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Med Neur 2 > Somatosensory Review > Flashcards

Somatosensory Review Flashcards

1
Q

Modality of Dorsal column/ ML

A

fine touch, vibration, limb position

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2
Q

Modality of Anterolateral

A

pain/temp/crude touch

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3
Q

Major tract of Dorsal column/ML

A

F. gracilis
F. cuneatus
–> at medulla, both enter Medial lemniscus

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4
Q

Major tract of Anterolateral tract

A
  • spinoreticular
  • spinothalmic
  • spinomesenphalic
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5
Q

Placement of tract for Dorsal Column/ML

A

Located dorsally, middle part of dorsal sp cd on both sides—- posterior fasciculus

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6
Q

Placement of tract for Anterolateral

A

Ventral, lateral sp cd on both sides

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7
Q

Diversity of pathways: Dorsal Column

A

1 path to medulla (through sp cd)

1 major path to thalamus

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8
Q

Diversity of pathway for anterolateral system

A

3 major that run together in sp cd but terminate in dif places
Spinothalmic: thalamus
Spinoreticular: reticular formation in medulla or pons
Spinomesenphalic: midbrain PAG, superior colliculus

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9
Q

Crossing pt for Dorsal column/ML

A

X to opp side in ONE place = Sensory decussation in caudal medulla where they then synapse and head up Medial lemniscus

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10
Q

Crossing pt for Anterolateral system

A

X to opp side in sp cd and cross all along at levels near where primary afferents enter (w/in 2-3 segments of entering)

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11
Q

Results of damaged sp cd: Dorsal Column

A

Ipsilateral loss of tactile, vibration, jt position below level of lesion

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12
Q

Result of damaged sp cd: Anterolateral

A

Contrlateral loss of pain and temp w/in 2-3 cord segments of lesion

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13
Q

By the ________ and _______ both pain and touch fibers are simular and all information has crossed

A

thalamus and cortex

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14
Q

Lesions in thalamus and cortex for both pain and fine touch will produce ________ deficiets

A

contralateral

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15
Q

Somatosensory information goes _____ thus lesion will cause loss of sensation _____

A

up

below

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16
Q

A patient presenting with alternating sensory loss is key for what kind of lesion

A

Unilateral lesions in spinal cord

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17
Q

Sugical cutting of dorsal root
Use for pain relief
cut dorsal roots that innervate affected dermatome

A

Rhizotomy

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18
Q

Rhizotomy will result in

A

loss of fine discr, jp, vibration AND pain and temperature in just dermatome of affected cut roots IPSILATERAL to lesion
-pain often reoccurs

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19
Q

Surgical cutting of anterolateral fiber tracts in cord for pain relief in terminally ill
cut 2-3 above area you want to relieve pain

A

Cordotomy

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20
Q

Cut one side anterolateral tract for cordotomy you will lose pain/temp on the _____

A

contrallateral side

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21
Q

Loss of fine touch/pain temp in specific dermatome ______ results in loss of feeling in foot, back of calf and shin

A

L4/L5/S1

–Herniated disk

22
Q

Glove and stocking deficeits result from

A 
Peripheral neuropathy (diabetes)
affects multple derms and d/t
23
Q

A herniated disk in L4/L5 will affect

A

L5 spinal nerve

24
Q

Bilateral loss of all sensation below lesion and loss of motorl control and voluntary musle contration below lesion

A

Complete cord transection

25
Q

causes of cord transection

A

trauma/tumor/bullet or knife wound

26
Q

Bilateral loss of pain and temp below lesion and often weakness, ususally spares DCs so fine discriination and jp is okay

A

Anterior cord syndrome

27
Q

cause of anterior cord syndrome

A

anterior spinal artery syndrome
frxt vertebrae, contusion of sp cd
infarct or ischemia form anterior spinal artery, emoblism or compresion of artery

28
Q

loss of fine touch and discrimination, vibration and joint position on both sides with pain and temp okay

A

posterior cord syndrome

29
Q

posterior cord syndrome affects

A

dorsal columns

30
Q

caues of post. cord syndrome

A 
tabes dorsalis (demyl or degen from syphalis)
-tumor in dorsal area
trauma
31
Q

Central cord syndrome: small lesion: usually cervicle ressults in

A

bilateral loss of pain and temp in derms of spinal levels WITH THE LESION and sparing of dorsal columns and tactile sense as well as sparing anterolateral tracts below lesion

32
Q

bilateral loss of pain and temp in derms of spinal levels WITH THE LESION and sparing of dorsal columns and tactile sense as well as sparing anterolateral tracts below lesion

A

Central cord syndrome

33
Q

central cord syndrome affects where?

A

2nd order anterolateral fibers that are crossing

34
Q

Syringomyelia causes

A

central cord syndrome
loss of pain and temp on level of lesion bilaterally only
cyst in the central canal

35
Q

bilateral loss of fine discrimination, joint position below lesion
can affect motor neurons in ventral horn so loss of motor control
can affect anterolateral tracts–> bilateral loss of pain/temp below lesion
may bet sacral sparin

A

large central cord syndrome

36
Q

why are sacral regions spared in large central cord syndrome

A

because they are on the periphery

37
Q

Hemisection of cord called

A

brown-sequard syndrome

38
Q

fine discriniation and pain/temp lost on atlernating sides
ipsi loss of fine touch/discrimination
contra loss of pain/temp w/in 2-3 segments below lesion
loss of ALL sensation at level of lesion
ipsilateral paralysis and loss of muscle control

A

Brown-sequard syndrome or hemisection of cord

39
Q

hemisection of cord

A

fine discriniation and pain/temp lost on atlernating sides
ipsi loss of fine touch/discrimination
contra loss of pain/temp w/in 2-3 segments below lesion
loss of ALL sensation at level of lesion
ipsilateral paralysis and loss of muscle control

40
Q

contralateral loss of fine discriminiation AND

contralateral loss of pain/temp must be lesion in

A

VPL of thalamus

41
Q

face intact

loss of pain/temp/fine touch on contralateral side of body means

A

VPL of thalamus lesion

VPM spared

42
Q

contralateral loss of fine discrimination pain/tem in face and head while sesnation in body intact

A

VPM lesion

43
Q

lesion slightly lateral to the middle of the SI cortex results in

A

loss of fine touch/pain/temp on contralateral side of body on HAND AND WRIST

44
Q

lesion very laterally of the SI cortex results in

A

loss of fine touch/pain/temp on contralateral side of FACE/tongue

45
Q

Brainstem lesion in lateral medulla results in

A

interuption of anterolateral pathways and spinal trigeminal tract or nucleus

46
Q

loss of pain/temp body on CONTRA side
loss in pain/temp face IPSlateral
loss
loss of pain/temp on Contralateral side too

A

lesion in lateral medulla

the fine touch on face is spared bc that doesn’t descend to the spinal tract like the pain fibers do

47
Q

If entire 1/2 of medulla is lesioned (opposed to just the lateral portion)

A

loss in fine touch in body on contralateral side in addition to:
loss of pain/temp body on CONTRA side
loss in pain/temp face IPSlateral
loss
loss of pain/temp on face Contralateral side too

48
Q

if you see olives and pyramids we know we are in

A

rostral medulla

49
Q

Lesion in the medial lemniscus on the rostral medulla on left side of body results in

A

loss of vibration on right side of body below level of neck

  • -face doesn’t come in until level of pons
  • -the fibers have already crossed by this pont
50
Q

GSW interupts the entire left half of sp cd at thoracic C6, we see loss of

A

loss of pain and temp on right

loss of fine touch and discrimination on left

51
Q

Pt with loss of pain and temp sensation on right half of body below level of neck and loss of fine discrmination on right half of body from neck below.. Pt has infarct where

A

left VPL

Med Neur 2 (12 decks)

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