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Nervous System And Neuropsychiatry > Session 6: Motor Disorders > Flashcards

Session 6: Motor Disorders Flashcards

1
Q

What are the components of the Motor Pathway?

A
  • Corticospinal tract
  • Corticobulbar tract
  • Extrapyramidal tracts
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2
Q

Where is the cerebellum located?

A
  • Located in the posterior cranial fossa at the back of the brain
  • Separated from the occipital and parietal lobes by the tentorium cerebelli
  • Separated from the pons by the 4th ventricle
  • It has an important role in motor control and coordination
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3
Q

What are the component of the Cerebellum?

A
  • Vermis in the midline which regulates the trunk musculature
  • Lateral hemispheres which regulate the distal structures (limbs)
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4
Q

How does pathology in the cerebellum affect the body?

A

-Tracts are ipsilateral in the cerebellum so pathology affect the ipsilateral side

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5
Q

How does the cerebellum communicate with brainstem and cortex?

A
  • Superior cerebellar peduncle attaches cerebellum to midbrain
  • Middle cerebellar peduncle attaches cerebellum to pons
  • Inferior cerebellar peduncle attaches cerebellum to medulla
  • Cerebellum communicates with the cortex via the thalamus
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6
Q

What is the effect of a midline lesion of the cerebellum?

A
  • Midline lesions can cause truncal ataxia and abnormal gait
  • Extension of midline lesions can also cause 4th cranial nerve lesions, ipsilateral arm tremors compression of 4th ventricle and lead to hydrocephalus
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7
Q

What are the symptoms of cerebellar pathology?

A

Dysdiadochokinesis – Inability to perform rapid alternating movements
Ataxia – abnormal movement
Nystagmus – rapid eye movements
Intention tremor – tremor when attempting to do something
Slurred speech
Hypotonia – floppy movements

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8
Q

What is the Basal Ganglia?

A
  • Area of the brain know to be involved in motor function

- Communicates with the cortex and cerebellum to aid with the initiation of movement

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9
Q

What are the important Structures of the Basal Ganglia?

A
  • Caudate
  • Lentiform nucleus
  • Substantia nigra (pars compacta and pars reticularis)
  • Subthalamic Nucleus
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10
Q

What are the components of the Lentiform Nucleus?

A
  • Putamen
  • Globus pallidus externa
  • Globus pallidus interna
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11
Q

What is the output of the basal ganglia?

A

Thalamus

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12
Q

What are most of the nuerons in the striatum?

A

-GABAergic

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13
Q

What is the striatum?

A

Putamen + Caudate Nucelus

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14
Q

What is the substantia nigra made of?

A

Made up of pigmented neurones:

  • Pars compacta dorsally
  • Pars Reticularis which is a ventral strip
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15
Q

Which neurons are found in the substantia nigra pars compacta?

A

-Dopaminergic neurons

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16
Q

How is the circuitry of the basal ganglia arranged?

A

Direct and Indirect pathways to the thalamus

17
Q

What is the overall effect of the direct pathway?

A
  • Overall has a stimulatory effect on the cortex without dopamine
  • Dopamine merely encourages stimulation of the cortex
18
Q

What is the overall effect of the indirect pathway?

A
  • Overall has an inhibitory effect on the cortex without dopamine
  • Addition of dopamine however stimulates the cortex
19
Q

What is the overall net effect of direct and indirect pathways on the motor cortex?

A

-Overall net effect of DOPAMINE in the direct and indirect pathways is motor cortex stimulation via the thalamus

20
Q

What are the symptoms of basal ganglia disorders?

A

Affects the contralateral side:

  • Abnormal motor control
  • Altered posture
  • Affects muscle tone
  • Dyskinesia
21
Q

What cause Parkinson’s Disease?

A

Degeneration of substantia nigra pars compacta leading to deficiency of dopamine

22
Q

What is Parkinson’s Disease?

A
  • Chronic, progressive movement disorder characterised by triad of symptoms
  • Inhibition of motor function due to indirect pathway functioning without dopamine so Bradykinesia
  • Lack of encouragement of direct pathway
23
Q

What are the symptoms of Parkinson’s Disease?

A
  • Bradykinesia
  • Tremor at rest
  • Hypertonia (rigidity)
24
Q

What are other associated features of Parkinson’s Disease?

A
  • Hypophonia
  • Reduced facial expression
  • Micrographia (smaller handwriting)
  • Dementia
  • Depression
25
Q

What is Huntington’s Disease?

A
  • Autosomal dominant progressive neurodegenerative disorder

- Onset of disease around 30-50 years

26
Q

What are symptoms of Huntington’s Disease?

A
  • Chorea (more pronounced at the start)
  • Dystonia
  • Incoordination
  • Cognitive decline
  • Behavioural difficulties
27
Q

What is Huntington’s Disease associated with?

A

Associated with cell loss within the basal ganglia (striatum) and cortex.

28
Q

What is Hemiballismus?

A
  • Rare movement disorder associated with dysfunction contralateral sub-thalamic nuclei
  • Results in unilateral abnormal movement
  • Damage often secondary to sub cortical stroke
29
Q

Cerebral peduncles contain all motor fibres. True/False

A

True

Nervous System And Neuropsychiatry (20 decks)

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