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Neurology > Class 7 > Flashcards

Class 7 Flashcards

1
Q

What is a Spinothalamic Tract?

A

spinothalamic tracts are sensory pathways from skin to
thalamus. From the thalamus, sensory information is relayed upward to somatosensory cortex of postcentral gyrus.

relays nociceptive “pain”, temperature, & crude (poorly localized) touch.

Decussates at level of spinal cord where first order neuron (unipolar) enters.

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2
Q

Dorsal Columns carry what kind of information?

A

Dorsal Columns carry sensory information that includes gentle touch such as caresses, ability to recognize shape of an object being held (stereognosis), fine touch (two-point discrimination) & conscious proprioception. This tract decussates in midbrain.

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3
Q

What is the Gracile Fasciculus?

A

Carries afferent input from lower trunk & lower limbs via segments below T6 spinal cord level.

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4
Q

What is the Cuneate Fasciculus?

A

Located lateral to Gracile Fasciculus. It carries signals from upper body except face & ear which is carried by trigeminal nerve.

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5
Q

What is the Spinocerebellar Tract?

A

Starts in spinal cord & terminates on ipsilateral side of cerebellum

The tract carries unconscious proprioceptive information from:
- Golgi tendon organs, sensory receptors that monitor muscle tension
- Muscle spindles (stretch receptors)

This information is brought to the cerebellum for coordination of movements.

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6
Q

What is the corticospinal tract pathway?

A

Modern neurons from motor cortex (frontal lobe) synapse directly on motor neurons in ventral horn of spinal cord; these motor neurons innovate skeletal muscles.

Most of the corticospinal fibres decussate. Crossing of these fibres form an “elevated area” known as pyramidal decussation.

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7
Q

What is the corticospinal tract function?

A

Pathway for fine voluntary motor control of limbs. Pathway also controls voluntary body posture adjustments.

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8
Q

What is the corticobulbar tract pathway?

A

Motor neurons from frontal lobe motor cortex to several CN nuclei in brainstem, including V, VII, XI

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9
Q

What is the corticobulbar tract function?

A

Involved in control of facial & jaw, musculature, swallowing & tongue movements.

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10
Q

What are the 2 Pyramidal Tracts aka Direct aka Voluntary?

A

•Corticospinal tract
• Corticobulbar tract

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11
Q

Bulbar palsy is most commonly caused by _______________________.

A

a brainstem stroke or tumor.

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12
Q

What is Bulbar palsy?

A

Bulbar palsy is a term that includes difficulty swallowing, lack of gag reflex, inability to articulate words & excessive drooling

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13
Q

Extrapyramidal tracts originate in _________________________.

A

the brainstem, carrying motor signals to the spinal cord

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14
Q

Extrapyramidal tracts are responsible for?

A

involuntary & automatic control of all musculature such as muscle tone, balance, posture, & locomotion.

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15
Q

Extrapyramidal functions include?

A

being and to make movements we don’t want to make (inhibition)

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16
Q

Extrapyramidal Tracts pathologies result in _______________.

A

disinhibition

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17
Q

Extrapyramidal system centres on regulation (indirect control) of motor neurons arising from the ____________________________.

A

ventral horns of the spinal cord

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18
Q

What are the 2 Extrapyramidal Tracts aka Indirect aka Involuntary?

A

• Tectospinal Tract
• Vestibulospinal Tract

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19
Q

What is the function of the Tectospinal Tract?

A

Involved in involuntary adjustment of head position in response to visual information.

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20
Q

What is the function of the Vestibulospinal Tract?

A

Responsible for unconsciously adjusting posture to maintain balance.

21
Q

Causes of extrapyramidal disorders include?

A

vascular disorders, degenerative disorders, brain trauma, meningitis, and antipsychotic drugs. Antipsychotics block dopamine & this is what causes side effects.

22
Q

Extrapyramidal disorders include?

A

Akathisia (‘agitation”), feeling of restlessness, making it hard to sit down or hold still. Symptoms include tapping your fingers, rocking, & crossing & uncrossing your
legs.

23
Q

Tardive dyskinesia results in?

A

uncontrollable facial movements such as sucking or chewing, lip-smacking, sticking your tongue out or blinking your eyes repeatedly.

24
Q

What is Dystonia?

A

Condition that causes muscles to involuntarily contract &
contort. This can lead to painful positions or movements.

25
Q

What is the Vestibulospinal Tract?

A

Antigravity muscle is a muscle that acts, often via stretch reflex, to counterbalance pull of gravity & maintain an upright posture.

Many antigravity muscles have high proportion of slow-twitch (aerobic) muscle fibres and are often called tonic muscles.

Vestibulospinal tract provides much of the innervation of these muscles which are for the most part extensors.

26
Q
  • ___________ is the main central connection for cranial nerves that move eyeballs
A

Medial Longitudinal Fasciculus (MLF)

27
Q

What is the Medial Longitudinal Fasciculus (MLF)?

A

These bundles of axons are situated near midline of brainstem & are made up of both ascending & descending fibres that arise from a number of sources & terminate in different areas.

MLF is the main central connection for cranial nerves that move eyeballs.

Carries tectospinal tract & vestibulospinal tracts into
cervical spinal cord & innervates some muscles of neck & upper limbs.

lesion of MLF is usually associated with involuntary jerky eye movements (nystagmus).

Because MS causes demyelination of axons of CNS, it can cause pathologic nystagmus.

28
Q

Lesion of the ___________ is usually associated with involuntary jerky eye movements (nystagmus).

A

Medial Longitudinal Fasciculus (MLF)

29
Q

Because MS causes demyelination of the axons of the CNS, it can cause ____________________.

A

pathologic nystagmus

30
Q

White matter refers to relatively large expanses of myelinated tracts. Tracts are bundles of axons in the CNS.
Tracts run in 3 principal directions which include?

A
  1. Association nerve fibres
  2. Commissural nerve fibres
  3. Projection (vertical) nerve fibres
31
Q

What do Association nerve fibres do?

A

connect & transmit impulses between lobes in same hemisphere.

32
Q

What do Commissural nerve fibres do?

A

transmit impulses from one cerebral hemisphere to opposite cerebral hemisphere.

33
Q

What is the corpus callosum?

A

largest of commissural tracts. Evidence indicates that corpus callosum not only functions for exchange of information between hemispheres, but for one hemisphere to assert dominance over the other hemisphere.

In patients with severe & disabling epileptic seizures, corpus callosum is sometimes cut to prevent spread of seizure from one hemisphere to the other.

34
Q

What may be an option for people with focal seizures?

A

Epilepsy surgery may be an option for people with focal seizures that remain a problem despite other treatments.

Other treatments include at least a trial of two or three medications. Common procedures include cutting out hippocampus, removal of tumors, & removing parts of
neocortex. Some procedures such as corpus callosotomy are attempted in an effort to decrease number of seizures rather than cure condition

35
Q

What do Projection (vertical) nerve fibres do?

A

Form tracts that transmit APs between cerebrum & other parts of the CNS. The term projection fibres can refer to ascending or descending fibres. They are not considered
commissural even though they decussate. Eg. include
spinothalamic & corticospinal tracts.

36
Q

What is spinal stenosis?

A

Condition where space in vertebral canal narrows due to
inflammation, or narrows because of degenerative changes in vertebrae. Changes cause excessive bone growth (osteophytes), ligament hypertrophy, or loss of spinal disc height.

Most commonly seen in adults over age of 50.

Depending on amount of pressure on spinal cord, symptoms vary & include pain, muscle weakness, & loss of bladder, bowel, & sexual functions.

Finding bent forward position while walking or sitting down helps decompress area & relieve pain.

Severe cases laminectomy is an option to immediately relieve pressure off nerves. Laminae come together to form spinous process.

Milder cases or immediately post-surgery, rehabilitative treatment including massage is recommended to improve posture & strength of muscles around lower back & abdominal region. Helps reduce amount of compression on spinal cord.

37
Q
  • A person’s level of SC injury is defined as?
A

The lowest level of full sensation & function. In other words, a COMPLETE C3 SPINAL CORD INJURY MEANS THAT
EVERYTHING BELOW C3 IS AFFECTED. C3 IS FINE.

38
Q

What is C4 injury?

A

tetraplegia (quadriplegia); complete paralysis below neck UL &LL

39
Q

What is T6 injury?

A

paraplegia; results in paralysis below chest - UL

40
Q

What is L1 injury?

A

results in paralysis below the waist LL

41
Q

What is complete SCI?

A

all feeling (sensory) & all ability to control movement
(motor function) are lost below spinal cord injury

42
Q

What is Incomplete Spinal Cord Injuries?

A

If some motor or sensory function below affected area is lost, spinal cord injury is called incomplete. There are varying degrees of incomplete injury.

43
Q

What is Central cord syndrome?

A

Most common form of incomplete spinal cord injury. Characterized by problems in upper limbs & to lesser extent in legs. Can result from trauma to vertebrae or discs in neck region may be due to gradual weakening of vertebrae & discs in elderly other possible causes include spinal stenosis

44
Q

What is Anterior Cord Syndrome?

A

Motor paralysis below level of lesion. Often caused by ischemia within anterior spinal artery which itself is
often result of an iatrogenic issue, Eg. aortic aneurysm repair

45
Q

What is iatrogenic?

A

relating to illness caused by medical treatment

46
Q

What is aneurysm?

A

bulge in a blood vessel caused by a weakness in the blood vessel wall, usually where it branches

47
Q

What is Posterior Cord Syndrome?

A

Just dorsal columns of spinal cord are affected. Main signs & symptoms include loss of proprioception

48
Q

What is Cauda Equina Syndrome (CES)?

A
  • Not a true SCI as its nerve roots that are damaged & not cord itself
  • Back pain, weakness or paralysis in lower limbs, loss of sensation, bowel & bladder dysfunction, & loss of reflexes.
  • Cause is often compression e.g. by ruptured intervertebral disk or tumor

Neurology (12 decks)

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