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Term 1
Definition 1
Formation of a Spinal Nerve 1. outer _____ matter 2. inner _____ matter 3. dorsal horn is associated with what type of neurons? 4. ventral horn is associated with what type of neurons? 5. dorsal and ventral roots unite to form a ________
Term 2
Formation of a Spinal Nerve 1. outer white matter 2. inner grey matter 3. dorsal horn is sensory unipolar neurons concerned with general sensation which have receptors peripherally. 4. ventral horn is motor multipolar neurons which synapse with effector organ 5. dorsal and ventral roots unite to form a spinal nerve Definition 2
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Term 2
Definition 2
1. spinal n. has two major branches which are the dorsal and ventral primary rami (mixed nerves) 1. two major branches of spinal n. 2. dorsal primary rami innervate: 2. dorsal primary rami innervate..... 3. ventral primary rami innervate... -deep muscles of the back -dermatomes of posterior surface of neck and trunk
Term 3
#of spinal nerves
3. ventral primary rami innervate everything else: Definition 3 -all the skin and muscles of the UE and LE -s/f muscles of the back -remaining muscles and lateral/anterior dermatomes of the trunk. 31 pairs
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Term 4
Definition 4
Describe the 2 modalities of General Sensation What are the sensations of each modalities?
Epicritic: precise and pinpoint 1. fine touch 2. proprioception (muscle/tendon stretch and tension) 3. vibration Protopathic: diffuse but quick as ascends to CNS. 1. Pain (fast acute & slow chronic) 2. Temperature
Term 5
Definition 5
Motor AND sensory Skeletal muscle has what type of innervation? Sensory receptors are associated with epicritic proprioception: -Muscle spindles are stretch receptors in muscle. -Golgi tendon organs are tension receptors in tendons.
Term 6
Definition 6
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Term 6
Definition 6
Sensory Vocab: 1. loss of all sensation 2. without pain.
1. loss of all sensation. anesthesia 2. without pain. analgesia
3. ability to recognize an object 3. ability to recognize an object through sense of touch without visual through sense of touch without visual cues (this is of which modality?). cues, but involved memory (this is of stereognosis (epicritic) which modality?) 4. related to movement, perception of angle of joint, and relative weight of objects 4. related to movement, perception of angle of joint, and relative weight of objects. Kinesthesia
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Term 7
Definition 7
1 - analgesia is related to what modality? 2-astereognosis and akinesthesia are related to what modality?
1 - analgesia is related to what modality? protopathic 2-astereognosis and akinesthesia are related to what modality? epicritic
Term 8
Definition 8
Sensory neurons 1. of which root, type of neuron. dorsal root, unipolar 2. innervate what 2 structures - skin (dermis/epidermis for pain, touch, temp, and pressure)
Sensory neurons 1. of which root, what type of neuron.
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1. of which root, what type of neuron. 2. innervate what 2 structures
Term 9
Definition 9
Sensory Receptors in Skin 1. innervate what 2 layers 2. naked nerve endings 3. Pacinian Corpuscle Sensory receptors in Skeletal Muscle 1. receptor of stretch/length 2. receptors of tension
Sensory Receptors in Skin 1. innervate what 2 layers - epidermis and dermis 2. naked nerve endings - nociceptors (pain receptors) 3. Pacinian Corpuscle - associated -skeletal muscle (stretch and with pressure sense tension) Sensory receptors in Skeletal Muscle 1. receptor of stretch/length - muscle spindles IN MUSCLE 2. receptors of tension - golgi tendon organ (GTO) IN TENDONS
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Term 10
Definition 10
-1 Neuron 1. unipolar 2. cell body location - dorsal root ganglion -1 Neuron 3. peripheral process (part that goes to 1. unipolar or bipolar the skin) associated with a a receptor 2. cell body location that responds specific stimulus 3. peripheral process (part that goes to 4. central process enters the spinal the skin) associated with a _______ cord via the dorsal root 4. _____enters the spinal cord via the 5. synapses where? - CNS (spinal cord _____ or brain stem depending on modality) 5. synapses where? 6. Entire 1 neuron is unilat (located on 6. Entire 1 neuron is unilat or bilat? 1 side of body)
Term 11 Definition 11
Common Characteristics of the 3-neuron General Sensation Pathway (includes epicritic and protopathic):
-2 Neuron -2 Neuron 1. cell body location 1. cell body location - CNS (spinal cord 2. **axon immediately _______ or brain stem depending on modality) 3. ascends in CNS via ________ 2. **axon immediately decussates to 4. Synapses CNS term for nerve. where? Accumulation of contralat side this is definitely on test, bitches - Dr. H axons that have a similar function. Tract -3 Neuron 3. ascends in CNS via long ascending Form bundles of white matter 1. cell body location tract (tract in brain and spinal cord (myelinated axons) in CNS. 2. axon ascends via _____________ form white matter = bundles of 3. synapses in the myelinated axons). ________&________ of the ______lobe 4. Synapses where? - thalamus in the somatosensory cortex for general sensation. -3 Neuron Term 12 12 -thalamus 1. cell bodyDefinition location 1. Largest structure in diencephalon
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Thalamus 1. Largest structure in _______ of the brain. 2. Serves as a ... 3. _____ matter existing bilaterally. 4. Location of ____neuron and the synapse of _____ neuron of general sensory pathways.
1. Largest structure in diencephalon of the brain. 2. Serves as a relay center to/from cerebral cortex. 3. Grey matter existing bilaterally. 4. Location of 3 neuron and the synapse of 2 neuron of general sensory pathways.
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Term 13
Definition 13
area 3,1,2 which is the somatosensory cortex (comprised of laterally, the postcentral gyrus and medially, the posterior paracentral lobule of parietal lobe) The first level of consciousness for general sensation occurs where?
Term 14
Definition 14
Sensory signals from the lower extremity terminate where?
paracentral lobule
Term 15
Definition 15
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EPICRITIC PATHWAY: Faciculus Gracilis (recieves epicritic info from T7 and below) & Fasiculus Cuneatus ( from T6 and above) contribute to dorsal white matter of spinal cord, aka dorsal column, which are the axons of the primary neuron which ascend in spinal cord and synapse in medulla.
Fasciculus Gracilis & Fasciculus Cuneatus
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Term 16
Definition 16
EPICRITIC PATHWAY: Bundles of 2 neuronal axons of the epicritic pathway which begin in the medulla and immediately decussate to contralateral side to ascend through the pons, midbrain, and synapse in the thalamus
Medial Lemniscus
Term 17
Definition 17
Stimuli from 1 neuron enter the dorsal column white matter of the spinal cord, comprised of the fasciculus gracilis (which recieves stimuli from T7 and Describe the Epicritic Pathway (fine below) and the fasciculus cuneatus touch, proprioception, vibration) from: (which recieves stimuli from T6 and above). 1. Stimuli from T7 and below. 2. Stimuli from T6 and above. 2 neurons begin in the medulla and immediately decussate to contralateral side via bundles of axons called the medial lemniscus. The information ascends through the pons and Term 18 midbrain and Definition synapses 18 in the
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1. If you injure the system superior to decussation, you should expect to see what neurological deficit? 2. If you injure the system inferior to the decussation, you should expect to see what neurological deficit? 1. Contralateral 2. Ipsilateral neurological deficit from below the level of injury.
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Term 19
Definition 19
When you are describing a neurological deficit, what is your reference point?
The site of the lesion.
Term 20
Definition 20
What is special about C1 nerves?
C1 is only a motor nerve, there is no dermatome.
Term 21
Definition 21
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1. Spinal Protopathic Pathway modalities 2. fast/acute pain tract 3. slow/chronic pain tract
1. Spinal Protopathic Pathway modalities - pain, temperature, crude touch 2. fast/acute pain tract - lateral spinothalamic tract (LST) 3. slow/chronic pain tract - anterior spinothalamic tract (AST)
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Term 22
Definition 22
Spinal Protopathic Pathway (Spinal Thalamic Pathway) vs. Spinal Epicritic Pathway (Dorsal Column) 1. decussation location 2. 1 neuron synapse
1.DECUSSATION -Protopathic: segmental decussation at every level in the spinal cord via anterior white commisure, specifically the level in which it is recieved. -Epicritic: decussates in medulla via medial lemniscus. 2. 1 neuron synapse -Protopathic: synapses in dorsal horn of gray matter -Epicritic: synapses in medulla
Definition 23
Term 23
Pain, temp, and crude touch stimuli from 1 neuron synapse in dorsal (posterior) horn. Describe the Spinothalamic Pathway for Protopathic Modalities of acute pain, temp, chronic pain, and crude touch. 2 neuron decussates and the same spinal level from which is was recieved via the anterior white commisure and ascends via the lateral spinothalamic tract (fast/acute pain and temp) or anterior spinothalamic tract (slow, chronic pain and crude touch) and synapses in the thalamus. 3 neuron ascends Definitionthrough 24 pons,
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Term 24
Where is the level of consciousness of pain and temperature protopathic modalities?
Thalamus (vs. cortex for epicritic pathways)
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Term 25
Definition 25
DESCRIBE THE NEUROLOGICAL DEFICIT: 1. a lesion in the L posterior limb of internal capsule results in... 2. a lesion in the L pons results in... 3. A L hemi-lesion in the spinal cord results in...
1. a lesion in the L posterior limb of internal capsule results in... R (contralateral) loss of general sensation (both epicritic and protopathic modalities). 2. a lesion in the L pons results in... R (contralateral) loss of general sensation (both epicritic and protopathic modalities. 3. A L hemi-lesion in 1 level of the spinal cord results in... L (ipsilateral) Definition loss26 of epicritic 1. LMN: multipolar neurons directly modalities & synapsing on voluntary skeletal R (contralat) loss of protopathic muscle. Only motor neurons that modalities BELOW THE LEVEL OF innervateINJURY skeletal muscle. -injury=flaccid paralysis 2. UMN: neurons associated with motor cortex and brainstem, and synapse on LMN. -injury=spastic paralysis 3. Basal Ganglia: grey matter bilaterally, subcortical structures (no conscious awareness), Definition 27neurons which
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Term 26
Normal Voluntary Movement requires what 4 functioning systems? Describe the mov't disorder associated each system is injured individually.
Term 27
Damage to what system of voluntary movement results in.... 1. flaccid paralysis 2. spastic paralysis 3. dyskinesia 4. ataxia
1. spastic paralysis - upper motor neuron 2. flaccid paralysis - lower motor neuron 3. dyskinesia - basal ganglia 4. ataxia - cerebellum
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Term 28
Definition 28
Alpha motor neurons: 1. type of motor neuron - LMN Alpha motor neurons: 1. type of motor neuron 2. innervation 3. physical characteristics (size, myelination, polarity) 4. conduction velocity 5. location 2. innervation - extrafusal skeletal muscle fibers, aka muscle cells, which control muscle contraction across a joint. 3. physical characteristics - large, heavily myelinatied multipolar neurons 4. conduction velocity - fast
Term 29
Gamma motor neurons: 1. type of motor neuron 2. innervation 3. physical characteristics 4. conduction velocity 5. location
5. location - all Definition spinal29 nerves and all Gamma neurons: cranial nervesmotor but I, II, VIII (olfactory, 1. type of motor neuronare - LMN optic, vestibulocochlear only sensory). 2. innervation - intrafusal skeletal muscle fibers, which are special fibers within muscle spindle that maintain the spindle as an effective stretch receptor. 3. physical characteristics myelinatied multipolar neuron, not as large as gamma. Oh 4. conductionDefinition velocity 30 - slower than
Term 30
Oh Oh, To Touch And
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Oh
Oh Oh, To Touch And Feel A Girl's Vagina, Ah Heaven

I - Olfactory - Purely Sensory Sense of smell II - Optic - Purely Sensory vision III - Oculomotor Levator palpebrae (eyelid open)
Review the cranial nerves. Which are purely sensory?
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Term 31
Definition 31
An unconscious response
Reflex
Term 32
Definition 32
Myostatic Stretch Reflex (knee jerk) 1. Associated with what receptor? 2. What and where is the sensory neuron? 3. Where is the synapse between sensory and motor neurons? 4. Where is the cell body location of the motor neuron? What is its path? 5. What happens to the antagonistic muscle? (in this case the hamstring).
Term 33
1. What receptor? Muscle Spindle Stretch receptor (proprioceptor) within the muscle (which stretches when you tap the patellar tendon) 2. What and where is the sensory neuron? 1 neuron of epicritic pathway which enters the dorsal horn 3. Where is the synapse between sensory and motor neurons? integrating Definition center 33
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3 parts involved in DTR
Testing sensory neuron function, motor neuron function, and muscle function.
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Term 34
Definition 34
Tendon Reflex 1. occurs when? 2. what is the receptor? 3. receptor innervation and path 4. what connects sensory and motor neuron? 5. what is the motor response?
1. occur when? with excessive tension on muscle tendon - it is a protective reflex 2. what is the receptor? golgi tendon organ in the tendon (proprioceptor) 3. receptor innervation sensory 1 neuron of epicritic system which enters spinal cord via dorsal horn 4. what connects Definition sensory 35 and motor 1. involves what sensory pathway? neuron? protopathic of pathway (pain, temp) -a Interneuron the integrating center protective reflex 5. what is the motor response? 2.RELAXES What is the receptor and its effector muscle innervation? (and contracts antagonistic muscle) Nociceptor innervated by 1 neuron of protopathic pathway. 3. What is the motor response? contracts many effector muscles to withdrawal from the pain. 4. What happens Definition to stabilize 36 the body LMN disease is characterized as
Term 35
Withdrawal Reflex (when you touch something painful): 1. involves what sensory pathway? 2. What is the receptor and its innervation? 3. What is the motor response? 4. What happens to stabilize the body during the withdrawal reflex?
Term 36
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LMN disease is characterized as _____________. 1. status of voluntary muscle (2) 2. Muscle tone (4) 3. Status of superficial and deep reflexes (2) 4. effects of lesion 5. lesion location (2) 6. types of injury (3)
LMN disease is characterized as flaccid paralysis 1. status of voluntary muscle (2) -paralysis -paresis 2. Muscle tone (4) -absent -hypotonicity (decreased) -fasciculations (occur 1st, mini twitches) -fibrillations (occur later, inobservable)
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Term 37
Definition 37
Poliomyelitis is a disease of....
Poliomyelitis is a disease of LMNs
Term 38
Definition 38
Primary Motor Cortex 1. aka AREA 4 Primary Motor Cortex 1. aka 2. location 2. location precentral gyrus (laterally) and anterior paracentral lobule (medially) of the FRONTAL lobe.
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2. location 3. what is directly posterior to this region?
Term 39
Definition 39
1. innervation of upper extremity Cervical Enlargement (Brachial Plexus) 1. motor innervation of upper extremity 2. motor innervation of lower extremity 3. motor tract of UE & LE 4. motor tract of head region. concerned with synapsing what? 2. innervation of lower extremity lumbar and sacral enlargement 3. motor tract of UE & LE corticospinal tract 4. motor tract of head region. concerned with synapsing what? corticobulbar tract synapses LMNs from brainstem to cranial nerves.
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Term 40
Definition 40
Corticospinal Tract Corticospinal Tract 1. UMN synapse on what, where? 2. cortex is what side of the body? 3. system location and trauma 1. UMN synapse on LMN in the spinal cord 2. cortex is connected to contralateral side 3. from cortex to cord, system is located close to the peripheral surface, easily injured in trauma
Term 41
Definition 41
1. Epicritic Pathway - sensory: fine touch, proprioception, vibration What systems coarse through the posterior limb of the internal capsule? (3) 2. Protopathic Pathway - sensory: pain, temp 3. UMN of corticospinal tract - motor
Term 42
Definition 42
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Injury to the internal capsule will NEVER cause UMN or LMN disease.
Injury to the internal capsule will NEVER cause LMN disease. *Only the UMN coarses through posterior limb of internal capsue = UMN disease.
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Term 43
Definition 43
Corticospinal Tract (Motor function) 1. aka - pyramidal tract 1. aka 2. From the motor cortex, the _____ 2. From the motor cortex, the upper neuron coarses through the motor neuron coarses through the ___________ en route pyramids of the posterior limb of the internal capsule medulla en route pyramids of the medulla 3. what % of fibers decussate, where does the decussation occur, and what 3. where does the decussation occur? tract do the fibers end up in after the pyramidal decussation in the medulla decussation? involves about 85% of the fibers, 4. where do the fibers that don't which descend via lateral white matter decusatte descend? (lateral corticospinal tract) of the spinal 5. where does the synapse with LMN cord occur? Term 44 Definition 44 UMN Disease is characterized as 4. where do the fibers that don't spastic paralysis decusatte descend? UMN Disease is characterized as anterior corticospinal tract of spinal __________. 1. Status of voluntary later) muscle (2) cord (which decussate not on -paralysis exam 1. Status of voluntary muscle (2) -paresis 2. Muscle tone 5. where does the synapse with LMN 3. Superficial Reflex status 2. Muscle tone occur? 4. Deep Reflex Status -hypertonicity (rigidity, increased tone) spinal gray matter 5. Effects of lesion 6. lesion location 7. types of injury (4)
Term 45
3. Superficial Reflex status -Babinski sign - dorsiflexion and fanning of the toes (this is normal for prewalking child Definition b/c corticospinal 45 tract
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A babinski sign (dorsiflexion and fanning of the toes) is indicative of what disease? In what population of patients is this a normal response?
A babinski sign (dorsiflexion and fanning of the toes) is indicative of what disease? UMN Disease In what population of patients is this a normal response? Children in pre-walking stage b/c the corticospinal tract has not fully developed yet.
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Term 46
Definition 46
Is it UMN or LMN disease? 1. peripheral nerve/rootlet injury 2. injury to posterior limb of internal capsule 3. CVA 4. Multiple Sclerosis 5. Poliomyelitis 6. Tumors 7. Trauma 8. A lesion in the CNS
Term 47
Is it UMN or LMN disease? 1. peripheral nerve/rootlet injury - LMN 2. injury to post limb of internal cpsule - UMN 3. CVA - UMN or LMN 4. Multiple Sclerosis - UMN 5. Poliomyelitis - LMN 6. Tumors - UMN 7. Trauma - UMN or LMN 8. A lesion in the CNS - UMN or LMN
Definition 47
Where is the lesion? Left-sided... -spastic hemiplegia -loss of all general sensation
R-sided Lesion of the posterior limb of the internal capsule results in CONTRALATERAL motor and sensory neuro deficits. Left-sided... a) spastic hemiplegia Corticospinal tract UMN b) loss of all general sensation Epicritic (medial lemniscus) & Protopathic pathways
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Term 48
Definition 48
Where is the lesion? Right-sided... -loss of fine touch, DTRs, & vibration -loss of pain and temp sensation -spastic hemiplegia
L-sided lesion of the pons (part of brainstem) results in CONTRALATERAL motor and sensory neuro deficits. Right-sided... a) loss of fine touch, DTRs, & vibration - Epicritic (medial lemniscus) b) loss of pain and temp sensation - Protopathic pathway c) spastic hemiplegia Corticospinal tract UMN
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Term 49
Definition 49
Where is the lesion? Waist and below... -L sided loss of fine touch, DTRs, & vibration. -L sided spastic paralysis. -R sided loss of pain and temp sensation.
L-sided hemi-lesion of the L1 spinal segment results in IPSILATERAL epicriticand UMN deficits & CONTRALATERAL protopathic deficits BELOW THE LEVEL OF INJURY. Waist and below... a) L sided loss of fine touch, DTRs, & vibration-Dorsal column system (epicritic) b) R sided loss of pain and temp sensation-spinothalamic tract (protopathic) c) L Definition sided 50 spastic 1. a lesion in the posterior limb of paralysis-corticospinal tract (UMN) internal capsule -Corticospinal Tract (UMN):
Term 50
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State the neurological deficit of... 1. a lesion in the posterior limb of internal capsule 2. a lesion in the pons (brain stem) 3. a hemi-lesion of a spinal segment
-Corticospinal Tract (UMN): contralateral spastic hemiplegia -Contralateral loss of ALL general sensation (epicritic & protopathic) 2. a lesion in the pons (brain stem) -Medial Lemniscus: contralat loss of epicritic modalities (fine touch, proprioception, vibration) -anterior & lateral spinothalamic tracts: contralat loss of protopathic modalities (pain Definition & temp) 51 -Corticospinal Tract (UMN): contralat spastic hemiplegia When all the LMNs to a muscle group are injured, you will clinically be able to 3. a hemi-lesion of a spinal group segment see THAT SPECIFIC muscle Losses level of injury: having flaccifbelow paralysis. -dorsal column: ipsilat loss of epicritic modalities Eg: Assume we have a Lesion that -spinothalamic: contral loss of affects 3-4 spinal segments of anterior protopathic modalities horn, which damages MANY of motor -corticospinal (UMN): ipsilateral neurons: spastic paralysis Ipsilat flaccid paralysis for affected muscles, Everything else has spastic
Term 51
When will LMN disease mask UMN disease?
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Term 52
Definition 52
Amyotrophic Lateral Sclerosis 1. affects what neuronal systems? 2. Neuro deficits seen
1. Corticospinal Tract: UMN and LMN 2. Neuro deficits: -LMN = ipsilat flaccid paralysis of muscle groups corresponding to affected spina segments. -UMN = ipsilateral spastic paralysis inferior to the affected spinal segments
Term 53
Definition 53
CST and CNIII injury: 1. Contralat Spastic Hemiplegia (UMN SCT) 2. Ipsilateral Flaccid Paralysis (LMN CNIII) of SR, MR, IR, IO extraocular muscles, levator palpebrae superioris (upper eyelid), and CNIII parasympathetic loss (pupil constriction & accomidation). This results in CNIII palsy= down and out eyeball Definition with dilated 54 pupil. CST and CNVI (Abducens) injury:
superior alternating hemiplegia what are the neuro deficits you will see?
Term 54
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CST and CNVI (Abducens) injury: 1. Contralat spastic hemiplegia (UMNCST) Middle Alternating Hemiplegia What are the neuro deficits seen? 2. ipsilateral flaccid paralysis of lateral rectus muscle (LMN- CNVI Abducens)
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Term 55
Definition 55
CST and CNXII (hypoglossal) injury: 1. Contralateral Spastic Paralysis (UMN - CST) Inferior Alternating Hemiplegia What are the neuro deficits seen? 2. Ipsilateral Flaccid Paralysis of tongue muscles (LMN - CNXII) tongue deviates to side of lesion
Term 56
Definition 56
Pt sticks out his tongue and you notice it deviates to the right. On the left side of the body, Pt has increased resistance to passive stretch when moved with more speed, muscles have persistent spasms, and exaggerated DTRs. What does this suggest?
Right-sided lesion causing INFERIOR ALTERNATING HEMIPLEGIA: -LMN injury involving CN XIIhypoglossal ipsilaterally.
Note the wasted left side of the tongue and deviation to the left suggesting a left lower motor neurone lesion.
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Term 57
Definition 57
Corticobulbar Tract 1. arises from __________ 2. axons coarse through_________. -CST injury causing spastic paralysis 2. axons coarse through genu of the 3. axons terminate (synapse) on the contralaterally. internal capsule ____ in the _________. 4. Injury to this system superior to the 3. axons terminate (synapse) on the Facial Nucleus ( which is located in LMNs (cranial nerves) in the brain stem the_____ ) results in what neuro deficit? 4. Injury to this system superior to the Facial Nucleus (which is located in the pons) results in what neuro deficit?
Corticobulbar Tract 1. arises from headportion of primary motor cortex
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Term 58
Definition 58
contralat spastic paralysis for the lower muscles of facial expression. From the interenet: LMN of brainstem receive bilat corticobulbar input. Unilat lesions have no effect on head/neck muscles clinically except those muscles which are bilat: 1) contralat lower facial paralysis, and 2) contral genioglossus tongue muscle (tongue deviates to affected side). Summary: Definition 59 a lesion involving all of the cerebellum corticospinal and corticobulbar fibers from the left cerebral cortex produces 1. Right hemiparesis (weakness of the right upper and lower limbs). 2. Weakness of the right face below the forehead. 3. Deviation of the tongue to the right upon protrusion (transient). 1.function - coordination of voluntary movement; monitors and compares intention and actual movement and Definition 60 feedback. sends out corrective
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Neurological deficits associated with injury to the genu of the internal capsule.
Term 59
cerebellum 1.function (compares what mov't and does what?) 2.influences ipsilateral or contralateral musculature? 3. direct injury results in what deficit? 4. 3 segments/lobes of cerebellum and resulting motor disorders.
Term 60
Pt presents with following sx, where is the disorder?

-hypertonicity -intention tremor -dysmetria (past pointing) -dysdiodochokinesia (difficulty with RRAMs) -asynergia/dyssynergia (lack of smoothness) -dysarthria (difficulty with speech)
Posterior Lobe (cerebrocerebellum) of Cerebellum
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Term 61
Definition 61
1. Truncal ataxia - where is the disorder? 2. Gait ataxia -where is the disorder? -involves input from what type of receptors? -in what population is this degeneration seen?
Term 62
1. Truncal ataxia - where is the disorder? Flocculonodulae Lobe of Cerebellum (Vestibulocerebellum) 2. Gait ataxia -where is the disorder? Anterior Lobe of Cerebellum (Spinocerebellum) -involves input from what type of receptors? proprioceptors -in what Definition population 62 is this degeneration seen? alcoholics Caudate Nucleus Putamen
5 areas of basal ganglia *Don't Memorize, this is FYI*
Globus Pallidus Subthalamic Nucleus Substantia Nigra
Term 63
Definition 63
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Term 63
Definition 63
Basal Ganglia 1. Functions *This is FYI, don't memorize* 2.Influence ipsilat or contralat musculature? 3. Injury/Disease characterized by... 4. Name 4 disorders of basal ganglia
Basal Ganglia 1. Functions - muscle tone, posture, gross movement, programmed movement, cognitive aspect of movement and sequencing, suppress unwanted movement 2. Influence contralateral musculature. 3. Injury/Disease characterized by contralateral dyskinesias 4. Name 4 disorders of basal ganglia
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Term 64
Definition 64
Parkinson's Disease 1. Disorder of what region 2. 5 clinical signs (tone, movement initiation & speed, tremors, expression)
Parkinson's Disease 1. Disorder of what region - basal ganglia (decr stimulation from decr dopamine) 2. 5 clinical signs -lead pipe rigidity -akinesia (hesitancy initiating movement) -bradykinesia -rest tremors -masked expression
Definition 65
Term 65
Pain Categories 1. tranduced from peripheral receptors that are being destroyed 2. damage to peripheral or central nerves (give two examples of diseases) 3. sharp & abrupt. Lasts minutes to weeks. Eventually dissapates if cause is alleviated. 4. unresolved acute pain.
Term 66
Pain Categories 1. Nocioceptive pain - tranduced from perepheral receptors that are being destroyed 2. Neuropathic Pain - damage to peripheral or central nerves (eg. Carpal Tunnel Syndrome, MS) 3. Acute - sharp & abrupt. Lasts minutes to weeks. Eventually dissapates if we can alleviate the Definition cause.66
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Learned Pain 1. strong ________ component 2. generated by ______ centers 3. involves ________changes within the CNS
Learned Pain 1. strong affective component (pt's mood) 2. generated by supraspinal centers 3. involves plastic changes within the CNS (responding to stimulation)
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Term 67
Definition 67
Anterolateral System (ALS) Anterolateral System (ALS) 1. Transmits which modalities 2. Pain projector neurons (nociceptors) in dorsal horn of spinal grey can project to what 3 areas via what tracts. 1. Transmits which modalities Protopathic (pain and temp) 2. Pain projector neurons (nociceptors) in dorsal horn of spinal grey can project to what 3 areas via what tracts to cause what response? a) reticular formation via spinoreticular tract - in brainstem, consists of cells that modulate Definition pain. 68 a) periaqueductal gray (PAG) via spinomesencephalic tract - in mesencephalon, gives us endogenous endorphines to shut 1) prior experience off pain 2) projection context neurons at reticular formation; also, in 3) emotion situations chronic stimulation 4) frequency of of stimulation = plasticity can turn on pain progression centers in reticular formation to increase amount of pain. c) Spinothalamic tract - thalamus 69 resulting in projects Definition to cortex,
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Term 68
4 components of pain
Term 69
1) peripheral hypersensitivity - lower sensitivity of dorsal root primary afferent neurons Plastic Changes from Chronic Pain 1) in PNS (1) 2) in CNS (5) 2) central hypersensitivity - pain projection neurons - reticular formation - periaquaductal grey - thalamus/hypothalamus - cerebral hemispheres (sensory cortex and frontal lobe to create personality changes)
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Term 70
Definition 70
describe peripheral hypersensitivity causes of the wind upof the CNS to transmit pain 1. activitation of... 2. threshold lowering of... 3. conversion of... 4. degeneration of...
describe peripheral hypersensitivity causes of the wind upof the CNS to transmit pain Peristant stimulation of primary nociceptors causes... 1. activitation of dormant nociceptors in skin 2. threshold lowering of projection neurons, causing them to fire with less stimuli 3. conversion Definition of multimodal 71 dorsal horn neurons to pain projection neurons 4. degeneration of inhibitory 2 results of peripheral interneurons that are normally hypersensitivity/plastic changes: stimulated by rubbing a painful area. 1. Allodynia - painful response to normally painless stimulation. 2. Spontaneous Pain/Spinal Memory
Term 71
2 results of peripheral hypersensitivity/plastic changes:
Term 72
Definition 72
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Learned pain Phantom Limb Pain is what type of pain? What is the best type of anesthesia to reduce the occurence of phantom limb pain? General Anesthesia + Supplemental Spinal Block (to shut down spinal transmission for prevention of plastic changes).
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Term 73
Definition 73
Increased input from primary afferent nocioceptors trigger the following cellular changes (3)
1. Increased dendritic arborization 2. Increased sprouting of dendritic spines 3. Increased numbers of synapses
Term 74
Definition 74
CNS hypersensitivity of pain 1. pain modulation centers that have the ability to inhibit or excite dorsal horn pain projection neurons. 2. receives descending info from hypothal and cerebral cortices and sends excitatory input to RVM. 3. processes all sensory input (except olfaction) and relays to conscious level.
Term 75
1. Rostral Ventral Medulla (RVM) - pain modulation centers that have the ability to inhibit or excite dorsal horn pain projection neurons. 2. Periaqueductal Grey (PAG) receives descending info from hypothal and cerebral cortices and sends excitatory input to RVM. 3. Thalamus - processes all sensory input (except olfaction) and relays to conscious level.
Definition 75
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Term 75
Definition 75
Hypothalamus Frontal and Prefrontal cortices Insular cortex Limbic lobe Amygdala
Hypothalamus Frontal and Prefrontal cortices Insular cortex Limbic lobe Amygdala
.....are all structures sensitized by .....are all structures sensitized by increased nocioceptive input & all increased nocioceptive input & all project to the_____, which sends project to the periaqueductial grey excitatory input to the ________, which (PAG), which sends excitatory input to can either inhibit (during acute pain) or the Rostral ventral medulla (RVM), excite (during chronic pain) the dorsal which can either inhibit or excite the horn pain projection neurons. dorsal horn pain projection neurons.
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Term 76
Definition 76
This structure is sensitized by increased nociceptive input and involves emotion. This lays within the above structure and is involved in extreme/emphatic emotion. (These two structures influence why people with pain are in severe emotional distress.)
Term 77
Limbic Lobe - This structure is sensitized by increased nociceptive input and involves emotion. Amygdala - This lays within the above structure and is involved in extreme/emphatic emotion.
Definition 77
There is no need for an external Why are there no 1st order neurons in nociceptive stimulus b/c the pain pain learned chronic pain? pathway is so strong it functions on its (These two structures influence why own. people with pain are in severe emotional distress.)
Term 78
Definition 78
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Prevention Stop the source of the pain, which prevents plastic changes. What is the best way to prevent learned pain? Treatment of Learned Pain? (2) Treatment NSAIDS Dorsal Column stimulation (dorsal horn multimodal neurons can transmit pain or proprioception - treadmill training swtiches them back to proprioception)
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Term 79
Definition 79
Pain transmission is decreased with increased propriospinal input. Why? Dorsal horn multimodal neurons can transmit pain or proprioception. Chronic pain results in plastic changes of the conversion of the multimodal neurons to pain receptors. Treadmill training swtiches them back to proprioception.
Definition 80
Pain transmission is decreased with increased ________ input. Why?
Term 80
What % of all neuro deficits are attributed to vascular problems?
50%
Term 81
Definition 81
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Term 81
Definition 81
Middle Meningeal Artery - major arterial supply to the dura matter what is the major arterial supply to the dura matter? What is the pathology when it ruptures? Pathology: Epidural Hematoma has classic bulging inward shape.
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Term 82
Definition 82
Cerebral Bridging Veins - large veins that drain into the venous sinuses What are the large veins on the cerebral cortex that drain into the venous sinuses? What happens when they rupture?
Term 83
Definition 83
A rupture of superficial branches of the anterior, middle, and posterior cerebral arteries causes a subarachnoid hematoma. A rupture of superficial branches of the anterior, middle, and posterior cerebral arteries causes what?
Term 84
Definition 84
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Term 84
Definition 84
Internal Carotid System Vertebrobasilar System
The circle of willis is formed by what 2 arterial systems, known as the "dual system"?
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Term 85
Definition 85
Internal carotid artery branches: Internal Carotid System - Major Branches (4) 1. retina 2. optic tract, lateral geniculate nucleus, posterior limb internal capsule (do you remember what this contains??) 3. medial surface of cerebral cortex 4. lateral surface of cerebral cortex 1. Opthalmic artery: retina 2. Anterior choroidal artery: optic tract, lateral geniculate nucleus, posterior limb internal capsule (post limb contains neurons of the epicritic dorsal column pathway and protopathic spinothalamic pathway sensory pathways!) 3. Anterior Cerebral artery: medial surface of Definition cerebral 86 cortex Anterior Cerebral Artery Syndrome 4. Middle Cerebral artery: lateral 1. surface Contralateral hemiplegia of cerebral cortexor hemiparesis of the lower extremity
Term 86
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Anterior Cerebral Artery Syndrome results in what neuro deficits.
2. Contralateral epicritic and protopathic sensory deficits from the lower extremity
Term 87
Definition 87
Middle Cerebral Artery Branches (2): 1. supplies basal ganglia, internal capsule, optic radiations 2. supplies frontal, parietal, temporal lobes.
Middle Cerebral Artery Branches 1. Lenticulostriate Arteries: basal ganglia (bradykinesia, chorea), internal capsule, optic radiations
REMEMBER: Anterior cerebral artery supplies the medial surface of the cerebral cortex as shown below:
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Term 88
Definition 88
Middle Cerebral Artery Syndrome 1, 2, 3) Describe the 3 neuro deficits, not specific to the the R or L hemisphere. 4) Neuro deficit specific to the L cerebral hemisphere 5) Neuro deficit specific to the R cerebral hemisphere.
Term 89
Middle Cerebral Artery Syndrome 1. Contralateral hemiplegia or hemiparesis 2. Contralateral epicritic and protopathic sensory deficits (lenticulostriate a. branch supplies internal capsule) 3. Homonymous hemianopsia(L or R) (lenticulostriate a. branch supplies optic radiations)
Definition 89
Vertibrobasilar System 1. vertebral artery system branches (3) 2. basilar artery branches (4)
Vertibrobasilar System 1. vertebral artery system branches: -Anterior spinal artery -2 Posterior spinal arteries -Posterior inferior cerebellar artery
This is an example of L. Homonymous Hemianopsia
4. Aphasia: Left cerebral hemisphere

Term 90
5. Spatial perception Definition disorders: 90 Right 1. Bilateral sensory and motor signs
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1. Bilateral sensory and motor signs 2. Inferior alternating hemiplegia (medulla) Vertebrobasilar Artery Syndromes (5)
--contralateral hemiplegia of arm & leg (pyramidcorticospinal fibers) --contralateral loss position sense, vibration, discrim. touch (medial lemniscus) --deviation of tongue to ipsilateral side when protruded; muscle atrophy (CN XII hypoglossal nerve in medulla or CN XII nucleus)
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Term 91
Definition 91
Circle of Willis 1. formed by what arteries 2. completely formed in what % of population.
1. Anterior Cerebral Arteries (2), anterior communicating artery, internal carotid arteries (2), posterior communicating arteries (2), posterior cerebral arteries (2) 2. Completely formed in 20% of population
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#of spinal nerves

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Sensory Vocab: 1. loss of all sensation 2. without pain.

1. loss of all sensation. anesthesia 2. without pain. analgesia

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Sensory neurons 1. of which root, what type of neuron.

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1. of which root, what type of neuron. 2. innervate what 2 structures

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Sensory signals from the lower extremity terminate where?

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Fasciculus Gracilis & Fasciculus Cuneatus

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The site of the lesion.

What is special about C1 nerves?

C1 is only a motor nerve, there is no dermatome.

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Where is the level of consciousness of pain and temperature protopathic modalities?

Thalamus (vs. cortex for epicritic pathways)

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Oh Oh, To Touch And

Oh Oh, To Touch And Feel A Girl's Vagina, Ah Heaven

Review the cranial nerves. Which are purely sensory?

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3 parts involved in DTR

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Poliomyelitis is a disease of....

5 areas of basal ganglia Don't Memorize, this is FYI