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Neuro Block 7 > Sensory Pathways > Flashcards

Sensory Pathways Flashcards

1
Q

Sensation of posteiror column-medial leminiscal pathway

A

Proprioception
Vibration
Fine, discriminative touch

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2
Q

Sensation of anterolateral pathway

A

Pain
Temp
Crude touch

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3
Q

Sensations of trigeminothalamic tract

A

All sensation from face and upper scalp

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4
Q

1st order neuron cell bodies of sensory pathways

A

In the dorsal root ganglion

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5
Q

What does each dorsal root ganglion cell do

A

Bifurcates and sends a peripheral process that conveys sensory info from the skin and internal body structures/infor from the spinal cord through dorsal nerve roots

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6
Q

A peripheral region innervated by sensory fibers from a single nerve root level called a _______

A

Dermatome

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7
Q

What is the only sensory that does not synapse in the thalamus

A

Olfactory

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8
Q

Levels that sense light Bruch’s

A

Hair follicles

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9
Q

Cells that sense dynamic deformation

A

Meissner corpuscle

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10
Q

Cells that sense indentation depth

A

Merkel

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11
Q

Cells that sense stretch

A

Ruffini

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12
Q

Cells that sense touch

A

C-fibrre LTM

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13
Q

Cells that sense injurious force

A

Mechano-nociceptor polydermal nociceptor

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14
Q

Central axons of the posterior column-medial lemnicus pathways

A

Enter the ipsilateral posterior columns to ascend all the way to the posterior column nuclei in the caudal medulla

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15
Q

What are the two parts of the dorsal column?

A

Fasciculus gracilis

Fasciculus cuneatus

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16
Q

What info does the fasciculus gracilis carry

A

Info from the legs and lower trunk

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17
Q

What info does the fasciculus cuneatus carry

A

Info from the upper trunk above about T6, the arms, and neck

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18
Q

How do fibers add onto the dorsal column as it ascends the spinal cord

A

Laterally

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19
Q

Second order axons of the posterior column-medial lemniscus pathway

A

Decussate at caudal medulla as arcuate fibers and form the medial lemniscus on the other side of the medulla

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20
Q

Where does the medial lemniwscus ascend

A

Through the brainstem

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21
Q

Where do the second order neurons in the posterior column-medial lemniscus synapse

A

VPL of the thalamus

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22
Q

Which has bigger axons, anterolateral or posterior column-medial lemniscus

A

Posterior column-medial lemniscus

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23
Q

Carries info for pain and temp

A

Anterolateral pathway

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24
Q

Where do the central axons of the anterolateral pathway enter spinal cord

A

Via the dorsal root

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25
Q

Where is the first synapse of the anterolateral pathway?

A

In the gray matter of dorsal horn

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26
Q

After the primary neuron synapses in the anterolateral tract, how does the secondary neuron run?

A

Cross over in the spinal cord anterior commissure to ascend in the anterolateral white matter

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27
Q

The anterolateral pathway crosses over at the spinal cord level. Is it the first or second order neuron that does the crossing over

A

Second order. The first order synapses on the dorsal horn on the ipsilateral side that it comes in on and then the second order neuron cross the anterior commissure

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28
Q

Sensory distribution in the anterolateral pathway

A

Most neurons move up 2-3 levels and then cross over so sensory loss is a little different, loss is a couple levels down

You will have a block where there is all loss of sensation ipsilateral for about 2-3 dermatome levels, and then you will have level down contralteral pain and temp loss

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29
Q

Somatotoic organization of anterolateral pathway

A

Arms more medial
Legs more lateral

This map is preserved as it passes through the brainstem

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30
Q

Location and intensity of the pain stimulus is detected in this tract

A

Spinothalamic tract

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31
Q

Where does the spinothalamic tract project to

A

VPL nucleus of the thalamus

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32
Q

This tract conveys the emotional and arousal aspects of pain

A

Spinoreticular tract

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33
Q

Where does the spinoreticular tract terminate

A

On the reticular formation

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34
Q

Where does the spinoreticular tract project to

A

The inralaminar thalamic nuclei

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35
Q

How does the spinoreticular tract project to the cerebrum

A

Diffusely

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36
Q

This tract participates in central modulation of pain

A

Spinomesecephalic tract

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37
Q

Where does the spina mesencephalic tract project to

A

The midbrain periaqueductal gray matter

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38
Q

Somatosensory pathways from the spinal cord relay in the ______ nucleus

A

VPL

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39
Q

Somatosensory pathways from the cranial nerves relay in the _______ nucleus

A

VPM

40
Q

Where do the VPL and VPM project to

A

The primary somatosensory cortex

41
Q

Visual info is relayed in the ____ nucleus

A

LGN

42
Q

Auditory info is relayed in the _____ nucleus

A

MGN

43
Q

Mnemonic for remembering the nuclei in which visual and auditory stimuli terminate on

A

Lateral light (vision), medial music (auditory)

44
Q

What does the internal capsule look like in a horizontal brain section

A

Internal capsule

45
Q

What structures are medial to the internal capsule

A

Thalamus and caudate nucleus

46
Q

What structures are lateral to the internal capsule

A

Globes pallidus and putamen

47
Q

What are the 3 parts to the internal capsule

A

Anterior limb
Posterior limb
Genu

48
Q

Where in the internal capsule does the corticospinal tract lie

A

In the posterior limb of the internal capsule

49
Q

Somatotopic map in the internal capsule

A

Face most anterior
Arm and leg are progressively more posterior

Despite the somatotopic arrangement, the fibers of the internal capsule are compact enough that lesions at this level often produce sensory (or motor) deficits of the entire contralateral body, however, occasionally capsular lesions can also produce more selective motor deficits

50
Q

Where do sensory tracts that ascend go in the internal capsule

A

Posterior limb of the internal capsule

51
Q

Where is somatosensory info from the VPL and VPM conveyed t

A

The primary somatosensory cortex in the postcentral gyrus

52
Q

How is the primary somatosensory cortex organized

A

Somatotopically, with the face represented most laterally and the legs most medially

53
Q

Integrates all sensation from body and face, communicates with the association motor cortex

A

Association sensory cortex

54
Q

The primary somatosensory cortex sends projections to the secondary somatosensory association cortex located within the _______ in the _____ lobe

A

Sylvia’s fissure

Parietal

55
Q

What do the primary somatosensory cortex and the somatosensory association cortex have extensive connections with

A

The motor cortex

56
Q

Medial part of the sensory cortex blood supply

A

ACA

Legs

57
Q

Lateral part of the sensory cortex blood supply

A

MCA

Head

58
Q

Strokes involving the MCA and their effect on the sensory cortex

A

Contralteral hemiparesis and sensory loss predominantly in the face and upper extremity

(Face and upper extremity is a give away!!)

59
Q

Strokes involving the MCA affecting the internal capsule

A

Contralateral sensory loss for all types of sensation

Usually contralateral hemiparesis

60
Q

Strokes involving the ACA main symptoms

A
  1. Contralteral hemiparesis in the lower extremities
  2. Contralateral sensory loss predominantly in the lower extremity
  3. Urinary incontinence

GIVE AWAYS!

61
Q

Ascending nocicpetive signals reach and activate periaquductal grey (PAG) neurons via an ______ pathway

A

Enkephalinergic

62
Q

Emotional areas of the brain

A

Cingulate gyrus, insula, amygdala

63
Q

Ascending nociceptive signals project through

A

Pulvinar and intralaminar nuclei in the thalamus to various cerebral cortical regions

64
Q

Injury to tissue

A

Leads to release of NT that are excitatory at specific membrane receptors on the pain fibers

65
Q

What are the NT that activate pain fibers

A
  • bradykinin
  • prostaglandins
  • serotonin (platelets)
  • leukotrienes
66
Q

When pain fibers get activated, what do they do

A

They also release NT onto dorsal horn

67
Q

What are the NT that the pain fibers release onto the dorsal horn neurons

A

Glutamate
Substance P
CGRP neuropeptide

68
Q

Inflammatory cells in injured tissue

A

Can cause a release of histamine from mast cells, which causes edema, which causes pain. This starts the cycle over again

69
Q

Pain and suffering and received by ___ brain regions

A

Separate

70
Q

What pathway is involved in the localization of painful stimuli

A

Neospinothalamic

71
Q

_____ pathways that access the hypothalamus and limbic system via the reticular formation and PAG are involved in the suffering component of the pain experience

A

Paleospinothalamic pathways

72
Q

What does the periaqueductal gray mater receive

A

Inputs from the hypothalamus, amygdala, and cortex

73
Q

What does the periaqueductal gray do

A

Inhibits pain transmission in the dorsal horn via the rostral ventral medulla (RVM)

74
Q

End result of central modulation of pain

A

Activation of inhibitory interneuron in the dorsal horn that releases enkephalin (Enk), an endogenous opioids, that binds an inhibitory receptor on the projection neuron

75
Q

What is the NT that inhibits pain

A

Enkephalin

76
Q

What exerts their analgesic effects through receptors found on peripheral nerves and neurons in the spinal dorsal horn

A

Opiate medications such as morphine

77
Q

Where enkephalin, B-endorphin, and dynorphin found

A

In high concentrations at key points in the pain modulators pathways

These alleviate all pain and cause euphoria

78
Q

What are these: morphine, heroin, codeine, oxy

A

Opioids

79
Q

Addiction signs of opioid

A
  • tolerance
  • physical dependence
  • withdrawal syndrome
  • preoccupation to obtain and take opioids
  • using more than intended despite social and professional consequences
80
Q

Addiction to opiates mechanisms

A
  • brain adjusts and becomes irresponsive to normal doses

- reward/pleasures

81
Q

Withdrawal symptoms of opioids

A
  • agitation
  • diarrhea
  • dilated pupils
  • goose bumps
82
Q

Treatment for opioids addiction

A

Replacement with methadone

Naloxone in treatment of opioid overdose

83
Q

Lesions of the somatosensory pathways

A

Negative symptoms of sensory loss

Abnormal positive sensory phenomenon called paresthesias

84
Q

Lesions of the posterior column

A

Medial lemniscal pathways , patients commonly described a tingling, numb sensation

85
Q

Lesions of the anterolateral pathways

A

Sharp burning or searing pain

86
Q

Lesions of the thalamus

A

Severe contralateral pain called Dejerine-Roussy syndrome

87
Q

Lesions of the cervical spine

A

Electricity like sensation running down the back and into the extremities upon neck flexion

88
Q

Lesions of nerve roots

A

Radical are pain that radiates down the limb in a dermatomal distribution, is accompanied by numbness an tingling, and is provoked by movements that stretch the nerve root

89
Q

Peripheral nerve lesions

A

Pain, numbness, and tingling in the sensory distribution of the nerve

90
Q

Thalami nuclei after damage

A

Can undergo changes that can occur directly as a result of damage to the ascending pathways or secondarily as a result of removal of sensory inputs

Can cause chronic pain or phantom limb pain

91
Q

Receptive fields

A

Area of skin innervated by branches of a sensory afferent fiber

92
Q

Greatest density of cutaneous tactile receptors

A

Fingertips

93
Q

Least dense region of tactile receptor is found

A

Back

94
Q

Lesion to thalamic ventral posteiror lateral (VPL) and VPM nuclei

A

Deficit is contralteral to the lesion

95
Q

Lesion of the primary sensory cortex

A

A clinical pearls for damage to primary cortex: mild or “uneven” sensory loss!

96
Q

Heineglect syndrome

A

Sensory association cortex

Lesion of the right parietal or right frontal lobes

Neuro Block 7 (10 decks)

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