Lecture 2: Proprioception and Tactile Pathways Flashcards

1
Q

What are the 4 pathways which transmit different types of somatic sensations (i.e., touch, vibration, proprioception, etc..)?

A
  1. Posterior column-medial lemniscal
  2. Trigeminolthalamic pathways
  3. Spinocerebellar pathways
  4. Anterolateral system
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2
Q

What is the primary pathway that transmits discriminative touch, flutter-vibration, and proprioceptive information?

A

Posterior column-medial lemniscal pathway

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3
Q

Size, shape, and texture discrimination, recognition of 3-D shape (stereognosis), motion detection, concious awarness of body positon (proprioception) and limb movement (kinesthesia) involve which system?

A

Posterior column-medial lemniscal system (PCMLS)

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4
Q

What are the characteristic features in terms of afferent fiber conduction, synaptic relays, and somatotopic organization of the PCMLS?

A
  • Afferent fibers with fast conduction velocities and limited number of synaptic relays
  • Precise somatotopic organization
  • Basis for the accurate localization of touch on different parts of the body, with high fidelity and a high degree of spatial/temporal resolution
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5
Q

What is frequency vs. population coding?

A

Frequency = cell’s firing rate signals stimulus intensity or temporal aspects of the tactile stimulus

Population = distribution in time/space of the number of activated cells signals location of the stimulus as well as its motion/direction

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6
Q

The high degree of resolution of the PCMLS results from what; sharpening discrimination between separate points on the skin is critical for?

A
  • Inhibitory mechanisms such as: feed-forward, feedback, and lateral (surround) inhibition
  • Critical for two-point discrimination
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7
Q

Why does two-point discrimination vary widely over different parts of the body?

A

Related to the density of peripheral nerve endings

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8
Q

If the mechanical pressure applied to peripheral mechanoreceptors is great enough what will occur?

A
  • Mechanical pressure is transduced into an electrical signal by the primary afferent neuron
  • If this depolarizes the neuron to threshold, an action potential is produced and relayed to the CNS via PCMLS
  • Somatic sensations of touch are evoked
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9
Q

What is the tactile receptor density of the digits and perioral region vs. other regions, such as the back?

A
  • Digits and perioral regions have increased density of tactile receptors
  • Other regions, like the back have decreased density

*Accuracy with which a tactile stimulus is localized depends on receptor density and receptive field size

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10
Q

What is a receptive field and where are there small and large receptive fields; how does this affect sensory discrimination?

A
  • Area of skin innervated by branches of a somatic afferent fiber
  • Small receptive fields are found in areas such as fingertips, where receptor density is high = increased discrimination
  • Large receptive fields are present in areas with low receptor density (i.e., the back) = decreased discrimination
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11
Q

What is the relationship like between the size of the receptive field and representation of that body part in the somatosensory cortex?

A
  • Inverse relationship
  • Small receptive fields = larger representation
  • Densely innervated body parts are represented by greater number of neurons —> Take up a disproportionally large part of the somatosensory cortex
  • Fingertips and lips provide CNS w/ most specific and detailed info about tactile stimulus
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12
Q

Primary afferent fibers consist of what 3 parts and what are their locations?

A
  1. A peripheral process extending from the DRG (mechanoreceptor or free nerve ending)
  2. A central process extending from DRG into CNS
  3. A pseudounipolar cell body in the DRG
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13
Q

Large-diameter primary sensory fibers relay what type of information; these fibers enter the spinal cord via?

A
  • Discriminative touch, flutter-vibration and proprioception
  • Enter the spinal cord via the medial division of the posterior root and then branch
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14
Q

After large-diameter primary sensory fibers enter the spinal cord via the medial division of the posterior root and branch what occurs to these branches; especially the largest set of branches?

A
  • One set of branches terminates on second-order neurons in the spinal cord gray matter at, above, and below the level of entry
  • Largest set of branches ascends cranially and contributes to the formation of the fasciculus gracilus and fasciculus cuneatus —> collectively termed the posterior columns
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15
Q

How are sacral level fibers up to T6 positioned topographically within the posterior columns; what contribution of posterior column do these fibers ultimately form?

A
  • Sacral level fibers are positioned medially
  • Fibers from more rostral levels (up to T6) are added laterally
  • Forms the fasciculus gracilus
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16
Q

How are fibers above T6 and cervical fibers organized topographically in the posterior columns and what do they ultimately form?

A
  • Thoracic level above T6 will be more medial
  • Low cervical will be lateral to this and upper cervicals will be most lateral
  • Form the laterally placed, fasciculus cuneatus
17
Q

How do SC lesions affect discriminative, positional, and vibratory tactile sensations?

A
  • Ipsilateral reduction or loss
  • At and below the segmental level of injury
18
Q

SC lesions resulting in ipsilateral reduction or loss of discriminative, postional, and vibratory tactile senations at or below the segmental level of injury will present how?

A
  • Sensory ataxia, loss of muscle stretch (tendon) reflexes and proprioceptive losses from the extremities due to lack of sensory input
  • Patient may also have a wide-based stance and may place the feet to the floor with force, in an effort to create the missing proprioceptive input
19
Q

What are the 2 posterior column nuclei, where are they located, what type of neurons do they contain, what type of input do they receive?

A
  • Nucleus gracilus and nucleus cuneatus are in posterior medulla

- Contain second-order neurons of the PCMLS

  • Receive input from first-order neurons (primary afferents) from the ipsilateral DRG
20
Q

How do core “clusters” and outer “shells” of posterior column nuclei (nucleus gracilus and nucleus cuneatus) contribute to the segregation of tactile inputs?

A
  • Core “clusters” receive inputs from rapidly and slowly adapting afferents
  • Outer “shells” receive inputs from muscle spindles, joints, and Pacinian corpuscles
21
Q

Explain the route of the axons from the second-order neurons of the posterior column as they ascend, where do they decussate, what do they ascend as and what happens to the fiber?

A
  • The axons of second-order sensory neurons of the posterior column are known as internal arcuate fibers, which loop anteromedially in medulla
  • Cross the midline as the sensory decussation, causing the axons of the nuclei to be sent to the contralateral thalamus
  • Ascend as the medial lemniscus (ML) on the opposite side
  • As ML extends rostrally, it rotates laterally in pons. UE fibers are now medial and LE fibers are now lateral
22
Q

Somatotopic organization of the body is maintained as the medial lemniscus terminates where?

A

Ventral posterolateral nucleus (VPL) of the thalamus

23
Q

PC lesions at brainstem levels lead to deficits in; on what side?

A
  • Deficits in discriminative touch, vibratory, and positional sensibilities
  • Over the CONTRALATERAL side of the body from the lesion
24
Q

What are the 2 ventral posterior nuclei, what separates them, and which is specific for the information from the head and the body?

A
  • Ventral posterolateral nucleus (VPL) receives body proprioceptive info
  • Ventral posteromedial nucleus (VPM) receives head prorioceptive information
  • Separated by fibers of the arcuate lamina
25
Q

The VPL and VPM are supplied by which arterial branches and what does compromise of this artery lead to?

A
  • Thalamogeniculate branches of Posterior Cerebral artery
  • Compromise can result in loss of all tactile sensation over the contralateral body and head
26
Q

How do fibers from the contralateral nucleus cuneatus terminate in the VPL versus fibers of the nucleus gracilus?

A
  • Fibers from the contralateral nucleus cuneatus terminate medial to those of nucleus gracilis
  • Remember that the nucleus cuneatus started lateral and the gracilis was medial, but as ML extends rostrally, it rotates laterally in the pons and the fibers switch postions
27
Q

How do rapid/slowly adapting inputs target the VPL vs. Pacinian and joint/muscle inputs?

A
  • Rapidly and slow adapting inputs target the VPL core
  • Pacinian and joint/muscle inputs target VPL shell
28
Q

The VPL for the trunk and extremities contains 2 populations of identified neurons, what are their functions?

A
  1. Third-order neurons: large-diameter axons that traverse posterior limb of the internal capsule and terminate in the primary (S1) and secondary (SII) somatosensory cortices
  2. Local circuit interneurons (inhibitory): receive excitatory corticothalamic inputs and influence the firing rates of third-order neurons
29
Q

Axons from third-order neurons (thalamus) terminate in primary somatosensory (S1) cortex, which comprises which gyri and sulci?

A
  • Postcentral gyrus and posterior paracentral gyrus
  • Bordered by central sulcus (anteriorly) and postcentral sulcus (posteriorly)
30
Q

Which 2 arteries provide blood supply to the SI cortical areas; which artery if compromised produces loss over upper body/face and which for lower limb?

A
  • The ACA and MCA
  • MCA lesions = tactile loss over contralateral upper body and face
  • ACA lesions = tactile loss over contralateral lower limb
31
Q

What are the functional subdivisions of the primary somatosensory cortex (S1) from anterior to posterior?

A
  • Broadmann areas: 3a, 3b, 1 and 2
  • Area 3a: located in depths of the central sulcus, abuts area 4 (primary motor cortex)
  • Areas 3b and 1: extend up the bank of the sulcus onto the shoulder of postcentral gyrus
  • Area 2: lies on the gyral surface and abuts area 5 (somatosensory association cortex)
32
Q

Lesions in subdivision area 1, area 2, and area 3b of the somatosensory cortex would produce what kind of deficits; which is the most profound and what does this suggest?

A
  • Lesions in area 1 produce a deficit in texture discrimination
  • Lesions in area 2 result in a loss of size and shape discrimination (astereognosis)
  • Lesions in area 3b have a more profound effect —> deficits in both texture and size/shape discrimination
  • Suggests that there is hieracrchial processing of tactile information in SI cortex and that area 3b performs initial processing and distributes information to areas 1 and 2
33
Q

Typically, SI lesions include larger areas, encompassing mutliple subdivision and result in what kind of deficits?

A

Loss of proprioception, position sense, vibratory sense, and pain/thermal sensations on the contralateral side of the body

34
Q

How is it possible to have cross sensory syndrome/findings with brainstem lesions?

A
  • Sensory deficits of trunk/extremities contralateral to lesion, but sensory deficits of face/CN ipsilateral to lesion
  • The right face and left arm/leg lack proprioceptive info
  • All dependent on where the fibers cross and damage occuring at one level will likely damage multiple tracts.
35
Q

Where is the Secondary Somatosensory (SII) cortex, what does it contain, and receives inputs from where?

A
  • Lies deep in the inner face of the upper bank of lateral sulcus
  • Contains somatotopically representation of body surface
  • Inputs arise from ipsilateral SI cortex and Ventral Posterior Inferior (VPI) of the thalamus
36
Q

What inputs does the Parietal cortical somatosensory region receive, where is it located?

A
  • Posterior to area 2, includes area 5 and area 7 (7b)
  • Receives some medial lemniscal input and inputs from SI (tactile inputs)
37
Q

Lesions in the parietal association area can produce what deficits?

A
  • Agnosia
  • Contralateral body parts are lost from the personal body map
  • Sensation is not radically altered, but the limb is not recognized as part of the patient’s own body
38
Q

The spinocerebellar pathways transmit what kind of information?

A
  • Proprioceptive and limited cutaneous info to the cerebellum
  • Includes information about limb position, joint angles, and muscle tension/length