Workshop 5 BSG/PD

Question 1

Upper Motor Neuron Cell Bodies situated where?

Answer 1

Pre-Central Gryus- Motor Cortex

Question 2

LMNs located?

Answer 2

ventral horn of the gray matter
Motor nucluei of cranial nerves in the brainsteam

Question 3

BSG Def

Answer 3

group of subcortical nuclei, base of forebrain

Question 4

BSG and Cerebellum are Diff to other motor system as

Answer 4

they modulate movement
other functions in addition to modulating motor control

Question 5

Damaged BSG leads to

Answer 5

damaged in primary motor structures

Question 6

BSG Functions-

Answer 6

Dont directly LMNS
Regulate activity of UMNs
Prevenet UMNs from iniating unwanted movements
Prepare motor cirucits for initation
Regulate transition from 1 pattern to another of voluntary movements

Question 7

BG Anatomy

Answer 7

Striatum(forebrain)
Dorsal Stratium
Caudate Nuclues & Ventral Straitum=Nucleus Accumbens)

Globus Pallidus: Base of forebrain:
Internal, External Segment

Subthalamic Nucleus

Susbtantia nigra

Question 8

Functional Classification Intrinsic Nuclei:

Answer 8

Globus Pallidus(external)
Subthalamic Nucleus
Substantia nigra

Question 8

Functional Classification Intrinsic Nuclei:

Answer 8

Globus Pallidus(external)
Subthalamic Nucleus
Substantia nigra

Question 9

Functional Classification- Striatum(Input Nuclei)

Answer 9

Caudate Nucleus
Putamen
Nucleus Accumbens

Question 10

BSG Functions

Answer 10

-Modulate and Regulate Activity
Goal Directed Movement
Motor Learning
Motor Pattern Selection

Fine tuning the starting and stopping voluntary movements
Preventing unwanted movements
Procedural Learning ie: complex patterns/sequences of movement
Planning and controlling movement intensiitees an directions
eye movements
cognition
emotions

Question 11

Motor Loops

Answer 11

BG work with other CNS regions to modulate movements both before and during their execution
Actions effected via body movements and Oculomotor

Question 12

Putamen

Answer 12

acts as a reservoir for learning motor programs
assembles an approipiate motor sequence for desired movements
info is sent to the Supplementary Motor Area

Question 13

Damage to the Substania Nigra

Answer 13

inhibition of the direct pathways and dishibition of the indirect pathway

Question 14

Functional Classification Output Nuclei:

Answer 14

Globus Pallidus (internal)
Subthalamic Nucleus
Substania Nigra

Question 15

BG: Functional Connections Step by Step

Answer 15

Cerebral Cortex, Thalamus, Limbic System send excitatory information to input nuclei
Information is processed and sent to the intrinsic nuclei
Input Nuclei process & pass info output nuclei
Output Nuclei send info to thalamus
Thalamus relays info to motor cortex

Question 16

Resting State

Answer 16

Globus Pallidus Internal inhibits the motor thalamic neurons hence no output to upper motor neurons in the motor cortex

Question 17

Direct Pathway:

Answer 17

Reduced Inhibition of Thalamic Neurons
Increased Thalamic Output to Cortex
Increased Motor Cortex Output
Increased Motor Activity in Corticospinal tract
Increased Movement

Question 18

Indirect Pathway

Answer 18

Increased Inhibition of Thalamic Neurons
Reduced thalamic Output to Cortex
Inhibition of Motor Cortex
Reduced Motor activity in corticospinal tract
Reduced Movement

Question 19

Role of the Substantia Nigra

Answer 19

Turns up the Direct and Turns Down the Indirect
Less Thalamic Inhibition
Increased thalamic Output to Motor Cortex
Increased Activity in the Motor Cortex
Increased Output in the Corticospinal Tract
Increased Movement

Question 20

Motor learning involves what structures?

Answer 20

Prefrontal (cognitive)
Head of Caudate Nucleus receives projections from the prefrontal cortex and appears to participate in motor learning

Question 21

Limbic Loop role?

Answer 21

giving motor expression to emotions
High in dopamine

Question 22

PD Etiology

Answer 22

idiopathic degeneration of the dopamine producing cells in the substantia nigra resulting in reduced dopamine production

Question 23

PD Initial Motor Stages

Answer 23

Akinesia
Bradykinesia
Rigidity
Resting tremor
Decreased mm power
Impaired automatic postural responses to position and movement

Question 24

PD: Advanced Motor Manifestations

Answer 24

Festinating Gait
Montonous/Weak Voice
Micrographia
Dysphagia

Question 25

PD Non-Motor Symptoms

Answer 25

Constipation
Sleep-related Disorders
Erectile Dysfunction
Anosmia

Question 26

PD Stage 1

Answer 26

Mild, uni-lateral symptoms which don’t interfere with quality of life

Question 27

PD Stage 2

Answer 27

Symptoms worsen become bi-lateral. Daily activities become more difficult and take more to complete

Question 28

PD Stage 3

Answer 28

Individual loss balances, move more slowly and falls are common. Ssx impair daily activites

Question 29

PD Stage 4

Answer 29

Symptoms are severe: assistance needed for walking and performing daily activities

Question 30

PD Stage 5

Answer 30

Individual is unable to walk and needs full time assistance with living

Question 31

PD Diagnosis

Answer 31

Clinically no lab tests

Question 32

PD DD’s

Answer 32

Alzheimers
Cardio-embolic stroke
Neurological manifestations of vasuclar dementia

Question 33

PD: Treatment/Management:

Answer 33

Gold Standard: Levodopa and Carbidopa

Question 34

How long do these medications lasts for?

Answer 34

4-6years

Question 35

Mechanism of Levodopa

Answer 35

Resembles a dopamine precursor, taken orally crosses the blood-brain barriers. Taken up by dopaminergic and converted to dopamine

Question 36

Levodopa Brand Name:

Answer 36

none-
found in combination with carbidopa

Question 37

Mechanism of Action for Carbidopa

Answer 37

Doesnt cross the brai barrier, added to levodpa before it crosses the brain.
Reduces the risk of side effects from levodopa such as vommitng and nausea