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Neuro Ch. 7 > Neuro Ch. 7 one-liners > Flashcards

Neuro Ch. 7 one-liners Flashcards

1
Q

Function of posterior column pathway:

A

Convey proprioception, vibration, and fine, disciminative touch

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2
Q

Name of the posterior column’s secondary neuron pathway?

A

medial lemniscal pathway

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3
Q

Where does the posterior column pathway decussate?

A

internal arcuate fibers of the lower medulla

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4
Q

Where do primary neurons of the posterior column synapse?

A

posterior dorsal column nuclei in the medulla

      - gracile nucleus
      - cuneate nucleus
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5
Q

Where do secondary neurons/medial lemniscus of the posterior column synapse?

A

VPL (ventral posterior lateral nucleus) of thalamus

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6
Q

Where does the posterior column pathway ascend?

A

ipsilaterally in the posterior/dorsal column white matter, until the medulla, where it decussates, then contralaterally to the thalamus VPL

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7
Q

Main tract of the anterolateral pathway

A

spinothalamic tract

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8
Q

Function of anterolateral pathway

A

senses pain, temperature, and crude touch

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9
Q

Where does the anterolateral pathway decussate?

A

anterior commissure of the spinal cord (immediately as it enters); takes 2-3 segments to cross

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10
Q

Where does the anterolateral pathway ascend?

A

contralaterally in the spinothalamic tract of the anterolateral white matter, until it reaches its synapse in the VPL of the thalamus

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11
Q

What sensory receptor is involved in the stretch reflex?

A

muscle spindles - which sense the amount and rate of stretch

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12
Q

How is touch affected in an isolated lesion to the posterior column?

A

Touch sensation will not be eliminated because touch is carried by both the posterior (fine, descriminative) and anterolateral (crude) columns

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13
Q

How is touch affected in an isolated lesion to the anterolateral column?

A

Touch sensation will not be eliminated because touch is carried by both the posterior (fine, descriminative) and anterolateral (crude) columns

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14
Q

Where are the cell bodies of sensory neurons located?

A

Dorsal root ganglia

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15
Q

What is a dermatome?

A

A peripheral region innervated by sensory fibers from a single nerve root level

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16
Q

What sensory neurons fibers are associated with proprioception, and what is their associated receptor?

A

A-alpha (muscle spindle and golgi tendon organ receptors)

A-beta (Muscle spindle receptors)

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17
Q

What sensory neuron fibers and receptors are associated with deep touch and vibration?

A

A-beta (pacinian corpuscles and ruffini endings)

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18
Q

What neuron fibers and receptors are associated with touch and vibration?

A

A-beta (hair receptor)

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19
Q

What sensory neuron fibers and receptors are associated with superficial touch?

A

A-beta (Meissner’s corpuscles and merkel’s receptor)

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20
Q

What sensory neuron fibers are associated with pain, and what is their associated receptor?

A

A-delta (bare nerve ending)

C (bare nerve ending)

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21
Q

What sensory neuron fiber and receptor is associated with cool temperature?

A

A-delta (bare nerve ending)

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22
Q

What sensory neuron fiber and receptor is associated with warm temperature?

A

C (bare nerve ending)

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23
Q

What sensory neuron fibers and receptors are associated with itch?

A

A-delta (bare nerve ending)

C (bare nerve ending)

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24
Q

Which sensory neuron fiber types are myelinated?

A

A-alpha, A-beta, and A-delta (*all the A’s)

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25
Q

Which sensory neuron fiber types are unmyelinated?

A

C (C fibers are the outCasts)

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26
Q

What type of axons conduct faster?

A

larger-diameter, myelinated

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27
Q

Describe the somatotopic organization of the posterior column pathway:

A

dorsal/posterior columns: of the spinal cord; legs and lower trunk medially in fasciculus gracilis, and upper trunk above T6, arms, and neck laterally in the fasciculus cuneatus
medulla: medial lemniscus is vertical in medulla with feet ventrally (then lower trunk, upper trunk, arms, neck)
pons and midbrain: the medial lemniscus lies back down reversing position; arms medially and legs laterally

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28
Q

What pathway is analogous to the medial lemnisual pathway?

A

Trigeminal leminiscus conveying touch from face, but goes to VPM

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29
Q

What types of axons are found in the posterior column pathway?

A

larger-diameter, myelinated

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30
Q

What types of axons are found in the anterolateral pathway?

A

smaller-diamter, unmyelinated (conveying pain and temperature)

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31
Q

What is Lissauer’s tract?

A

Some axon collaterals from the anteriolateral pathway first ascend or descend for a few segments through this tract before entering gray matter

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32
Q

What pathway is analogous to the spinothalamic tract?

A

trigeminothalamic tract sensing pain and temperature of face (CN V)

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33
Q

What are the three tracts of the anterolateral pathway?

A

spinothalamic, spinoreticular, and spinomesencephalic

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34
Q

what is the function of the spinothatlmic tract and where does it synapse?

A

disciminative aspects of pain and temperature sensation: location and intensity (synapses in VPL); also with spinoreticular for emotional and arousal aspects of pain (to intralaminar thalamic/central lateral nucleus and mediodorsal nuclei)

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35
Q

What is the function of the spinoreticular tract and where does it synapse?

A

emotional arousal aspects of pain; intralaminar thalamic nuclei/central lateral nuclesu and mediodorsal nuclei

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36
Q

Where do the intralaminar nuclei project?

A

diffusely to entire cerebral cortex; involved in behavioral arousal

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37
Q

What is the function of the spinomesencephalic tract and where does it project?

A

central modulation of pain; projects to periaqueductal gray matter and superior colliculus

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38
Q

From where does the spinothalamic tract arise?

A

Laminae I and V

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39
Q

From where does the spinoreticular tract arise?

A

diffusely from lamina VI-VIII (intermediate zone and ventral horn)

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40
Q

From where does the spinomesencephalic tract arise?

A

laminae I and V

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41
Q

What is cortical sensory loss?

A

characteristic deficits associated with lesions of the somatosensory cortex and adjacent regions

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42
Q

Where is the secondary somatosensory association cortex located?

A

in the parietal operculum (along the superior margin of the Sylvian fissure)

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43
Q

Where is the sensory association cortex located?

A

in the superior parietal lobule (Brodmann’s 5 and 7)

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44
Q

What sensory fibers are involved in pain modulation?

A

large-diameter A-beta

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45
Q

How do TENS devices work to control chronic pain?

A

gate-control theory: A-beta fibers reduce pain transmission through the dorsal horn

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46
Q

Role of serotonergic (5-HT) neurons?

A

from RVM raphe nucleus project to spinal cord for modulation of pain in the dorsal horn

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47
Q

Role of supbstance P?

A

neuropeptide from RVM neurons to mediate locus ceruleus

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48
Q

NE neurons in pain modulation?

A

from locus ceruleus to dorsal horn

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49
Q

Hisamine contributes to pain modulation

A

through H3 receptors

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50
Q

What are the endogenous opiate peptides?

A

enkephalin, Beta-endorphin, and dynorphin

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51
Q

Where are enkephalin neurons found in high concentrations?

A

periaqueductal gray matter, RVM, and spinal cord dorsal horn

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52
Q

Where are dynorphin neurons found in high concentrations?

A

periaqueductal gray matter, RVM, and spinal cord dorsal horn

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53
Q

Where are Beta-endorphin neurons concentrated?

A

regions of the hypothalamus that project to the periaqueductal gray

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54
Q

Which have a greater number of projections - corticothalamic or thalamocortical?

A

corticothalamic

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55
Q

What forms the diencephalon?

A

thalamus, hypothalamus, and epithalamus

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56
Q

What is the internal medullary lamina?

A

Y-shaped white matter that divides the thalamus into medial, lateral, and anterior nuclear groups

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57
Q

Where are intralaminar nuclei located?

A

In the internal medullary lamina

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58
Q

What is the thalamic reticular nucleus?

A

forms an extensive thin sheet envoloping the lateral aspect of the thalamus

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59
Q

What nuclei does the epithalamus consist of?

A

several small nuclei, including habenula, parts of pretectum, and pineal body

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60
Q

What are the three main categories of thalamic nuclei?

A

Relay, intralminar, and reticular; see table 7.3 for details of each

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61
Q

Where are the midline nuclei located?

A

A thin collection of nuclei lying adjacent to the third ventricle (several are continuous with and functionally similar to the intralaminar nuclei

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62
Q

The thalamus is mostly made up of which type of nuclei?

A

Relay nuclei

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63
Q

Which of the relay nuclei are the most localized?

A

projections to the primary sensory and motor areas (VPL, VPM, LGN, MGN, VL)

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64
Q

Which thalamic nuclei is just medial to the internal capsule?

A

Reticular Nucleus

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65
Q

Which thalamic nuclei does not project to the cortex?

A

Reticular nucleus only

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66
Q

Which thalamic nuclie contains primarily GABAergic neurons?

A

Reticular nucleus

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67
Q

Which thalamic nucleus is involved in thalamic regulation?

A

Reticular nucleus

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68
Q

Which thalamic nuclei relays somatosensory spinal inputs to the cortex?

A

Ventral posterior lateral nucleus (VPL)

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69
Q

Which thalamic nucleus relays somatosensory CN inputs and taste to the cortex?

A

Ventral posteromedial nucleus (VPM)

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70
Q

Which thalamic nucleus relays visual inputs to the cortex?

A

lateral geniculate nucleus (LGN)

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71
Q

Which thalamic nucleus relays auditory inputs to the cortex?

A

medial geniculate nucleus (MGN)

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72
Q

Which thalamic nuclei relays basal ganglia and cerebellar inputs to the cortex?

A

ventral lateral (VL) and ventral anterior (VA) nuclei

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73
Q

which thalamic nucleus relays behavioral orientation toward relvant visual and other stimuli?

A

puvlinar nucleus

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74
Q

Which thalamic nuclei functions with anterior nuclei?

A

lateral dorsal nucleus

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75
Q

which thalamic nuclei functions with pulvinar nucleus?

A

lateral posterior nucleus

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76
Q

which thalamic nucleus helps to maintain alert, conscious state?

A

ventral medial nucleus and rostral intralaminar nuclei

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77
Q

which thalamic nuclei are involved with projecting limbic pathways and cognitive functions?

A

mediodorsal nucleus (MD), anerior nuclear group (anterior nucleus), and midline thalamic nuclei

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78
Q

which thalamic nuclei are involved with motor relay for basal ganglia?

A

caudal intralaminar nuclei

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79
Q

What sensory modality does not have a relay nucleus in the lateral thalamus?

A

olfaction

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80
Q

Inputs of VPL

A

medial lemniscus and spinothalamic tract

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81
Q

outputs of VPL

A

somatosensory cortex

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82
Q

inputs of VPM

A

trigeminal leminiscus, trigeminothalamic tract, taste inputs

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83
Q

outputs of VPM

A

somatosensory and taste cortex

84
Q

intputs of lateral geniculate nucleus (LGN)

A

retina

85
Q

outputs of lateral geniculate nucleus (LGN)

A

primary visual cortex

86
Q

Inputs of medial geniculate nucleus (MGN)

A

inferior colliculus (auditory info)

87
Q

Outputs of MGN (medial geniculate nucleus)

A

primary auditory cortex

88
Q

inputs of VL (ventral lateral nucleus)

A

motor pathways leaving cerebellum and basal ganglia:

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

89
Q

Outputs of VL (ventral lateral nucleus)

A

motor, premotor, and supplementary motor cortex

90
Q

Inputs of VA (ventral anterior nucleus)

A

substantia nigra pars reticulata
internal globus pallidus
deep cerebellar nuclei

91
Q

Outputs of VA (ventral anterior nucleus)

A

Widespread to frontal lobe, including prefrontal, premotor, motor, and supplementary motor cortex

92
Q

Inputs of pulvinar nucleus

A

tectum (extrageniculate visula pathway), other sensory inputs

93
Q

Outputs of pulvinar nucleus

A

parietotemporo-occipital association

94
Q

Inputs of lateral dorsal nucleus

A

limbic pathways; mammillary body, hippocampal formation

95
Q

Outputs of lateral dorsal nucleus

A

anterior cingulate gyrus

96
Q

Inputs of lateral posterior nucleus

A

tectum (extrageniculate visula pathway), other sensory inputs

97
Q

Outputs of lateral posterior nucleus

A

parietotemporo-occipital association

98
Q

Inputs of ventral medial nucleus

A

midbrain reticular formation

99
Q

Outputs of ventral medial nucleus

A

widespread to cortex

100
Q

What is the main nucleus of the medial nuclear group?

A

mediodorsal nucleus (MD)/dorsomedial nucleus

101
Q

Inputs of the medial nucleuar group/MD

A

amygdala, olfactory cortex, limbic basal ganglia

102
Q

Outputs of the medial nuclear group/MD

A

frontal cortex

103
Q

Main nucleus of the anterior nuclear group

A

Anterior nucleus

104
Q

Inputs of the anterior nuclear group/anterior nucleus

A

limbic pathways: mammillary body, hippocampal formation

105
Q

Outputs of the anterior nuclear group/anterior nucleus

A

anterior cingulate gyrus

106
Q

What are the midline thalamic nuclei?

A

Paraventricular, parateaenial, interanteromedial, intermediodorsal, rhomboid, reuniens (medial ventral)

107
Q

Main inputs for the midline thalmic nuclei

A

hypothalamus, basal forebrain, amygdala, hippocampus

108
Q

Outputs for the midline thalamic nuclei

A

amygdala, hippocampus, limbic cortex

109
Q

What are the intralaminar nuclei?

A

rostral and caudal intralaminar nuclei (main inputs and outputs are from the basal ganglia)

110
Q

What are the rostal intralaminar nuclei?

A

central medial nucleus, paracentral nucleus, central lateral nucleus

111
Q

Inputs of the rostral intralaminar nuclei?

A

(basal ganglia); deep cerebllar nuclei, globus pallidus, brainstem ascending reticular activating systems (ARAS), sensory pathways

112
Q

Outputs of the rostral intralaminar nuclei?

A

(basal ganglia); cerebral cortex, striatum

113
Q

What are the caudal intralaminar nuceli?

A

centromedian nucleus, parafascicular nucleus

114
Q

Inputs of the caudal intralaminar nuclei

A

(basal ganglia); globus pallidus, ARAS (ascending reticular activating systems), sensory pathways

115
Q

Outputs of the caudal intralaminar nuceli

A

(basal ganglia); striatum, cerebral cortex

116
Q

Inputs of the reticular nucleus

A

cerebral cortex, thalamic relay and intralaminar nuceli, ARAS (ascending reticular activating systems)

117
Q

Outputs of the reticular nucleus

A

thalamic relay and intralaminar nuclei, ARAS (ascending reticular activating systems), *the only thalamic nuclei that doesn’t project to the cortex

118
Q

What occurs with lesions of somatosensory pathways?

A

sensory loss or paresthesias

119
Q

Paresthesias associated with lesions to the posterior column-medial lemniscal pathway

A

tingling, numb sensation
tight, bandlike sensation around trunk or limbs
sensation similar to gauze around fingers with palpation

120
Q

Paresthesias associated with lesions to the anterolateral pathways

A

sharp, burning, or searing pain

121
Q

Paresthesias associated with lesions to the parietal lobe

A

contralateral numb tingling, pain can also be prominent

122
Q

Paresthesias associated with lesions to the primary sensory cortex

A

contralateral numb tingling, pain can also be prominent

123
Q

Paresthesias associated with lesions to the thalamus

A

Dejerine-Roussy syndrome (severe contralateral pain)

124
Q

Dejerine-Roussy syndrome

A

associated with lesions of the thalamus; severe contralateral pain

125
Q

Paresthesias associated with lesions to the C-spine

A

Lhermitte’s sign (electricity-like ensation running down the back and into the extremities upon neck flexion)

126
Q

Lhermitte’s sign

A

electricity-like ensation running down the back and into the extremities upon neck flexion; associated with lesions to the C-spin

127
Q

Paresthesias associated with lesions to nerve roots

A

radicular pain - radiates down the limb in a dermatomal distributsion, accompanied by numbness and tingling, provoekd by movements that stretch the nerve root

128
Q

Paresthesias associated with peripheral nerve lesions

A

numbness, tingling, and pain in the sensory distribution of the nerve

129
Q

Dysesthesia

A

unpleasant, abnormal sensation

130
Q

allodynia

A

painful sensations provoked by normally nonpainful stimuli (like light touch)

131
Q

Hyperpathia

A

enhanced pain to normally painful stimuli

132
Q

Hyperalgesia

A

enhanced pain to normally painful stimuli

133
Q

hypesthesia

A

decreased sensation

134
Q

What are the most common causes of spinal cord dysfunction?

A

extrinsic compression due to degenerative disease of the spine
trauma
metastatic cancer

135
Q

Where must you image with an MRI if you suspect spinal cord lesions?

A

cervical and thoracic (and suspected level); soemtimes lesions may be higher than level suggested by sensory or motor levels involved

136
Q

What is spinal shock?

A

occurs in cases of acute, severe spinal cord lesions (such as trauma);

  • flaccid paralysis below the lesion
  • decreased sympathetic outflow to vascular SM - decreases BP
  • absent sphincteric reflexes and tone
  • after weeks-months, UMN signs develop and sphincteric and erectile reflexes may return, although without voluntary control
137
Q

What may inprove the outcome of traumatic spinal cord lesions?

A

treating within the first 8 hours with high doses of steroids

138
Q

In what spinal regions is chronic myelopathy most commonly seen?

A

cervical and lumbar

139
Q

What commonly causes chronic myelopathy?

A

degenerative disorders of the spine

140
Q

Does chronic myelopathy caused by degenerative disorders cuase UMN or LMN signs?

A

both - b/c both spine and nerve roots are often compressed; sometimes mimicking motor neuron disease

141
Q

What is the most common cause of neoplastic spinal cord compression?

A

metastic spread to the epidural space (spinal cord tumors can also be seen)

142
Q

What artery is commonly involve in infarction of the spinal cord?

A

anterior spinal artery occlusion, causing anterior cord syndrome

143
Q

What results in anterior cord syndrome

A

Spinal cord infarction caused by anterior spinal artery occlusion

144
Q

How do you prevent irreversible loss of ambulation in cord compression caused by tumors?

A

prompt treatment with radiation and/or surgical intervention (rule of thumb = 80%)

145
Q

What are common causes of spinal cord infarction?

A

anterior spinal artery occlusion, trauma, aortic dissection, thromboemboli, disc emboli, watershed infarction (T4-T8), spinal dural AVM

146
Q

How does myelitis present?

A

quick development, hours to days

147
Q

What does MRI show in myelitis?

A

T2 bright areas

148
Q

What does CS ften show in myelitis?

A

elevated WBC - usually lmymphocytic-predominant

149
Q

What are common causes of infectious myelitis?

A

viral (HIV), lyme disease, tertiary syphilic, tropical spastic paraperesis, schistosomiasis

150
Q

What are common causes of inflammatory myelitis?

A

MS, SLE, postinfectious myelitis

151
Q

What are causes of nutritional spinal cord dysfunctions?

A

Vitamin B12 and Vitamin E deficiencies

152
Q

What are examples of neoplastic spinal cord dysfunctions?

A

epidural metastasis, meningioma, schwannoma, carcinomatous meningitis, astrocytoma, ependymoma, hemangioblastoma

153
Q

What are examples of degenerative/developmental spinal cord dysfunctions?

A

spina bifida, chiari malformation, syringomyelia

154
Q

What are examples of tramatic or mechanical spinal cord dysfunctions?

A

contusion, compression, disc herniation, degenerative disorders of vertebral bones, disc embolus

155
Q

What are examples of vascular spinal cord dysfunctions?

A

anterior spinal artery infarct, watershed infarct, spinal dural AVM, epidural hematoma

156
Q

Pattern fo primary somoatosensory cortex deficits

A

contralateral sensory loss - with discriminative touch andpropriosenation most severely affected (all modalities may be involved)
cortical sensory loss may be present with primary modalities spared
associated deficits of adjacent cortical areas: UMN weakness, visual field deficits, aphasia

157
Q

Pattern for thalamic VPL, VPM, or thalamic somatosensory radiation deficits

A

contralteral sensory loss (not neatly at midline) of all sensory modalities
sometimes no motor deficit
more noticable in: face (lips), hand (fingertips), and foot (rather than trunk and proximal extremities)
associated deficits: hemiparesis or hemianopia (internal capsule, lateral geniculate, or optic radiations invovlement), hemisensory loss with hemiparesis (somatosensory radiation proximity to corticobulbar and corticopsinal fibers), less commonly midbrain or upper pons cause contralateral face, arm, and leg somatosensory deficits

158
Q

What might be some associated deficits of primary somatosensory cortex lesions

A

adjacent cortical areas: UMN weakness, visual field deficits, aphasia

159
Q

What might be some associated deficits of thalamic lesions

A

hemiparesis or hemianopia (internal capsule, lateral geniculate, or optic radiations invovlement), hemisensory loss with hemiparesis (somatosensory radiation proximity to corticobulbar and corticopsinal fibers), less commonly midbrain or upper pons cause contralateral face, arm, and leg somatosensory deficits

160
Q

What pathways are involved in lesions to the lateral pons?

A

anterolateral pathways and spinal trigeminal nucleus of the same side

161
Q

What pathways are involved in lesions to the lateral medulla?

A

anterolateral pathways and spinal trigeminal nucleus of the same side

162
Q

What deficit is seen in lesions involving the lateral pons?

A

loss of pain and termperature to the ipsilateral face and contralateral body

163
Q

What deficit is seen in lesions involving the lateral medulla?

A

loss of pain and termperature to the ipsilateral face and contralateral body

164
Q

what pathways are involved in lesions to the medial medulla?

A

medial lemniscus

165
Q

what associated deficits are seen in lesions to the lateral pons?

A

lateral pontine syndrome

166
Q

what associated deficits are seen in lesions to the lateral medulla?

A

lateral medullary syndrome

167
Q

What deficits are seen in lesions to the medial medulla?

A

contralateral loss of vibration and joint position to the body

168
Q

What is the associated deficit of lesions to the medial medulla?

A

medial medullary syndrome

169
Q

What deficit is seen in distal symmetrical polyneuropathies?

A

bilateral sensory loss is a “glove and stocking” distribution

170
Q

What deficit is seen in specific nerve or root lesions?

A

sensory loss to specific territories

171
Q

What are associated deficits of lesions of peripheral nerves or roots?

A

LMN-type weakness

172
Q

What spinal cord lesion causes partial or complete interruption to all sensory and motor pathways?

A

transverse cord lesions

173
Q

What are common causes of transverse cord lesions?

A

trauma, tumors, MS, transverse myelitis

174
Q

What spinal cord lesion causes ipsilateral UMN weakness, ipsilateral loss of vibration and proprioception, ipsilateral 1-2 segments of pain and temperature loss, and contralateral loss of pain and temperature?

A

Hemicord lesions; Brown-Sequard Syndrome

175
Q

What causes the ipsilateral pain and temperature loss of 1-2 segments in Brown-Sequard Syndrome?

A

damage to posterior horn cells before their axons cross

176
Q

What are common causes of Brown-Sequard syndrome?

A

penetrating injuries, MS, lateral compression from tumors

177
Q

What spinal cord lesions involves sacral sparing?

A

large central cord lesions

178
Q

what spinal cord lesion is involved with cape distribution of pain and temperature loss?

A

small C-spine central cord lesions

179
Q

what spinal cord lesions is involved in bilateral suspended sensory loss to pain and temperature?

A

small central cord lesions

180
Q

What are common causes of central cord lesions?

A

spinal cord contusion, syringomyelia (non or post-traumatic), intrinsic spinal cord tumors (hemangioblastoma, ependymoma, or astrocytoma)

181
Q

What spinal cord lesion is involved with loss of vibration and propioception?

A

posterior cord lesions

182
Q

What are common causes of posterior cord lesions?

A

trauma, compression from posteriorly located tumors, MS, Vit B12 def, tabes dorsalis

183
Q

What would be an additional affect of a large posterior cord lesion?

A

involvement of corticospinal tract causing UMN weakness

184
Q

What spinal cord lesion is involved with weakness, loss of pain and temperature, and incontinence?

A

anterior cord syndromes

185
Q

What would be an additional deficit of a large anterior cord lesion?

A

involvement of corticospinal tract causing UMN weakness

186
Q

What spinal cord lesion is often associated with incontience?

A

anterior cord lesions

187
Q

What are common causes of anterior cord lesions?

A

trauma, MS, anterior spinal artery infarct

188
Q

What preferentially affects the posterior cord?

A

Vitamin B12 deficiency and tabes dorsalis (tertiary syphilis)

189
Q

What spinal levels are involved in sensory info from the rectum, bladder, urethra, and genitalia?

A

S2-S4

190
Q

What are the sacral motor nuclei?

A

sacral parasympathetic nuclei, onuf’s nucleus, and anterior horn cells

191
Q

What is the function of Onuf’s nucleus?

A

provides somatic innervation of urethral and external anal sphincters, and somatic motor pathway for ejection of semen

192
Q

What are the nerve roots for Onuf’s nucleus?

A

S3 (urethral sphincte), S4 (external anal sphincter)

193
Q

What is the function of the sacral parasympathetic nuclei?

A

parasympathetic innervation to the detrucor muscle, internal anal sphincter, descending colon, rectum, bartholin’s glands, and erectile pathway

194
Q

What are the nerve roots of the sacral parasympathetic nuclei?

A

S2-S4; (S2 esp for erection)

195
Q

What is the funciton of the anterior horn cells?

A

somatic innervation of the pelvic floor muscles, somatic motor pathway for ejection of semen

196
Q

What are the nerve roots for the anterior horn cells?

A

S2-S4

197
Q

What is the function of the dorsal motor nucleus of vagus?

A

parasympathetic innervation of the gut above the splenic flexure

198
Q

What are the nerve roots of the dorsal motor nucleus of vagus?

A

CN X

199
Q

What initiates the detrusor/voiding reflex?

A

descending pathways from medial frontal micturition centers after a feeling of bladder fulness reaches the sensory cortex

200
Q

What mediates the detrusor reflex?

A

intrinsic spinal cord circuits

201
Q

What regulates the detrusor reflex?

A

the pontine micturition center; also possibly cerebellar and basal ganglia pathways

202
Q

What is the urethral reflex?

A

when urine flow stops, the urethral sphincters contract, which triggers detrusor relaxation

203
Q

What is triggered by voluntary relaxation of the external uerthral sphincter?

A

inhibition of sympathetics to the bladder neck, causing it to relax
activation of parasympathetics, causing detrusor muscle contraction

204
Q

What is the affect of the sensation of urine flow through the urethra?

A

Activation of continued sphincter relaxation and dtrusor contraction

205
Q

How can urine flow be interrupted?

A

voluntary closure of the urethral sphincter, which triggers detrusor relaxation

206
Q

What occurs with lesions affecting bilateral medial frontal micturition centers?

A

frontal-type incontinence: reflex activation of pontine and spinal micturition cneters when the bladder is full - normal but not voluntary; pt may or may not be aware of incontinence

207
Q

What are common causes of frontal-type incontinence?

A

hyrdocephalus, parasagital meningioma, bifrontal glioblastoma, traumatic brain injury, neurodegenerative disorders

Neuro Ch. 7 (1 decks)

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