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L13 - ascending pathways Flashcards

1
Q

dermatome

A

A specific region of skin of the body innervated by the sensory fibres of a single segmental spinal nerve

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2
Q

general sensory pathways

A

Carry information of different types or modalities from: Skin, mucus membranes, joints and muscles to the brain

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3
Q

modalities

A 
pain
temperature
touch, pressure
proprioception
vibration
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4
Q

dorsal columns

A

ascending:

fine touch
vibration
pressure
joint position sense

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5
Q

components of DCML pathway

A

gracile fascicles above T6

cuneate fascicles if below T6

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6
Q

DCML

A

dorsal column medial lemniscus

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7
Q

ventral corticospinal tract

A

descending fibres

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8
Q

lateral coricospical tract

A

descending motor neurones - autonomic

- mainly sympathetic

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9
Q

spinothalamic tract

A

ascending

crude touch
pain
temperature

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10
Q

how many neurones in sensory pathway

A

3

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11
Q

first order sensory neurones

A

from PNS to CNS

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12
Q

what type of neurones are first order sensory neurones

A

pseudounipolar

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13
Q

location of first order sensory neurones

A

dorsal root ganglion

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14
Q

location of second order neurones

A

CNS ipsilateral grey mater

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15
Q

where do second order sensory neurones terminate

A

VPL nucleus of thalamus

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16
Q

location of third order sensory neurones

A

in the thalamus

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17
Q

where do third order sensory neurones terminate

A

primary somato-sensory cortex

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18
Q

first synapse of spinothalamic pathway

A

at the dorsal cord

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19
Q

route of second order neurone in spinothalamic pathway

A
  • sends axon and crossing over occurs at the ventral white commissure
  • travels contra laterally to entrance
  • reach VLP of thalamus
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20
Q

second synapse of spinothalamic pathway

A

thalamus

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21
Q

route of third order neurone in spinothalamic pathway

A

from thalamus to primary somato-sensory cortex

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22
Q

lamina

A

where there are synapses from the spinothalamic tract

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23
Q

spinal lemniscus

A

spinothalamic tract as soon as it leaves the medulla

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24
Q

DCML amove T6

A

cuneate fascicle

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25
Q

DCML below T6

A

gracile fascile

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26
Q

medial dorsal column

A

gracile

27
Q

lateral dorsal column

A

cuneate

28
Q

first order neurone in DCML

A

enters at dorsal aspect of cord and ascends ipsilaterally, jumping out to the fascicles

29
Q

dorsal column medial lemniscus

A

discriminative touch, vibration, proprioception, pressure

30
Q

first synapse of DCML

A

closed medulla

- cuneate / gracile nucleus

31
Q

route of second order neurones of DCML

A
  • send axons to cross the midline at the level of the medulla
  • travel in medial meniscus to enter the thalamus on the contralateral side
32
Q

where do axons cross the midline in the spinothalamic pathway

A

dorsal cord

33
Q

where do axons cross the midline in DCML

A

closed medulla

34
Q

medial lemniscus

A

ascending white matter fibres

35
Q

arcuate fibres

A

2nd order fibres which arch out the cuneate / gracile nucleus to reach the medial lemniscus

36
Q

second synapse of DCML

A

thalamus and axons travel to primary sensory cortex

37
Q

which ascending pathway travels contralaterally

A

spinothalamic

38
Q

which ascending pathway travels ipsilaterally

A

dorsal column medial lemniscus

39
Q

in which region of the cerebral cortex does the spinothalamic and DCML pathway terminate

A

primary sensory / post-central gyrus

40
Q

internal capsule

A

bundle of white matter fibres between brain and CNS which connects the brain to lower centres

41
Q

what type of fibres are located in the internal capsule

A

projection

ascending and descending

42
Q

how to ascending fibres reach the brain

A

travel within the internal capsule, specifically in the posterior limb

43
Q

location of posterior limb of internal capsule

A

between thalamus and lentiform nuclei

44
Q

which cranial nerves carry general somatic sensation to the head

A

CN5 - trigeminal
CN7 - facial
CN9 - glossopharyngeal
CN10 - vagus

45
Q

somatic sensation from CN5

A

face
nose
scalp
dura

46
Q

somatic sensation from CN7

A

external ear

47
Q

somatic sensation from CN9

A

post 1/3 tongue
pharynx
middle ear

48
Q

somatic sensation from CN10

A

auditory canal
larynx
pharynx
oesophagus

49
Q

location of somatic sensory cranial nerve fibres

A

run within the trigeminal sensory nucleus to the thalamus

50
Q

location of motor nuclei in relation to sensory nuclei

A 
motor = medial
sensory = lateral
51
Q

spinal tract

A

collection of descending white matter axons

52
Q

spinal nucleus

A

collection of cell bodies

53
Q

3 divisions of sensory nuclei from trigeminal nuclei

A

mesencephalic
pontine
spinal

54
Q

pontine nucleus

A
  • discriminative touch

- largest located in the pons

55
Q

mesencephalic nucleus

A
  • proprioception

- extends to midbrain

56
Q

spinal nucleus

A
  • touch and pressure (more rostral)

- pain and temperature (bottom)

57
Q

trigeminothalamic pathway for pain and temperature

A
  • enter pons via trigeminal ganglion
  • white matter fibres start to descend
  • synapses with second nucleic in the caudal spinal nucleus
  • secondary nucleus ascends contralaterally in the trigeminothalamic tract to VPM in the thalamus
58
Q

trigeminothalamic pathway for crude touch and pressure

A
  • enter pons via trigeminal ganglion
  • white matter fibres start to descend
  • synapses with second nucleic in the rostral spinal nucleus
  • secondary nucleus ascends contralaterally in the trigeminothalamic tract to VPM in the thalamus
59
Q

Sensory consequences of a lesion affecting the lateral medulla

A

sensation from face:
- loss of pain, temperature, touch and pressure on ispilateral side

sensation from body
- loss of pain, temperature, touch and pressure on contralateral side

60
Q

fibres carrying pain and temperature pathways from body

A

spinothalamic pathway

61
Q

fibres carrying pain and temperature pathways from head

A

trigeminothalamic pathway

62
Q

trigeminothalamic pathway

A
  • descends through medulla to spinal nucleus

- cross below entry

63
Q

trigeminothalamic pathway for discriminatory touch

A
  • Primary sensory neuron with cell body in trigeminal ganglion
  • Synapse with 2nd order neuron occurs at the pontine / chief nucleus in the pons
  • Axon crosses the midline to go to the oposite VPM of the thalamus
64
Q

trigeminothalamic pathway for proprioception

A
  • Cell bodies are not in the trigeminal ganglion (ONLY EXEPTION TO THE RULE)
  • They are instead located in the mesencephalic nucleus directly
  • From there, they make contact with another cell body of a second order neuron just beside it in the brainstem
  • This axon crosses the midline to go to the VPM in the thalamus

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