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SF2 2 > Ascending Spinal Cord > Flashcards

Ascending Spinal Cord Flashcards

1
Q

Agraphesthesia

A

The inability to recognize letters and numbers drawn on the palm of the hand

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2
Q

Three tracts in the anterolateral pathway

A

1) Spinothalamic
2) Spinoreticular
3) Spinomesencephalic

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3
Q

Two ways Rostral Ventral Medulla (RVM) modulates pain

A

1) Inhibits pain by signaling to dorsal horn of spinal cord

2) Promotes Locus Ceruleus (Rostral Pons) which sends noradrenergic projections to regulate spinal cord

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4
Q

Origin of Posterior Spinocerebellar Tract

A

Clarke’s Nucleus (medial part of Vamina VII). Axons run to the lateral funiculus of that same side to form the posterior spinocerebellar tract

Note: Both the tract and Clarke’s Nucleus do not exist caudal to L2

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5
Q

Function(s) of Spinothalamic Tract

A

Believe to interact with spinoreticular in the emotional and arousal aspects of pain

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6
Q

Bare nerve endings use which sensory neuron fiber type(s)? [Involve Pain, temperature, and itch]

A

A-delta and C

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7
Q

Two types of non-conscious sensation. They’re not not perceived but routed to the cerebellum

A

1) Proprioception - afferent information reaching the cerebellum though the spinocerebellar pathways, essential for smooth motor coordination
2) Interoception - References unconscious afferent signals involved in visceral reflexes

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8
Q

Subacute Combined Degeneration

A

Chronic demyelination and loss of axons in the dorsal and dorsolateral columns; more posterior columns than lateral corticospinal tract. May also involve deep white matter of hemispheres (dementia).

Patient shows loss of proprioception, discriminative touch, vibration, ataxia, and spastic weakness/paralysis

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9
Q

Location of decussation for Anterolateral Pathway

A

Spinal Cord Anterior Commissure

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10
Q

Laminae from which Spinomesencephalic Tract arises from

A

Laminae I & V of dorsal horn

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11
Q

Two major major pathways involved in somatic sensory perception (therefore ascending)

A

1) Posterior (Dorsal) Column-Medial Lemniscal Pathway

2) Spinothalamic (Anterolateral) Pathway

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12
Q

Location of the somatosensory cortex

A

post central gyrus

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13
Q

SNRIs, TCAs (Tricyclic Antidepressants), and SSRIs – which are analgesic

A

SNRIs and TCAs. SSRIs are not

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14
Q

Contralateral Neglect is a sign of what?

A

Cortical sign (occurs only from cortex lesion)

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15
Q

Function of Posterior Spinocerebellar Tract

A

Conveys tactile, pressure, and proprioceptive information about the ipsilateral leg

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16
Q

Function of Cuneocerebellar Tract

A

Sensory from ipsilateral upper thorax and arm

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17
Q

Difference in function between Posterior/Anterior Spinocerebellar Tracts – which both deal with the leg

A

Anterior S.C Tract not only has Group I fibers (from mainly Golgi tendon organs) but also wide variety of cutaneous receptors like spinal interneurons and fibers of descending tracts. Activity is related more to attempted movement than simply to sensory signals!

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18
Q

Termination of Cuneocerebellar Tract

A

Vermis

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19
Q

Function(s) of Spinomesecephalic Tract

A

Involved in central regulation of pain

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20
Q

The Spinocerebellar pathways enter the cerebellum from either the inferior or superior peduncles. Which is which?

A

Posterior Spinocerebellar Tract - Inferior
Anterior Spinocerebellar Tract - Superior
Cuneocerebellar Tract - Inferior

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21
Q

Two types of conscious sensation perceived at the level of the cerebral cortex

A

1) Exteroceptive - sensations from the external world

2) Proprioceptive - arise within the body

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22
Q

Function(s) of Spinoreticular Tract

A

Involved with pain and emotions.

  • Arouses cerebral cortex to induce/maintain waking state
  • Reports to the limbic cortex of anterior cingulate gyrus about nature of a stimulus
  • emotional response may be pleasurable (stroking) or aversive (pinprick)
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23
Q

Ascending pathway which carries touch, joint sensation, two-point discrimination, and vibratory sense from receptors to the cortex

A

Posterior Column-Medial Lemniscal Pathway

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24
Q

Cause of Subacute Combined Degeneration

A

Deficiency in Vitamin B12 intake or metabolism

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25
Q

Medial Medullary Lesion

A

Lesion involves the medial lemniscus. Causes contralateral loss of vibration and joint position sense

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26
Q

Areas most noticeably affected (somatosensory) with a lesion in the thalamic region

A

Contralateral deficit most noticeable in face, hands, and foot

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27
Q

Termination of Anterior Spinocerebellar Tract

A

Vermis

28
Q

Paresthias

A

Abnormal tingling/prickling sensation

  • Lesions in the anterolateral system more likely to produce painful paresthesias
  • Lesions in the dorsal column/medial lemniscal system are more likely to produce numbness or tingling
29
Q

What region does the Periaqueductal Gray Matter (Midbrain), itself controlled by higher brain regions and spinal cord, send signals to regulate pain?

A

Rostral Ventral Medulla (RVM) in the Medulla

30
Q

Distal Symmetrical Polyneuropathies

A

Cause bilateral sensory loss in a “glove and stocking” distribution (longest nerves affected) of all modalities

31
Q

Location of decussation for Posterior Column-Medial Lemniscal Pathway

A

Caudal medulla

32
Q

Lhermitte’s Sign

A

Electric-like shock that occurs when there is damage to the dorsal columns in cervical areas of the spinal cord; it can be elicited by asking the patient to bend their neck forward

33
Q

Most affected senses in a Somatosensory Cortex lesion

A

Discriminative touch and joint position sense

34
Q

Where do Posterior Columns terminate

A

Posterior column nuclei in the medulla oblongata

35
Q

Spinal segments where fasciculus cuneatus is found

A

Only found in the cervical segments

36
Q

All afferent tertiary (neuron order) input ends up where

A

somatosensory cortex

37
Q

Spinocerebellar Pathways

A

Sensory fiber tracts running from spinal cord to cerebellum.

1) Posterior Spinocerebellar Tract
2) Anterior Spinocerebellar Tract
3) Cuneocerebellar Tract

38
Q

Termination of Spinoreticular Tract

A

Medullary-Pontine Reticular Formation

39
Q

Termination of Posterior Spinocerebellar Tract

A

Inferior Cerebellar Peduncle

40
Q

Origin of Anterior Spinocerebellar Tract

A

Spinal Border Cells (T12-L5)

41
Q

What might you see if cervical areas of the spinal cord are affected by Multiple Sclerosis?

A

Lhermitte’s Sign

42
Q

Tabes Dorsalis

A
  • Caused by tertiary syphilis; inflammatory involvement of the dorsal roots results in degeneration of dorsal columns
  • Patient presents with bilateral loss of fine touch, vibration and conscious proprioception
  • Romberg and/or Lhermitte Signs may be present
43
Q

Disturbance of posterior column function is most often associated with what group of pathologies

A

Demyelinating diseases such as multiple sclerosis

44
Q

Another mechanism in MS besides just the demyelination

A

Primary loss of neurons (neurodegeneration)

45
Q

Common manner in which Posterior Column-Medial Lemniscal and Spinothalamic Pathways ascend CNS

A
  • First-order neurons occupy posterior root ganglia
  • Second-order somas on same side as original first-order neurons
  • Second-order neurons decussate (cross the midline) and ascend to terminate in thalamus
  • third-order neurons project form thalamus to somatic sensory cortex
46
Q

Laminae from which Spinoreticular Tract arises from

A

Laminae VI-VII of dorsal horn

47
Q

Romberg’s Sign

A

Swaying when the patient stands with feet together and eyes closed (can be seen in demyelinating diseases and vestibular disorders)

48
Q

Two-Point Discrimination test

A

Measures tactile perception. Posterior (Dorsal) Column-Medial Lemniscal Pathway

49
Q

Synapse in the Ventral Posterior Medial (VPM) nuclei of the thalamus

A

Cranial nerves

50
Q

Among A-alpha, A-beta, A-delta, and C sensory neuron fiber types – which is/are myelinated?

A

All but C are myelinated

51
Q

Lesions of the Postcentral Gyrus

A

Large lesion results in sensory loss involving fine touch, proprioception, vibration in the part of the body represented in that somatotopic projection. Paresthesias may present

52
Q

Sensory Ataxia

A

Patients with severe sensory ataxia can stand unsupported only with feel well apart and with gaze directed downward to include the feet. Gait broad-based with stamping action that maximizes any conscious proprioceptive function that remains

53
Q

Internal Arcuate Fibers

A

Axons of second order sensory neurons from the nucleus gracilis/cuneatus

54
Q

Manner in which sensory fibers add to the posterior columns

A

They add laterally.

Medial portion of gracile fasciculus starts with information from legs and lower trunk. Cuneate fasciculus adds information from upper trunk, arm, neck and then finally the occiput

55
Q

Termination of Spinothalamic Tract

A

Some neurons of the spinothalamic terminate in the intralaminar and mediodorsal nuclei of the thalamus

56
Q

Origin of Cuneocerebellar Tract

A

Lateral Cuneate Nucleus

57
Q

Receptors involved with proprioceptive sensation (both conscious and non-conscious)

A

Receptors of the locomotor system (muscles, joints, bones) and of the vestibular labyrinth (ears and balance remember)

58
Q

Structures carrying the Posterior Column-Medial Lemniscal Pathway

A

Fasciculus Gracilis and Fasciculus Cuneatus

59
Q

Function of Anterior Spinocerebellar Tract

A

Sensory from ipsilateral leg

60
Q

Receptors involved with conscious exteroceptive sensation

A

Somatic: Touch, pressure, heat, cold and pain
Telereceptors: Vision and hearing

61
Q

Synapse in the Ventral Posterior Lateral (VPL) nucleus of the thalamus

A

Medial lemniscus

62
Q

Lateral Pontine or Medullary Lesion

A
  • Affects contralateral anterolateral and ipsilateral trigeminal pathway.
  • Loss of pain and temperature sensation in the body opposite the lesion
  • Loss of pain and temperature sensation in the face on the side of the lesion
63
Q

Asterogenesis

A

Loss of size/shape/texture discrimination

64
Q

Other names for spinothalamic pathway

A

Anterolateral or ventrolateral

65
Q

Termination of Spinomesencephalic Tract

A

Deviates from the anterolateral pathway in the midbrain to project to the midbrain periaqueductal gray and superior colliculus

66
Q

The Spinocerebellar pathways differ from Posterior Column-Medial Lemniscal and Anterolateral pathways by being ipsilateral. What’s odd, though, about the Anterior Spinocerebellar Tract?

A

It’s ipsilateral but crosses midline twice; once in spinal cord and again in cerebellum.

SF2 2 (14 decks)

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