventral Posteromedial Nucleus
D. Ventral Posterolateral Nucleus
- C
- B
- D
Match the following thalamic nuclei to its function.
Receives trigeminal and gustatory pathways
A. Lateral Geniculate Body
B. Medial Geniculate Body
C. Ventral Posteromedial Nucleus
D. Ventral Posterolateral Nucleus
C. Ventral Posteromedial Nucleus
Match the following thalamic nuclei to its function.
Sensations from the limbs
A. Lateral Geniculate Body
B. Medial Geniculate Body
C. Ventral Posteromedial Nucleus
D. Ventral Posterolateral Nucleus
D. Ventral Posterolateral Nucleus
Lateral Geniculate Body gets visual information from the ________ field of vision
opposite
This structure has an effect on the homeostasis and behavior of the entire body
Hypothalamus
The following statements are conditions may occur d/t a damaged hypothalamus, EXCEPT:
A. Sleep disturbance
B. Diabetes mellitus
C. Obesity and wasting
D. Hyperthermia
E. None of the above
B. Diabetes mellitus
NOTE: Diabetes insipidus occurs
Determine the hypothalamic condition.
- Generally associated with genital hypoplasia or atrophy
- May have impotence or amenorrhea post-puberty
- Caused by head injury or after surgical operations in the region
- Have no signs of malaise
5.
A. Obesity and wasting
B. Sexual disorders
C. Hyperthermia and hypothermia
- A
- B
- C
- C
Determine the hypothalamic condition.
- Patient passes a large volume of urine of low specific gravity
- Occurrence of frequent short periods of sleep during waking hours or insomnia
- Result of lesion from the supraoptic nucleus
- Result of interruption of the nervous pathway to the posterior lobe of hypophysis
- Attacks of unexplained weeping or laughter, uncontrollable rage, depressive reactions, maniacal outbursts
A. Diabetes insipidus
B. Sleep disturbance
C. Emotional disorders
- A
- B
- A
- A
- C
TRUE OR FALSE: Wasting is less common than obesity in hypothalamic conditions.
True
Match the Hypothalamic Nuclei to its function.
- Synthesizes oxytocin
- Control sympathetic system
- Important in patients who have decreased BP
A. Supraoptic nucleus
B. Paraventricular nucleus
C. Preoptic and anterior nuclei
D. Posterior and lateral nuclei
E. Suprachiasmatic nucleus
- B
- D
- A
Match the Hypothalamic Nuclei to its function.
- Controls circadian rhythms
- Synthesizes vasopressin
- Control parasympathetic system
A. Supraoptic nucleus
B. Paraventricular nucleus
C. Preoptic and anterior nuclei
D. Posterior and lateral nuclei
E. Suprachiasmatic nucleus
- E
- A
- C
Match the Hypothalamic Nuclei to its function.
- Initiate eating and increase food intake
- Regulate temperature (response to heat)
- Increase water intake
A. Anterior hypothalamic nucleus
B. Posterior hypothalamic nucleus
C. Medial hypothalamic nucleus
D. Lateral hypothalamic nucleus
E. Supraoptic nucleus
- D
- A
- D
Match the Hypothalamic Nuclei to its function.
- Responsible for decreasing water excretion by the kidneys
- Inhibit eating and reduce food intake
- Regulate temperature (response to cold)
A. Anterior hypothalamic nucleus
B. Posterior hypothalamic nucleus
C. Medial hypothalamic nucleus
D. Lateral hypothalamic nucleus
E. Supraoptic nucleus
- E
- C
- B
GABA is (1)_______ in nature, while Glutamate is (2)_____. Both binds to (3)______ ion channels
- inhibitory
- stimulatory
- ligand-gated
Match the following thalamic nuclei with its functions.
- plays a role in fine motor control
- influence the levels of consciousness and alertness of an Individual
- concerned with a mechanism by which the cerebral cortex regulates thalamic activity
A. Reticular nucleus
B. Midline nuclei
C. Intralaminar nuclei
D. Lateral posterior nucleus
E. Lateral dorsal nucleus
- D
- C
- A
Match the following thalamic nuclei with its functions.
- influences motor activity
- influences the activities of the motor cortex
- closely associated with that of the limbic system and is concerned with emotional tone and the mechanisms of recent memory
A. Lateral dorsal nucleus
B. Ventral anterior nucleus
C. Anterior thalamic nuclei
D. Ventral lateral nucleus
E. Dorsomedial nucleus
- D
- B
- C
Match the following thalamic nuclei with its functions.
- involved in specific cognitive, sensory, and motor functions
- provides inputs to limbic cortical areas and is involved in spatial learning and memory
- responsible for the integration of a large variety of sensory information, including somatic, visceral, and olfactory information, and the relation of this Information to one’s emotional feelings and subjective states
A. Anterior thalamic nuclei
B. Dorsomedial nucleus
C. Intralaminar nuclei
D. Midline nuclei
E. Lateral dorsal nucleus
- D
- E
- B
This is a Y shaped white matter structure that divides the thalamus into 3 sections
Internal or medial medullary lamina
In what Brodmann area does the lateral geniculate nucleus send its information?
primary visual cortex; BA 17
In what Brodmann area does the medial geniculate nucleus send its information?
primary auditory cortex; BA 41, 42
