chapter 6 Flashcards
(123 cards)
1
Q
lesion on ___ get apraxia, patients have normal strength but have deficits in higher order motor planning and higher order sensory loss
A
parietal association cortex
2
Q
what is crucial for planning motor activity?
A
premotor cortex and supplementary motor area
3
Q
what is housed in the precentral gyrus?
A
primary motor cortex
4
Q
a lesion where will give you paralysis
A
primary motor cortex
5
Q
central sulcus posterior border=_____
A
frontal lobe
6
Q
Central sulcus Anterior border=____
A
parietal lobe
7
Q
what is housed on the surface of the post central Gyrus?
A
primary somatosensory cortex
8
Q
a lesion where will cause loss of sensations
A
primary somatosensory cortex
9
Q
____and ___ connections work together (walking uphill and then changing to walk down hill)
A
sensory and motor
10
Q
somatosensory representation: increase corticorepresentation would increase the ____
A
complexity of movements of the ability to process the information
11
Q
the arms are medial to the legs except in?
A
primary sensory motor cortex and posterior columns
(these both are lateral)
12
Q
if you have leg weakness you have a lesion where?
A
lesion on interhemispheric fissure
13
Q
patient has arm and face weakness, where is it?
A
lateral cortico surface
14
Q
lower motor neuron in reflex of ____
A
movement
15
Q
interneurons send out ___
A
bifurcations
16
Q
spinal nerve bifurcates into ___ and ___
A
ventral and dorsal
17
Q
has cell body
A
dorsal root ganglion
18
Q
dorsal horn –> marginal zone–> ____
A
laminae I
19
Q
-receiving info primarily from lissauers tract (posterolateral tract)
-relaying info about pain and temp
A
laminae 1
20
Q
this tract is involved in neurological deficits seen in patients that have B12 anemia where they might develop numbness in hands/feet and poor reflexes
A
laminae I
21
Q
autoimmune disease that attacks parietal cells in stomach and prevents them from making intrinsic factor
A
pernicious anemia
22
Q
absorption and blood clotting
A
intrinsic factor
23
Q
-do not have the ability to modulate pain in this lamina
-synapses are coming in where you will have the ability to modulate pain later
A
laminae I
24
Q
-fibers coming into laminae I contribute to the _____ tract
-if there is an occlusion of the ventral artery of the spinal cord then this tract and the dorsal column are the only ones that are spread
A
spinothalamic
25
dorsal horn --> substantia gelatinosa--> _____
laminae II
26
-relaying info about pain, temperature, and some crude touch
-given its name suggesting that it has a gelatinous texture due to the low amount of myelinated fibers and neuroglia cells that are resident here
laminae II
27
-cells here modulate pain signaling through neurotransmitter and neuropeptide release
-so we have mu and kappa opioid receptors here--> pain modulation can be targeted here
-neuropeptides require greater intensity/frequency compared to neurotransmitters to release peptides
laminae II
28
first order spinothalamic neurons synapse here to modulate pain
1. glutamate ___ perception of pain
2. GABA ____ perception of pain
3. opiods inhibit the release of ___
1. increase
2. decrease
3. glutamate and substance P
29
when you take opiods (morphine) it inhibits the release of glutamate and substance P and gives us the feeling of ___
analgesia
30
has C and delta A fibers terminate here. fibers continue up to medulla where it becomes spinal nucleus of trigeminal nerve.
Laminae II
31
C fibers terminate in laminae II and they carry ___
slow conducting pain
32
delta A fibers terminate in Laminae II and they carry ____
fast conducting pain sensatio
33
axons that carry noxious painful and temperatur impulses synapse in ____and ____--> cross midline via anterior white commissure --> ascend as the lateral spinothalamic tract
Laminae I and II
34
Dorsal horn--> nucleus proprius--> ____
laminae III and IV
35
-contains first order spinothalamic neurons that carry pain and temperature from our peripheral system
-projects to deeper lamina of spinal cord for further processing
laminae III and IV
36
-axons that carry vibrations and pressure leads to synapses that are being received here
-carry conscious proprioceptive impulses up to the cortex then travels through the dorsal medial lemniscus pathway
Laminae III and Iv
37
dorsal horn --> neck of dorsal horn -->____
laminae V
38
-process sensory afferent stimuli from cutaneous muscle and joint receptors and visceral nociceptors
-will have some visceral and somatic signals converging here
laminae V
39
dorsal horn --> base of dorsal horn --> ____
laminae VI
40
-do not have nociceptive input that occurs here
-recieves input from muscles, joint and muscle spindles --> sensitive to innocuous joint movements that feeds info to the cerebellum (anterior lobe) where you can modulate muscle accordingly
laminae VI
41
what lobes does the cerebellum have?
posterior, anterior and flocculonodular lobe
42
flexion reflex is processed here
-it is a reflex withdrawal from painful stimuli
-works with lamina 8 to coordinate spinal reflexes
lamina VI
43
intermediate zone --> clarkes nucleus, intermediolateral nucleus --> _____
laminae VII
44
-only present in segments from T1 to L2
-housing preganglionic sympathetic neurons; sends impulses to our face, neck, heart and organs
laminae VII
45
any compression of clarkes nucleus (laminae VII)= ___
-this syndrome affects face and eye on ONE side of the body
-decrease pupil size; this can also signify a stroke or tumor
-droopy eyelid
-decreased sweating on one side of body
Horners syndrome
46
-houses preganglionic parasympathetic neurons between S2-S4
-send impulses to pelvis and few abdominal organs
Laminae VII
47
ventral horn --> comissural nucleus -->___
laminae VIII
48
has interneurons and proprioceptive neurons
-functions with lamina 6 to process our reflexive patheay
laminae VIII
49
laminae VIII has ____ and ___ tracts synapsing here
vestibulospinal and reticulospinal tracts
50
ventral horn--> motor nuclei--> ____
laminae IX
51
have medial motor nuclei that innervate our proximal muscles, lateral motor column and central motor column
laminae IX
52
medial motor nuclei that innervate our proximal muscles?
deep back muscles, prevertebral neck region (intercostals) and anterior body wall muscles
53
what consists of the lateral motor column of laminae IX
1. only in the lumber and cervical enlargements of spinal cord
2. innervates distal muscles (arms, legs, shoulders and pelvic girdle)
54
the central motor column in laminae IX around C1-C5 houses ___ nucleus
accessory
55
the central motor column in laminae IX around C3-C5 houses ____ nucleus -> phrenic nerve (innervates diaphragm)
phrenic
56
gray matter surrounding central canal --> grisae centralis --> ___
laminae X
57
-have axons that cross over to the contralateral side
-crossing fibers
laminae X
58
___ at the skull: foramen Magnum in occipital lobe
-transition between spinal cord and medulla
cervicomedullary junction
59
the blood supply to the spinal cord arises from branches of the ____ and ___
vertebral arteries and spinal radicular arteris
60
The vertebral arteries give rise to the anterior spinal artery that runs along the ventral surface of the spinal cord, this supplies the ___ of the spinal cord
anterior 2/3
61
two posterior spinal arteries arise from the vertebral or posterior inferior cerebellar arteries to supply the ____surface of the cord
dorsal
62
The anterior and posterior spinal arteries form a ___ surrounding the spinal cord
spinal arterial plexus
63
1. ____ segmental arterial branches enter the spinal cord along its length
2. most branches arise from the ___ and supply the meninges (dura, arachnoid, pia)
3. ____reach the spinal cord as radicular arteries
1. 31
2. aorta
3. 6-10
64
the ____ is the most prominent and usually arises on the left side between T9 and T12, but can be T5-L3
great radicular artery of Adamkiewicz
65
The great radicular artery of Adamkiewicz supplies the major blood supply to the ___ and ____ cord
lumbar and sacral
66
The ___ is between the vertebral and lumbar arterial supplies and is a vulnerable zone of relatively decreased perfusion
mid thoracic region (T4-T8
67
what is most susceptible to infarction during thoracic surgery?
mid thoracic region
68
why is the mid thoracic region a vulnerable zone of relatively decreased perfusion?
because we are getting a feed of vertebral arteries going to the cervical spinal cord
69
venous return from the spinal cord initially drains into ____
Batsons plexus
70
Batsons plexus, is a plexus of veins in the ___, before returning to systemic circulation
epidural space
71
Batsons plexus do not contain valves, so elevated intrabdominal pressure can cause reflux of blood carrying metastatic cells (prostate cancer) or ____
pelvic infections into epidural space (challenge in treating here)
72
upper motor neurons (cortex) carry motor system output to the lower motor neurons (___ and ___)
brainstem and spinal cord
73
what are the lower motor neuron types?
alpha, gamma and beta motor neuron types
74
-most common and innervate skeletal muscles
-sensory info comes in and forms interferon synapse or direct synapse pathway, then ventral horn to ventral root
-acetylcholine neurotransmitter leads to contraction, action potential following this always leads to contraction but not always in the brain
alpha motor neuron
75
innervates muscle spindles, controls stretch reflexes (this helps protect the muscles)
gamma motor neurons
76
less common, innervate muscle fibers inside and outside of muscle spindles
beta motor neurons
77
The ____ is essential for rapid, dexterious movements at individual digits or joints
lateral corticospinal tract
78
the function of the ___ is unknown
rubrospinal tract
79
both rubrospinal tract and lateral corticospinal tract cross over and descend to control ____
contralateral extremities
80
-control over upper limb position
-modulating flexor movements; decreasing angles to the axis in our muscle and our posture.EX: in posture with abnormal flexion of upper limbs with extension of lower limbs results in painful trauma response (Qb of dolphins)
-what happens here is a loss of info coming into the cortex that controls your motor behaviors and there is a disinhubtion on the red nucleus which causes you to go in flexor movements
rubrospinal tract possible function
81
both rubrospinal tract and lateral corticospinal tract will project to the ___.
lateral anterior horn cells
82
the medial motor systems project to the ___
medial anterior horn cells
83
what is part of the medial motor systems?
anterior corticospinal vestibulospinal, recticulospinal and tectospinal tract
84
control bilateral axial and girdle muscles
anterior corticospinal vestibulospinal tract
85
controls automatic posture (any gait related movements, by controlling muscle spindles)
-responsible for bilateral coordination (needed for postural movements or locomotion) EX: starting to walk
recticulospinal tract
86
-control coordination of reflexes and eye movements (in animals, uncertain in humans)
-pathway here that is basal ganglia independent that regulates motor movements (in humans but is not a common pathway that is activated)
-EX: walking and see something in periphery vision coming towards us and you shut down basal ganglia so we move out of the way (reflex movement)
tectospinal tract
87
control the position of head and neck
medial vestibulospinal tract
88
control balance
lateral vestibulospinal tract
89
together the medial and lateral vestibulospinal tract control ___ and ____
tone and posture
90
lateral anterior horn cells control ____ of extremities, while medial anterior horn cells control ____ muscles (back)
1. distal
2. proximal
91
The medial motor systems terminate on ___ that project to both sides of the cord, so unilateral lesions of the medial motor systems dont produce obvious deficits
interneurons
92
over 1/2 of the corticospinal tract originate in the ____
primary motor cortex (BA 4)
93
The other 1/2 of the corticospnal tract arise from the _____ and ___ or from the ____
premotor and supplementary motor areas (BA 6) or the parietal lobe (BA 3,1,2,5,7)
94
The primary motor cortex neurons are mainly in cortical ____(betz cells) and synapse directly in the ventral horn of the spinal cord
layer 5
95
what are the three parts of the internal capsule
anterior, posterior and Genu
96
located at the intraventricular foramen of Monro which is associated with the ventricles (CSF flow from lateral ventricles to the intraventricular foramen of monro to the third ventricles)
anterior and Genu internal capsule
97
-separates head of caudate from globus Pallidus and putamen
-contains anterior thalamic radiations
anterior internal capsule
98
caudate and putamen make up the ___
striatum
99
putamen and globus pallidus make up the ___
lepiform nucleus
100
-separates thalamus from globus pallidus and putamen
-contains the corticospinal tract and corticopontine tract (project to pons)
posterior internal capsule
101
-knee of internal capsule
-at the level of the foramen of Munro
-contains superior thalamic radiations (VA and VL sensory to motor regions of frontal lobe), frontopontine tract, corticobulbar, and CST)
Genu
102
The somatopic map is preserved in the internal capsule (___ is anterior, ___ posterior)
face, limbs
103
at the cervicomedullary junction, about ___ of the CST decussates to form the LCST
85%
104
about 15% of CST fibers continue ___ to form the ACST
ipisilaterally
105
lesion on corticospinal tract at level of cortex it will produce a deficit on ___ side
contralateral
106
lesion on rostural medulla produce deficit ____side
contralateral
107
lesion at internal capsule leads to ___
contralateral
108
lesion at midbrain and pons leads to ___
contralateral side
109
lesion on spinal cord leads to ___
ipsalateral
110
In ___, cells project directly from the CNS to the skeletal muscle
somatic efferents
111
in ___, there is a peripheral synapse located ganglion interposed between the NCS and the effector gland or smooth muscle
autonomic efferents
112
The ANs has 2 main subdivisions: _____
SNS and PNS
113
has neural plexus that likes the walls of the gut which controls movement through the Gut and GI secretions
enteric
114
-arises in T1 to L2
-fight or flight
-release NE onto end organs
sympathetic
115
-arise from cranial nerve nuclei and also from S2-S4
-rest and digest
-release ACh
parasympathetic
116
one exception to neurotransmitter is the ____, which are innervated by sympathetic neurons that release ACh
sweat glands
117
parasympathetic postganglionic fiber ACh on ____
muscaranic receptors
118
sympathetic and parasympathetic preganglionic fiberes release ACh that can act on ___ or __ or __
muscarnic ACh, nicotonic ACh, or NE receptors
119
upper motor neuron lesion what signs do you have?
weakness, increased reflexes and increased tone, positive Babinski sign (bc of loss of descending info coming in)
120
lower motor neuron lesion what signs do you have?
weakness, atrophy, fasciculations (twitching), decreased relfexes, decreased tone
121
___ has increased muscle tone from tremors at rest, and have increased rigidity because decrease in flexibility
parkinsons
122
-gradual degeneration of both upper and lower motor neurons
-usual onset in 50s to 60s
-most cases are sporadic, some autosomal dominant, recessive or X-linked
-weakness/clumsiness that begins focally and then spreads to adjacent muscles
-painful cramping
-survival is 23-52 months
-riluzole extends life several months
amyotrophic lateral sclerosis
123
-just decreases cramping
-allosteric binding from GABA receptor, increasing GABA signaling
-targets voltage gated Na+ channels TTX, goal to inhibit glutamate
riluzole
