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Flashcards in Ascending Pathways - SRS Deck (73):
1

Identify the blocked out structures

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Anterolateral System

Ventral Spinocerebellar tract

Dorsal spinocerebral tract

Fasciculus Cuneatus

Fasciculus Gracilis

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2

What three categories of information do spinal cord tracts carry?

  1. Discriminatory
  2. Reflexive
  3. Postural

3

The spinal cord has tracts that carry discriminatory information which determines type, location and intesity of the stimulus.  What are the tracts that carry this?

  1. Dorsal columns/medial lemniscus (DCML)
    • Fasciculus gracilis
    • Fasciculus cuneatus
  2. Anterolateral system
    • ​​Neospinothalamic

4

The spinal cord has tracts that carry reflexive information which activates responses to create behavioral state change with appropriate stereotyped motor responses.  What are the names of these tracts?

  1. Anterolateral system
    • ​​Paleospinothalamic
    • [spinoreticular]
    • [spinomesencephalic]

5

What senssation types are carried by the discriminatory tracts?

Tactile (temperature, blunt/sharp, locality)

6

The spine carries postural information regarding joints, tendon and muscle position.  What tracts do this?


•Spinocerebellar tracts
–Cuneocerebellar
–[Rostral spinocerebellar]
–Dorsal spinocerebellar
–Ventral spinocerebellar
 

7

Fast, wide diameter axons travel to white matter in the?

Posterior funiculi

8

Slower, thin-diameter axons travel to what structures in the dorsal horn?

Lamina I-VI

9

How many neurons long are the discriminatory pathways?

3

10

How many neurons long are postural pathways?

2

11

What are the types of information in the pathways of the dorsal columns?  What are the two portions of this pathway?

Tactile discrimination, conscious proprioception

Posterior columns and medial lemniscus

12

What are the point of origin receptors for the dorsal columns?


–Meissner’s corpuscles, merkel’s disks, pacinian corpuscles, ruffini’s endings in skin muscle spindles, golgi tendon organs  in muscles, joints and tendons
 

13

Where are the primary cell bodies of the dorsal columns located?

Dorsal root ganglia (DRG)

14

Where is the first synapse for the dorsal columns?


–Nucleus cuneatus (for upper body) and nucleus gracilis (for lower body), in caudal medulla
 

15

Where do neurons for the dorsal columns enter the spinal cord?  

Medial aspect of dorsal horn

16

Where do discriminatory fiber tracts decussate?

Internal arcuate fibers ventral to cuneatus and gracilis (becomes "medial lemniscus")

17

Where is the second synapse of the dorsal columns?

Ventral posteriolateral (VPL) Nucleus of the Thalamus

18

What is the final destination of the dorsal columns? 

Via what structures?

The primary somatosensory cortex (Via internal capsule and corona radiata)

19

Dermatomes segregate cuneatus from gracilis.  What body segments do each represent?

Cuneatus - Thoracic and Cervical

Gracilis - Lumbar and Sacral

20

What are the nuclei of the Cuneatus and Gracilis seperated by?

Posterior intermediate septum

21

Identify where the thoracic, sacral, lumbar and cervical tracts are in this spinal segment.

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22

Identify the indicated structures.  What portion of the spinal cord is this?

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Medulla

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23

Identify the tagged structures.  Where is this section from?

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Thalamus

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24

Describe the somatotopy of the primary somatosensory cortex.

See attachment

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25

The third pathway takes the anterolateral system.  What tract is this?

Neospinothalamic tract

26

What type of information is conveyed in the neospinothalamic tract?

Pain

Temperature

Poorly localized touch

27

What are the point of origin receptors involved in the neospinothalamic tract?

Free Nerve endings (TRP channels) in skin, viscera, muscles

28

Where are the primary cell bodies of the neospinothalamic tract located?

DRG

29

Where is the first synapse for the neospinothalamic tract?

Lamina I-VI

30

What is the path into the spinal cord and through it that the neospinothalamic tract takes?

 

  1. dorsal horn (Lissauer’s Fassciculus to ascend at least 1 segment)
  2.  after 1st synapse, travels through anterior white commissure
  3.  ascends through anterolateral spinothalamic tract

31

Where does the neospinothalamic tract fiber decussate?

In the anterior white commissure after the first synapse

32

Where is the second synapse for the neospinothalamic tract?

Ventral Posteriolateral Nucleus (VPL) of the Thalamus

33

What is the final destination of the neospinothalamic tract?


–Primary somatosensory cortex (via internal capsule and corona radiata)
 

34

Identify the tagged structures

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35

What type of information is carried in the paleoospinothalamic tract?

Poorly localized pain

36

What is the point of origin receptor for the paleospinothalamic tract?

Free nerve endings (TRP channels) in skin, viscera, muscles

37

Where are the primary cell bodies of the paleoospinothalamic tract?

DRG

38

Where is the first synapse for the paleoospinothalamic tract?

Lamina I-VI

39

Describe the paleospinothalamic tract from the point it enters the spinal column to its ascent.


1. dorsal horn (Lissauer’s Fassciculus to ascend at least 1 segment),

2. after 1st synapse, travels bilaterally,

3. ascends through anterolateral spinothalamic tract
 

40

Where does the paleospinothalamic tract decussate?

It doesn't necessarily, but the fibers that do decussate do so through the anterior white commissure. 

41

Where is the second synapse for the paleoospinothalamic tract?

Intralaminar nuclei of the Thalamus

42

What is the final destination of the paleoospinothalamic tract?


–Bilateral cortex, poorly localized (includes cingulate gyrus and insula)
 

43

Identify the indicated structures

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44

Identify the blocked out labels.

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45

What four tracts make up unconscious proprioception?


•Dorsal spinocerebellar
•Ventral spinocerebellar
•Rostral spinocerebellar (?) (not often in humans)
•Cuneocerebellar
 

46

What kind of information do the fifth and 6th pathways carry?

(Dorsal Spinocerebellar and cuneocerebellar)


Unconscious proprioception
 

47

What receptors are involved in the 5th and 6th pathways?

(Dorsal Spinocerebellar and cuneocerebellar)

Muscle spindles and golgi tendon organs in muscles, joints and tendons

48

Where are the primary cell bodies of the dorsal spinocerebellar and cuneocerebellar pathways located?

DRG

49

What is the location of the first synapse for the dorsal spinocerebellar and cuneocerebellar tracts?

Spinocerebellar - Clarke's nucleus (AKA nucleus dorsalis) of thoracic cord.

 

Cuneocerebellar -  Accessory cuneate nucleus in the caudal medulla

 

50

Where do the 5th and 6th pathways enter/travel in the spinal cord?

Posterior funiculi (hitchhikes with the dorsal columns)

51

Where do the spinocerebellar and cuneocerebellar pathways decussate?

They do not.

52

Where is the second synapse for the dorsal spinocerebellar and cuneocerebellar pathways?


–vermis/paravermis of the cerebellum via inferior cerebellar peduncle
 

53

What is the final destination of the spinocerebellar and cuneocerebellar tracts?


–Deep cerebellar nuclei (via purkinje cells)
 

54

Identify the red circle

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55

When below C8, unconsious proprioceptive information hitchhikes on the posterior column.  Where does it synapse?  Where is it visible?


–Synapses in Lamina VII
–Visible L3 to C8
      •CLARKE’S COLUMN/CLARKE’S NUCLEUS/NUCLEUS DORSALIS
 

56

What is the structure circled in red?

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Accessory Cuneate nucleus

57

When above C8, the cuneocerebellar tract synapses in the?


•accessory/external/lateral cuneate nucleus
 

58

Identify the indicated structures

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59

Identify indicated structures

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60

Identify indicated structures

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61

What do the ventral spinocerebellar and rostral spinocerebellar pathway carry, information wise?

Broad integrated information from the entire limb

62

What type of information is carried by the ventral spinocerebellar tract?


Unconscious proprioception
 

63

What are the receptors associated with the ventral spinocerebellar tract?


–muscle spindles, golgi tendon organs  in muscles, joints and tendons
 

64

Where are the primary cell bodies of the ventral spinocerebellar pathway located?

DRG

65

Where is the first synapse of the ventral spinocerebellar?

Lamina VII.

66

Where does the ventral spinocerebellar pathway enter the spinal cord/travel?

Posterior funiculi

67

Where does the ventral spinocerebellar pathway decussate?

Immediately in the spinal cord

68

Where is the second synapse for the ventral spinocerebellar pathway?  What is unusual about this pathway after the second synapse?


–vermis/paravermis of the cerebellum via superior cerebellar peduncle. Will then decussate again!
 

69

What is the final destination of the ventral spinocerebellar tract?

Deep cerebellar nuclei (via purkinje cells)

70

Identify the indicated structure.  What is the spinal section this is from?

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Upper Cervical

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71

Patient has a lesion of the right fasciculus cuneatus at C2. Tell me all of the sensory systems affected, and on which side of the body…

  1. Right-sided, upper-limb tactile discrimination,
  2. conscious proprioception
  3. unconscious proprioception of individual muscles/tendons
     

72

Patient has a Lesion of Lamina VII in left thoracic spinal cord. Tell me all of the sensory systems affected, and on which side of the body…


•Left sided unconscious proprioception of lower limbs (individual fibers)
 

73

Patient has Allodynia (pain due to a stimulus that usually does not provoke pain) on the right side of the leg. Name the possible areas where there might be a lesion…

  1. Right sided peripheral axons/free nerve endings,
  2. right sided dorsal horn (Lamina I-V),
  3. Anterior white commissure,
  4. Left sided Lateral spinothalamic tract,
  5. left sided VPL thalamus,
  6. left sided primary somatosensory cortex