Neuro Block III- Basal Ganglia

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1

what is the role of the basal ganglia

modulate activity of other brain regions

2

what does a pyramidal disorder indicate that there is a problem with

corticospinal tract

3

what does an extrapyramida disorder indicate that there is a problem with

something outside the pyramidal system

4

what types of extrapyramidal connections exist

BG to spinal cord, although though there are no direct connections; this is through cerebral cortex's corticospinal and corticoreticulospinal tracts

5

what is a term for the negative signs associtead with basal ganglia disorders

hypokinesia

6

what is associated with hypokinesia

bradykinesia
akinesia

7

what is bradykinesia

slow movement

8

what is akinesia

lack of movement

9

what are negative signs considered

'poverty of movement'

10

what is another name for positive signs

hyperkinesia

11

what is chorea

uncontrollable jerking movements

12

what is athetosis

uncontrollable writhing movements

13

what is ballismus

uncontrollable flailing movements

14

what is tremor

uncontrollable shaking movements

15

what is dystonia

movement disorder where muscles contract involuntarily

16

what are some disorders associated with the basal ganglia

Parkinson's disease
progressive supranuclear palsy (Parkinson's plus)
Huntington's disease
Athetoid (Cerebral) Palsy
Hemiballismus
Sydenham chorea
Wilson's disease (hepatolenticular degeneration)
tardive dyskinesia
tourette's syndrome and obsessive compulsive disorders

17

what is progressive supranuclear palsy called

parkinson-plus

18

what types of lesions cause hemiballismus

lesions of subthalamic nucleus or its connections

19

what is another name for sydenham chorea

saint vitus dance

20

what is another name for wilson's disease

hepatolenticular degeneration

21

what happens in Wilson's disease

copper metabolism issue which leads to ring in iris called Kaiser-Fleisher rings

22

what is tardive dyskinesia

iatrogenic disorder from treathment with neuroleptics that leads to mouth movements

23

what type of medicines can lead to tardive dyskinesia

anti-psychotic meds
dopamine antagonists and others

24

what other than movement disorders can basal ganglia disorders affect

neural function in processes underlying body mvoement, eye movement, and cognition

25

what are the basic parts of the basal ganglia

caudate nucleus
putamen
globus pallidus

26

what are structures often included with the basal ganglia

substantia nigra (reticular and compact part)

subthalamic nucleus

27

what is the reticular part of the substantia nigra similar to

globus pallidus

28

what is within the compact part of the substantia nigra

melanin containing cells that also have dopamine

29

where is the subthalamic nucleus

below thalamus near substantia nigra

30

when is the subthalamic nucleus active

spontaneously

31

what type of stimulation does the subthalamic nucleus send out

excitatory neurons

32

what is the striatum

caudate and putamen

33

what is the palladium

internal and external globus pallidus

34

what are the functinoally and structurally important parts of the basal ganglia

striatum (caudate and putamen) and palladium (internal and external globus pallidus)

35

what is the striped body across axons

striatum

36

what part of the basal ganglia is an artifact of structure

lenticular (or lentiform nucleus)

37

what is included in the lenticular nucleus

globus pallidus and putamen

38
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39
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40
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41

what is the main artery to the basal ganglia

branches of middle cerebral artery's lenticulostriate arteries

42

what suppplies blood to the thalamus

thalamogenicular artery

43

what supplies blood to the internal capsule

anterior choroidal artery

44

what suppplies blood to the basal ganglia proper

lenticulostriate arteries and medial striate artery

45

what is the lenticulostriate artery a branch of

middle cerebral artery

46

what is the medial striate artery a branch of

anterior cerebral artery

47

what suppplies blood to the subthalamic nucleus and substantia nigra

posterior cerebral and posterior communicating arteries

48

is the dorsal or ventral basal ganglia better known

dorsal

49

what are the components of the dorsal basal ganglia

dorsal striatum
dosral palladium

50

what is part of the dorsal straitum

caudate
putamen

51

what is part of the doral pallidum

globus pallidus

52

what is part of the ventral basal ganglia

ventral striatum
ventral palladium

53

what is part of the ventral striatum

nucleus accumbens

54

what is part of the ventral palladium

substantia innominata

55
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...

56

what is considered the "entry point" to the basal ganglia

striatum

57

what are the contents of the striatum

caudate and putamen

58

how are the caudate and putamen similar

embryonic origin
structure
NTs
head of caudate and putamen join across internal capsule

59

wht are the primary efferents of the striatum

medium spiny neurons

60

what NT is used in medium spiny neurons

GABA

61

what are the peptide neuromodulators of the spiny neurons

enkephalin and substance P

62

where do the spiny neurons project to

globus pallidus

63

what do spiny neurons release in the globus pallidus

either GABA and enkephalins or GABA and substance P

64

what other types of neurons are in the striatum besides spiny neurons

cholinergic neurons

65

what is the actino of cholinergic neurons on the striatum

local circuit neurons that modulate activity within the striatum

66

what are the matrix striatosomes like

acetylcholinesterase rich

67

what are the small striosomes in the striatum like

acetylcholinesterase-poor regions

68

what is known as the basal ganglia exit point

palladium

69

what are the parts of the palladium

medial (internal) GP and lateral (external) GP

70

what are teh NTs used in the palladium

GABA

71

what is characteristic of teh palladium's activity

high rate of spontaneous activity

72

what are teh basic connectinos of the basal ganglia like

cortex to striatum, striatum to pallidum, pallidum to thalamus, thalamus to cortex

several parallel loops

73

what are the parallel loops of the basal ganglia

somatomotor
oculomotor
cognitive
limbic

74

what is the second most common degenerative nervous system disease

Parkinson's disease

75

how many cases of parkinsons' are there in the US

1000000, 40000 new cases each year

76

what is the cause of parkinsons dieases

death of nerve cells in brain particularly in substantia nigra pars compacta

77

what pathway in parkinsons loses dopamine

nigrostriatal pathway

78

what ist he nigrostriatal pathway

substantia nigra pars compacta to the caudate and putamen

79

what does parkinson's result in

abnormal pattern of brain activity involving basal ganglia and in turn to a disruption of brain function

80

what is probably true about parkinsons and it's classification of disease

probably a family of diseases with similar pathology and efects, no cure so far

81

are there effective treatments forparkinsons?

yes but they have many side effects

82

what is the central problem of parkinsons

about 4% of nerve cells in substantia nigra are lost per decade, and PD symptoms begin when 70% of nerve cells in Sn are lost and the disease progresses as the loss continues

83

what appears to be true about the SN loss in people with PD

earlier and greater loss

84

what chemically is going on with the central problem of PD

not enough dopamine in striatum, relatively too much acetylcholine

85

what are the movement disorders associated with parkinsons

rigidity: lead pipe or cogwheel

bradykinesia/akinesia: limited facial expression and micrographia

tremor at rest

flexed posture

impaired balancing reflexes

shuffling gait

86

what are some visceral disorders of PD

low BP while standing up

constipation and incontinence

excessive sweating

87

what are some senosry diordeders of PD

anosmia

sense of body position

pain

sense of inner restlessness (akathisia)

88

what are some cognitive disorders of PD

depression

anxiety

diminished executive function

memory problems

dementia

89

what happened with those drug users

the breakdown product was MPP+ which was toxic to the cells of their substantia nigra

90

how many PD cases have recognized causes

25%

91

what are some causes of PD

head injury
genetic releated (may include "early onset")
strokes involving substantia nigra
infections
drugs that damage nerve cells in the substantia nigra

92

how many PD cases are idiopathic

75%

93

what is an idea about PD from an idiopathic cause

focus is on environmental factors (metal exposure: iron, manganaese) or pesticide/herbicide/fungicide expsure

94

what are some suspected compounds that could cause SN

paraquat, maneb, rotenone

95

what type of factors could combine to make PD a reality

environmental factors may combine with innate susceptivility of neurons in substantia nigra

96

what type of exposure could start Parkinson's onset

chronic, low level exposure may suffice

exposure early in life, re-exposure later in life

97

waht is another idea about idiopathic SN other than environmental factors

special susceptibility of SN neurons generation of highly reactive free radicals in SN take a toll on cells

98

what are the "targets" of free radicals

cell membranes, nuclear components, enzymes and mitochondria

neurons in SNr may be at particular risk for damage due to free radicals

99

what combined interactino of several factors foster produciton of free radicals

presence of dopamine and melanin in the cells
active microglial cells
high level of iron

100

what promotes production of free radicals during dopamine oxidation

iron

101

what does iron bind to which also becomes an oxidant and generates free radicals

melanin

102

what do glial cells help in oxidation of that produces free radicals

dopamine

103

what does free iron from storage generate

more free radicals

104

what dopamine precursor is used to replace dopamine and why

L dopa

it can cross BBB

105

what is L dopa combined with and why

carbidopa, limits productino of L dopa in PNS

106

what does prevention of dopamine catabolism do

may be protective and may slow progress of disease

107

what are some dopamine catabolism preventers

MAOIs and COMTIs

108

what is the result of preventing dopamine catabolism

fewer free radicals

109

what are some dopamine agonists

pergolide, pramipexole, bromocriptine, ropinirole

110

what drug stimulates dopamine release from surviving neurons

amantadine

111

what are some anticholinergics

benzotropine

112

what is the action of anticholinergices

limit activity at synapses that use acetylcholine

113

what are some side effects of L dopa

nausea, vomiting, uncontrollable movements, hallucinations, confusion

on-off syndrome

114

what is on off syndrome due to

rise in dopamine levels throughout levels (too little dopamine in straitum adequate dopamine elsewhere OR more dopamine in striatum excess dopamine elsewhere)

nerve cells become more responsive to dopamine; upregulation of dopamine receptors on striatal neurons

115

what is the challenge of PD treatments

search for best drug, dosage, combos

116

what are usually used along in early PD

dopamine agonists to reduce later complications that may be caused by other medications like L dopa

117

what are some newer approaches to PD therapy

antioxidants

nerve cell growth factors

118

what are some surgical treatments of PD

ablation: destroy with precision
- part of thalamus (thalotomy)
- part of globus pallidus (pallidotomy)

this is a later treatment for severe PD

deep brain stimulation

119

what is deep brain stimulation

electrically stimulate globus pallidus or subthalamic nucleus to create a fucntional blockade

120

why are surgical treatments of PD effective

an abnormal pattern of activity is present in PD, and blocking the abnormal activity may compensate so a "more normal" pattern of activity resumes

121

what are some experimental approaches to the surgical treatment of Parkinson's disease

implants of substantia nigra neurons
stem cells

122

what exactly do basal ganglia do?

1. contribute to automated exectuion of learned movement sequences

2. act as brake to prevent unwanted movements

3. function as components of opposing parallel pathways that increase or decrease excitatory and inhibitory input to produce or prevent movement

123

when limbs move, what is most active either in the basal ganglia or related to it

subthalamic nucleus activity

globus pallidus activity

increased putamen activity

124

where does the direct pathway of the basal ganglia originate in the cerebral cortex

prefrontal, temporal, and parietal association areas

primary motor cortex

supplemental motor cortex

premotor cortex

somatosensory cortex

125

what does teh cerebral cortex (prefrontal, temporal, parietal assocation areas) (primary motor, supplemental motor, premotor, and somatosensory cortices) use as a neurotransmitter to influence the putamen and caudate nucleus

glutamate

126

what are the putamen and caudate nucleus together known as

striatum

127

how does the putamen communicate with the medial globus pallidus (NT and neuron)in the direct pathway

spiny neuron and GABA+substance P

128

how does the caudate nucleus communicate with the substantia nigra pars reticula (NT) in the direct pathway

GABA and substance P

129

what does the substantia nigra pars reticula communicate with in the direct pathway

dorsal thalamus

130

what NT is used to connect the substantia nigra pars reticula with the dorsal thalamus

GABA

131

how does the medial globus pallidus connect with the dorsal thalamus (NT)

GABA

132

what provides a larger inhibition of the direct pathway, the putamen-medial globus pallidus, caudate nucleus-substantia nigra, or MGP and rSN to dorsal thalamus

P-MGP and CN-rSN is larger than rSN and MGP to DT

133

what is the inhibition of the dorsal thalamus called

disinhibition

134

what eventually sends information to our somatic motor neurons in the brain stem and spinal cord

corticobulbar and corticospinal and corticoreticular pathways

135

where does the indirect pathway start in the cerebral cortex

prefrontal, temporal, parietal association areas

primary motor, supplemental motor, premotor, somatosensory cortices

136

what NT does the cerebral cortex use to communicate with the putamen and caudate nucleus

glutamate

137

what type of influence does the striatum have from the cortex

positive

138

what types of neurons go from the putamen and caudate nucleus to lateral globus pallidus

medium spiny neurons

139

what NTs do the putamen and caudate nucleus use to influence the lateral globus pallidus in the indirect pathway

GABA and enkephalin

140

what cells die in huntington's disease

caudate nucleus

141

where is disinhibition in the indirect pathway

lateral globus pallidus to subthalamic nucleus via GABA

142

how is the subthalamic nucleus activated in the indirect pathway

spontaneously

143

where does the subthalamic nucleus influence with its glutamate NTs

rSN and medial globus pallidus

144

what does the rSN influence in the indirect pathway

dorsal thalamus

145

what is used rSN influence (NT) to the dorsal thalamus

GABA

146

how does medial globus pallidus influence the dorsal thalamus

GABA

147

what does the cSN influence in the brain and through what NT

putamen and caudate nucleus through both positive and negative pathways

148

what types of dopamine receptors cause excitatory nigrostriatal input

D1 receptors

149

what types of neurons go from cSN to the putamen and caudate nucleus and excite the striatum

spiny neurons in direct pathway

150

what types of neurons go from the cSN to the putamen and caudate nucleus and inhibit the straitum

spiny neurons in indirect pathway

151

what types of dopamine receptors cause inhibitory nigrostriatal input

D2 receptors

152

what is a main hypokinetic BG disorder

parkinson's diesase

153

what does the imbalance in the nigrostriatal pathway favor in parkinsons disease

indirect pathway

154

what is a main hyperkinetic BG disorder

huntington's diseas

155

what does the imbalance in the nigrostriatal pathway favor in huntington's disease

direct pathway