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PBL Spring 2015 - Block 2 > NEURO 7 > Flashcards

NEURO 7 Flashcards

1
Q

Lateral corticospinal tract
function
decussation

A

motor

pyramidal decussation at cervicomedullary junction

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2
Q

Posterior column-medial lemniscal pathway
function
location

A

sensory (vibration, propioception, fine touch)

internal arcuate fibers at lower medulla

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3
Q

Anterolateral pathway
function
location

A

sensory (pain, temperature, crude touch)

anterior commissure in spinal cord

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4
Q

sensory neruon bodies located in

A

dorsal root ganglia

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5
Q 
Sensory neuron fiber A-alpha
Name
Myelination
Receptors
Sensory modalities
A

I
Yes
Muscle spindle, golgi tendon
propioception

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6
Q 
Sensory neuron fiber A-beta
Name
Myelination
Receptors
Sensory modalities
A

II
Yes
Muscle spindle, Meissner’s corpuscle, Merkel’s receptor, Pacinian corpuscle, Ruffini ending, hair receptor
Superficial touch, proprioception, deep touch, vibration

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7
Q 
Sensory neuron fiber A-delta
Name
Myelination
Receptors
Sensory modalities
A

III
Yes
Bare nerve ending
Pain, cool temperature, itch

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8
Q 
Sensory neuron fiber C
Name
Myelination
Receptors
Sensory modalities
A

IV
No
Bare nerve ending
pain, warm temperature, itch

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9
Q

Order of sensory neuron fibers from small to large

A

C < A-delta < A-beta < A-alpha

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10
Q

Lesions of somatosensory cortex and adjacent regions cause

A

cortical sensory loss

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11
Q

Gate control theory

A

sensory inputs from large A-beta fibers reduce pain transmission through dorsal horn

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12
Q

Reduce chronic pain by activating

A

A-beta fibers - shaking thumb after hammer

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13
Q

periaqueductal gray receives inputs from ___,___,___ and inhibits pain transmission in the ___

A

hypothalamus, amygdala, cortex

rostral ventral medulla

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14
Q

What modulates pain in the dorsal horn

A

serotonergic 5-Ht

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15
Q

contributes to pain modulation through H3 receptors

A

histamine

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16
Q

opiate receptors and endogenous opiate peptides found in high concentration

A

key points in pain modulatory pathways

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17
Q

thalamus is part of what part of the brain

A

diencephalon

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18
Q

Ventral posterior lateral nucleus
Main input
Main output
Function

A

Medial leniscus, spinothalamic tract
somatosensory cortex
relays input to cortex

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19
Q

Ventral posteromedial nucleus
Main input
Main output
Function

A

trigeminal lemniscus, trigeminothalamic tract, taste inputs
somatosensory and taste cortex
relays inputs to cortex

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20
Q

Lateral geniculate nucleus
Main input
Main output
Function

A

Retina
Primary visual cortex
relays inputs to cortex

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21
Q

Ventral lateral nucleus
Main input
Main output
Function

A

internal globus pallidus, deep cerebellar nuclei, substantia nigra pars reticulata

motor, premotor and supplementary motor

Relays basal gangliaand cerebellar inputs to cortex

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22
Q

Medial geniculate nucleus
Main input
Main output
Function

A

inferior colliculus
Primary auditory cortex
relays auditory inputs to cortex

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23
Q

Ventral anterior nucleus
Main input
Main output
Function

A

substantia nigra pars reticulata, internal globus pallidus, deep cerebellar nuclei
Frontal lobe
Relays basal ganglia and cerebellar inputs

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24
Q

Pulvinar
Main input
Main output
Function

A

Tectum
Paritotemporooccipital association
Behavioral orientation towards relevant visual stimuli

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25
Q

Mediodorsal nucleus
Main input
Main output
Function

A

amygdala, olfactory, limbic basal ganglia

frontal cortex

limbic pathways, major relay to frontal cortex

26
Q

Anterior nucleus
Main input
Main output
Function

A

mammillary body, hippocampal foramtion

cingulate gyrus

limbic pathway

27
Q

centromedian nucleus
Main input
Main output
Function

A

AGlobus pallidus, ARAS

striatum, cerebral cortex

motor relay for basal ganglia

28
Q

Only nucleus of thalamus that does not project to cortex

A

reticular, consists purely of inhibitory GABAergic neurons

29
Q

Lesions in posterior column - medial leniscal pathway

A

tingling, numbness, bandlike sensation, fingers wrapped in gauze

30
Q

Lesions in anterolateral pathways

A

sharp, burning, searing pain

31
Q

Lesions of parietal lobe or primary sensory cortex

A

CL numb tingling and pain

32
Q

Lesions of thalamus

A

CL pain = Dejerine - ROussy syndrome

33
Q

Lesions of cervical spine

A

Lhermitte’s sign = electricity like sensation down back w/ neck flexion

34
Q

Lesions of nerve roots

A

radicular pain which radiates in dermatomal pattern

35
Q

dysesthesia

A

unpleasant abnromal sensation

36
Q

allodynia

A

painful sensation provoked by nonpainful stimuli

37
Q

hyperpathia or hyperalgesia

A

enhanced pain to painful stimuli

38
Q

hypesthesia

A

decreased sensation

39
Q

spinal shock

A

flaccid paralysis below lesion

40
Q

What is used to treat acute traumatic spinal cord lesions

A

steroids

41
Q

What usually causes chronic myelopathy

A

degenerative disorders of the spinal

42
Q

cord compression by tumors can eventually cause

A

irreversible loss of ambulation

43
Q

what causes infarction of spinal cord

A

anterior spinal artery occlusion due to trauma, aortic dissection, thromboemboli and disc emboli

44
Q

MRI of myelitis

A

T2 bright areas, CSF has elevated WBCs, lymphocytic predominant

45
Q

Primary Somatosensory cortex lesion

A

deficit is CL, discriminative touch and joint position most severely affected or cortical sensory loss is present w/ extinction sterognosis and graphesthesia

46
Q

Thalamic Ventral posterior lateral and medial nuclei lesion

A

deficit is CL, more noticeable in hand, face, foot - all sensory modalities involved

47
Q

Lateral pons or medulla lesion

A

IL: causes loss of pain and temp in face
CL: causes loss of pain and temp in body

48
Q

Medial medulla lesion

A

CL loss of vibration and joint position sense

49
Q

Nerve root lesion

A

glove and stocking distribution

50
Q

Transverse cord lesion

A

Sensory and motor pathway interrupted

51
Q

Hemicord Lesion = Brown-Sequard Syndrom

A

Lateral corticospinal tract damage = IL UMN weakness

Posterior column damage = IL loss of vibration and joint position sense

Anteriolateral system damage = CL loss of pain and temperature ** may also cause sensory loss to pain and temperature on IL

52
Q

Small Central cord syndrome

A

bilateral regions of suspended sensory loss to pain and temperautre

53
Q

Lesion of cerival cord

A

cape distribution of pain and temperature

54
Q

Large Central cord syndrome

A

sacral sparing

55
Q

Posterior cord syndrome

A

loss of virbation and position sense below the level of the lesion

56
Q

Anterior cord syndrome

A

Anterolateral pathway: loss of pain and temperature below lesion

Anterior horn: LMN weakness at level of lesion

Large = incontinence and UMN

57
Q

Bladder
Normal function

Lesion in bilateral medial frontal micturition centers

Lesion below pontine micturiton center

Lesion of peripheral nerve S2-S4

A

completely volunteer
medial frontal micturition center = activates voiding/detrusor reflex which is regulated by pontine micturition center

urine flow and bladder emptying no longer under voluntary control

flaccid, acontractile (atonic) bladder

flaccid areflexic bladder

58
Q

Bowel

Normal

A

Sphincter closure maintained by internal smooth muscle sphincter innervated by parasympathetics, external striated muscle sphincter innervated from Onuf’s nucleus and pelvic floor muscles from sacral anterior horn

59
Q

Bowel lesions

A

fecal incontinence and constipation

60
Q

Sexual function

Normal

A

sensation from genitalia via pudendal nerve S2-S4, lubrication from Bartholin’s glands (parasympathetic) and increased vaginal blood flow (sympathetic), ejaculation sympathetic

61
Q

Sexual function lesion

A

reflex erection and ejaculation possible but variable

PBL Spring 2015 - Block 2 (11 decks)

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