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cranial nerve 5 Flashcards

1
Q

Hyperalgesia

A
  • Pain hypersensitivity

- noxious stimulus that evokes pain sensation greater than normal

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2
Q

Allodynia

“differing from normal-pain”

A
  • pain hypersensitivity

- non-noxious stimuli that evokes pain sensation

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3
Q

Inflammatory pain

A

A) caused by tissue damage
B) produces hypersensitivity at site
C) usually resolved when disease controlled

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4
Q

Neuropathic pain

A

A) caused by nervous system lesion
B) independent of peripheral pathology
C) pain persists after lesion is healed

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5
Q

Peripheral sensitization-

A

stimulation of afferent endings

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6
Q

hyperalgesia

A

repeated stimulation producing “autosensitization”

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7
Q

Sensitizing agents

peripheral sensitization

A

A) bradykinin
B) norepinephrin
C) prostaglandins
D) seratonin

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8
Q

T/F: peripheral sensitization takes a long time to reverse

A

FALSE

its quickly reversible

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9
Q

Central sensitization:

A

intense and prolonged stimulation of nociceptive fibers

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10
Q

Prolonged stimulation of nociceptive fibers can result in:

A

A) modification of peripheral receptors

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11
Q

modifying peripheral receptors results in what?

central sensitization

A

A) enhanced receptor sensitivity

B) increased number of receptor sites

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12
Q

where does central sensitization “wind-up” occur?

A

in the posterior horn/trigeminal spinal nucleus

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13
Q

enhanced activity of C fibers (pain fibers) results in what?

A

A) increased sensitivity of glutamate receptors

B) suppressed activity of inhibitory interneurons

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14
Q

Migroglia: overview

A

1) morphology changes with activity- microgliosis

2) microglia are physically active with pre and post synaptic elements

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15
Q

how does the microglia morphology change when they are activated?

A

Surveillance state= resting state
- small central region and long, narrow processes

enhanced response state= activated state
-enlarged, ameoboid configuration

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16
Q

how long do microglia make synaptic contact? how often does this occur?

A

make contact for roughly 5 minutes

one contact per hour

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17
Q

Astrocytes- the 2 states and when they occur

A

a) active state- normal state

b) reactive state- during pain hypersensitivity

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18
Q

Active state of astrocytes

A
  • interact between neuron and vascular supply

- recycle neurotransmitters (mainly glutamate)

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19
Q

how do active state astrocytes recycle glutamate?

A

glutamate-glutamine shuttle

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20
Q

Reactive state astrocytes

A

enhance synaptic activity

promote microglia into “enhanced response state”

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21
Q

during acute inflammatory pain, what is the role of astrocytes?

A

promoting microlglia toward enhanced response state

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22
Q

what is the main promotor factor involved in acute inflammatory pain?

A

ATP

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23
Q

what do microglia release during acute inflammatory pain?

A

Release inflammatory cytokines

activate neurons within spinal cord

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24
Q

what region of the spinal cord is activated by inflammatory cytokines? (acute infl pain)

A

spinal cord dorsal horn / trigeminal spinal nucleus

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25
what occurs when peripheral inflammatory situations resolve?
microglia enhanced response state returns to resting state
26
what causes chronic neuropathic pain?
long-term change in CNS structure
27
microglia activity in chronic neuropathic pain
Migroglia remain in enhanced response state -continue releasing inflammatory cytokines
28
astrocyte activity in chronic neuropathic pain
continue promoting activation of microglia a result of positive-feedback from microglia
29
name the 3 branches of the trigeminal nerve
1) Opthalmic division- V1 2) maxillary division- V2 3) mandibular division- V3
30
what region does V1 supply?
upper face *sensory only
31
what region does V2 supply?
middle face *sensory only
32
what region does V3 supply?
lower face *BOTH sensory and motor
33
T/F: the borders between skin areas served by CN V show moderate overlap
FALSE borders between each division are sharp
34
what type of nerve fiber makes up 2/3rds of the trigeminal nerve?
C fibers
35
Cell body origin of SVE for the trigeminal nerve
trigeminal motor nucleus
36
which division of CN V do the SVE fibers travel thru?
mandibular division (V3)
37
what do the SVE fibers of the trigeminal nerve control? where do they terminate?
VOLUNTARY control of started muscles terminate on muscles of mastication
38
where is the trigeminal motor nucleus located?
Dorsolateral pontine tegmentum
39
the supratrigeminal nucleus is part of what?
reticular formation
40
what is the supratrigeminal nucleus responsible for?
rhymic actions of the motor neurons
41
trigeminal motor nucleus fibers exit thru the what?
thru the pons as smaller motor root
42
CN V, GSA proprioception: where is the cell body of origin? where does it project to?
CBO- A) unipolar cell bodies B) trigeminal mesencephalic nucleus project to- A) trigeminal motor nucleus B) supratrigeminal nucleus
43
the trigeminal mesencephalic nucleus: 1) where is its found? 2) what does the nucleus consist of?
1) found in the rostral pons and mesencephalon | 2) consists of unipolar cells of neural crest origin
44
Jaw jerk reflex- GSAp component
- neuromuscular spindles- V3 - trigeminal mesencephalic nucleus - trigeminal motor nucleus
45
Jaw jerk reflex- SVE component
- trigeminal motor nucleus | - muscles of mastication- V3
46
jaw jerk reflex: upper an lower motor neuron lesions:
LMNL- attenuates reflex | UMNL- accentuate reflex
47
CN V: GSAe (General Somatic Afferent Exteroceptive Sensation)
Skin of face Oronasal mucous membranes Teeth Dura mater
48
what are the 3 divisions of the trigeminal spinal nucleus?
1) pars oralis 2) pars interpolaris 3) pars caudalis
49
GSAe of trigeminal spinal nucleus
- Pain (slow and fast pain) - Crude Touch - Temperature
50
which cranial nerves give fibers to the trigeminal spinal nucleus
CN 5, 7, 9, 10
51
70-80% of tooth pulp fibers are what type?
A-delta and C fibers
52
which fibers make up 10-30& of tooth pulp fibers?
A-beta fibers
53
tooth pulp fibers project to which nuclei
- Trigeminal principal sensory nucleus (Main projection) - trigeminal spinal nucleus - upper cervical spinal cord
54
which trigeminal spinal nucleus division receives most of the tooth pulp fibers?
pars oralis
55
pars oralis receives input from what
intraoral and perioral structures
56
divisions of pars interpolaris
A) interpolaris proper | B) caudalis-interpolaris transition zone
57
the interpolaris proper activates what reflex
trigemino-autonomic reflex
58
the caudalis-interpolaris transition zone:
A) not somatotopically organized B) responds to pain stimuli from CN 5 C) may help with pain supression
59
pars caudalis- what is the MPH
medullary posterior horn
60
the laminar structure of the pars caudalis is similar to what?
to the spinal cord posterior horn
61
what feature of the pars caudalis gives us the "onion peel" organization?
somatotopic organization | inverted representation of the face
62
the substantial gelatinosa of the pars caudalis contain what
-excitatory and inhibitory neurons
63
what substance is released from rap he spinal tract fibers onto the pars caudalis?
(in the substantia gelatinosa) serotonin
64
the pars caudalis receives afferents from what
cranial nerves 7, 9, 10
65
the pars caudalis is the target of what type of nerve fibers
A) a-delta and c fibers (pain) | B) fibers from TMJ
66
estrogen receptors are found where?
Trigeminal spinal nucleus Parabrachial nucleus Periaqueductal gray Hypothalamus
67
high estrogen levels and stress increase activity in _________________ in response to pain
trigeminal spinal nucleus caudalis laminae
68
GABA normally dampens pain-induced activity in the what?
trigeminal spinal nucleus caudalis
69
GABAergic activity is suppressed by high ________ levels
estrogen
70
Trigeminocardiac reflex: caused by a stimulation of what?
``` A) eye and periocular structures B) nasal mucosa C) face (diving reflex) D) needle into CN 5 E) TMJ surgery ```
71
trigeminocardiac reflex can result in:
- bradycardia (increase vagal tone) - apnea - arterial hypotension - gastric hypermobility
72
trigeminal neuralgia: what divisions are effected?
A) V3- 70% of cases | B) V1 - less than 5% of cases
73
what procedure can help stop trigeminal neuralgia?
microvascular decompression
74
trigeminal principal sensory nucleus is homologous with what?
posterior column nuclei - Two point discrimination - Vibratory sense
75
what are the 2 ascending trigeminal pathways?
A) The ventral trigeminothalamic tract | B) The dorsal trigeminothalamic tract
76
which ascending trigeminal pathway projects contralaterally? bilaterally?
Contralaterally- ventral bilaterally- dorsal
77
where are the cortical representation from cranial nerve 5?
Parietal lobe - Postcentral gyrus - Brodmann’s Areas 1, 2 & 3
78
The Simple Story: | Trigeminal mesencephalic nucleus
Homologous with proprioceptive component of posterior | column - medial lemniscal system
79
the simple story: trigeminal principal sensory nucleus
Homologous with discriminative touch component of posterior column - medial lemniscal system
80
The Simple Story: Trigeminal spinal nucleus
Homologous with pain, crude touch, and temperature | sensation carried by anterolateral system
81
Jaw reflexes: | Input from:
Jaw muscles (proprioception) Tactile infomation (food in mouth) Pain information
82
output of the jaw reflexes
to muscles of mastication
83
jaw closing reflex: caused by _______
food in contact with oral membranes
84
jaw opening reflex is caused by what?
- Periodontal afferents activated by dental occlusion | - Pain afferents from mucosal membranes
85
Corneal reflex: caused by what?
stimulation of cornea (trigeminal nerve)
86
Corneal reflex: trigeminal nerve projects to what?
- Trigeminal pricipal nucleus -Trigeminal spinal nucleus | - Relays bilaterally to facial nucleus
87
the _____ is responsible for closing the eye during the corneal reflex
facial nerve
88
the corneal reflex is considered a ____ reflex
direct and consensual

Neuro- exam 3 (9 decks)

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