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Neuo Block 1 > Spinal Cord 2 > Flashcards

Spinal Cord 2 Flashcards

1
Q

What function does the corticospinal system control?

A

Voluntary motor function

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2
Q

What tracts are involved in voluntary motor control?

A

Lateral and anterior corticospinal tracts

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3
Q

What tracts are involved in fine touch and proprioception?

A

Dorsal column with posterior funiculus

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4
Q

What tracts are involved in pain, temp, and crude touch?

A

Anterolateral system

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5
Q

Which motorneurons come from the precentral gyrus?

A

Uppermotor neurons

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6
Q

Any cranial nerve that does motor function is considered what?

A

Lowermotor neurons

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7
Q

What are the cranial nerves that are lowermotor neurons?

A

3,4,5,6,7,9,10,11,12

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8
Q

In cranial nerve nuclei and spinal cord, there is a synapse that provides communication for what?

A

Between upper and lower motor neurons

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9
Q

The corticospinal tract divides into what two tracts? Where does it split? Which one crosses the midline?

A
  • anterior and lateral corticospinal tract
  • in the medulla
  • lateral corticospinal tract crosses the midline (lateral tract is bigger)
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10
Q

The lateral CST controls what? How does it terminate?

A
  • upper and lower limbs

- terminates ipsilaterally (on opposite side where it originates)

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11
Q

The anterior CST does what? How does it terminate?

A
  • head and neck (axial)

- terminates bilaterally

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12
Q

In the anterior horn, where are flexor and where are extensor?

A

Flexor are more towards the center and the extensor are more towards the edge

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13
Q

How are anterior horn motor neurons organized?

A

In vertical (rostral caudal) columns

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14
Q

How does the lateral CST run?

A
  • descends through body in lateral funiculus
  • synapse in anterior horn (on opposite side)
  • serves limbs contralateral to cortex
  • serves limbs ipsilateral to tract
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15
Q

What is the excitatory NT in corticospinal projections? Inhibitory?

A

Glutamate is excitatory

GABA is inhibitory

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16
Q

What happens when CST are damaged rostral to pyramidal decision?

A

-produces limb paralysis on side contralateral to lesion (left side damage means right side weakness)

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17
Q

what happens when the LATERAL CST has damage CAUDAL to pyramidal decussation?

A

-produces weakness ipsilateral to the lesion (left side damage means left side weakness)

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18
Q

Damage to the lateral CST produces what kind of deficits?

A
  • level down
  • suprasegmental deficits
  • damage to uppermotor neurons
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19
Q

Damage to ventral hor, ventral roots, and peripheral nerves produce what kind of deficits?

A
  • lower motor damage
  • segmental deficits
  • only damage at that level, not down
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20
Q

Which tract can compensate for the other when it is damaged and result in no significant deficit?

A

The lateral can compensate for the anterior.

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21
Q

Describe what happens to strength when there is lowermotor damage. Uppermotor Damage?

A

Lower: decreased
Upper:decreased

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22
Q

Describe what happens to muscle tone when there is lowermotor damage. Uppermotor?

A

Lower: decreased
Upper: increased

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23
Q

What happens to stretch reflexes when there is damage to the lowermotor neuron? Upper?

A

Lower: decreased
Upper: increased! Clonus! You took out the inhibitory effect from descending inputs

24
Q

Damage to what kind of motorneuron shows severe atrophy?

A

Lowermotor neuron damage

25
Q

What are fasciculations?

A

-spontaneous contractions of a group of muscle fibers visible as muscle twitches

26
Q

What are fibrillation?

A

-spontaneous contraction of individual muscle fibers, not grossly visible, but detectable

27
Q

Damage to which motorneurons causes fibrillation and fasciculation?

A

Lowermotor neuron damage

28
Q

What is babinskis sign? What kind of motorneurons is damaged?

A
  • foot should show dorsal flexion when touched on dorsal side, but instead you see extension and the toes fan out
  • uppermotor neuron damage
29
Q

Uppermotor neuron signs are also called…

A

Spastic weakness

  • NO atrophy
  • increased muscle tone
  • exaggerated reflexes
  • clonus
30
Q

Lowermotor signs are also called….

A

Flaccid weakness

  • muscle atrophy
  • decreased muscle tone
  • decreases ref;exes
  • fasciculation
31
Q

In order for UMN signs to occur, what must the LMN be?

A
  • LMN must be intact in order to see lowermotor neuron signs

- if they are both damaged, patient shows LMN signs

32
Q

What is discriminative sense?

A
  • fine spatial/temporal resolution

- able to detect what the stimulus is

33
Q

What is position sense>

A
  • conscious proprioception

- tell where your limbs are in space

34
Q

So sensory fibers synapse in the spinal cord?

A

Nah

-they enter posterior funiculus and go to contralateral cortex

35
Q

The posterior column system is an ascending system that ends where?

A

In cortex

36
Q

Third order neurons in ___________ project to somatosensory cortex (postcentral gyrus)

A

Thalamus

37
Q

Second order neurons in posterior column system synapse where?

A

In thalamus

38
Q

What supplies all of the sensory innervation for the face?

A

The trigeminal nerve joins the posterior column system

39
Q

Where do first order neurons from posterior dorsal column system synapse?

A

In the medulla

40
Q

What kind of deficit is there when there is damage to fasciculus gracilis and fasciculus cuneatus?

A
  • level down sensory loss(ipsilateral to legion)
  • fine/discriminative touch and conscious proprioception
  • NO LOSS OF PAIN OR TEMP!!! THAT IS A DIFFERENT SYSTEM
41
Q

Does the posterior/dorsal column system cross the midline?

A

Nope!! Right lesion always means right sensory loss

42
Q

What does the anterolateral system control?

A

Pain/temp/crude touch

43
Q

Is there a midline cross in the anterolateral system?

A

Yes! At the anterior white commissure

44
Q

Where do the sensory fibers synapse in the anterolateral system?

A

Synapse in the posterior/dorsal horn before they cross the midline

45
Q

An intramedullary tumor damaging the cord from medial to lateral is more likely to cause damage to what?

A

-cervical region

(Medial to lateral)

  • cervical
  • thoracic
  • lumbar
  • sacral
46
Q

An extramedullary tumor compressing the cord from lateral to medial is most likely to cause damage to what?

A

-sacral!

47
Q

Visceral innocuous sensory receptors project via what nerves to the spinal cord?

A

Parasympathetic

48
Q

Visceral nociception project via what nerves to the spinal cord?

A

Sympathetic

49
Q

What is referred pain?

A

Convergence of somatic and visceral pain sensation in the spinal cord.
-cross talk between somatosensory and viscerosensory

50
Q

What kind of information does the spinocerebellar pathway provide?

A

Non-conscious proprioception to cerebellum

-check balance and coordination

51
Q

What is Friedreich’s ataxia? What pathway would you see damage in?

A
  • impaired coordination of walking
  • unsteady during standing with eyes closed(Romberg’s sign)
  • degeneration in dorsal columns, dorsal cerebellar tracts, lateral CST
52
Q

What is tabes dorsalis?

A
  • degeneration of dorsal roots and dorsal column
  • impaired somatosensation and conscious proprioception loss
  • Tabetic gait: high stepping and foot flapping when foot strikes ground
53
Q

What is subacute combined degeration?

A

-degeneration of dorsal roots, dorsal columns, LCST

54
Q

Gimme some examples of dermatomes

A
  • diaphragm (C3,4,5)
  • Heart(T1-T4)
  • Stomach (T6-T9)
55
Q

What is stereognosis? Graphesthesia?

A
  • coin identification
  • trace letters on patient

-testing fine touch and posterior/dorsal pathway

56
Q

The lowermotor neuron in corticospinal system has an axonal projection that….

A

-projects out of the spinal cord, into subarachnoid space, and through the intervertebral foramen

Neuo Block 1 (10 decks)

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