Organization of the spinal cord and the brainstem Flashcards

Dr. Mokha

1
Q

Brainstem:

A

Pons
Medulla
Midbrain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T/F: Right thalamus will receive sensory information from the right side of the body?

A

False. The right thalamus will receive sensory information from the left side of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Principle of 2nd order axons:

A

Axons of 2nd order neurons in sensory pathways crossover contralaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does somantosensory initially travel?

A

From the peripheral nerve fibers to the spinal cord then finally arriving at the CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Sensory function Proprioception:

A

Receptor type: Muscle spindle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Sensory function: Touch

A

Receptor type: Merkel, meissner, pacinian, and ruffini cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sensory function: Pain, temperature

A

Receptor type: free nerve ending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is the medial leminiscus located?

A

Inside the middle portion of the medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is the Gracile nucleus located?

A

Inside the frontal portion of the medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is the Cuneate nucleus located?

A

Inside the temporal portion of the medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Spinal nerve:

A

Dorasal root (sensory)
Ventral root (motor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Spinal cord:

A

31 pairs of spinal nerves:
C=8
T=12
L=5
S=5
C=1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where does the spinal cord end?

A

Causally end between L1 and L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What spinal nerves are good for obtaining CSF and epidural injections?

A

Cauda Equina L2-S4. Only spinal nerves and no spinal cord tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anterolateral system (ALS):

A

Pain, temperature, and itch pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Damage to the Lateral corticospinal tract:

A

Spastic paralysis, babinski sign, loss of motor movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dorsal columns:

A

Touch and proprioception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the lateral motor columns?

A

C5-T1
L1-S3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lateral motor column C5-T1:

A

Innervates muscles of the upper extremity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lateral motor column L1-S3:

A

Innervates muscles of the lower extremity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Dorsal nucleus of Clarke:

A

Spinal level C8-L3
Nucleus of origin of the dorsal spinocerebellar

22
Q

Medial motor columns:

A

All levels; lower motor neurons innervating axial musculature

23
Q

Lateral motor columns:

A

C5-T1; lower motor neurons innervating muscles of the upper extremity

24
Q

Lesions in the rostral medulla, pons, midbrain, internal capsule (posterior limb) and cortex:

A

Will produce symptoms contralaterally

25
Q

Corticospinal tract:

A

-Originates from the primary cortex (precentral gyrus) (upper motor neurons)
-Crosses at the level of caudal medulla
- Lesions in the spinal cord causes ipsilateral (same side) symptoms: Spastic paralysis, Babinski sign

26
Q

Fas Cuneatus:

A

T6 and above; upper extremities

27
Q

Fas Gracilis:

A

Lower extremities

28
Q

Two point discrimination:

A

The ability of the brain to discern between two closely located touch like stimuli; the smaller the difference the larger the number of receptors

29
Q

T/F: Right thalamus receives sensory information from the left side of the body

A

True.

30
Q

Dorsal column medial lemniscal (DCML):

A

Touch pathway (non-painful)

31
Q

Where are the first neurons that synapse for DCML located?

A

First order neurons will synapse in the relay nuclei and have their cell bodies located in the dorsal root ganglion

32
Q

Where does decussation (cross over) occur in DCML?

A

2nd order neuron inside the caudal medulla

33
Q

2nd order neuron for DCML:

A

2nd order neuron will synapse in the VPL, will have their cell bodies located in the cuneatus and gracilis nuclei

34
Q

Lesions above the sensory decussation (above the 2nd order neuron) for DCML:

A

Loss of tactile (touch) non-painful sensations- contralateral

35
Q

Lesions at or below the spinal cord (above the 2nd order neuron) for DCML:

A

Loss of tactile (touch) sensations; non-painful; ipsilateral

36
Q

3rd order neurons for DCML:

A

Will synapse in the primary somatosensory cortex, and have their cell bodies in the VPL nucleus of the thalamus. Will terminate @ the cortex

37
Q

Where is decussation (crossing over) located for pain and temperature?

A

Contained within the spinal cord (ALS specific)

38
Q

What are some functions of the DCML system?

A

Morphosynthesis
Graphesthesia
Two-point discrimination
Texture discrimination
Vibration
Proprioception

39
Q

Is DCML an ascending or descending pathway ?

A

Ascending pathway

40
Q

First order neurons for ALS:

A

1st order neurons that synapse in lamina I, II, or V will have their cell bodies in the dorsal root ganglion

41
Q

Second order neurons for ALS:

A

2nd order neurons that synapse in the VPL have their cell bodies in lamina I, II, or V

42
Q

Third order neurons for ALS:

A

3rd order neurons that synapse in somatosensory cortex, cell bodies in the VPL of the thalamus (termination)

43
Q

Where does decussation occur for ALS?

A

At the spinal cord

44
Q

Lesions for ALS:

A

At or below the spinal cord; ipsilateral
Above the spinal cord; Contralateral loss of pain and temperature below the lesion after a few (2 or 3) spinal segments

45
Q

Horner’s Syndrome:

A

-Miosis: Decreased pupillary size
-Ptosis:Drooping of the upper eyelid
-Anhidrosis: Decreased sweating of the ipsilateral face and neck
-Loss of sympathetic innervation

46
Q

C fibers termination:

A

II, I

47
Q

A delta fibers termination:

A

I , V

48
Q

Spinothalamic tract neurons located in:

A

Lamina I, V

49
Q

Lamina neurons II:

A

Interneurons (excitatory or inhibitory) modulate transmission

50
Q

Where does the sensory information from the thalamus (pain, touch, and temp leave from

A

Leaves via thalamo-cortical projections; located in the posterior limb of the internal capsule

51
Q

Brown sequard syndrome:

A

-DCML lesion; touch and proproioception ipsilateral
-ALS lesion; pain and temp contralateral
-Corticalspinal tract lesion; Babinski sign and Spastic paralysis ipsilaterally. Loss of volitional control of movement ipsilaterally