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CMED 311 > Trans 043 Movement Disorders > Flashcards

Trans 043 Movement Disorders Flashcards

1
Q

o physical sign of abnormal movement in absence of
weakness
o the syndrome that causes such motor abnormalities

A

Movement Disorder

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2
Q

where is the pathology in movmnt disorders?

A

basal ganglia

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3
Q

along lateral side of each lateral ventricle

A

Caudate nucleus

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4
Q

what comprises the basal ganglia?

A 
Caudate nucleus
putamen
GP
Subthalamic nucleus
Substantia nigra
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5
Q

small structure on border between brain stem &

cerebrum, lateral & inferior to hypothalamus

A

Subthalamic nucleus

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6
Q

BG do not connect directly to spinal neurons. T or F?

A

T

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7
Q

major receiving area

o Input from all areas of cortex

A

Striatum

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8
Q

the main output stations of the basal ganglia

A

GPe + SNr

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9
Q

Hypokinetic movement disorders are usually called

A

Akinetic-

rigid syndromes

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10
Q

progressive neuro-degenerative
disorder that is associated with the loss of dopaminergic
neurons in the substantia nigra pars compacta.

A

PD

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11
Q

Hallmarks of PD?

A

o resting tremor
o rigidity
o akinesia/bradykinesia
• Gait and postural disturbances also characterize the disease.
 Usually in the latter part of the disease

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12
Q

Direct vs Indirect pathway

A

o Direct Pathway
▪ Facilitates movement
o Indirect Pathway
▪ Inhibits movement

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13
Q

how does dopamine facilitate movement?

A

Dopamine Facilitates movement through the activation of
the direct pathway and the inhibition of the indirect
pathway

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14
Q

Resting, static, or non-intention tremor
• slow, coarse, and compound in type
• Onset is usually in one hand; it may later involve the
contralateral upper limb or ipsilateral lower limb.
• The rate vary from 2 to 6 Hz, averaging 4 to 5 Hz

A

Parkinsonian Tremor

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15
Q

parkinsonian rigidity complicated by parkinsonian tremor

A

Cogwheel rigidity

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16
Q

most disabling component in PD?

A

Bradykinesia - slowness of voluntary movements and poverty of normal
associated movements

17
Q

eye movement that has less than the magnitude that would be required to gain fixation of the object.

A

saccadic hypometria

18
Q

early PD, the posture may show

A

early PD, the posture may show
o slight flexion of the neck or trunk
o slight lean to one side

19
Q

Abnormalities of gait in PD include

A

Abnormalities of gait include
o asymmetrIcally reduced arm swing,
o overall slowing of gait and early fatigue,
o shortened stride length
o Intermittent shuffle, or tripping over objects,
o Sometimes with ankle dystonia
o Inability to turn quIckly`

20
Q

examples of parkinsonian syndromes?

A 
• Progressive supranuclear palsy
 Associated with gaze abnormality
• Multisystem atrophy
• Olivopontocerebellar degeneration (sporadic form)
 Associated with some cerebellar signs
• Striatonigral degeneration
• Shy-Drager syndrome
 Associated with autonomic dysfunction
• Diffuse Lewy body disease
• Corticobasal degeneration
 Associated with dementia
• Drug-induced parkinsonism
• Dopa responsive dystonia
VII. TREMOR
21
Q

• series of involuntary, relatively rhythmic purposeless,
oscillatory movements due to intermittent muscle
contractions

A

Tremor

22
Q

simple vs compound tremor?

A 
• Simple tremor
o involves only a single muscle group
• Compound tremor
o involves several muscle groups
o several elements in combination
o resulting in a series of complex movements
23
Q

Tremors are accentuated by emotional excitement
o Many normal individuals develop tremor with anxiety,
apprehension, and fatigue

T or F?

A

T

24
Q

present in normal individuals
▪ frequency varies from 8 to 12 Hz
▪ Can occur in normal persons by anxiety, fright, fatigue
(rock climber’s tremor)
▪ In conditions with increased adrenergic activity

A

Physiologic tumor

25
Q

is characterized by involuntary,
irregular, purposeless, random, non-rhythmic hyperkinesias
• movements are spontaneous, abrupt, brief, rapid, jerky, and
unsustained
• movements are actually random and aimless
• They are present at rest but Increased by activity, tension,
emotional stress and self-consciousness
• patient may be able to temporarily and partially suppress the
movements
• disappear in sleep

A

Chorea

26
Q

CAUSES OF CHOREA

A 
• Drugs:
o levodopa in Parkinson's patients
o oral contraceptive pill
o many psychiatric drugs
• Vascular disease of the basal ganglia:
o atheroma
o systemic lupus erythematosus
• Degenerative diseases:
o Huntington's disease
• Post-Infectious:
o Sydenham's chorea
• Other causes:
o Thyrotoxicosis
27
Q

Most common cuase of chorea in the PH?

A

Rheumatic fever

28
Q

(milkmaid grip)

A

patient holds the examiner’s finger in her fist, there are

constant twitches of individual fingers

29
Q

means “without fixed position”
• Involuntary, irregular, coarse, somewhat rhythmic, and
writhing or squirming in character (twisting)
• Hyperkinesias are slower, more sustained, and larger in
amplitude than those in chorea
• May involve the extremities, face, neck, and trunk
• In the extremities they affect mainly the distal portions, the
fingers, hands, and toes
• movements are characterized by any combination of flexion,
extension, abduction, pronation, and supination, often
alternating and in varying degrees

A

Athethosis

30
Q

Causes of athetosis

A

May be congenital due to perinatal injury to the basal ganglia
• May be present in association with other neurological deficits
(athetotic cerebral palsy)
• It may be either unilateral or bilateral
• The predominant pathologic changes are in the caudate and
putamen, there may also be cortical involvement
• Many patients have features of athetosis plus chorea

31
Q

refers to movements that lie between
chorea and athetosis in rate and rhythmicity, and may
represent a transitional form

A

Choreoathetosis

32
Q

Dramatic neurologic syndrome of wild, flinging (forceful),
incessant (uninterrupted or continuous) movements that
occur on one side of the body
• Due to infarction or hemorrhage in the region of the
contralateral subthalamic nucleus
• Results in disinhibition of the motor thalamus and the cortex,
resulting in contralateral hyperkinetic movements

A

hemiballismus

33
Q

Hemiballismus is difficult to treat, incredibly disabling, and
sometimes fatal because of exhaustion and inanition. T or F?

A

T

34
Q

Single or repetitive, abrupt, brief, rapid, lightning-like, jerky,
arrhythmic, asynergic, involuntary contractions involving
portions of muscles, entire muscles, or groups of muscles
• Movements are quicker than chorea
• Seen principally in the muscles of the extremities and trunk,
but the involvement is often multifocal, diffuse, or widespread
• May involve the facial muscles, jaws, tongue, pharynx, and
larynx
• May be successive or simultaneous Involvement of many
muscles

A

myoclonus

35
Q

Myoclonus may appear symmetrically on both sides
• Such synchrony may be an attribute unique to myoclonus

T or F?

A

T

36
Q

are myoclonic jerks that appear during the
process of falling asleep, but disappear during sleep
 Minsan you will see them nahuhulog sa kama

A

Hypnic Jerks

37
Q

Myoclonus occurs without prominent seizures in a number of

other conditions, including

A 
Myoclonus occurs without prominent seizures in a number of
other conditions, including
o Metabolic disorders (especially uremic and anoxic
encephalopathy)
o Subacute sclerosing panencephalitis
o Hallervorden-Spatz syndrome
o Creutzfeldt-Jakob disease
o Alzheimer's disease
o Wilson's disease
o Huntington's disease
o Corticobasal degeneration
o Viral encephalitis
o General paresis
o Hashimoto's encephalopathy
o lipidoses
38
Q

Negative vs Postive motor symptoms?

A

slow movements vs excessive involuntary movements

39
Q

postural vs kinetic vs intention vs resting tremor?

A

postural pag hinold against gravity
kinetic any voluntary movement
intention tuwing ggagalaw

CMED 311 (47 decks)

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