Ascending pathways Flashcards

1
Q

What do Hair follicle receptors sense?

A

Hair follicles = touch

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2
Q

What do Merkel endings sense?

A

Merkel endings = pressure and low frequency vibration

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3
Q

What do Meissner corpuscles sense?

A

Meissner corpuscles = light touch

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4
Q

What do Pacinian corpuscles sense?

A

Pacinian corpuscles = vibration and JPS

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5
Q

What do Nociceptors sense?

A

Nociceptors = Pain (can be chemical, mechanical, heat, cold - hence why don’t have same mechanical ending as others)

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6
Q

What do Golgi tendon organs sense?

A

Golgi tendon organs = JPS

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7
Q

What do Muscle spindles sense?

A

Muscle spindles = muscle length, proprioception

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8
Q

What do Ruffini endings sense?

A

Ruffini endings = Skin stretch, pressure, JPS

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9
Q

What are the different nerve receptors that you can find in the conscious and unconscious ascending pathways and their modalities?

A

Each nerve receptor specialises in one or more sensations.

Receptors;

Hair follicle receptors - sense touch

Merkel endings - sense pressure and low frequency vibration

Meissner corpuscles - sense light touch

Pacinian corpuscles - sense vibration and JPS

Ruffini endings - Skin stretch, pressure, JPS

Nociceptors - Pain (can be chemical, mechanical, heat, cold - hence why don’t have same mechanical ending as others)

Muscle spindles - muscle length, proprioception

Golgi tendon organs - JPS

Most of these apart from pain use stetch receptors to pass on signal

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10
Q

Why are dermatomes important?

A

As they tell up what nerve supplies regions of skin and where a lesion may be!

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11
Q

How do the different sensory cutaneous receptors vary?

A

Obviously function is the main variation but the different receptor types also detect sensory input over a variety of receptive fields;

E.g Meissner’s corpuscles have smaller receptive fields when they are in the tips of the fingers than when they are on the palms of the hands and Pacinian corpuscles have generally large receptive fields each of which has a smaller more sensitive area within it

This allows for better discrimination in fingertips than palms, important in fingers not palms

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12
Q

Why do the receptor fields overlap?

A

Each sensory neuron has a receptive field where dendrites are dense in the centre of it and diffuse at the periphery. Stimuli at the centre of the field will activate more dendrites than at the periphery so stronger stimulation will cause a faster firing rate of the action potential.

Receptive fields overlap and if you provide a stimulus in middle of A you get faster AP from A than B and allows the brain know the stimulus is closer to the centre of receptor field A . Its getting no reespponse from receptive field c so can roughly locate the stimulis

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13
Q

What is the concept of lateral inhibition?

A

Lateral inhibition relies on reciprocal inhibition between two adjacent neurons where the extent of inhibition from each one is linked to the stimulus point on the neuronal receptive field overlap.

Example;
When red is firing fast it will cause inhibition to the green receptor field and the green will slightly inhibit the red one back so we get a slight reduction in the area with the stimulus (red) but we have a much better idea of the area of where the stimulation is coming from and allows us to locate. Side paths of fields are inhibited and centre is being left alone

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14
Q

How do different receptors vary in their axons?

A

Different receptors types have specific axon types.

This affects the speed of transmission of the information to the CNS.

Some modalities therefore are slower at being transmitted to the brain than others.

Axon from muscles types;

Group 1; 13-29 µm diameter, 270mph conduction rate, its receptors are proprioceptors of skeletal muscle (Aa axons from skin)

Group 2; 6-12 µm diameter, 167mph conduction rate, its receptors are mechanoreceptors of the skin (Aß axons from skin)

Group 3; 1-5 µm diameter, 67mph conduction rate, its receptors are for pain and temperature (A∂ axons from skin) (supposed to be delta)

Group 4; 0.2-1.5 µm diameter, 5 mph conduction rate, its receptors are for itch, pain and temperature (C axons from skin) - unmylinated

These all use saltatory conduction except from last as isn’t myelinated!

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15
Q

How does somatic sensory input work?

A

The signal comes in from the spinal nerve to the dorsal root ganglion where it synapses and passes on to the dorsal root (sensory) into the dorsal horn of the spinal cord

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16
Q

How does the spinal cord adapt to be able to carry out it neurological functions?

A

The structure of the spinal cord changes along its length

Where additional neurones are needed (to deal with lower limbs and then upper limbs) the spinal cord swells

As sensory information is added, the internal structure changes to accommodate this

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17
Q

How is the white matter of the spinal cord divided ?

A

Its divided up into tracts of axons carrying typified information in the spinal cord

E.g;
- Fasciculus gracilis which carries information from the lower body extremities

  • Fasciculus cuneatus which carries information from upper body extremities
  • Dorsal and Ventral spinocerebellar tracts carry proprioceptive information from the muscle spindles (dorsal) and Golgi organs (ventral)
  • Spinothalmic tracts which carry pain and temperature transmission etc. - Also known as anterolateral as found in 2 places, anterior and lateral
18
Q

How is the primary somatosensory cortex arranged topographically ?

A

Laterally (closer to lateral sulcus) it has all the sensitive parts you would find more so in the face and more superiorly it is for upper extremities and medially it is for waist down (closer to longitudinal sulcus)

19
Q

What is the layout of the general somatosensory system?

A

Most conscious sensory tracts follow this pattern

The primary afferent neuron is a first order neuron which picks up the impulse from the sensory nerve fibres and carries it into the spinal cord or brain stem where it synapses with a second order neuron which then projects it into the thalamus where another synapse occurs and it is projected by a 3rd order neuron up into the somatosensory cortex.

20
Q

Where does all sensory information go before it goes into the cortex?

A

Through the thalamus!

21
Q

What is the thalamus?

A

A reciprocal relay station between the periphery and the cortex (kinda like a train station that organises impulses and sends them to the right area of brain).

22
Q

How does feedback benefit the thalamus?

A

The thalamus also receives feedback and can modular cortical activity.

This gives it the option to either upregulate or downregulate signals to and from the brain!

23
Q

What are the three principal ascending tract systems in the spinal cord

A

1). Dorsal column-medial lemniscus pathways

2). Spinothalamic pathways

3). Spinocerebellar pathways

24
Q

What is the Dorsal column-medial lemniscus pathway for?

A

Its for mechanical stimuli;
- Conscious proprioception
- Discriminative touch
- Vibration
- Pressure

25
Q

Describe the Dorsal column-medial lemniscus pathway for?

A

The first order neuron / the dorsal root axon Aß (a very long axon in the dorsal column) and synapses high up in the spinal cord just before it crosses over to the other side of the brainstem to bring the signal to the second order neuron / medial lemniscus. It crosses over and the signal synapses on to the thalamus where is it is transferred onto the third order neuron which will take it to the cerebral cortex

26
Q

Why does it matter what level a lesion is and how will it affect mechanical function in the Dorsal column-medial lemniscus pathway ?

A

Low lesion you will block off all info from that lesion and below on that side

More info lost higher up you go, so more body that looses sensation = higher up lesion

Use this to work out where lesion is - ipsilateral only lose on 1 side

27
Q

What are the cortical functions that you get from the Dorsal column-medial lemniscus pathway ?

A

Fine tacticle and proprioceptive information is used

1). To determine the shape of an object (without sight) - Proprioception from the finger joints and fine discriminating touch provides a very accurate model of any object that is handled

2). To determine the texture of an object (without sight) - Texture is determined by vibration and slip receptors as well as fine discriminating touch. Note please can be associated with this pathway

Requires the somatosensory association area in the parietal lobe is functioning normally

28
Q

What is Steriognosis and asteriognosis?

A

Steriognosis (the mental perception of depth or three-dimensionality by the senses, usually in reference to the ability to perceive the form of solid objects by touch.)

VS

Asteriognosis (the inability to discriminate shape and size by touch and the inability to recognize objects by touch)

29
Q

What would a lesion of one of the somatosensory association cortex’s cause?

A

Leads to amorprosynthesis - You can recognise complexed objects on opposite side of lesion

Patient unable to recognise complex object by feel on opposite side to the lesion

Patients often only explore on hand of an object during testing of object recognition

Patients can also neglect the whole opposite side of their body such that they overlook motor output on that side

Note that although the patients still have an appreciation of pain and temperature, they are unable to locate with any uncertainty the location of the source of stimulus

30
Q

What would a lesion of the Dorsal column-medial lemniscus pathway cause?

A

Lesions of the gracile fasciculus can cause gait problems, as the brain (cortex and cerebellum) is deprived of information about the position of the feet

Lesions in the cervical cord also cause upper extremity movement problems

Often patient is able to compensate vision thus minimise the effects f sensory loss

31
Q

What is a classic sign of gait (or sensory) ataxia?

A

A classic sign of gait (or sensory) ataxia is the stamp and stick gait - patient stamps down feet to enhance sensory input and maintains a broad based stance.

32
Q

What are the features of the spinothalamic pathway?

A

Spinothalamic pathways is composed of smaller diameter (slow either A∂ or C fibres) with no specialised sensory endings.

Lightly or unmyelinated fibres are ‘quick to cross’

A∂ fibres detect Discriminative sensation (strong stimuli that does not damage skin) heat or cold and sharp pain

C fibres detect dull aching pain and itch (histamine sensitive) plus thermal and mechanical

33
Q

What is the journey through spinothalamic pathway?

A

1st order neurons synapse with 2nd order neurons in the dorsal horn, which then decussate (cross over) and ascend in either lateral or anterior spinothalamic tract depending on this sensory modality.

At the thalamus synapse with 3rd order neurons which then projects to the sensory cortex in the same way as the dorsal lemniscal pathway.

34
Q

What are the 2 different spinothalamic pathways ?

A

The 2 different spinothalamic pathways are referred to as the anterolateral pathway and they each have modal specificity. Both routes follow the same basic pattern of connectivity.

Spinothalamic lateral route, mixture of A∂ and C fibres carrying information about pain and temperature via A∂ heat or cold activated fibres and c fibres (dull pain and itch)

Spinothalamic anterior or ventral route - only C fibres carrying information about coarse, non discriminating touch via mechxnosensitive receptors.

35
Q

How can pathologies in the lateral spinothalmic tract present?

A

Lateral spinothalamic tract;

Lesions in the lateral spinothalamic tract cause decreased perception of pain and temperature on thee contralateral side of the body, always one or 2 dermatomes blow the lesion.

Spinothalamic tract lesions can cause paraestoesia which experienced as shooting pain or ‘electrical pain’ (as there’s a cut in the tract and ions are stimulating it).

Patients can also come more aware of their pain and temperature deficit when they experience painless cuts or burns

36
Q

What makes up the anterolateral spinothalmic tract ?

A

The neospnothalamic tract (lateral pathway) which terminates in the ventral posterior lateral nucleus (VPL) is mainly composed of A∂ fibres.

The palaeospinothalamic tract (anterior pathway) which terminates in the dorsomedial (dm) and intra laminar areas is composed of C fibres

As the VPL is somatotropin, there is location discrimination along this pathway

Whereas the dorsomedial (DM) nucleus and intralaminar areas only provide a generalised location for pain

37
Q

How can pathologies in the anterolateral spinothalmic tract present?

A

Lesions in the Neo part off the anterolateral tract cause decreased perception of pain and temperature on the contralateral side of the body, always on or two dermatomes below the level of thee lesion (Lissauers tract)

Used as a surgical procedure (cordotomy) for terminal disease pain, pain returns after about 1 year.

Example of pain relief following cervical cordotomy in which the left anterolateral portion of the cord is lesioned using electrical current

38
Q

What is the general function off the spinocerebellar pathway?

A

It takes information about the body’s position and movements to the cerebellum for integration with motor intention and other sensory inputs

2 principal routes for information, they are the anterior route and the posterior route

39
Q

What is the more in depth function off the spinocerebellar pathway?

A

Carries information from muscle spindles (muscle length), Golgi organs (proprioception) and touch receptors

Used by cerebellum for for the control off posture and co-ordination of movement

Each (anterior and posterior) contains only two neurones along its length (1st and 2nd order)

In both cases the cell bodies of the second order neurones are located in the dorsal horn of the spinal cord, and terminate in the vermis of the cerebellum

Anterior pathways are still slightly unclear, but lesions in the cerebellum always produce ipsilateral effect. IIt is thought that some parts of the anterior pathway are double-crossed and others not, however the posterior pathway is entirely ipsilateral

40
Q

What are the 4 clinical sensory testing?

A

Joint Position Sense - Exclusively dorsal columns - stabilise joint

Pain and temperature - Exclusively lateral spinothalamic tracts - Sharp/dull for cold tuning

Light touch - Localises lesion (not pathway)

Vibration sense - Good screening for several pathologies - 125hz tuning fork

41
Q

What would lesion in the spinocerebellar pathway cause?

A

Ipsilateral JPS and vibration