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Neuro
Tracts and such
68
Medical
Graduate
11/10/2010

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Term
Lateral spinothalamic tract
Definition
carries info about pain
Term
Anterior spinothalamic tract
Definition
carries info about crude touch
Term
anterolateral system (ALS)
Definition
combined tracts for pain, temp and crude touch
Term
spinothalamic tract
Definition
1st order neuron: dorsal root ganglion-->dorsolateral
fasciculus of Lissauer into the
dorsal horn, 2nd order neuron-->axon passes through the
ventral white commissure to
reach the contralateral side, ascends-->medulla,pons,midbrain,ventral posterolateral
nucleus (VPL) of the thalamus, 3rd order neuron-->axon passes
through the posterior limb of
the internal capsule to reach
the postcentral gyrus (primary
sensory cortex)
Term
TRIGEMINOTHALAMIC tract
Definition
1st order neuron: semilunar
ganglion-->enter mid-pons, descend to spinal nucleus in medulla, 2nd order neurons-->axons cross and ascend to reach ventral
posteromedial nucleus (VPL) of thalamus, third-order neurons--> axons travel through posterior limb of the
internal capsule to reach the postcentral gyrus (primary sensory cortex)
Term
Lateral medullary syndrome of wallenburg
Definition
ipsilateral loss of pain and temp in face and contralateral pain and temp in body
Term
Maxillary division (V2) lesion
Definition
Loss of sensation to the cheeks and upper teeth
Term
Ophthalmic division (V1) lesion
Definition
Loss of sensation to the forehead as far as the vertex; loss of sensation to the nose, loss of sensation to the cornea
Term
Mandibular division (V3) lesion
Definition
Loss of sensation to the anterior 2/3 of the tongue, mandible, lower teeth, chin
Term
DORSAL COLUMN – MEDIAL LEMNISCUS SYSTEM FOR FINE TOUCH, CONSCIOUS PROPRIOCEPTION, AND BONE VIBRATORY
SENSE
Definition
1st order neuron: dorsal root ganglion--> fibers enter the dorsal root medial to the dorsolateral fasciculus of Lissauer (axons of T6 and below: fasciculus gracilis, those above T6:fasciculus cuneatus)-->ascend to nuclei (cuneatus/gracilis) in medulla, 2nd order neurons--> axons cross over as internal arcuate fibers in caudal medulla and ascend as medial lemniscus thru rostral medulla,pons,midbrain to ventral
posterolateral nucleus (VPL) of the thalamus, 3rd order neurons--> thru internal capsule to postcentral gyrus
Term
Where in the body are the
lateral spinothalamic tract for the right
half of the body and the trigeminal fibers
for the left side of the face near enough
to each other that a single lesion could
damage both?
Definition
lateral medulla
Term
contralateral loss of pain and
temperature and fine touch for the contralateral half of the body, including the face
Definition
lateral spinothalamic,
Trigeminothalamic and medial lemniscus
Fibers are all on the same side: in the midbrain
Term
Where can the nucleus ambiguus for the vagus nerve be interrupted along with the lateral spinothalamic tract and the trigeminal system?
Definition
medulla
Term
Horner's syndrome
Definition
results from a lesion of the sympathetic pathways to the eye. It consists of a triad of partial ptosis (slightly drooping eyelid), miosis
(constricted pupil), and anhydrosis (loss of sweating from the ipsilateral side of the face). associated with MIDBRAIN LESIONS, PONTINE TEGMENTAL LESIONS,
LATERAL MEDULLARY SYNDROME OF WALLENBERG,
BROWN-SEQUARD SYNDROME INVOLVING T1-T3
Term
accessory oculomotor nucleus (Edinger-Westphal) fx
Definition
parasympathetic innervation
Term
Horner’s syndrome
Definition
an infection of the
middle ear (otitis media) can
produce a *** since the internal carotid
artery passes through the middle
ear in the petrous temporal bone
Term
postganglionc Horner’s syndrome
Definition
if one places cocaine eyedrops onto the surface of a patient with ***, no effect will occur bc there is no norepinephrine that can be released
Term
preganglionic Horner’s syndrome
Definition
placing cocaine on the cornea of a patient with ***, will cause dilation of the pupil due to release of norepinephrine
Term
One cause of a *** is a superior sulcus
tumor of the lung (Pancoast’s tumor)
Definition
preganglionic peripheral Horner’s syndrome
Term
central Horner's syndrome
Definition
triad of partial ptosis (slightly drooping eyelid), miosis
(constricted pupil), and anhydrosis (loss of sweating) to ipsilateral face, plus anhydrosis to entire side of the
body, and all sympathetic functions for that side of the body will be lost
Term
TROCHLEAR PALSY
Definition
diplopia is present when the eye is adducted and depressed
Term
Anterior Cerebral Artery infarct
Definition
an infarct of which will cause weakness or paralysis from the knee downwards contralaterally. Patient presentation of LEG>>ARM=TRUNK
Term
Middle Cerebral Artery infarct
Definition
; infarction here would cause weakness or paralysis above the knee contralaterally. Patient presentation of ARM=TRUNK>>LEG
Term
2. Pre-motor cortex: located directly in front of the pre-central gyrus in Brodman’s area 6 on the lateral side of the cortex. Involved in planning the movements initiated in the motor cortex
Definition
results in mild paresis (weakness) and impaired skilled movements, especially involving proximal limb muscles
Term
Supplemental Motor Area (SMA)
Definition
a. Lesions affecting this area will result in akinesia: inability to initiate movement. Can be caused by a tumor in the falx cerebri. Also, bilateral coordination of movements will be impaired
Term
Dorsolateral Pre-frontal Cortex
Definition
Involved in planning and strategizing during complex movements, as well as thinking about movements and their consequences. Activates the SMA as soon as a person intends to make a movement
Term
genu
Definition
Fibers for the face (corticobulbar tract) are located in the *** of the internal capsule
Term
posterior limb of the internal capsule
Definition
Motor fibers for the face and body run through the ***, which separates the thalamus from the lentiform nucleus
Term
internal capsule, contralateral
Definition
May be lesioned by an infarction of the lenticular striate arteries… patient will present with *** loss of motion or paralysis will affect ARM=TRUNK=LEG, and also face if the genu is damaged.
Term
UMN syndromes affecting facial nerves result in
Definition
facial hemiparesis contralaterally on the lower half of the face only (patient will still be able to life eyebrows)
Term
LMN syndromes affecting facial nerves (such as Bell’s Palsy, involving nerve VII)
Definition
result in hemiparesis of the entire half of the face, contralaterally
Term
lateral vestibular nucleus
and medullary reticular
formation (location?)
Definition
medulla
Term
superior colliculus and
red nucleus are located in
Definition
midbrain
Term
pontine
reticular formation is located
in
Definition
pontine tegmentum
Term
rubrospinal tract arises in the ** and decussates to descend to the cervical
spinal cord to activate flexor movements of the arm
Definition
contralateral red nucleus, flexor movements of the arm
Term
tectospinal tract
Definition
arises in the contralateral superior colliculus and (together with the medial vestibulospinal tract)
coordinates movements of the head with those of the eyes
Term
Lateral Vestibulospinal Tract
Definition
Cell bodies in the Lateral Vestibular Nucleus in the Medulla, descends through the spinal cord to innervate extensor muscles of the upper and lower limb ipsilaterally. Important for maintaining posture during motion/acceleration
Term
Medial Reticulospinal Tract
Definition
arises from the Pontine Reticular Formation in the Pons, descends through the medulla and spinal cord to innervate flexors of the upper and lower limbs ipsilaterally. Used in anti-gravity reflexes and movements
Term
Lateral Reticulospinal Tract
Definition
arises from the Medullary Reticular Formation in the Medulla, descends through the spinal cord to inhibit reflex muscles of the upper and lower limb ipsilaterally to allow for voluntary motion
Term
Cranial Nerve IV (Trochlear)
Definition
pts with this palsy show Bielchowsky’s sign: patient tilts head towards the unaffected side to try and align vision fields
Term
Perinaud’s Syndrome:
Definition
lesion in dorsal midbrain that affects the Superior Colliculus and Occulomotor Nucleus. Will see ipsilateral paralysis of upwards gaze, dilated pupil, and lid retraction. Can occur with tumor of Pineal Gland, tumor in the corpora quadrigemina, non-communicating hydrocephalus, or stroke of the basal or posterior cerebral artery
Term
Benedikt’s Syndrome:
Definition
Midbrain lesion affecting the Red Nucleus, superior cerebellar peduncle, medial lemniscus, and Occulomotor Nerve. Will see closed eyelid, dilated pupil, abducted and depressed eye, loss of fine touch, proprioception, and vibratory sense contralaterally. Damage to the red nucleus causes contralateral involuntary movements and an intention tremor
Term
Weber’s Syndrome
Definition
Midbrain lesion affecting the cerebral peduncle and the Occulomotor Nerve. Will see contralateral spastic hemiparesis for the body and ipsilateral symptoms of Occulomotor destruction (closed eyelid, abducted and depressed eye, blown pupil)
Term
Colliculospinal tract fx
Definition
Involved in involuntary adjustment of head position in response to visual information
Term
Rubrospinal tract fx
Definition
Involved in involuntary adjustment of arm position in response to balance information (flexor movements of arm); support of the body
Term
corticobulbar tract fx
Definition
Control of facial and jaw musculature, swallowing and tongue movements (attachments to the cranial nerves with motor vs. sensory functions)
Term
Vestibulospinal tract fx
Definition
Responsible for adjusting posture to maintain balance
Term
o Lateral inferior pontine syndrome
Definition
 Results from occlusion of a long circumferential branch of the basilar artery, AICA
Term
o Medial inferior pontine syndrome
Definition
 Results from occlusion o f the paramedian branches of the basilar artery
Term
o Medial inferior pontine syndrome (symptoms)
Definition
 Includes the following affected structures and resultant deficits:
1. Abducent nerve roots (intra-axial fibers)
o Ipsilateral lateral rectus paralysis
2. Corticobulbar tracts
o Contralateral weakness of the lower face
3. Corticospinal tracts
o Contralateral hemiparesis of the trunk and extremities
4. Base of the pons (middle cerebellar peduncle)
o Ipsilateral limb and gait ataxia
5. Medial lemniscus
o Contralateral loss of proprioception, discriminative tactile sensation, and vibration sensation from the trunk and extremities.
Term
o Lateral inferior pontine syndrome (AICA syndrome) (symptoms)
Definition
 Includes the following affected structures and resultant deficits:
1. Facial nucleus and intra-axial nerve fibers
o Ipsilateral facial nerve paralysis
o Loss of taste from the anterior two-thirds of the tongue
o Loss of the corneal and stapedial reflexes
2. Cochlear nuclei and intra-axial nerve fibers
o Unilateral central nerve deafness
3. Vestibular nuclei and intra-axial nerve fibers
o Nystagmus, nausea, vomiting, and vertigo
4. Spinal trigeminal nucleus and tract
o Ipsilateral loss of pain and temperature sensation from the face
5. Middle and inferior cerebellar peduncles
o Ipsilateral limb and gait dystaxia
6. Spinothalamic tracts
o Contralateral loss of pain and temperature sensation from the trunk and extremities
7. Descending sympathetic tract
o Ipsilateral Horner syndrome (ptosis, miosis, hemianhidrosis, vasodilation, and apparent anophthalmos)
Term
BENEDIKT’S SYNDROME
Definition
A 67 year-old woman presents with tremor and ataxia on the left side
of the body excluding the head. Her right eye is closed (complete ptosis). When the
examining physician lifts her eyelid, he notices that her eye is depressed and abducted.
The patient exhibits anisocoria. The pupil of her right eye is mydriatic (dilated). No
sensory losses are observed.
Term
Guillain-Barre
Definition
A 43 year-old woman presents with a five-day history of increasing weakness in all four limbs, lower back pain, and sensory symptoms in her hands and feet. She has no significant medical or family history. She has recently been
on vacation in the Canary islands, where she experienced a diarrheal illness.

On examination she has some slight facial weakness, a cough, and weakness
of the arms and legs. She has lost reflex activity, and an anesthesia to light
touch and pinprick on the wrist and ankle.
Term
Ventral horns and lateral columns of the spinal cord
Definition
A 68 year-old man has been diagnosed as having amyotrophic lateral sclerosis
after experiencing some weakness in his legs. Over the next year, the disease
was progressive and he lost mobility in the use of his arms, legs, and some
cranial nerves. Which region or regions of the spinal cord are primarily
affected by this disorder?
Term
Lower motor neuron paralysis of the muscles of the leg
Definition
A 47 year-old man was diagnosed with a form of motor neuron disease that
initially affected the motor neurons located in the dorsolateral aspect of the
ventral horn at L1-L4. Which of the following deficits is likely to be present in
this patient?
Term
Superior (upper) Brachial Plexus Injury:“Erb-Duchenne syndrome”
Definition
“Waiter’s tip position”
Upper limb with adducted shoulder, medially rotated arm, & extended elbow; loss of sensation on lateral aspect of upper limb
Limb adducted and medially rotated
Term
LOWER BRACHIAL PLEXOPATHY (Dejerine-Klumpke syndrome)
Definition
Paralysis of the muscles & loss of sensation of the shoulder & arm supplied by C8-T1
The intrinsic muscles of the hand are affected
Results in characteristic appearance: “claw hand”
Ring & little fingers are hyper-extended at MP joints & flexed at IP joints (ulnar n.
Cannot extend phalanges at the PIP and DIP joints to straighten fingers
Term
A patient presented to the emergency room with a mid-humeral fracture. Which nerve and artery are at risk in this patient?
Definition
RADIAL NERVE
Term
median nerve
Definition
PRONATOR SYNDROME. The *** passes between the two heads of
the pronator teres muscle. Excessive contraction of the muscle can cause
pain in the area of the pronator teres and decreased sensation in the lateral
three and one-half digits of the hand. Pronation against resistance increases
the pain. Unless the syndrome is far advanced, motor changes may not occur.
Term
high median nerve palsy
Definition
When the patient attempts to make a fist, the index and
middle fingers will remain extended. The presence of the medial portion of
the flexor digitorum profundus (ulnar nerve) will ensure that the ring and
little fingers can flex. The result is called a “preacher’s hand”
Term
optic chiasm lesion
Definition
Bitemporal heteronymous hemianopsia
Term
optic tract lesion
Definition
Contralateral homonymous hemianopsia
Term
Meyer's loop lesion
Definition
Homonymous superior quadrantanopsia
Term
optic radiation lesion
Definition
Contralateral honomymous hemianopsia
Term
Contralateral homonymous hemianopsia
Definition
visual cortex lesion
Term
8 Bilateral macular cortex lesion
Definition
Bilateral central scotomas
Term
partial optic nerve lesion
Definition
Ipsilateral scotoma
Term
complete optic nerve lesion
Definition
Ipsilateral blindness
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