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Questions and Answers
Which of the following is NOT a destination for second-order neurons in the anterolateral system, unlike the dorsal column medial lemniscus (DCML) pathway?
Which of the following is NOT a destination for second-order neurons in the anterolateral system, unlike the dorsal column medial lemniscus (DCML) pathway?
- Colliculi
- Reticular formation
- Thalamus
- Hypothalamus
- Cerebellum (correct)
The spinothalamic tract (STT) is primarily responsible for the transmission of which type of pain?
The spinothalamic tract (STT) is primarily responsible for the transmission of which type of pain?
- Chronic pain
- Neuropathic pain
- Visceral pain
- Acute (fast) pain (correct)
- Emotional pain
What type of receptor is predominantly associated with the anterolateral system pathways for pain and temperature?
What type of receptor is predominantly associated with the anterolateral system pathways for pain and temperature?
- Free nerve endings (correct)
- Merkel's disks
- Pacinian corpuscles
- Ruffini's endings
- Meissner's corpuscles
Which component of the spinothalamic tract is considered the 'clinically important pathway' and is tested using the pinprick test?
Which component of the spinothalamic tract is considered the 'clinically important pathway' and is tested using the pinprick test?
Besides pain, what other primary sensation is transmitted by the lateral spinothalamic tract?
Besides pain, what other primary sensation is transmitted by the lateral spinothalamic tract?
In the spinal cord, where is the lateral spinothalamic tract located?
In the spinal cord, where is the lateral spinothalamic tract located?
Where are the cell bodies of the first-order neurons of the lateral spinothalamic pathway located?
Where are the cell bodies of the first-order neurons of the lateral spinothalamic pathway located?
At what anatomical structure does the decussation of the second-order neurons occur in the lateral spinothalamic tract pathway?
At what anatomical structure does the decussation of the second-order neurons occur in the lateral spinothalamic tract pathway?
Which tract in the brainstem do the second-order neurons of the lateral spinothalamic pathway ascend in?
Which tract in the brainstem do the second-order neurons of the lateral spinothalamic pathway ascend in?
In which thalamic nucleus do the second-order neurons of the lateral spinothalamic tract synapse with third-order neurons?
In which thalamic nucleus do the second-order neurons of the lateral spinothalamic tract synapse with third-order neurons?
Through which part of the internal capsule do the third-order neurons of the lateral spinothalamic pathway pass?
Through which part of the internal capsule do the third-order neurons of the lateral spinothalamic pathway pass?
To which area of the cerebral cortex do the third-order neurons of the lateral spinothalamic pathway project?
To which area of the cerebral cortex do the third-order neurons of the lateral spinothalamic pathway project?
What type of nerve fibers primarily constitute the lateral spinothalamic pathway, enabling fast pain transmission?
What type of nerve fibers primarily constitute the lateral spinothalamic pathway, enabling fast pain transmission?
Where are the cell bodies of the first-order neurons for pain and temperature sensation from the face located?
Where are the cell bodies of the first-order neurons for pain and temperature sensation from the face located?
The ventral trigeminothalamic tract (VTT) decussates in which part of the brainstem?
The ventral trigeminothalamic tract (VTT) decussates in which part of the brainstem?
In the ventral trigeminothalamic tract pathway, where do second-order neurons synapse with third-order neurons?
In the ventral trigeminothalamic tract pathway, where do second-order neurons synapse with third-order neurons?
Which of the following is a descending pain modulation pathway that contains opioid receptors?
Which of the following is a descending pain modulation pathway that contains opioid receptors?
The Rostral Ventromedial Medulla (RVM) is a key structure in descending pain modulation. Where is the RVM located?
The Rostral Ventromedial Medulla (RVM) is a key structure in descending pain modulation. Where is the RVM located?
What type of sensory deficit is typically observed with a lesion above the pons affecting the pain and temperature pathways?
What type of sensory deficit is typically observed with a lesion above the pons affecting the pain and temperature pathways?
A spinal cord lesion leads to what specific type of sensory deficit regarding pain, temperature and proprioception?
A spinal cord lesion leads to what specific type of sensory deficit regarding pain, temperature and proprioception?
Which factor most significantly increases the conduction velocity of an action potential in a neuron?
Which factor most significantly increases the conduction velocity of an action potential in a neuron?
Which type of nerve fiber is associated with fast pain and has an intermediate diameter and light myelination?
Which type of nerve fiber is associated with fast pain and has an intermediate diameter and light myelination?
What type of nerve fiber is associated with slow, chronic pain and is unmyelinated with the smallest diameter?
What type of nerve fiber is associated with slow, chronic pain and is unmyelinated with the smallest diameter?
A lesion in the left lateral medulla could cause facial anesthesia on which side of the face, based on the ventral trigeminothalamic tract pathway?
A lesion in the left lateral medulla could cause facial anesthesia on which side of the face, based on the ventral trigeminothalamic tract pathway?
If a medullary hemisection affects the ventral trigeminothalamic tract, what is the expected outcome regarding facial anesthesia?
If a medullary hemisection affects the ventral trigeminothalamic tract, what is the expected outcome regarding facial anesthesia?
Which of the following tests is used to assess the function of the lateral spinothalamic tract?
Which of the following tests is used to assess the function of the lateral spinothalamic tract?
What type of sensation is assessed using cotton wool to lightly touch the skin?
What type of sensation is assessed using cotton wool to lightly touch the skin?
Which sensory pathway from the face is responsible for transmitting proprioception, vibration, and discriminative touch?
Which sensory pathway from the face is responsible for transmitting proprioception, vibration, and discriminative touch?
Where does the decussation of second-order neurons occur in the ventral trigeminothalamic tract pathway?
Where does the decussation of second-order neurons occur in the ventral trigeminothalamic tract pathway?
Sensory information from the face related to pain and temperature is initially processed in which nucleus of the trigeminal nerve?
Sensory information from the face related to pain and temperature is initially processed in which nucleus of the trigeminal nerve?
Which of the following describes spinocerebellar tracts?
Which of the following describes spinocerebellar tracts?
To which part of the cerebellum do spinocerebellar tracts primarily project?
To which part of the cerebellum do spinocerebellar tracts primarily project?
Perception of basic sensations like pain and touch, without discrimination or localization, occurs at which level?
Perception of basic sensations like pain and touch, without discrimination or localization, occurs at which level?
More detailed sensory processing, including localization and quality of sensation, occurs at which level?
More detailed sensory processing, including localization and quality of sensation, occurs at which level?
Stereognosis and graphesthesia are examples of which type of sensory function?
Stereognosis and graphesthesia are examples of which type of sensory function?
Deficits in visuospatial awareness and awareness of the body are most commonly associated with lesions in which cerebral lobe?
Deficits in visuospatial awareness and awareness of the body are most commonly associated with lesions in which cerebral lobe?
Right parietal lobe lesions are more likely to cause hemineglect and inattention to which side of space?
Right parietal lobe lesions are more likely to cause hemineglect and inattention to which side of space?
Cortical sensations can only be reliably tested if which type of sensory modalities are intact?
Cortical sensations can only be reliably tested if which type of sensory modalities are intact?
In the somatotopic organization of the sensory pathway in the spinal cord, where are lower limb neurons typically located compared to upper limb neurons?
In the somatotopic organization of the sensory pathway in the spinal cord, where are lower limb neurons typically located compared to upper limb neurons?
What is 'sacral sparing' in the context of spinal cord lesions?
What is 'sacral sparing' in the context of spinal cord lesions?
A lesion affecting a spinal nerve root will typically result in sensory loss in which distribution?
A lesion affecting a spinal nerve root will typically result in sensory loss in which distribution?
If a patient presents with complete sensory loss in a specific dermatome, possible locations of the lesion include:
If a patient presents with complete sensory loss in a specific dermatome, possible locations of the lesion include:
In a clinical scenario of subacute combined degeneration of the cord due to Vitamin B12 deficiency, which part of the spinal cord is primarily affected, leading to sensory ataxia?
In a clinical scenario of subacute combined degeneration of the cord due to Vitamin B12 deficiency, which part of the spinal cord is primarily affected, leading to sensory ataxia?
What type of sensory loss would be expected with a lesion confined to the dorsal gray horn of the spinal cord?
What type of sensory loss would be expected with a lesion confined to the dorsal gray horn of the spinal cord?
If a patient has pain and temperature loss below a specific dermatome level on the contralateral side, and no proprioceptive loss, where is the most likely location of the lesion within the spinal cord?
If a patient has pain and temperature loss below a specific dermatome level on the contralateral side, and no proprioceptive loss, where is the most likely location of the lesion within the spinal cord?
Which of the following is the primary type of receptor associated with the anterolateral system for detecting pain and temperature?
Which of the following is the primary type of receptor associated with the anterolateral system for detecting pain and temperature?
What is the primary function of the lateral spinothalamic tract?
What is the primary function of the lateral spinothalamic tract?
Where do second-order neurons in the lateral spinothalamic tract decussate?
Where do second-order neurons in the lateral spinothalamic tract decussate?
What type of nerve fibers are predominantly found in the lateral spinothalamic pathway?
What type of nerve fibers are predominantly found in the lateral spinothalamic pathway?
Where do first-order neurons of the ventral trigeminothalamic tract synapse with second-order neurons?
Where do first-order neurons of the ventral trigeminothalamic tract synapse with second-order neurons?
What is the primary function of the ventral trigeminothalamic tract?
What is the primary function of the ventral trigeminothalamic tract?
A patient has a lesion in the posterior limb of the internal capsule. Which sensory deficits would MOST likely be observed?
A patient has a lesion in the posterior limb of the internal capsule. Which sensory deficits would MOST likely be observed?
What is the expected sensory deficit from a lesion affecting the entire dorsal horn of the spinal cord at a specific level?
What is the expected sensory deficit from a lesion affecting the entire dorsal horn of the spinal cord at a specific level?
A patient presents with loss of pain and temperature sensation starting two segments below the level of the lesion on the contralateral side. Where is the MOST likely location of the lesion?
A patient presents with loss of pain and temperature sensation starting two segments below the level of the lesion on the contralateral side. Where is the MOST likely location of the lesion?
What type of sensory loss is expected with damage limited to a single spinal nerve root?
What type of sensory loss is expected with damage limited to a single spinal nerve root?
Which of the following best describes the function of spinocerebellar tracts?
Which of the following best describes the function of spinocerebellar tracts?
Which of the following is a key characteristic of cortical sensations?
Which of the following is a key characteristic of cortical sensations?
A patient is unable to recognize objects by touch (astereognosis) in their left hand, but can feel basic sensations such as pain and light touch. Which area of the brain is likely affected?
A patient is unable to recognize objects by touch (astereognosis) in their left hand, but can feel basic sensations such as pain and light touch. Which area of the brain is likely affected?
A patient shows symptoms of visuospatial neglect, predominantly ignoring the left side of their body and visual field. Lesions in which area of the brain are most likely?
A patient shows symptoms of visuospatial neglect, predominantly ignoring the left side of their body and visual field. Lesions in which area of the brain are most likely?
A patient demonstrates loss of proprioception and vibration sense bilaterally, along with clumsiness that worsens at night. MRI imaging shows increased signal intensity in the dorsal columns of the spinal cord. Which vitamin deficiency is MOST likely responsible for these findings?
A patient demonstrates loss of proprioception and vibration sense bilaterally, along with clumsiness that worsens at night. MRI imaging shows increased signal intensity in the dorsal columns of the spinal cord. Which vitamin deficiency is MOST likely responsible for these findings?
Flashcards
Antero-Lateral System
Antero-Lateral System
An ascending sensory pathway carrying pain and temperature information to higher brain centers.
Lateral Spinothalamic Tract
Lateral Spinothalamic Tract
A sensory tract responsible for fast pain, temperature and intensity.
Anterior Spinothalamic Tract
Anterior Spinothalamic Tract
Sensory tract responsible for crude touch.
Anterior White Commissure
Anterior White Commissure
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Ventral Trigeminothalamic Tract
Ventral Trigeminothalamic Tract
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Spinocerebellar Tracts
Spinocerebellar Tracts
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Thalamus (Sensory)
Thalamus (Sensory)
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Cortical Sensations
Cortical Sensations
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Somatotopic Organization
Somatotopic Organization
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Dermatome
Dermatome
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Contralateral Hemisensory Loss
Contralateral Hemisensory Loss
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Dissociated Sensory Loss
Dissociated Sensory Loss
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Study Notes
Antero-Lateral System Destinations
- The antero-lateral system has multiple destinations for the second-order neurons, unlike the dorsal column-medial lemniscus pathway
- The thalamus is one destination, via the spinothalamic tract (STT)
- Other destinations include:
- Colliculi, via spinotectal tracts (STCT)
- Reticular formation, via spinoreticular tract (SRT)
- Hypothalamus, via spinohypothalamic tract (SHT)
Function of Antero-Lateral System Tracts
- The antero-lateral system tracts serve different functions related to pain such as acute pain, chronic pain, emotional aspects of pain, pain-related reflexes, and pain modulation
- Acute (fast) pain is transmitted via the spinothalamic tract
- Chronic (slow) pain involves conduction and has differing aspects
- Receptors for antero-lateral system are mostly free nerve endings
Lateral Spinothalamic Tract
- The lateral spinothalamic tract is a component of the spinothalamic tracts and carries a fast pain pathway
- Functions of the lateral spinothalamic tract are immediate awareness, localization, and intensity of pain
- The lateral spinothalamic tract transmits temperature sensations and is clinically important for the pinprick test
- Carried in the lateral spine segment with awareness and localisation, intensity
Lateral Spino-Thalamic Pathway (LST)
- The 1st-order neurons start from free nerve endings, and cell bodies are in the dorsal root ganglia
- Central processes of the neurons enter into the dorsal horn spinal cord
- The 2nd order neurons synapse directly with the first-order neurons in the dorsal horn
- These neurons take an oblique, upward course, crossing anterior to the central canal via the anterior white commissure
- Pathway ascends about two segments before entering the LST
- The 2nd order neurons continue into the brainstem, ascending as the spinal lemniscus to the thalamus
- The 3rd order neurons synapse with the 2nd order neurons in the ventral posterolateral (VPL) nucleus
- These then pass through the posterior limb of the internal capsule, corona radiata and reach the somatosensory cortex
- The pathway mostly consists of fast-conducting A delta-type neurons
Pain/Temp Conduction - Ventral Trigeminothalamic Tract
- This pathway traces pain/temperature sensations from the face
- 1st order neurons originate from receptors and have cell bodies located in the trigeminal ganglion
- Their processes enter the pons, then descend into the medulla as the spinal trigeminal tract
- 2nd order neurons synapse with the 1st in the spinal nucleus of trigeminal
- These neurons decussate and enter the VTT before synapsing with 3rd order
- The 3rd order neurons are located in the ventral posteromedial nucleus (VPM) of the thalamus, and then enter the posterior limb of the internal capsule
- Following this they will pass through the corona radiata and reach the head representation of the primary somatosensory cortex
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