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Neuroscience > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Somatosensation

A

Sensory information from skin and musculoskeletal system

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2
Q

Speed of somatosensation information processing is determined by:

A
  1. Diameter of axons
  2. Degree of axonal myelination
  3. Number of synapses in the pathway
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3
Q

Define cutaneous innervation

A

Receptive fields overlap which leads to better localization, and protection from loss of neurons and their individual receptive fields.

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4
Q

Which region of cutaneous innervation has greater density of receptors?

A

Distal regions

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5
Q

In what 2 ways is touch defined?

A

Fine: variety of receptors and subsensations
Coarse: mediated by free endings throughout skin

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6
Q

Describe intrafusal fibers

A

Contractile only at the ends; central region cannot contract

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7
Q

Describe the primary endings of Type Ia neurons

A

Wrap around central region of each intrafusal fiber

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8
Q

Describe secondary endings of TII afferents

A

End on nuclear chain fibers adjacent to primary endings

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9
Q

What are the different joint receptors?

A

Ligament receptors (1b)
Ruffini’s and Paciniform endings (II)
Free nerve ending

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10
Q

What are the 2 types of Large myelinated fibers for proprioception

A

1a: muscle spindles
1b: GTO, Ligament receptors

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11
Q

What are different receptors of medium myelinated receptors for proprioception?

A

II: Muscle spindle, Paciniform and Ruffini-type

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12
Q

What are the medium myelinated receptors for cutaneous and subcutaneous touch and pressure?

A

A-beta: Meissner’s, Pacinian, Ruffii’s, Merkel’s, hair follicle

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13
Q

What are the receptors of small myelinated receptors for pain and temperature?

A

A-delta: Free nerve endings

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14
Q

What type of sensations do A-delta fibers sense?

A

Fast, sharp pain and cold

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15
Q

What are the receptors of small unmyelinated receptors for pain and temperature?

A

C: Free nerve ending

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16
Q

What type of sensations do C fibers sense?

A

Slow, aching pain and hot

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17
Q

Describe Conscious relay

A

Transmit info to many locations in brainstem and cerebrum; has high fidelity to make fine distinctions about stimuli

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18
Q

What are the 4 types of somatosensation that reach conscious awareness?

A
  1. Touch
  2. Proprioception
  3. Temperature
  4. Pain
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19
Q

Describe divergent diffuse systems

A

Transmit info to many locations in brainstem and cerebrum; Info used at both conscious/unconscious levels

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20
Q

What are the 3 types of divergent diffuse systems ?

A
  1. Discriminative touch
  2. Conscious proprioception
  3. Stereognosis
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21
Q

What is unconscious relay?

A

Unconscious proprioceptive and other movement-related info carried to cerebellum; Essential role in automatic adjustment of movements and posture

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22
Q

Spinocerebellar

A

Movement-related info; terminates at cerebellum

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23
Q

DC/ML system transmission

A

DRG–>GN or CN–>VPL–>Somatosociation cortex area

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24
Q

What happens with injuries below Caudal medulla

A

Sensory impairments on same side of injury

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25
Q

What happens with injuries above Caudal medulla

A

Sensory impairments on opposite side of injury

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26
Q

Describe movement of information from the face

A

Trigeminal ganglia–>CSNU (pons)–>VPM (in Thalamus)–>Trigeminal neuron (CC)

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27
Q

How is temperature sensation detected?

A

Heat/Cold detected by specialized free nerve endings of small myelinated and unmyelinated neurons

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28
Q

Nociceptive pain

A

Receptors or neurons that receive/transmit info about stimuli that damage or threaten to damage tissue

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29
Q

What is the Spinothalamic pathway associated with?

A

Fast pain; temp contralateral

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30
Q

What is the Spinolimbic pathway associated with?

A

Slow pain; dull, throbbing ache following fast pain that is not well localized

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31
Q

Transmission of fast, localized nociception in lateral system:

A

DRG–>Dorsal horn SC–>Cross midline–>VPL (Thalamus)–>Somatosensory Cortex

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32
Q

Crossed angalgesia

A

Lesion in Pons/Medulla; Loss of pain sensation to IPSILATERAL face and CONTRALATERAL body

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33
Q

Lesions to Cerebrum, Midbrain, or Upper pons results in:

A

Entire Contralateral loss

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34
Q

Damage to Lower pons, or medulla results in:

A

Crossed analgesia

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35
Q

Damage to Spinal region results in:

A

Loss of pain/temp sensation from contralateral body 1-2 levels below sensation

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36
Q

Damage to Peripheral region results in:

A

Ipsilateral loss

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37
Q

What happens:

Right side complete T4 damage

A

DC/ML: Right side damage T4 and down resulting in loss of CP and DT
Spinothalamic: Left side T5/T6 down resulting in loss of pain and temp.

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38
Q

What happens:

Injury to both dorsal columns at C3

A

Both side DC/ML damage C3 and down causing both sided loss in DC and CP

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39
Q

What happens:

Injury to VPL/VPM on R

A

All sensations (P/T, DT/CP) lost on contralateral side

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40
Q

What happens:

Injury to medial CC left

A

DC/ML loss in DT/CP and Spinothalamic loss in P/T both on contralateral side

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41
Q

What happens:

Injury to lateral CC right

A

Spinaltrigeminal loss in P/T in contralateral face/Hand

Trigeminalthalamic loss in CP/DT

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42
Q

What happens:

Injury to medulla on right

A

Loss P/T ipsilateral face, contralateral body

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43
Q

What sensations does the Spinothalamic pathway pick up?

A

Sharp/dull pain

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44
Q

What does activation of the medial pain system result in?

A

Affective, motivational, withdrawal, arousal and autonomic responses

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45
Q

Describe Spinomesencephalic tract:

A
  • Not perceived as pain
  • Nociceptive info to SC and PG
  • SC (tectum): Orient vision to pain
  • PG: Regulate pain perception
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46
Q

Describe Spinoreticular tract:

A
  • Not perceived as pain

- Modulates arousal, attention, and sleep-waking cycles

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47
Q

Describe Spinolimbic tract:

A
  • Slow pain info to medial and intralaminar nuclei in thalamus
  • Emotional response to noxious stimuli
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48
Q

Describe Trigeminoreticulolimbic pathway:

A
  • Slow pain info from face

- If doesn’t reach Thalamus, not interpreted

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49
Q

What happens to info that doesn’t reach conscious awareness?

A
  • Contribute to arousal
  • Gross localization
  • Autonomic regulation
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50
Q

What does the Spinothalamic pathway sense?

A

Hot and cold

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51
Q

What do the unconscious relay tract to cerebellum do?

A
  • Activity in spinal interneurons

- Adjust movements

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52
Q

What does inadequate proprioceptive input to unconscious relay tract to cerebellum cause?

A

Ataxia

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53
Q

What are the 2 pathways that relay high-fidelity information?

A
  • Posterior spinocerebellar: from legs and lower 1/2 of body

- Cuneocerebellar: Arm and upper 1/2 of body

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54
Q

What side information do internal feedback tracts produce?

A

Ipsilateral

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55
Q

What are the 2 internal feedback tracts?

A
  • Anterior spinocerebellar: from thoracolumbar SC

- Rostrospinocerebellar: from cervical SC to ipsi cerebellum

56
Q

Describe Spinocerebellar tracts:

A
  • Info from proprioceptors, spinal interneurons, descending motor pathways
  • Info that doesn’t reach conscious awareness contributes to automatic movements and postural adjustment
57
Q

What are the tests for somatosensation for?

A
  • DT
  • CP
  • Fast pain
  • Discriminative temp
58
Q

What are the 6 guidelines to improve reliability of sensory testing

A
  1. Quiet setting
  2. Seated or lying on firm surface
  3. Explain
  4. Demonstrate
  5. Block vision
  6. Apply stimuli near center of dermatome
59
Q

Examples of damage to nerve(s):

A
  • Stroke or diabetic neuropathy: body region

- SCI or nerve root damage: dermatome

60
Q

What are the 2 different Electrodiagnostic studies?

A
  • Nerve conduction (PNS)

- Somatosensory-evoked (CNS)

61
Q

Describe Nerve conduction study

A

-Stimulate in periphery, measure in periphery

62
Q

3 numerical values compared during Electrodiagnostic studies:

A
  • Distal latency
  • Amplitude
  • Conduction velocity
63
Q

Will a nerve conduction study pick up MS?

A

No; NCS tests in periphery and MS takes place in CNS

64
Q

Describe Somatosensory-evoked potentials

A
  • Function of pathway from periphery to Upper SC or to CC
  • Stim in periphery, record in CNS
  • Verify subtle signs and locate lesions
65
Q

Will Somatosensory-evoked potentials pick up MS?

A

Yes; Somatosensory-evoked potentials test in CNS

66
Q

Define ataxia:

A
  • Incoordination not d/t weakness

- Damage to cerebellum

67
Q

What are the 3 types of Sensory ataxia?

A
  • Sensory
  • Vestibular
  • Cerebellar
68
Q

What is sensory ataxia?

A

Balance with eyes open, not with eyes closed

69
Q

What is cerebellar ataxia?

A
  • Can’t balance with eyes open or closed

- Wide-based stance

70
Q

Describe Romberg test

A

-Pt stands up, feet together, close eyes, to see if balance loss

71
Q

What is the order of loss of senses?

A

(Loss in order to 1st to last; regain from last to 1st)

CP/DT, cold, fast pain, heat, slow pain

72
Q

Transection

A
  • All sensation prevented 1-2 levels below lesion

- Voluntary motor control below lesion lost

73
Q

Hemisection (Brown-Sequard lesion)

A
  • Spinothalamic: Complete loss of pain 2-3 dermatomes below lesion contralateral
  • DC/ML: DT/CP lost ipsilateral to lesion
74
Q

Describe posterior column lesions:

A
  • CP, 2pt discrimination, vibration lost below level of lesion
  • Ataxic movement
  • Unable to recognize objects by palpation if lesion above C6
75
Q

Common causes of posterior column lesions

A
  • Untreated syphilis

- Whiplash

76
Q 
Damage to Spinal N will result in losses to:
DC/ML:
Spinothalamic:
Trigeminothalamic:
Spinotrigeminal:
A

DC/ML: I
Spinothalamic: I
Trigeminothalamic: X
Spinotrigeminal: X

77
Q 
Damage to Trigeminal N will results in losses to:
DC/ML:
Spinothalamic:
Trigeminothalamic:
Spinotrigeminal:
A

DC/ML: X
Spinothalamic: X
Trigeminothalamic: I
Spinotrigeminal: I

78
Q 
Damage to SC will result in losses to:
DC/ML:
Spinothalamic:
Trigeminothalamic:
Spinotrigeminal:
A

DC/ML: I
Spinothalamic: C
Trigeminothalamic: X
Spinotrigeminal: X

79
Q 
Damage to Lateral Medulla will result in losses to:
DC/ML:
Spinothalamic:
Trigeminothalamic:
Spinotrigeminal:
A

DC/ML: X
Spinothalamic: C
Trigeminothalamic: X
Spinotrigeminal: I (Crossed analgesia)

80
Q 
Damage to the Midbrain will result in losses to:
DC/ML:
Spinothalamic:
Trigeminothalamic:
Spinotrigeminal:
A

DC/ML: C
Spinothalamic: C
Trigeminothalamic: C
Spinotrigeminal: C

81
Q

Describe central cord syndrome:

A
  • P/T sensation lost at level of injury

- Lesion in ventral white commissure

82
Q

Causes of central cord syndrome

A

Syringomyelia, Trauma, Shingles

83
Q

Somatosensory cortex lesion:

A
  • Loss of discriminative sensations

- Sensory extinction: unilateral neglect

84
Q

Referred pain from heart:

A
  • Sensory input from heart

- P/T neurons carry sensation to cortex for that part of arm

85
Q

Pain matrix:

A
  • Brain process and regulate pain info
  • Capable of creating pain perception in absence of nociceptive input
  • Antinociception: inhibit pain
  • Pronociception: Increase pain
86
Q

What is motivational-affective pain?

A
  • Experience on emotions and behavior

- Increased arousal and avoidance

87
Q

What is cognitive-evaluative pain?

A

-Meaning person ascribes to the pain

88
Q

What happens with injury of the anterior cingulate cortex?

A
  • Block emotional aspects of pain

- Discrimination still intact

89
Q

Gate theory:

A

-1st explanation propose of how pressure inhibits pain transmission

90
Q

Counterirritant theory:

A
  • Inhibition of nociceptive signals
  • Stimulation of nonproprioceptive receptors
  • Dorsal horn SC
91
Q

4 types of dorsal horn processing

A
  • Normal
  • Suppressed: N
  • Sensitized: N
  • Reorganized: P
92
Q

What are the 3 sites of antinociception?

A
  • Spinolimbic: Periphery–>Thalamus
  • Spinomesencephalic: Periphery–>Midbrain PAG
  • Spinoreticular: Periphery–>Reticular formation, etc.
93
Q

What do Locus ceruleus and Raphi make?

A

Locus ceruleus: NE

Raphi: Serotonin

94
Q

What are the different types of Pronociception?

A
  • Edema and endogenous chemicals

- Anxiety/depression

95
Q

Nociceptive chronic pain:

A
  • D/t continuing nociceptive stim
  • Primary: sensitivity in injured tissue
  • Secondary: sensitivity in uninjured tissue
96
Q

What is chronic pain?

A

Inhibitory/excitatory circuits in CNS either diminish or amplify pain

97
Q

4 types of chronic pain:

A
  • Nociceptive:
  • Neuropathic:
  • Pain matrix dysfunction:
  • Pain syndromes
98
Q

What are some causes of Nociceptive pain?

A
  • Mechanical LBP
  • Cancer
  • Arthritis
  • Burns
99
Q

What are some causes of Neuropathic pain?

A
  • Nerve entrapment/compression
  • CNS pain
  • Diabetic/Gullian-berre neuropathy
  • Phantom limb pain
100
Q

What are some causes of Pain matrix dysfunction?

A
  • Fibromyalgia
  • Whiplash
  • Headache
  • Antinociception reduced or pronociception intensified
101
Q

What are some causes of Pain syndromes?

A
  • CRPS

- Chronic LBP

102
Q

What is Neuropathic pain?

A
  • Arise from consequence of lesion of disease to somatosensory system
  • Genetic basis: Less enzyme regulating Cat. and encephalin
103
Q

Symptoms of Neuropathic pain:

A
  • Paresthesia: abnormal sensation
  • Dysesthesia: Unpleasant sensation
  • Allodynia: pain that shouldn’t be painful
  • Secondary hyperalgesia: Pain in uninjured tissue
104
Q

5 mechanisms of Neuropathic pain:

A
  • Ectopic foci
  • Ephaptic transmission:
  • Central sensitization
  • Structural reorganization
  • Altered top-down regulation
105
Q

Ectopic foci:

A
  • Damaged myelin
  • Excess Mechano/chemo ion channels
  • Demyelianted regions generate APs
106
Q

Ephaptic transmission:

A

-Cross-talk between axons in demyelinated regions

107
Q

Central sensitization:

A
  • Sensitization of CNS output

- CNS sends strong nociceptive info

108
Q

Structural reorganization:

A
  • Nociceptive neuron dead
  • Touch neurons sprouts
  • Touch now seen as painful
109
Q

Generation of neuropathic pain in the periphery:

A
  • Nerve resection
  • Partial damage: allodynia, Eshock
  • Ephaptic transmission
  • Ectopic foci
110
Q

Generation of neuropathic pain in CNS

A
  • Neuron active when periphery is absent
  • Deafferentation: burning pain
  • SCI: Thalamus
  • MS:
111
Q

Different types of Top-down regulation:

A
  • Fibromyalgia
  • Tension-type headache
  • Migraine, whiplash
112
Q

Pathophysiology of Fibromyalgia:

A
  • Substance P and glutamate 2x normal

- Decreased pain inhibition

113
Q

Criteria for tension-type headache:

A
  • Mild-mod bilateral pain
  • 30 min-7days
  • Not agg. by PA
  • No nausea/vom

-Supersens. of N.O

114
Q 
Pharmacological treatment of pain and where they focus on:
CC:
PAG:
Rostral ventromedial medulla:
Dorsal horn:
A

CC: Opioids, TCAs, SSRIs, SNRIs
PAG: Opioids, NSAIDs
RVM: Cannabinoids, opioids
DH: TCAs, Cannabinoids, Opioids

115
Q

What are the 3 D’s of chronic pain

A
  • Distress
  • Disuses
  • Disability
116
Q

Interventions that may decrease activation of pain and improve coping:

A
  • Relaxation
  • Biofeedback
  • Imagery
  • CBT
117
Q

What is the site of Chemoreceptors for pH?

A

Medulla

118
Q

What are the chemoreceptors for O2?

A

Carotid and aortic bodies

119
Q

What are the chemoreceptors for Glucose and electrolytes?

A

Hypothalamus

120
Q

What sensations do CNs VII, IX, X carry?

A
  • All: taste

- IX, X: Visceral sensation

121
Q

What visceral control is Medulla responsible for?

A

-HR, Breathing, BV regulation

122
Q

What visceral control are pons responsible for?

A

Respiration

123
Q

What visceral modulation is Hypothalamus responsible for?

A
  • Master control homeostasis

- CV, Metabolic, electrolyte, digestion

124
Q

What visceral modulation is Thalamus responsible for?

A
  • Relay station to limbic system/cortex

- Visceral function and emotions

125
Q

What visceral modulation is Limbic system responsible for?

A

-Physiology and emotions

126
Q

Preganglionic neuron found in spinal levels:

A

T1-L2

127
Q

What eye functions are cholinergic neurons for?

A

Dilation

128
Q

What eye functions are adrenergic neurons for?

A

Constriction

129
Q

What are some of the activities that Sympathetic cervical ganglion is responsible for?

A
  • Pupil dilation
  • Increase metabolic rate: warm
  • Decrease BF to skin: warm
  • Sweating: cool
  • Piloerection: warm
130
Q

What spinal levels is Craniosacral in:

A

S2-S4

131
Q

What is CN III responsible for?

A
  • Oculomotor
  • Constrict pupil
  • Inc. convexity of lens (near vision)
132
Q

What is CN VII responsible for?

A
  • Facial

- Salivary glands

133
Q

What is CN IX responsible for?

A
  • Glossopharyngeal

- Salivary/lacrimal glands

134
Q

What is CN X responsible for?

A
  • Vagus

- 75% Autonomic efferents

135
Q

Unique functions of Sympathetic system:

A
  • Limbs, face, body wall

- Elevate upper eye lid

136
Q

Unique functions of Parasympathetic system:

A

-Increase convexity of lens (near vision)

137
Q

Describe Horner’s Syndrome:

A
  • Dmg to Cervical Gang.
  • Ipsi face redness
  • Drooping eye lid
  • Face flushing
  • Caused by pancoast tumor

Neuroscience (6 decks)

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