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physiology > trigeminal system > Flashcards

trigeminal system Flashcards

1
Q

what is included in trigeminal perception

A 
touch
Proprioception
temp
pain
chemesthesis (common chemical sense)
Stereognosis
Flavor
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2
Q

what is stereognosis

A

3D ability to sense in the mouth

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3
Q

what can be sensed via stereognosis

A

size
texture
viscosity
hardness

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4
Q

what makes up flavor(mouth feel)

A 
taste
olfaction (special senses)
texture
temp
chemesthesis (trigeminal)
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5
Q

3 major visions of the trigeminal

A

Ophthalmic
Maxillary
Mandibular

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6
Q

what does the opthalmic trigeminal do

A

sensory only

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7
Q

what does the maxillary trigeminal do

A

sensory only

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8
Q

what does the mandibular trigeminal do

A

sensory and motor

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9
Q

parts of the spinal trigeminal nucleus

A 
oralis
interpolaris
caudalis (medullary dorsal horn)
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10
Q

where is the spinal trigeminal nucleus located

A

in the medulla

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11
Q

what is the trigeminal motor nucleus and the priniciple (main/chief) sensory nucleus located

A

pons

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12
Q

where is the mesencephalic nucleus located

A

Midbrain

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13
Q

do all cell bodies that work in the trigeminal system find themselves in the trigeminal gnaglion

A

no, some cell bodies in the mesencephalic nucleus to project to the motor nucleus

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14
Q

cell bodies found in the mesencephalic nucleus that project to the trigeminal motor nucleus give rise to what

A

Monosynaptic motor reflexes

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15
Q

where does the trigeminal ganglion terminites

A
  • priniciple sensory nucleus

- spinal trigeminal nucleus (oralis, interpolaris, caudalis)

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16
Q

projections of the trigeminal nerve must past through what to get to the primary sensory cortex

A

pass through the ventral posterior medial nucleus of thalamus

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17
Q

does the trigeminal project conra or ipsilateral to its primary somatic sensory cotex

A

contralateral side

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18
Q

what does the fact that the trigeminal nerves projectioning to the primary somatic sensory cortex mean

A

that you need to sense and be aware of this stuff

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19
Q

how does the face and hand look based on there somatotpic representation

A

both very large representations

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20
Q

ranking of fibers based on size

A

A-beta: large
A-delta: medium
C: small

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21
Q

speed ranking of fibers

A

A-beat: fast
A-delta: medium
C: slow

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22
Q

threshold ranking of fibers

A

A-beta: low
A-delta: medium
C: high

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23
Q

rolls of A belta fibers

A

no pain
touch
proprioceptive
Muscle I and II

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24
Q

rolls of A-delta fibers

A 
sharp pain
touch
temp
chemesthesis
Muscle III
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25
Q

roll of C fibers

A 
Dull and burning pain
temp
chemesthesis
Touch?
Muslce IV
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26
Q

RA I mechanoreceptors

A

Small sharp bordered receptive field ( good locationing)

Fast, with no static responce adaptation (changes quickly)

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27
Q

RA II mechanoreceptors

A

Large, obscure borded receptive field (wide borders)

Fast, with no static response adaptation (changes quickly)

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28
Q

SA I mechanoreceptors

A

Small sharp bordered receptive fields ( good locationing)

Slow, static responding adaptation (changes slowly)

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29
Q

SA II mechanoreceptors

A

Large obscure bordered receptive fields (wide borders)

Slow static responding adapatation (Changes slowly)

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30
Q

mechanoreceptor for meissner corpuslce

A

RAI

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31
Q

roll of meissner corpuscle

A

Spatial discrimination

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32
Q

mechanoreceptor for merkel disk

A

SA I

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33
Q

roll of merkel disk

A

Pressure

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34
Q

Mechanoreceptor for Pacinian corpuscle

A

RA II

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35
Q

roll of pacinian corpuscle

A

Vibration

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36
Q

Mechanoreceptor for Ruddini ending

A

SA II

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37
Q

roll of Ruffini ending

A

Skin stretch

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38
Q

what makes up a Pacinian Corpuscle

A

composed of myelinated fiber (A beta) surrounded by lamellae)

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39
Q

roll of the lamellae of Pacinian Corpuscles

A

provides a cushion to applied stimulus

upon release, decompression imparts a 2nd (off) response to nerve ending

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40
Q

what makes up the lamellae of Pacinian corpuscle

A

cells and collagen fibers separated by fluid

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41
Q

what are the mechanisms of mechanotransduction

A

ENaC (epithelial Na+ Channels)
TRP channels (transient receptor potentials)
Piezo1 and Piezo 2

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42
Q

how many transmembrane domains are in ENaC

A

6 transmembtrane domains

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43
Q

how many transmembrane domains are in TRP channels

A

6 transmembrane domains

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44
Q

how many transmembrane domains are in piezo1 and piezo2

A

36

45
Q

what does stretch or mechanical contact do to mechanoreceptors

A

opens cation channels

46
Q

steps of merkel cell activation

A
  • Piezo2 found in merkel cells
  • pressure on piezo2 leads to depolarization
  • Voltage gated Ca++ channels open
  • neurotransmitter release (glutamate)
  • Postsynaptic response leading to action potentials
47
Q

what rule is merkel cell activation an exception of

A

exception to the rule regarding somatosesnory transduction taking place on primary afferent rather than specialized sensory (since it is special sensory cell)

48
Q

what factors influence mechanorecepotrs

A
  • size of fiber and degree of myelination
  • location of receptor (deep vs superficial)
  • structure of ending (degree of encapsulation
  • transduction (piezo1 and piezo2, ENacS, TRP channels)
49
Q

what happens to the response time if piezo2 on both the merkel cell and the afferent

A

leads to a slow response

50
Q

what is a threshold stimuuls

A

stimulus intensity detected on 50% of trials

51
Q

what does a doctor use to measure touch discrimination

A

Semmes - weinstein monofilamens (Von Frey Hairs)

52
Q

is the lateral part of face or the midline have better two point discrimination

A

the midline (lips)

53
Q

what is microneurography

A

Recording from human nerves
Maps receptive fields
Determine neuron properties

54
Q

what does the infraorbital branch off

A

Maxillary N (Div 2)

55
Q

what are the lips equally sensitive to

A

finger tips

56
Q

what kind of receptors are found in the infraorbital nerve

A

Both SAI and SAII
RAI
No RAII (No pacinian corpuscles)

57
Q

what does the fact that the face has no pacinian corpuscles lead to

A

low vibrotactile sensitivity

58
Q

the lingual nerve branches off what

A

the mandibular nerve

59
Q

tongue sensitivity to threshold mg

A

tip is very sensitive, then fingers (for comparison), the back of the tongue

60
Q

what type of endings are found a lot in the tongue

A

unencapsulated ending predominant

61
Q

what specific types of ending are found in the tongue

A

Krause end bulbs- something similar in structure to meissner corpuscles (RA1)
free endings

62
Q

what are Krause end bulbs

A

coiled ending in the tongue

63
Q

are all mechanoreceptors in the tongue raapid or slowly redapting

A

actually both, despite having one type of ending

64
Q

is the midline or the lateral more sensitive in the face

A

Midline is the most sensitive

65
Q

what receptors does the face lack

A

pacinian corpuscles

66
Q

what part of the face has the lowest 2 point thresholds

A

lips

67
Q

what can be damaged during 3rd molar extractions

A

Lingual and mental nerves (branch of IA)

68
Q

is the lingual or the mental nerve more impacted by 3rd molar extaction

A

mental nerve (Lip)

69
Q

damge to the mental nerve via 3rd molar leads to

A

tongue biting and hot fluid burns and lics

NO problem with taste

70
Q

where are merkel cells found in the oral mucosa

A

Buccal mucosa, gingiva, and palate

71
Q

do merkel cells stop dividing

A

Can proliferate in peripheral tissue

72
Q

where are merkel cells most likely to be found

A

in regions with high masticatory load (tissue subjec to mechanical stress)

73
Q

what type of patients have lots of merkel cells

A

edentulous patients that use soft tissues for checking

74
Q

what is found in merkel cells

A

contain peptides and growth factors that can promote cell divisions

75
Q

what happens when merkel cells are proliferated in gingival grafts

A

MCs not innervated and some tissues is anesthetics

76
Q

are some MErkel cell phenotypes cancerous

A

yes (merkel cell carcinoma)

77
Q

the auriculotemporal nerve branches from

A

Mandibular Nerve

78
Q

what part of the the TMJ does the messeter nerve innervate

A

Anterior

Medial

79
Q

what part of the TMJ does the Auriculotemporal nerve innervate

A

Medial
Posterior
Latal
Also anterior slightly via the posterior deep temporal nerve

80
Q

what determines what nerve gets activated in the TMJ

A

the direction of movement of the TMJ

81
Q

what type of nerve endings are found in the TMJ

A

mostly free nerve endings (C-fibers)

then Ruffini, Golgi tendon organs, and then leads Pacinian

82
Q

microneurography of the TMJ

A

Not possible

83
Q

what does the mechanoreceptors for the PDL

A 
superior alveolar (maxillary)
Inferior alveolar (mandibular)
84
Q

what teeth have the more senseitve PDL fibers

A

the anterior teeth have more sensitive PDLs

85
Q

what endings are founding in the PDL

A

Complex Ruffini
Simple Ruffini
Unmyelinated free endings

86
Q

Are PDL fibers very seneitive

A

No, need a very thick hair

87
Q

what parts of the pDL does the Trigeminal ganglia innervate

A

the middle of the root

88
Q

what parts of the PDL does the Mesencephalic nucleus innervate

A

The appex

89
Q

how are mandibular and maxillary PDL’s different

A

no real difference in sensitivity

90
Q

what sides of the tooth are more sensitive

A

the labial is more than the lingual

the distal is more than the mesial

91
Q

what happens to the PDL mechanoreceptors as you apply stimuli more slowly

A

fewer APs so rate sensitive

92
Q

how does the PDL mechanoreceptors adapt

A

slowly

93
Q

do all cells have the same directional sensitivity in the PDL

A

different cells have different directional sensitivies

94
Q

what determines sensivity in PDLs

A

location of Ruffini endings in the PDL

95
Q

rol of PDL with bite force

A

helps to control bite force

96
Q

effect of Dentures and Implants on forces

A

have trouble controlling force, but have no problem generating force

97
Q

denture effect on steognosis sensitivity (shape receognition)

A

less stereognosis sensitivity

98
Q

PDL Receptor Function

A 
Detect force to teeth
Regulate bite force
Interdental discrimination
stereognosis
Jaw reflexes
Salivation
99
Q

Dual Innervation PAttern of PDL

A

Sensory Pathway

Reflex Pathway

100
Q

path of the sensory pathways

A
  • TG
  • both to the spinal trigeminal N (O) and the Principle trigeminal nucleus
  • spinal trigeminal to motor trigeminal then anterior digastric muscle
  • bPinciple trigeminal nucleus to VPM
101
Q

path of the reflex pathway

A
  • to trigeminal mes nucleus
  • to both motor and salivatory nucleus
  • motor nucleus to anterior digastric
102
Q

are all oro-facial tissues equally sesnitive to temp

A

Not equally sensitive with variation for warm and calt

103
Q

what is the elast sensitve of intra-oral tissues for warm

A

Buccal mucosa

104
Q

what are thermal fibers responsive to

A

responsive to a range of gibers but have a temp to which they respond to the most

105
Q

what happens with temp change in warm fibers

A

fire more when temp chagnes from low to high

106
Q

what happens with temp changes in cold fibers

A

fire more when temp changes from high to low

107
Q

what receptors mediate temperature transduction

A

TRP channels (multiple types)

108
Q

what temp is the threshold for pain

A

42 degrees celsius

109
Q

afferents from the trigeminal ganglion project to what

A

decending: oralis of the medulla

asscending to the principle(main or chief) sensory nucleus

physiology (32 decks)

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