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Neuro > Lecture 11 > Flashcards

Lecture 11 Flashcards

1
Q

conus medullaris

A

the termination of spinal cord located at T12/L1 vertebra in an adult

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2
Q

cauda equina

A

the lumbosacral nerve roots that descend in lower vertebral canal and sacral canal

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3
Q

lumbar cistern

A

enlargement of the subarachnoid space that is located distal to the conus medullaris
- contains cerebrospinal fluid and the cauda equina nerve roots

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4
Q

filum terminale

A

interna = a continuation of pia that extends to “bottom” of the lumbar cistern
externa = a continuation of dura that extends to the coccyx bone

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5
Q

denticulate ligaments

A

pia extension anchor spinal cord to arachnoid/dura layers

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6
Q

dorsal nerve root

A

sensory input FROM peripheral nerve

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7
Q

ventral nerve root

A

motor output TO peripheral nerve

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8
Q

gray matter

A

“H” shape located in the middle of a spinal cord cross section that contains nuclei/unmyelinated nerve fibers

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9
Q

grey matter - posterior horn

A

receives sensory input from the body - sensory (afferent) neurons of the dorsal nerve root terminate in the dorsal horn

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10
Q

gray matter - anterior horn

A

contains cell bodies of ventral nerve root neurons that exits out the ventral nerve root (lower motor neurons)

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11
Q

lower motor neuron lesion

A

damage to the motor pathways in the anterior horn of the spinal cord
muscle tone = hypotonia
reflexes = hyporeflexia
weakness = flaccid paralysis
atrophy = quick atrophy

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12
Q

white matter

A

contains myelinated ascending sensory tracts and descending motor tracts of the spinal cord

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13
Q

white matter - sensory function

A

ascending tracts in the white matter transmit sensory information from body up to the brainstem, cerebellum, dicephalon, and cerebrum

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14
Q

white matter - motor function

A

descending tracts in the white matter transmit motor information from cerebrum and brainstem to the muscles of the body

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15
Q

white matter - posterior (dorsal) column

A

location: posterior of the “H”
motor: no motor tracts
sensory: 1 sensory tract that carries proprioception, discriminating touch and vibration information

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16
Q

white matter - lateral column

A

location: lateral to the “H”
motor: contains 2 lateral motor tracts
sensory: contaisn 2 sensory tracts that carry pain/temp information and unconscious proprioception information

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17
Q

white matter - anterior (ventral) column

A

location: anterior to the “H”
motor: contains the “medial motor tracts”
sensory: contains a sensory tract that carries pain/temp information

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18
Q

anterior spinal artery

A

“single” artery that descends anteriorly along the length of the spinal cord
originates: R/L vertebral arteries, various segmental branches at different levels of the spinal cord
supplies anterior 2/3 of spinal cord (lateral and anterior columns)

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19
Q

posterior spinal arteries (R/L)

A

descend posteriorly along the length of the spinal cord
originate: small branches of the vertebral arteries, various segmental branches at different levels of the spinal cord
supply posterior 1/3 of spinal cord (posterior column)

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20
Q

lateral corticospinal tract function

A

controls fine motor movement of distal extremities

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21
Q

lateral corticospinal tract pathway

A

motor cortex output -> internal capsule -> ipsilateral anterior brainstem
- cross midline (decussate) in lower medulla (pyramids)
- descend in the lateral column of spinal cord
- TERMINATE on the anterior horn motor neurons that supply the UE/LE muscles

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22
Q

lateral corticospinal tract - lesion ABOVE medulla

A

stroke/tumor of motor cortex, internal capsule or anterior brainstem
CONTRALATERAL hemiparesis

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23
Q

lateral corticospinal tract - lesion BELOW medulla

A

spinal cord injury or MS/ALS in lateral spinal cord
IPSILATERAL hemiparesis below lesion

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24
Q

rubrospinal tract function

A
  1. supportive role of lateral corticospinal tract (fine motor movement)
  2. promotes UR flexors and inhibits UE extensord
  3. function is more involved in upper extremities vs, lower extremities
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25
Q

rubrospinal tract pathway

A

originates in red nucleus of the midbrain
descends in lateral column of spinal cord just anterior to lateral corticospinal tract
terminates on anterior horn motor neurons that supply the UE/LE muscles

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26
Q

rubrospinal tract lesion

A

lesions involving the red nucleus itself influence abnormal posturing responses known as decorticate and decerebrate

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27
Q

decerebrate

A

brainstem involving the red nucleus and BELOW
decreased UE flexor tone and allowes UE extensor tone to dominate
*more severe and worst prognosis

28
Q

decorticate

A

brainstem damage ABOVE the red nucleus
excessive flexor tone of UE and allows excessive UE flexor tone to dominate

29
Q

medial (anterior) motor tracts are involved in axial (trunk)/proximal limb control/balance

A

anteromedial corticospinal tract
tectospinal tract
reticulospinal tract
vestibulospinal tract - lateral/medial

30
Q

anterior (medial) corticospinal tract function

A

control and maintain axial/proximal limb voluntary movement

31
Q

anterior (medial) corticospinal tract pathway

A

motor cortex to brainstem
DOES NOT cross midline in medulla
descends in anteromedial spinal cord
terminates near medial ventral horn of most levels of spinal cord

32
Q

tectospinal tract function

A

visual reflexes/coordination of head and eye movement
reflexive reactions to visual input

33
Q

tectospinal tract pathway

A

originates in superior colliculi of midbrain -> crosses immediately -> descends in anteromedial spinal cord -> terminates in anterior horn cervical spine
supplies postiral muscles of head/neck

34
Q

reticulospinal tract function

A

modulates reflexive/automatic motor movements related to posture/gait

35
Q

reticulospinal tract pathway

A

originates in reticular nuclei in lower 2/3 of brainstem -> descends in anteromedial spinal cord -> terminates on motor nuclei in the anterior horn in all levels of spinal cord
does NOT cross

36
Q

medial vestibulospinal tract function

A

control head and neck movement/posture

37
Q

medial vestibulospinal tract pathway

A

begins medial vestibular nuclei or medulla -> descends in aneromedial spinal cord BILATERALLY -> terminates on motor nuclei of the neck muscles located in the anterior horn of cervical spinal cord
vestibulospinal tract only found in cervical spine

38
Q

lateral vestibulospinal tract function

A

maintain balance and extensor tone

39
Q

lateral vestibulospinal tract pathway

A

begins lateral vestibular nuclei of medulla -> descends in anteromedial spinal cord -> terminates on motor nuclei of antigravity (extensor) muscles located in the anterior horn in all levels of spinal cord

40
Q

corticobulbar tract function

A

contralateral voluntary motor movement of the lower facial muscles (lower CN 7) and tongue (CN 12)
bilateral voluntary motor movement of upper face/mouth/pharynx/larynx muscles

41
Q

corticobulbar tract pathway

A

begins in the primary motor cortex -> descends through the internal capsule -> descend in the anterior brainstem and terminates on the motor nuclei of CN 5, 7,10, and 12

42
Q

corticobular tract CN 7

A

upper face - BILATERAL innervation
lower face - CONTRALATERAL innervation

43
Q

corticobular tract CN 12

A

tongue - CONTRALATERAL innervation

44
Q

corticobulbar tract lesion

A

lesion in cortex or corticobulbar tract - contralateral hemiparesis of the lower facial muscles (CN 7) and the tongue (CN 12)
Bell’s palsy - damage to CN 7, hemiparesis to both upper and lower facial muscles

45
Q

upper motor neuron (UMN)

A

cortex, internal capsule, descending motor tracts in brainstem/spinal cord, terminal end of descending neuron before synapse with motor nucleus in the anterior horn

46
Q

lower motor neuron (LMN)

A

anterior horn - motor nucleus
motor root
motor postion of spinal nerve root and peripheral nerve

47
Q

UMN lesion

A

damage to motor pathway anywhere above the anterior horn cell
cortex, internal capsule, descending motor tracts in brainstem/spinal cord
pathologies = stroke SCI, tumor, MS, ALS

48
Q

UMN lesion signs/symptoms

A

hyper reflexia
hyper tonicity
spastic weakness
small amount of muscle atrophy due to disuse

49
Q

UMN lesion pathological reflexes

A

plantar reflex test + Babinski’s sign = extension of the great toe and fanning of other toes
Hoffman’s sign = flexion of thumb or index after flicking middle or ring finger at DIP joint

50
Q

LMN lesion

A

damage to motor pathway to, or distal to, the anterior horn

51
Q

LMN lesion signs/symptoms

A

hyporeflexia
hypotonicity
flaccid weakness
severe muscle atrophy
pathological reflexes NOT present

52
Q

dorsal column-medial lemniscus system function

A

discriminating touch (well-localized touch), pressure, vibration, and proprioception (joint position sense) from the body

53
Q

dorsal column-medial lemniscus system pathway

A

sensory information enters posterior horn and ascends in the ipsilateral posterior column up to the medulla -> crosses midline at the medulla, ascends to thalamus in medial leminiscus and projects to primary somatosensory cortex (3,1,2)

54
Q

dorsal column-medial lemniscus system - lesion ABOVE medulla

A

CONTRALATERAL loss of proprioception, discriminating touch and vibration

55
Q

dorsal column-medial lemniscus system - lesion BELOW medulla

A

ipsilateral loss of proprioception, discriminating touch and vibration below the level of the lesion

56
Q

dorsal column-medial lemniscus system clinical exam procedures

A

vibration sense test
joint position sense test
discriminating touch tests
romberg’s test

57
Q

spinocerebellar tracts function

A

transmits unconscious proprioception to cerebellum

58
Q

spinocerebellar tracts pathway

A

proprioceptive information enters spinal cord and ascends in the ipsilateral lateral column of spinal cord -> ascend to brainstem and enter cerebellum
does NOT cross midline

59
Q

spinocerebellar tracts lesion

A

ataxia but isolated lesion is rare
any ataxia impairment from a lateral column injury/lesion is often overshadowed by co-existing hemiparesis

60
Q

lateral spinothalamic tract function

A

mediates discriminative aspects of pain/temp sensation from the body
detect and localize pain/temp from body
fast pain pathway

61
Q

lateral spinothalamic tract pathway

A

nociceptive information enters spinal cord and crosses midline immediately -> ascends in the contralateral lateral column up to the thalamus and projects to primary somatosensory cortex

62
Q

lateral spinothalamic tract lesion

A

contralateral loss of pain and temperature below the lesion

63
Q

lateral spinothalamic tract clinical exam procedures

A

pinprick/pinwheel test - detect ability to sense sharp pain
temperature test - compare cold vs. warm object

64
Q

anterior spinothalamic tract function

A

mediate visceral, consciousness, autonomic and emotional/behavioral reactions to pain
involved in central modulation of pain
slow pain pathways

65
Q

anterior spinothalamic tract pathway

A

nociceptive information enters posterior horn and immediately crosses midline in spinal cord -> ascends contralaterally in anterior column and terminates in different CNS structures
reticular nuclei in brainstem
tectum-superior colliculi
pretectal (periaqueductal gray)
thalamus and project to limbic

66
Q

anterior spinothalamic tract clinical exam procedures

A

response to painful stimuli
Glasgow Coma Scale

Neuro (21 decks)

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