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Thomadaki Neur I ex2

NYCC Exam II - Thomadaki WI10 also see demyelinating disorders slides

QuestionAnswer
the modalities of vibration, discriminatory touch, stereognosis, graphaesthesia, pressure, and proprioception are all qualities of the DEEP SENSIBILITY PATHWAY
graphesthesia ability to recognize letter or number being drawn on skin
stereognosis ability to recognize 3-D object by touch
proprioception is _________ & _________ position and kinesthesia
name 4 modalities (big ones) of deep sensibility pathway vibration, discrimination, pressure, proprioception
V.D. on your PeePee -that's deep, man! Vibration, Discrimination, Proprioreception, Pressure (Deep Sensibility)
how do the modalities for Deep Sensibility ascend to the brain (VD on your PeePee)? through the medial lemniscus/dorsal columns and spinocerebellar tracts
what kind of axons carry Deep Sensiblity (VD on your PP)? large, myelinated alpha and gamma (A's)
the DORSAL COLUMN pathway is also called the MEDIAL LEMNISCUS pathway
another term for medial lemniscus is dorsal columns
why can the medial lemniscus also be called the dorsal columns? Dorsal columns are where information for the medial lemniscus in the medulla and rest of brain come from.
what comprises the dorsal columns Fasiculus Gracilis from T6 down, Fasiculus Cuneatus from T6 up
Where do the dorsal columns end, to synapse with the CNS and go to #2afferent? the Fasiculus Cuneatus ends in the NUCLEUS CUNEATUS and Fasiculus Gracilis ends in the NUCLEUS GRACILIS, both Nuclei beginning at the inferior olivary nucleus level of Medulla
The fasiculus Gracilis is _________ to Fasiculus cuneatus an supplies medial, supplies T6 down with Vibration, Discrimination, Pressure
what DOESN'T fasiculus Gracilis supply for T6 down? proprioception
What does supply the lower half with proprioception instead of fasiculus gracilis? spinocerebellar tract
Fasiculus GRACILIS supplies VDP (no Proprio) to ________ (side) lower extremities IPSIlateral (same side)
Axons of fasiculus GRacilis synapse with what axons in the medulla? NUCLEUS GRACILIS
Does the fasiculus Gracilis carry proprioreception for lower half? NO, that is done by spinocerebellar tract
Fasiculus CUNEATUS is lateral to FG and it's peripheral asonal receptors detect what? VDPP (Vibration, Discrimination, Pressure, Proprioreception)
The Fasiculus Cuneatus detects VDPP for what part of body? T6 and up!
Where do the axons of Fasiculus Cuneatus synapse? at the NUCLEUS CUNEATUS in the medulla at the inferior olivary nucleus level
Does the Fasiculus Cuneatus detect VDPP ipsilaterally or contralaterally? IPsilaterally
Some fibers of the _______ _________ diverge from others and enter the cerebellum through the inferior cerebellar peduncles. Fasiculus Cuneatus
What are the fibers or tract called that diverges from Fasiculus Cuneatus and enters the cerebellum via the inferior cerebellar peduncles? Cuneo-cerebellar tract
the Cuneo-cerebellar tract is responsible for unconscious proprioreception
Why would the cuneo-cerebellar tract be responsible for unconscious propriorecption? because the divergent f. cuneate fibers never reach the conscious cortex of the brain - they subvert it via the inferior cerebellar peduncles and go straight to the cerebellum - ergo, "unconscious proprioception"
Dorsal Column fibers from both Fasiculus Cuneatus (upper) and Fasiculus Gracilis (lower) send collateral fibers into various levels of the dorsal and ventral horns for bilateral reflexes at all levels
In what do the collateral FG and FC bilateral reflexive fibers travel? a thin outline of grey matter in spinal cord called FASICULUS PROPRIUS
fasiculus proprius = bilateral reflexes (collaterals of dorsal columns)
Pathway of Deep Sense for Fasiculus Gracilis DPP only, NO proprioception: 1*primary enters FG dorsal column, ascends to Nucleus Gracilis - 2*secondary crosses medulla at level of inf. olivary nucleus via arcuate fibers - enters medial lemniscus and ascends to thalamus - 3*tertiary to cortex
Alternate name for Dorsal Columns pathway Medial Lemniscus pathway
Path of Fasiculus Cuneatus (VDPP) Cover unconscious propriorecepton on next slide VDPP: 1*primary enters F.Cuneatus dorsal column, ascends to Nucleus Cuneatus @ inf. olivary nucleus level of medulla - synapses 2* and crosses via arcuate fibers to contralateral medial lemniscus, ascends-Thalamus! 3*tertiary to cortex.
Unconscious proprioreception (-P)of upper body (T6 and up): (-P): 1*primary enters fasiculus cuneatus, ascends to inferior cerebellar peduncle - diverges to cerebellum. Called CUNEO-CEREBELLAR tract, unconscious because dodges cortex of brain altogether and goes straight to cerebellum for editing
What pathway is responsible for conscious proprioception of upper body? Fasiculus cuneatus-nucleus cuneatus-medial lemniscus-thalamus-cortex
What is responsible for proprioreception from lower body, since fasiculus gracilis is NOT? DORSAL and VENTRAL SPINO-CEREBELLAR TRACTs
Dorsal Spino-cerebellar tract is via primary afferent fribers entering cord from lumbar and sacral dorsal roots at fasiculus gracilis
Only some of the fibers for the dorsal spino-cerebellar tract go up to synapse on 2*secondary afferents in #4 I am the Dor, I can feel Clarke's feet on the floor - NUCLEUS DORSALIS where they move to white matter on ipsilateral side and ascend to the medulla via Dorsal SpinoCerebellar Tract.
What happens to the ascending ipsilateral Dorsal Spinocerebellar tract after 2* get to medulla? Before they enter the inferior cerebellar peduncle, some give off collateral branches that remain in medulla. Collaterals are CONSCIOUS(+P)and they synapse in NUCLEUS Z, while others go to cerebellum (-P). Nucleus Z 2* cross Medial Lemniscus to Thalamus!
Conscious +P 1*,2*,3*,opens the Dor, then synapses at Nucleus Z! And crosses Lem Mediall-y, to climb the meniscus through the medulla, pons, and midbrain, see?
Negative -P diverts from Fasiculus G, "FG is For-Get about it" and becomes the Spino-Cerebellar, Laterally!
Conscious +P 1*,2*,3* opens the Dor, then synapses at Nucleus Z! And crosses Medially, to climb the meniscus through theMedulla, Pons, and Midbrain to Thalamus. See?
NEgative -P, Diverts from Fasiculus G, and becomes the Spino-Cerebellar, Laterally! Conscious +P synapses in Nucleus Z, and crosses Medially, climbs the meniscus up the medulla, pons and midbrain to thalamus, see?
What does "Conscious +P 1*,2*,3*" mean? there are 3 afferents in the pathway for conscious proprioreception from the lower body/fasiculus gracilis: 1*=F.Gracilis, 2*=Nucleus Dorsalis/Clarke's Column, 3*=Nucleus Z to medial lemniscus to thalamus
What tract carries Proprioception from LOWER extremities, since fasiculus gracilis does not? SPINO-CEREBELLAR tracts to IPSIlateral cerebellum
I am the Dor, #4, I can feel Clarke's feet on the floor Nucleus Dorsalis
the _______ ________ gives rise to the DORSAL spinocerebellar tract nucleus dorsalis
from where do the spinocerebellar tract's nucleus dorsalis run and on which side? ascends to the medulla, ipsilateral/uncrossed
FG-ND-NZ or ICP- if ICP, then Cerebellum and unconscious proprioception (dorsal spino-cerebellar tract) Fasiculus Gracilis-Nucleus Dorsalis-Nucleus Z or Inferior Cerebellar Peduncle - ICP to cerebellum for unconscious proprioception from lower limb
Unconscious proprioception = cuneo-cerebellar tract of F. Cuneatus diverting at Inferior cerebellar peduncles & dorsal spino-cerebellar tract from F. Gracilis
heavily myelinated means: (modality) deep sensibility
light or none at all myelin means: (modality) pain & temperature, itch
what fibers represent mostly deep sensibilty A-alpha & A-beta
what fibers represent heavily myelinated deep sensibility A-alpha & A-beta
what fibers represent mostly pain & temp, + itch A-delta & C fibers
where to A-alpha and A-beta fibers enter the spinal cord? dorsal columns/dorsal funiculus for deep sensibility
where do A-delta and C fibers enter the spinal cord? DLF (dorsolateral funiculus - our "Dear Little Friend")
Deep sensibility receptors are ___________ and react to? encapsulated, VDPP (vibration, discriminative touch, pressure, proprioception)
Pain & temperature + itch fibers are "________" (ie, there is no such thing as a pain receptor). They respond to? naked, Pain/temperature/Itch/tickle
what is another term for "naked" pain&temp fibers? free nerve ending
Pain & temperature is: free nerve endings using A-delta and C fibers
temperature perceptions become itch
Cold receptors thermoreceptors
Heat receptors Nociceptors
Mechanical receptors mechanoreceptors
Named receptors of CUTANEOUS & SUBCUTANEOUS MECHNORECPTORS for deep sensibility: (5) Meissener's, Merkel disc, Pacinian, Ruffinian, Hair-tylotrich (hair guard)
Named receptors of MUSCLE & SKELETAL MECHANORECEPTORS for deep sensibility: (4) muscle-spindle fibers, Golgi tendon organs, stretch receptors, joint receptors
Free nerve ending receptors for pain and temperature: (2) thermoreceptors (cold), nociceptors (hot)
FAST-ADAPTING RECEPTORS are good at telling you when things change! (constant change/on-off)
SLOW-ADAPTING FIBERS are good at maintaining information throughout (steady feedback)
Spinal cord ends at the bottom of L1 (becomes cauda equina)
what kind of receptors are good at telling you when things change? fast-adapting receptors
what kind of fibers are good at maintaining information throughout (steady feedback)? slow-adapting fibers
what is the most commonly "busted up" disc you will see as a chiro? L5-S1
the dorsal columns (fasiculus gracilis and fasiculus cuneatus) are also called the medial lemniscus pathway
What pathways provide deep sensibility? Medial lemniscus system, spinocerebellar tracts (dorsal and ventral)
modalities of deep sensibilities Vibration, Discriminatory touch, Pressure, Proprioception
Discriminatory touch includes (2) stereognosis, graphesthesia
Proprioreception includes kinesthesia and position sense
stereognosis "3D Knowledge" ability to recognize difference between three-dimensional objects in your hand by shape (ie, difference between a quarter and a penny)
graphesthesia ability to identify things written on your skin
discriminative touch is also called (2) fine point discrimination, 2-point discrimination
position sense static proprioreception
kinesthesia dynamic (moving) proprioreception
kinesthesia and position sense are both (modality) conscious proprioreception
fast-adapting receptors tell you constant change (on-off)
slow-adapting receptors maintain steady
cerebellar is ___________proprioception unconscious
deep sensibility is ___________ proprioreception conscious
conscious proprioception is deep sensibility
unconscious proprioreception is cerebellar
unconscious proprioreception from upper extremities goes into _________ through the inferior cerebellar peduncle and becomes the ________________ tract for unconscious proprioreception from upper body cerebellum, cuneocerebellar tract
what kind of proprioception from upper extremities goes into cerebellum? unconscious
How does unconscious proprioception from the upper extremities reach the cerebellum from the spine? (structure) inferior cerebellar peduncle
tract for unconscious proprioreception from upper body Cuneocerebellar ("cuneatus" + "cerebellar")
what modality is not transmitted by fasiculus gracilis for the lower extremities? proprioreception (conscious and unconscious)
the cuneo-cerebellar tract is an offshoot to the cerebellum from __________ at the level of ____________. It is ipsilateral. fasiculus cuneatus, inferior cerebellar peduncle (before pyramidal decussation)
what does transmit conscious AND unconscious proprioreception from the lower extremity? Dorsal spinocerebellar tract (ventral is only unconscious)
Unconscious and conscious proprioreception from lower body: (describe pathway) 1* (primary afferent) through dorsal column, synapse Clarke's column (Nucleus Dorsalis), 2* to dorsal spinocerebellar ipsilateral, some to cerebellum (unconscious) on same side, some to synapse Nucleus Z, 3* (tertiary) to thalamus for conscious proprio.
#4, I am the Dor, I can feel Clarke's feet on the floor Nucleus Dorsalis (conscious and unconscious proprio for lower extremities)
what does nucleus dorsalis contain, in relationship to dorsal spinocerebellar tract? cell bodies for secondary afferent of conscious/unconscious proprioreception
cerebellar fibers are always ipsilateral and unconscious
where is nucleus Z? have to look it up for a picture (coming soon)
how does unconscious proprioreception travel from the lower extremities? Ventral spinocerebellar tract
where does proprioreception from the ventral spinocerebellar tract go (structure)? to the cerebellum because it is unconscious proprioreception
Describe the ventral spinocerebellar tract pathway 1* primary enters dorsal columns, synapses in Nucleus Proprius with cell bodies, 2* secondary afferent crosses VWC to dorsal spinocerebellar, ascends, crosses again at Decussation of Superior Cerebellar Peduncles, enters cerebellum
What's the trick to the ventral spinocerebellar tract? the 2* afferent, after crossing from side of detection, ascends and crosses back to the side of detection, entering the cerebellum on the same side of the body which initially registered the proprioreception.
Lesioning the ventral spinocerebellar tract in the spine, before it reaches the cerebellum, results in a(n) ________lesion contralateral
Lesioning the dorsal spinocerebellar tract, before it reaches the cerebellum, results in a(n) __________ lesion ipsilateral
lesioning the left cerebellum will cause a loss of unconscious proprioreception from the ___________ side. same side (ipsilateral)
Dorsal spinocerebellar tract travels in the _________ cerebellar peduncles, while Ventral spinocerebellar tract fibers travel in the __________ cerebellar peduncles. dorsal=inferior, ventral=superior
ventral spinocerebellar tract fibers cross at the _________________before entering the cerebellum, so they must enter the __________ cerebellar peduncles to do so. Decussation of the superior cerebellar peduncles, superior
the _______ spinocerebellar tract provides a secondary axon to the cerebellum via the superior cerebellar peduncles on the contralateral side for unconscious proprioreception from the ________. Ventral, legs (Hey baby, do those legs go all the way up? Yes, to the Superior Cerebellar Peduncles after the SCP Decussation)
the nucleus __________of the grey matter determines what is 'appropriate' proprius
in order for a sensation to become "conscious," it must reach the Thalamus
The _________sends information to appropriate level of cortex. thalamus
the thalamus sends information to the appropriate level of cortex for all incoming sensations except olfactory
the ______ tells you Quality (what) and Localization (where sensation is coming from) cortex
In the Dorsal Spinocerebellar pathway, which afferent synapses at cerebellum for unconscious proprioreceptin from the lower extremities? Second (2*) afferent in pathway
In the contralateral Medial Lemniscus pathway, Nucleus Gracilis & Cuneatus are what degree afferent? second (2*) afferent in pathway
In the Dorsal Spinocerebellar pathway, Nucleus Z is what degree afferent? third (3*) afferent in pathway
Name the nuclei which extend arcuate fibers across the Great Sensory Decussation to form the Medial Lemniscus pathway for deep sensibility and for Dorsal Spinocerebellar tract for conscious propiroreception 1- Nucleus Gracilis and Nucleus Cuneatus, 2- Nucleus Z
To what structure do the fibers from the great Sensory decussation go, having crossed as arcuates from nuclei gracilis, cuneatus, and Z for deep sensibility/medial lemniscus pathway? Thalamus
what is the last stop before the thalamus for fibers in the Dorsal Spinocerebellar tract for conscious proprioreception after the secondary afferents that did not go to cerebelum but will continue to synapse at third afferent? Nucleus Z (then on to thalamus as 3* afferents)
somatotopic organization of Medial Lemniscus starts as dorsal ventral Cervical to Sacral and switches longwise medial to lateral Cervical to Sacral in pons/midbrain area
where does the Medial Lemniscus pathway end thalamus
clinical term for thalamus diecephalon
where do fibers go from thalamus after medial lemniscus ends? Sensory cortex of brain
What tract for Pain & Temperature? Spinothalamic tracts
receptors that respond to noxious stimuli nociceptors
what do nociceptors respond to (kind of pain) noxious stimuli from injury to skin or soft tissue
Nociceptor activation will usually cause pain
what responds to pain, temperature, itch, tickle - especially all of these in relevance to skin injury? Free nerve endings
what is another name for the free nerve endings that respond to pain, especially skin/soft tissue level pain? Nociceptors
pain resulting from nociceptor activation due to tissue injury and resultant inflammation Nociceptive pain
pain resulting from direct insult to the nerve (ie, ulnar nerve "funny bone" pain) Neuropathic pain
Nociceptive vs Neuropathic pain from nociceptor activation (soft tissue injury) vs. pain from direct insult to nerve (ie, ulnar nerve in medial elbow)
Pain is subjective
what makes pain different from any other sensation? it is subjective, and sometimes we feel pain without nociceptor activation
why are there 2 qualities (sensations) of pain? ie, fast sharp vs. slow dull because there are 2 sets of fibers carrying pain (one is fast, one is slow)
what kind of pain is transmitted to the spinal cord by myelinated A-delta fibers that carry thermal and noxious stimuli? Fast, sharp pricking pain
what kind of pain is transmitted to the spinal cord by unmyelinated C fibers that carry high intensity thermal, chemical, and mechanical noxious stimuli (sickening waves of pain)? Slow, dull pain (siCkening waves)
fast fibers A-delta, fast sharp pricking pain
slow fibers C fibers, slow dull siCkening
which fibers are myelinated, A-delta or C fibers? A-delta (fast, sharp pricking)
which fibers respond more preferentially to chemical burns, A-delta's or C fibers? C-fibers (slow, dull siCkening)
pain from the viscera works backwards through the _____________ sympathetic system
on a graph, which fiber type shows more of a bell curve? C fibers (slow, dull siCkening)
Visceral pain is not localized, but because it works the same way somatic pain does (body pain), it has well-documented ___________ patterns. referral patterns
Trick with spinothalamic/pain & temp getting into cord is that it enters 2 levels up to DLF
Pain sensation begins @ mixed spinal nerve at nociceptor, then through ventral ramus to dorsal root (except from back which is dorsal ramus), then goes 2 doors up to DLF, then what? to substantia gelatinosa, to Nucleus Proprius, crosses VWC to enter Lateral Spinothalamic Tract and ascend to thalamus.
Which ramus includes the hypaxial muscles of front, upper and lower muscles and skin? Ventral
Why can't we pinpoint visceral pain, since it refers in known patterns? the brain is not used to getting information (pain sensations) from viscera (due to edema, swelling), for instance the heart, so the brain thinks, "It must be coming from the heart."
What behaviour is unique to pain sensations? Primary Hyperalgesia
Primary Hyperalgesia Injury means inflammation response. Due to release of chem messengers, the activation threshold of peripheral nerve endings (nociceptors) is lowered, creating HYPERSENSITIVITY around inflammed areas.
__________ _____________is when the pain threshold of free nerve endings around an injury is lowered, due to the chemicals released to lower the activation threshold for a pain message to be sent. Primary Hyperalgesia
Primary Hyperalgesia refers to sensitization of surrounding nociceptors _________injury or inflammation. (before or after?) after, gotta give those chemicals time to set the activation threshold lower
examples of chemical messengers released around injured area that cause primary hyperalgesia (hypersensitivity around injury): bradykinins, prostaglandins, substance P, CGRP -- all decrease nociceptor activation threshold
CGRaP! that hurts like hell and raises bp's! CGRP, bradykinin, prostaglandin, substance P
Most NSAID's block__________ by diminishing inflammation at the site of injury prostaglandins
A lowered threshold for pain (primary hyperalgesia) means a lowered activation energy required, due to CGRaP & bps
Primary Hyperalgesia is an ___________stage of pain lowered threshold/lowered activation threshold. acute
Central Hyperalgesia is a _________state of lowered pain threshold/lowered activation threshold. chronic
Pain that is chronic is referred to as CENTRAL HYPERALGESIA
Sensitization of dorsal horn cells after injury. Central hyperalgesia
Central hyperalgesia results when dorsal horn cells are sensitized chronically after injury. What chemical upset causes this to happen (vs. primary hyperalgesia) persistent activation of NMDA receptors by the glutamate-releasing C fibers (siCkening).
If you persistently activate NMDA receptors via glutamate-releasing C fibers, what are you doing? setting up a long term decrease in pain threshold of the patient
The pain threshold decrease called central hyperalgesia results from so much glutamate being dumped into the Nucleus Proprius of the dorsal horn by the C fibers that the NMDA receptors never shut off. One long, continuous pain message gets sent to the brain.
Are all injuries predisposed to central hyperalgesia? yes, you must break pain cycle with RICE or whatever protocol you adhere to for inflammation relief
The central axons of the _______ & _______ fibers generally ascend 2 segments in the dorsolateral fasiculus of Lissauer (DLF) before they synapse in the dorsal horn. A-delta & C fibers
The primary A-delta and C fiber afferents synapse with (3) parts of dorsal horn: pericornual cells, substantia gelatinosa, nucleus proprius
Most of the synapses of A-delta and C fibers in the DLF to Nucleus Proprius primary pathway involve _________ in the secondary pathway that control pain perception. Interneurons
The axons of the Nucleus Proprius are going to cross the midline (VWC) and form the _____________________ which ascends to the thalamus in the anterolateral system. Lateral spinothalamic tract (for pain & temp)
the Lateral & Ventral Spinothalamic tracts are collectively called the Anterolateral system
In its course to the thalamus, the Lateral spinothalamic tract sends ______ to the reticular formation, the periaqueductal grey (PAG), nucleus gracilis and cuneatus, and the hypothalamus. collaterals from the Lateral Spinothalamic tract
Reticular Formation function consciousness, awake, alert! injured causes coma.
Periaqueductal Grey (PAG) function the gray matter located around the cerebral aqueduct within the tegmentum of the midbrain. It plays a role in the descending modulation of pain and in defensive behaviour. (Wiki)
The enkephalins & dynorphins are released by inibitory interneurons in the dorsal horn and these endogenous opiod NT's bind to ____ receptors on A-delta and C fibers coming in with pain sensation from peripheral nociceptors (2 doors down). (wiki) Mu
where are Mu opiod receptors found?(wiki) on the A-delta and C fibers synapsing on interneurons in the substantia gelatinosa (dorsal horn pain editor)
The activation of the mu-opioid receptor inhibits the release of __________from these incoming first-order neurons (A-delta and C fibers/nociception from peripheral free nerve endings). (wiki) Substance P
Mu-opiod receptor activation inhibits the activation of the ___________ neuron that is responsible for transmitting the pain signal up the spinothalamic tract to the ventroposteriolateral nucleus (VPL) of the thalamus. (wiki) second-order
Mu-opioid receptors inhibit the activation of the second-order neuron that is responsible for transmitting the pain signal up the ___________tract to the ventroposteriolateral nucleus (VPL) of the thalamus. (wiki) spinothalamic
Mu-opioid receptors inhibit the activation of the second-order neuron that is responsible for transmitting the pain signal up the spinothalamic tract to the ventroposteriolateral nucleus (VPL) of the thalamus by inhibiting ___________(wiki) Substance P.
The _________ signal is inhibited (by mu-opiod receptors) before it was able to reach the cortical areas that interpret the signal as "pain" (such as the anterior cingulate). (wiki) nociceptive (all cascading effects of PAG stimulation)
Hypothalamus function autonomic control of pain
5 areas that the Lateral Spinothalamic tract sends collaterals to, on its way to thalamus: RF, PAG, Nucleus Cuneatus, Nucleus Gracilis, Hypothalamus
After the Lateral spinothalamic tract fibers synapse in the thalamus, those fibers ascend to the sensory cortex
Two levels of INTERNAL control of Pain: 1-control in the spinal cord (Gate Theory)2-control in the brain (Endogenous Morphines/Opiates)
Gate Control theory of pain is based on using A-beta fibers (mechanoreceptors and proprioreceptors) to overwhelm A-delta and C fiber signals distracts the brain from pain
The observation that mechanical (non-nociceptive) and proprioreceptive stimulation diminishes the perception of pain the Gate Control theory (spinal cord pain management)
The lateral spinothalamic tract (pain) sends collaterals to LR, PAG, Nuclei Cuneatus & Gracilis, and Hypothalamus. The A-beta mechanoreceptors also send collaterals to the __________ _____________ of the dorsal horn. substantia gelatinosa
The Lateral Spinothalamic tract begins when A-delta and C fibers synapse 2 doors up in the DLF and into the Nucleus Proprius via pericornual and sub. gelatinosa. What other system sends collaterals to the sub. gelatinosa? A-beta mechanoreceptors
The substantia gelatinosa edits pain. It has _________ that control this pain perception. Interneurons
Which is fastest: A-beta, A-delta, C-fibers A-beta mechanoreceptors are faster than the other two
What gives off collaterals to the substantia gelatinosa, besides the Lateral Spinothalamic tract? A-beta mechanoreceptors
The substantia gelatinosa, with its inhibitory neurons, inhibits the ____________________. Nucleus Proprius (the last stop before synapsing, crossing VWC, and ascending via L.spinothalamic to thalamus for pain signal to reach brain)
_________ mechanoreceptors, when stimulated, are faster than _________ & C fibers, so their collaterals reach the substantia gelatinosa first. What is the outcome? A-beta faster than A-delta and C fibers so reach substantia gelatinosa, inhibit pain message to Nucleus Proprius, diminishing signal by overwhelming the A-delta and C fiber's inhibition of substantia gelatinosa in pain pathway.
A-delta and C fibers (nociceptors) usually __________ the substantia gelatinosa, in order to transmit signal to Nucleus Proprius then cross VWC, then up Lateral spinothalamic tract to deliver pain message. inhibit
when A-beta mechanoreceptors overwhelm the A-delta and C fiber signal, substantia gelatinosa is _________ and blocks message to Nucleus proprius - stops pain. excited (ergo, it goes to work and it "edits" pain message)
Mechanoreceptors turn pain _______ off.
Nociceptors turn pain _______ on. (noxious reception)
What man-made mechanical stimulator is based on the modulation of pain via mechanoreceptor stimulation? TENS unit (transcutaneous electrical nerve stimulation) controls relative excitation of both pathways
stimulation of the Periaqueductal Grey (PAG) excites the _____ system of pain control in the _____. Opiate, brain
Stimulation of the ___________________ results in profound and specific analgesia and blocks withdraw reflexes in response to painful stimuli. Periaqueductal Grey
analgesia subject can feel touch and vibration but not pain
In analgesia, the subject can feel _____ & _________ but not _____. touch and vibration (yes), pain (no)
stimulation of the PAG induces profound analgesia and blocks ? withdraw reflex in response to painful stimuli
What two structures does the PAG excite and what NT's do they release in response to pain? Raphe Nuclei = serotonin, Locus Coeruleus = NE
Both Nuclei of the Raphe N. and Locus Coeruleus send fibers that travel in the __________________ to inhibit output of the pericornual cells and the nucleus proprius (pain). DLF (Dorsolateral Fasiculus of Lissauer)
Fibers sent by Raphe Nuclei (5-HT) and Locus Coeruleus (NE) go to the DLF to interfere with output signals of the (2): pericornual cells and nucleus proprius
the descending pathways to the DLF from Raphe Nuclei (5-HT) and Locus Coeuruleus (NE) seem to ultimately interfere with ___________________of the primary pain afferents (signals to brain). GLUTAMATE secretion (remember: central hyperalgesia is persistent activation of NMDA receptors by glutamate-releasing C-fibers). Glutamate bad!!!
Like electrical stimulation, ______administration in the PAG results in anesthesia. opiod
The use of __________&___________as effective pain relievers pointed to the idscovery of endogenous morphine receptors and opiods (Candace Pert, PhD) morphine and codeine
3 endogenous opiod neuropeptides released in various areas of the nervous system: Enkephalins, Beta-endorphin, Dynorphin
3 kinds of opiate RECEPTORS in nervous system: Mu, Beta, and K opiod receptors
Result of having Mu, Beta, and K opiod receptors in varying parts of the nervous system? different symptoms of opiate use unrelated to pain mgmt. occur (side effects like constipation, inability to urinate, etc.)
where are the Raphe nuclei located? Midbrain
The symptomology of losing proprioreception, deep sensibility ipsilaterally (dorsal columns) and losing pain & temp contralaterally (medial lemniscus) only happens when there is a spinal cord injury
If both deep sensibility and pain & temp are absent contralaterally, it must be a lesion above the Great Sensory Decussation
_______________ carry 2ยบ afferent axons for pain and temperature from the contralateral half of the body to the thalamus Spinothalamic Tracts
see slides for pathway review see slides for path review (3)
where is the decussation for the trigeminal nuclei? Trigeminal Lemniscus!
Lesion of Nucleus of Spinal Tract of Trigeminal CN V loss of Pain & Temp from ipsilateral face
Is Nucleus of Spinal tract of V sensory or motor? sensory only - for pain and touch from face (NST for P&T face)
Why is lesion to Nucleus of Spinal Tract of Trigeminal V ipsilateral result? Has not crossed trigeminal lemniscus yet
Lesion of Chief Sensory Nucleus of Trigeminal V? loss of Touch from ipsilateral face (Chief Touch of the 5 Trigeminal Tribes)
Why is a lesion to Chief Touch of the 5 Trigeminal Tribes ipsilateral loss of touch from face, instead of contralateral? Has not crossed over to trigeminal lemniscus
Lesion of MESencephalic nucleus of Trigeminal V loss of proprioreception from ipsilateral face
Loss of motor nucleus of Trigeminal V loss of muscles of mastication, paralysis with jaw deviation to weak side (side of lesion)
Nucleus of Spinal Tract of Trigeminal is pain & temp ipsi face
Chief Sensory Nucleus of Trigeminal is touch ipsi face
Mesecephalic Nucleus of Trigeminal is proprioreception ipsi face
Motor nucleus of Trigeminal is mastication ipsi mandibular/face
Trigeminal Lemniscus lesion BELOW midpons contralateral loss of Pain & Temp (Nucleus of Spinal Tract of Trigeminal is the ONLY one decussating from below midpons)
Trigeminal Lemniscus lesion ABOVE midpons contralateral loss of everything: deep sensibility (mesencephalic nucleus), touch (chief sensory), and pain&temp (nucleus of spinal tract)
Lesion of CN V Trigeminal @ midpons Ipsilateral Anesthesia, flaccid (LMN because it's a nerve) paralysis to muscles of mastication with deviation of jaw to weak/lesioned side - tic douloureaux, trigeminal neuralgia
3 divisions of Trigeminal Nerve V V1-ophthalmic, V2-maxillary, V3-mandibular
V1 Ophthalmic division of trigeminal sensory to head
V2 Maxillary division of trigeminal sensory to maxilla, nose
V3 Mandibular division of trigeminal Motor to muscles of mastication, Sensory to posterior 1/3 of tongue
the _______is the first part of registered "consciousness" thalamus
why is the thalamus considered the first part of consciousness (what does it do?) sensation reception/relay
The thalamus disperses _________ to the correct cortex of the brain. sensation
At the thalamus you get the first sign that something has happened - you don't "Feel" until you get to the brain
Thalamic sensation/detection can be perverted, as in the case of phantom limb syndrome, because the cortex still has the representation
embryological structure that gives rise to all things named "thalamus" diecephalon
there are entranceways to the diecephalon from the lateral ventricles
connection between the two hemispheres corpus callosum, a cerebral structure.
The thalamus is a collection of __________that performs many functions. nuclei
The thalamus lies on the floor of the 3rd ventricle
The thalamus forms the _________ & _________walls of the 3rd ventricle. superior & lateral
Superior and middle thalamus is covered by ependymal cells
What connects the thalmic nuclei and in what percentage of people does it not exist? Interthalamic adhesion (massa intermedia) absent in 30% of population
the IIIrd ventricle is made by 2 thalami and hypothalamus together
Hydrocephalus is usually due to plug usually of the Foramen of Munro or in the aqueduct that causes CSF accumulation and swellng of brain
the ependymal lining of the 3rd ventricle is reflected fromone side to the other along the _______________________________to form the roof of the 3rd ventricle. striae medullaris thalami
the Striae Medullaris Thalami goes straight to the _______________, so it is an epithalamus structure. habenula
The lateral surface of the thalamus is covered by a thin sheet of fibers called the external medullary lamina
lamina are (white or grey) white matter (myelinated axons)
only sensation that does NOT go to thalamus olfactory/smell
Internally, the thalmus is divided by a vertical sheet of white matter called the internal medullary lamina
If the lateral surface of thalamus is called external medullary lamina and the internal surface is called internal medullary lamina, where do you figure the two meet/end? Lamina terminalis - the anterior boundary of the 3rd ventricle
the thalamus receives all sensation, vision, hearing from body and all motor from _____________ & ______________ and sends it to the cortex. basal ganglia and cerebellum
Along with sensory/motor relay job, the thalamus also is involved in the autonomic maintenance of consciousness
why do smelling salts jolt a person from unconscious to conscious so quickly? fastest way to brain - olfaction doesn't have to navigate thalamus first
3 sensory inputs to thalamus: sensation, vision, hearing
2 motor inputs to thalamus: basal ganglia and cerebellum
1 autonomic input to thalamus: consciousness
What divides the thalamus into 3 big parts? Internal Medullary Lamina (vertical walls of white matter)
top of thalmus (direction) dorsal
bottom of thalamus (direction) ventral
What letter is the internal medullary lamina of the thalamus shaped like? Y
is the pulvinar of thalamus on the anterior or posterior aspect? posterior, over geniculate bodies
With regards to the motor inputs of the thalamus, the cerebellum tell you _____to move, the basal ganglia tells you ______ to move. cerebellum = HOW, basal ganglia = WHEN
There are __ nuclear groups of thalamus. 6
where is the anterior nucleus of thalamus? under the anterior tubercle, on top
the anterior tubercle forms the back wall/posterior boundary for the Interventricular foramen of Munro (leading to 4th ventricle)
what forms the anterior boundary for the interventricular foramen of Munro, considering the anterior tubercle of thalamus forms the posterior border? a Column of Fornix (one on each side diving down to mammillary bodies on each side)
in the "Y" shape of internal medullary lamina of thalamus, where is the anterior nucleus? takes up entire upper part (bowl) of the Y
see thalamus slide did you see the thalamus slide? do you know this stuff already? are you looking at me? are you looking at ME? Hey! Yeah, I'm talking to you...look at the slide.
long term memory potentiation was first discovered in (structure) hippocampus
what does long term memory potentiation let you do? create memories, um...long term? yes, move the magnesium out of the way with bombardment (you remember biopsychology in undergrad)
follow my finger: hippocampus to fornix to column of fornix to mammillary body to mammillothalamic tract in the anterior nucleus of thalamus
It belongs to the limbic system and plays important roles in long-term memory and ______________. Like the cerebral cortex, with which it is closely associated, it is a paired structure, with mirror-image halves in the left and right sides of the brain. Spatial navigation
If you have no LTP (long term memory potentiation) and less than perfect spatial navigation, what structure have you damaged? hippocampus
The hippocampus is part of what system? Limbic
Limbic system is for (the 3 F's: feeding, fighting, *******) DEFENSE, REPRODUCTION, REACTIONS
how does information from the limbic system (3 F's) get to the thalamus? hippocampus to fornix to column of fornix to mammillary body to mammillothalamic tract of Anterior Nucleus of thalamus
Outwardly, to the naked eye, what does the anterior nucleus of thalamus appear to be? Anterior tubercle, making up posterior wall of 3rd ventricle.
why does it make sense for thalamus anterior nucleus to be directly under fornix? because it's forming a loop from the hippocampus through the fornix through the mammillary bodies and back up to the anterior nucleus via mammillothalamic tract
what information does the mammillothalamic tract receive and where is it? limbic system information from the mammillary bodies (got from fornix and hippocampus), anterior nucleus of thalamus
mammillothalamic tract of anterior nucleus of thalamus projects to: (2) cingulate gyrus and frontal cortex
is the limbic system (emotions) specific to the anterior nucleus of thalamus? no
syndrome affecting anterior nucleus of thalamus (limbic from hippocampus - LTP & spatial navigation) Korsakoff's psychosis (syndrome)
primary identifying feature of Korsakoff's confabulation (lying outright because your LTP is shot)
Korsakoff's is the direct result of alcoholism - what defieciency? Thiamine (B)
alcoholism causes lesions around the 3rd ventricle, especially the _________ and _________ thalamic nuclei, the mammillary bodies and the connections between them. medial and anterior
what pathway is distorted if anterior thalamic nuclei and/or mammillary bodies and their connections are lesioned due to alcohol? mammillothalamic pathway for limbic (3F's) information - Korsakoff's results
Korsakoff's is the only ____________ where patients lie/confabulate amnesia
what kind of amnesia is memory loss from now on? anterograde
___________amnesia is the only kind of memory loss people try to make up for by lying. Anterograde
is the limbic system (emotions) specific to the anterior nucleus of thalamus? no
syndrome affecting anterior nucleus of thalamus (limbic from hippocampus - LTP & spatial navigation) Korsakoff's psychosis (syndrome)
primary identifying feature of Korsakoff's confabulation (lying outright because your LTP is shot)
Korsakoff's is the direct result of alcoholism - what defieciency? Thiamine (B)
alcoholism causes lesions around the 3rd ventricle, especially the _________ and _________ thalamic nuclei, the mammillary bodies and the connections between them. medial and anterior
what pathway is distorted if anterior thalamic nuclei and/or mammillary bodies and their connections are lesioned due to alcohol? mammillothalamic pathway for limbic (3F's) information - Korsakoff's results
Korsakoff's is the only ____________ where patients lie/confabulate amnesia
what kind of amnesia is memory loss from now on? anterograde
___________amnesia is the only kind of memory loss people try to make up for by lying. Anterograde
where is the Medial group of Nuclei of thalamus using the Y metaphor of internal medullary laminae? the side of the Y which faces inward to third ventricle (right side of Y for left thalamus, left side of Y for right thalamus)
the anterior nuclei of thalamus project to the cingulate gyrus and frontal cortex (spatial talents and storytelling)
That boy's got a spatial talent for storytelling! I'll bet he's an alcoholic and has Korsakoff's (damage to ant. nuclei of thalamus, mammillary bodies, or medial nuclei) that ruins connect to hippocampus/limbic sys. and causes people to lie to cover anterograde amnesia
what part of your brain gets hooked on instant gratification, avoids pain like the plague, and enjoys cocaine for both of these reasons? amygdala (good ol' dopamine)
what are the other groups, for this lecture, involved in emotional responses to pain? basal ganglia, amygdala, midbrain (remember those Raphe nuclei and Locus Coeruleus 5-HT and NE from PAG excitation), and some spinothalamic fibers
why would the medial group of nuclei function in memory and behavior? it receives information from basal gang, amygdala, midbrain, and some spinothalamic fibers and then projects the emotional information to the prefrontal lobe.
Ablation of medial nuclei of thalamus results in docile, quiet person with no emotion.
Ablation of _____________________of thalamus parallels a prefrontal lobotomy, creating docile patients who feel pain but are not bothered by it. medial group of thalamic nuclei (no amygdala, no emotion, no problem)
the medial group of thalamic nuclei is aslo affected in ____________ syndrome Korsakoff's
Thalamic nuclei receiving info from basal ganglia (specifically the substantia nigra) and dentate nucleus Ventral (bottom) anterior and Ventral lateral nuclei
VA and VL inhibition makes Parkinson's symptoms better
cerebellar patients (dentate nuclei) and basal ganglia patients can move, just cannot move ___________. correctly
the VA/VL nuclei of thalamus project to the (2) motor and premotor cortices (movement and planning)
VA and VL inhibition makes Parkinson's symptoms better
cerebellar patients (dentate nuclei) and basal ganglia patients can move, just cannot move ___________. correctly
the VA/VL nuclei of thalamus project to the (2) motor and premotor cortices (movement and planning)
a drunk person has affected their coordination and challenges their own (and your) consciousness. What nuclei of thalamus are being affected and why? VA and VL, because they receive from basal gang and dentate and project to motor and premotor cortices, so they affect motor integration and maintenance of consciousness
What has been shown to ameliorate Parkinsonian symptoms? ablation of the VA/VL nuclei of thalamus
Classic Parkinsonism vs. Atypical Parkinsonism? Classic: no DA, tremors, L-Dopa works awhile but fades Atypical: no results with L-Dopa because it's not due to dopamine - destroying thalamus or Globus Pallidus (basal gang) lessons symptoms instead of oral DA
The VPN of thalamus are the most famous - why? ALL SENSATION (except smell) pass into consciousness here, are integrated, and sent to sensory cortex! Helluva job!
V.P. Medial is for the face/head
V.P. Lateral is for the body
lesion to the VPN anesthesia (loss of sensation) or thalamic syndrome (hypersensitivity)
thalamic syndrome is what is results when? hypersensitivity, lesion to the VPN
which VPN is face/head medial
which geniculate body receives information from the inferior brachium and is for auditory medial geniculate body (inferior brachium from inferior colliculus)
I see we have a lot of LGB people here tonight. Lateral Geniculate Body - sight
the Medial Geniculate Body (MGB) drives what road to the auditory cortex? Auditory Radiation road of crossed paths (so contralateral hearing loss if lesioned)
The Lateral Geniculate Body (LGB) receives information from the optic tract (remember pathway to Edinger-Westphal nucleus)
the LGB projects to the visual cortex via optic radiation
Lesion to the Lateral Geniculate Body contralateral visual loss in opposite half of visual field, not in opposite eye
I'm so depressed I'm going to Lie DowN for a week. (LDN) Lateral Dorsal Nucleus has reciprocity with the limbic system so emotion expression
VPN Medial all sensory info from head and face
VPN Lateral body sensory
I'm so depressed! I'm going to Lie DowN for a week. LDN Lateral Dorsal Nucleus - limbic reciprocity, ergo emotions
Lateral Posterior Nucleus connections with sensory association cortex of parietal lobe, integration of sensory info
My mother IS an LPN Integrate Sensory Lateral Posterior Nucleus (instead of Licensed Practical Nurse)
coordinates visual attention, receives fibers from retina & superior colliculus, projects in the parietal/occipital/temporal lobes, functions in visual reflexes and eye movement PULVINAR of thalamus
Is the pulvinar on the anterior or posterior aspect of the thalamus? posterior
what is right below the pulvinar on the posterior aspect of the thalamus superior brachium and lateral geniculate nucleus to the side
why does it make sense for the pulvinar to function in visual reflexes and eye movement? Because it is positioned directly over the superior colliculus from which it receives fibers (also from the retina, via the superior colliculus)
the eyes have to move, see, and sense. Name the 3 lobes to which the pulvinar projects: parietal, occipital, temporal
Somebody has to retain the sanity of the thalamus itself. The Den Mother of the thalamus. Which nuclei? Reticular nucleus: reciprocal connections with the thalamus and cortex, functions in modulation of thalamic activity
Reticular nucleus reciprocal cx with thalamus and cortex, functions in modulating the thalamic activity
Intra-laminar Nuclei is a ______________ nucleus centromedian
the _______________nuclei functions as part of the limbic system in maintaining consciousness and alertness, and in integrating emotional responses to pain Intra-laminar. How will you keep this distinct from LDN?
LDN vs Intralaminar nuclei both involved in emotional responses to pain due to reciprocity with limbic system BUT intralaminar nuclei also maintains conscious awareness and is called the Centromedian nucleus
Midline Nuclei form most of the interthalamic adhesion (massa intermedia)
function of the midline nuclei of thalamus no known function
Inferior part of the lateral wall and floor of IIIrd ventricle - includes the mammillary bodies, tuber cinerum, etc. hypothalamus
where are reflex fibers (for deep sensibility pathway) in fasiculus proprius (area around grey matter of spinal cord (like circular sulcus around insula)
divided into anterior, intermediate and a posterior zone, each with a number of nuclei within hypothalamus
what system is hypothalamus a part of? limbic
what does hypothalamus, as part of the limbic system, control? autonomic response
Hypothalamus is limbic system (autonomic) and ___________ system (hormones) endocrine
2 parts of pituitary gland of hypothalamus neurohypophysis, andenohypophysis
what part of pituitary gland is posterior? adenohypophysis
Anterior hypophysis (______________) makes hormones. neurohypophysis
how does the hypothalamus exercise endocrine control over the body formation of excitatory (releasing) or inhibitory (non-releasing) factors that promote or inhibit production of hormones by cells of the anterior pituitary
the hypothalamus controls the (structure) Neurohypophysis (anterior pituitary gland)
why doesn't the hypothalamus control the adenohypophysis (posterior pituitary) via releasing or release-inhibition factors? because the adenohypophysis does not make any hormones, ergo it does not need hormonal tweaking by the hypothalamus
secretions of the neurohypophysis are ___________hormones like _____. growth hormones like GH
Each pituitary secretion, such as GH, has what to regulate it? an inhibitory and an excitatory releasing factor, made by the hypothalamus
Growth Hormone STIMULATING factor, made by hypothalamus, tells the ____________ to do what? neurohypophysis to release Growth Hormone
Growth Hormone INHIBITING factor, released by the ____________, tells the neurohypophysis to inhibit the release of Growth Hormone. pituitary
#1 function of hypothalamus control the growth hormones released by neurohypophysis via Growth Hormone STIMULATING or INHIBITING factors
proper anatomical structure name for pituitary gland hypophysis (neuro- and adeno-)
How does the Hypothalamus send hormones to the adenohypophysis (posterior pituitary)? via the hypothalamo-hypophyseal tract
What is the process of releasing hormones into the hypothalamo-hypophyseal tract called? neurosecretion
Hypothalamus - neurosecretion of ______________ & _____________ to adenohypophysis. oxytocin & ADH (vasopressin)
Oxytocin is made by the _______________ nucleus paraventricular
ADH/Vasopressin is made by the _____________nucleus supraoptic
The paraventricular nucleus of hypothalamus makes _________________ and neurosecretes it to the adenohypophyis via the hypothalmo-hypophyseal pathway. Oxytocin
oxytocin, made by paraventricular nucleus of hypothalamus, is one of the only known positive feedback mechanisms in humans (birth, breastfeeding, orgasm)
Vasopressin is also known as Anti-Diuretic (no-pee) Hormone
The ______________nucleus of the hypothalamus makes ASH/Vasopression and neurosecretes it via the hypothalamo-hypophyseal pathway to the adenohypophysis. Supraoptic Nucleus
function of ADH/Vasopressin keeps most liquid out of kidneys, therefore in the body, so we stay hydrated (ergo, an Anti-diuretic like alcohol or coffee makes you urinate)
Why does the hypothalamus send oxytocin and ADH to the adenohypophysis? Because the adenohypophysis does not make hormones.
Lesion to the Supraoptic Nucleus Supraoptic nucleus of hypothalamus makes Vasopressin/ADH so lesion causes DIABETES INSIPIDUS -perpetual thirst, perpetual urination (polydipsia, polyuria)
Diabetes Insipidus may be caused by a lesion to Supraoptic Nucleus, stops Vasopressin/ADH production and release to adenohypophysis
"siphon that is tasteless" diabetes insipidus
Danger or physicality tells the Hypothalamus to increase _____________ activity, causing excitation/inhibition of __________ nervous system. Sympathetic, sympathetic (general autonomic effects of Hypothalamus (para and sympa)
Cutaneous vasodilation is caused by hypothalamic stimulation of the __________zone, increasing body temperature and SWEATING anterior
Vasoconstriction and shivering occurs when the _________zone of hypothalamus is stimulated. posterior ('freezing my ass off' would be vessel constriction in my posterior zone;-)
The hypothalamus contains a ______________________center, the lesioning of which causes hyperphagia glucose sensitivity saiety (lesion causes overeating)
where is the glucose-sensitive saiety center of hypothalamus? under the median eminence of tuber cinerum, between the infundibulum and mammillary bodies
Think of the median eminence as a round belly on the tuber cinerum of hypothalamus. Lesioning it causes it to swell (metaphorically) and produces what condition? hyperphagia (overeating) because the glucose-saiety center is damaged
the Hypothalamus has a ____________________center. Lesioning this or the effects of aging may cause hypophagia (loss of appetite). hunger and thirst
LOW blood pressure regulation by the hypothalamus is acheived with the hormone ADH, causing water retention
_______________is acheived by means of water and food to obtain ELECTROLYTES, glucose, amino acids. Osmolarity
How does the Hypothalamus control sexual behaviour and reproduction? controls GONADotrophin production by neurohypophysis
where is GONADotrophin made? neurohypophysis (anterior pituitary) and is therefore modulated by the hyopthalamus with an excitatory and an inhibitory releasing factor.
gametogenesis, cyclic variations, maturation and maintenance of secondary sexual characteristics is encouraged or discouraged due to _______________ production by the neurohypophysis. What modulates this hormone? GONADotrophin by neurohyophysis. Modulated by Gonadotrophin releasing factor and Gonadotrophin inhibiting factor made by the hypothalamus.
______________nucleus is involved in Circadian rhythms SupraCHIASMATIC nucleus = circadian rhythms
The hypothalamus affects biological clocks via the suprachiasmatic nucleus, which is involved in circadian rhythms and affects the fluctuation of body temperature during 24 hr. cycle
the hypothalamus, _________system, and __________match feelings to their appropriate emotional expression. limbic, prefrontal cortex
3 brain structures that match your feelings to the appropriate emotional expression (so you don't laugh when you are enraged) hypothalamus, limbic system, prefrontal cortex
Bulimia is universal; ________ is not. anorexia
transition zone between the midbrain and thalamus SUBthalamus
the SUBthalamic nucleus is a functional constiuent of the ________________ (limbic) basal ganglia
what neurotransmitter is manufactured/used by the basal ganglia? DA (dopamine)
What disease results when there is too little dopamine? Too much? too little = Parkinson's, too much = schizophrenia
Since dopamine in the basal ganglia helps regulated movement (the "when" of movement + the "how" regulated by cerebellum), what would a lesion to the SUBthalamic nucleus of basal ganglia cause? Hemiballismus (the origin of the phrase, "to go ballistic")
hemiballismus lesion of SUBthalamic nucleus of basal ganglia (dopamine is motor, emotion, reward) that causes huge uncontrollable torsional violent movements
where are the SUBthalamic nuclei, in relation to the structures of the midbrain? directly over the Substantia Nigra, hence DA and basal ganglia involvement
lesion to SUBthalamic nucleus hemiballismus (DA)
The limbic system matches the face to the emotion
With physical or mental abuse, what happens to the limbic system function? Lessens, we become less able to match the correct emotion with the face (someone who smiles as they hit you can ruin your association of smile to happy)
The limbic system is your fear & anger center; if you are constantly angry, you will be constantly afraid (women tend to be more depressed, men more angry when afraid)
Tourette's is basal ganglia + _____. OCD
Chorea is tic-like movements of distal muscles, while ___________ is tic-like movement of large, proximal muscles. hemiballismus (lesion to SUBthalamic nucleus of hypothalamus/basal ganglia/limbic/dopamine)
Each cerebral hemisphere is divided into 4 lobes
4 lobes of the cerebral hemisphere frontal, parietal, temporal, occipital
What separates the frontal and parietal lobes of the cerebral hemispheres Central sulcus
each lobe of cerebral hemisphere is subdivided into ________ by fissures called __________. gyri, sulci (gyrus, sulcus)
Each cerebral hemisphere primarily controls or recieves information from the ____________ ____. contralateral body
Are the two cerebral hemispheres functionally identical? no, of course not
the _________________ connects the two brains corpus callosum
___________'s areas are the _____ cortical divisions presenting with different histological layouts. Broadmann's, 52
The Insula is considered to be part of the __________lobe. temporal (deep, through the lateral fissure)
Boundary of Frontal lobe central sulcus
THE primary motor cortex is which gyrus/which Broadmann's area? Precentral Gyrus/Broadmann's Area 4
surgeon that mapped the frontal lobe? Penfield
Personality lobe Prefrontal lobe
superior, middle, inferior gyri, and precentral gyrus on lateral surface, and gyrus rectus and orbital gryi on the inferior surface - which lobe? FRONTAL
The Primary Motor cortex concerned with motion of a joint along a vector is, my fellow chiropractors, what? Precentral gyrus
motion of a joint along a vector will be represented in the ______________ gyrus of the frontal lobe precentral
____________is the representation of the cortical areas dedicated to processing information from a particular part of the body (the schematic person overlayed on the brain) homunculus
the _________homunculus refers to the precentral gyrus. MOTOR
which gyrus represents the motion of a joint along a vector and where is it? precentral gyrus is motor homunculus, between precentral sulcus and central sulcus of frontal lobe
a long pole pierces your prefrontal cortex and you live but are never the same. What is your name? Phineas Gage
The area anterior to the precentral gyrus and sulcus is the premotor and supplementary motor cortex
Premotor and supplementary motor cortex anterior to precentral gyrus (primary motor) and is associated with motor preparation and programming
the area associated with motor preparation and planning in the frontal lobe premotor and supplementary motor cortex
the ________cortex is concerned with motor integration and planning, judgement, and on the dominant hemisphere it is associated with language production. PREFRONTAL
cortex concered with motor integration, planning of movement, judgement of movement, and on the dominant side, the brain's equivalent of movement = language production! PREFRONTAL
which cortex do you suppose contains Broca's area? PREFRONTAL
Broca's area is found in the posterior portion of the ______________________gyrus. inferior frontal
lesion to Broca's area aphasia (expressive) - nonfluent speech, impaired repetition, but mostly preserved language comprehension
what does "expressive aphasia" mean? understands but cannot produce language
Broca's aphasia only happens when the dominant hemisphere is lesioned (language only exists in the dominant hemisphere)
the _______________lobule is around the central sulcus. paracentral
the ____________shows us predictable patterns of brain mapping homunculus
the ___________lobe consists of superior, middle, and inferior gyri on the lateral surface, and the parahippocampal gyrus, and medial and lateral occipitotemporal gyri on the inferior surface. Temporal lobe
the primary auditory cortex is what gyri and which lobe? Transverse temporal gyri of Heschi of the Temporal lobe
Deep in the lateral fissure is the __________ concerned with auditory integration and taste. INSULA
difference between transverse temporal gyri of Heschi and the Insula TTGH is primary auditory cortex while Insula is auditory integration and Taste
visual association areas (gyri) Occipitotemporal gyri (medial and lateral)
the ______________gyri are concerned with the perception of contrast color and shape (ability to name the differences) Occipitotemporal gyri (medial and lateral)
agnosia inability to name things
Lesion to occipitotemporal medial or lateral gyri agnosia - inability to name things
example of an agnosia prosopo-agnosia - inability to tell faces apart
prosopoagnosia example of agnosia - inability to tell faces apart
inability to name things agnosia
lesion to medial occipitotemporal gyri agnosia of some sort
agnosia of some kind would result from lesion to medial or lateral occipitotemporal gyri
the bottom of the _______ is responsibile for the ability to carry a tune insula
what lobe is the lateral occiopitotemporal gyrus part of? temporal
two names for same gyrus on temporal lobe, depending on whether inferior view or lateral view Inferior view - lateral occipitotemporal gyrus, Lateral view - inferior temporal gyrus
the ____________gyrus of the temporal lobe has the hippocampal formation and amygdala, both part of the limbic system (feeding, fighting, f***ing, and memory) Parahippocampal gyrus
the Parahippocampal gyrus has 2 components of the limbic system: hippocampal formation, amygdala (dopamine makes a dope addict!)
hippocampal formation responsible for mapping where you are relative to your surroundings
amygdala is center of anger and fear
where are hippocampal formation and amygdala of limbic system located temporal lobe, parahippocampal gyrus
consists of precuneus on medial surface, postcentral gyrus, superior and inferior lobules on lateral surface, with inferior lobule divided into supramarginal gyrus and angular gyrus Parietal lobe
divisions of inferior parietal lobule supramarginal gyrus and angular gyrus
how do you find the supramarginal gyrus trace the lateral fissure north to end
how do you find the angular gyrus trace the superior temporal sulcus to its north end
is cuneus part of parietal lobe? no (occipital)
is paracentral lobule part of parietal lobe? no (frontal)
primary somatosensory cortex postcentral gyrus
primary motor cortex precentral gyrus (area 4)
primary motor cortex responsible for motion of a joint along a vector precentral gyrus (area 4)
Broadmann's areas 3.1.2 postcentral gyrus - primary somatosensory cortex 312
area posterior to postcentral gyrus (primary somatosensory 312) is the sensory association area
representation of the cortical areas dedicated to processing information from a particular part of the body homunculus (see slide for Parietal lobe)
the sensory homunculus refers to the ______________ gyrus postcentral gyrus
If Broca's is the motor part of language found in inferior frontal gyrus, then Wernicke's must be the _________part of language. sensory
the superior and inferior parietal lobules make up the posterior parietal association areas (remember, everything to the rear of the postcentral sulcus in the parietal lobe is sensory association area)
superior and inferior parietal lobules receive ________, ________ and __________ inputs concerning 3-D perceptions visual, auditory, limbic
the posterior parietal association area (structure and function superior and inferior parietal lobules, receive visual, auditory and limbic input for 3-D perception
lesion of posterior parietal association areas (superior and inferior parietal lobules for 3-D) agnosias, personal neglect syndrome, spatial neglect syndrome
prosopoagnosia inability to tell faces apart; may result from lesion to parahippocampal gyrus of temporal lobe
astereognosis inability to recognized 3-D objects through touch)
personal neglect syndrome ignoring the left side of one's body
spatial neglect syndrome ignoring the left visual field
lesion to posterior parietal association areas astereognosis (no 3D touch), personal neglect and spatial neglect syndromes (ignoring LEFT side of body and visual field)
cannot tell shapes apart -see slide astereognosis (lesion to posterior parietal association areas) -see slide
lack of knowledge, inability to name things or tell them apart (general disorder) agnosia
which is worse, receptive or expressive aphasia? receptive, because you don't understand what you are being told (versus expressive, where you understand but you cannot speak fluently or coherently)
Wernicke's area is found in the posterior portion of the superior temporal gyrus and with the adjoining supramarginal and angular gyrus (inferior parietal lobule) on the DOMINANT SIDE
Broca's area is found posterior portion of inferior frontal gyrus
Lesion to Wernicke's area receptive aphasia - no comprende whatsoever
Tonotonotonotono....the guy on Youtube with _______ aphasia, a lesion to Wernicke's area receptive aphasia, characterized by fluent speech that makes no sense, impaired repetition, and little comprehension
which is worse, receptive or espressive? why? receptive (Wernicke's area inferior parietal lobule of supramarginal and angular gyri)
what lobe is responsible for vision occipital lobe
components of Occipital lobe cuneus and lingual gyri
Cuneus and Lingual Gyri make up occipital lobe
the occipital lobe consists of both _________ & ___________ visual cortices (areas 17.18.19) primary and association cortices
anopisa lack of vision
lesion to either the lingual gyri or cuneus anopsia - lack of vision
sulcus separating cuneus from lingual gyri CALCARINE sulcus (joins with parieto-occipital sulcus after separating cuneus from lingual)
The ______________ somatic portion of the ANS provides innervation to ___________ muscle. motor, skeletal
The _____________ somatic portion of the ANS provides ________________ to skin, bone, and muscle. sensory, deep sensibility
2 components of Somatic ANS: motor to skeletal muscle, sensory for deep sensibility to skin, bone, joints
What kind of neuron does the motor ANS use for skeletal muscle innervation? Alpha motor neuron
The _____________component of the ANS provides innervation to smooth and cardiac muscle, to glands, sympathetic and parasympathetic motor, and a sensory component to detect distension, peristalis, etc. There is also an afferent component. Visceral ANS
example of smooth muscle innervated by visceral autonomic afferents: GI tract, vessels
example of glandular component of visceral autonomic afferents: lacrimal, salivary, hormones
example of organ/visceral sensations via visceral autonomic afferents: respiratory, cardiac, stomach (ie, depressed breathing, tachycardia, distension of stomach or bladder)
There are two divisions of the visceral nervous system: 1._____________, 2.__________ 1. autonomic, 2.endocrine
Cranial nerve example of afferent/efferent visceral components: Vagus - efferent parasympathetic to all of G.I. tract but afferents travel from stomach through Vagus to the brain to tell when "empty" or "full"
Somatic motor neurons go directly from the CNS to the PNS. What is their neurotransmitter? Acetylcholine
Somatic motor neurons go directly from the CNS to the PNS. They use acetylcholine. What type of receptors do skeletal muscles have for Ach detection? cholinergic NICOTINIC Ach receptors
Skeletal muscle uses somatic _________ neurons which go from the CNS directly to the PNS. They use the neurotransmitter _____________. They have cholinergic __________ Ach receptors. motor, acetylcholine, Nicotinic Ach receptors
parasympathetic means rest and digest
sympathetic means fight or flight
Both sympathetic and parasympathetic ANS use a ___-cell system. 2. Each uses Ach in the first part, both have N-Ach receptors in first part. Symp uses NE receptors 2nd half VS. Parasymp uses Muscarinic Ach receptors 2nd half
The SYMPATHETIC ANS starts in the central nervous system with Acetylcholine. Soon after firing, the primary fiber synapses on the second cell body in the pathway. The receptor in the first synapse/ganglion is a ___________Ach receptor for sympathetics. Nicotinic
What type of receptor in the ganglion awaits the primary nerve in the preganglionic sympathetic pathway? N-Ach receptors (nicotinic acetylcholine)
The secondary fiber of the ganglion in the sympathetic N-Ach pathway is very ___________ distance-wise to the primary CNS cell body that sent the original message. close
Remember this one relationship, and you will know all the others: "Preganglionic is pretty short on sympathy" The distance from primary to secondary afferent in the sympathetic N-Ach pathway is short.
The distance between the primary and secondary afferent in the sympathetic pathway is ______. short (preganlionic is pretty short on sympathy)
The distance between the primary and secondary afferent (ganglion) in the sympathetic pathway is short. This is called the __________ portion of the sympathetic pathway. preganglionic (preganglionic is pretty short on sympathy)
If the preganglionic is pretty short on sympathy, what is the distance between the ganglion and the target gland, cardiac muscle or smooth muscle? long
postganglionic sympathetic pathway is _______. long
Neurotransmitter for preganglionic is pretty short on sympathy pathway: Acetylcholine is NT, Nicotinic Ach is the receptor
Neurotransmitter for the postganglionic long pathway from ganglion to target gland, cardiac or smooth muscle: Norepinephrine (noradrenaline/NE)
What does noradrenaline/norepinephrine/NE do to your heart and what pathway uses it? speeds up heart, used by sympathetic N-Ach to NE
The postganglionic sympathetic autonomic ganglion releases NE to speed up heart, etc. (fight or flight responses)
What does the postganglionic sympathetic fiber do when it reaches its target cells? releases NE
Preganglionic is PRE-tty SHORT on SYMPATHy distance from primary to secondary or CNS to ganglion is short in sympathetic pathway
Parasympathetic means rest and digest, slow it down, take a break
The distance between primary and secondary cell body/ganglion of parasympathetic is long.
Neurotransmitter of parasympathetic preganglionic Long pathway? Acetylcholine (same as sympathetic)
What is the ganglionic receptor of the parasympathetic preganglionic pathway? N-Ach (same as sympathetic)
Distance between parasympathetic ganglion and target gland, cardiac or smooth muscle? short
neurotransmitter between parasympathetic ganglion and target gland, cardiac or skeletal muscle? Acetylcholine
Type of target receptor in postganglionic parasympathetic pathway? MUScarinic Ach receptors in glands, cardiac or smooth muscle.
What does effect does Ach have via Muscarinic receptors of the postganglionic parasympathetic pathway? slows heart down, speeds up peristalsis, etc. Rest and digest is MUScadine wine time!
Muscadine wine time is rest and digest (parasympathetic postganglionic muscarinic Ach receptor effect)
_________ are diseases in which unwanted superfluous movements occur. Dyskinesias
lesions to corpora striata cause dyskinesias such as dystonia and ________`` chorea
A dyskinesia that causes sudden flailing movement at the proximal joints of limbs, usually caused by a vascular lesion to the contralateral Subthalamic Nucleus Ballism (hemiballism)
Ballism is a dyskinesia characterized by sudden flailing movements of the proximal limb joints. It is caused by contralateral lesion to SUBthalamic nucleus(BALL-SUB)
A dyskinesia characterized by muscular rigidity, tremor of distal muscles, and bradykinesia (poverty of movement). Primary lesion is loss of DA neurons in pars compacta of Substantia Nigra. Parkinson's disease
DA neurons are normally active most of the time, continually modulating the striatum and indirectly the premotor and supplementary motor areas. Withdrawing the excitatory action of DA releases the pallidal inhibition of the ______________nucleus of T. VENTRAL LATERAL (VLa)
The VLa is _________ to the premotor cortex, so in Parkinson's disease, the cortical activity is reduced. VLa
Unilateral damage to a cerebellar hemisphere (vascular occlusion, a tumor, demyelination of white matter in one or more of the cerebellar peduncles) results in symptoms that affect the __________ side of the body. same (unilateral)
Cerebellar dysfunction, as opposed to damage, is usually bilateral, and is seen in such demyelinating autoimmune diseases like _______. M.S.
what type of fibers are often affected in M.S. cerebello-thalamic
Lesions in the midline of the cerebellum affect the estibular and spinal connections, so an _______ gait is the most prominent abnormality. ataxic.
The ANS is largely an ___________system. involuntary
Where are ANS preganglionic fibers? clustered in a cell nucleus in the CNS (like Facial n. sending Greater petrosal with Deep petrosal as the Vidian, out to the pterygopalatine ganglia in order to reach the lacrimal gland.)
Where is the cell body for a postganglionic fiber? Inside or outside the CNS? outside! In your face, on your abdominal aorta, etc.
Ratio of pregangs to postgangs in sympathetic fight or flight: 1:10
Ratio for pregangs to postgangs in parasympathetic rest and digest: 1:3
Which fibers are "pretty short on sympathy"? Preganglionic sympathetics are short!
What does the 1:10 ratio of pregans to postgangs in sympathetic fight or flight ANS imply? 1 sympathetic preganglion can talk to as many as 10 postganglionics, meaning they are far reaching.
What does the 1:3 ratio of pre- to postganglionic parasympathetic rest and digests imply? localized!
Are autonomic fibers and their targets specialized? Why or why not? no - so neurotransmitters of ANS (Acetylcholine and NE) may travel great distances before they reach their target.
There are many synapses in the ANS pathways so more check points means a greater measure of control
Preganglionic terminals release ____________, mediated by ______________receptors Ach, Nicotinic Ach
Both pregang and postgang terminals release a number of neuropeptides that functions directly into the target tissues (Candace Pert, PhD) or have modulatory role: Substance P, neuropeptide Y, neurotensin, somatostatin, ENKEPHALINS!
What is the point of NE and what system uses it? to speed things along for sympathetic ANS reactions
Postganglionic sympathetic terminals release norepinephrine
How many receptors mediate the NE released by postgangs? 5
What are the 5 NE receptor mediators? alpha 1,2 and beta 2,3
alpha 1,2 and beta 2,3 are noradrenergic receptors in postgang sympathetic pathway
Postgang sympathetics use NE to speed things up. Postgang PARAsymps use acetylcholine to slow things down. How can Ach slow things down parasympathetically? Via MUSCARINIC-Ach receptors (M1,M2,M3)
sympathetic and parasympathetic both innervate what 3 things? smooth muscle, cardiac muscle, glands (and some visceral reflexes)
What system has great autonomy in that is almost solely responsible for digestive reflexes? the Enteric division of ANS
Autonomic fibers are both sensory and motor. What sensory role do the ANS fibers play? inform CNS about visceral homeostasis
this test will focus mostly on the ____________aspect of the ANS motor
If you have a copy of Barr's The Human Nervous System, turn to chapter 24 and find illustration of visceral efferent and afferent neurons assoc. with thoracic segment of spinal cord. What follows is an unfortunate translation of an excellent diagram. Google a picture of paravertebral sympathetic ganglion and remember where the Intermediolateral cell column in the grey matter of the spinal cord is located.
Where are preganglionics for the CNS located? Interomediolateral cell column/gray from T1-L2.
Where is the intermediolateral cell column? lateral horn of all thoracic spinal segments and upper 2 lumbar
What kind of ganglia are associated with all the spinal nerves, although at cervical levels they are condensed into upper, middle, and stellate? Paravertebral ganglia of sympathetic division
The sympathetic outflow of ANS originates in the intermediolateral cell column/gray of lateral horn (T1-L2)
Sympathetic preganglion fibers exit out the ____________root from the Intermediolateral cell column (T1-L2) Ventral (Ventral is motor!)
After leaving IMLcc and traveling the ventral root, sympathetic preganglionic fibers briefly join the spinal nerve and ventral ramus
The sympathetic preganglions don't stay in the spinal nerve and ventral ramus long - they "take a left at Albuquerque" and go into the ? white rami communicantes
How do sympathetic axons of preganglionic neurons reach the sympathetic trunk? ventral root to spinal nerve to ventral ramus to WHITE RAMI COMMUNICANTES
It's a good bet the sympathetic fibers headed to the white rami communicantes are ____________, while those heading out of the grey rami communicantes are ____________. We know which one is faster! myelinated, unmyelinated
Where do the sympathetic preganglionic fibers go, once they have reached the white rami communicantes? Paravertebral sympathetic ganglia.
What is another name for paravertebral sympathetic ganglion ganglia of sympathetic trunk (remember they are paravertebral/close to spinal origin because the preganglionics are short on sympathy!)
The ANS uses a 2 cell system. Now that our sympathetic preganglion fibers have made it to the sympathetic chain ganglion via the grey rami communicantes, they are headed out. What kind of receptors must be in the sympathetic postganglionic cell bodies? Nicotinic-Ach that release NE
Can sympathetic preganglionic fibers synapse with the sympathetic chain ganglion of other levels besides their own? yes, (same, above, or below)
Once the sympathetic preganglionic fiber synapses on the cell body of a sympathetic chain ganglion, what happens to the second set of fibers in this 2 cell pathway? They exit via the GREY rami communicantes and head towards their targets.
The sympathetic preganglion cell starts in the _______________ and ends in the ______________. Intermediolateral cell column (T1-L2), sympathetic chain ganglion/paravertebral ganglion via the white rami communicantes.
Sympathetic _____________ fibers form the grey rami communicantes and leave the sympathetic chain ganglion as the second cell fibers of the ANS 2-cell pathway. postganglionic
Sympathetic postganglionic fibers leave the grey rami communicantes and enter the spinal nerve (to target!)
Postganglionic sympathetic fibers (second in 2-cell ANS pathway) travel from sympathetic/paravertebral ganglion of cervical, thoracic, and lumbars via spinal nerves. Where are they headed? Peripheral blood vessels, glands, errector pili muscles (arrectores pilorum)
targets of second cell in 2-cell ANS sympathetic pathway peripheral blood vessels, glands, errector pili muscles
arrectores pilorum and arrector pili are the same as errector pili (hair on end!)
Sympathetic postganglionic fibers (of the second cell in the 2-cell ANS pathway) from the CERVICAL PLEXUS get to their targets how? cranial nerves (Vagus, Facial,etc.) or direct plexuses (ciliary, optic, pterygopalatine, submandibular)
Targets of sympathetic postganglionic fibers of cervical plexuses (upper, middle, stellate): cranial blood vessels, sweat glands, hair follicles, secretomotor glands (parotid, submandibular, sublingual, nasal, lacrimal), and visceral organs of head and thorax (heart and lungs via cardiac plexus of C1)
short list of cervical sympathetic postganglionic fibers from upper, middle, stellate: cranial blood vessels, sweat glands, secretomotor glands, hair follicles, visceral organs (heart and lungs)
Lesion of superior cervical ganglion (sympathetic postganglionic fibers to sweat glands, hair follicles, secretomotor glands, cranial blood vessels, heart and lungs) causes: Horner's syndrome - ptosis (Levator palpebrae superioris of CN III), miosis (dialator pupillae of ciliary body of ciliary ganglion), anhydrosis (no sweat!), enophthalmos (retraction of eyeball) and loss of ciliospinal reflex
Horner's syndrome is lesion to cervical sympathetic chain
Horner's syndrome causes ptosis, miosis, anhydrosis, enophthalmos, loss of ciliospinal reflex (if you pinch patient's neck, pupillary constriction should occur but will not if Horner's syndrome)
Some sympathetic PREganglionic fibers go through the sympathetic trunk ganglion and never synapse. Where are they headed instead? They will form the SPLANCHNIC NERVES and go to pre-vertebral ganglia (coeliac, superior and inferior mesenteric)
where are the celiac, superior mesenteric gang and inferior mesenteric gang? along the abdominal aorta, for the celiac trunk, superior mesenteric vessels, and inferior mesenteric vessels (gross III)
Who feeds the celiac, superior mesenteric and inferior mesenteric ganglia? SPLANCHNIC nerves!
Why would the fibers becoming splanchnic to abdomen and pelvis have to be PREganglionic sympathetics? there are only 2 cells in the 2-cell ANS pathway. These are still the first cell fibers from the intermediolateral cell column until they reach a celiac, superior or inferior prevertebral plexus.
Why are the celiac, superior, and inferior mesenteric ganglia of the splanchnic targets called "prevertebral"? because they lie in front of the vertebrae on the abdominal aorta
What do the splanchnic nerves postganglionic fibers innervate once they reach celiac/superior mesenteric/inferior meseneteric ganglia? thoracic and abdominal viscera (guts, GI, liver, pancreas, genitalia, kidneys, bladder)
Some splanchnic fibers bypass the celiac and mesenteric ganglia to go straight to the mother of all Fight or Flight organs: Adrenal medulla of suprarenals!
Where are the postganglionic sympathetic cell bodies of adrenal glands and who goes there and why? adrenal medulla, splanchnic nerve sympathetic pregangs synapse there, gets adrenals to release NE and E into circulation
3 options for Sympathetic preganglionic fibers: sympathetic trunk ganglion (if cervical, then different effects), celiac/superior mes/inferior mes ganglion as splanchnic, adrenal medulla as splanchnic
which plexus for sympathetic head smooth muscles and glands superior cervical ganglion
which plexus for sympathetic trunk viscera superior, middle, stellate (inferior) cervical ganglia and upper 5 thoracic ganglia
which plexus for sympathetic abdominal and pelvic prevertebral ganglia (celiac, superior and inferior mesenteric) as splanchnic nerves
which plexus for sympathetic release of NE and E no plexus - goes to adrenal medulla as splanchnic and synapses directly with its cells
What segmental part of spine gives rise to parasympathetic preganglionics of intermediolateral cell column? S2-S4
What Cranial nerves give parasympathetic preganglionics? III-Oculomotor, VII-Facial, IX-Glossopharyngeal, X-Vagus
What are the 4 nuclei of the brainstem that give preganglionic parasympathetics to III, VII, IX and X? Edinger-Westphal (III), Superior Salivatory nucleus (VII), Inferior Salivatory nucleus (IX), Dorsal motor nucleus of Vagus (X)
III parasympathetic pathway: Edinger-Westphal to Oculomotor III to ciliary ganglion to sphincter pupillae and ciliaris muscles
lesion to Edinger-Westphal nucleus, III, ciliary ganglion? mydriasis (dialated pupil due to busted sphincter pupillae), cycloplegia (no accommodation due to busted ciliaris), any lesion to III loses all extrinsic muscles of eye except LR & SO
VII parasympathetic pathway: Superior salivatory nucleus to Facial (VII) to pterygopalatine ganglia (Great petrosal n. of VII)for lacrimal, serous and nasal glands and submandibular ganglion (chorda tympani n. of VII) for submandibular and sublingual salivary glands
lesion to superior salivatory nucleus, VII (Greater Petrosal and Chorda Tympani nerves), pterygopalatine ganglion, submandibular ganglion possibilities no lacrimal tears, no nasal mucous or serous mucus (pterygopalatine ganglion), dry mouth, loss of taste from anterior 2/3 tongue (chorda tympani n. of VII), Lesion to VII is Bell's Palsy
IX parasympathetic pathway: Inferior salivatory nucleus to Glossopharyngeal (Lesser Petrosal n.)to Otic ganglion to ParOtid gland
lesion to Inferior Salivatory nucleus, Glossopharyngeal (carotid body and sinus, too), Otic Ganglion Parotid is largest salivatory gland in mouth so no saliva emitted opposite 2nd upper molar, Lesion to IX is loss of motor and sensory posterior 1/3 tongue and motor to stylopharyngeus (dysphonia,dysphagia)
X Parasympathetic pathway Dorsal Motor Nucleus (of Vagus) to Vagus X to thoracic and abdominal ganglia (cardiac, celiac, superior mesenteric, inferior mesenteric ganglion) to heart, esophagus, lungs, stomach, liver, gall bladder, pancreas, foregut and midgut derivatives
lesion to Dorsal Motor Nucleus of Vagus, Vagus X, thoracic or abdominal ganglion Failure! Loss of parasympathetics to abdominal and thoracic viscera, dysphonia, dysphagia, uvular deviation to good side, cadavaver palate on bad side, reduced gag reflex, loss of taste to esophagus
Created by: hecutler