Spinal Cord and Periphery Flashcards

1
Q

Describe dorsal and ventral horn?

A

Sensory axons for dorsal root and Motor neurons for ventral root

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2
Q

What are the columns of white matter arranged into?

A

Posterior, lateral and anterior
Each column has various tracts of axons

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3
Q

What is the difference between ascending and descending tracts?

A

Ascending - sensory
Descending - motor

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4
Q

What are some ascending tracts?

A

Lateral spinothalamic, medial spinothalamic, dorsal column, spinocerebellar, cuneocerebellar, spinoreticular, spino-olivary

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5
Q

What are some descending tracts?

A

Corticospinal, reticulospinal, rubrospinal, vestibulospinal, tectospinal

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6
Q

Where is the dorsal column?

A

Dorsal or posterior part of the spinal cord behind the grey matter

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7
Q

What does the corticospinal/ pyramidal tract carry?

A

Motor impulses from motor cortex to skeletal muscles

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8
Q

What does the posterior/ dorsal column carry?

A

Carries touch, tactile localisation, vibration sense and proprioception (sensory impulse from muscles)

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9
Q

What does the lateral spinothalamic tract carry?

A

Pain and temperature

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10
Q

What is the blood supply for the internal capsule?

A

Middle cerebral artery - direct continuation of ICA (frequently implicated by occlusion leading to strokes)
Lead to dense stroke as projection fibres of corticospinal tract are here

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11
Q

What is the function of the corticospinal tract?

A

Control of voluntary skilled movements - motor pathway

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12
Q

Where does the corticospinal tract start and where does the projection fibres lead into?

A

Motor cortex - area 4
Leads into the posterior limb of the internal capsule

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13
Q

What are corticobulbar fibres?

A

Fibres which are coming from precentral gyrus and ten leave tract to go to
contralateral cranial nerve nuclei
These fibres do not go into spinal cord

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14
Q

Where do corticospinal fibres mostly cross?

A

Decussation of pyramids as 10 crania nerves leave the brainstem

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15
Q

Where do the rest of fibres from corticospinal tract (not corticobulbar) go?

A

Down medulla - forming projection - pyramids
At lower part of pyramid they cross - decussation
Tract to lie now in lateral column of spinal cord forming the lateral corticospinal tract

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16
Q

How does lateral corticospinal tract synapse with skeletal muscles?

A

Axon enters into grey matter where it synapses - impulse assed through ventral root to spinal nerve then spinal muscles

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17
Q

Where do the corticospinal fibres sit in midbrain?

A

Motor fibres at very front of midbrain
In the crus cerebri - in front of the substantia nigra (part of basal ganglia)

18
Q

Where does the corticospinal fibres lie in the pons?

A

Anterior region but are separated - not one bundle, broken up

19
Q

Describe where the corticospinal fibres are in the medulla

A

Anterior and back in a bundle
Form projections called pyramids - at lower part of pyramids is where the fibres cross over

20
Q

How many neurons in the corticospinal pathway?

A

2 neurons - upper and lower motor neurons
1st neuron at cell body in grey matter of precentral gyrus
Synapses in ventral horn of grey matter - depending on which muscle

21
Q

Describe the first and second neurons in the posterior column

A

1st neuron ends by synapsing with cell body of 2nd neuron - situated in lower par of medulla
2nd order neuron crosses over at medulla

22
Q

What is the medial lemiscus?

A

When 2nd order neuron crosses over in medulla
This tract passes through the medulla, pons and midbrain to reach the thalamus

23
Q

Where is the 3rd order neuron of medial lemniscus?

A

Starts from thalamus and axons pass through internal capsule and radiate to post-central gyrus

24
Q

Where does the posterior column fibre synapse in medulla?

A

Gracile and cuneate nuclei

25
Q

Where does the first order neuron enter in lateral spinothalamic tract?

A

Neurons of pain and temperature enters into grey matter of spinal cord and ends at same level that it entered

26
Q

Describe the 2nd and 3rd order neuron of the lateral spinothalamic tract

A

Crosses over to reach lateral column in grey matter and now is lateral spinothalamic tract
Ends in thalamus
3rd order neuron passes through IC, coronal radiator to reach post-central gyrus

27
Q

Where is decussation happening in lateral spinothalamic tract?

A

At level of entry

28
Q

What is the definition of reflexes?

A

Involuntary stereotypes pattern of response brought about by sensory stimuli
Many reflexes are mediated at level of spinal cord - spinal reflexes
Can be monosynaptic or polysynaptic

29
Q

Describe the stretch reflex

A

Tenon is stretched - muscle fibres stretched so intrafusal muscle fibres stimulated
Sensory neuron is activated - dorsal root ganglion to come to synapse in ventral horn - effector neuron (motor)
Spinal nerve back to that muscle

30
Q

What other muscles are innervated in stretch reflex?

A

Some fibres go to other segments of the spinal cord to inhibit neurons - innervates muscle to relax
This is reciprocal innervation causing relaxation

31
Q

Why is the stretch reflex important?

A

Control of muscle tone and posture

32
Q

Why is the flexor reflex important?

A

protects the body from painful stimuli

33
Q

Describe the flexor reflex and crossed extensor

A

Pain receptors stimulated - activate sensory neuron which goes through dorsal root into dorsal grey matter of spinal cord
Acts on inhibitory neuron on ventral horn - contraction of muscle
Crossed extensor response to stimulate muscle for balance

34
Q

What are reflexes mediated by?

A

Lower motor neurons

35
Q

What happens to reflexes in upper motor neuron lesions?

A

Reflexes are exaggerated
LMN is compensating for firing excessively

36
Q

What controls tone of muscle?

A

Requires LMN
UMN lesion causes increased tone (spasticity) while LMN lesion causes flaccidity

37
Q

What happens if here is a left UMN lesion in internal capsule?

A

Right sided paralysis
Hyper-reflexia
Increased tone

38
Q

What happens if there is a lesion in left UMN at upper cervical spinal cord?

A

Left sided paralysis as crossed over
Hyper-reflexia
Increased tone

39
Q

What happens if lesion in left LMN?

A

Left sided paralysis
Absent reflexes
Flaccid muscles

40
Q

Describe motor neuron disease

A

Group of diseases affecting the lower motor neuron in ventral horn of spinal cord
Neuron dies and as a result the muscle supplied by it atrophies
Progressive and incurable disease