ODK #3- Neuro

What type of sensation receptors were tested on the NIHSS? (Nocireceptors)
List 3 things that mechanoreceptors sense? (Touch, pressure, vibration, proprioception)
Which sensation receptor senses temperature? (Thermoreceptors)
Which sensation receptor senses pain? (Nociceptors)
What is your awareness of where your limbs are in space? (Proprioception)
Process that conveys information regarding the body and its interaction with the environment to the brain? (Somatosensation)
Somatosensory system includes receptors in the skin, muscles, joints and blood vessels which send neural signals to the ______ lobe via the spinal nerves/spinal cord and cranial nerves/brain stem. (Parietal)
The somatosensory system can be organized by: (types of sensation, types of specialized receptors, 3 neuron organization, innervation patterns)
Mechanical displacement of nerve ending? (Mechanoreceptors)
The specialized receptors are organized by: (Sensitivity (responsiveness) & adaptability to stimuli)
Reduction of response to sustained stimuli: (Adaptiveness)
Describe adapting. (responds/adapts quickly then the response quickly becomes weaker)
Describe non-adapting: (responds slow, doesn’t adapt (response remains steady)
Encapsulated Endings (Tactile)
Where are encapsulated endings located? (Subcutaneous tissues, skin, fingertips, palms, lips, external genitalia)
Are encapsulated endings adapting or non-adapting? Adapting
What are two types of encapsulated endings & what do they respond to? a. Pacinian corpuscles: deep pressure touch, high frequency vibrationb. Meissner’s corpuscles: light touch (on fingertips, palms, soles, face, lips, tongue)
Free Nerve Endings (sense pain, temperature, some tactile)
Where are free nerve endings located? (Throughout body, skin, cutaneous tissue, visceral organs)
Are free nerve endings adapting or non-adapting? (Non-adapting)
Expanded Tip Endings (temp., tactile, pressure)
Where are extended tip endings located? (Dermis, joints)
Are expanded tip endings adapting or non-adapting? (Moderately adapting)
What are two types of expanded tip endings? (Merel receptors and Ruffini endingsTHREE-NEURON ORDERS
What is the 1st order? (Dorsal Root Ganglion (DRG))
What is the 2nd order? (Info enters CNS at spinal cord or brainstem (if cranial nerve) and project to opposite side crossing midline to thalamus)
What is the 3rd order? (Thalamus neurons which project to primary sensory cortex)
What information does the Dorsal Column-Medial Leminscal Tract carry? position, vibration, fine touch
Where does decussation occur? (medulla)
Describe the axons and the myelin sheath in the DCMLT: (Large diameter axons, thick myelin sheath)
Describe the “Cough Hack” (Signal from cough reaches brain faster than pain from shot. Pain is part of the anterolateral pathway which has thinner myelin sheath and doesn't conduct signal as fast. Cough (vibration) gets to brain first bc faster conduction in dorsal pathway.)
Dorsal Column-Medial Lemniscal Tract/System is also called? (Epicritic System)
The Dorsal Column-Medial Lemniscal (aka Epicritic System) carries what information? (fine discriminative touch, vibration, proprioception (limb position), kinesthesia (limb movement), deep pressure)
What is awareness of limb position? (proprioception)
Awareness of limb movement? (kinesthesia)
The Anterolateral Tract/System is also called the? (Protopathic System)
The Anterolateral tract carries what information? (Pain, Temperature, Diffuse/gross touch)
What are 2 tracts within the Anterolateral System? (Lateral spinothalamic tract & Anterior spinothalamic tract)
What is the Dorsal Column-Medial Lemniscal (aka Epicritic System) important for? (Fine discriminative touch, vibration, limb position, kinesthesia & deep pressure)
What is fine touch discrimination? (stereognosis= if you get 2 pricks, you can discriminate that there are 2 points of contact)
What is another name for the Anterolateral system? (aka Protopathic System)
Fine touch discrimination? ID object with eyes closed? (Stereognosis)
Recognizing numbers written on body? (Graphesthesia)
What are 2 other functions important for skilled movement? (Recognizing Two and multiple point touch & Deep touch)
What are the receptors in the Dorsal Column-Medial Lemniscal System? (Meissner’s and Pacinian corpuscles & Muscle Spindle Organs)
Describe Meissner’s and Pacinian corpuscles? (encapsulated end receptors, highly sensitive and adaptable)
Muscle Spindle Organs tell about (kinesthesia and proprioception)
Which 2 fasciculi mediate discriminative touch from different body areas? What are their shapes? What part of the body is mediated? a. Fasciculus Gracilis (slender, graceful) – sacral to midthoracic level (upper body)b. Facsiculus Cuneatus (short wedge-shaped) -above midthoracic level (upper body)
What is fasciculus white matter tracts
Describe the Dorsal Column-Medial Lemniscal System Pathway of Information. a. Peripheral nerves via Spinal Cord b.Brainstem Nuclei c. Thalamus (through Internal Capsule) d.Primary Sensory Cortex (BA 1,2,3) e.Primary Association Cortex (BA 5, 7) – mapped spatially (homunculus)
Why do people with dysarthria have motor and sensory problems? (the primary motor and primary sensory cortex’s are right next to each other.)
If injury is inferior to decussation, where will the deficit be? (the ipsilateral/same side – dorsal-medial)
If injury is superior to decussation, where will the deficit be? (the contralateral/opposite side – antereolateral)
Name two tests to test DCMLS: (2-Point Discrimination, Stereognosis, Graphesthesia, Vibratory, and Romberg Test)
Name the neuron organization system for the Anterolateral System: (Spinal Ganglion, cross to spinal tract, ventral posterolateral n. of thalamus)
If a lesion occurs before the midline cross, what kind of problems will occur in the PNS or spinal cord lesion? (Ipsilateral)
If the lesion occurs in the spinal or brainstem lesion, what kind of problems will occur? (Contralaterally)
What is a body area innervated by the neurons in a single dorsal root ganglion (the dorsal part of the spinal nerve)? Dermatone
How can dermatomes help distinguish between psychiatric and neurological injury? a. Psychiatric conversion disorder: 3 separate dermatomes are affecting hands or feet, so it is psychiatricb. Neurological disorder: certain part of hand/foot hurts where the dermatomes are
Referred pain: (one side has pain but it is felt in another site)
Analgesia: No sensation
Hypalgesia Decreased pain; higher threshold
What is increased pain? (hyperalgesia- lower threshold)
What are the three receptors in the Anterolateral system? (encapsulated endings, free nerve endings, expanded tip endings)
Does interruption to the three receptors in the Anterolateral system cause obvious deficit? No.
What is the system for conscious proprioception? (dorsal column-medial lemniscus system)
What is the pathway for conscious proprioception? (Thalmaus and cerebral cortex, enabling one to describe the position of a limb)
What is the system for unconscious proprioception? (spinocerebellar tract)
What is the pathway for unconscious proprioception? (Cerebellum enables one to walk, articulate, swallow, write without having to think about what muscles/joints to use)
If there is a right side cerebellar problem, where will the problems occur on the body? (right side)
Primary Motor Cortex (M1)–Pre-central gyrus- BA 4 -Important for motor initiation-Contains Betz Cells-large pyramidal cells
Corticospinal Tract (Superior 2/3) voluntary movements of muscles controlled via spinal nerves.
Corticobulbar Tract (Inferior 1/3) Facial and associated muscles- project to cranial nerve nuclei.
Where is the Premotor Cortex? Anterior PMC- BA 6
What does the Premotor Cortex do? Helps to regulate posture by dictating an optimal position to the motor cortex for any given movement.
What is the Supplementary Motor Area? Important for the planning and initiation of complex movements.
What percent of descending motor fibers originate from the PreMC? 30%
What did Penfield Discover? that BA 4 stimulation results in highly localized &discrete movements of the contralateral musculature.
What percent of descending motor fibers originate from the PMC? 30%
The Primary Sensory Cortex consists of: Postcentral gyrus – BA 3, 1, 2Somatosensory association areas – BA 5, 7
What does the Primary Sensory Cortex do? (PSC) Receives somatosensory information and then uses them to determine the positions of the body and the target in space AND Produces internal models of the movement to be made prior to the involvement of the motor and premotor cortices.
What percent of descending fibers originate here? 40%
Upper motor neurons (UMN): Cortical motor neurons before they synapse at the spinal or cranial nervesAKA pyramidal neurons
Lower motor neurons (LMN): Motor neurons in the brainstem and spinal cord that project to the muscles (cranial and spinal nerves)
The 3 major cortical areas for voluntary movement are ____, ____, and ___. (primary motor cortex, premotor cortex, primary sensory cortex)
The corticospinal tract is also referred to as the ____ tract. Pyramidal
The corticobulbar tract is also referred to as the ____ tract. corticonuclear
The motor cortices output information ____, so the left arm is controlled by the right motor cortex. contralaterally
Axons of pyramidal cells are projected onto the spinal motor nuclei to form the ____ tract. (corticospinal)
Axons of pyramidal cells are projected onto the _____ motor nuclei to form the corticobulbar tract. (corticonuclear)
The corticospinal tract is divided into what two parts? Lateral and Anterior
The lateral corticospinal tract controls the _____ while the anterior spinal tract controls the ____. (distal limbs, proximal axial & girdle muscles)
What is spastic hemiplegia? Lesions in corticospinal fibers.
What is paralysis of facial, lingual, palatal and laryngeal muscles? Lesions in corticobulbar fibers.
Decussation happens at the ____ in the CST (caudal end of medulla)
Describe the pathway of the CBT: lower 1/3 of motor cortex through internal capsule, pes pedunculi, crossing midline to lower cranial nerve nuclei
Decussation of CN 3: Midbrain
Decussation of CN 5 & 7: Pons
Decussation of CN 10 & 11: Medulla
The upper face, jaw, and larynx are innervated ___. (bilaterally: ipsilateral and contralateral)
The CBT is more __ while the CST is more ___. (ipsilateral, contralateral)
A patient has an UMN problem. What would be his symptoms? (flaccidity followed by spasticity, increased muscle tone, abnormal Babinski sign, hyperflexia)
UMN affects which tract? Corticospinal and corticobulbar
LMN affects which tract? corticobulbar
A patient has a LMN problem. What would be his symptoms? (flaccidity, decreased muscle tone, muscle atrophy, hyporeflexia, fabrillations)

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