Spinal Cord Pathways Flashcards
1
Q
What is the function of the dorsal columns?
A
Tactile, vibratory and conscious proprioception sensation
2
Q
What is the function of the lateral spinothalamic tract?
A
Itch, pain, temperature
3
Q
What is the function of the anterior spinothalamic tract?
A
Crude touch
4
Q
What is the function of the anterior spinocerebellar tract?
A
Unconscious proprioception
(movement and posture of the entire lower extremity)
5
Q
What is the function of the posterior spinocerebellar tract?
A
Proprioception
(fine coordination of posture and movement of individual muscles of the lower limb)
6
Q
Tactile, vibratory, and conscious proprioception sensation are functions of this ascending tract
A
Dorsal columns
7
Q
Itch, pain and temperature are functions of this ascending tract
A
Lateral Spinothalamic
8
Q
Crude touch is a function of this ascending tract
A
Anterior spinothalamic
9
Q
Unconscious proprioception (Movement and posture of the entire lower extremity) is a function of this ascending tract
A
Anterior spinocerebellar
10
Q
Proprioception (Fine coordination of posture and movement of individual muscles of the lower limb) is a function of this ascending tract
A
Posterior spinocerebellar
11
Q
Pacinian corpuscles, Meissner’s corpuscles, muscle spindles, golgi tendon organs are inputs of this ascending tract
A
Dorsal columns
12
Q
Free nerve endings, thermal receptors, pain fibers, Merkel tactile disks are inputs of this ascending tract
A
Spinothalamic
13
Q
Pressure receptors, muscle spindles, golgi tendon organs are inputs of this ascending tract
A
Spinocerebellar
14
Q
What level of the spinal cord are the cell bodies of first order neurons of the Dorsal columns?
A
All levels
15
Q
What level of the spinal cord are the cell bodies of first order neurons of the anterior spinocerebellar tract?
A
L1 to S2
16
Q
What level of the spinal cord are the cell bodies of first order neurons of the posterior spinocerebellar tract?
A
C8 to S3
17
Q
Where are the cell bodies of second order neurons of the dorsal columns?
A
Nucleus gracilis (lower limbs) and Nucleus cuneate (upper limbs)
18
Q
Where are the cell bodies of second order neurons of the spinothalamic tract?
A
Posterior horn
19
Q
Where are the cell bodies of second order neurons of the anterior spinocerebellar tract?
A
Intermediate grey matter
20
Q
Where are the cell bodies of second order neurons of the posterior spinocerebellar?
A
Branch 1: Clarke’s nucleus on L3
Branch 2: Accessory cuneate nucleus
21
Q
Cell bodies of second order neurons in the dorsal columns for lower limbs are found here
A
Nucleus gracilis
22
Q
Cell bodies of second order neurons in the dorsal columns for upper limbs are found here
A
Nucleus cuneate
23
Q
Where are the cell bodies of third order neurons of the dorsal columns?
A
Ventral posterolateral nucleus of thalmus
24
Q
Where are the cell bodies of third order neurons of the spinothalamic tract?
A
Ventral posterolateral nucleus of thalmus
25
Cell bodies of first order neurons of these two ascending pathways are found in dorsal root ganglion at all levels of spinal cord
Dorsal columns
Spinothalamic
26
Cell bodies of first order neurons of this pathway are found in spinal ganglia from L1 to S2
Anterior spinocerebellar
27
Cell bodies of first order neurons of this tract are found in spinal ganglia from C8 to S3
Posterior spinocerebellar
28
Cell bodies of second order neurons of this tract are found in the nucleus gracilis and nucleus cuneate
Dorsal columns
29
Cell bodies of second order neurons of this tract are found in posterior horn
Spinothalamic
30
Cell bodies of second order neurons of this tract are found in intermediate grey matter
Anterior spinocerebellar
31
Cell bodies of second order neurons of this tract are found in Clarke's nucleus on L3 or Accessory cuneate nucleus
Posterior spinocerebellar
32
This is the final destination of the dorsal columns tract
Postcentral gyrus
33
This is the final destination of the spinothalamic tract
Postcentral gyrus
34
This is the final destination of the anterior spinocerebellar tract
Cerebellum
35
This is the final destination of the posterior spinocerebellar tract
Inferior cerebellar peduncle
36
What is the Decussation location of the dorsal columns tract?
Medulla oblongata
(becomes the medial lemniscus pathway)
37
What is the Decussation location of the spinothalamic tract?
Anterior white commissure (spinal cord)
38
What is the Decussation location of the anterior spinocerebellar tract?
Anterior white commissure (spinal cord)
39
What is the Decussation location of the posterior spinocerebellar tract?
Is uncrossed
40
Which ascending pathway is uncrossed?
Posterior spinocerebellar tract
41
Which ascending pathway crosses in the medulla oblongata?
Dorsal columns
42
Which two ascending pathways cross at the anterior white commissure of the spinal cord?
Spinothalamic and Anterior spinocerebellar
43
This descending tract functions in intentional movements, predominantly limb movements
Lateral corticospinal
44
This descending tract functions in axial and proximal upper limb movements
Anterior corticospinal
45
Descending tract that functions in upper limb movements
Rubrospinal
46
Descending tract that functions in reflexive postural movements from auditory and visual stimuli
Tectospinal (aka Colliculospinal)
47
Descending tract that functions in excitatory anti-gravity extensors
Medial/pontine reticulospinal
48
Descending tract that functions in inhibitory for axillary extensors
Lateral/medullary reticulospinal
49
Descending tract that functions in neck muscle coordination with saccadic eye movements
Medial/medullary vestibulospinal
50
Descending pathway that functions in postural control (excitatory of extensors, inhibitory flexors)
Lateral/pontine vestibulospinal
51
What is the function of the lateral corticospinal tract?
Intentional movements, predominantly limb movements
52
What is the function of the anterior corticospinal tract?
Axial and proximal upper limb movements
53
What is the function of the rubrospinal tract?
Upper limb movements
54
What is the function of the tectospinal (aka Colliculospinal) tract?
Reflexive postural movements from auditory and visual stimuli
55
What is the function of the medial/pontine reticulospinal tract?
Excitatory anti-gravity extensors
56
What is the function of the lateral/medullary reticulospinal tract?
Inhibitory for axillary extensors
57
What is the function of the medial/medullary vestibulospinal tract?
Neck muscle coordination with saccadic eye movements
58
What is the function of the lateral/pontine vestibulospinal tract?
Postural control (excitatory of extensors, inhibitory flexors)
59
The first order neurons of this tract are located in the precentral gyrus, paracentral lobule, premotor cortex, postcentral gyrus
Corticospinal
60
The first order neurons of this tract are located in the red nucleus
Rubrospinal
61
The first order neurons of this tract are located in the superior colliculus
Tectospinal (aka Colliculospinal)
62
The first order neurons of this tract are located in the medial vestibular nucleus (medulla)
Medial/medullary vestibulospinal
63
The first order neurons of this tract are located in the lateral vestibular nucleus (pons)
Lateral/pontine vestibulospinal
64
What is the Decussation location for the lateral corticospinal tract?
Pyramidal decussation
65
What is the Decussation location for the Anterior corticospinal?
Anterior white commissure
66
What is the Decussation location for the rubrospinal tract?
Immediately at ventral tegmental decussation
67
What is the Decussation location for the Tectospinal (aka Colliculospinal) tract?
Immediately (in midbrain)
68
What is the Decussation location for the reticulospinal tract?
Is uncrossed
69
What is the Decussation location for the vestibulospinal tract?
Uncrossed
70
The dural sac past L2 makes up this
Lumbar Cistern
71
The dural sac past this vertebra level makes up Lumber Cistern
L2
72
Past L2, this becomes the Filum Terminale Internum
Pia Mater
73
This spinal segment is more circular since it must pass through the foramen magnum
Spinomedullary segment
74
This spinal segment is more oval, as it carries white matter tracts for the whole body
Cervical cord
75
This spinal segment is smaller and more rounded
Has no enlargement, still carries white matter tracts for lower body
Thoracic
76
Spinal segment that is circular and larger than thoracic
Has enlargement
Lumbar
77
Spinal segment that has significant grey matter to white matter ratio
Sacral
78
Spinal cord marker with input of sensory fibers
Posterolateral sulcus
78
Spinal cord marker with exit of motor fibers
Anterolateral sulcus
79
Spinal cord marker that is the site of the anterior spinal artery
Anterior median fissure
80
This artery runs through the anterior median fissure of the spinal cord
Anterior spinal artery
81
Artery that supplies 2/3 of the spinal cord except the dorsal columns
Anterior spinal artery
82
Part of the spinal cord that contains the structures: horns and laminae
Grey matter
83
Part of the spinal cord that contains the structures: tracts and fasciculi
White matter
84
Cell bodies of first order neurons of sensory pathways are found here
Dorsal root ganglion
85
Cell bodies of second order neurons of sensory pathways are found here
Brain stem, dorsal horns of spinal cord
86
Cell bodies of third order neurons of sensory pathways are found here
Higher regions (e.g. thalamus)
87
Cell bodies of first order neurons of motor pathways are found here
Cerebral cortex (precentral gyrus) or some brainstem nuclei
88
Cell bodies of second order neurons of motor pathways are found here
Ventral horn of spinal cord
89
First order neurons of ascending pathways travel via these
Peripheral nerves
90
This is the intermediate zone next to the central canal where branch 1 of first order neurons of the posterior spinocerebellar tract end
Clarke's nucleus
91
Clarke's nucleus is an intermediate zone next to this part of the spinal cord
Central canal
92
This extends from the midbrain to the spinal cord and carries ascending and descending tracts
Involved tracts include medial vestibulo, tectospinal, oculomotor and trochlear and abducens white matter tracts
Medial longitudinal fasciculus
93
Tracts along margins of grey matter called fasciculus proprius
Propriospinal/spinospinal tracts
94
Type of neurons in the Propriospinal tract that are most peripheral in fasciculus proprius
Long propriospinal neurons
95
Type of neurons in the Propriospinal tract that can run entire length of cord
Long propriospinal neurons
96
Type of neurons in the Propriospinal tract that are most peripheral in fasciculus proprius and can run entire length of cord
Long propriospinal neurons
97
Type of neurons in the Propriospinal tract that are intermediate in fasciculus proprius and run several segments between targets
Intermediate propriospinal neurons
98
Type of neurons in the Propriospinal tract that are adjacent to grey matter
Short propriospinal neurons
99
Type of neurons in the Propriospinal tract that are adjacent to grey matter and run 1 to 2 segments
Short propriospinal neurons
100
Type of neurons in the Propriospinal tract that run 1 to 2 segments
Short propriospinal neurons
101
Type of neurons that directly innervate skeletal muscles
Lower motor neurons
102
Lower motor neurons are found in this part of the spinal cord
Anterior horns
103
Flaccid paralysis, areflexia, muscle atrophy, fasciculations and fibrillations are signs of damage to this type of neuron
Lower motor neurons
104
Flaccid paralysis is a sign of lower or upper motor neuron damage?
Lower motor neurons
105
Areflexia is a sign of upper or lower motor neuron damage?
Lower motor neurons
106
Muscle atrophy is a sign of upper or lower motor neuron damage?
Lower motor neurons
107
Pathological clonus, hyperreflexia, positive babinski sign, and hypertonia are signs of damage to this type of neuron
Upper motor neurons
108
Pathological clonus is a sign of upper or lower motor neuron damage?
Upper
109
Hyperreflexia is a sign of upper or lower motor neuron damage?
Upper
110
Positive Babinski sign is a sign of upper or lower motor neuron damage?
Upper
111
Hypertonia is a sign of upper or lower motor neuron damage?
Upper
112
Inflammation of part of or a complete spinal cord segment(s)
Transverse myelitis
113
Transverse myelitis of this spinal tract results in UMN signs below inflammation
Corticospinal tract
114
Transverse myelitis of this spinal tract results in hypesthesia, decreased vibratory and proprioception
Dorsal columns
Spinocerebellar
115
Transverse myelitis of this spinal tract results in diminished pain and temperatures sense 2 segments below inflammation
Spinothalamic
116
Transverse myelitis of this spinal tract results in LMN signs at site of inflammation
Ventral horn
117
Expansion of the central canal causing compression of surrounding structures (most notably is the anterior white commissure)
Syringomyelia
118
In syringomyelia, compression leads to this
Demyelination
119
Chronic condition of this leads to anterior horn cell destruction (LMN signs)
Syringomyelia
120
Which 3 spinal tracts decussate at the anterior white commissure?
(and thus may be impacted in syringomyelia)
Lateral spinothalamic
Anterior spinocerebellar
Anterior corticospinal
121
Pain and temperature "cape like distribution" is seen during syringomyelia when it affects this tract
Lateral spinothalamic
122
What is the triad seen in Cauda equina syndrome?
Overflow incontence
Sexual dysfunction
Saddle area paresthesia/numbness
123
Overflow incontence, Sexual dysfunction, and Saddle area paresthesia/numbness is a characteristic triad of this condition
Cauda equina syndrome
124
Incredibly rare condition where one of the lateral halves of the spinal cord is cut
Brown sequard (aka spinal hemisection)
125
Brown sequard (aka spinal hemisection) of this spinal tract results in ipsilateral UMN signs below transection
Corticospinal
126
Brown sequard (aka spinal hemisection) of this spinal tract results in ipsilateral hypoesthesia, decreased vibratory and proprioception below transection
Dorsal columns
spinocerebellar
127
Brown sequard (aka spinal hemisection) of this spinal tract results in contralateral diminished pain and temperatures sense below transection
Spinothalamic
128
Brown sequard (aka spinal hemisection) of this spinal tract results in ipsilateral diminished pain and temperature at transection level
Dorsal horn
129
Brown sequard (aka spinal hemisection) of this spinal tract results in LMN signs at site of transection
Ventral horn
130
Anterior spinal cord syndrome affecting this tract results in UMN signs below injury site
Corticospinal tract
131
Anterior spinal cord syndrome affecting this tract results in hypalgesia and loss of temperature sensation below injury
Spinothalamic
132
Are dorsal columns affected in anterior spinal cord syndrome?
No
Proprioception and vibratory sense are retained
133
Annular constriction leading to damage of the central cord
Central cord syndrome
134
Central cord syndrome affecting this tract results in bilateral upper extremity weakness, worse distally
Partial corticospinal
135
Central cord syndrome affecting this tract results in bilateral hypoesthesia and loss of temperature sensation severeal segments up to 2 below injury site
Spinothalamic
136
Central cord syndrome affecting this tract results in problems with unconscious proprioception
Muscle strength will be normal, but will have trouble walking
Anterior spinocerebellar
137
Central cord syndrome affecting this tract results in difficulty with axial and upper limb movement
Anterior corticospinal
138
Compression or loss of posterior spinal cord
Posterior/dorsal cord syndrome
139
Posterior cord syndrome affecting this tract affects vibration, tactile, conscious proprioception below the site of the lesion
Dorsal columns
140
Posterior cord syndrome affecting this tract affects most to all sensory input at site of injury but not below
Dorsal horn
141
Condition where a sudden change from a hyponatremic state causes areas of the CNS to lose myelin
Central pontine myelinolysis
(aka osmotic demyelination)
142
Hyponatremic encepholpathic symptoms include nausea, vomiting, confusion, seizures, headache (non-specific neurological symptoms) and are seen initially in this condition
Central pontine myelinolysis
(aka osmotic demyelination)
143
3-5 days post normalization with this condition, patient develops sudden neurological symptoms:
Respiratory dysfunction
Ataxia, psychosis, confusion, motor and sensory deficits
Central pontine myelinolysis
(aka osmotic demyelination)
144
Condition caused by destruction of lateral corticospinal tracts, anterior horn cells, as well as Bulbar CNs (CN 9-12)
Amyotrophic lateral sclerosis (aka Lou Gerhig’s disease)
145
Amyotrophic lateral sclerosis (aka Lou Gerhig’s disease) is the destruction of these 3 things
Lateral corticospinal tracts
Anterior horn cells
Bulbar CNs (CNs 9-12)
146
Bulbar signs include dysphagia, decreased gag reflex, dysarthria and dysphonia, and are a poor prognosis of this condition
Amyotrophic lateral sclerosis (aka Lou Gerhig’s disease)
147
What is the #1 cause of death in patients with Amyotrophic lateral sclerosis (aka Lou Gerhig’s disease)?
Respiratory failure
148
Patients with this condition have only motor signs and symptoms (UMN and LMN signs), but will not have sensory, bladder, bowel or sexual dysfunction
Amyotrophic lateral sclerosis (aka Lou Gerhig’s disease)
149
Condition that begins in children with loss of dorsal root ganglion, posterior columns, spinocerebellar tracts, lateral corticospinal tract, sensory peripheral nerves
Friedrich's ataxia
150
Wide based gait ataxia (cerebellar ataxia) and hyporeflexia are seen in this genetic condition
Friedrich's ataxia
151
“Explosive dysarthria” aka Scanning Speech, is seen in patients with this condition
Patient separates words by syllables and varies volume with each syllable (cerebellar hemispheric damage)
Friedrich's ataxia
152
3 tracts that are affected in Friedrich's ataxia
Dorsal columns
Spinocerebellar
Corticospinal
153
Condition characterized by loss of anterior horn cells in children
Werdnig Hoffman disease (aka Spinal muscular atrophy)
154
Does Werdnig Hoffman disease (aka Spinal muscular atrophy) involve UMN or LMN signs?
LMN
Best gross motor milestone will be sitting up
155
What is the usual cause of death in patient with Werdnig Hoffman disease (aka Spinal muscular atrophy)?
Respiratory failure
156
A common demyelinating disease resulting in plaques in the CNS
Multiple sclerosis
157
Are males or females more likely to have multiple sclerosis?
Females
158
Condition that can have any symptoms from white matter tract loss
Multiple sclerosis
159
Internuclear opthalmoplegia is the common first symptom of this disease
Multiple sclerosis
160
What is the common first symptom of Multiple sclerosis?
Internuclear opthalmoplegia
(from MLF demyelination)
