Final Exam Flashcards

1
Q

Brain Development:
Beginning is the Embryonic-flat disc, what are the 3 layers and what do they become?

A

*Endoderm—becomes many internal organs
*Mesoderm—becomes musculoskeletal
*Ectoderm—becomes CNS; PNS and skin

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2
Q

Embryonic Development of the Nervous System

A
  • Neural Groove (dent in the center of the embryonic disc, looks like a mustache; begins development)
    *Neural folds (walls of the groove; mustache tails)
    *Neural tube (neural folds that come together and fuse)
    *Neural crest (bits that are pinched off when the tube rolls up)
    *Neural crest becomes the Peripheral Nervous System
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3
Q

Brain Regions: Embryo- 1 Month

A

-Forebrain
-Midbrain
-Hindbrain

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4
Q

Brain Regions: Embryo- 5 Weeks

A

Forebrain becomes:
-Telencephalon
-Diencepahlon
Midbrain becomes:
-Mesencephalon
Hindbrain becomes:
-Metencephalon
-Myelencephalon

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5
Q

Brain Regions: Structures in Adulthood

A

Telencephalon becomes:
-Cerebrum (cerebral hemispheres; includes cerebral cortex, white matter, basal nuclei)

Diencepahlon becomes:
-Diencephalon (thalamus, hypothalamus, epithalamus)

Mesencephalon becomes:
-Midbrain (part of brainstem)

Metencephalon becomes:
-Pons (part of brainstem)
-Cerebellum

Myelencephalon becomes:
-Medulla Oblingata (part of brainstem)

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6
Q

Role of Grey Matter

A

(cell bodies and dendrites of neurons)
-Not myelinated
-Process information in the brain by processing signals generated in the sensory organs or other areas of the grey matter, directing sensory (motor) stimuli to nerve cells in the CNS where synapses induce a response to the stimuli.
-Forms the cortex (edge/outer layer) of the cerebral hemispheres and cerebellum
-Folds and raised areas called the Gyrus
-Depressions within the gyrus is called the Sulcus

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7
Q

Role of White Matter

A

(axons bundles of neurons)
-Myelinated
-Helps the body process information by connecting regions that send and receive signals, affecting the ability to focus and learn, solve problems, and stay balanced when walking

-Surrounds the nuclei in the brain stem
-Forms the core of the cerebellum and cerebral hemispheres
-Fibers connect the right and left cerebral hemispheres
-Corpus callosum lies above the diencephalon and is the bridge between the hemispheres
-Projection fibers carry impulses to the lower centers of the brain stem and SC in one direction, up or down

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8
Q

Role of Basal ganglia

A

-This is movement initiation and control
-Basal ganglia communicates with the cortical motor areas, cortex transfers the information to the tracts. Relies on sensory input from the environment

-Located at the base of the cerebral hemispheres and in the midbrain.
-Types include:
-Striatum
-Globus pallidus
-Subthalamic nucleus
-Substantia nigra
-Basal ganglia function as a whole
-Influence through descending pathways from the cortical motor areas

-Motor loop cycle
*Cerebral cortex—-basal ganglia——through thalamus—–back to cortex

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9
Q

In the brain, white matter is found inside the brain and grey matter is found on the outside. Where are they on the spinal cord?

A

White matter is on he outside of the spinal cord and the grey matter is on the inside.

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10
Q

Brain Regions & Function: Frontal

A

Primary motor area impacts muscle groups
-Generates movement on the opposite side of the body
-Cell bodies project to groups of muscles not isolated muscles
-Consider the motor homunculus

Premotor area requires involvement from other lobes to plan a motor task integrated with the occipital and temporal lobes for vision and auditory to guide body movement by integrating sensory information and controls muscle group that are closest to the body’s midline. Neurons descend directly to SC or indirectly via the primary motor cortex.

Supplementary motor area isn’t autonomic, is internally planned.
-Planning of movement that is internally directed

Motor speech area if there is a speech defect going on then that means that there is something going on in the left side of the frontal lobe of the brain.
-Broca’s production of fluent speech

Prefrontal area connected to the limbic system to control the emotional aspect basically a reaction to a motor activity.
-Interacts with the limbic system and controls the emotional aspect of movement
-Planning of goal directed movement and behavior, and modifies according the changes in the environment (executive function)

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11
Q

Brain Regions & Function: Parietal

A

-Sensory processing from receptors in all parts of the body including eyes and ears
-Awareness of body parts position in space during movement and spatial awareness of the environment

Somatosensory area
-Pathways from skin receptors, muscles, and joints on the opposite side of the body connect with the primary sensory cortex via the thalamus

Sensory association area
-Processing of sensory information—being able to identify objects, temperature, weight, shape, size without vision=stereognosis
-Body scheme-position of body in relation to each other and space
-Also receives input from visual and auditory about the environment
-All giving the ability to use objects and tools

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12
Q

Brain Regions & Function: Temporal

A

-Processes auditory information
-Memory
-Wernicke’s area—extension of the auditory association and plays a role in receptive speech and language
-Visual and auditory input from written and spoken word
-Memory —specifically the hippocampus—helps us find our way

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13
Q

Brain Regions & Function: Occipital

A

Primary vision—striate cortex
-Information from the retina is processed in each striate cortex
-The left half of the visual field for both eyes is processed in the right striate cortex and visa versa for the right
Prestriate cortex
-In association with the parietal and temporal lobes, involves recognition of objects, faces, and in understanding the written word.

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14
Q

Brain Regions & Function: Cerebellum

A

Also known as the “little brain”

Responsible for coordinated and accurate movement.

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15
Q

Brain Regions & Function: Brainstem

A

-Midbrain: a relay system, transmitting information necessary for vision and hearing

-Pons: 90% of synapse occur & relay info to the cerebellum. Connects the cerebral cortex to the cerebellum.

-Medulla Oblongata: Connection for different motor & sensory functions (hearing, taste, and tongue movement (CN XII), touch->somatic sensory info from the SC to thalamus

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16
Q

Brain Regions & Function: 4th Ventricle

A

Processes sensory information, control of voluntary movement, and regulates ANS.

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17
Q

Understand that the cerebral cortex is the outer layer of the brain and has the highest level of neuronal organization and function

A

Organized into distinct functional areas made up of sensory, motor and association areas. It has a broad range of functions including perception and awareness of sensory information, planning, and initiation of motor activity.

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18
Q

Understand that the right and left hemispheres control…

A

…the opposite side of the body’s motor and sensory function

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19
Q

Homunculus

A

MAP OF WHAT PARTS OF THE MOTOR CORTEX ARE DEDICATED TO CERTAIN PARTS OF THE BODY
-Depicts how much brain space is required for certain sensory and motor aspects
-Represents the movements of individual body parts, which often require the coordinated activity of large groups of muscles throughout the body (does not represent the movement of individual muscles, but represents them as a coordinated group)

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20
Q

The difference between the basal ganglia and cerebellum with regards to their individual role in movement

A

Basal ganglia initiates movement while the cerebellum adds fine motor adjustments for balance and motor actions.

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21
Q

Understand the differences between the “subsections” of the motor cortex

A

Frontal Lobe
*Primary motor area
-Generates movement on the opposite side of the body
-Cell bodies project to groups of muscles not isolated muscles
-Consider the motor homunculus

*Premotor area
-Integrated with the occipital and temporal lobes for vision and auditory to guide body movement by integrating sensory information and controls muscle group that are closest to the body’s midline
-Neurons descend directly to SC or indirectly via the primary motor cortex

*Supplementary motor area
-Planning of movement that is internally directed

*Motor speech area
-Broca’s production of fluent speech

*Prefrontal area
-Interacts with the limbic system and controls the emotional aspect of movement
-Planning of goal directed movement and behavior, and modifies according the changes in the environment (executive function)

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22
Q

Differentiate between the different type of sensation

A

*Pain- sharp cutting; dull burning; deep aching

*Temperature- warm/hot; cool/cold

*Touch (tactile)- Itch/tickle & crude touch; discriminative touch (touch, pressure, flutter, vibration)

*Proprioception- (internal forces generated by position and movement) Position: static forces (muscle length and tension; joint pressure. Movement: dynamic forces (muscle length and tension; joint pressure; joint angle).

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23
Q

Circle of Willis: understand the sequence of circulation and areas of the brain

A

Two VERTEBRAL arteries supply the blood to the brain
Vertebral arteries–>converge and form the BASILAR artery–>the basilar splits to form right and left SUPERIOR CEREBELLAR arteries and the POSTERIOR CEREBRAL arteries–>posterior cerebral arteries have branches called the POSTERIOR COMMUNICATING arteries–>which provides the connection to the INTERNAL CAROTID arteries–>
Internal carotids branch to form–>MIDDLE CEREBRAL arteries and the ANTERIOR CEREBRAL arteries–>each anterior artery (on each side) are connected by an ANTERIOR COMMUNICATING artery

24
Q

Which artery in the Circle of Willis provided the most blood to the brain and where does it supply?

A

The middle cerebral arteries supply the majority of the lateral surface of the hemisphere, except the superior portion of the parietal lobe (via the anterior cerebral artery) and the inferior portion of the temporal lobe and occipital lobe (via the posterior cerebral artery).

25
Q

What is nondeclarative/implicit memory?

A

-Memory about things we don’t need to think about, we just automatically do them.
-Memory of novel events and familiar information; learning is reflected in changes in future behavior as a result of prior behavior without conscious memory of the experience itself; procedural memory—motor skills, habits
-Includes:
-Non-associative: occurs in response to a single stimulus, without reinforcement.
-Associative learning:
occurs through the association of two previously unrelated stimuli, and includes reinforcement.

26
Q

What is declarative/explicit memory?

A

-Things you can remember (specifics; where to go, where to park, etc)
-Information that can be consciously declared to have been learned or experienced; conscious awareness of learned information; facts and events.
-Working memory
-We pay attention to small fraction of sensory information.
-Some sensory information held briefly in working memory.
-Small capacity—limited resource
-Mostly discarded, some may be converted to long-term memory
-A capability of neocortex found in numerous brain locations

27
Q

What are the types of memory?

A

i.Long term:
The memeory process in the brain that takes information form the short term memory store and
ii.Executive function:
Planning of goal directed movement and behavior, and modifies according the changes in the environment
Includes working memory, flexible thinking, and self-control.

28
Q

Cranial Nerves: Functions of CN III(3), IV(4), VI(6), X(10), XI(11), XII(12) and is the nerve sensory, motor, or both?

A

CN III (3)- Oculomotor
-Motor
-Moving eye up, down, medially (rectus muscles); raising eyelid; constrict pupil.

CN IV (4)- Trochlear
-Motor
-Moving eye down and medially (superior oblique muscle)

CN VI (6)- Abducens
-Motor
-Abducting the eye (lateral rectus muscle)

CN X (10)- Vagus
-Both
-Visceral regulation; speech

CN XI (11)- Spinal accessory
-Motor
-Scapular elevation (trapezius muscle); rotation of head (sternocleidomastoid muscle)

CN XII (12)- Hypoglossal
-Motor
-Movements of tongue

29
Q

Define Visual Pathways

A

THE RETINOFUGAL PROJECTION:
Diencephalon region
*Lateral geniculate nucleus (LGN)
-Principle target for retinal ganglion cells
-Relays visual signals to ->primary visual cortex, and->higher order visual areas in occipital, temporal, and parietal lobes
-Pathway serving conscious visual perception originates in the retina.
*Suprachiasmatic nucleus of the hypothalamus
-Responsible for our circadian rhythms to natural day/night cycle
-Light sensitive elements

30
Q

What are the right and left visual hemifields and and what are their general pathways?

A

Right Eye
-Left half: Nasal hemifield
-Right half: Temporal hemifield

Left Eye
-Left half: Temporal hemifield
-Right half: Nasal hemifield

Easy way to remeber:
-Outer half of the eyes are TEMPORAL HEMIFIELDS
-Inner half of the eyes are NASAL HEMIFIELDS

  • Temporal fields stay on corresponding sides
    Nasal fields cross over L->R & R->L at the optic chism
31
Q

What is visual processing and visual attention?

A

Visuals processing consists of:
-Visual input (what you see)
-Visual memory (what you can recall from visual input)
-Visual cognition (end product of using both visual input and memory to draw a conclusion)

All of these aspects together produce visual attention.

32
Q

Visual Perception: Body Scheme

A

Being able to identify the locations of body parts

*An unconscious automated system that is required for environmental exploration through movements and static posture
*Neural foundation for the integration of sensory input from muscle, proprioception, tactile, vestibular, cutaneous, visual, auditory, attention, memory, and language to know body position and the relationship of the body and its parts
*Theorist say the parietal lobe (esp R) and cerebellum are linked to body scheme

33
Q

Visual Perception: Depth perception

A

This is the space between object/item/person and self

*Judgment of spatial relations
*Provides three dimension
-Need visual acuity and ocular alignment
-Requires on binocular disparity
*Parietal lobe has been associated with 3-D

34
Q

Visual Perception: Figure ground

A

*Ability to distinguish the foreground from the background
*The foreground (figure) is the center of the person’s attention; incoming stimuli from the background is not the center of attention
*Visual separation of features such as color, luminance, depth, orientation, texture, motion, and temporal information

35
Q

Visual Perception: Spatial relations

A

Refers to the space between items

*The capacity to localize objects in relation to each other and understand the location of objects with respect to oneself
*Can judge distances, distinguish forms, and separate objects from a surrounding background
*Important for orienting to environment, recognizing objects, scenes, and language, and manipulation of objects in hand
*Parietal lobe primarily the R

36
Q

Auditory Pathway

A

SUMMARY
Sound is the compression and expansion of air molecules- creating sound waves. These waves of air hit the external portion of the ear or the pinna,
and through the auditory canal the sound waves in air are converted to fluid motion and then electrical signals

BREAK DOWN
Outer Ear
-The first step in the process is the transfer of the air waves through the outer and middle ear
-The pinna extends into the external auditory meatus which in turn connects with the eardrum
-These structures amplify sound frequencies, particularly those in the range of human speech

Middle Ear
-The ear drum is the entrance to the middle ear
-The middle ear modifies the air waves into a usable form for the inner ear (cochlea) which is fluid filled
-The middle ear contains three small bones and tiny muscles whose job it is to transmit the air waves to the fluid and protect the inner ear from sounds that are too loud.
-The fluid moves and stimulates hair cells much like in the vestibular system
-The cochlea is coiled, with its base near the oval window wider than its tip. It is made up of a membrane with sensory hair cells. The membrane is called the basilar membrane and it is wider at the tip and narrower at the base of the cochlea.

Cochlea
-The cochlea is filled with fluid which is moved when the oval window is pushed by the stapes
-The fluid sends a wave which “hits” at different portions of the coil.
-Different portions are receptive to different frequencies
-We perceive frequency based upon which cells fire

37
Q

Vestibular: Role of the Otoliths

A

*There are two otolith organs, the utricle and saccule
*They both detect linear accelerations and changes in head angle
*Each contains a sensory cell layer called the macula. In the utricle it is horizontal when your head is upright and in the saccule it is vertical.

38
Q

Role of the semicircular canals

A

*Sense angular rather than linear acceleration.
*Sense sudden rotational movements.
*Are also filled with hair cells called the crista.
*The entire canal is filled with endolymph, a sticky thick fluid.
*When the head accelerates in a rotating direction, the fluid moves and the hair cells all bend together in one direction or the other.
* Head Movements
“Yes”= up & down
“No”= left & right
“Idk”= lateral flexion

39
Q

Vestibular ocular reflex (VOR)

A

KEEPS VISION STABLE WHILE IN MOVEMENT
Uses information from the vestibular system of the inner ear to generate movements that stabilize gaze during head movements.

40
Q

Role of vestibular system with the cerebellum

A

-They contribute to the stabilization of body posture during locomotion.
-Helps to maintain equilibrium posture, body support against gravity, and eye movements.

41
Q

Vestibulospinal tract

A

Function
*Medial Vestibulospinal tracts: Send information from the inner ear to monitor head position; mediate postural adjustments and head movements; help the body to maintain balance.
-Excites antigravity muscles in order to exert control over postural changes necessary to compensate for tilts and movements of the body
-Innervates neck muscles in order to stabilize head position as one moves around the world. It is also important for the coordination of head and eye movements.

Head and eye coordination: performs synchronization of the movement of the eye with the movement of the head so that the eyes do not lag behind when the head moves to one side.

42
Q

Lateral and anterior corticospinal tract (upper motor neurons)—role of UMN with LMN

A

i.Function
-Carry conscious/voluntary motor information from the primary motor cortex
-Tracts synapse on the motor spinal nerves (in ventral horn that innervate skeletal muscle

ii.Origin
-Primary motor cortex

iii.Decussation
-Medulla LCS
-Decussate at the spinal level ACS

iv.Destination
-Synapse on the interneuron in the ventral horn on the motor neuron of the motor spinal nerve that innervate skeletal muscle.

v.Pathway
-Cell bodies located in the motor cortex
-At the medulla the lateral corticospinal tract decussates
-Synapses in an interneuron in the gray matter that innervates a descending motor spinal nerve
-Spinal nerve exists the ventral rootlet and root to travel to a target skeletal muscle in the PNS

43
Q

Dorsal columns (posterior column pathway

A

i. Function (both gracilis and cuneatus)—touch and proprioception; interpretation of pain
-Carries cutaneous information to the cortex: discriminative touch; pressure; vibration; proprioception; kinesthesia

ii. Origin
-Nucleus gracilis (LE) and nucleus cuneatus (UE)—In SC dorsal horn

iii. Decussation
-Medulla

iv. Destination
Primary somatosensory cortex

v. Pathway
-Skin receptors in the PNS send sensory information along the peripheral SN
-SN synapse on the interneuron in the dorsal horn of the SC (in the CNS) on the cell bodies of the dorsal horn and ascends through the fasciculus gracilis or cuneatus in the dorsal columns.
-The tract ascends to synapse in the postcentral gyrus (sensory cortex)

44
Q

Lateral spinothalamic tract (anterolateral pathway)

A

i. Function
-Carries conscious sensory information to the cortex regarding pain and temperature

ii. Origin
-Dorsal horn

iii. Decussation
-Spinal cord level—crosses as soon as the SN enters the cord and synapses on the tract

iv. Destination
-Primary somatosensory cortex

v. Pathway
-Skin receptors in the PNS send sensory information along the peripheral SN
-Sensory nerves travel through the dorsal root and rootlets (still in the PNS) and enters the dorsal horn (in the CNS)
-Once in dorsal horn, the SN synapses on the interneuron that joins to the cell bodies of the lateral spinothalamic tract and crosses the midline.
-Ascends up the SC and joins the dorsal column in the pons and continues to ascend and finally synapses in the somatosensory cortex.

45
Q

Anterior spinothalamic tract (anterolateral pathway)

A

i. Function
-Carries conscious sensory information to the cortex regarding crude touch and light touch

ii. Origin
-Dorsal horn

iii. Decussation
-Spinal cord level—crosses as soon as the SN enters the cord and synapses on the tract

iv. Destination
-Primary somatosensory cortex

v. Pathway
-Skin receptors in the PNS send sensory information along ascending SN to dorsal roots and rootlets
-SN synapses on the interneuron in the dorsal horn with the cell bodies of the ascending spinothalamic tract
-Tract crosses the midline of the SC and travels to the medulla and up to the somatosensory cortex

46
Q

Posterior spinocerebellar tracts

A

i. Function
-Carries unconscious sensory information from the LE to the cerebellum regarding proprioception (pressure and tension of skeletal muscles and coordination of motoric movement of individual muscles.
-Carries information form the muscle spindles, golgi tendons, and joint receptors in the PNS. Information never reaches the cortex for conscious interpretation

ii. Origin
-Dorsal horn at the T6 and below level

iii. Decussation
-None-ipsilateral

iv. Destination
-Cerebellum

v. Pathway
-The muscle spindles, golgi tendons, and joint receptors in the PNS send proprioceptive information along the ascending sensory SN to the dorsal root and rootlets.
-The sensory SN then synapse on an interneuron in the dorsal horn
-The interneuron joins to the cell bodies of the posterior spinocerebellar tract in the dorsal horn, and the tract begins to ascend up the ipsilateral side to the medulla and synapses in the cerebellum

47
Q

Anterior spinocerebellar tracts

A

i. Function
-Carries unconscious sensory information from the LE to the cerebellum regarding proprioception (pressure and tension of skeletal muscles and coordination of posture and movement of limbs.
-Carries information form the muscle spindles, golgi tendons, and joint receptors in the PNS to the cerebellum

ii. Origin
-Dorsal horn in the lumbar region

iii. Decussation
-SC level in the lumbar section
-Decussates as soon as the SN synapses on the cell bodies of the anterior spinocerebellar tract

iv. Destination
-Cerebellum

v. Pathway
-The muscle spindles, golgi tendons, and joint receptors in the PNS send proprioceptive information along the ascending sensory SN to the dorsal root and rootlets.
-The sensory SN then synapse on an interneuron in the dorsal horn
-The interneuron joins to the cell bodies in the dorsal horn, then decussates across the midline and ascends up the pons and synapses in the cerebellum

48
Q

Cuneocerebellar spinocerebellar tracts

A

i. Function
-Carries unconscious sensory information from the trunk and UE to the cerebellum regarding proprioception (pressure and tension of skeletal muscles and coordination of motoric movement of individual muscles.
-Carries information form the muscle spindles, golgi tendons, and joint receptors in the PNS. Information never reaches the cortex for conscious interpretation

ii. Origin
-Dorsal horn at the T6 and above level

iii. Decussation
-None-ipsilateral

iv. Destination
-Cerebellum

v. Pathway
-The muscle spindles, golgi tendons, and joint receptors in the PNS send proprioceptive information along the ascending sensory SN to the dorsal root and rootlets of T6 and above
-The sensory SN then synapse on an interneuron in the dorsal horn
-The interneuron joins to the cell bodies of the cuneocerebllar tract in the dorsal horn, and the tract begins to ascend to the inferior cerebellar peduncle in the medulla, and the tract synapses in the cerebellum

49
Q

Rostral spinocerebellar tracts

A

i. Function
-Carries unconscious sensory information from the trunk and UE to the cerebellum regarding proprioception (pressure and tension of skeletal muscles and coordination of posture and movement of limbs.
-Carries information form the muscle spindles, golgi tendons, and joint receptors in the PNS to the cerebellum

ii. Origin
-Cervical level

iii. Decussation
-Does not decussate—ipsilateral
iv. Destination
-Cerebellum
v. Pathway
-The muscle spindles, golgi tendons, and joint receptors in the PNS send proprioceptive information along the ascending sensory SN to the dorsal root and rootlets of the cervical levels.
-The sensory SN enter the dorsal horn of the SC and synapse in the ventrolateral gray on the interneuron.
-The interneuron then synapses on the cell bodies of the rostral spinocerebellar tract, the tract begins to ascend to the lateral white funiculus
o The tract then ascends to either the inferior cerebellar peduncle or the superior cerebellar peduncle and synapses in the cerebellum

50
Q

PNS: ASIA Dermatome diagram for cervical region (C5, C6, C7, C8) with sensory distribution of UEs

A

THIS MAKES THE CONNECTION BETWEEN THE NERVES AND THEIR ROOTS
These focuses on the motor aspects.

PERIPHERAL SENSORY NERVE DISTRIBUTION

VOLAR SIDE:
Radial- lateral half of thumb
Median- medial half of thumb, index, middle, lateral half of ring finger.
Ulnar- medial half of ring finger and pinky

DORSAL SIDE:
Radial- full thumb, index, middle, and lateral half of ring finger from the PIP up.
Median- tips, up to the PIP of the index, middle, lateral half of ring finger.
Ulnar- medial half of ring finger and pinky

DERMATOME
C6: Thumb and index
C7: Middle finger
C8: Ring and pinky

51
Q

What is a myotome?

A

Group of muscles innervated by a spinal root

52
Q

What is a dermatome?

A

Sensory representation of a cervical level

53
Q

What is peripheral sensory nerve?

A

Refers to the branches of the brachial plexus

54
Q

How to tell the difference between cervical and peripheral sensory nerve being affected?

A

If its a portion of a body part (i.e. half of a finger) it is a PSN (branch), if its that whole body part its a cervical issue (spinal level).

55
Q

Difference between motor and sensory synapses?

A

Motor synapses occur once, where sensory synapses occur multiple times.