Neurophysiology - trigeminal system Flashcards

1
Q

What does the trigeminal system provide?

A

sensory innervation to the face and mucous membrane of the oral cavity

motor innervation to the muscles of mastication

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2
Q

What type of nerve is the trigeminal nerve?

A

branchiomeric nerve

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3
Q

What is a branchiomeric nerve?

A

innervates skeletal muscles of branchial arch

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4
Q

Where is the first synapse of the primary afferent neurons?

A

CNS

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5
Q

Describe the general sensory pathway of the trigeminal nerve?

A
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6
Q

What do you call a collection of cell bodies in the peripheral nervous system?

A

Ganglion

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7
Q

What are tracer methods? (anatomical)

A

HRP, fluorescent dyes, autoradiography

Applying dyes to see where the nerves are synapsing, where is the rain it ends up …

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8
Q

Apart from anatomical studied, how else can you study CNS structures?

A

Electrophysiological

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9
Q

How do you study the CNS electrophysiologically?

A

What type of peripheral stimuli excite cells in the nuclei

What part of the CNS is activated in response to stimuli

Intracellular recording

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10
Q

How do you study the CNS neuropathologically?

A

What happens if one or more nucleus is destroyed by disease (or surgery)

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11
Q

Where is the cell body of the trigeminal primary Afferent neurons?

A

Trigeminal ganglion

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12
Q

What do you call the second order neuron?

A

Trigemino -thalamic Tract

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13
Q

What are the 3 main parts of the brain stem?

A
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14
Q

What are the 3 main components of the trigeminal sensory neculei?

A
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15
Q

What are the primary Afferent of the main sensory nucleus?

A

Large diameter
Myelinated Afferent nerve fibers from V1,2,3

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16
Q

What do the primary afferents of the main sensory neuron synapse with? (2)

A
  1. Cross the midline, join the ventral trigeminothalmic tract and terminate in ventral posteromedial nucleus (VPM) of the thalamus
  2. Don’t cross the midline, joint the dorsal trigeminothalmic tract and terminate in VOM of the thalamus
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17
Q

What is the function of the main sensory nucleus?

A

Processing discriminative tactile

Processing proprioceptive sensation

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18
Q

Where do the spinal trigeminal nucleus extend to?

A

Both nucleus and tract extend caudally to about the third cervical segment of the spinal cord

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19
Q

What are the 3 parts of the spinal trigeminal nucleus?

A
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20
Q

What is the function of the spinal trigeminal nucleus?

A

Processing of pain and temperature information from the face, mouth and nose

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21
Q

What neurons cross the line between PNS and CNS?

A

Primary Afferent neurones

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22
Q

Where is the 2nd synapse of the general sensory pathway?

A

Thalamus

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23
Q

Where is the third general sensory synapse?

A

cerebral cortex

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24
Q

What happens between the 1st and 2nd synapse?

A

cross the midline

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25
Q

What are 3 different ways to study the CNS?

A

anatomical

Electrophysiological

Neurological/neuropathological

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26
Q

Where is the first synapse of the trigeminal sensory pathway?

A

trigeminal sensory nucleus

CNS

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27
Q

What neurone connects the trigeminal sensory nucleus and the thalamus in the trigeminal sensory pathway?

A

Trigeminal-thalamus tract

28
Q

Where does the trigeminal-thalamic tract neurone synapse?

A

In the thalamus

29
Q

What is the final destination of the trigeminal sensory pathway?

A

Somatosensory cortex

30
Q

The second order neuron is called a tract, what is a tract?

A

a collection of the neuron fibers in the CNS

connects the trigeminal and thalamus = trigemino-thalamic tract

31
Q

Where is the trigeminal nucleus of the trigeminal nerve located?

A

pons

32
Q

What view of the brainstem is shown?

A

Dorsal

33
Q

How is the branching organized foe trigeminal sensory nucleus?

A

not about where they come from but the type of fiber

34
Q

Describe options A and B of the second order neurons?

A

A = dorsal trigeminothalmic tract

B = ventral trigeminothalmic tract (cross midline)

35
Q

Where does A terminate?

A

Ventral posteromedial nucleus (VPM) of the thalamus

36
Q

Where does B terminate?

A

Ventral posteromedial nucleus (VPM) of the thalamus

37
Q

If someone loses sensation to one side of the face, what is affected?

A

VTTT

DTTT

Tract effected

38
Q

What are the subdivision of the spinal trigeminal nucleus?

A
39
Q

Where does the V nucleus causal is extend from and to?

A

Extending from the spinal cord to the obex

40
Q

V nucleus caudalis

A

A = trigeminal spinal tract

B = trigeminothalmic tract (TTT)

C ventral posteromedial nucleus in the thalamus

41
Q

features of the primary afferents of the spinal trigeminal nucleus (V nucleus caudalis)

A

small and large-diameter fibres

turn caudally and join the spinal trigeminal tract

from V1,2,3

42
Q

What do the second-order neurones of the spinal trigeminal nucleus (V nucleus caudalis) do? what do they join? Where do they terminate?

A

cross the midline

join the trigeminothalmic tract (TTT)

terminate in the VPM of the thalamus

43
Q

What is the function of the V nucleus caudalis?

A

Processing in pain and temperature information from face, mouth and nose

44
Q

nociceptive pathway?

A

pathway of pain in the body

will cause the body harm

45
Q

Why can a patient find it hard to locate where the pain is in the mouth or point to a different part (not the actual site of pain)?

A

divergence in nociceptive pathways

convergence in nociceptive pathways

46
Q

Where do the second-order neurons relay information to? (V nucleus oralis and interporalis)

A

all cross midline!

some to the condralateral VPM (tactile info)

some to cerebellum

47
Q

What is the function of the V nucleus oralis and interporalis neurones/fibres?

A

tactile information

processing of pain and temperature info from the teeth and other intraoral structures (mouth) - more towards centre of the face

reflexes e.g. corneal reflex

48
Q

What is the onion skin pattern?

A

arrangements of afferents and their endings in the spinal trigeminal system

49
Q

What happens if you have damage to the caudalis part of the nucleus?

A

you lose sensation to the opter part of the face, not the central part

50
Q

What is the most ventral nerve of trig.?

A

opthalmic

51
Q

What is the most dorsal nerve of trig.?

A

mandibular

52
Q

Where do parts A-C go in the spinal nucleus?

A

A = oralis

B = interpolaris

C = caudalis

53
Q
A
54
Q

What nucleus is most superior/rostral?

A

trigeminal mesencephalic nucleus

55
Q

In the trigeminal mesencephalic nucleus, is there a synapse between the primary afferents and the second order neurones?

A

no synapse

56
Q

What are the cell bodies of the trigeminal mesencephalic nucleus for?

A

jaw muscle spindles afferents

some mechanoreceptive afferents from PDL

57
Q

What is unique about the cell bodies of the primary afferents for the jaw muscles and PDL? (mesencephalic nucleus)

A

they are not in the PNS but the CNS

58
Q

Where is the parent axon in the mesencephalic nucleus?

A

V motor root - V3

59
Q

Where is the first synapse of the mesencephalic nucleus?

A

V motor nucleus

60
Q

The trigeminal mesencephalic nucleus pathway does not go to higher cortex, it is a closed loop?

A

it is a reflex - jaw jerk

non-conscious proprioception

61
Q

What is the receptor in the jaw jerk reflex?

A

muscle spindle

62
Q

In jaw jerk reflex, what does the trigeminal mesencephalic nucleus synapse with?

A

trigeminal motor nucleus

63
Q

What are the efferent in the motor root (mandibular)?

A

muscles of mastication

64
Q

Is the mesencephalic a motor or sensory root?

A

motor root

65
Q
A

A = sensory root

B = motor root

66
Q

What happens of there is damage to the trigeminal motor nucleus?

A

ipsilateral muscle atrophy - muscles of mastication