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Apex Review > Spinal cord 2 > Flashcards

Spinal cord 2 Flashcards

1
Q

Which pathway transmits afferent nociceptive input to the brain?
a. medial lemniscal system
b. anterolateral system
c. corticospinal tract
d. Lissauer tract

A

b. anterolateral system

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2
Q

The ____________ tract transmits motor impulses.

A

corticospinal tract

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3
Q

The __________ tract is an intermediary pathway that relays sensory input in the spinal cord.

A

Lissauer

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4
Q

The _______ tract transmits fine touch, proprioception, vibration, and pressure

A

medial lemniscal system (dorsal column)

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5
Q

The anterolateral system is a

A

three-neuron sensory pathway

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6
Q

The anterolateral system transmits

A

pain
temperature
Crude touch
itch
tickle
sexual sensation

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7
Q

The anterolateral system consists of

A

smaller, myelinated and nonmyelinated, slower conducting fibers

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8
Q

In the anterolateral system, ____________ is not present

A

two-point discrimination

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9
Q

The anterolateral system transmits

A

sensory information 1/2 to 1/3rd as fast as the dorsal column

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10
Q

Nociceptors transmit

A

pain

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11
Q

Mechanoreceptors transmit

A

pressure, crude touch, tickle, itch, and sexual sensation

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12
Q

Thermoreceptors transmit

A

temperature

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13
Q

The first-order neurons of the anterolateral system contain

A

two nerve fiber types:
a-delta
c-fibers

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14
Q

A-delta fibers are

A

“first” pain, mechanoreceptors

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15
Q

C-fibers are

A

“slow” pain, polymodal nociceptors

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16
Q

The first order neurons of the anterolateral system may ascend or descend

A

1-3 levels on the ipsilateral side in the Lissauer tract before synapsing with the second-order neruon

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17
Q

Pain neurons in the anterolateral tract synapse with the second-order neuron in the

A

substantia gelatinosa- Rexed lamina 2

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18
Q

Primary pain neurons of the anterolateral tract also may synapse with the second-order neuron in the

A

dorsal horn laminae 1,4,5 and 6

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19
Q

Second-order neurons of the anterolateral system synapse with third-order neurons in the

A

reticular activating system and the thalamus

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20
Q

Second-order neurons cross

A

to the contralateral side of the spinal cord then ascend towards the brain via two pathways

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21
Q

What two pathways do second order neurons of the anterolateral system use to ascend towards the brain?

A

lateral spinothalamic tract
anterior spinothalamic tarct

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22
Q

The lateral spinothalamic tract transmits

A

pain and temperature

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23
Q

The anterior spinothalamic tract transmits

A

crude touch and pressure

24
Q

Injury to the corticospinal tract above the level of decussation in the medulla will result in: (select 2)
a. flaccid paralysis
b. contralateral paralysis
c. ipsilateral paralysis
d. spastic paralysis

A

b. contralateral paralysis
d. spastic paralysis

25
Q

The corticospinal tract carries

A

motor signals from the cerebral cortex to the muscles of the body

26
Q

If there is an injury to the corticospinal tract above the level of decussation then the patient will experience

A

spastic paralysis on the contralateral side

27
Q

If there is an injury to the corticospinal tract below the level of decussation, then the patient will experience

A

flaccid paralysis on the ipsilateral side

28
Q

The _____________ is the most important motor pathway

A

corticospinal tract

29
Q

The corticospinal tract is also called the

A

pyramidal tract

30
Q

All the other motor pathways outside of the corticospinal tract are known collectively as the

A

extrapyramidal tract

31
Q

The upper motor neurons begin in the _________________ and synapse with the lower motor neurons in the _________________

A

cerebral cortex and synapse with the lower motor neurons in the ventral horn of the spinal cord

32
Q

Examples of upper motor neuron diseases include

A

cerebral palsy & ALS

33
Q

Upper motor neuron injury below the level of decussation leads to

A

spastic ipsilateral paralysis

34
Q

Upper motor neuron injury above the level of decussation leads to

A

spastic contralateral paralysis

35
Q

Lower motor neurons begin in the ___________ and end at the ___________

A

ventral horn and end at the neuromuscular junction

36
Q

A lower motor neuron injury results in

A

ipsilateral paralysis

37
Q

Lower motor neuron injuries present with

A

impaired reflexes and flaccid paralysis

38
Q

The primary function of the corticospinal tract includes

A

voluntary fine motor control to the limbs and coordination of posture

39
Q

This test assesses the integrity of the corticospinal tract

A

The Babinski test

40
Q

The lower motor neurons pass messages from the

A

spinal cord to the muscles

41
Q

Where does the upper motor neuron begin and end?

A

it begins in the cerebral cortex and ends in the ventral horn of the spinal cord

42
Q

Which findings are MOST likely to occur during the acute phase of spinal cord transection at C7?
a. autonomic hyperreflexia and hypothermia
b. bradycardia and hypothermia
c. tachycardia and hypotension
d. hypothermia and tachycardia

A

B. bradycardia and hypothermia
the patient with an acute C7 transection will experience neurogenic shock

43
Q

Acute spinal cord injury is most commonly caused by

A

a motor vehicle accident, fall, assault, or sports injury

44
Q

The most common site of spinal cord injury is

A

C7

45
Q

Complete spinal cord injury damages the

A

upper motor neuurons

46
Q

With a complete spinal cord injury, spinal cord reflexes are _________ but they __________

A

lost during the acute phase (flaccid paralysis) but they return later (spasticity)

47
Q

SCI can cause _______ shock

A

neurogenic

48
Q

Neurogenic shock presents as

A

hypotension, bradycardia, and hypothermia with pink, warm extremities

49
Q

The major causes of morbidity and mortality in patients with cervical and upper thoracic lesions are

A

ineffective alveolar ventilation and the inability to clear pulmonary secretions

50
Q

What drug should be avoided in patients with spinal cord injury?

A

succinylcholine!

51
Q

The higher the injury, the greater degree of

A

hemodynamic instability

52
Q

Neurogenic shock can last

A

1-3 weeks

53
Q

Describe how bradycardia and reduced inotropy in SCI occurs.

A

impairment of cardiaccelerator fibers (T1-T4)–> unopposed cardiac vagal tone

54
Q

Describe how hypotension occurs in SCI.

A

decreased SNS tone–> vasodilation–> venous pooling–> decreased CO and BP

55
Q

Describe how hypothermia occurs in SCI.

A

impairment of sympathetic pathways from the hypothalamus to blood vessels–> inability to vasoconstrict or shiver–> hypothermia

Apex Review (224 decks)

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