CH 7: Proprioception, Touch & Tactile Discrimination Flashcards Preview

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Flashcards in CH 7: Proprioception, Touch & Tactile Discrimination Deck (97):
1

tactile sensations are complex because they involve both ___ and ___?

tactile stimuli can also be ____ or ____?

a blending of light cutaneous contact (touch)

variable degrees of pressure depending on the intensity of the stimuli

can also be static or dynamic

2

tactile sensations are complex because they involve both ___ and ___?

tactile stimuli can also be ____ or ____?

a blending of light cutaneous contact (touch)

variable degrees of pressure depending on the intensity of the stimuli

can also be static or dynamic

3

tactile sensation is divided into ___ and ____?

light touch

tactile discrimination

4

light touch involves?

detection of contact with the skin

5

tactile discrimination involves?

perception of the size and shape of objects

6

tickling and itching sensations are related to ___?

related to pain and not to tactile sense

7

what are Von Frey hairs?

fine hairs of graduated stiffness used to apply stimuli at calibrated intensities to the skin

8

what are 4 methods used to test tactile discrimination?

1- stereognosis

2-two point discrimination

3- complex tactile discrimination

4- flutter-vibration

9

what is stereognosis?

eyes closed

identify common small objects placed in one hand

10

what is two point discrimination?

determine whether one touch stimulus or two simultaneous stimuli have been applied to the skin

11

what is complex tactile discrimination?

ask subject to identify numbers or letters written on the surface of the skin with a blunt object

12

what is flutter-vibration?

an important component of tactile sensation

flutter- is a feeling of repetitive movement

vibration-- is a more diffuse and penetrating feeling of "humming" when the base of a vibrating fork contacts a bony prominence of the body

13

proprioceptive sensation includes both:

static limb position

kinesthesia- the sense of movement

14

what are the 2 different sets of sensory pathways in the SC that provide essential information to the brain about muscle action, joint position and the objects with which a person is in contact?

1: Pathways that project to the cerebellum

2: Pathways that project to the cerebral cortex

** both use mechanoreceptors

15

what 3 pathways project to the cerebral cortex by way of the thalamus?

-spinal lemniscus
-spinothalamic tract
-lateral cervical system

information carried by these pathways is perceived consciously

16

what 3 pathways project to the cerebral cortex by way of the thalamus?

-spinal lemniscus
-spinothalamic tract
-lateral cervical system

information carried by these pathways is perceived consciously

17

tactile sensation is divided into ___ and ____?

light touch

tactile discrimination

18

light touch involves?

detection of contact with the skin

19

tactile discrimination involves?

perception of the size and shape of objects

20

tickling and itching sensations are related to ___?

related to pain and not to tactile sense

21

what are Von Frey hairs?

fine hairs of graduated stiffness used to apply stimuli at calibrated intensities to the skin

22

what are 4 methods used to test tactile discrimination?

1- stereognosis

2-two point discrimination

3- complex tactile discrimination

4- flutter-vibration

23

mechanoreceptors are mostly innervated by:

large diameter myelinated fibers, with the exception of free nerve endings

the cell bodies of these peripheral nerve fibers are in the dorsal root ganglia and their central processes enter the medial side of the dorsal root zone

24

what is two point discrimination?

determine whether one touch stimulus or two simultaneous stimuli have been applied to the skin

25

what is complex tactile discrimination?

ask subject to identify numbers or letters written on the surface of the skin with a blunt object

26

what is flutter-vibration?

an important component of tactile sensation

flutter- is a feeling of repetitive movement

vibration-- is a more diffuse and penetrating feeling of "humming" when the base of a vibrating fork contacts a bony prominence of the body

27

proprioceptive sensation includes both:

static limb position

kinesthesia- the sense of movement

28

what is the Ventral spinocerebellar tract?

the most peripheral tract in the ventral margin of the lateral funiculus

crosses (contralateral)

L1-S5 and ascends throughout the SC

terminates in the cerebellum (unconscious coordination of motor movements

Function: Ib, FRA from WRF
unconscious proprioception

29

what 4 pathways project to the cerebellum?

-dorsal spinocerebellar
-ventral spinocerebellar
-cuneocerebellar
-rostral spinocerebellar tract

uses the information for the coordination of movement but not for conscious perception

30

what 3 pathways project to the cerebral cortex by way of the thalamus?

-spinal lemniscus
-spinothalamic tract
-lateral cervical system

information carried by these pathways is perceived consciously

31

mechanoreceptors in the muscles, joints and skin mediate the various separate and integrated sensations of ____, ___ and _____

proprioception
touch
tactile discrimination

32

what is the dorsal spinocerebellar tract?

located just posterior to the ventral spinocerebellar tract in the lateral funiculus

origin- Laminae 7

T1-L2/3 and ascends throughout the SC

uncrossed (ipsilateral)

terminates at the cerebellum

function: Ia, Ib and II unconscious proprioception

33

muscle spindle afferents chiefly provide information about __?

static limb position

34

joint receptor afferents and receptors in the skin, muscles and joints provides information about ____?

kinesthetic sensation (joint movement)

35

what are pacinian corpuscles?

found in the skin and CT surrounding bones and joints

detect vibration

36

what are Meissner's corpuscles?

mediates superficial phasic touch sensation

37

free nerve endings detect ..?

the movement of hairs in hair follicles- conveys a sense of touch

38

mechnoreceptors are mostly innervated by:

large diameter myelinated fibers, with the exception of free nerve endings

the cell bodies of these peripheral nerve fibers are in the dorsal root ganglia and their central processes enter the medial side of the dorsal root zone

39

after entering the SC, afferent fibers from mechanoreceptors distribute to what 3 different sites?

1- interneurons and motoneurons in the ventral horn of the SC

2- neurons in the dorsal and intermediate gray areas of the SC that are the origin of the ascending pathways

3- neurons of the dorsal column nuclei in the medulla

40

what is the rostral spinocerebellar tract?

the UE equivalent of the ventral spinocerebellar tract

originates: in the cervical enlargement (C4-8) from cells of the intermediate zone (laminae 7) of the SC gray area.

axons of these cels project to the cerebellum and terminate with fibers of the ventral spinocerebellar tract

function: Ib, FRA from WRF, unconscious proprioception, movement and posture
mediates info chiefly from GTOs and from pressure and pain receptors

41

GTO afferents (Aalpha Ib fibers) synapse on:

interneurons that inhibit motoneurons innervating the muscle in which the tendon organ is located. they also make excitatory polysynaptic connections with motoneurons of antagonist muscles

42

what are the 2 pathways that carry proprioceptive and other somatosensory stimuli from the lower limbs to the cerebellum?

ventral and dorsal spinocerebellar tracts

(some proprioceptive fiber collaterals, especially from GTOs, as well as fibers conveying other sensory modalities such as pressure and pain, synapse with neurons in the intermediate gray area and the base of the posterior horn of the SC)

43

what is the Ventral spinocerebellar tract?

the most peripheral tract in the ventral margin of the lateral funiculus

44

the nucleus dorsalis, or Clarke's nucleus, is located at ?

the base of the posterior horn in spinal segments T1-L2

45

the cerebellar tracts are also concerned with.. ?

processes that govern standing and walking

46

axons of the neurons in the nucleus dorsalis ascend rostrally on the ...?

ipsilateral side in the dorsal spinocerebellar tract

47

what is the dorsal spinocerebellar tract?

located just posterior to the ventral spinocerebellar tract in the lateral funiculus

origin- Laminae 7

T1-L2/3 and ascends throughout the SC

uncrossed (ipsilateral)

terminates at the cerebellum

function: Ia, Ib and II unconscious proprioception

48

proprioceptive afferents from dorsal roots T1-L2 synapse in the nucleus dorsal is at the level where they enter the SC. Corresponding afferents from dorsal roots L3-S5 ascend in the ______?

facsciculas gracilis of the dorsal funiculus until they can reach and synapse with the nucleus dorsalis at L2

49

the dorsal spinocerebellar tract, as a fascicle of fibers on the surface of the lateral funiculus begins at?

L2 segment of the SC

50

what are the 2 pathways that carry proprioception and other somatosensory information to the upper limbs?

1- cuneocerebellar tract

2-rostral spinocerebellar tract

51

afferent fibers from C2-T5 travel up the dorsal funiculus in the _____ to synapse on neurons in the ______?

fasciculus cuneatus

to synapse on neurons in the accessory (or lateral) cuneate nucleus (ACN) in the lower medulla

52

what is the ACN?

accessory cuneate nucleus

in the lower medulla

the upper-extremity counterpart of the nucleus dorsalis and gives rise to the ipsilateral cuneocerebellar tract

53

what does the cuneocerebellar tract mediate?

information chiefly from muscle spindles, cutaneous touch receptors and joint receptors

54

what is the cuneocerebellar tract?

originates from the ACN in the lower medulla

uncrossed/ ipsilateral

terminates at the cerebellum

function: Ia, Ib, II unconscious proprioception

55

what is the rostral spinocerebellar tract?

the UE equivalent of the ventral spinocerebellar tract

originates: in the cervical enlargement (C4-8) from cells of the intermediate zone (laminae 7) of the SC gray area.

axons of these cels project to the cerebellum and terminate with fibers of the ventral spinocerebellar tract

function: Ib, FRA from WRF, unconscious proprioception, movement and posture
mediates info chiefly from GTOs and from pressure and pain receptors

56

the ascending fibers of the dorsal spinocerebellar, cuneocerebellar, and rostral spinocerebellar pathways enter the cerebellum through the ___?

inferior cerebellar peduncle

57

ascending fibers of the ventral spinocerebellar tract continue through the ___?

pons and ascend into the cerebellum through the superior cerebellar peduncle

58

all 4 of the cerebellar tracts terminate primarily in the __?

midline (vermis and intermediate zone) portions of the cerebellum ipsilateral to the cells of origin of the tracts

59

the cerebellar tracts project especially heavily to the ___?

anterior lobe but also to the caudal part of the posterior lobe

60

the cerebellar tracts are also concerned with.. ?

processes that govern standing and walking

61

what are the 3 pathways to the cerebral cortex?

1- spinal lemniscal system

2- spinothalamic tract

3-lateral cervical system (spinocervicothalamic pathway)

62

what does the spinal lemniscal system to?

carries proprioceptive information from the receptors for position sense, kinesthesia and tactile discrimination to the cerebral cortex

63

what does the spinothalamic tract do?

from the anterolateral system

subserves light touch sensation and pain and temperature

64

what does the lateral cervical system do?

spinocervicothalamic pathway

mediates tactile, vibratory and proprioceptive sensation

65

afferent fibers from ___, _____ and ____ provide inputs to the spinal lemniscal system?

these inputs contribute to ___?

muscle spindles
GTOs
mechanoreceptors in joints and skin

contribute to conscious position and movement sense

other fibers in this system convey information about touch, pressure, and flutter-vibration

66

other fibers of the spinal lemniscal system that are responsible for information about touch, pressure and flutter vibration are...?

dorsal root afferents that ascend in the posterior funiculi without synapsing in the SC and end in relay nuclei in the lower part of the medulla

other fibers in this system are axons of dorsal horn cells that receive synapses from mechanoreceptor afferents

67

the posterior funiculus consists of two large bundles of fibers called ____ ?

fasciculi

68

what forms the fasciculus gracilis?

fibers from the leg ascend adjacent to the dorsal median septum and form the fasculus gracilis

69

what forms the fasciculus cuneatus?

fibers from the arm ascend lateral to the leg fibers and constitute the fasciculus cuneatus

70

the fibers in the posterior funiculus maintain a ____ organization?

somatotopic (body map)

fibers from the foot enter the spinal lemniscal system in the lower segments of the SC, followed in ascending order by thosefrom the leg, thigh, trunk, hand, arm, and neck

71

the fasciculus gracilis and the fasciculus cuneatus ascend to the ______, where they end in the ____ and _______

ascend to the lower medulla

end in the nucleus gracilis and nucleus cuneatus respectively

72

clinicians refer to the FG and FC tracts as the ___ and the nuclei as the _____?

dorsal column pathways

dorsal column nuclei

73

the dorsolateral pathway consists of :

the spinal lemniscal system

additional fibers of the spinal lemniscal system that travel within the dorsal part of the lateral funiculus and accompany the lateral cervical system

"dorsolateral pathway" = the entire lemniscal pathway in the SC

74

the cells of the dorsal column nuclei give rise to the ____ which promptly cross to the opposite side of the medulla in the ______?

they then ascend as the _______ to the thalamus and terminate in the _______?

internal arcuate fibers

decussation of the medial lemniscus

medial lemniscus

terminate in the ventral posterolateral nucleus (VPL)

75

the internal arcuate fibers of the spinal lemniscal system maintain a somatotopic organization in both the ____ and _____

medial lemniscus

VPL

76

in the medulla, medial lemniscus fibers from the nucleus gracilis convey information from the ___and lie ___?

in the pons and midbrain, these gracile fibers lie ____

leg

lie ventral to fibers from the nucleus cuneatus in the medulla

lie lateral to cuneate fibers in the pons and midbrain

77

the band of cerebral cortex in the postcentral gyrus of the parietal lobe that receives thalamocortical fibers from the VPL is the ___?

primary somatosensory cortex (where topographic representation of the body areas is imilar to that of the motor strip that lies parallel to it on the opposite side of the central sulcus)

78

the primary somatosensory area includes Brodmann's areas __?

3, 1, and 2

79

the spinal lemniscal system mediates the senses of __, ____, ___, and ____

sense of limb position and movement (including the sense of steady joint angles)

sense of motion produced by active muscular contraction (kinesthesis) or passive movement

sense of tension exerted by contracting muscles

sense of effort

80

the conscious recognition of body and limb posture requires __?

cortical participation

81

in addition, the lemniscal pathway provides information about ___, ___, and ______ of neural activity evoked by mechanical stimulation of skin, particularly moving stimuli on the skin

thus this pathway to the cerebral cortex is necessary for ___?

place
intensity
temporal and spatial patterns


discriminative tactile sensation

also important in recognition of flutter-vibration

82

almost all neurons of the lateral cervical system respond to light mechanical stimulation of the skin on the ____

ipsilateral side of the body

*a few are activated by noxious stimuli

83

peripheral nerve fibers entering the lateral cervical system enter by:

making synaptic connections in the dorsal horn (primarily in lamina IV) throughout the length of the SC

heavily myelinated axons from the second order neurons arise in this lamina and ascend ipsilaterally in the most dorsal corner of the lateral funiculus to terminate in the lateral cervical nucleus (located just lateral to the dorsal horn of the first 3 cervical segments)

84

projections from the lateral cervical nucleus cross the spinal cord in the ventral white commissure to joint the __

contralateral medial lemniscus and proceed with it to terminate in the thalamus.

projects from the thalamus reacch the somatic sensory areas of the cerebral cortex

85

the fibers of the entire lateral cervical system conduct ..?

very rapidly

86

in the various relay nuclei of the pathways mediating tactile discrimination, each neuron receives synaptic input from many afferent fibers, and each afferent fiber ends on many relay cells. Thus, the relay cells receive sensory information that undergoes both ____ and ____

convergence and divergence

in addition, afferent fibers reaching relay nuclei activate not only relay cells but also excitatory and inhibitory interneurons.

Consequently, the sensory pathways both transmit information and modulate and transform the information as it moves along to higher levels of the NS

87

in the somatic sensory system, synaptic inhibition occurs:

not in the peripheral receptor but in the first synaptic site in the dorsal horn or dorsal column nuclei and in subsequent synaptic sites along the pathway

88

what are the 2 types of inhibitory processes?

1- local feedback inhibition

2-distal feedback inhibition

89

local feedback inhibition involves:

"lateral inhibition"

involves the inhibition of dorsal horn and dorsal column relay cells that surround the relay cells activated by incoming sensory volleys

this inhibition is mediated by collaterals of the activated cells synapsing on inhibitory interneurons in the relay nucleus

limits the extent of excitation among adjacent neurons and thereby functionally decreases the divergence of excitation and sharpens the localization of signals

90

distal feedback inhibition consists of:

"presynaptic inhibition"

the inhibition of presynaptic activity in the terminals of dorsal root ganglion cells in dorsal horn and dorsal column nuclei.

this inhibition comes from the axons of neurons in the motor and somatosensory areas of the cerebral cortex and in the brain stem

allows higher levels of the NS to regulate the information that moves upward

91

the receptive field of each neuron is:

the area on the body surface that, when stimulated, either excites or inhibits that neuron

neurons in each of the nuclei along the lemniscal pathway, including the dorsal column nuclei, the VPL and the somatosensory area of the cerebral cortex, have specific receptive fields

the size of the receptive fields of individual neurons varies considerably

the tips of the fingers, the lips and the tongue are the regions of the body that are most sensitive to touch bc they contain the highest density of sensory nerve endings per unit area. this increased density of afferent fibers serving a given region transmits information to larger numbers of relay cells with smaller receptive fields than the parts of the system serving less sensitive areas of the body (arm, back). the more sensitive regions therefore also have the larges areas of representation in the postcentral gyrus

92

what is inhibitory surround?

stimulation of skin within the receptive field of a neuron usually excites the neuron, and stimulation of skin surrounding the excitatory area usually inhibits the neuron

the result of this arrangement is max firing of a neuron in response to a stimulus limited to the area of its receptive field. if the stimulus impinges equally on the receptive field and the inhibitory surround, the neuron will show little or no response

93

what type of skin sensibility is the least likely to be impaired by SC lesions?

simple touch

thus, a lesion of the dorsal columns usually abolishes ipsilateral tactile discrimination of the direction of movement of a cutaneous stimulus, but recognition of light touch decreases only slightly or not at all bc the spinothalamic tract also transmits light touch sense.
conversely, after transection of the spinothalamic tract, pain perception is lost on the opposite side of the body, but light otuch generally persists bc the dorsolateral pathways can also mediate this function

94

complete loss of proprioceptive sensation from a spinal lesion requires :

bilateral interruption of the dorsolateral pathway (both dorsal columns and the lateral cervical system in the dorsal part of the lateral columns)

lesions in this location cause deficits in position sense, vibration sense, and tactile discrimination

the symptoms occur prominently on the same side of the body after unilateral injury of a dorsolateral pathway

95

lesions of the lemniscal pathway leaved preserved the :

sensation of pain, temperature and simple touch

96

interruption of the dorsal columns without injury to the lateral columns results in:

loss of tactile discrimination of the direction of a moving stimulus on the skin, but appreciation of touch and joint position sense remains intact

97

clinical signs of injury to the lemniscal (dorsolateral) pathways include:

these are frequently tested in neurologic examination

1- inability to recognize limb position
2- astereognosis-(keys)
3-loss of 2 point discrimination
4-loss of vibratory sense
5- + Romberg sign (pts with dorsolateral pathway lesions may be able to maintain balance with eyes opened but lose balance with eyes closed)