ascending pathways Flashcards

1
Q

types of senses

A
  • special
  • general
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2
Q

general senses

A

spread through the body

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3
Q

special senses

A

localized by their respective sensory organ

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4
Q

5 special senses and their CN

A
  • olfaction (CNI)
  • vision (CNII)
  • taste (CNVII, IX)
  • hearing (CNVIII)
  • vestibular (CNVIII)
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5
Q

general sense types

A
  • interoception
  • exteroception
  • proprioception
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6
Q

interoception

A

pain, temp, touch pressure of the viscera

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7
Q

exteroception

A

pain, temp, touch pressure of environmental stimuli

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8
Q

proprioception

A

position sense from joints, tendons, ligaments

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9
Q

general sense information detected via

A
  • nociceptors
  • thermoreceptors
  • mechanoreceptors
  • chemoreceptors
  • baroreceptors
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10
Q

nociceptors

A

monitor tissue damage

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11
Q

thermoreceptors function and location

A
  • monitor temperature
  • found in skin, muscle liver and hypothalamus
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12
Q

mechanoreceptors

A
  • monitor contact and pressure
  • found mostly in the skin
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13
Q

chemoreceptors

A

monitor chemical composition of body fluids (O2, CO2, pH)

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14
Q

baroreceptors

A
  • subset of mechanoreceptors
  • monitor changes in pressure of tubular organs (vessels, ureters, bowel)
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15
Q

motor areas

A
  • precentral gyrus of frontal lobe
  • primary motor cortex (directs voluntary movements)
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16
Q

sensory areas

A
  • postcentral gyrus of the parietal lobe
  • primary somatosensory cortex (receives somatic sensory information)
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17
Q

somatic sensory information

A

touch, pressure, pain, vibration, taste, temp

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18
Q

dermatome

A
  • area of skin supplied by a particular spinal nerve
  • correspond to the entry or exit point of ventral (motor) and dorsal (sensory) rootlets
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19
Q

if a spinal nerve is cut …

A

sensation is lost in the dermatome

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20
Q

symptoms that follow a dermatome may indicate ?

A

pathology that involves the related nerve root

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21
Q

ganglia

A

cell bodies lining the nerves in the peripheral nervous system

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22
Q

nuclei

A

cell bodies in the central nervous system

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23
Q

types of ascending somatosensory pathway in the spinal cord

A
  • spinothalamic (anterolateral)
  • medial lemniscus (dorsal column-medial lemniscus pathway)
  • spinocerebellar
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24
Q

spinothalamic (anterolateral) pathway function

A

pain and temp, crude touch

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25
Q

medial lemniscus (dorsal column-medial lemniscus) pathway function

A
  • fine touch
  • conscious proprioception
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26
Q

spinocerebellar pathway function

A

proprioception

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27
Q

somatosensory axons are relayed to the ?

A

primary somatosensory sortex

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28
Q

3 orders of neurons in the ascending pathways

A
  • PNS (dorsal root ganglion)
  • CNS (grey matter spinal cord)
  • CNS (ventral posterolateral thalamus)
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29
Q

interoception, exteroception, and proprioception from the trunk and limbs are delivered to the CNS by ?

A

1st order neurons (PNS)

29
Q

divergence of pathway depend on ?

A

sensory modality

30
Q

pain and temp, crude touch pathways

A
  • decussate in spinal cord
  • ascend contralaterally via the spinothalamic tract to the primary somatosensory cortex
31
Q

tactile and proprioceptive pathways

A
  • ascend ipsilaterally via the fascilia gracile and cuneatus
  • decussate in the brainstem
  • ascend contralateral to the primary somatosensory cortex via the medial lemniscus pathway
32
Q

spinocerebellar pathway

A
  • ipsilateral
  • ventral spinocerebellar double crosses
  • dorsal spinocerebellar does not cross
33
Q

spinothalamic system

A
  • lateral spinothalamic tract
  • anterior spinothalamic tract
  • appreciation of mild noxious stimulus
34
Q

lateral spinothalamic tract function

A

pain and temp

35
Q

anterior spinothalamic tract

A
  • crude touch, pressure, tickle, itch
  • limbs and trunk
  • decussate immediately
36
Q

spinothalamic system lesion result

A

contralateral loss of sensation below lesion

37
Q

medial lemniscus system

A
  • fien touch and proprioception
  • limbs and trunk
  • ascend ipsilaterally to the medulla before decussating
  • high degree of spatial orientation
38
Q

medial lemniscus system lesion result

A
  • below decussation of its fibers = loss of sensation ipsilaterally
  • above decussation = lose sensation contralaterally
39
Q

primary somatosensory cortex properties

A

contralateral, disproportionate, inverted

40
Q

trigeminothalamic tract nerves

A
  • trigeminal nerve
  • facial nerve
  • glossopharyngeal nerve
  • vagus nerve
41
Q

trigeminal nerve supplies…

A

face/oral cavity

42
Q

facial nerve supplies…

A

skin around ear

43
Q

glossopharyngeal nerve supplies…

A
  • upper pharynx
  • post 1/3 of tongue
44
Q

vagus nerve supplies…

A
  • external auditory meatus
  • tympanic membrane
45
Q

trigeminothalamic tract

A
  • enter brainstem
  • synapse at trigeminal nuclear complex
  • decussate before ascending to post central gyrus
46
Q

trigeminal nuclear complex

A

midbrain, pons, medulla

47
Q

peripheral receptors and sensation structures served by the trigeminothalamic tract

A
  1. Cornea
  2. Mucocutaneous tissues around mouth and nostrils.
  3. Oral and nasal mucosae
  4. Paranasal sinuses
  5. Tongue (anterior two thirds)
  6. Teeth and gums
  7. Dura of anterior and middle cranial fossae
  8. Skin of face to the vertex except angle of jaw
  9. Parts of external ear
48
Q

primary sensory neurons

A
  • trigeminal ganglion (semilunar)
  • unipolar neurons similar to dorsal root ganglion cells
  • 3 nerve roots give rise to: ophthalmic nerve (CNV-1), maxillary nerve (CNV-2), and mandibular nerve (CNV-3)
  • peripheral distribution of 3 branches (back of head and angle of the jaw not supplied by CNV, areas around ear supplied by CNSVII, IX, X)
49
Q

trigeminal nerve (CNV) branches

A
  • ophthalmic nerve (CNV-1)
  • maxillary nerve (CNV-2)
  • mandibular nerve (CNV-3)
50
Q

second order trigeminal neurons

A
  • principal (chief) trigeminal nucleus
  • spinal (descending) trigeminal nucleus
51
Q

principal (chief) trigeminal nucleus

A
  • mediates fine touch stimuli (two point discrimination), joint position, and vibration
  • located in the middle of pons lateral to the motor nucleus of trigeminal nerve
52
Q

spinal (descending) trigeminal nucleus

A

mediates pain and temp

53
Q

axons of the second order neurons form the ? pathway to the ?

A

trigeminothalamic; ventroposteromedial nucleus of the thalamus

54
Q

third order neurons in ? project to ?

A

thalamus; postcentral gyrus (primary sensory cortex)

55
Q

peripheral nerve lesion cause

A

neuritis

56
Q

peripheral nerve lesion result

A
  • primary order neurons affected
  • disease or dysfunction of nerves (problems in any normal nerve function)
  • loss of function (numbness, tremor, gait)
  • gain of function (tingling, pain, itching, crawling, pins and needles)
  • hypersensitivity
57
Q

neuritis

A

inflammation of the PNS

58
Q

neuritis causes

A
  • physical/chemical injury
  • infection (herpes, shingles, lyme)
  • radiation
  • nutritional deficiency
59
Q

sensory system lesions

A
  • dissociated sensory loss
  • all ascending axons decussate in the spinal cord (STT) or lower brainstem (MLP) so lesions in the upper brainstem result in the loss of contralateral sensation
60
Q

dissociated sensory loss

A

deficit in pain/temp or touch/proprioception

61
Q

spinothalamic tract lesion

A

contralateral loss of pain/temp sensation below level of the lesion

62
Q

medial lemniscus pathway lesion

A

ipsilateral loss of touch/ proprioception below the level of the lesion

63
Q

syringomyelia

A
  • disrupts the decussating fibers of the spinothalamic system
  • usually in cervical and upper thoracic regions
  • usually not the ascending fibers of the dorsal column-medial lemniscal system
  • cape-like distribution of loss of pain, temp, crude touch sensation from above lesion
64
Q

brown-sequard syndrome

A
  • caused by spinal cord tumor, trauma, ischemia, infectious or inflammatory diseases (tuberculosis, MS)
  • contralateral loss of pain and temp, sensation, and ipsilateral loss of position and vibration sensation
65
Q

are spinal cord injuries rarely limited to a particular tract

A

yes

66
Q

incomplete spinal cord lesion characterized by

A

hemisection of the spinal cord

67
Q

neuropathic pain

A
  • complex, chronic state accompanied by tissue injury affecting the STT
  • nerve fibers may be damage, dysfunctional, or injured
  • causes: spinal cord injury, MS, stroke
68
Q

referred pain

A
  • pain perceived at a location other than the site of the painful stimulus
  • pain from an internal organ coincides with the part of the body served by somatic sensory neurons
  • why we have chest/arm pain with a heart attack
69
Q

STT and somatosensory cortex cannot discern clearly ?

A

whether pain is coming from body wall or viscera