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Neurology > Sensory and motor pathways > Flashcards

Sensory and motor pathways Flashcards

1
Q

2 main somatosensory pathways

A

Lateral spinothalamic tract

Dorsal columns tract

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2
Q

what does somatosensory mean

A

a sensation that can occur anywhere in the body

( pressure, pain and temp) in contrast to one localised at a sense organ.

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3
Q

cranial nerves sense

A 
Vision
Taste
 Smell
 Hearing
 Balance
 Touch on face
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4
Q

spinal nerves sense

A 
pain 
touch 
pressure 
temp
proprioception 
vibration
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5
Q

How main neurones do sensory neurones involve ?

A

3
1st order - soma in dorsal root ganglion
2nd- soma in spinal cord
3rd - soma in the thalamus

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6
Q

is the thalamus the common relay station?

A

yes

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7
Q

Lateral spinothalmic tract all 3 neurones

A
  • 1st order neurone enters in dorsal root with soma in dorsal root ganglion. Synapses here 2nd order – ascends in lateral spinothalamic tract on opposite side – soma in spinal cord - 3rd order – soma in the thalamus – takes information to the cortex
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8
Q

Dorsal columns tract

A

soma in the DRG – enters the DC on the ipsilateral side

  • Synapses and crosses in the medulla – 2nd order neurone with soma in the medulla
  • 3rd order neurone synapses and has soma in the thalamus, sending signals to the cortex
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9
Q

What does the lateral spinothalamic tract carry

A

pain, temp and course touch

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10
Q

what does the dorsal columns tract carry

A

proprioception , vibration, pressure and fine touch

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11
Q

where dose the LSTtract decussate

A

spinal level

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12
Q

where does the DCTract decussate

A

medulla

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13
Q

What is Brown sequard syndrome

A

A lesion in the spinal cord which results in weakness or paralysis on one side of the body and loss of sensation on the other. Due to STtract and corticospinal tract injuries - unilateral

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14
Q

Anterior spinal artery syndrome

A

Anterior 2/3 damage to spinal cord- sudden loss of supply AVN
Loss of pain sensation and temperature

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15
Q

Syringomyelia

A

Fluid filled cyst within the spinal cord- central
spinothalamic tract affected first
Pain/temp loss bilaterally

( 2nd order neurone is affected as they cross the spinal cord)

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16
Q

What cranial nerve carries somatosensory information from the head and the neck

A

trigeminal nerve - sends to thalamus via trigemini-thalamic tract

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17
Q

Consequence of irritating the trigemini-thalamic tract

A

contralateral face pain

also trigeminal neuralgia - sneosry fibres irritated

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18
Q

Where does the UMN go between

A

motor cortex and spinal cord

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19
Q

Where does the LMN go between

A

spinal cord and the muscles

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20
Q

Are cranial nerves UMN or LMN

A

LMN because the UMN synapses in the brianstem

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21
Q

What and where is the motor cortex

A

region of the cerebral cortex involved in planning and control and execution of voluntary muscles.
zoned by blood supply. Blockage of ones of these arteries will affect relevant motor distrutions

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22
Q

What does the anterior cerebral artery supply

A

medial part which is the leg and waist part of the motor cortex

if drooping is seen then it is a stroke until proven otherwise

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23
Q

what does the medial cerebral artery supply

A

supplies the hand and face, if drooping is seen then it is a stroke until proven otherwise

24
Q

How far does the spinal column go down to

A

Spinal column goes down to Coccyx 1

25
Q

Where does the spinal cord finish

A

spinal cord finishes at L1-2

26
Q

Lateral cortico spinal tract pathway

What percentage of motor movement does it control

A

UMN starts in motor cortex and crosses in the medulla(pyramids)
synapses with LMN in grey matter of anterior horn on contralateral side

  • 85% of movement
  • If lost, there is a greater affect
27
Q

anterior corticospinal tract

A

starts in the cortex and decussates at exit level in the spinal cord

motor nerve moves down passed the thalamus and enters the anterior corticospinal tract

  • Fine movements, not a big deal to lose
28
Q

Whee does the LCST decussate

A

medulla

29
Q

Where does the ACST decussate

A

exit level in spinal cord

30
Q

what area does the ACST supply

A

neck and upper limbs and upper limbs

31
Q

What is a motor unit

A

a motor neurone and all the muscle fibres it innervates - all or nothing manner

32
Q

function of muscle spindles

A

Muscle spindles allow for control – special sensory organ in muscles detecting when the muscle fibre stretches

  • When the opposite muscle is stretched it contracts to control the movement
  • When the tendon is hit the muscle contracts to control the stretch – lower motor neurone pathology when it is tapped and doesn’t move enough
  • When the tendon hit causes exaggerated movement – upper motor neurone could be affecte
33
Q

What is clonus

A

involuntary muscle contractions

34
Q

A 95 year old presents with a reduced conscious level and weakness. CT scan showed an acute bleed from the middle cerebral artery.
Which of the following features would be present on examination?

A

Presence of clonus, upgoing plantar reflexes, hypertonia, hyperreflexia

35
Q

If a person has increased muscle spasticity(contracted) and tone, increased clonus and upping bainski reflex

A

UMN

36
Q

if a person has decreased muscle tone so relaxed and flaccid and decreased clonus and downgoing reflexes

A

LMN

37
Q

C4 injury

A

paralysis below neck , quadriplegia

38
Q

C6 injury

A

partial paralysis of arms , hand and lower body

39
Q

T6 injury

A

below the chest paralysis

40
Q

L1 injury

A

below the waist paralysis

41
Q

What is Spondylosis

A

narrowing of the c5 nerve root – common in elderly, can cause problems

42
Q

What is Myositis

A

autoimmune attack of muscle – measured by listening to muscle
causes weakness and tiredness

43
Q

hypertonia

A

too much muscle tone so that arms or legs, for example, are stiff and difficult to move.

44
Q

hyperreflexia

A

overactive or overresponsive reflexes

45
Q

how does the motor pathways split control in terms of percentage between the two major tracts

A

Anterior corticospinal – 15% ish of motor control

  • Lateral corticospinal – 85% ish of motor control
46
Q

the lateral corticospinal tract decussates high in the pyramids where does the anterior CST decussate

A

low in the spinal cord

47
Q

the ACST supplies the neck and upper limbs where does the LCST supply

A

all spinal levels

48
Q

The lateral CST does most motor functions what does the Anterior CST do

A

fine movements such as and especially the hands

49
Q

what neurone does a stretch reflex use

A

interneurone

50
Q

the efferent impulses which cause contraction of the stretched muscle that resits the stretch also do what

A

inhibit contraction of the antagonistic muscle

51
Q

A stretch reflex is also called

A

rapid monosynaptic reflex

52
Q

do nociceptors have bare nerve endings

A

yes

53
Q

what are the 2 types of pain conduction

A

Fast response

Slow response

54
Q

Fast response to pain uses what fibres

A

Adelta fibres are large and myelinated up to 10m/sec - sharp stabbing pain

55
Q

slow response to pain uses what fibres

A

Slow response - Cfibres small and unmyelinated 1.2m/sec - aching, burning pain

56
Q

are local anaesthetics proton acceptors

A

yes they are bases

Neurology (13 decks)

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