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Neuro II > Somatosensory II > Flashcards

Somatosensory II Flashcards

1
Q

what information is carried by the anterolateral system (ALS)

A

nondiscriminative touch

thermal and nociceptive sensation

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2
Q

what are sxs of lesion to the ALS

A

numbness, tingling, paresthia, anesthesia

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3
Q

where is sensory information within the ALS relayed

A

body => thalamus => somatosensory and limbic cortices

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4
Q

where is sensory information within the anterior trigeminothalamic pathway relayed

A

face/head => thalamus => sensory and limbic cortices

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5
Q

where do cutaneous nociceptor fibers enter the SC

A

lateral division of the posterior root entry zone

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6
Q

which laminae are central targets of the primary afferents of the ALS

A

laminae I, II, and V of the posterior horn

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7
Q

where do fibers of the ALS travel within the spinal cord?

A

the posterolateral fasciculus (lissauer tract)

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8
Q

where do axons of the 2nd order neurons of the direct spinothalamic pathway cross midline

A

the anterior white comissure, then ascent in the contralateral ALS

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9
Q

where do descending branches of fibers of the direct spinothalamic pathway terminate

A

on interneurons within the grey mater

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10
Q

what is the function of indirect spinothalamic pathways

A

relays noxious and innouous mechanical and thermal information

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11
Q

where do branches of the indirect spinothalamic pathway synapse?

A

laminae II and III

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12
Q

do axons of the indirect pathways join the contralateral ALS

A

YES

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13
Q

what is the blood supple to the ALS

A

arterial vasocorona

sulcal branches of the anterior spinal a

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14
Q

how does occlusion of the arterial vasocorona/sulcal branches of the anterior spinal artery present clinically?

A

patchy loss of nociceptive, thermal and touch sensation over the contralateral side 2 segments below the lesion

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15
Q

what lesion would be indicated in a patient with ipsilateral loss of discriminative tactile, vibratory and position sense at and below the lesion

A

posterior column damage

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16
Q

what is syringomyelia

A

cystic cavitation of the central regions of spinal grey matter

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17
Q

what important structure may be impinged by syringomyelia

A

anterior white commissure

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18
Q

how might syringomyelia cause bilateral loss of nondiscriminative tactile, nociceptive and thermal sensation

A

lesion of the AWC which contains ALS fibers from both sides

19
Q

how does a patient with impingment of the ALS by syringomyelia present

A

bilateral loss of nondiscriminative tactile, nociceptive and thermal sensation several segments below the lesion in UEs to nipple

20
Q

where are medullary ALS fibers positioned

A

near anterolateral surface, anterior to trigeminal nucleus

21
Q

what is dissociated sensory loss?

A

contralateral loss of either discriminative touch and vibratory sense OR pain and thermal sensation

22
Q

lesions to what area can cause dissociated sensory loss

A

vascular lesions or tumors of the lower brainstem

23
Q

in the upper cervical spinal cord, what does the spinal trigeminal tract become

A

Lissauer’s tract

24
Q

what are the three parts of the trigeminal tract

A

pars caudalis
pars oralis
pars interpolaris

25
Q

which part of the trigeminal tract extends from C2/C3 to the obex (4th ventricle)

A

pars caudalis

26
Q

which part of the trigeminal tract is in the superior medulla

A

pars interpolaris

27
Q

which part of the trigeminal tract extends from the main sensory nucleus to the pontomedullary jxn

A

pars oralis

28
Q

what is onion-peel sensory loss

A

a characteristic pattern of sensory loss depending on how rostral/caudal a lesion to the spinal trigeminal tract is

29
Q

what provides the blood supply to trigeminal structures in the medulla

A

PICA and posterior spinal artery

30
Q

where do secondary axons from pars caudalis terminate

A

contralateral VPM (ventral posteromedial nucleus) of the thalamus

31
Q

between what structures do tertiary axons of pars caudalis extend

A

in the posterior limb of the internal capsule to the primary somatosensory cortex

32
Q

what is the reticular formation

A

a set of connected nuclei responsible for regulating wakefulness and sleep-wake transitions

33
Q

which part of the reticular formation does trigeminal input facilitate

A

ARAS (ascending reticular activating system)

34
Q

from what region does pars oralis receive tactile information

A

central face

35
Q

from what region does pars interpolaris receive tactile information

A

periphery of the face

36
Q

what lesion of the trigeminal nerve would be indicated in a pt with loss of jaw-jerk reflex, anesthesia in trigeminal dermatomes, atrophy of muscle of mastication, and loss of ipsilateral corneal reflex

A

unilateral

37
Q

what is alternating analgesia

A

ipsilateral hemianalgesia of the face

contralateral hemianalgesia of the body

38
Q

what kind of lesion would cause alternating analgesia

A

brainstem lesions in the upper medulla => destruction of primary trigeminal n fibers in the spinal trigeminal tract AND secondary fibers in the medial lemniscus

39
Q

what causes alternating trigeminal hemiplegia

A

unilateral destruction of the trigeminal nerve and corticospinal tract in the pons

40
Q

what is alternating trigeminal hemiplegia

A

IPSILATERAL trigeminal anesthesia and paralysis

CONTRALATERAL spastic hemiplegia

41
Q

what artery supplies both the ALS and spinal trigeminal tract?

A

posterior inferior cerebellar a

42
Q

what is the result of vascular lesion to the posterior inferior cerebellar a

A

lateral medullary syndrome (AKA wallenberg syndrome)

43
Q

what are the sxs of lateral medullary syndrome

A

contralateral loss of pain and temperature sensation in the body AND
ipsilateral loss of pain and temperature in the face

44
Q

when testing the corneal reflex, where do trigeminothalamic fibers information to initiate blinking

A

bilateral collateral fibers to the facial motor nucleus

Neuro II (16 decks)

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