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Gross Anatomy II > Nociception And Proprioception > Flashcards

Nociception And Proprioception Flashcards

1
Q

Receptors that receive information about the external environment (i.e. Touch, temp, pain)

A

Exterceptors

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2
Q

Receptors that receive information about the internal environment (i.e. Stretch receptors of organs/ visceral pain perception)

A

Interoreceptors

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3
Q

___________ provides information about the position and movement of the body

A

Proprioception

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4
Q

What are the 4 destinations of general sensory afferent (GSA) neurons?

A

Spinal cord segments

Cortex (via thalamus) conscious perception

Cerebellum -unconscious proprioception (muscle tone and balance)

ARAS (ascending reticular activating system)

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5
Q

What system maintain wakefulness?

A

Recticular formation (ARAS)

Neuronal network within the brainstem

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6
Q

What is parallel processing ?

A

Different aspects of the same sensory experience are perceived in different parts of the brain

Eg color, motion, form, and depth

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7
Q

What is the somatosensory pathway?

A

Receptor -> 1st order neuron (afferent) -> stimulation interneurons (2nd order) which may synapse other interneurons-> thalamus -> cortex

most will decussate to contralateral side
Excitatory or inhibitory

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8
Q

What is the relay and processing point for all conscious perception, except olfactory?

A

Thalamus

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9
Q

What are the three different pathways by which somatosensory pathways can reach the cortex?

A
  1. Afferent -> synapse to interneuron and ascend on ipsilateral side -> synapse to interneuron in lateral cervical nucleus-> decussate -> synapse in thalamus -> cortex
  2. Afferent -> ascend ipsilatterally in spinal cord before synapsing onto interneuron in the nucleus gracilis and cuneatus-> thalamus—-> cortex
  3. Afferent -> synapse and decussate to contralateral side -> ascend-> thalamus -> cortex
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10
Q

What are two important somatosensory pathways in the dorsal column of the spinal cord?

A

Fasciculus cuneatus

Fasciculus gracilis

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11
Q

___________ position is assessed via joint angle

A

Static

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12
Q

___________ position is assessed via movement of joints and muscles

A

Kinesthetic

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13
Q

General proprioception has two pathways. The ___________ pathway terminates in the cerebral cortex and the _____________ pathway goes to the cerebellum or the spinal cord

A

Conscious; unconscious

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14
Q

What is the somatosensory cortex?

A

Parietal lobe

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15
Q

What are the two primary conscious proprioceptive pathways?

A

Dorsal Column-Medial Lemniscal Pathway (DCML)

Trigeminal-Medial Lemniscal Pathway

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16
Q

The Dorsal Column- Medial Lemniscal Pathway carry conscious proprioception about

A

Limbs and body

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17
Q

The Trigeminal-Medial Lemniscal Pathway carry conscious proprioception about

A

Face

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18
Q

What are the Dorsal Column- Medial Lemniscal Pathway receptors??

A

Muscle spindles (change in muscle length)

Golgi tendon organs (tension in tendon and joint capsules)

Cutaneous mechanoreceptor

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19
Q

In the dorsal column what are the two tracts for conscious proprioception?

A 
Fasciculus gracilis (medial) 
Fasciculus cuneatus (lateral)))))
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20
Q

The ______________ transmits sensory information from the lower body and is medially located in the dorsal column

A

Fasciculus gracilis

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21
Q

The ____________ transmits sensory information from the upper body and is laterally located in the dorsal column

A

Fasciculus cuneatus

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22
Q

Tracts of conscious proprioception traveling in the dorsal column will travel (ipsilateral or contralateral)?

A

Ipsilateral

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23
Q

The dorsal column CP pathways decussate in the ________

A

Medulla

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24
Q

The dorsal column CP pathways synapse onto second order neurons in the medulla at the _________ and ___________ nuclei

A

Cuneate and gracile

correspond to the tracts they run in… fasciculus cuneatus and fasciculus gracilis

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25
Q

2nd order neurons from the cuneate/gracile nuclei travel in the _________ to the thalamus

A

Medial lemniscus

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26
Q

Sensory information from the face travels in the trigeminal nerve to the ____________nucleus

A

Trigeminal nucleus

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27
Q

What is the conscious proprioceptive pathway of the face?

A

Trigeminal nerve (afferent) -> trigeminal nucleus -> 2nd order neuron -> medial leminiscus -> thalamus -> 3rd order neuron -> cortex

28
Q

What can be observed in a proprioceptive deficit?

A 
Gait abnormalities 
-long stride
-hypermetria (excessive flexion)
-wide swing phase 
Knuckling/dragging/scuffing toes
29
Q

At what levels can a lesion occurs that would lead to proprioceptive ataxia

A 
Peripheral nerve
Dorsal root
Spinal cord
Brainstem 
Thalamus
Cortex
30
Q

What is the processing of noxious stimuli?

A

Transduction -> stimuli to electrical signal

Transmission -> AP to spinal cord

Modulation -> modified in the spinal cord

Perception -> awareness = nocciception

31
Q

What kind of pain perception is discriminative and may be perceived as more “uncomfortable”

A

Superficial pain

32
Q

What type of pain is non-discriminative but elicits strong behavioral responses or changes, referred to as “true pain”

A

Deep pain

33
Q

Superficial pain perception is received by nociceptors in the _________ while deep pain perception is received by nociceptors in the ________________

A

Skin; muscle, joint, and bone

34
Q

What are the fast conducting nociceptive fibers

A

Myelinated (A-delta)

35
Q

What are the slow conducting nociceptive neuron fibers

A

Unmyeliniated (C) fibers

36
Q

What are characteristics of myelinated (A-delta) fibers?

A

Fast conduction and accurate localization

Sharp pinprick pain

Pain does not outlast stimulus

Activated by mechanical and temperature stimuli of painful realm (and cold temperature)

Afferent component of reflex arcs

37
Q

High levels of ___________________ fibers are found in the skin

A

Myelinated (A-delta) fibers

38
Q

What are characteristics of Unmyelinated (C) neuron fibers

A

Slow conducting; not accurately localized

Dull, aching, throbbing pain

Can persist after stimulus is removed

High activation threshold

Activated by mechanical, thermal, and chemical stimuli

39
Q

High levels of _______________ fibers are found in deep tissues (eg viscera or bone)

A

Unmyelinated (C) neuron fibers

40
Q

What two ascending nociceptive pathways transmit superficial pain?

A

Spinocervicothalamic

Spinothalamic

Also transmit tactile sensation

41
Q

The ___________ tract transmits deep and visceral pain

A

Spinorecticular

42
Q

True/False: Somatotopy is well defined in the spinorecticulr tract

A

False

Not well defined due to multiple synapses and a larger receptive field

43
Q

What is the pathway of the spinocervicothalamic tract?

A

Primary neuron -> synapse at dorsal horn -> 2nd order neuron ascends ipsilaterally in lateral funiculus ->synapse at lateral cervical nucleus(C1/C2) -> 3rd order neuron decussate in medulla -> synapse to 4th order neuron in thalamus -> cortex

44
Q

What is the pathway of the spinothalamic tract?

A

Primary neuron -> synapse, decussate immediately and ascend in contralateral side -> lateral cervical nucleus (C1/C2)->3rd order neuron-> -> thalamus -> cortex

45
Q

Describe the spinorectular tract

A

Multisynaptic
Synapse every 3-5 segments
Remain ipsilateral or contralateral

Ascend to reticular formation and thalamus -> cortex

46
Q

The ___________ system is activated via the thalamus for emotional response to pain from the spinorecticular tract

A

Limbic

47
Q

What role does the limbic system play in pain response. How could a lesion affect this response?

A

Limbic system -> negative emotional response to main

Lesion -> can feel and identify pain, but have no aversion to it

48
Q

Nociception from the head is transmitted via the _________ nerve

A

Trigeminal

49
Q

What type of pain arises from trauma or inflammation, is appropriate, and protective to the body

A

Acute pain

50
Q

What type of pain persists beyond the time frame of the disease/injury, a maladaptive resposne.

A

Chronic pain

51
Q

What type of neurons are responsible for referred pain?

A

Wide dynamic range (WDR)

nociceptive and non-noxious stimuli both synapse onto the same WDR neuron -> perceive pain coming from the non-noxious neuron

52
Q

What is the purpose of inflammatory mediators?

A

Directly stimulates nociceptors

Lowers threshold of nociceptors
-in damaged/inflamed tissues the nociceptors are more easily activated and the perception of pain occurs more frequently with stimulation

53
Q

_____________is released by sensory nerve terminals in response to a noxious stimuli. What is its purpose?

A

Substance P

Neurotransmitter and inflammatory mediator
-> increased sensitization of nociceptors and other sensory receptors

54
Q

________ is when a minimal noxious stimuli produces greater than normal nociceptive activity

A

Hyperalgesia

55
Q

__________ is when an innocuous stimuli provokes a pain response

A

Allodynia

56
Q

What can contribute to hyperalgesia and allodynia?

A

Substance P-> sensitization of nociceptors and innocuous nerve fibers

57
Q

What is wind-up?

A

Continuous firing of afferent nociceptors

Repeated stimulation of C type fibers -> sustained depolarization of spinal cord neurons

Prolonged stimuli leads to decreased threshold -> less stimulus is required to induce pain

58
Q

What neurotransmitters have anti-nociceptive properties?

A

Endorphins, enkephalins, serotonin, and norepinephrine

Decrease pain perception

59
Q

What is gate control theory

A

Inputs from non-nociceptive fibers activate inhibitory interneurons in the spinal cord -> inhibit projection neurons (pain) to the thalamus

Eg 
Compression 
Massage 
Water therapy 
Acupuncture
60
Q

What is the decreased perception of pain

A

Hypoalgesia

61
Q

What is the complete absence of pain perception?

A

Analgesia

62
Q

What is the absence of all sensory perception

A

Anesthesia

63
Q

What nerve fibers are involved in itch

A

Mainly C type, some A-delta types

travels in same pathway as nocicpetion

64
Q

Where does differentiation between pain and itch occur

A

Spinal cord

65
Q

Do you test for deep pain if superficial pain is intact?

A

No

Superficial pain would be lost before deep pain

66
Q

Is it possible to have an absent withdrawal reflex and an normal deep pain reaction

A

Yes

Lesion could be relative to somatic efferent when afferent neurons, interneurons, and nociceptive pathways are intact

Gross Anatomy II (11 decks)

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