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Questions and Answers
Which of the following best describes the anatomical arrangement of the spinal cord's internal structure?
Which of the following best describes the anatomical arrangement of the spinal cord's internal structure?
- An inner core of connective tissue surrounded by alternating layers of gray and white matter.
- Each half consists of inner white matter and outer gray matter, divided by the posterior median septum.
- Each half consists of inner gray matter and outer white matter, divided by the anterior median fissure. (correct)
- An inner layer of white matter surrounding an outer layer of gray matter.
Which of the following tracts is responsible for carrying discriminative touch, pressure and vibration from the lower limbs?
Which of the following tracts is responsible for carrying discriminative touch, pressure and vibration from the lower limbs?
- Lateral spinothalamic tract
- Cuneate tract
- Gracil tract (correct)
- Ventral spinothalamic tract
A patient has lost the ability to perceive pain and temperature on the left side of their body, two segments below the site of a spinal cord lesion. Which tract is most likely affected?
A patient has lost the ability to perceive pain and temperature on the left side of their body, two segments below the site of a spinal cord lesion. Which tract is most likely affected?
- Ventral spinothalamic tract
- Ventral corticospinal tract
- Dorsal column medial lemniscus pathway
- Lateral spinothalamic tract (correct)
In the spinal cord's gray matter, which group of neurons primarily innervates the muscles of the trunk?
In the spinal cord's gray matter, which group of neurons primarily innervates the muscles of the trunk?
Which of the following is the primary function of the ventral spinocerebellar tract?
Which of the following is the primary function of the ventral spinocerebellar tract?
What is the role of the substantia gelatinosa of Rolando in the spinal cord?
What is the role of the substantia gelatinosa of Rolando in the spinal cord?
Which of the following describes the path of the 2nd order neuron in the dorsal column medial lemniscus pathway?
Which of the following describes the path of the 2nd order neuron in the dorsal column medial lemniscus pathway?
Which ascending tract does not decussate in the spinal cord?
Which ascending tract does not decussate in the spinal cord?
A patient experiences a loss of unconscious proprioception from the lower limb. Which of the following spinal cord structures is most likely involved?
A patient experiences a loss of unconscious proprioception from the lower limb. Which of the following spinal cord structures is most likely involved?
Which of the following sensations is primarily mediated by the nucleus proprius in the dorsal horn of the spinal cord?
Which of the following sensations is primarily mediated by the nucleus proprius in the dorsal horn of the spinal cord?
A lesion in the medial lemniscus will result in loss of:
A lesion in the medial lemniscus will result in loss of:
What is the critical function of the Clark's nucleus (nucleus dorsalis) in the spinal cord?
What is the critical function of the Clark's nucleus (nucleus dorsalis) in the spinal cord?
Which of the following ascending tracts carries sensory information that allows you to know the position of your limbs without looking?
Which of the following ascending tracts carries sensory information that allows you to know the position of your limbs without looking?
Following a spinal cord injury, a patient exhibits paralysis and loss of fine touch sensation on the same side of the body below the level of the lesion. Which descending and ascending tracts are most likely affected, respectively?
Following a spinal cord injury, a patient exhibits paralysis and loss of fine touch sensation on the same side of the body below the level of the lesion. Which descending and ascending tracts are most likely affected, respectively?
A patient has selective damage to the lateral horn of the spinal cord in the thoracic region. Which of the following functions would MOST likely be impaired?
A patient has selective damage to the lateral horn of the spinal cord in the thoracic region. Which of the following functions would MOST likely be impaired?
A researcher is studying the sensory pathways in the spinal cord. They inject a tracer that is taken up by first-order sensory neurons. Where would they expect to find the cell bodies of these neurons?
A researcher is studying the sensory pathways in the spinal cord. They inject a tracer that is taken up by first-order sensory neurons. Where would they expect to find the cell bodies of these neurons?
The ventral spinothalamic tract is responsible for conveying which type of sensory information?
The ventral spinothalamic tract is responsible for conveying which type of sensory information?
If a lesion occurred affecting the axons crossing in the anterior white commissure of the spinal cord, which sensory loss would most likely occur?
If a lesion occurred affecting the axons crossing in the anterior white commissure of the spinal cord, which sensory loss would most likely occur?
What type of receptor is primarily responsible for detecting muscle stretch and contributing to proprioception?
What type of receptor is primarily responsible for detecting muscle stretch and contributing to proprioception?
Why might no sensory loss be detected following a lesion of the ventral spinothalamic tract?
Why might no sensory loss be detected following a lesion of the ventral spinothalamic tract?
Which of the following describes the arrangement of motor neuron pools within the ventral horn of the spinal cord?
Which of the following describes the arrangement of motor neuron pools within the ventral horn of the spinal cord?
A patient presents with impaired fine touch and conscious proprioception from the right lower limb, but normal function in the upper limb. Where is the MOST likely lesion?
A patient presents with impaired fine touch and conscious proprioception from the right lower limb, but normal function in the upper limb. Where is the MOST likely lesion?
If a lesion completely transects the left side of the spinal cord at the level of T10, which sensory deficits would be expected below the level of the lesion?
If a lesion completely transects the left side of the spinal cord at the level of T10, which sensory deficits would be expected below the level of the lesion?
A patient has a lesion affecting the internal arcuate fibers. Which of the following sensory deficits would MOST likely result from this lesion?
A patient has a lesion affecting the internal arcuate fibers. Which of the following sensory deficits would MOST likely result from this lesion?
A patient presents with a loss of pain and temperature sensation two segments below the level of the lesion. Which structure is MOST likely damaged?
A patient presents with a loss of pain and temperature sensation two segments below the level of the lesion. Which structure is MOST likely damaged?
Which of the following best explains why damage to the ventral spinothalamic tract may not result in readily detectable sensory loss?
Which of the following best explains why damage to the ventral spinothalamic tract may not result in readily detectable sensory loss?
A patient with a spinal cord injury exhibits loss of unconscious proprioception from the lower limb but intact motor function. Which tract is likely affected?
A patient with a spinal cord injury exhibits loss of unconscious proprioception from the lower limb but intact motor function. Which tract is likely affected?
A researcher is investigating the sensory pathways for discriminative touch in the spinal cord. If they were to trace the path of a second-order neuron in this pathway, where would they expect to find its axon?
A researcher is investigating the sensory pathways for discriminative touch in the spinal cord. If they were to trace the path of a second-order neuron in this pathway, where would they expect to find its axon?
Following a spinal cord injury, a patient demonstrates an inability to coordinate movements on the right side of the body, specifically affecting the lower limb. Which of the following pathways is MOST likely affected?
Following a spinal cord injury, a patient demonstrates an inability to coordinate movements on the right side of the body, specifically affecting the lower limb. Which of the following pathways is MOST likely affected?
Which of these tracts does NOT contain primary sensory neurons?
Which of these tracts does NOT contain primary sensory neurons?
A lesion in the spinal cord affects the nucleus proprius. What sensory loss results from this lesion?
A lesion in the spinal cord affects the nucleus proprius. What sensory loss results from this lesion?
Where do the central processes of the dorsal root ganglion ascend to form the gracile and cuneate tracts?
Where do the central processes of the dorsal root ganglion ascend to form the gracile and cuneate tracts?
Which of the following best describes the function of spinal border cells in the context of unconscious proprioception?
Which of the following best describes the function of spinal border cells in the context of unconscious proprioception?
What is the functional significance of the decussation that occurs within the internal arcuate fibers?
What is the functional significance of the decussation that occurs within the internal arcuate fibers?
A patient reports a loss of pain and temperature sensation beginning two segments below the level of a spinal cord lesion. Which specific part of the ascending pathway is MOST likely involved?
A patient reports a loss of pain and temperature sensation beginning two segments below the level of a spinal cord lesion. Which specific part of the ascending pathway is MOST likely involved?
A patient has a lesion that selectively disrupts the function of the accessory cuneate nucleus. What specific sensory deficit would MOST likely result from this lesion?
A patient has a lesion that selectively disrupts the function of the accessory cuneate nucleus. What specific sensory deficit would MOST likely result from this lesion?
Which statement BEST integrates the function and location of the substantia gelatinosa?
Which statement BEST integrates the function and location of the substantia gelatinosa?
A patient presents with impaired pain and temperature sensation three segments below the level of the spinal cord lesion on the contralateral side. The MOST likely explanation involves damage to which specific structure?
A patient presents with impaired pain and temperature sensation three segments below the level of the spinal cord lesion on the contralateral side. The MOST likely explanation involves damage to which specific structure?
A person steps on a sharp object. Which sequence BEST describes the order that the sensory neurons will take?
A person steps on a sharp object. Which sequence BEST describes the order that the sensory neurons will take?
Damage to the gracile fasciculus would result in deficits of:
Damage to the gracile fasciculus would result in deficits of:
Which nuclei in the ventral horn are responsible for controlling extensor muscles?
Which nuclei in the ventral horn are responsible for controlling extensor muscles?
At what level of the spinal cord are the central group neurons located?
At what level of the spinal cord are the central group neurons located?
What is the primary function of the lateral corticospinal tract?
What is the primary function of the lateral corticospinal tract?
A lesion affecting the ventral spinocerebellar tract would MOST directly impair which function?
A lesion affecting the ventral spinocerebellar tract would MOST directly impair which function?
After a complete spinal cord injury at the T6 level, which ascending tract would LEAST likely transmit signals from the lower extremities?
After a complete spinal cord injury at the T6 level, which ascending tract would LEAST likely transmit signals from the lower extremities?
Which of the following is a key function of the ventral spinothalamic tract?
Which of the following is a key function of the ventral spinothalamic tract?
Which of the following describes the neurons of the Gracilis and Cuneatus?
Which of the following describes the neurons of the Gracilis and Cuneatus?
What is a distinguishing feature of the lateral horn of the spinal cord?
What is a distinguishing feature of the lateral horn of the spinal cord?
The cell bodies for the second-order neurons of the spinothalamic tract are located in which structure?
The cell bodies for the second-order neurons of the spinothalamic tract are located in which structure?
Which tract decussates in the medulla oblongata, after ascending in the spinal cord?
Which tract decussates in the medulla oblongata, after ascending in the spinal cord?
The anterolateral system transmits what sensation?
The anterolateral system transmits what sensation?
What is the function of the tectospinal tract?
What is the function of the tectospinal tract?
A patient presents with loss of motor function in the left leg and foot. Imaging reveals a lesion affecting a descending tract within the ventral column of the spinal cord. Which tract is most likely involved?
A patient presents with loss of motor function in the left leg and foot. Imaging reveals a lesion affecting a descending tract within the ventral column of the spinal cord. Which tract is most likely involved?
Lesions in the posterior limb of the internal capsule would directly impact which of the following sensory pathways?
Lesions in the posterior limb of the internal capsule would directly impact which of the following sensory pathways?
Spinal border cells perform what function?
Spinal border cells perform what function?
Which sensory receptor type is primarily responsible for the detection of discriminative touch?
Which sensory receptor type is primarily responsible for the detection of discriminative touch?
The dorsal column-medial lemniscus pathway crosses at what level of the nervous system?
The dorsal column-medial lemniscus pathway crosses at what level of the nervous system?
What is the main sensory modality transmitted by the gracile fasciculus?
What is the main sensory modality transmitted by the gracile fasciculus?
Central processes of the dorsal root ganglion ascend how many segments before synapsing?
Central processes of the dorsal root ganglion ascend how many segments before synapsing?
Where do the axons of gracil and cuneate nuclei terminate after decussation?
Where do the axons of gracil and cuneate nuclei terminate after decussation?
Flashcards
Anterior Median Fissure & Posterior Median Septum
Anterior Median Fissure & Posterior Median Septum
Divides the spinal cord into two halves.
Gray vs. White Matter Composition
Gray vs. White Matter Composition
Inner part contains nerve cell bodies; outer part contains axons of nerve cells.
Ascending Tracts
Ascending Tracts
Carry sensory information from the body to the brain.
Descending Tracts
Descending Tracts
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Medial Group (Ventral Horn)
Medial Group (Ventral Horn)
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Lateral Group (Ventral Horn)
Lateral Group (Ventral Horn)
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Ventral Nuclei Functon
Ventral Nuclei Functon
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Dorsal Nuclei Function
Dorsal Nuclei Function
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Lateral Horn
Lateral Horn
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Gracil Tract
Gracil Tract
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Cuneate Tract
Cuneate Tract
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Lateral Spino-Thalamic Tract
Lateral Spino-Thalamic Tract
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Ventral Spino-Thalamic Tract
Ventral Spino-Thalamic Tract
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Spinal Border Cells
Spinal Border Cells
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Clark Nucleus
Clark Nucleus
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Accessory Cuneate Nucleus
Accessory Cuneate Nucleus
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Function of Gracil & Cuneate Tracts
Function of Gracil & Cuneate Tracts
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1st Order Neuron Receptors
1st Order Neuron Receptors
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2nd Order Neuron Pathway
2nd Order Neuron Pathway
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3rd Order Neuron
3rd Order Neuron
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Ventral Horn
Ventral Horn
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Distribution of Dorsal Horn
Distribution of Dorsal Horn
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N.B: Discriminative
N.B: Discriminative
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2nd order neuron path
2nd order neuron path
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Rexed Lamination II
Rexed Lamination II
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Ventral Column
Ventral Column
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Lateral Column
Lateral Column
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Ventral Horn: Medial group
Ventral Horn: Medial group
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Sensory Decussation
Sensory Decussation
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2nd Order Neuron for Ventral Spinothalamic Tract
2nd Order Neuron for Ventral Spinothalamic Tract
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Substantia Gelatinosa of Rolandi
Substantia Gelatinosa of Rolandi
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Nucleus Proprius
Nucleus Proprius
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Study Notes
- Anterior median fissure and posterior median septum divide the spinal cord into 2 halves.
- Each half consists of inner gray matter (nerve cell body) and outer white matter (axon of nerve cells).
White Matter
- Ascending tracts include the gracil and cuneate tracts.
- Descending tracts consist of rubro-spinal and lateral cortico-spinal tracts.
- Lateral column contains lateral spino-thalamic, dorsal spino-cerebellar, ventral spino-cerebellar, rubro-spinal, and lateral cortico-spinal tracts.
- Ventral column contains ventral spino-thalamic, ventral cortico-spinal, tecto-spinal, vestibule-spinal, and olivo-spinal tracts.
Gray Matter
- Ventral horn contains motor neurons arranged in medial, lateral, and central groups.
- Medial group supplies muscles of the trunk.
- Lateral group supplies muscles of the limbs.
- Central group is found only at lumbo-sacral segments.
- Ventral nuclei control extensors, while dorsal nuclei control flexors.
- Lateral horn is present only in the thoraco-lumbar region and contains sympathetic nerve cells.
Dorsal Horn
- Postero-marginal zone is Rexed lamination I and mediates pain and temperature sensation.
- Substantia gelatinosa of rolandi is Rexed lamination II and mediates pain and temperature sensation.
- Nucleus proprius is Rexed lamination III & IV and mediates simple touch and pressure sensations.
- Clark's nucleus ("nucleus dorsalis") is Rexed lamination VII and mediates unconscious proprioception; found between C8-L2.
Sensations from the Body
- Proprioception can be unconscious or conscious.
- Exterioception includes touch and pain/temperature sensations.
- Unconscious proprioception involves ventral spino-cerebellar (from lower limb) and dorsal spino-cerebellar (from lower limb & trunk).
- Conscious proprioception is mediated by the gracil and cuneate tract (cuneo-cerebellar: from upper limb)
- Touch sensations are discriminative (Localization, 2 point discrimination & Steriognosis) and simple touch & pressure
- Discrimitive tough = fine tough whil simple touch = light/crude touch
- Pain and temperature sensations are transmitted via the lateral spino-thalamic tract.
Sensory Order Neurons
- 1st order neuron: peripheral process from dorsal root ganglion relay on the sensory receptors, the central process enters the spinal cord to synapse on 2nd order neuron.
- 2nd order neuron gives rise to an axon that crosses to the opposite side and ascends to a higher level of the central nervous system, where it synapses with 3rd order neuron.
- 3rd order neuron is usually in the thalamus and projects fiber that passes in the internal capsule to reach the sensory area of the cerebral cortex.
Gracile & Cuneate Tracts
- Function is to carry conscious proprioception, discriminative touch, simple touch & pressure, and vibration.
- Gracile tract carries sensations from below T6
- Cuneate tract carries sensation above T6
- 1st order neurons: peripheral processes of dorsal root ganglion end in receptors for muscle tendon & spindle for proprioception, touch (merckel and meissner), and pressure & vibration (pacinian).
- The central process ascends in the dorsal column to form gracile & cuneate tracts, relaying in gracile & cuneate nuclei in the medulla.
- 2nd order neurons: axons of gracile & cuneate nuclei form internal arcuate fibers ("sensory decussation") in the closed medulla, crossing to the opposite side and forming the medial leminscus ending at the ventral posterior lateral nucleus of the thalamus “VPLNT”.
- 3rd order neurons: axons of VPLNT ascend in the posterior limb of the internal capsule to the general sensory area.
- Lesion: Loss of conscious proprioception and discriminative touch below the lesion level occurs on the same side with gracile & cuneate tract lesions and on the opposite side with medial leminscus lesions.
Lateral Spino-Thalamic Tract
- Carries pain & temperature sensations.
- 1st order neuron: peripheral processes of dorsal root ganglion end in pain (fine nerve endings) and temperature receptors (Krause and Hot receptor = Ruffini).
- Central processes ascend 2 segments forming lisseur tract to end at Postero-marginal & substantia gelatinosa of rolandi & nucleus propious.
- 2nd order neuron: Axons of Postero-marginal & nucleus propious cross to the opposite side and ascend in the lateral column of the spinal cord, ending on the ventral posterior lateral nucleus of the thalamus “VPLNT”.
- The role of substantia gelatinosa of rolandi is to produce encephalin for pain suppression.
- Ventral & lateral spino-thalamic tracts join to form spinal leminscus.
- 3rd order neuron: Axons of VPLNT ascend in posterior limb of Internal capsule to reach general sensory area.
- Lesion: Contralateral loss of pain & temperature 2 segments below lesion level.
Ventral Spino-Thalamic Tract
- Carries simple touch & pressure sensations.
- 1st order neuron: Peripheral processes of dorsal root ganglion end in receptors for touch (merckel and meissner) and pressure & vibration (pacinian).
- Central processes of dorsal root ganglion synapse at nucleus propious.
- 2nd order neuron: Axons of the 2nd order neuron cross to the opposite side at 10 segments to ascend in the anterior column of the spinal cord and end on the ventral posterior lateral nucleus of the thalamus "VPLNT".
- Ventral & lateral spino-thalamic tracts join to form spinal leminscus.
- 3rd order neuron: Axons of VPLNT ascend in the posterior limb of the internal capsule to reach the general sensory area.
- Lesion: No sensory loss is detected: The same sensations are also carried by gracile & cuneate, and the ventral spinothalamic tract crosses the midline at many levels.
Unconscious Proprioception
- Peripheral processes of dorsal root ganglion end in receptors ("muscle tendon & muscle spindle").
- Central processes of dorsal root ganglion relay on spinal border cells, Clark's nucleus, or the accessory cuneate nucleus.
- Spinal border cells carry unconscious proprioception from the lower limb.
- The form ventral spino-cerebellar tract crosses to the opposite side to enter the cerebellum through the superior cerebellar peduncle, then recrosses to end on the ipsilateral cerebellar hemisphere.
- Clark's nucleus carries unconscious proprioception from the lower limb & trunk and forms the dorsal spino-cerebellar tract, which enters the ipsilateral cerebellar hemisphere through the inferior cerebellar peduncle.
- Accessory cuneate nucleus carries unconscious proprioception from the upper limb and forms the cuneo-cerebellar tract, which enters the ipsilateral cerebellar hemisphere through the inferior cerebellar peduncle.
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