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65 Cards in this Set
- Front
- Back
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Location of sensory neuron cell bodies
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DRG
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Location of first synapse in the Posterior Column pathway
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Nucleus Gracilus/Cuneatus
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Second synapse in Posterior Column pathway
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VPL Thalamus
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Location of decussation of second order neurons in Posterior Column pathway
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Internal Arcuate fibers at caudal medulla
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trace Posterior Column pathway
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Enter Dorsal root on primary neurons (Cell bodies in DRG), travel up gracilis/cuneatus fasiculi, synpase at Nulceus Gracilis/Cuneatus, cross over at internal arcuate fibers, travel up medial lemniscus to VPL of thalamus to synapse, travel to somatosensory area of cortex
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pathway Posterior Column takes between VPL and somatosensory cortex
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Posterior Internal Capsule
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Analogous pathway to Posterior Columns in brain
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Chief Trigeminal Sensory Nucleus / Trigeminal Lemniscus
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Location of synapase between first and second order neurons in Anterolateral pathway
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Dorsal Horn grey matter (marginal zone)
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Lissauer's Tract
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Portion of axons of anterolateral pathway which ascend or descend a few segments before entering central grey matter
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Crossover point of Anterolateral pathway
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at level of entry or a few segments superior on anterior commissure
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location of anterolateral pathway in medulla
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between inferior olive and inferior cerebral peduncle
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Analogous pathway to anterolateral in brain
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Spinal Trigeminal Nucleus / Trigeminothalamic tract
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The spinoreticular tract terminates at the ________ and functions in ______
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Pontomedullary reticular formation
Behavior Arousal |
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The spinomesencephalic tract projects to the midbrain _____ and ____, and function in _______
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Periaqueductal Gray matter and superior colliculi
Modulation of pain |
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If you step on a tac, the ______ tract makes you feel something, the ______ tract makes you feel the pain, and the ______ tract makes the pain go down
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Spinothalamic
Spinoreticular Spinomesencephalic |
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In a mechanism called ___ ____ ____, sensory inputs from large diameter Aß fibers reduce pain transmission through the dorsal horn
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Gate Control Theory
ex - shaking your hand reduces pain |
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The _____ ____ recieves input from the hypothalamus, amygdala, and cortex, and inhibits pain transmission in the dorsal horn via the ___ ___ ___
what does this area secrete? |
Periaqueductal Grey Matter
RVM Serotonin and Substance P (which triggers NE release from locus ceruleus) |
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Location of Thalamic Reticular Nucleus
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Thin sheet on lateral portion of thalamus
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only sensory modality without specific relays in thalamus
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olfaction
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thalamic relay for visual information
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LGN
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thalamic relay for sound
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MGN
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Thalamic relay for motor signals from cerebellum and basal ganglia
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VL
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Thalamic relay for behavioral orientation towards relevant stimuli
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Pulvinar
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Thalamic relay for Limbic System and frontal association cortex
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MD
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Function of Rostal Intralaminar Nulcei
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Alertness/Consciousness
motor relay of Basal Ganglia (input and output from BG) |
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Function of Caudal Intralaminar Nuclei
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Motor relay for Basal Ganglia
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Regulation of other thalamic nuclei via GABA action
only thalamic nulceus without projection to cortex |
Reticular Nucleus
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Abnormal positive sensory phenomena
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Paresthesias
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Paresthesias of Posterior Pathway
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Tingling/numbing
Gauze on fingertips Bandlike sensation around trunk/limbs |
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Paresthesias of Anterolateral Pathway
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Pain
Burning Sensation |
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Lesions of the thalamus can cause severe contralateral pain
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Dejerine-Roussy Syndrome
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Lesions of cervical spine accompained by an electricity-like sensation running down the back and into extremities upon neck flexion
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Lhermitte's Sign
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Lesions of nerve roots producing radiating pain
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Radicular Pain
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sensory abnormalities
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dysesthesia
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painful sensations provoked by normally nonpainful stimuli
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allodynia
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In cord compression from tumors (or in general) it is essential to treat before what symptom occurs
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loss of ambulation
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MCC neoplastic spinal cord compression
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Metastatic spread to the epidural space
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MCS Spinal Cord Infarction / Artery involved
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T4-T8
Anterior Spinal Artery |
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Rapid onset spinal cord dysfunction with T2 bright areas and ↑WBC in CSF
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Myelitis
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Sensory presentation of lesions in lateral pons or medulla
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Loss of pain and temperature on oppsite sides (face ipsilateral, body contralateral)
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Sensory presentation of Medial Medulla lesions
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Contralateral loss of vibration and proprioception
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Presentation - Cause
Loss of all sensory and motor modalities below a distinct level |
Transverse cord lesion
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Ipsilateral loss of motor function, proprioception/vibration. Contralateral loss of temp/pain beginning a few segments lower
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Brown Sequard Syndrome
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bilateral cape distribution loss of pain and temperature sensation
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Small Central Cord
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Bilateral loss of pain/temp with sacral sparing
LMN signs at level of lesion UMN signs below lesion |
Large Central Cord
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bilateral loss of proprioception and vibration sense
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Posterior Cord Syndrome
B12, Tabes Dorsalis, MS |
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Bilateral loss of pain and temperature sense
LMN at level Incontinence |
Anterior Cord Syndrome
not sacral sparing in central cord, incontinence in anterior cord |
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Sensory information from the rectum/bladder/urethra is conveyed to
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S2-S4
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Voluntary Somatic control of Urethral and anal sphincters
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Onuf's Nucleus @ S2-S4
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Pelvic Sympathetics arise from
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T11-L1
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Pathway from Micrurition
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1 - Medial Frontal Center / Pontine Micruration center
2 - Voluntary Sphincter relaxation 3 - Inhibition of Sympathetics, relaxation of bladder next 4 - Parasympathetic activation, detrussor contraction |
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Urine flow and bladder emptying normal however no longer under voluntary control
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Bilateral medial frontal micturition center lesions
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Cause of Atonic bladder
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Acute lesions between pontine micruration center and S2-S4
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Cause of Hyperreflexic (spastic) bladder
urinary frequency and urge incontinence, elevated residual volume |
Chronic lesion between pontine micturation center and S2-S4
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Flaccid Areflexic bladder
overflow incontinence |
Lesion of peripheral nerves (S2-S4)
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Innervation of internal smooth muscle sphincter (anal)
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Sacral parasympathetics
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Innervation of external anal sphincter
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Onuf's
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Innervation of pelvic floor muscles
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Sacral anterior horn cells
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Genitalia sensation
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pudendal to S2-S4
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Bartholin Gland secretion
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Parasympathetic
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vaginal blood flow and secretions
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sympathetic
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Ejaculation
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sympathetic
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Blood supply to thalamus (3)
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Lenticulostriae off MCA
Anterior Choroidal off ICA Thalamoperforator off PCA |
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Cauda Equina cannot occur above what spinal level
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L1/L2
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Average onset of Postraumatic Syringomyelia
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9 years
(few months to 30 years) |
