2) Proprioception & Tactile Pathways Flashcards

1
Q

What is the primary pathway that transmits discriminative touch, flutter-vibration & proprioceptive information?

A

Posterior column – Medial lemniscal pathway

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2
Q

Why type of signal coding registers a cell’s firing rate or intensity?

What is the other type of coding that registers distribution in time/space as well as motion/direction?

A

Frequency coding

Population coding

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3
Q

PCMLS provides two-point discrimation, what is two-point discrimination related to?

A

It is related to the density of peripheral nerve endings… more endings = better two-point discrimination

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4
Q

What is responsible for converting mechanical pressure into electrical signal?

A

The primary afferent neuron turns mechanical signals into action potentials, which is conveyed by the PCMLS

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5
Q

Receptive fields are areeas of skin innvervated by branches of a somatic afferent fiber.

Small receptive fields are found in areas such as _______.

Large receptive fields are present in areas such as ______.

A

Small = fingertips, where receptor density is high

Large = back, where receptor density is low

** small receptive fields provide increased discrimination

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6
Q

Denser areas of neurons take up ____ of the somatosensory cortex.

A

alot, a disproportionately large part

The trunk (large receptive fields) = small representation

Fingers (small receptive fields) = large representation

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7
Q

Peripheral distribution of the afferent nerves arising from each spinal level delineates what?

What is being relayed?

A

The segmental pattern of dermatomes

Pain/thermal information

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8
Q

What kind of primary fibers relay dscriminative touch, flutter-vibration & proprioception?

Where do these fibers enter the spinal cord?

A

Large-diameter primary fibers

Enter the SC via the medial division of the posterior root

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9
Q

One set of branches terminates on second-order neurons in the spinal cord gray matter at, above, & below the level of entry, while the largest set of branches does what?

A

Largest set of branches ascends cranially & contributes to the formation of the fasciculus gracilus & fasciculus cuneatus→ collectively termed the posterior columns

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10
Q

Fibers w/in the posterior columns are organized topographically, how are the fibers organized in both the fasciculus gracilus and fasciculus cuneatus?

A

Sacral level fibers are positioned medially & fibers from progressively more rostral levels (up to thoracic level T6) are added laterally to form the fasciculus gracilus

Thoracic fibers above T6 & cervical fibers form the laterally placed fasciculus cuneatus in the same manner

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11
Q

SC lesions at the fasciculi gracili & cuneatus result in what kind of deficit?

A

Ipsilateral reduction or loss of discriminative, positional, & vibratory tactile sensations at & below the segmental level of injury

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12
Q

If a patient has a wide-based stance and places feet to the floor with force, what might they be suffering from?

A

Sensory ataxia

Loss of muscle stretch (tendon) reflexes, & proprioceptive losses from the extremities due to lack of sensory input

Possibly at fasciculi gracili & cuneatus

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13
Q

After the primary neuron at the fasciculi where do the neurons go?

A

Nucleus gracilus & nucleus cuneatus are in posterior medulla. Contain second-order neurons of the PCMLS. Receive input from first-order neurons (primary afferents) from the ipsilateral DRG

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14
Q

Where do the second-order neurons send their axons to?

What are these fibers called?

Where do they cross?

What do they become?

A

To the contralateral thalamus

Internal arcuate fibers: loop anteromedially in medulla

Sensory decussation at the midline

Ascend as the medial lemniscus on the opposite side

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15
Q

As the medial lemniscus ascends, it ends up terminating, where is this at?

A

In the ventral posterolateral nucleus (VPL)

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16
Q

Damage to the brainstem levels of the posterior column (medial lemniscus) result it what?

A

Deficits in discriminative touch, vibratory, & positional sensibilities over the contralateral side of the body

17
Q

What is the ventral posterior nuclei?

What are the two parts? What are they separated by?

A

Wedge-shaped cell group located in caudal thalamus

Ventral posterolater nucleus (VPL), and Ventral posteromedial nucleus (VPM)

Separated by arcuate lamina

18
Q

What is the purpose of both the VPL and VPM respectively?

What artery supplies them?

A

VPL = maintains somatotopic arrangement of the body

VPM = proprioceptive information of the head

Posterior cerebral artery

19
Q

What does the posterior cerebral artery supply?

What if it is compromised?

A

It supplies the VPL and VPM

Compromise can result in loss of all tactile sensation over the contralateral body & head

20
Q

The VPL sends out third order neurons, what do these do?

A

They are large-diameter axons that terminate in the primary (SI) & secondary (SII) somatosensory cortices. (form homunculus)

21
Q

Third-order axons from the thalamus (VPL) terminate where?

A

In the primary somatosensory (SI) cortex (homunculus)

22
Q

What two gyri make up the homunculus?

What is the homunculus?

A

Postcentral and posterior paracentral gyri.

“Foot to tongue” pattern along medial → lateral axis. Regions with ↑↑↑ receptor density (hand/lips), have large amount of dedicated cortical tissue. Regions with ↓↓ receptor density (back) have small cortical representations

23
Q

What provides the blood supply to the SI cortical areas?

A

Anterior & medial cerebral arteries

24
Q

The anterior & middle cerebral artery supply _____?

What happens with compromise?

A

It supplies the SI cortical areas (primary somatosensory cortex)

MCA lesions produce tactile loss over the contralateral upper body & face

ACA lesions affect the contralateral lower limb

25
Q

Typically, SI lesions usually include larger areas & frequently result in more global deficits, such as???

A

Loss of proprioception, position sense, vibratory sense, and pain & thermal sensations on the contralateral side of the body

26
Q

In general what is the difference between brainstem lesions and SC lesions?

A

Brainstem lesions = Sensory deficits of trunk/extremities contralateral to the lesion, but sensory deficits of face/CN ipsilateral to the lesion. Ex: The right face & the left arm/leg lack proprioceptive information

SC lesions result in proprioceptive deficits on the right, but anesthesia on the left (or vice versa)

27
Q

Lesions in which area of the somatosensory cortex can produce agnosia? and what is agnosia?

A

Lesions in the parietal association area can produce agnosia.

Contralateral body parts are lost from the personal body map.

Phantom limb kinda…

28
Q

Side note for future lectures: what do afferent cerebellar pathways play an integral role in?

A

Cerebellar input plays an integral role in guiding control of body muscle tone, movement, & posture
Includes information about limb position, joint angles, & muscle tension/length