Podcast
Questions and Answers
The trigeminal nerve divides into three branches before exiting the cranial cavity. Which of the following is correct?
The trigeminal nerve divides into three branches before exiting the cranial cavity. Which of the following is correct?
- CN V2 - Maxillary branch exits via the superior orbital fissure.
- CN V1 - Ophthalmic branch exits via the foramen ovale.
- CN V3 - Mandibular branch exits via the foramen ovale. (correct)
- CN V1 - Ophthalmic branch exits via the foramen rotundum.
Which statement accurately describes the sensory innervation of the trigeminal nerve divisions?
Which statement accurately describes the sensory innervation of the trigeminal nerve divisions?
- The ophthalmic division (V1) provides sensation to the lower face and jaw.
- The mandibular division (V3) provides sensation to the mid-face and upper jaw.
- The ophthalmic division (V1) provides sensation to the cornea of the eye. (correct)
- The maxillary division (V2) provides sensation to the forehead and upper eyelid.
In a clinical exam, which action is appropriate and directly evaluates the motor function of the trigeminal nerve (CN V)?
In a clinical exam, which action is appropriate and directly evaluates the motor function of the trigeminal nerve (CN V)?
- Asking the patient to clench their teeth while palpating the masseter muscle. (correct)
- Having the patient follow a moving finger with their eyes.
- Testing light touch sensation on the cheek.
- Touching the forehead with a cotton swab to test corneal reflex.
Which of the following statements accurately describes the sensory component of the corneal reflex?
Which of the following statements accurately describes the sensory component of the corneal reflex?
Which nerve is primarily affected in trigeminal neuralgia?
Which nerve is primarily affected in trigeminal neuralgia?
What symptoms would you expect with damage in the right side of the brainstem, specifically affecting the trigeminal nerve's nuclei?
What symptoms would you expect with damage in the right side of the brainstem, specifically affecting the trigeminal nerve's nuclei?
Regarding the muscles of mastication, which of the following statements is most accurate?
Regarding the muscles of mastication, which of the following statements is most accurate?
If asked to test temporalis muscle function, what action is most appropriate to test?
If asked to test temporalis muscle function, what action is most appropriate to test?
Damage to the facial nerve as it exits the stylomastoid foramen is most likely to result in:
Damage to the facial nerve as it exits the stylomastoid foramen is most likely to result in:
Which of the following components of the facial nerve is responsible for innervating the stapedius muscle?
Which of the following components of the facial nerve is responsible for innervating the stapedius muscle?
Which of the following is most likely affected by problems with the superior salivatory nucleus?
Which of the following is most likely affected by problems with the superior salivatory nucleus?
What part of the face is affected if there is damage to the facial nerve (CN VII) at the cerebellopontine angle?
What part of the face is affected if there is damage to the facial nerve (CN VII) at the cerebellopontine angle?
A patient presents with the inability to wrinkle their forehead on the right side, but can still move the lower parts of their face normally. Where is the most likely location of the lesion?
A patient presents with the inability to wrinkle their forehead on the right side, but can still move the lower parts of their face normally. Where is the most likely location of the lesion?
A patient has the inability to wrinkle their forehead, close their eye, and move their mouth on the left side of their face. Where is the most likely location of the lesion?
A patient has the inability to wrinkle their forehead, close their eye, and move their mouth on the left side of their face. Where is the most likely location of the lesion?
A tumor located at the cerebellopontine angle is most likely what?
A tumor located at the cerebellopontine angle is most likely what?
During parotid surgery, what is the most significant risk?
During parotid surgery, what is the most significant risk?
Which of the following muscles is responsible for closing the eyes tightly?
Which of the following muscles is responsible for closing the eyes tightly?
Which of the following muscles is responsible for closing, or pursing the lips?
Which of the following muscles is responsible for closing, or pursing the lips?
Which statement accurately describes key differences between upper motor neuron (UMN) and lower motor neuron (LMN) facial nerve palsy?
Which statement accurately describes key differences between upper motor neuron (UMN) and lower motor neuron (LMN) facial nerve palsy?
Which of the following is a primary function of the vestibulocochlear nerve (CN VIII)?
Which of the following is a primary function of the vestibulocochlear nerve (CN VIII)?
Which anatomical structures does the vestibulocochlear nerve (CN VIII) pass through to exit the skull?
Which anatomical structures does the vestibulocochlear nerve (CN VIII) pass through to exit the skull?
The vestibular nuclei, which receive input from the vestibulocochlear nerve, are primarily located in the:
The vestibular nuclei, which receive input from the vestibulocochlear nerve, are primarily located in the:
What inner ear structure is most directly responsible for transducing sound vibrations into electrical signals?
What inner ear structure is most directly responsible for transducing sound vibrations into electrical signals?
Which of the following structures is primarily responsible for detecting angular acceleration of the head?
Which of the following structures is primarily responsible for detecting angular acceleration of the head?
Which is a symptom associated with vestibular neuritis?
Which is a symptom associated with vestibular neuritis?
After the vestibulocochlear nerve transmits auditory information, which area receives sound?
After the vestibulocochlear nerve transmits auditory information, which area receives sound?
Which of the following is most likely associated with sensorineural hearing loss?
Which of the following is most likely associated with sensorineural hearing loss?
Which nerve damage is most likely when there is a base of skull fracture?
Which nerve damage is most likely when there is a base of skull fracture?
Following a traumatic injury, a patient reports hearing loss and dizziness together. A fracture to which cranial fossa is most likely?
Following a traumatic injury, a patient reports hearing loss and dizziness together. A fracture to which cranial fossa is most likely?
The chorda tympani is a branch of which cranial nerve?
The chorda tympani is a branch of which cranial nerve?
In the auditory pathway, what is the first structure to receive bilateral input?
In the auditory pathway, what is the first structure to receive bilateral input?
A lesion to the right internal acoustic meatus would most likely affect which combination of functions?
A lesion to the right internal acoustic meatus would most likely affect which combination of functions?
Unlike the Dorsal Column-Medial Lemniscus (DCML) pathway, the Antero-Lateral System (ALS) has multiple destinations for its second-order neurons. Which of the following is a destination of the ALS?
Unlike the Dorsal Column-Medial Lemniscus (DCML) pathway, the Antero-Lateral System (ALS) has multiple destinations for its second-order neurons. Which of the following is a destination of the ALS?
The spinothalamic tract is responsible for carrying sensory information related to pain and temperature. What is the primary type of receptor associated with this system?
The spinothalamic tract is responsible for carrying sensory information related to pain and temperature. What is the primary type of receptor associated with this system?
The lateral spinothalamic tract is crucial for sensing specific types of somatosensory information. Which of the following sensations is primarily transmitted by the lateral spinothalamic tract?
The lateral spinothalamic tract is crucial for sensing specific types of somatosensory information. Which of the following sensations is primarily transmitted by the lateral spinothalamic tract?
What is the primary role of the anterior spinothalamic tract?
What is the primary role of the anterior spinothalamic tract?
Where do second-order neurons of the lateral spinothalamic tract decussate?
Where do second-order neurons of the lateral spinothalamic tract decussate?
In the lateral spinothalamic tract, where do the third-order neurons synapse?
In the lateral spinothalamic tract, where do the third-order neurons synapse?
Which type of nerve fiber is primarily associated with the fast pain pathway mediated by the lateral spinothalamic tract?
Which type of nerve fiber is primarily associated with the fast pain pathway mediated by the lateral spinothalamic tract?
What type of sensory information is carried by the ventral trigeminothalamic tract?
What type of sensory information is carried by the ventral trigeminothalamic tract?
Where are the cell bodies of the first-order neurons located in the ventral trigeminothalamic tract?
Where are the cell bodies of the first-order neurons located in the ventral trigeminothalamic tract?
Where do second-order neurons of the ventral trigeminothalamic tract decussate?
Where do second-order neurons of the ventral trigeminothalamic tract decussate?
Which brain structure serves as the location for the third-order neuron cell bodies in both the lateral spinothalamic tract and the ventral trigeminothalamic tract?
Which brain structure serves as the location for the third-order neuron cell bodies in both the lateral spinothalamic tract and the ventral trigeminothalamic tract?
Which of the following describes the primary function of the spinocerebellar tracts?
Which of the following describes the primary function of the spinocerebellar tracts?
Which of the following is true regarding the inputs to the cerebellum from the spinocerebellar tracts?
Which of the following is true regarding the inputs to the cerebellum from the spinocerebellar tracts?
Why are the unconscious proprioceptive inputs from the spinocerebellar tracts important for cerebellar function?
Why are the unconscious proprioceptive inputs from the spinocerebellar tracts important for cerebellar function?
What is the main difference between primary and secondary (cortical) somatosensory sensations?
What is the main difference between primary and secondary (cortical) somatosensory sensations?
Which of the following best describes the key characteristics of primary sensory inputs?
Which of the following best describes the key characteristics of primary sensory inputs?
Which of the following sensory functions relies most heavily on cortical inputs compared to other primary sensations?
Which of the following sensory functions relies most heavily on cortical inputs compared to other primary sensations?
A lesion in the primary sensory cortex would most likely result in:
A lesion in the primary sensory cortex would most likely result in:
A patient has difficulty recognizing objects by touch (astereognosis) and identifying letters traced on their palm (graphaesthesia). Where is the most likely location of a lesion causing these deficits?
A patient has difficulty recognizing objects by touch (astereognosis) and identifying letters traced on their palm (graphaesthesia). Where is the most likely location of a lesion causing these deficits?
What type of deficits are most likely associated with lesions commonly occurring in the right parietal lobe?
What type of deficits are most likely associated with lesions commonly occurring in the right parietal lobe?
What clinical sign is most indicative of visuospatial neglect following a right hemisphere lesion?
What clinical sign is most indicative of visuospatial neglect following a right hemisphere lesion?
What is the likely sensory deficit in a patient with visuospatial neglect following a right parietal lobe stroke?
What is the likely sensory deficit in a patient with visuospatial neglect following a right parietal lobe stroke?
After a stroke, a patient is unable to feel a pinprick on the left side of their body but retains the ability to feel light touch. Where is the most likely location of the lesion?
After a stroke, a patient is unable to feel a pinprick on the left side of their body but retains the ability to feel light touch. Where is the most likely location of the lesion?
What is the expected sensory deficit from a lesion that involves only the dorsal horn of the spinal cord?
What is the expected sensory deficit from a lesion that involves only the dorsal horn of the spinal cord?
Sensory deficits from damage to a single spinal nerve root will:
Sensory deficits from damage to a single spinal nerve root will:
Why does a spinal cord lesion often result in sacral sparing?
Why does a spinal cord lesion often result in sacral sparing?
Lesions above the pons typically result in what type of sensory deficit?
Lesions above the pons typically result in what type of sensory deficit?
What sensory finding is characteristically associated with a spinal cord lesion?
What sensory finding is characteristically associated with a spinal cord lesion?
If a patient has a dissociated sensory deficit, such as losing pain on the left side of the body and proprioception on the right, the lesion is likely located in the:
If a patient has a dissociated sensory deficit, such as losing pain on the left side of the body and proprioception on the right, the lesion is likely located in the:
Which of the following best describes the reason that night time makes sensory ataxia more obvious for patients?
Which of the following best describes the reason that night time makes sensory ataxia more obvious for patients?
A patient displays clumsiness and gait issues that worsen significantly at night. Muscle power is normal, and pain/temp are intact. Proprioception and vibration are diminished in both arms and legs. Which vitamin deficiency is most likely associated with these findings?
A patient displays clumsiness and gait issues that worsen significantly at night. Muscle power is normal, and pain/temp are intact. Proprioception and vibration are diminished in both arms and legs. Which vitamin deficiency is most likely associated with these findings?
A patient reports numbness and tingling throughout the entire C8 dermatome on their left side. Examination reveals decreased sensation to light touch, pinprick, and temperature in this area. The most likely location of the lesion is:
A patient reports numbness and tingling throughout the entire C8 dermatome on their left side. Examination reveals decreased sensation to light touch, pinprick, and temperature in this area. The most likely location of the lesion is:
A patient presents with loss of pain and temperature sensation starting 2 segments below a spinal cord lesion. What is the most likely explanation for this phenomenon?
A patient presents with loss of pain and temperature sensation starting 2 segments below a spinal cord lesion. What is the most likely explanation for this phenomenon?
Which of the following best explains the somatotopic organization of the sensory pathways in the spinal cord?
Which of the following best explains the somatotopic organization of the sensory pathways in the spinal cord?
A patient has right sided loss of lower extremity fine touch sensation, and left sided loss of leg pain / temperature. Where is the lesion most likely located?
A patient has right sided loss of lower extremity fine touch sensation, and left sided loss of leg pain / temperature. Where is the lesion most likely located?
Which of the following fiber types has the slowest conduction velocity?
Which of the following fiber types has the slowest conduction velocity?
A patient exhibits loss of pain and temperature sensation on the left side of the face. Where is the MOST likely location of the lesion?
A patient exhibits loss of pain and temperature sensation on the left side of the face. Where is the MOST likely location of the lesion?
A patient has an injury near the spinal cord that affects both the dorsal column and spinothalamic tract on the same side. What are the most likely sensory deficits they will experience?
A patient has an injury near the spinal cord that affects both the dorsal column and spinothalamic tract on the same side. What are the most likely sensory deficits they will experience?
Which statement is most accurate regarding the destinations of second-order neurons in the Antero-Lateral System (ALS)?
Which statement is most accurate regarding the destinations of second-order neurons in the Antero-Lateral System (ALS)?
A patient reports a burning, poorly localized pain. Based on the provided information, which pathway is most likely involved in transmitting this type of pain?
A patient reports a burning, poorly localized pain. Based on the provided information, which pathway is most likely involved in transmitting this type of pain?
After a spinal cord injury, a patient has an immediate loss of pain and temperature sensation. Which of the following tracts is most likely affected?
After a spinal cord injury, a patient has an immediate loss of pain and temperature sensation. Which of the following tracts is most likely affected?
During a neurological exam, which tract is being primarily assessed when a pin prick test is administered?
During a neurological exam, which tract is being primarily assessed when a pin prick test is administered?
Why might a lesion affecting the anterior white commissure impact pain and temperature sensation?
Why might a lesion affecting the anterior white commissure impact pain and temperature sensation?
Following a stroke, a patient exhibits loss of pain and temperature sensation on one side of their body, originating approximately two spinal segments below the level of the lesion. What is the most likely explanation for this specific sensory deficit?
Following a stroke, a patient exhibits loss of pain and temperature sensation on one side of their body, originating approximately two spinal segments below the level of the lesion. What is the most likely explanation for this specific sensory deficit?
Which of the following best describes the somatotopic organization within the spinal cord influencing how lesions may present?
Which of the following best describes the somatotopic organization within the spinal cord influencing how lesions may present?
A patient has a spinal cord lesion that results in loss of pain and temperature sensation on the left side of the body and loss of proprioception on the right side. Where is the lesion most likely located?
A patient has a spinal cord lesion that results in loss of pain and temperature sensation on the left side of the body and loss of proprioception on the right side. Where is the lesion most likely located?
In a patient with known B12 deficiency presenting with sensory ataxia that is worse at night, what is the most likely underlying mechanism?
In a patient with known B12 deficiency presenting with sensory ataxia that is worse at night, what is the most likely underlying mechanism?
Which of the following scenarios would you most likely suspect damage to the trigeminal nerve?
Which of the following scenarios would you most likely suspect damage to the trigeminal nerve?
Which of the following is the most accurate description of how the trigeminal pathway carries pain and temperature information?
Which of the following is the most accurate description of how the trigeminal pathway carries pain and temperature information?
A patient presents with clumsiness when handling small objects, especially at night. Examination reveals intact motor strength, but impaired proprioception and vibration sense in both arms and legs. Where do the responsible pathways travel?
A patient presents with clumsiness when handling small objects, especially at night. Examination reveals intact motor strength, but impaired proprioception and vibration sense in both arms and legs. Where do the responsible pathways travel?
A patient exhibits a loss of crude touch sensation. Which of the following pathways is likely affected?
A patient exhibits a loss of crude touch sensation. Which of the following pathways is likely affected?
What is the key characteristic of primary sensory inputs compared to secondary (cortical) sensations?
What is the key characteristic of primary sensory inputs compared to secondary (cortical) sensations?
A patient with a right parietal lobe lesion is asked to draw a clock. Which of the following is the most likely presentation given this information?
A patient with a right parietal lobe lesion is asked to draw a clock. Which of the following is the most likely presentation given this information?
Flashcards
CN V
CN V
Cranial Nerve V, responsible for sensory and motor functions in the face.
Gasserian Ganglion
Gasserian Ganglion
The sensory root expands into this ganglion, located in the middle cranial fossa.
CN V Branches
CN V Branches
CN V divides into three branches before exiting the cranial cavity: Ophthalmic (V1), Maxillary (V2), and Mandibular (V3).
Superior Orbital Fissure
Superior Orbital Fissure
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Foramen Rotundum
Foramen Rotundum
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Foramen Ovale
Foramen Ovale
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Main sensory nucleus
Main sensory nucleus
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Mesencephalic nucleus
Mesencephalic nucleus
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Spinal nucleus of V
Spinal nucleus of V
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Ophthalmic Nerve
Ophthalmic Nerve
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Maxillary Nerve
Maxillary Nerve
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Mandibular Nerve
Mandibular Nerve
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CN V Sensory Testing
CN V Sensory Testing
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Corneal Reflex
Corneal Reflex
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Sensory Component Of Corneal Reflex
Sensory Component Of Corneal Reflex
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Motor Component Of Corneal Reflex
Motor Component Of Corneal Reflex
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Herpes Zoster (Shingles)
Herpes Zoster (Shingles)
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Trigeminal Neuralgia
Trigeminal Neuralgia
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Carbamazepine
Carbamazepine
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Muscles of Mastication
Muscles of Mastication
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Pontomedullary junction
Pontomedullary junction
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Facial Nerve (CN VII)
Facial Nerve (CN VII)
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Facial Canal Lesion
Facial Canal Lesion
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Cerebello-Pontine Angle Tumor
Cerebello-Pontine Angle Tumor
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Facial nerve terminal motor branches
Facial nerve terminal motor branches
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Auditory pathway
Auditory pathway
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Vestibulocochlear Nerve
Vestibulocochlear Nerve
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Vestibulocochlear nerve
Vestibulocochlear nerve
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Vestibular Neuritis
Vestibular Neuritis
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Sensorineural Loss
Sensorineural Loss
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Antero-Lateral System
Antero-Lateral System
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ALS destinations
ALS destinations
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Lateral Spinothalamic Tract
Lateral Spinothalamic Tract
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Anterior Spinothalamic Tract
Anterior Spinothalamic Tract
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Free Nerve Endings
Free Nerve Endings
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STT Synapse Location
STT Synapse Location
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STT Decussation
STT Decussation
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STT ascent
STT ascent
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A delta fibers
A delta fibers
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Ventral Trigeminothalamic Tract
Ventral Trigeminothalamic Tract
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VTT-Medulla
VTT-Medulla
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Descending pain modulation pathways
Descending pain modulation pathways
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Pain Testing
Pain Testing
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Temperature Testing
Temperature Testing
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Dermatome
Dermatome
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Group A fibers
Group A fibers
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Group B fibers
Group B fibers
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Group C fibers
Group C fibers
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Somatotopic Organization
Somatotopic Organization
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Thalamus
Thalamus
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Spatial neglect
Spatial neglect
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Study Notes
Pain & Temperature Pathways
- Unlike the Dorsal Column-Medial Lemniscus (DCML), the Antero-Lateral System has multiple destinations for the 2nd order neurons.
- Thalamus is a destination via the Spinothalamic tract (STT).
- The Colliculi is a destination via Spinotectal tracts (STCT)
- The Reticular formation is a destination via the Spinoreticular tract (SRT)
- The Hypothalamus is a destination via the Spinohypothalamic tract (SHT)
- Tracts are likely to have different functions in relation to pain
- Acute (fast) pain uses the Spinothalamic tract
- Chronic (slow) pain involves conduction with different aspects
- Emotional aspects of pain are also processed
- Pain related reflexes occur
- Pain modulation occurs through spinotectal and spinoreticular pathways via tectum to control other aspects
- Receptors for pain and temperature are mostly free nerve endings.
Spinothalamic Tracts
- There are 2 components - Lateral and Anterior
- Lateral Spinothalamic Tract
- It is a fast pain pathway for immediate awareness, localization, and intensity of pain
- It is clinically important and a substrate for the pin prick test
- It also transmits temperature sensation
- Travels in the lateral spine segment and relates to awareness, localisation, and intensity
- Anterior Spinothalamic Tract
- Responsible for crude touch
- Primarily lateral tract, mediates temperature, pain, and discriminative touch
Lateral Spinothalamic Pathway (LST)
- 1st order neurons originate from free nerve endings with cell bodies in the dorsal root ganglia
- Central processes enter the dorsal horn of the spinal cord
- They synapse directly with 2nd order neurons in the dorsal horn
- 2nd order neurons take an oblique upward course crossing to the opposite side anterior to the central canal via the Anterior White Commissure
- Enter the LST about two segments above
- 2nd order neurons ascend in the brainstem as the Spinal Lemniscus to the thalamus
- They synapse directly with 3rd order neurons in the Ventral Postero-Lateral (VPL) nucleus
- 3rd order neurons pass into the posterior limb of the internal capsule
- They pass through the corona radiata and reach the primary somatosensory cortex
- Pathway mostly consists of fast conducting A delta type neurons, which decussate and takes 2 segments
Pain/Temp Conduction from Head - Ventral Trigeminothalamic Tract
- 1st order neurons originate from receptors with their cell bodies in the Trigeminal ganglion
- Central processes enter the Pons.
- These neurons then descend into the Medulla as the Spinal Trigeminal Tract.
- They synapse with cell bodies of 2nd order neurons located in the Spinal Nucleus of Trigeminal.
- The 2nd order neurons decussate in the medulla and enter the VTT (Ventral Trigeminothalamic Tract).
- 2nd order neurons ascend in the VTT, synapsing with 3rd order neurons in the Ventral Postero-Medial nucleus (VPM) of the thalamus.
- 3rd order neurons enter the posterior limb of the internal capsule
- These then passes through the corona radiata and reach the area representing the head the primary somatosensory cortex.
Anterior Tracts of ALS
- Pathway mostly consists of slow conducting C type (unmyelinated) neurons (very small - type C chronic pain, slow)
-
- Anterior Spinothalamic Tract relates to crude touch sensation
- Spino-mesencephalic pathway
- Spino-reticular pathway: Type A - fast
- descending signals from cerebral cortex down to help modulate pain
- Involved with opioids
Descending Pain Modulation Pathways
- Projects to the dorsal column, starting with the second neuron
- Periaqueductal gray matter (PAG - contains opioid receptors)
- Rostral ventromedial medulla (RVM) projects descending singals
- Terminates mostly on C fibers, influencing slow pain
Lateral Spinothalamic Pathway (LST)
- Left medullary lesion could cause left sided facial anesthesia (True or False?)
- Hemisection could cause anesthesia whole face (True or False?)
- Affects spinal tract and results in pain and temperature deficits
- Affects the same (ipsilateral) side
- Affects Pina, and temperature mostly Lateral Spino-Thalamic-VTT relates to the right side of the face, in hemisection - affect both sides of face Involved neurons from both sides at the level of decussation.
Tests
- Pain testing method involves using a tooth pick or safety pin, asking the patient if they feel sharp or dull, comparing the test on two sides, in order to localize the site of pain or deficit
- Temperature is evaluated by using test tubes containing warm and cold solutions, asking the patient if they feel warm or cold
- Crude touch is tested by touching the patient with cotton wool, asking them if they can feel anything, and comparing two sides using the cotton wool ALS for crude touch
Sensory Pathways from the Face
- All somatic sensations (Pain/temp/Proprioception/Discriminative touch) sensations derived from the head region sent through the 3 main branches of the Trigeminal nerve to the brainstem
- Ophthalmic
- Maxillary
- Mandibular 1st neuron cell bodies are located in Trigeminal ganglion Yellow = pain - BLUE touch or Proprioception .synapse at pons stay stay and synapse 2nd neuron cell bodies are located in Nuclei, MIDBRAIN
- Mesencephalic nucleus ,Unconscious, Proprioception, PONS
- Main sensory nucleus pons relates Touch and Conscious Proprioception, Spinal nucleus of V-spinal trigeminal enter pont ,Pain and Temperature
Ventral Trigeminothalamic Tract
- Ventral Trigeminothalamic tract Proprioception , Vibration, Discriminative-Head Receptors for
Ophthalmic ,Maxillary N , Mandibular Proprioception , Vibration , Discriminative touch
- 1st order neuron ascends upwards to thalamus.
Spinocerebellar Tracts
- These pathways carry proprioceptive info to the cerebellum (unconscious) via multiple pathways
- Dorsal spinocerebellar tract (DSCT)- Proprioceptive input to IPSILATERALcerebellum
- Ventral spinocerebellar tract (VSCT)- Mainly info regarding spinal interneuron activity in relation to stretch reflex to IPSILATERAL cerebellum.
What you need to know
- The pathways transmit unconscious proprioceptive input ,that are ipsilateral
- These inputs are important for cerebellum about executed movement
- Important to supervise (coordinate) the movements.
Primary and Secondary Cortical Sensations
- Primary sensory inputs include proprioception, vibration, pressure, crude touch and discriminative touch
- Perception of primary sensation occurs at the level of thalamus
- Patient is able to to feel pain and crude touch, however the patient will have no discriminating ability or localizing ability
- Processing of proprioception generally needs cortical inputs, but also
- Secondary uses multiple primary sensory inputs to process together at supra thalamic levels
- Primary sensory cortex is Contralateral - localizing, in regards to quality and intensity
- Cortical sensations
- Stereognosis, Graphaesthesia is secondary which need primary sesnosory in order for fine touch ,pressure is needed- or 2 point D
- Contralateral Contralateral Visuo Awareness awareness what happens on to deficits side
- See why in next slide
Processing of spatial awareness
-
Right Posterior Parietal cortex is responsible for Visuospatial awareness on both left and right
-
Left Posterior Parietal cortex is responsible for Visuospatial awareness on the right side "world"
-
Lesion of the left results in cannot process info process can the right Hemineglect uncommon is where LT hemisphere - RT space
-
Can be the inability to do sterognosis also , inability side to do Sterognosis
Tests for Cortical Sensations
Sensory attention
- Stereognosis- familiar object close eyes cortical
- Numbers and letters cortical
- Double stimulation test - open eyes stimuli if right will- problems this is issue 1ry tested modalities sensations
Somatotopic Organization of Sensory pathway in Spinal Cord
- Spinal cord tracts-leg medial, face lateral , C - cervical, TG - thoracic, L- lumbar, S - sacral lumbar and sacral periphera
- Lateral Cortico spinal tract Lateral Lesions . sacral involved
- Similar to lower
- Most are located periphery upper limb centrally lesions sacord -Sacral sparing . cord sensory
Patterns of Sensory Deficits – Central & Peripheral Lesions
Spinal - Pink Lateral Dorsal is cord
- The deficits cord Lateral
""".
Patterns of Sensory Deficits – Central & Peripheral Lesions
- VTT is not the Lateral to not the
Dermatome
- Area of skin innervated by nerve will ,spinal this Spinal dermatome and
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