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Neurophysiology > Sensory Pathways 2 > Flashcards

Sensory Pathways 2 Flashcards

1
Q

Which type of fibres does the neo-spinothalamic tract transmit?

A

A delta

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2
Q

Which type of fibres does the paleo-spinothalamic tract transmit?

A

C fibres

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3
Q

Where do second order neurones of the neospinothalamic tract synapse?

A

Ventral posterolateral nucleus (VPL) of the thalamus

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4
Q

Where do second order neurones of the paleospinothalamic tract synapse?

A

Intralaminar and dorsomedial nuclei of the thalamus

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5
Q

What type of information does the neospinothalamic pathway carry?

A

Fast, sharp pain

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6
Q

What type of information does the paleospinothalamic pathway carry?

A

Slow, dull pain

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7
Q

Why is the neo pathways referred to as discriminating and the paleo referred to as undiscriminating?

A

VPL has somatotopic map so gives locational discrimination

DM and intralaminar areas only provide generalised location for pain

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8
Q

What is the role of the spinoreticular pathway?

A

Motor response and ascending arousal

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9
Q

What is the role of the spinomesencephalic pathway?

A

Descending pain modulation

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10
Q

Which rexed laminae do the spinothalamic and spinomesencephalic tracts originate from?

A

1 and 5

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11
Q

Which rexed laminae does the spinoreticular tract originate from?

A

6-8 (intermediate zone)

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12
Q

What is the overall function of the spinothalamic tracts?

A

Pain basis for avoidance behaviours that protect us from harm

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13
Q

What is said to be one of the hardest pains to bear?

A

Prolonged stimulation of the paleo-spinothalamic pathway

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14
Q

Why does pain prevent sleep?

A

Spinothalamic tracts synapse with brainstem nuclei to increase arousal

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15
Q

Why does pain make you sweat and feel nauseous?

A

Spinothalamic tracts indirectly stimulate autonomic circuitry

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16
Q

Why is there an emotional component of pain?

A

Spinothalamic tracts positively associated with the limbic system

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17
Q

How would a lesion to the neospinothalamic pathway present?

A

Decreased perception of pain and temperature on the contralateral side of the body, always one or two dermatomes below the level of the lesion (Lissauers tract)

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18
Q

What is a cordotomy?

A

Surgical procedure where anterolateral portion of cord is lesioned using electrical current used in terminal disease pain

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19
Q

How are paraesthesias associated with the spinothalamic tract felt?

A

Searing, shooting or burning pain

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20
Q

What is the function of the mesencephalic nucleus?

A

Proprioception from mouth/jaw

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21
Q

What is the function of the sensory nucleus?

A

Discriminating tough, vibration and conscious proprioception from the face

22
Q

What is the function of the spinal nucleus?

A

Pain and temperature sensation from face, back of tongue, pharynx, larynx and ear

23
Q

Where do neurones from the sensory nucleus project to?

A

VPM of thalamus

24
Q

What information is carried in the trigeminal lemniscus from the sensory nucleus?

A

Touch and sensation from the face

25
Q

What information is carried in the posterior trigeminothalamic tract from the sensory nucleus?

A

Touch and vibration from the mouth

26
Q

Where does the trigeminal lemniscus project to from the VPM?

A

Somatosensory cortex

27
Q

Which side of the spinal cord do the trigeminal lemniscus and posterior trigeminothalamic tracts travel from the sensory nucleus?

A

Posterior trigeminothalamic - ipsilateral

Trigeminal lemniscus - contralateral

28
Q

Where do C and A delta fibres enter the spinal cord from the spinal nucleus?

A

Mid pontine level

29
Q

Where is the spinal trigeminal nucleus?

A

C1

30
Q

Where do C and A delta fibres travel when they enter the spinal cord?

A

Down the cord to spinal nucleus in spinal trigeminal tract

31
Q

What is the path taken by 2nd order neurons from the spinal nucleus?

A

Cross midline and ascend contralaterally in trigeminal lemniscus
Give off trigeminoreticular and trigeminomesencephalic tracts

32
Q

Where do 2nd order neurons from the spinal nucleus synapse?

A

VPM of thalamus

33
Q

What are the symptoms of trigeminal neuralgia?

A

Intense shotting sharp pain in areas innervated by the trigeminal nerve often in response to light tough

34
Q

What is thought to cause trigeminal neuralgia?

A

quasi-ectopic firing of nerve induced by normally low frequency APs

35
Q

What disease is trigeminal neuralgia associated with?

A

Demyelinating disorders such as MS

36
Q

What is trigeminal neuralgia treated with?

A

Voltage sensitive sodium channel blockers e.g. phenytoin

37
Q

What information enters the posterior spinocerebellar pathway?

A

LL proprioception

38
Q

What information enters the cuneocerebellar pathway?

A

UL proprioception

39
Q

Where do axons carrying proprioception from the lower limb synapse?

A

Clarke’s nucleus

40
Q

Where do axons carrying proprioception from the upper limb synapse?

A

Accessory cuneate nucleus

41
Q

Where do the posterior spinocerebellar and cuneocerebellar pathways enter the cerebellum?

A

Inferior peduncle

42
Q

Where do axons from the limbs in the integrated pathway synapse?

A

Spinal border cells

43
Q

What 3 pathways synapse on spinal border cells?

A

Descending modulation
Reflex arcs
Limb proprioception

44
Q

Describe the path taken by neurons in the anterior spinocerebellar from the spinal border cells

A

Cross midline and ascend contralaterally
Enter cerebellum at contralateral superior peduncle then recross
==> ipsilateral

45
Q

Describe the path taken by neurons in the rostral spinocerebellar from the spinal border cells

A

Ascend ipsilaterally

Enter cerebellum via the superior and inferior peduncles

46
Q

What information is carried in the rostral spinocerebellar pathway?

A

Integrated UL proprioception

47
Q

What information is carried in the anterior spinocerebellar pathway?

A

Integrated LL proprioception

48
Q

Name the 2 integrated cerebellar pathways

A

Anterior and rostrals spinocerebellar

49
Q

Name the 2 unintegrated cerebellar pathways

A

Cuneocerebellar

Posterior spinocerebellar

50
Q

Which protein is affected in Friedreich’s ataxia?

A

Frataxin (multiple repeats of gene)

51
Q

What are the clinical features of Friedreich’s ataxia?

A

Progressively uncoordinated limbs
Wide based ‘reeling’ gait
Intention tremor

Neurophysiology (17 decks)

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