341 Exam 3 - Motor Systems Pt 2

false

True or false: damage to higher centers, such as the basal nuclei and cerebellum, typically causes weakness.

involuntary, incoordination, initiating, slowed, tone

The following are signs and symptoms of damage to higher centers, such as the basal nuclei and cerebellum:

• ____ movements

• ____

• difficulty ____ movement

• ____ or diminished movement

• altered muscle ____

Note that damage to upper motor neurons (UMN), lower motor neurons (LMN), or muscles are likely to cause weakness and other signs; damage to higher centers does NOT tend to cause weakness.

basal nuclei

gray matter collections that form a subcortical, unconscious motor system in the “base” of the cerebrum; sometimes referred to as “basal ganglia”

basal ganglia

What is another term for basal nuclei?

basal nuclei

What is another term for basal ganglia?

subcortical, unconscious

Basal nuclei form a ____, ____ motor system in the “base” of the cerebrum.

caudate nucleus, nucleus accumbens, putamen, globus pallidus, subthalamic nuclei, substantia nigra

Name the 6 basal nuclei structures. 

6 

How many basal nuclei structures were identified in lecture? 

4, 1, 1

The basal nuclei include

• ____ forebrain structures

• ____ diencephalon structure

• ____ brainstem structure

caudate nucleus, nucleus accumbens, putamen, globus pallidus

Name the 4 basal nuclei structures of the forebrain.

subthalamic nuclei

Name the basal nuclei structure of the diencephalon. 

substantia nigra

Name the basal nuclei structure of the brainstem. 

midbrain

What part of the brainstem is the substantia nigra located in?

caudate nucleus, nucleus accumbens, putamen

Which 3 basal nuclei structures comprise the striatum or dorsal striatum?

putamen, globus pallidus

Which 2 basal nuclei structures comprise the lenticular nucleus (lentiform nucleus)? 

striatum

Together, the caudate nucleus, nucleus accumbens, and putamen are referred to as the ____.

lenticular nucleus

Together, the putamen and globus pallidus are referred to as the ____.

putamen

Which structure of the lenticular nucleus is more lateral: the putamen or the globus pallidus?

lentiform nucleus

What is another term for the lenticular nucleus? 

lenticular nucleus

What is another term for the lentiform nucleus? 

dopamine, acetylcholine

Name the 2 major neurotransmitters involved in the basal nuclei.

dopamine

Name the excitatory neurotransmitter involved in the basal nuclei.

acetylcholine

Name the inhibitory neurotransmitter involved in the basal nuclei.

initiation, cessation, excitatory, inhibitory

The basal nuclei is associated with motor control functions, including ____ and ____ of movement by balancing ____ and ____ impulses.

habits, automatic, cognitive, affective

The basal nuclei is associated with motor control functions, especially ____, ____ motor patterns, and ____ or ____ processes that involve the timing of motor responses.

hyperkinetic, hypokinetic, dystonia 

Name the 3 classifications of basal nuclei disorders as described in lecture. 

hyperkinetic disorders

classification of basal nuclei disorders characterized by excessive movement and decreased muscle tone

hypokinetic disorders

classification of basal nuclei disorders characterized by impaired initiation of movement, bradykinesia, and increased muscle tone

dystonia

classification of basal nuclei disorders characterized by disturbances in muscle tone and sustained muscle contractions resulting in abnormal posture and repeated movements

chorea

hyperkinetic basal nuclei disorder characterized by continuous, rapid movements of the face, tongue, or limbs; can involve distal and proximal movements and facial expressions (e.g., grimacing, eyebrow raising, eye rolling)

Huntington’s disease

chronic, degenerative, inherited hyperkinetic disorder characterized by chorea, progressive dementia, and mood alterations; involved degeneration of the striatum and cortex

Huntington’s chorea

What is another term for Huntington’s disease?

striatum

Huntington’s disease is a hyperkinetic basal nuclei disorder especially involving structures of the ____.

caudate nucleus, nucleus accumbens, putamen

Name the 3 specific basal nuclei structures prominently involved in Huntington’s disease. 

athetosis 

hyperkinetic basal nuclei disorder characterized by slow, continuous, writing movement of extremities and aimless, purposeless movement of the distal extremities; movements often have twisting or turning quality; involves striatum 

striatum

Athetosis is a hyperkinetic basal nuclei disorder especially involving structures of the ____.

caudate nucleus, nucleus accumbens, putamen

Name the 3 specific basal nuclei structures prominently involved in athetosis. 

striatum 

Both Huntington’s disease and athetosis involve structures of the ____. 

hemiballism

hyperkinetic basal nuclei disorder characterized by violent thrashing of extremity contralateral to lesion of the subthalamic nuclei; most often seen in adults who have had strokes

subthalamic nuclei

Name the basal nuclei structure involved in hemiballism.

chorea, Huntington’s disease, athetosis, hemiballism

Name the 4 hyperkinetic disorders of the basal nuclei discussed in lecture.

Parkinson’s disease

hypokinetic basal nuclei disorder caused by loss of dopamine-containing cells in the substantia nigra; characterized by rigidity (hypertonicity in all muscles with strength and reflexes intact), bradykinesia, hypokinesia, resting tremor, stooped posture, and shuffling gait

substantia nigra

Name the basal nuclei structure involved in Parkinson’s disease.

rigidity

hypertonicity in all muscles with strength and reflexes intact; may be plastic/lead-pipe or cog-wheel; common sign of Parkinson’s disease

plastic/lead-pipe, cog-wheel

Name the 2 types of rigidity discussed in lecture as a sign of Parkinson’s disease.

plastic/lead-pipe rigidity

rigidity that is uniform throughout range

cog-wheel rigidity

rigidity interrupted by a series of brief relaxations

tremor

common sign of movement disorders characterized by rhythmic movements due to alternating contractions between agonist and antagonist muscles

resting tremors

tremors that stop once voluntary movement is initiated and increase with emotional stress; also called pill-rolling tremors

pill-rolling tremor

What is another term for resting tremor?

resting tremor

What is another term for pill-rolling tremor? 

Sinemet

most common pharmacological treatment for Parkinson’s disease; combination of levodopa and carbidopa; side effects include decreased appetite, nausea, increased sexual interest, reduced control of blood pressure, and drug tolerance

LSVT BIG

therapeutic intervention for Parkinson’s disease involving high effort/large amplitude movements while focusing on the sensory awareness of the movement's “bigness”

focal dystonia

movement disorder characterized by unwanted muscle contraction leads to involuntary movement during specific tasks; often associated with anxiety or high-stress performances (e.g., musicians, athletes, surgeons); linked to disruption in motor pathway involving the basal nuclei

tics

repetitive, brief, rapid, involuntary, and purposeless movements involving single or groups of muscles; can also be fragments of movements or thoughts

echolalia

specific tic characterized by involuntary repetition of words just spoken by another person

coprolalia

specific tic characterized by involuntary utterance of curse words

echolalia, coprolalia

Name 2 specific types of vocal tics, as discussed in lecture.

Tourette’s syndrome

inherited likely basal nuclei disorder with childhood onset characterized by vocal and motor tics

obsessive-compulsive disorder (OCD)

mental health condition involving obsessive thoughts, fears, and worry with behavioral compulsions; involves 3 primary brain areas

• orbital frontal gyrus → generates feeling of “mistake”

• cingulate gyrus → triggers anxiety

• caudate nucleus → decreased dampening of excessive signals coming from other brain areas, leading to a breakdown in the normal suppression of unwanted habits and urges

vermis

a midline structure located on the dorsal surface of the cerebellum, connecting the two cerebellar hemisphere

medullary center

What is the area beneath the cerebellar cortex called?

folia

cortical ridges of the cerebellum

true

True or false: the cerebrum exhibits contralateral control and the cerebellum exhibits ipsilateral control.

synergy

The cerebellum is responsible for the ____ of movement: all components of movement working together smoothly. 

equilibrium, tone, posture, coordination, voluntary

The cerebellum is responsible for the synergy of movement: all components of movement working together smoothly. It controls:

• ____

• muscle ____ and ____

• ____ of ____ movements

Purkinje cells

neurons of the cerebellar cortex that have highly branched dendritic trees which allow them to take in and integrate a large amount of information; axons project to deeper areas of the cerebellum

medullary center

portion of the cerebellum deep to the cerebellar cortex that contains deep cerebellar nuclei which project out of the cerebellum

flocculonodular lobe, anterior lobe, posterior lobe

Name the 3 lobes of the cerebellum. 

anterior lobe, posterior lobe

What 2 lobes of the cerebellum comprise the corpus cerebelli

corpus cerebelli

body of the cerebellum, comprised of the anterior lobe and posterior lobe

vermis, medial hemispheres, lateral hemispheres

Name the 3 longitudinal zones of the cerebellum.

inferior cerebellar peduncles, middle cerebellar peduncles, superior cerebellar peduncles

Name the 3 pairs of cerebellar peduncles. 

inferior cerebellar peduncles

pair of cerebellar peduncles that provide mainly afferent inputs related to position sense to the cerebellum from the spinal cord and brainstem

middle cerebellar peduncles

pair of cerebellar peduncles that provide mainly afferent inputs related to the motor plan to the cerebellum from the pontine nuclei, which provides information from the cerebral cortex 

superior cerebellar peduncles

pair of cerebellar peduncles that project efferent pathways carrying movement feedback from the cerebellum to the midbrain and thalamus, which then project to the cerebral cortex

lateral hemispheres

Which cerebellar zones are involved in the planning and programming of voluntary movements of the limbs, especially learning, skillful movements that become more rapid, precise, and automatic with practice? (vermis, medial hemispheres, or lateral hemispheres)

medial hemispheres

Which cerebellar zones are involved in adjusting limb movements as an “error-detecting device”? (vermis, medial hemispheres, or lateral hemispheres)

vermis

Which cerebellar zone is involved in postural adjustments and stereotyped movements? Additionally, along with the flocculus, is involved with equilibrium and eye tracking movements

motor, cognitive

The cerebellum is involved in ____ learning and ____ functions.

ataxia, hypotonia

Name 2 common signs of cerebellar dysfunction, as described in lecture.

ataxia

loss of muscle coordination to produce smooth movements; most common sign of cerebellar dysfunction

ataxia

What is the most common sign of cerebellar dysfunction? 

hypotonia

decreased muscle tone; common sign of cerebellar dysfunction

cerebellar hypoplasia

congenital underdevelopment of cerebellum

non-progressive

Are congenital malformations of the cerebellum typically progressive or non-progressive?

Friedreich’s ataxia

rare, inherited, degenerative disease involving the spinal cord, peripheral nerves, and cerebellum

Friedreich’s ataxia

Name an example of a hereditary ataxia

spinal cord, peripheral nerves, cerebellum

What 3 nervous system structures are involved in Friedreich’s ataxia?

anterior lobe syndrome

acquired condition often found in people with chronic alcoholism due to degeneration of the cerebellar cortex that starts anteriorly in the anterior lobe and works posteriorly

intentional tremor

tremor that occurs when attempting to make a voluntary movement; type of ataxia

scanning speech

impaired ability to smoothly modulate speech; type of ataxia

gait ataxia

type of ataxia characterized by unsteady walking with a wide base of support

truncal ataxia 

type of ataxia characterized by jerky, unsteady movements of the trunk

optic ataxia

type of ataxia characterized by jerky, unsteady movements of the eyes

intentional tremor, scanning speech, gait ataxia, truncal ataxia, optic ataxia

Name 5 types of ataxia related to the cerebellum as discussed in lecture.

strength, mixed, decreased, increased, decreased, ataxia, atrophy, involuntary, initiating

The following are characteristic of basal nuclei and cerebellum lesions

• intact ____

• ____ muscle tone

  • hyperkinetic basal nuclei disorders: ____ tone 

  • hypokinetic basal nuclei disorders: ____ tone

  • cerebellar disorders: ____ tone

• decreased stretch reflexes in some cases (cerebellar ____) 

• mild-no ____

• ____ movement 

• difficulty ____ movement 

• dyskinesia 

• tremors 

• ataxia