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Neuro- exam 3 > cranial nerve 5 > Flashcards

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
Q

what occurs when peripheral inflammatory situations resolve?

A

microglia enhanced response state returns to resting state

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26
Q

what causes chronic neuropathic pain?

A

long-term change in CNS structure

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27
Q

microglia activity in chronic neuropathic pain

A

Migroglia remain in enhanced response state

-continue releasing inflammatory cytokines

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28
Q

astrocyte activity in chronic neuropathic pain

A

continue promoting activation of microglia

a result of positive-feedback from microglia

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29
Q

name the 3 branches of the trigeminal nerve

A

1) Opthalmic division- V1
2) maxillary division- V2
3) mandibular division- V3

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30
Q

what region does V1 supply?

A

upper face

*sensory only

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31
Q

what region does V2 supply?

A

middle face

*sensory only

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32
Q

what region does V3 supply?

A

lower face

*BOTH sensory and motor

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33
Q

T/F: the borders between skin areas served by CN V show moderate overlap

A

FALSE

borders between each division are sharp

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34
Q

what type of nerve fiber makes up 2/3rds of the trigeminal nerve?

A

C fibers

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35
Q

Cell body origin of SVE for the trigeminal nerve

A

trigeminal motor nucleus

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36
Q

which division of CN V do the SVE fibers travel thru?

A

mandibular division (V3)

37
Q

what do the SVE fibers of the trigeminal nerve control? where do they terminate?

A

VOLUNTARY control of started muscles

terminate on muscles of mastication

38
Q

where is the trigeminal motor nucleus located?

A

Dorsolateral pontine tegmentum

39
Q

the supratrigeminal nucleus is part of what?

A

reticular formation

40
Q

what is the supratrigeminal nucleus responsible for?

A

rhymic actions of the motor neurons

41
Q

trigeminal motor nucleus fibers exit thru the what?

A

thru the pons as smaller motor root

42
Q

CN V, GSA proprioception:

where is the cell body of origin?
where does it project to?

A

CBO-
A) unipolar cell bodies
B) trigeminal mesencephalic nucleus

project to-
A) trigeminal motor nucleus
B) supratrigeminal nucleus

43
Q

the trigeminal mesencephalic nucleus:

1) where is its found?
2) what does the nucleus consist of?

A

1) found in the rostral pons and mesencephalon

2) consists of unipolar cells of neural crest origin

44
Q

Jaw jerk reflex- GSAp component

A
  • neuromuscular spindles- V3
  • trigeminal mesencephalic nucleus
  • trigeminal motor nucleus
45
Q

Jaw jerk reflex- SVE component

A
  • trigeminal motor nucleus

- muscles of mastication- V3

46
Q

jaw jerk reflex: upper an lower motor neuron lesions:

A

LMNL- attenuates reflex

UMNL- accentuate reflex

47
Q

CN V: GSAe (General Somatic Afferent Exteroceptive Sensation)

A

Skin of face
Oronasal mucous membranes
Teeth
Dura mater

48
Q

what are the 3 divisions of the trigeminal spinal nucleus?

A

1) pars oralis
2) pars interpolaris
3) pars caudalis

49
Q

GSAe of trigeminal spinal nucleus

A
  • Pain (slow and fast pain)
  • Crude Touch
  • Temperature
50
Q

which cranial nerves give fibers to the trigeminal spinal nucleus

A

CN 5, 7, 9, 10

51
Q

70-80% of tooth pulp fibers are what type?

A

A-delta and C fibers

52
Q

which fibers make up 10-30& of tooth pulp fibers?

A

A-beta fibers

53
Q

tooth pulp fibers project to which nuclei

A
  • Trigeminal principal sensory nucleus (Main projection)
  • trigeminal spinal nucleus
  • upper cervical spinal cord
54
Q

which trigeminal spinal nucleus division receives most of the tooth pulp fibers?

A

pars oralis

55
Q

pars oralis receives input from what

A

intraoral and perioral structures

56
Q

divisions of pars interpolaris

A

A) interpolaris proper

B) caudalis-interpolaris transition zone

57
Q

the interpolaris proper activates what reflex

A

trigemino-autonomic reflex

58
Q

the caudalis-interpolaris transition zone:

A

A) not somatotopically organized
B) responds to pain stimuli from CN 5
C) may help with pain supression

59
Q

pars caudalis- what is the MPH

A

medullary posterior horn

60
Q

the laminar structure of the pars caudalis is similar to what?

A

to the spinal cord posterior horn

61
Q

what feature of the pars caudalis gives us the “onion peel” organization?

A

somatotopic organization

inverted representation of the face

62
Q

the substantial gelatinosa of the pars caudalis contain what

A

-excitatory and inhibitory neurons

63
Q

what substance is released from rap he spinal tract fibers onto the pars caudalis?

A

(in the substantia gelatinosa)

serotonin

64
Q

the pars caudalis receives afferents from what

A

cranial nerves 7, 9, 10

65
Q

the pars caudalis is the target of what type of nerve fibers

A

A) a-delta and c fibers (pain)

B) fibers from TMJ

66
Q

estrogen receptors are found where?

A

Trigeminal spinal nucleus Parabrachial nucleus Periaqueductal gray
Hypothalamus

67
Q

high estrogen levels and stress increase activity in
_________________ in
response to pain

A

trigeminal spinal nucleus caudalis laminae

68
Q

GABA normally dampens pain-induced activity in the what?

A

trigeminal spinal nucleus caudalis

69
Q

GABAergic activity is suppressed by high ________ levels

A

estrogen

70
Q

Trigeminocardiac reflex: caused by a stimulation of what?

A 
A) eye and periocular structures
B) nasal mucosa
C) face (diving reflex)
D) needle into CN 5
E) TMJ surgery
71
Q

trigeminocardiac reflex can result in:

A
  • bradycardia (increase vagal tone)
  • apnea
  • arterial hypotension
  • gastric hypermobility
72
Q

trigeminal neuralgia: what divisions are effected?

A

A) V3- 70% of cases

B) V1 - less than 5% of cases

73
Q

what procedure can help stop trigeminal neuralgia?

A

microvascular decompression

74
Q

trigeminal principal sensory nucleus is homologous with what?

A

posterior column nuclei

  • Two point discrimination
  • Vibratory sense
75
Q

what are the 2 ascending trigeminal pathways?

A

A) The ventral trigeminothalamic tract

B) The dorsal trigeminothalamic tract

76
Q

which ascending trigeminal pathway projects contralaterally? bilaterally?

A

Contralaterally- ventral

bilaterally- dorsal

77
Q

where are the cortical representation from cranial nerve 5?

A

Parietal lobe

 - Postcentral gyrus
 - Brodmann’s Areas 1, 2 & 3
78
Q

The Simple Story:

Trigeminal mesencephalic nucleus

A

Homologous with proprioceptive component of posterior

column - medial lemniscal system

79
Q

the simple story: trigeminal principal sensory nucleus

A

Homologous with discriminative touch component of posterior column - medial lemniscal system

80
Q

The Simple Story: Trigeminal spinal nucleus

A

Homologous with pain, crude touch, and temperature

sensation carried by anterolateral system

81
Q

Jaw reflexes:

Input from:

A

Jaw muscles (proprioception) Tactile infomation (food in mouth) Pain information

82
Q

output of the jaw reflexes

A

to muscles of mastication

83
Q

jaw closing reflex: caused by _______

A

food in contact with oral membranes

84
Q

jaw opening reflex is caused by what?

A
  • Periodontal afferents activated by dental occlusion

- Pain afferents from mucosal membranes

85
Q

Corneal reflex: caused by what?

A

stimulation of cornea (trigeminal nerve)

86
Q

Corneal reflex: trigeminal nerve projects to what?

A
  • Trigeminal pricipal nucleus -Trigeminal spinal nucleus

- Relays bilaterally to facial nucleus

87
Q

the _____ is responsible for closing the eye during the corneal reflex

A

facial nerve

88
Q

the corneal reflex is considered a ____ reflex

A

direct and consensual

Neuro- exam 3 (9 decks)

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