Term
| Abnormal movements caused by basal ganglia dysfunction are called what? |
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Definition
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| Unilateral movement disorders are _______ to basil ganglia lesions |
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Definition
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Definition
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Definition
| decreased amount of movements |
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Definition
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| When rigidity is used to characterize movement what does this mean? |
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Definition
| stiff movements or increased resistance to passive movement |
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Term
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Definition
| assuming abnormal, often distorted, positions of limbs, trunk, or face. These are more sustained and slower than in athetosis. muscles contract involuntarily — causing an uncontrollable twisting of the affected body part. |
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Definition
| -writhing twisting movements of the limbs, face, and trunk that sometimes merge with faster choreic movements (choreoathetosis) |
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Term
| What is chorea? what disease is this usually associated with? |
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Definition
| movement disorder characterized by nearly continuous involuntary movements that have a fluid or jerky, constantly varying quality. It is rhythmic and non patterned and does not include a resting tremor. associated with Huntington's disease. |
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Term
| What is the cause of dyskinesias? |
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Definition
| overactivity of the neurotransmitter dopamine in the areas of the brain that control movemen |
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Definition
| violent flinging movements of the limbs, sometimes affecting onle one side of the body (hemiballismus) |
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Definition
| a sudden brief action that is preceded by an urge to perform it, followed by a sense of relief |
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Term
| What is myoclonus? What is it associated with? |
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Definition
| sudden involuntary jerking of muscles or a group of muscles. clonic-tonic are only seen in gran mal epilepsy |
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Term
| What is a tremor? What are the three types of tremors? |
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Definition
| Rhythmic oscillating movements. resting, postural, and cerebellar |
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Term
| What is the cause of the common type of tremor we see with asthma patients? |
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Definition
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Term
| What type of rigidity is associated with frontal lobe disorders? |
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Definition
| -gegenhalten= actively resisting movements of their limbs, it has a more inconsistent, almost voluntary quality than other causes of rigidity |
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Term
| What type of rigidity is associated with basal ganglia disorders? |
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Definition
tends to be more continuous throughout attempts to bend the limb, it has therefore been called plastic, waxy, or lead pipe rigidity.
-Cogwheel rigidity= seen in Parkinson's because of the ratchet like interruptions in tone that can be felt as the limb is bent |
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Term
| What type of rigidity is associated with UMN lesions? |
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Definition
| -spasticity= rigidity is velocity dependent. resistive tone initially increases as the muscles of the limb are stretched but it may then decrease giving rise to the term clasp knife rigidity |
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Term
| What type of rigidity is seen in people with tetanus? what is the tetanus vaccine? |
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Definition
| lock jaw rigidity. DPT vaccine (?) |
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Term
| what is controlled in the frontal lobe? the prefrontal lobe? |
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Definition
-frontal lobe= voluntary motor activity
-prefrontal= higher order of thinking |
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Term
| The upper motor neuron is the first motor neuron coming from the ______ lobe of the brain |
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Definition
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Term
| What is an example of an UMN lesion that can be due to ischemia or hemorrhage? |
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Definition
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Term
| Explain the focal dystonia: torticollis |
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Definition
| involves the neck muscles (sternocleidomastoid) |
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Term
| Explain the focal dystonia: blepharospasm |
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Definition
| involves the facial muscles around the eyes |
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Term
| Explain the focal dystonia: spasmodic dysphonia |
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Definition
| involves the laryngeal muscles (aka laryngeal spasm) |
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Term
| Explain the focal dystonia: writer's cramp |
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Definition
causes a cramp or spasm affecting certain muscles of the hand and or fingers
-ex's: mogigraphia and scrivener's palsy |
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Term
| What are two drugs that can cause dystonia? |
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Definition
-haldol= given to patients with schizophrenia, drug abusers, and depression
-propofol= what killed MJ |
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Term
| What disease is choreathetosis commonly seen in? What is it a side effect of? |
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Definition
-Wilson's disease. the build up of copper in the body tissues.
-side effect of antiparkinson or antipsychotic meds |
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Term
| What are the two types of tics? what syndrome is associated? |
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Definition
-motor tics
-vocal tics (more elaborate vocalizations, including coprolalia--> obscene words)
-Tourette's syndrome |
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Term
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Definition
| a sudden rapid muscular jerk (generally considered the fastest of all movement disorders) it can be focal, unilateral, or bilateral. |
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Term
| Myoclonus can have many causes that can have many possible localizations, name a few |
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Definition
-cerebral cortex
-cerebellum
-basal ganglia
-brainstem
-spinal cord |
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Term
| What are four possible causes of myoclonus? |
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Definition
-anoxic brain injury
-encephalitis
-toxins
-prion-related diseases (an infectious agent composed of protein) |
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Term
| What is a common variation of myoclonus? how do you test for it? |
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Definition
-asterixis: "flapping tremor" another form of brief, rapid movement.
- hold out arms with wrists extended as if stopping traffic: intermittent brief flexion movements bilaterally (actually caused by interruptions in wrist extensor contractions) |
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Term
| Describe a resting tremor. |
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Definition
"parkinsonian tremor"
-decreases when patient moves the limb
-"pill-rolling" bc he appears to be rolling something between thumb and fingers
-freq: 3-5 Hz |
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Term
| Describe a postural tremor |
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Definition
-most prominent when limbs are held in a position, disappears at rest
-called an "essential tremor"
-most common of all movement disorders
-freq: 5-8 Hz (measured on a graph by an EMG) |
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Term
| What are two things that are responsive to postural tremors? |
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Definition
-propanolol (beta blocker) taken by someone who is scared to talk in front of people
-alcohol |
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Term
| Describe a cerebellar tremor |
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Definition
"intention tremor"= ataxic tremor
-increases toward the target |
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Term
| What is Parkinson's disease? What causes it? |
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Definition
| A common idiopathic neurodegenerative condition caused by loss of dopaminergic neurons in the substantial nigra pars compacta |
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Term
| Parkinsonism and parkinsonian signs are more general terms used to describe several other conditions that have some features of Parkinson's disease, especially ____________ and ___________ |
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Definition
| bradykinesia and rigidity |
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Term
| Name two adjectives that describe the onset of Parkinson's. Parkinson's nearly always improves when treated with what? |
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Definition
-gradual and assymetrical. it is usually initially unilateral but later becomes bilateral, although severity usually remains asymmetrical.
-levodopa (a structural form of dopamine that is not broken down, so it lasts) |
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Term
| Sometimes parkinsonian signs can be drug induced by _________ antagonists. Give two examples. |
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Definition
-dopamine anatagonists
-haldol (antipsychotic) and compazine (prochlorperazine) |
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Term
| What are parkinsoniam plus syndromes? describe them |
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Definition
-neurodegenerative conditions other than Parkinson's that are associated with parkinsonism.
-produce relatively symmetrical symptoms, no resting tremor, early appearance of postural instability, and little response to dopaminergic agents. Also multi system atrophy and PSP (diminished vertical eye movements) |
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Term
| Where the tremor is and the amount of tremor exhibited by the patient are both dependent on what? |
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Definition
| involvement of the basal ganglia. the neurons in the BG that produce dopamine (inhibitory NT that inhibits movement) are significantly reduced |
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Term
| What color does the substantial nigra look like to the eye on cross section of a person with parkinsons? |
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Definition
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Term
| The remaining dopaminergic neurons in a parkinson's patient often contain what? |
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Definition
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Term
| What are the 4 symptoms that compose the clinical picture of Parkinson's disease? |
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Definition
-resting tremor
-bradykinesia (generalized--> less blinking, masked facies, monotone speech)
-cogwheel rigidity
-postural instability |
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Term
| Describe the Parkinsonian gait |
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Definition
| small shuffling steps (festinating gait) and the COG leaning forward |
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Term
| what other NT does dopamine produce? |
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Definition
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Term
| What drug is taken by patients with Parkinson's that prevents the breakdown of L-DOPA in peripheral tissues, making more LDOPA available to the brain? |
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Definition
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Term
| What are two dopaminergic agent used in the treatment of Parkinsons? |
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Definition
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Term
| What do COMT inhibitors do? |
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Definition
| COMT is an enzyme that breaks down dopamine, so it inhibits COMT's action and dopamine (or LDOPA) will last longer |
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Term
| what does Amantadine do for Parkinson's patients? |
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Definition
| increases release of dopamine in striatum |
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Term
| What alters the progression of Parkinson's? |
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Definition
| There are NO known agents that alter the progression of the disease |
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Term
| What are 3 problems associated with Parkinson's disease treatment? |
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Definition
-wearing off toward the end of time between doses
-on-off phenomenon= fluctuate between dyskinesias and immobility
-dyskinesias induced by the drugs |
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Term
| What is an example of a MSA (multiple system atrophy) that is a PSP? |
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Definition
-Shy dager syndrome= orthostatic hypotension, syncope, autonomic dysfunction, ataxia
**motor manifestations become less responsive to Levodopa as a general rule with shy drager syndrome |
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Term
| what is corticobasal ganglionic degeneration characterized by? |
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Definition
| alien hand syndrome, apraxia, dysphasia, cortical sensory loss |
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Term
| Why is dementia associated with Lewy bodies? |
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Definition
lewy bodies are a part of the neuron that is abundant in the hippocampus. Dementia is due to lewy body counts
-characterized by fluctuations in cognitive function, hallucinations, parkinsonism, falls, syncope, sensitivity to neuroleptics making parkinsonism worse |
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Term
| What is an autosomal dominant neurodegenerative condition on chromosome 4? |
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Definition
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Term
| What are 3 things that are characteristic of the clinical picture of Huntingtons? |
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Definition
-choreiform movements
-dementia
-psychiatric disturbances |
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Term
| Huntingtons is very progressive, eventually leading to death. Progressive atrophy of the __________ especially the __________/__________ apparent on MRI |
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Definition
-striatum
-caudate nucleus |
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Term
| What does deep brain stimulation do? |
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Definition
| helps control tremors and movement disorders. |
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