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1
Q

What is the basic function of the basal ganglia?

A

To modulate thalamo-cortical activity

2
Q

What executive commands does the basal ganglia process?

A

Initiation of appropriate movement

Suppression of inappropriate movement

3
Q

What are the structures of the basal ganglia?

A
caudate
putamen
globus pallidus
subthalamic nucleus
substantia nigra
4
Q

Caudate:

A

located in the cerebrum

5
Q

Putamen

A

located in the cerebrum

6
Q

Globus pallidus

A

located in the cerebrum

7
Q

Subthalamic nucleus

A

located within the diencephalon

8
Q

Substantia nigra

A

located within the midbrain

9
Q

Lentiform nucleus

A

globus pallidus and putamen

10
Q

Striatum

A

caudate and putamen

11
Q

Ventral striatum

A

junction of caudate and putamen

12
Q

Nucleus accumben

A

part of ventral striatum

13
Q

Where is dopamine from and to?

A

from substantia nigra to striatum

14
Q

What is the role of dopamine?

A

adjusts the signals to the output nuclei; the output nuclei provide the appropriate level of inhibition to their target nuclei

15
Q

What does output of the basal ganglia motor circuit regulate?

A

muscle contraction, muscle force, multijoint movements, and the sequence of movements

16
Q

The basal ganglia effects movements through inhibition of:

A

motor thalamus
ventrolateral pednculopontine nucelus (PPN)
midbrain locomotor region (MLR)

17
Q

Basal ganglia inhibition of motor thalamus:

A

To provide an appropriate level of facilitation in the motor cortex (such as corticospinal tracts), and ultimately a normal level to the LMNs that innervate muscles for voluntary movements

18
Q

Basal ganglia inhibition of ventrolateral pedunculopontine nucleus (PPN)

A

inhibit reticulospinal neurons which, in turn, provide the normal level facilitation to LMNs that innervate contraction of postural and girdle muscles, thus controlling muscle tone

19
Q

Inhibition of midbrain locomotor region (MLR):

A

the midbrain locomotor region stimulates the reticulospinal neurons that activate central or stepping pattern generators (CPG or SPG), eliciting rhythmical lower limb movements similar to walking or running

20
Q

Role of putamen:

A

receive input from premotor and motor cortex

21
Q

Role of subthalamic nucleus and substantia nigra compacta:

A

process information within the basal ganglia circuit

22
Q

Role of globus pallidus internus:

A

send output to motor areas of the cerebral cortex (via the motor thalamus), PPN and the midbrain locomotor region

23
Q

Besides motor control, parts of the four basal ganglia-thalamic loops include:

A

oculomotor
executive
behavioral flexibility and control
limbic

24
Q

What do all five loops of the basal ganglia contribute to?

A

prediction of future events, selecting desired behaviors, preventing undesired behaviors, motor learning, shifting attention, and spatial working memory

25
Q

Motor loop of basal ganglia:

A

movement selection and action

26
Q

Where in the cerebral cortex does the motor loop go?

A

motor and premotor cortex

27
Q

What basal ganglia is included in the motor loop?

A

putamen, globus pallidus

28
Q

Which thalamic nuclei are included in the motor loop?

A

ventral lateral

29
Q

Role of oculomotor loop of basal ganglia?

A

decisions about eye movements and spatial attention; initiation of fast eye movements

30
Q

Where in the cerebral cortex does the oculomotor loop go?

A

dorsolateral prefrontal cortex

31
Q

What basal ganglia is included in the oculomotor loop?

A

head of caudate, globus pallidus

32
Q

Which thalamic nuclei are included in the oculmotor loop?

A

ventral anterior

33
Q

Role of behavioral flexibility and control loop:

A

recognition of social disapproval, self-regulatory control, selecting relevant knowledge from irrelevant, maintaining attention, stimulus response learning

34
Q

Where in the cerebral cortex does the behavioral flexibility and control loop go?

A

ventrolateral prefrontal and lateral orbital cortex

35
Q

What basal ganglia is included in the behavioral flexibility and control loop?

A

head of caudate, substantia nigra reticularis

36
Q

Which thalamic nuclei are included in the behavioral flexibility and control loop?

A

mediodorsal

37
Q

Role of limbic loop:

A

links limbic, cognitive and motor systems; identifies value of stimuli; involved in reward guided behaviors, monitors error in predictions, concerned with seeking pleasure

38
Q

Where in the cerebral cortex does the limbic loop go?

A

medial orbital and medial prefrontal cortex

39
Q

What basal ganglia is included in the limbic loop?

A

ventral striatum, ventral pallidum

40
Q

Which thalamic nuclei are included in the limbic loop?

A

mediodorsal

41
Q

Hypokinetic

A

too little movement

42
Q

Hyperkinetic

A

excessive movement

43
Q

What does excessive inhibition lead to?

A

hypokinetic disorders

44
Q

What does inadequate inhibition result in?

A

hyperkinetic disorders

45
Q

What is the most common basal ganglia disorder?

A

parkinson’s disease

46
Q

What does parkinson’s disease interfere with?

A

both voluntary and automatic movements

47
Q

What are the three subtypes of Parkinson’s disease?

A

akinetic or rigid
tremor dominant
mixed

48
Q

Motor symptoms of PD:

A

Akinesia/bradykinesia/hypokinesia
Rigidity
Resting tremor
Postural instability

49
Q

Non motor symptoms of PD

A
Depression
Psychosis
PD dementia
Constipation
Fatigue
50
Q

What is Unified PD Rating scale (UPDRS)

A

Is a clinical tool used to evaluate the course of PD,

51
Q

PT intervention for PD:

A

Physical therapy/occupational therapy (PT/OT) improves mobility and functional status in individuals with Parkinson’s disease.
Speech therapy is provided for voice training

52
Q

PT for PD can reduce what symptoms:

A
Balance problems
Gait dysfunction
Muscle weakness
Lack of coordination
Mobility disability
Rigidity
53
Q

Parkinson-Plus Syndrome:

A

Is the collective name for primary neuro-degenerative diseases that cause signs similar to PD

54
Q

Parkinson-Plus Syndrome include:

A

progressive supranuclear palsy, dementia with Lewy bodies, and multiple system atrophy

55
Q

Progressive supranuclear palsy (PSP)

A

Is characterized by the early onset of gait instability with a tendency to fall backward, axial rigidity, freezing of gait, depression, psychosis, rage attacks, and supranuclear gaze palsy

56
Q

Dementia with Lewy bodies

A

Causes early, generalized cognitive decline, visual hallucinations, and Parkinsonism

57
Q

Multiple system atrophy:

A

Is a progressive degenerative disease affecting the basal ganglia, cerebellar and autonomic systems; the peripheral nervous system; and the cerebral cortex

58
Q

What is multiple system atrophy characterized by:

A

akinesia/rigidity
cerebellar signs
autonomic dysfunction
corticospinal tract dysfunction

59
Q

Parkinsomism

A

Encompasses disorders with signs that mimic PD but the cause is known to be toxic, infectious, or traumatic

60
Q

Signs of parkinsomism:

A

subacute, bilateral onset with rapid progression, early postural tremor, and involuntary movements of the face and mouth

61
Q

Abnormal involuntary movements are characteristics of

A

Huntington’s disease
Dystonia
Tourette’s disorder
Some types of cerebral palsy

62
Q

Huntington’s Disease:

A

Autosomal dominant hereditary disorder causes degeneration in many areas of the brain, most prominently in the striatum and cerebral cortex
Signs include dementia and chorea

63
Q

Dystonia:

A

Genetic, usually nonprogressive, movement disorders are characterized by involuntary sustained muscle contractions, causing abnormal posture, twisting, and repetitive movements

64
Q

Tourette’s Disorder:

A

Causes vocal and motor tics.
Involves abrupt, repetitive, stereotyped movements
onset during childhood

65
Q

Choreoathetotic Cerebral Palsy

A

a type of cerebral palsy
abnormal involuntary movements
associated with lesions involving both the basal ganglia and ventrolateral thalamus

66
Q

Chorea

A

abrupt, jerky movements

67
Q

Athetosis:

A

slow, writhing, purposeless movements