Exam 2 Deck 1 Flashcards
What is worrysome about a headache that is worse at night/in supine positions?
May be a tumor
Further increased ICP
What types of lesions affect the optic chiasm?
SATCHMO
Adenoma/Aneurysm, and Meningioma are common
Sarcoid
Adenoma/Aneurysm
Teratoma
Craniopharyngeoma
Hystiocytosis
Meningioma
Optic Glioma
What does the SATCHMO mnemonic stand for?
For lesions that can affect the optic chiasm
Sarcoid
Adenoma/Aneurysm
Teratoma
Craniopharyngeoma
Hystiocytosis
Meningioma
Optic Glioma
What is the hormone most commonly elevated in a benign pituitary tumor?
Prolactin
What is a drug that reduces prolactin production?
Bromocriptine
What is the most common age group for the initial onset of hereditary epilieptic disorders?
Teens
What cells in the retina see color?
Cones
What cells in the retina see light?
Rods
What color light is usually the first one to go in the loss of color vision?
Red light
What is a scotoma?
A missing patch of your visual field (can be any shape)
e.g.
What can cause pain with eye movements?
Optic nerve inflammation
Thyroid disease - extraocular muscle swelling + pain
Which way is nystagmus defined?
In the direction of the fast phase
In vestibular neuronitis, towards which side do you tend to fall?
Towards affected side
In vestibular neuronitis, towards which side do you see nystagmus?
Away from affeted side
What is a mnemonic for the direction of nystagmus in caloric testing?
COWS
Cold - opposite
Warm - same
What are exteroreceptors?
Sensory receptors receptive to stimuli on or beyond the body surface
What are interoreceptors?
Sensory receptors receptive to stimuli arising within the body itself.
What are proprioceptors?
Special group of interoceptors which are receptive to the position of the body, head or limbs in space.
What is the nature of the relationship between an axon and a sensory modality?
One axon only transmits sensation of one modality
What type of neurons are the sensory neurons?
Pseudounipolar DRG neurons
Where are the cell bodies of sensory neurons located?
DRG
What are the three main types of peripheral sensory nerve endings?
Free nerve endings
Unencapsulated endings associated with accessory structures Encapsulated endings
What are free nerve endings?
Majority of the sensory receptors in the skin
They display no obvious structural specialization, but evidence suggests that different fibers respond preferentially to painful stimuli, or warmth or cold, or to mechanical displacement of the skin
What is the difference between a neuropathy, radiculopathy, and myelopathy?
Neuropathy - nerve
Radiculopathy - root
myelopathy - spinal cord
What type of nerve fibers give rise to free nerve endings?
Unmyelinated (C fibers)
Myelinated (A-delta fibers)
What are unencapsulated nerve endings with accessory structures?
Terminal axon branches which end in intimate association with other cell types found in the skin
What is an example of an encapsulated nerve ending with accessory structures?
Hair - detects deflection
Merckel’s touch corpuscles - detect pressure
What are encapsulated nerve endings?
Nerve endings in which the terminal axon ends inside a distinct connective tissue capsule; these endings are often specialized for determining the direction or type of displacing force that acts on the contained sensory nerve terminals
What are examples of encapsulated nerve endings?
Pacinian Corpuscles - Vibratory information
Ruffini Endings - Pressure information
What type of fibers are encapsulated nerve endings innervated by?
Largest diameter myelinated fibers - A-beta fibers
How is intensity of a signal encoded by nerves?
By the frequency of action potentials and the number of fibers recruited
What is encoded by the frequency of action potentials and the number of fibers recruited?
Intensity
How is location of a stimulus encoded?
By the position and size of a neuron’s receptive field
What is encoded by the position and size of a neuron’s receptive field?
Localization of a stimulus
How is the duration and rate of change of a stimulus encoded?
By the discharge characteristics of an axon:
slowly adapting - discharges as long as the stimulus is present
rapidly adapting - discharges at the onset or offset of a stimulus
What are the two main ascending sensory columns in the spinal cord?
Dorsal Column-Medial Leminscal (DC-ML) System - Mechanosensation
Spinothalamic (Anterolateral) Tract - Pain and Temperature
How is the dorsal root organized?
Medial division contains touch, pressure and vibraton (A-beta fibers) and position and movement (Group I, II fibers); these are larger afferents
Lateral division contains pain and temperature (A-delta and C fibers) and crude touch (Group III, IV fibers); these are smaller afferents
What are the larger muscle sensory afferent fibers?
Group Ia - muscle spindle primary fibers
Group Ib - golgi tendon organ (GTO)
Group II - muscle spindle secondary fibers
Group III and IV are smaller, encode pain and temperature
What are the smaller muscle sensory afferent fibers?
Group III and Group IV - encode pain and temperature
What are the larger cutaneous sensory afferent fibers?
A-beta : encode touch and pressure
What are the smaller cutaneous sensory afferent fibers?
A-delta and C fibers : encode pain and temperature and crude touch
What happens to medial fibers entering the dorsal root?
They have three fates:
1) can terminate in Lamina III/ IV, VII, IX
2) can ascend a couple of spinal segments and then terminate in the tracts above - these travel through the fasiculus interfasicularis or the fasiculus septomarginalis
3) can ascend via the dorsal columns (fasiculus gracilis or cuneatus) to the medulla
What is the fasiculus interfasiculatus or the fasiculus septomarginalis?
Tract that allows for some branches of the medial division of the dorsal root nerve fibers (those that belong to the dorsal column - medial leminscal system) to travel up a few segments in the spinal cord and synapse in the appropriate lamina
What is the fasiculus gracilis?
Part of the dorsal columns
The more medial column that is present at ALL cord levels. Carries information from lower levels of the spinal cord (organized so that medial = toes; dorsal and f. cuneatus = arm + above)
What is the fasiculus cuneatus?
Dorsal column spinal tract present at T6 and above that carries information from the upper trunk and limbs (recall organization of the dorsal columns)
How is information organized in the dorsal columns?
Fibers in the spinal dorsal columns are somatotopically organized: sacral regions are represented by fibers lying most medially, next to the dorsal median septum, then, on moving laterally, foot, thigh, lower trunk (in the gracile fasciculus), upper trunk, upper limbs and neck (in the cuneate fasciculus).
What two tracts make up the dorsal columns?
Fasiculus gracilis (medial) and fasiculus cuneatus (lateral)
What side of the body do dorsal column - medial leminscal system fibers in the spinal cord correspond to?
Ipsilateral - DC-ML crosses over at the medulla
What happens to the lateral fibers entereing from the dorsal horn?
The fibers accumulate on the surface of, and immediately ventral-lateral to, the surface of the dorsal horn, where they form Lissauer’s tract (or dorsolateral tract).
In this tract, the C fibers and A-delta fibers branch over 2-5 segments and enter the ipsilateral dorsal horn, terminating on second-order neurons of laminae I and II mostly (substantia gelatinosa).
What is Lissaurer’s Tract?
Tract from the lateral fibers from the dorsal root, where the C fibers and A-delta fibers branch over 2-5 segments and enter the ipsilateral dorsal horn, terminating on second-order neurons of laminae I and II mostly (substantia gelatinosa).
(i.e. spinothalamic tract)
What information does the dorsal column-medial leminscal pathway transmit?
It is the principal pathway through which information about position, movement, touch and vibration is conveyed to higher perceptive centers of the brain (e.g. the cerebral cortex)—that is, it is concerned with discriminative aspects of somatic sensation.
Where do neurons of the dorsal column-medial lemiscal pathway synapse?
They synapse at the dorsal column nuclei
Either the gracile nucleus or the cuneate nucleus, depending on the fasiculus which it ascended in. These nuclei maintain the somatotopy, place, and modality specificity and send their neurons across the midline via the great sensory decussation to the medial lemniscus and up to the thalamus.
Where do the neurons of the dorsal column nuclei send their axons?
Send their axons across the midline via the great sensory decussation and then ascend up the opposite side of the brain to the thalamus via the medial lemniscus
What is the medial lemniscus?
Ascending sensory tract after the great sensory decussation that sends dorsal column nuclei axons up to the thalamus
What is the dorsal column-medial lemniscal pathway?
The continuation of the fibers which form the medial division of the dorsal roots. Extends up from the spinal cord through the gracile and cuneate faciculi where they end on their respective nuclei (nucleus gracilis and nucleas cuneatus). These dorsal column nuclei then send axons across the great sensory decussation and up the medial lemniscus. These fibers terminate in the thalamus.
What is the great sensory decussation?
Crossing over of sensory fibers in the medulla.
Fibers are those of the dorsal column nuclei (gracile nucleus or cuneate nucleus)
These fibers then ascend up the medial lemniscus and into the thalamus
What is the spinothalamic pathway?
The continuation of fibers which form the lateral division of the dorsal roots.
Transmits information of pain and temperature to the brain via A-delta and C fibers
Via laminae I and lamina V
Crosses in the cord via the ventral white commissure
Ascend via the anterolateral funiculus to the thalamus without interruption
Where does the dorsal column-medial lemiscal pathway cross over?
In the medulla at the great somensory decussation
Where does the spinothalamic pathway cross over?
In the spinal cord - at the ventral white commisure
What is syringomyelia?
A cavitation in the center of the spinal cord
Will cause segmential lesions to the sensory fields represented by the spinothalamic tract (pain and temperature) since they cross over in the spinal cord (bilateral).
Cape-like (suspended) sensory loss
What occurs in Brown-Sequard Syndrome?
Hemisection of the spinal cord causes:
IPSILATERAL loss of position and vibration
CONTRALATERAL loss of pain and temperature
What types of fibers are involved in the DC/ML system?
Large diameter, myelinated fibers that are topographically organized and convery proprioception and mechanosensation (touch, pressure, vibration)
Group I, Group II, A-beta fibers
What types of fibers are involved in the ST (spinothalamic) system?
Small-diameter, thinly/non-myelinated fibers that convey pain and temperature information
A-delta and C fibers
Where do large-diameter sensory fibers from the face terminate?
In the principal (or chief) trigeminal nucleus, in the pons on the ipsilateral side
These convey touch, pressure, and vibration
Where do touch, pressure and vibration sensory afferents from the face terminate?
In the principal (or chief) trigeminal nucleus, in the pons on the ipsilateral side
These are the large diameter fibers
What is the the analagous structure to the dorsal column nuclei for the trigeminal sensory system?
the principal (or chief) trigeminal nucleus
It is in the pons on the ipsilateral side of the sensory afferents
What is the course of touch, pressure, and vibration information (i.e. large diameter fibers) from the face?
From face to the trigeminal ganlgion where it synapses at the principal sensory nucleus (principal or chief trigeminal nucleus). Then secondary neurons cross in the pons and join the ascending medial lemiscal fibers, adding the face to the body plan that is conveyed and conserved in the tract. They then go up to the thalamus
What is the spinal tract of V?
Analagous to Lissauer’s Tracts but for the trigeminal nerve.
Axons course caudally to terminate in the spinal nucleus of V on the ipsilateral side
What is the analagous structure to Lissauer’s tract for the trigeminal nerve?
Spinal tract of V
Where do small diameter and unmyelinated fibers from the face terminate?
Course through the ipsilateral spinal tract of V to the caudal 1/3 of the spinal nucleus of V.
Where do the pain and temperature information fibers from the face terminate?
Course through the ipsilateral spinal tract of V to the caudal 1/3 of the spinal nucleus of V.
These are the small diameter fibers (A-delta) and the unmyelinated (C fibers)
What is the course of pain and temperature information from the face?
A-delta and C fibers from the face enter in the pons, but course caudally to the medulla via the ipsilateral spinal tract of V.
Once at the medulla, they terminate at the caudal 1/3 of the spinal nucleus of V (ipsilateral)
From here, the second and third order neurons cross the midline and join the ascending spinothalamic tract and go up to the thalamus
What do lesions that damage the medullary levels of the trigeminal pathways manifest as?
Ipsilateral pain and temperature sensation loss of the face
What do lesions that damage the pontine levels of the trigeminal pathways manifest as?
Ipsilateral touch, pressure, and proprioception loss; damage to the motor neurons
What do lesions that damage above the brainstem levels of the trigeminal pathways manifest as?
All sensory modalities affeted contralaterally
Motor function not affected - these are innervated bilaterally
How are sensory fibers somatotopically organized in the brainstem?
What is the somatotopy of the medial lemiscal tract at the point of entry to the thalamus?
More dorsal is legs, more ventral is face
What is the somatotopy of the spinothalamic tract upon entry to the thalamus?
None at this point
What is the major somatosensory relay nucleus of the thalamus?
The ventral posterior nucleus (contains VPL and VPM)
What is significant about the ventral posterior nucleus?
It is the major somatosensory relay nucleus of the thalamus and is the only site of termination of the medial lemiscus and a major site of termination of spinothalmaic fibers
Where do axons of VP neruons project to?
The first somatosensory cortex SI in the caudal bank of the central sulcus and the postcentral gyrus
Also to part of the parietal operculum, to an area called the second somatosensory area (SII or S2)
Where do dorsal column nuclei fibers terminate?
On the contralateral VPL
Where do principal trigeminal nuclei fibers terminate?
On the contralateral VPM
What is the relationship between VPL, VPM and the somatotopic organization of the sensory information from the dorsal column-medial leminiscal system?
Legs are lateral, face is medial, etc
Further extremities are ventral
Which areas have disproportionately large representaitons in the ventral posterior thalamus?
Foot, hand and lips
they have highest density of innervation
What is the relationship between VPL, VPM, and the sensory information relayed from the spinothalmaic tract?
Not much
How is the somatosensory information of the thalamus represented in the primary sensory cortex (S1)?
What types of neurons exist in the thalamic nuclei?
Relay neurons (relay to the cortex)
Inhibitory interneurons (which use GABA)
They exhibit properties which mirror those of their input (lemniscal or spinothalamic, not both)
What are properties of thalamic relay neurons with lemniscal inputs?
Great synaptic security (reproduce faithfully the temporal pattern of APs)
Modality and place specificity
Clustering of place and modality characteristics
Surround inhibition - activaiton of one group inhibits neighbors
What are properties of thalamic relay neurons with spinothalamic inputs?
Fewer cells that are hard to drive (require intense stimuli)
Large receptive fields
Respond specifically to noxious stimuli and thermal (cooling) stimuli
What information is projected to areas 3a and 2 of S1?
Proprioceptive information (i.e. from muscle spindle primary and secondary afferents and from joints) that comes from VP cell axons
What information is projected to areas 3b and 1 of S1?
Cutaneous tactile information (i.e. from A-beta fibers) from VP cell axons
What areas in S1 recieve thalamic innervation from the spinothalamic inputs?
all four areas (1, 2, 3a, 3b)
Which areas of S1 recieve proprioceptive information?
3a and 2
Which areas of S1 recieve cutaneous tactile information?
3b and 1
What cortical layers do spinothalamic thalamic neurons project to?
I
What cortical layers do lemniscal thalamic neurons project to?
IV
What information is represented in S2?
Bilateral neurons from VP thalamus
Somatotopically represented with the face anterior and the legs posterior
What are descriminative features of pain?
Ability to perceive and localize
What are affective features of pain?
Behaviors and emotions that affect mood and motivation (more nebulous a concept than the discriminative features of pain)
What is the pathway of pain perception from the neck down?
Spinothalamic tract from lateral fibers of dorsal root. Up to VPL and to cortex
What is the pathway of pain perception in the face?
From trigeminal nerve down the spinal trigeminal tract and across to join the spinothalamic tract and goes up to the VPM. Then to cortex
How is affective pain perception acheived?
There are many collateral branches from the ascending basic pathways of discriminative pain perception. These innervate structures along the way to the thalamus:
Periaqueductal Grey (PAG)
Rostroventral medulla (RVM) - parabrachial nucleus, reticular formation, raphe nucleus
VM and MD nuclei in the thalamus
Ventromedial hypothalamus (VMH)
amygdala
Globus pallidus
What structures contribute the emotional content of pain?
Amygdala, cingulate gyrus
What structures contribute to the motivational content of pain?
Globus pallidus, cingulate S1 gyrus, insula
What structures contribute to the generation of appropriate behaviors to threats?
Ventromedial hypothalamus (VMH)
What structures contribute descending control of nocioceptive information in the cord?
Amygdala, ventromedial hypothalamus, periacqueductal gray, rostroventral medulla (parabrachial nucleus, medullary reticular formation, locus cerulius (norepinephrine), raphe nucleus (serotonin))
How is pain perception modulated from the top down (descending modulatory systems)?
Periaqueductal grey plays a big role in integrating information from the top and from the ascending spinothalamic tracts
What is the end activity of top-down modulation of pain perception?
Periacqueductal grey neurons activate raphe nucleus (serotonin) and locus ceruleus (norepinephrine) neurons that act on local inhibitory interneurons that can release enkephalin to reduce the throughput of ascending spinothalamic signals (via lamina I and V neuron inhibition)
What is the effect of endogenous opiates on the transmission of pain signals in the cord?
Enkephalin shortens the duration of action potentials (limits calcium entry), which decreases neurotransmitter release. This diminishes the response of the subsequent neuron
Pre-synaptic (A-delta and C fibers): decreases neurotransmitter release
Post-synaptic - decrease afferent evoked EPSP by hyperpolarizing the cells
What are the four types of pain disorders?
Nociceptive (cutaneous adn visceral)
Inflammatory
Dysfunctional
Neuropathic
What is nociceptive pain (in the context of pain disorders)?
Physiological pain produced by noxious stimuli that activate high-threshold nociceptor neurons
Concept of first and second pain is involved here
As well as Gate Theory
What is the concept of first and second pain?
First pain is experienced because of A-delta fibers (sharp, quick)
Second pain is experiened because of C-fibers (duller, longer)
What is the Gate Theory?
Spinothalamic nerves receive convergent input from both Aδ/C (pain and temp) and Aβ fibers (mechanosensation). Aβ fibers can activate an inhibitory interneuron, which dampens the throughput of pain info from Aδ/C fibers to the spinothalamic pathway
What is referred pain?
Group III, IV (visceral pain afferents) terminate on spinothalamic tract neurons that are also receiving cutaneous Aδ/C fibers, so pain is perceived to be coming from the cutaneous receptive field
What is inflammatory pain (in the context of pain disorders)?
Pain hypersensitivity due to peripheral inflammation. Whole system is amped up.
Can serve a protective role
Can cause allodynia - normally non-painful stimuli become painful
Can cause hyperalgesia - exaggerated response to normally painful stimulus
What is allodynia?
Normally non-painful stimuli become painful. Seen in the context of inflammatory pain
What is hyperalgesia?
Exaggerated response to a normally painful stimulus
Seen in the context of inflammatory pain
What is the mechanism of inflammatory pain?
neurochemical mediators (IL-1β, IL-6, NO, bradykinin, NGF, H+) secreted by immune cells cause pain fibers to discharge APs aberrantly, which causes both peripheral and central amplification of pain pathways
What is dysfunctional pain?
Maladaptive pain that neither protects or supports healing and repair
Pain present without stimulus
Has all of the same components as inflammatory pain (hyperalgesia, allogynia) without evidence of inflammation
Examples include primary erythermalgia, fibromyalgia
What is primary erythermalgia?
Dysfunctional pain disorder - peripheral amplification (vs central like in fibromyalgia)
Rare
Red, warm, burning sensation in hand and feet
Caused by a sodium channelopathy where there is a gain of function mutation
What is fibromyalgia in the context of pain disorders?
Disfunctional pain disorder presenting with body-wide pain in joints and muscles
A process that is due to central amplification of pain (vs peripheral as in primary erythermalgia)
What is neuropathic pain in the context of pain disorders?
Maladaptive plasticity caused by a lesion or disease that alters nociceptive processing
Pain is felt in the absence of a stimulus
Can be chronic and debilitating
Hyperalgesia, allodynia, and pain that outlasts the stimulus
What are mechanisms of neuropathic pain?
CNS lesion or disease (stroke, spinal cord injury, MS)
PNS lesion or disease (nerve trauma, toxic and metabolic neuropathies, Herpes zoster, AIDS)
What is phantom limb pain?
Type of neuropathic pain that refers to pain in a body part that has been amputated or deafferented
Almost all amputees report this, but not all are painful
Can be short-lasting shocks to excruciating, chronic pain
Maladaptive reorganization of connections in CNS centers, mostly S1
What is the mechanism for phantom limb pain?
Cortical reorganization of S1: axons from neighboring cortex sprout into denervated regions of the cortex (previously receiving input from the amputated limb) and, for unknown reasons, this causes ectopic discharges (axons fire unpredictably), which is interpreted as pain
What are therapeutic strategies that attempt to manage pain?
Monoamine reuptake inhibition - enhance descending inhibitory control (antidepressants)
Block ectopic discharge (anticonvulsants - sodium channel)
Block transmitter release (anticonvulsants - calcium channel)
Enhance endogenous analgesic system (opiod agonists)
What are complications of using exogenous opiods (e.g. morphine)?
They drive the brain reward pathways too
Causes physcial, psychological dependence
Can see tolerance
Overdose
Constipation
Cognitive impairment
Cardiac arrhythmias
What occurs in central sensitization that is responsible for the development of chronic pain?
Synaptic signaling strength of pain pathways is greatly exageratted by maladaptive neoplastic mechanisms:
- increased membrane excitability in peripheral axons (Na channel upregulation)
- Increased synaptic efficacy (upregulation of glutamate receptors at non-primary neurons)
- Decreased inhibition in local interneuron networks
What structure does the epithalimus primarily connect to?
The hypothalamus
Notably not the cortex
What structure does the dorsal thalmus (i.e. the thalamus) primarily send and recieve axons from?
The cerebral cortex
Each relay nucleus projects to one (sometimes a few) cortical area in what are called thalmaocortical projections
They each also recieve feedback input from the same areas, called corticothalamic projections
These are notably ipsilateral, and excitatory (use glutamate)
To which side of the brain do thalamic communications with the cerebral cortex occur?
Ipsilateral
What type of signals (inhibitory/excitatory) do signals between the thalamus and cerebral cortex use?
Excitatory!
What neurotransmitter is used in the thalamocortical and corticothalamic projections?
Glutamate - excitatory
They are also ipsilateral
What is significant about the ventral thalamus?
It is a sheet of GABAergic inhibitory interneurons that surrounds the thalamus (dorsal thalamus). They send their axons ONLY to the dorsal thalamus and do not project to the cerebral cortex.
What is the thalamic reticular nucelus (TRN)?
Ventral thalamus structure that is a sheet of GABAergic inhibitory interneuron.
Sends axons ONLY to the dorsal thalamus and not to the cerebral cortex
What structure do the axons of the ventral thalamus (thalamic reticular nucleus - TRN) project to?
The dorsal thalamus only
No projections to the cerebral cortex
What are the three main nuclear groups of the thalamus?
Medial
Lateral
Anterior
What divides the three nuclear groups of the thalamus?
The internal medullary lamina
Which nucleus receives afferents from the dorsal column nuclei, the spinothalamic tract and the vestibular nuclei?
VPL
Sends efferents to S1, S2, and the posterior parietal cortex
Where does the VPL receive afferents and where does it send efferents to?
From: dorsal column nuclei, spinothalamic tract, vestibular nuclei
To: S1, S2, posterior parietal cortex
(sensory)
What is the primary function of the VPL relay neurons?
Sensory
What is the primary funciton of the VPM?
Sensory
From trigeminal nucleus and spinal nucleus of V
To S1, S2
Where does VPM recieve afferents from and send efferents to?
From: principal trigeminal nucleus, spinal nucleus of V
To: S1, S2
What thalamic nucleus do afferents from the prinicpal trigeminal nucleus and spinal nucleus of V relay at?
VPM
Where do axons of the nuclei of the solitary tract (taste) and of the spinothalamic tract project to in the hypothalamus?
VM nucleus
Send efferents to the gustatory cortex and insula
Where do VM nucleus neurons in the hypothalamus receive and send axons to?
From: Solitary tract nuclei (taste), spinothalamic tract
To: Gustatory cortex, insula
Where do LGN neurons receive afferents from and send efferents to?
From: Retina via optic tract
To: V1
What thalamic nucleus receives afferents from the retina via the optic tract?
LGN
To which thalamic nucleus do afferents from the superior colliculus send their axons?
LP (lateral posterior)/ pulvinar nucleus
Where does the LP/pulvinar nucleus in the thalamus receive afferents from and send efferents to?
From: Superior colliculus
To: Temporal and parietal visual association cortical areas
Which thalamic nucleus do neurons from the inferior colliculus send their axons?
Medial Geniculate Nucleus (MGN)
Where does the MGN send and receive its efferents/afferents?
From: Inferior colliculus
To: A1
Which thalamic nucleus receives its afferents from the substantia nigra and globus pallidus?
VA - motor
Sends to several frontal cortical areas
Where does the VA nucleus in the thalamus send/recieve efferents/afferents from?
From: Substantia nigra, globus pallidus
To: Several frontal cortical areas
What thalamic nucleus receives afferents from the globus pallidus?
VLa
(VA receives from globus pallidus too, but also receives from substantia nigra)
VLa sends efferents to the premotor cortex
Where does the VLa nucelus in the thalamus send/receive efferents/afferents to/from?
From: Globus pallidus
To: Premotor cortex
Which thalamic nucleus receives afferents from the cerebellum?
VLp
Sends efferents to M1
Where does the VLp nucleus in the thalamus send/receive efferents/afferents to/from?
From: Cerebellum
To: M1
Which thalamic nucleus receives afferents from the hypothalamus?
The anterior group
Where does the anterior group of the thalamus send/receive efferents/afferents to/from?
From: Hypothalamus
To: Cingulate cortex
Which thalamic nucleus receives afferent signals from the amygdala and subiculum?
The MD nucleus (Medial dorsal)
Where does the MD nucleus of the thalamus send/receive efferents/afferents to/from?
From: Amygdala, subiculum
To: Prefrontal cortex
Which thalamic nucleus receives afferent signals from the subiculum?
LD nucleus (Lateral dorsal)
The MD nucleus does too, but it also receives from the amygdala
Where does the LD nucelus of the thalamus send/receive efferents/afferents from/to?
From: subiculum
To: Prefrontal, retrosplenial cortices, parahippocampal gyrus
Where do the intralaminar nuclei of the thalamus send/receive efferens/afferents from/to?
From: Globus pallidus, spinothalamic tract, cerebellum, substantia nigra, multiple cortical areas
To: Striatum (caudate and putamen), multiple cortical areas - layer I
What is contained in every relay nucleus in the thalamus?
Excitatory relay neurons that project through the internal capsule to middle layers (mostly layer 4) of their cortical target fields
GABAergic inhibitory interneurons whose axons remain local - NOT part of the TRN.
How does corticothalamic input modulate the output of relay neurons in thalamic nuclei?
Feedback inhibition from the TRN, via thalamic-cortical collaterals
Feedforward inhibition from descending cortical fibers, via cortical-thalamic axon collaterals
And feedforward inhibition from ascending afferent fibers
What are the main roles of the thalamus?
Relay functions - synapses that preserve and sharpen topographic information and modality specificity while transferring information from the periphery to the cerebral cortex
States of consciousness - Different behavioral states (awake vs sleep) are associated with firing frequencies of thalamic neurons
How does the thalamus regulate states of consciousness?
By the frequency of its neuronal firing
Tonic firing = awake, alert
Burst firing = drowsy, asleep
What is tonic firing?
Thalamic state of relative depolarization (caused by neurotransmitters ACh, histamine, norepinephrine) that allows dorsal thalamic relay neurons to fire faithfully in response to depolarization.
This allows information to flow through the cotex and corresponds to wakefullness
Which thalamic firing pattern is associated with wakefullness/alertness/
Tonic firing
What is burst firing?
Thalamic neuron firing pattern that corresponds with drowsiness and sleep.
the resting membrane potential is hyperpolarized (serotonin can do this) and thalamic relay neurons fire in an oscillatory manner, which blocks the flow of information to the cortex. A functional loop between the TRN and dorsal thalamus maintains this pattern:
- TRN action potentails cause GABA release, generating IPSPs which hyperpolarize the dorsal thalamus relay neurons
- IPSPs trigger hyperpolarization-sensitive channels that allow for increased Na conduction and action potential firing
- This triggers an action potential in the TRN, which starts teh cycle again
Which thalamic firing pattern is associated with deep sleep/drowsiness?
Burst firing
What neurotransmitters regulate the thalamic firing pattern?
ACh, histamine, norepinephrine depolarize the membranes of dorsal thalamic nuclei, kicking the neurons into tonic firing
Serotonin hyperpolarizes the membranes of dorsal thalamic nuclei and TRNs, which triggers burst firing and prevents information from goign to the cortex
What is the effect of serotonin (5HT) on the thalamus?
Promotes burst-firing pattern of activity by hyperpolarizing the membranes of the dorsal thalamicn uclei and TRN
What is the effect of ACh on the thalamus?
Depolarizes the membrane of the dorsal thalamic nuclei, kicking neurons into tonic firing mode
What is the effect of histamine on the thalamus?
Depolarizes the membrane of the dorsal thalamic nuclei, kicking neurons into tonic firing mode
What is the effect of norepinephrine on the thalamus?
Depolarizes the membrane of the dorsal thalamic nuclei, kicking neurons into tonic firing mode
What is typically the cause of thalamic lesions?
Vascular issues
What is the reticular activating system?
parabrachial, pedunculopontine and other brainstem nuclei (ACh)
Locus ceruleus (norepinephrine)
Raphe nucleus (serotonin)
hypothalamic nuclei (histamine)
Help control the firing pattern of thalamic nuclei
What is thalamic syndrome?
Damage to posterior structures o the thalamus, including VPL/VPM
Characterized by contralateral hemianesthesia and excruciating pain
What is the effect of damage to the posterior thalamus (VPL, VPM)?
Thalamic syndrome
Contralateral hemianesthesia, excruciating pain
What are tremor states?
Rhythmic bursts in VA/VLa due to frequency abnormalities in GP-thalamus circuits (e.g. parkinsons)
What is caused by frequency abnormalities in GP-thalamus circuits?
Rhythmic bursts in VA/VLa that result in tremor states
What causes amnesia?
Lesions in anterior nuclei, MD nuclei that disrupt amygdala-hippocampal circuitry
What is caused by lesions in the anterior nuclei, MD nuclei that disrupt amygdala-hippocampal circuitry?
Amnesia
What are absence seizures?
Spike and wave patterns entrained by very long bursts in TRN GABAergic neurons that cause
Marked by sudden onset of consciousness that lasts a brief amount of time.
What is caused by very long bursts in TRN GABAergic neurons?
Spike and wave patterns that are characteristic for absence seizures
What are the broad components of the eye?
3 Layers (External, Intermediate, Internal)
3 Fluid Compartments (Anterior chamber, posterior chamber, vitreous body)
Crystalline Lens