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Anatomy 2 > Neuro 4 > Flashcards

Neuro 4 Flashcards

1
Q

Lateral zone - RF

A

reflux machinery and more.

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2
Q

Substantia nigra

A

really a part of basal ganglia

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3
Q

PAG

A

continuous with hypothalamus

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4
Q

GSA, General somatic afferent

A

Origin CNS: Spinal & main sensory nuclei
Mesencephalic nucleus

Peripheral origin or termination:
Skin & deep tissues of head, dura
Muscle spindles and other mechanoreceptors

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5
Q

SVE, Special visceral efferent

A

CNS: Trigeminal motor nucleus
PNS: MOM and the tensor twins”, etc (muscles of mastication)

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6
Q

Trigeminal Nerve

A

Three divisions:

Opthalmic:Upper face
Sensory only

Maxillary division: Middle face
Sensory only

Mandibular division: Lower face
Sensory and Motor

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7
Q

V motor components

A 
Branchial motor
Cell bodies: Trigeminal motor nucleus
Terminates in: Muscles of mastication
Lesion (injury):
Jaw closure is weakened
Opened jaw will deviate toward side of lesion
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8
Q

Supratrigeminal nucleus

A

Near V motor nucleus
Actually part of reticular formation (node)
Pattern generator for masticatory rhythm

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9
Q

V Mesencephalic nucleus

A

Sensory Afferent
Cell bodies: Trigeminal mesencephalic nucleus down to pons.
Centrally directed process terminates in:
Trigeminal motor nucleus - jaw jerk reflex
Supratrigeminal nucleus - chewing movements
Senses: proprioception; spindles in muscles of mastication, mechanoreceptors in gums, teeth and hard palate

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10
Q

Mesencephalic nucleus: Proprioception

A

Receptors:
Neuromuscular spindles of mastication muscles
Pressure/tension receptors in periodontal ligaments
Cell body of origin:
Unipolar cell bodies
Trigeminal mesencephalic nucleus
Projects to:
Trigeminal motor nucleus
Supratrigeminal nucleus (masticatory generator - rhythm)
Controls distance between mandible and maxilla
Occlusal vertical dimension (vertical dimension of occlusion

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11
Q

In pontine tegmentum

A

most to supratrigeminal, some to motor or main sensory nuclei

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12
Q

V3

A 
MOM stretch receptors (spindles)
Stretch receptors (Ruffini endings) in suspensory, periodontal ligaments of teeth
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13
Q

V2

A

Stretch receptors (Ruffini endings) in suspensory, periodontal ligaments of teeth

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14
Q

V Sensory Nuclei

A

The sensory nuclei form a column of cells the is almost continuous through the brainstem.

Main sensory nucleus is at about mid-pons and is a bit later to the trigeminal motor nucleus

Spinal nucleus extends caudally into the medulla

Mesencephalic nucleus extends into midbrain. It is rather thin and is accompanied by the mesencephalic trigeminal tract. The mesencephalic nucleus is odd in that is contains pseudounipolar neurons as seen in dorsal root ganglia of the cord, so it is as if a bit of a ganglion somehow got incorporated into the CNS. Myelinated processes from these pseudounipolar neurons form the mesencephalic tract. The peripheral processes go to spindles of muscles of mastication, mechanoreceptors of teeth, gums and hard palate.

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15
Q

Nuclei ascend

A

trigeminal thalamic tract goes up. Sometimes referred to as trigeminal lemniscus.

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16
Q

VPM

A

ventral posteriormedal nucleus. From here, they send to primary central cortex in parietal lobe.

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17
Q

Ventral posteriolateral nucleus

A

end of medial lemniscus

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18
Q

Cortical Representation V

A

Parietal lobe
Postcentral gyrus
Brodmann’s Areas 3, 1, 2

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19
Q

V: : Main Sensory Nucleus

A 
Sensory afferent
Region served:
Face, head
Oral cavity, teeth
Meninges
Cell bodies: Trigeminal ganglion
Terminates in: Main/ principal  trigeminal sensory nucleus
Discriminative touch & vibration
20
Q

V main/principal sensory nucleus

A

Homologue of posterior column nuclei
Discriminative tactile (face & oral cavity) and some proprioception (jaw position)
Two ascending pathways:
Crossed pathway joins medial lemniscus on its way to VPM
Uncrossed, dorsal trigeminal tract, inside of mouth represented to VPM (ends near uncrossed taste pathway

21
Q

V: Spinal trigeminal nucleus

A 
Sensory afferent
Region served:
Face
Oral cavity, teeth
Meninges
Cell bodies: Trigeminal ganglion – just like main sensory nucleus
Terminates in: Trigeminal spinal nucleus
Pain, crude touch, temperature
22
Q

Spinal trigeminal

A

pain – not very myelinated.

23
Q

Spinal trigeminal

A

Afferents descend thru spinal trigeminal tract and synapse in caudal nucleus
Second order neurons send axons across midline, ascend and join spinothalamic tract, terminates in VPM – tend to have longest axons.
Third order neurons are the ones that have cell bodies in VPM and go to cortex.

Vast majority is in caudal part of trigeminal spinal – pain and temp nucleus is here.

24
Q

Mesencephalic nucleus

A

Heavily myelinated fibers
Posterior column homologue– medial lemniscus system
Proprioception

25
Q

Main/ principal sensory nucleus

A

Heavily myelinated fibers- tactile descrimination.
Posterior column homologue – medial lemniscus system
Discriminative touch

26
Q

Spinal nucleus

A

Lightly myelinated fibers
Homologue of anterolateral system
Pain, crude touch, temperature

27
Q

From: Trigeminal spinal nucleus

A

Contralateral projection to: (not ipsilateral)
Ventral posteromedial nucleus of thalamus (VPM)
Internal capsule
Postcentral gyrus parietal lobe (Brodmann’s Areas 3,1,2)

28
Q

From: Main/ principal trigeminal sensory nucleus

A

Bilateral projection to:
Ventral posteromedial nucleus of thalamus (VPM)
Internal capsule
Postcentral gyrus parietal lobe (Brodmann’s Areas 3,1,2)

29
Q

Trigeminal nerve: major connections

A

Peripheral branches of mesencephalic neurons innervate masseter muscle spindles and other mechanoreceptors

Tactile afferents

Motor neuron fibers: muscles of mastication – descends.

Pain-temperature afferents

30
Q

Pars Caudalis

A

Laminar structure
Blends with posterior horn of cervical cord
Somatotopic organization
Inverted representation of face
‘Onion Peel’ representation – rostral (oral) to caudal (peripheral face)
Primarily pain fibers
Substantia gelatinosa (Lamina II)
Contains excitatory and inhibitory interneurons
Receives raphe spinal tract fibers (serotonin)
Receives afferents from cranial nerves
VII, IX & X – all for area near ear

31
Q

GSA, General somatic afferent VII

A

CNS: Spinal trigeminal nucleus
Geniculate ganglion

PNS: Skin of outer ear

32
Q

SSA, Special sensory afferent VII

A

CNS: Nucleus of solitary tract
Geniculate ganglion

PNS: Taste buds anterior 2/3 of tongue, Parts of nasal cavity and soft palate

33
Q

GVE, General visceral efferent VII

A

CNS:Superior salivatory nucleus
Submandibular & Pterygopalatine ganglia

PNS: Submandibular and sublingual glands, nasal and palatine glands, lacrimal glands

34
Q

SVE, Special visceral efferent (a.k.a branchial motor) VII

A

CNS: Facial motor nucleus

PNS: Muscles of facial expression, stapedius (Arch 2)

35
Q

Actions of VII

A 
Motor
Muscles of facial expression: Closes eye, closes lips
Stapedius muscle: Modulates sound volume
Sensory: 
Skin of outer ear
Geniculate ganglion
Palatine tonsil & posterior nasal cavity
Geniculate ganglion - Solitary nucleus
Taste: Anterior 2/3 of tongue
Salivation
Lacrimation: Lubricates cornea
36
Q

VII: Somatic sensory

A

Skin of outer ear
Fibers enter spinal trigeminal tract, dorsomedially situated
Act exactly as trigeminal afferents

37
Q

Facial motor nucleus & corticobulbar pathway

A

Motor neurons to lower facial muscles mainly innervated by contralateral cortex, but upper facial muscles innervated bilaterally
Unilateral damage to corticobulbar pathway (e.g. in cerebral peduncle)
Results in: inability to smile or bare teeth symmetrically; but ability to wrinkle forehead is unaffected

38
Q

Selective weakness of lower facial muscles

A

Corticobulbar gateway lesions:

Selective weakness of lower facial muscles
A) Muscles on left side of face are weak…… but can raise eyebrows symmetrically.

39
Q

Trigeminal neuralgia

A

Brief, episodes of excruciating pain in distribution of one (can be more) division of the trigeminal nerve
Mandibular division 70%
Ophthalmic division < 5%
No sensory trouble between attacks
Often a tactile stimulus triggers an attack
A number of cases due to trigeminal compression by a vessel, tumor etc.
Often responds to medications. How could surgery help?

Surgical procedures include cutting nerve root, introducing a lesion in trigeminal ganglion
Result: loss of all tactile sensation not just pain to the area

40
Q

Microvascular decompression

A

Branches of the superior cerebellar artery are most frequently involved in cases of trigeminal neuralgia that are due to vascular cause

41
Q

Bell’s palsy

A

Type of unilateral (<1% bilateral) facial paralysis due to VII dysfunction
Most common cause of acute facial nerve paralysis (>80%)
Some denture wearers experience discomfort
Cause unknown, by definition
Believed to be an inflammatory condition resulting in facial nerve swelling in facial canal
Commonly shows rapid onset with partial or complete paralysis; can occur overnight
Usually improves over time and function restored to normal or near-normal most of the time, steroids improve outcome

42
Q

Corneal blink reflex

A

Touch cornea and both eyes blink
Afferent limb: Vi to SpV tract
Efferent limb: VII elicited by bilateral projection from SpV nucleus/ reticular formation
Clinical test of V, VII & central connections

43
Q

Jaw opening & closing reflexes

A

Jaw closing reflex
Food in contact with oral membranes
Jaw opening reflex
Periodontal afferents activated by dental occlusion
Pain afferents from mucosal membranes
Input (V) from:
Jaw muscles (proprioception – trigeminal mesencephalic nucleus)
Tactile information (food in mouth – trigeminal main nucleus)
Pain information (trigeminal spinal nucleus)
Output (V) to:
Muscles of mastication

44
Q

Jaw-jerk reflex

A

Monosynaptic reflex
Downward tap on chin, stretches masseter
Afferent limb: mesencephalic V neuron innervating masseter spindle
Efferent limb: V motor neuron

45
Q

Nervus Intermedius

A

Aligns with VII nerve distal to genu

intermediate nerve

46
Q

Taste pathways in the CNS

A

Gustatory afferents reach nucleus of the solitary tract via the solitary tract
Second order fibers do 2 things:
Reflex activities: swallowing, salivation
Project uncrossed to thalamus (VPM), then to gustatory cortex (insula, medial surface of frontal operculum)
Gustatory cortex projects to orbitofrontal cortex, integrated there with olfactory info, reaches amygdala, from there to limbic system & hypothalamus

Anatomy 2 (15 decks)

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