• Extrapyramidle system {CNS}

• Semester 5th
 EXTRAPYRAMIDAL SYSTEM
Extrapyramidal system is provided habitual (usual)
movements.
Extrapyramidal system includes:
-in a cortex (cells in frontal lobes)
-basal ganglions (caudate nucleus, putamen, pall
balls, subthalamic nucleus)
-in a brainstem (black substance, red nucleus,
quadrigeminal plate of a midbrain)
-a reticular formation
-a cerebellum
-gamma motoneurons of a spinal cord
BASAL GANGLIONS
 EXTRAPYRAMIDAL SYSTEM

Striatum: Pallidum:
- caudate nucleus - black substance
- putamen - pall balls
- subthalamic nucleus
- red nucleus
- reticular formation
 PALLIDUM
Symptom complex affections of a pallidum carries the name
parkinsonism or akineticorigid syndrome.
Symptoms of parkinsonism:
-oligokinesia (scant movements)
-bradikinesia (slowness movements)
-bradypsychia (patient thinking in a slowed-up way)
-a phenomenon of catalepsy (patients are inactive, inert, held
down; they frequently stiff in an inconvenient pose )
-parkinsonian posture (the trunk is slightly bended, the head
is inclined forward, hands are bended and adducted to a trunk,
a sight is motionless)
-parkinsonian trembling is located in fingers of a hand and
displays by a phenomenon of “driving of pills“ or “accounts of
coins". Trembling is observed at rest and decreases at
voluntary movements
 PALLIDUM (CONTINUATION)
- change of a muscular tone on plastic type (a phenomenon of a
cogwheel)
- parkinsonian trample (the beginning of the motion is labored,
the patient moves hardly, makes short steps, hands at walking
are motionless)
- the patient cannot balance automatically. If the patient is
pushed, he runs in a direction of a push: anterior - propulsion,
aside - lateropulsion, back – retropulsion
- bradylalia (speech is monotonous, low and quiet)
- micrography (small letters)
- acairia (patients viscous, sticky, glutinous in dialogue, adhesive)
- hypomimia (the mimicry is poor) or amimia (the mimicry is
absent)
- hypersalivation (the salivation is intensified)
- hyperhidrosis
- greasiness of a patients skin
 STRIATUM
The feast affection of the striatic systems causes the muscular hypotonia and
superfluous involuntary movements which is called hyperkinesis.
Kinds of hyperkinesis:
-athetosis - slow, lumbrical, elaborate movements at distal departments of extremities
(in hands and feet). It can be observed in facial muscles of the person – protrusion of lips,
distortion a mouth, snap by language, grimacing

- hemiballism - are large wide, throw movements of

extremities. It is met in hands as a wave of “a wing of a
bird" . Violent movements at hemiballism are made with
the big force, they are difficult for stopping
 STRIATUM (CONTINUATION)
- choreic hyperkinesia - fast tractions of various groups of
muscles of a trunk and extremities. Hyperkinesis is not
rhythmical, not coordinated, it is extended on the big
groups of muscles. It is displayed at frowning eyebrowes, a
forehead, protrusion of language; gusty, chaotic
movements. Hyperkinesis can involve half of body –
hemichorea

- torsion dystonia - convulsive hyperextension

a vertebral column either both at lumbar and
cervical departments. Movements have the
rotary character accompanying by
hyperlordosis, a scoliosis, mannered poses
 STRIATUM (CONTINUATION)
- myoclonia - short flash-like clonic twitchings of muscles or groups
of muscular fibres, with rhythmic character. Can be as generalized
as local. The most often localization is proximal departments of
extremities, trunks, face. They are kept in rest and movements,
become more intensive at excitement. Do not cause movements
of extremities

- tics - fast clonic twitchings of the confined group of muscles, the

stereotyped character, simulating voluntary movements. They are
located in face muscles and are manifested with fast corrugate a
forehead, raising of eyebrows, blinking, protrusion language

- a writing spasm (graphospasm) - convulsive reduction in fingers of

a hand which appears during the writing
SYNDROMES OF
AFFECTION