Thalamus & Thalamocortical Relationships Flashcards

1
Q

How are the thalamus on each side connected?

A

Thalamic adhesion (massa intermedia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the thalamic relay nuclei (two sensory and two motor)?

A

Sensory:
VPL and VPM

Motor:
VA (to 6) and VL (to 4)

These project to a specific cortical area?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are thalamic association nuclei?

A

These connect diffusely to multiple cortical and subcortical areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are all the thalamic association nuclei?

A
  1. Anterior (ANT)
  2. Dorsomedial (DM)
  3. Intralaminar (CM-PF)
  4. Pulvinar (PULV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the epithalamus include?

A

Pineal body and habenula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the metathalamus include?

A

Medial and lateral geniculate nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What separates the thalamus from the hypothalamus?

A

Hypothalamic sulcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What divides the thalamus along its anterior-posterior axis and what is embedded in it?

A

Internal Medullary Lamina, includes the intralaminar nuclei. This is a myelinated axon bundle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What myelinated axon band surrounds the alteral surface of the thalamus, and what is lateral to it?

A

External Medullary Lamina. Lateral to it is the thalamic Reticular Nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is the thalamus lateral or medial to the posterior limb of the internal capsule? How does it relate to the ventricles?

A

Medial to posterior limb of internal capsule, inferior to the lateral ventricle, lateral to the third ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you differentiate between VA and VL thalamus?

A

VL thalamus will be found when there are three thalamic nuclei visible, including the small Lateral Dorsal nucleus (midthalamic level)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What three nuclei are present at the mid-thalamic level? What is present here most ventrally?

A

LD, VL, and DM

Most ventrally, the mamillary bodies will be present here

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does VL thalamus do?

A

Relays basal ganglia and cerebellar motor information to primary motor cortex (area 4) for fine regulation of voluntary movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does VA thalamus do?

A

Relays basal ganglia information to premotor cortex where motor programs are stored (area 6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where do ANT/LD thalamus project to?

A

Cingulate cortex - for limbic system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where does DM thalamus project to? Where does it receive input from?

How large is it?

A

Receives input from prefrontal cortex and amygdala, projects to prefrontal cortex

2nd largest thalamic nucleus, behind pulvinar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does LP/PULV receive input from, and which one is primary? Where does PULV project to?

A

Input from retina, superior colliculus, and visual cortex. Primary is visual cortex.

PULV projects to parieto-temporal-occipital cortices.

18
Q

What is the primary cortical regulator of thalamocortical rhythmicity?

A

Reticular Thalamic Nucleus. This receives input from the cortex and projects to the thalamus, but thalamus to does not project to it

19
Q

What causes thalamocortical dysrhythmia?

A

Loss / alteration of afferent input to the thalamus, including reticular thalamic nucleus, cerebral cortex, cerebellum, spinal cord / brainstem, or basal ganglia

20
Q

What is the postulated underlying cause of Parkinsonian tremors, intention tremors, or chronic intractible pain? How is it corrected?

A

Dysrhythmias due to loss of afferent input into the thalamus, causing thalamocortical dysrhythmia (TCD)

It is corrected via stereotaxic thalatomy or deep brain stimulation

21
Q

What causes the difference between an action tremor and a resting tremor?

A

Cerebellar vs GPi/SNr projections to the thalamus disrupt the rhythmicity of different motor thalamic cell populations.

22
Q

Where is Vim and what is it?

A

Ventral intermediate nucleus, located in ventrocaudal region of VL. It is the “muscle sensor” which picks up unconscious proprioceptive information from the efferents of cerebellum (via DSCT).

23
Q

What is Vim’s role in the firing rates of action vs resting tremors?

A

Vim cells have firing rates that are timelocked with peripheral tremors in patients with parkinson’s disease or essential tremor (a type of action tremor).

This is the nucleus that is targeted for surgical lesions (thalatomy) or deep brain stimulation.

24
Q

What can cause thalamic pain syndrome?

A

Any disruption of the ventral posterior (VP) thalamus, including tearing away of brachial / lumbosacral plexuses, herpes neuralgia, SCI, or strokes.

This results in TCD in CM-PF and CL nuclei which are involved in the limbic system transmitting pain.

25
Q

What is the CL nucleus? (central lateral) Where does it receive info from and give output to?

A

An intralaminar nucleus along the lateral edge of the DM thalamus.

It receives info from lamina X spinal neurons which carry viscerosensory information (organ afferents).

It projects to the limbic association and insular cortexes for mediating emotional responses to pain.

CL thalatomy has been shown to help with chronic intractable pain.

26
Q

What releases histamine into the telencephalon and diencephalon?

A

Hypothalamus

27
Q

What nuclei in the thalamus are particularly sensitive to arousal, and project to the cortex / BG?

A

Intralaminar thalamus (CM-PF, CL), sensitive to arousal via locus ceruleus, raphe nuclei, PPN (ACh), and hypothalamus.

They project to the cortex for arousal and alertness, and the basal ganglia via the thalamostriatal projections

28
Q

What do lesions of the intralaminar thalamus cause? Unilateral or bilateral?

A

Altered states of consciousness (acute mania, delirium).

Unilateral = Hemispatial unawareness
Bilateral = Coma
29
Q

How does the hippocampus communicate with the thalamus for memory information?

A

Hippocampus projects to mammillary body.

Mammillary body projects ANT nucleus of thalamus via mammillothalamic tract

30
Q

What lesion will cause severe memory deficits and what is one cause?

A

Lesion to anterior nucleus of thalamus, mammillary bodies, or mammillothalamic tract.

One cause: Korsakoff’s psychosis due to B1 deficiency

31
Q

Since LD thalamus is the partner to ANT thalamus, what is its function in memory?

A

No direct connection to the mammillary bodies, however, it connects to the parietal cortex and functions in memory related to spatial navigation

32
Q

What is the function of the DM thalamus with relation to the limbic system?

A

Communicates with amygdala and prefrontal cortex for emotional processing. Lesions will decrease emotional responses.

33
Q

What is the function of the DM thalamus with relation to the eye movements?

A

It stabilizes the visual perception during eye movements, especially saccadic ones.

Superior colliculus sends copy of image to FEF via the DM thalamus, and then FEF determines which way to move eyes in saccades.

34
Q

What is the general function of the pulvinar?

A

Functions in visual awareness and maintenance of visual attentiveness to a particular feature in a visual scene

35
Q

What will people with PULV damage experience difficulty with?

A

Temporal visual attentiveness problems, which is needed to focus on a second visual target of behavioral relevance after already being attentive to a first object

36
Q

What is the most common cause of thalamic damage?

A

Hemorrhagic stroke

37
Q

What two arteries supply thalamus?

A
  1. Posterior communicating artery

2. Posterior cerebral artery

38
Q

Why do thalamic strokes imitate other types of strokes?

A

Vascular accidents overlap a number of functional areas and produce a mixture of symptoms

39
Q

What thalamic nuclei do “Polar Zone” hemorrhagic strokes affect, and what are the patient’s symptoms?

A

Affects VA / ANT nuclei. This causes problems with executive motor programs for area 6 (apraxia), and memory due to ANT (disorientation)

40
Q

What thalamic nuclei do “Thalamo-Perforating Zone” hemorrhagic strokes affect, and what are the patient’s symptoms?

A

Affects DM and intralaminar thalamic nuclei. Produces decreased arousal and coma if bilateral (intrathalamic nuclei). Patients can show personality changes like apathy or agitation (DM), also impaired orientation and confusion

41
Q

What thalamic nuclei do “Thalamo-Geniculate Zone” hemorrhagic strokes affect, and what are the patient’s symptoms?

A

Affects VP and VL regions, infarcts produce abnormal pain and temperature sensitivity (VP), plus variable motor signs including ataxia and chorea (VL)

42
Q

What thalamic nuclei do “Posterior Choroid Zone” hemorrhagic strokes affect, and what are the patient’s symptoms?

A

Affects caudal CM-PF and PULV. This is relatively rare, but will lead to arousal problems and visual deficits, with varying motor deficits due to Vim, especially if it spreads to posterior limb of internal capsule.