NEURO 7 Flashcards by Kirsten Lederer

Lateral corticospinal tract
function
decussation

motor

pyramidal decussation at cervicomedullary junction

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Posterior column-medial lemniscal pathway
function
location

sensory (vibration, propioception, fine touch)

internal arcuate fibers at lower medulla

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Anterolateral pathway
function
location

sensory (pain, temperature, crude touch)

anterior commissure in spinal cord

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sensory neruon bodies located in

dorsal root ganglia

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Sensory neuron fiber A-alpha
Name
Myelination
Receptors
Sensory modalities

I
Yes
Muscle spindle, golgi tendon
propioception

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Sensory neuron fiber A-beta
Name
Myelination
Receptors
Sensory modalities

II
Yes
Muscle spindle, Meissner’s corpuscle, Merkel’s receptor, Pacinian corpuscle, Ruffini ending, hair receptor
Superficial touch, proprioception, deep touch, vibration

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Sensory neuron fiber A-delta
Name
Myelination
Receptors
Sensory modalities

III
Yes
Bare nerve ending
Pain, cool temperature, itch

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Sensory neuron fiber C
Name
Myelination
Receptors
Sensory modalities

IV
No
Bare nerve ending
pain, warm temperature, itch

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Order of sensory neuron fibers from small to large

C < A-delta < A-beta < A-alpha

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Lesions of somatosensory cortex and adjacent regions cause

cortical sensory loss

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Gate control theory

sensory inputs from large A-beta fibers reduce pain transmission through dorsal horn

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Reduce chronic pain by activating

A-beta fibers - shaking thumb after hammer

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periaqueductal gray receives inputs from ___,___,___ and inhibits pain transmission in the ___

hypothalamus, amygdala, cortex

rostral ventral medulla

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What modulates pain in the dorsal horn

serotonergic 5-Ht

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contributes to pain modulation through H3 receptors

histamine

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opiate receptors and endogenous opiate peptides found in high concentration

key points in pain modulatory pathways

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thalamus is part of what part of the brain

diencephalon

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Ventral posterior lateral nucleus
Main input
Main output
Function

Medial leniscus, spinothalamic tract
somatosensory cortex
relays input to cortex

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Ventral posteromedial nucleus
Main input
Main output
Function

trigeminal lemniscus, trigeminothalamic tract, taste inputs
somatosensory and taste cortex
relays inputs to cortex

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Lateral geniculate nucleus
Main input
Main output
Function

Retina
Primary visual cortex
relays inputs to cortex

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Ventral lateral nucleus
Main input
Main output
Function

internal globus pallidus, deep cerebellar nuclei, substantia nigra pars reticulata

motor, premotor and supplementary motor

Relays basal gangliaand cerebellar inputs to cortex

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Medial geniculate nucleus
Main input
Main output
Function

inferior colliculus
Primary auditory cortex
relays auditory inputs to cortex

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Ventral anterior nucleus
Main input
Main output
Function

substantia nigra pars reticulata, internal globus pallidus, deep cerebellar nuclei
Frontal lobe
Relays basal ganglia and cerebellar inputs

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Pulvinar
Main input
Main output
Function

Tectum
Paritotemporooccipital association
Behavioral orientation towards relevant visual stimuli

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Mediodorsal nucleus Main input Main output Function

amygdala, olfactory, limbic basal ganglia frontal cortex limbic pathways, major relay to frontal cortex

Anterior nucleus Main input Main output Function

mammillary body, hippocampal foramtion cingulate gyrus limbic pathway

centromedian nucleus Main input Main output Function

AGlobus pallidus, ARAS striatum, cerebral cortex motor relay for basal ganglia

Only nucleus of thalamus that does not project to cortex

reticular, consists purely of inhibitory GABAergic neurons

Lesions in posterior column - medial leniscal pathway

tingling, numbness, bandlike sensation, fingers wrapped in gauze

Lesions in anterolateral pathways

sharp, burning, searing pain

Lesions of parietal lobe or primary sensory cortex

CL numb tingling and pain

Lesions of thalamus

CL pain = Dejerine - ROussy syndrome

Lesions of cervical spine

Lhermitte's sign = electricity like sensation down back w/ neck flexion

Lesions of nerve roots

radicular pain which radiates in dermatomal pattern

dysesthesia

unpleasant abnromal sensation

allodynia

painful sensation provoked by nonpainful stimuli

hyperpathia or hyperalgesia

enhanced pain to painful stimuli

hypesthesia

decreased sensation

spinal shock

flaccid paralysis below lesion

What is used to treat acute traumatic spinal cord lesions

steroids

What usually causes chronic myelopathy

degenerative disorders of the spinal

cord compression by tumors can eventually cause

irreversible loss of ambulation

what causes infarction of spinal cord

anterior spinal artery occlusion due to trauma, aortic dissection, thromboemboli and disc emboli

MRI of myelitis

T2 bright areas, CSF has elevated WBCs, lymphocytic predominant

Primary Somatosensory cortex lesion

deficit is CL, discriminative touch and joint position most severely affected or cortical sensory loss is present w/ extinction sterognosis and graphesthesia

Thalamic Ventral posterior lateral and medial nuclei lesion

deficit is CL, more noticeable in hand, face, foot - all sensory modalities involved

Lateral pons or medulla lesion

IL: causes loss of pain and temp in face CL: causes loss of pain and temp in body

Medial medulla lesion

CL loss of vibration and joint position sense

Nerve root lesion

glove and stocking distribution

Transverse cord lesion

Sensory and motor pathway interrupted

Hemicord Lesion = Brown-Sequard Syndrom

Lateral corticospinal tract damage = IL UMN weakness Posterior column damage = IL loss of vibration and joint position sense Anteriolateral system damage = CL loss of pain and temperature ** may also cause sensory loss to pain and temperature on IL

Small Central cord syndrome

bilateral regions of suspended sensory loss to pain and temperautre

Lesion of cerival cord

cape distribution of pain and temperature

Large Central cord syndrome

sacral sparing

Posterior cord syndrome

loss of virbation and position sense below the level of the lesion

Anterior cord syndrome

Anterolateral pathway: loss of pain and temperature below lesion Anterior horn: LMN weakness at level of lesion Large = incontinence and UMN

Bladder Normal function Lesion in bilateral medial frontal micturition centers Lesion below pontine micturiton center Lesion of peripheral nerve S2-S4

completely volunteer medial frontal micturition center = activates voiding/detrusor reflex which is regulated by pontine micturition center urine flow and bladder emptying no longer under voluntary control flaccid, acontractile (atonic) bladder flaccid areflexic bladder

Bowel | Normal

Sphincter closure maintained by internal smooth muscle sphincter innervated by parasympathetics, external striated muscle sphincter innervated from Onuf's nucleus and pelvic floor muscles from sacral anterior horn

Bowel lesions

fecal incontinence and constipation

Sexual function | Normal

sensation from genitalia via pudendal nerve S2-S4, lubrication from Bartholin's glands (parasympathetic) and increased vaginal blood flow (sympathetic), ejaculation sympathetic

Sexual function lesion

reflex erection and ejaculation possible but variable

NEURO 7 Flashcards

(61 cards)