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Spinal Pathways
Dr. Yates and Reese Lecture 2/16/11
228
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Graduate
03/03/2011

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Term
List the Ascending Pathways
Definition
1. Dorsal Column/Medial Lemniscus
2. Anterolateral
3. Spinocerebellar
-Dorsal Spinocerebellar
-Cuneocerebellar
-Ventral Spinocerebellar
-Rostral Spinocerebellar
Term
List the Descending Pathways
Definition
1. Corticospinal
- Lateral Corticospinal
- Anterior Corticospinal
- Corticobulbar
2. Tectospinal
3. Rubrospinal
4. Reticulospinal
- Pontine (medulla) reticulospinal
- Medullary (lateral) reticulospinal
Term
Transmits impulses concerned with specific sensory modalities ultimately to the cerebral cortex for conscious perception or to the cerebellum for unconscious perception.
Definition
Ascending Spinal Tracts
Term
Where information is sent for conscious perception.
Definition
Cerebral cortex
Term
Where information is sent for unconscious perception.
Definition
Cerebellum
Term
Plays a role in regulating muscle tone and coordination of motor function.
Definition
Conscious and unconscious perception
Term
This pathway carries information concerned with touch, pressure, kinesthesia, vibratory sense, and 2 point discrimination
Definition
DC/ML
Term
Name the sensory receptors involved in the DC/ML pathway.
Definition
Pacinian Corpuscles
Joint Receptors
Meissner's Corpuscles
GTOs
Muscle Spindles
Term
This pathway has most of the sensory receptors...except free nerve endings.
Definition
DC/ML
Term
This pathway starts at the Dorsal Root Ganglion and ends at the somatosensory cortex in the parietal lobe.
Definition
DC/ML
Term
___ processes of DRG cells provide axons to the sensory receptors in the DC/ML pathway.
Definition
Peripheral
Term
Pick up information from the receptors and transmit information to the spinal cord.
Definition
Axons
Term
___ processes of the DRG cells enter the spinal cord by curving medially around the posterior horn and entering the posterior funiculus.
Definition
Central
Term
Ascending fibers from caudal segmental levels shift __ and ___ as they ascend in the posterior funiculus. DC/ML pathway.
Definition
Medially and Dorsally
Term
As fibers from higher levels of the cord enter the posterior funiculus, they assume a position more ___.
Definition
Laterally
Term
An organizational route from when fibers enter the spinal cord to where they get to the cortex.
Definition
Somatotopic Organization
Term
With somatotopic organization, the sacral fibers of the posterior funiculus are most __.
Definition
Medial
Term
With somatotopic organization, the lumbar and thoracic fibers of the posterior funiculus are most __.
Definition
intermediate
Term
With somatotopic organization, the cervical fibers of the posterior funiculus are most __.
Definition
Lateral
Term
The posterior funiculus on each side i divided by the posterior intermediate septum above T6 into 2 separate funiculi. Name Them.
Definition
Fasciculus Gracilis
Fasciculus Cuneatus
Term
Where is there a posterior intermediate septum present?
Definition
Above T6
Term
This fasciculus is present in all spinal levels.
Definition
Fasciculus Gracilis
Term
This fasciculus is present at only T6 and above.
Definition
Fasciculus Cuneatus
Term
This fasciculus contains long ascending branches of fibers from sacral, lumbar, and lower thoracic dorsal roots.
Definition
Fasciculus Gracilis
Term
This fasciculus contains long ascending branches of fibers from the upper 6 thoracic and all cervical dorsal roots.
Definition
Fasciculus Cuneatus
Term
Neurons in __ send their central processes ascending in the fasciculus gracilis and cuneatus are considered to constitute the 1st order neuron for the DC/ML pathway.
Definition
DRG
Term
Neurons in the DRG send their central processes ascending in the gracilis and cuneatus are considered to constitute what?
Definition
1st order neurons for DC/ML pathway
Term
Fibers in the fasciculus gracilis and cuneatus ascend ___
Definition
Ipsilaterally
Term
Where do the fibers in the gracilis and cuneatus terminate?
Definition
on relay neurons in the medulla
(nucleus gracilis and nucleus cuneatus)
Term
What do nucleus gracilis and nucleus cuneatus give rise to?
Definition
2nd order neurons
Term
Sweep ventromedially as internal arcuate fibers
Definition
2nd order neurons of DC/ML pathway
Term
The internal arcuate fibers of the DC/ML pathway decussate and form a compact fiber bundle located on each side of the brain stem. These bundles are known as what?
Definition
Medial Lemniscus
Term
Another Term for posterior
Definition
Dorsal
Term
Another term for Anterior
Definition
Ventral
Term
The medial lemniscus ascends through the contralateral half of the brain stem, and its fibers terminate where?
Definition
In the VPL (Ventral Posterolateral) nucleus of the thalamus
Term
From the VPL of the thalamus, ___ sends fibers to the postcentral gyrus of the cerebral cortex.
Definition
3rd order neurons
Term
3rd order neurons send fibers where?
Definition
To the Postcentral gyrus of the cerebral cortex
Term
Where is the postcentral gyrus of the cerebral cortex?
Definition
Parietal Lobe/Somatosensory cortex
Term
Lesions involving posterior columns diminish or abolish what?
Definition
2 point discrimination
kinesthetic sense
Term
What is impaired when you have loss of position sense in the LE's?
Definition
Equilibrium
Stance
Gait
Term
Loss of position sense in the LE's results in __.
Definition
Ataxia
Term
Information from what pathway passes through the thalamus through the posterior limb of the internal capsule, then onto the parietal lobe?
Definition
DC/ML pathway
Term
A group of pathways that trasmits nondiscriminative touch, temperature, and pain.
Definition
Anterolateral system
Term
Name the main pathway and the other fibers of the Anterolateral System.
Definition
Spinothalamic Tract
-Spinomesencephalic
-Spinoreticular
-Spinohypothalamic
Term
Carries pain to the cerebral cortex to help you identify, localize, and characterize pain.
Definition
Anterolateral system
Term
This tract contains peripheral receptors of free nerve endings of A-delta and C fibers.
Definition
Spinothalamic Tract
Term
Are A-delta and C fibers slow or fast moving in response?
Definition
Slow compared to information about muscle stretch.
Term
1st order neuron of the spinothalamic tract
Definition
DRG
Term
2nd order neuron of the spinothalamic tract
Definition
dorsal horn lamina I, II, IV
Term
3rd order neuron of the spinothalamic tract
Definition
VPL nucleus of the thalamus
Term
Where do axons of the 1st order neurons enter?
Definition
Dorsolateral Fasciculus (Lissauer's Tract)
Term
Axons of this may enter the dorsal horn or travel up the cord 1-5 segments then enter the dorsal horn.
Definition
1st order neurons
Term
In what order neuron does the decessation occur in the spinothalamic tract?
Definition
2nd
Term
The axons cross where in the spinothalamic tract?
Definition
anterior white commissure
Term
After the axons cross in the anterior white commissure, where do they ascend?
Definition
in the cord contralateral anterior and lateral funiculi
Term
One or more extra neurons may be involved prior to the crossing in the anterior white commissure in what tract?
Definition
Spinothalamic
Term
Where does the spinothalamic tract terminate?
Definition
in the primary somatosensory cortex of the contralateral cerebral hemisphere and a few other areas of the brain
Term
What does the spinothalamic tract mediate?
Definition
Pain, temperature, non-discriminatory touch
Term
Does the spinothalamic tract help mediate dull, vague pain or sharp, well-localized pain?
Definition
Sharp, well localized, fast, pain.
Term
Where does the spinomesencephalic fibers terminate?
Definition
in the superior colliculi and PAG
Term
Where is PAG located?
Definition
midbrain
Term
These fibers are involved in turning the eyes toward the site of pain and activating descending tracts that control pain.
Definition
Spinomesencephalic
Term
What does the superior colliculi do?
Definition
turn eyes toward pain
Term
What does PAG in the midbrain do?
Definition
activates descending tracts that inhibit pain
Term
Where do spinoreticular fibers terminate?
Definition
In the reticular formation of the brain
Term
A group of nuclei in the brainstem that are involved in arousal and alertness. They govern sleep/wake cycles.
Definition
Reticular Formation in Brain
Term
Where do spinohypothalamic fibers terminate?
Definition
Hypothalamus
Term
These fibers mediate emotional and autonomic responses to pain.
Definition
Spinohypothalamic
Term
Lesions of the spinothalamic tract cause what?
Definition
Contralateral Analgesia
Term
Will a lesion to the spinothalamic tract cause loss of touch?
Definition
No
Term
Will a lesion to the spinothalamic tract cause loss of temperature sensation?
Definition
Yes on the contralateral side
Term
If you had a lesion at C7 on the Left side. Where do you lose sensation?
Definition
Around T1 on the Right side because you lose pain sensation 1-2 segments below the actual lesion.
Term
Gray matter located around the cerebral aqueduct
Definition
PAG
Term
Where is PAG located?
Definition
midbrain
Term
__ has neurons that have opiate receptors that sends axons down to raphe nuclei in the medulla.
Definition
PAG
Term
produces serotonin
Definition
Raphe nuclei
Term
In the descending pain inhibitory pathway, PAG are opiate receptors that project to the raphe nuclei, then the raphe cells project to laminae __ and __ of the spinal cord.
Definition
Laminae II and III
Term
In the descending pain inhibitory pathway, once the raphe cells project to the lamina II and III in the spinal cord, there is activation of what type of neurons in the laminae II and III.
Definition
Enkephalinergic neurons
Term
In the descending pain inhibitory pathway, activation of enkephalinergic neurons inhibit what?
Definition
pain transmission
Term
Instead of the descending pain inhibitory pathway going thru all the steps, where can it go via direct connection?
Definition
PAG to dorsal horn
Term
Blocks pain along the anterolateral pathway.
Definition
Enkephalinergic neurons
Term
Where in the spinal cord are enkephalinergic neurons located?
Definition
Dorsal horn
Term
Give an example of opiates being given locally.
Definition
Epidural
Term
This type of opiate is produced by the body.
Definition
Endogenous Opiates (Endorphins)
Term
What type of opiates are ingested?
Definition
Exogenous Opiates
Term
Name 3 endogenous opiates (endorphins)
Definition
Enkephalins
Dynorphin
B-Endorphin
Term
Name 3 exogenous opiates
Definition
Morphine
Heroine
Other..
Term
Why are exogenous opiates dangerous?
Definition
They depress respiration
Term
Activates neurons with opiate receptors in PAG, raphe, and dorsal horn.
Definition
Opiates
Term
Opiates cause analgesia which is accompanied by what?
Definition
Decreased consciousness
Term
What does TENS stand for?
Definition
Transcutaneous Electrical Nerve Stimulation
Term
Activates large-diameter myelinated fibers (somatosensory fibers)
Definition
TENS
Term
With TENS, the collaterals from the large-diameter fibers stimulate what?
Definition
enkephalinergic interneurons in the dorsal horn
Term
In TENS, when the enkephalinergic interneurons at released, this inhibits the release of what and helps block pain transmission?
Definition
substance P
Term
Delivers electrical stimulus to control pain.
Definition
TENS
Term
Pain from visceral structures perceived as arising from superficial structures such as skin, bone, or muscle.
Definition
Referred pain
Term
Pain that arises from skin, bone, or muscle.
Definition
Somatic Pain
Term
Name a few visceral structures.
Definition
Gut, heart, gallbladder, kidney, etc.
Term
How is visceral pain transmitted.
Definition
Sympathetic fibers
Term
Visceral pain is typically referred to ___ structures whose afferents enter the cord via the same dorsal roots.
Definition
Somatic
Term
Visceral pain fibers may synapse on and activate what?
Definition
Dorsal horn tract cells
Term
Normally transmit somatic pain
Definition
Dorsal horn tract cells
Term
Once the dorsal horn tract cells are activated, the pain information travels along the ___ pathway
Definition
somatic
Term
Because visceral pain travels along the somatic pathway, what does the pain sensation feel like.
Definition
Somatic rather than visceral
Term
What may make the true origin of the pain source
Definition
Referred pain
Term
Visceral pain fibers are ___
Definition
autonomic
Term
Many patterns of referred pain are __ of visceral pathology
Definition
Diagnostic
Term
If you have pain coming from the diaphragm, where might it refer to?
Definition
Superior Shoulder (C3-4)
Term
If you have pain coming from the esophagus, where might it be referred to?
Definition
Substernal region
Term
If you have pain coming from the heart, where might it be referred to?
Definition
Left chest, shoulder, medial aspect of the left arm (T1-8)
Term
If you have pain from the stomach, where might it be referred to?
Definition
Epigastric area
Term
If you have pain from the gallbladder, where might it be referred to?
Definition
Lower, anterior border of the right rib cage; mid-scapular area
Term
If you have pain from the appendix, where might it be referred to?
Definition
McBurney's Point
Term
If you have pain from the kidneys, where might it be referred to?
Definition
Left inguinal region; lumbar spine
Term
If you have a patient coming in with reports of pain what should you try to discern?
Definition
If it is referred or musculoskeletal
Term
Controls the ipsilateral side of the body in balance, movement control, and body position.
Definition
Cerebellum
Term
An organ that provides unconscious control.
Definition
Cerebellum
Term
2 of these tracts serve the lower half of the body (T1 and below) and 2 of these tracts serve the upper half (Above T1)
Definition
Spinocerebellar Tracts
Term
Name the 2 spinocerebellar tracts that serve the lower half of the body (T1 and below)
Definition
DSCT Dorsal Spinocerebellar Tract
VSCT Ventral Spinocerebellar Tract
Term
Name the 2 spinocerebellar tracts that serve the upper half of the body (Above T1)
Definition
Cuneocerebellar Tract
Rostral Spinocerebellar Tract
Term
Convey information concerning muscle length and changes in length, tension in tendons, and touch and pressure from the skin to the cerebellum for unconscious control of movments.
Definition
Spinocerebellar tracts
Term
Name the 4 receptors involved in the spinocerebellar tracts.
Definition
GTOs
Muscle spindles
Touch receptors
Pressure receptors
Term
What are the sensory receptors for the DSCT?
Definition
GTOs (Type Ib fibers)
Muscle Spindle (Type Ia and II fibers)
Touch and pressure receptors
Term
What is the 1st order neuron for DSCT
Definition
DRG cells
Term
In the DSCT, the DRG cells central processes goes into the spinal cord and synapse on the what?
Definition
Nucleus Dorsalis
Term
Another name for Nucleus Dorsalis
Definition
Dorsal Nucleus of Clarke
Term
What is the 2nd order neuron for DSCT?
Definition
Nucleus Dorsalis
Term
In what spinal levels can you find the Nucleus Dorsalis?
Definition
T1 -L2
Term
Afferents below what level travel up in posterior columns to synapse on nucleus dorsalis neurons?
Definition
L2
Term
Name 2 things that have an intermediolateral cell column.
Definition
Nucleus Dorsalis
Lateral Horn
Term
What connects the cerebellum to the brainstem?
Definition
Inferior cerebellar peduncle
Term
A group of axons that connects one structure to another.
Definition
Peduncle
Term
A De-myelinating dizease with chances of a full recovery
Definition
Guillian Barre
Term
In the DSCT, neurons of the nucleus dorsalis give rise to large fibers that ascend in the posterolateral part of the what?
Definition
Lateral Funiculus
Term
In the DSCT, the fibers that ascend in the lateral funiculus become incorporated in what once they reach the medulla and terminate ipsilaterally in the cerebellum.
Definition
Inferior Cerebellar Peduncle
Term
This tract conveys proprioceptive information from the lower extremities.
Definition
DSCT
Term
What are the sensory receptors for the Cuneocerebellar tract?
Definition
Muscle Spindle
GTO
Touch and pressure receptors
Term
What is the 1st order neuron for the cuneocerebellar tract?
Definition
DRG cell
Term
In the cuneocerebellar tract, the DRG cells central processes travel in what to synapse on the 2nd order neurons in the lower medulla?
Definition
Fasciculus cuneatus
Term
Where is the 2nd order neuron of the cuneocerebellar tract located?
Definition
In the accessory (lateral) cuneate nucleus in the lower medulla
Term
Axons from the neurons in the cuneocerebellar tract enter the __ and terminate in the cerebellum ipsilateral to origin of tract.
Definition
Inferior Cerebellar Peduncle
Term
Name the spinocerebellar tract that deccussates twice.
Definition
VSCT
Term
This tract carries unconscious sensation to the cerebellum from the lower 1/2 of the body and also transmits information being carried to the spinal cord from descending motor pathways.
Definition
VSCT
Term
Name the sensory receptors for VSCT
Definition
GTO
Muscle Spindle
Touch
Pressure
Descending motor pathways
Term
What is the 1st order neuron of VSCT
Definition
Cells in laminae V, VI, VII in the lumbar segments
Term
Axons from the neurons of VSCT deccussate immediately in what to form a tract in the contralateral anterior lateral funiculus.
Definition
Anterior White Commissure
Term
In the upper pons, the VSCT enters the what to reach the cerebellum?
Definition
Superior Cerebellar Peduncle
Term
After the VSCT has entered the cerebellum it crosses again in the cerebellum to terminate in the side of the cerebellum ipsilateral to the origin of the tract. TRUE/FALSE
Definition
True
Term
This tract conveys information related to attempted movement.
Definition
VSCT
Term
What are the sensory receptors for the Rostral Spinocerebellar Tract?
Definition
GTO
Muscle Spindle
Touch and Pressure receptors
Term
What is the 1st order neuron of the Rostral Spinocerebellar Tract?
Definition
Cells in the posterior horn of the cervical enlargement
Term
Axons from the cells of the Rostral Spinocerebellar Tract ascend uncrossed in what funiculus of the spinal cord?
Definition
Lateral
Term
The cells of the rostral spinocerebellar tract travel to the ipsilateral cerebellum via what peduncles?
Definition
Inferior and Superior Cerebellar Peduncles
Term
The only pathway that originates in the cerebrum.
Definition
Corticospinal system
Term
Concerned with somatic and visceral motor (efferent) activities.
Definition
Descending Spinal Tracts
Term
Originate in the cerebral cortex or brainstem. Pathways that originate in the brainstem possess cortical control.
Definition
Descending Spinal Tracts
Term
Name the 2 pathways of the Corticospinal System.
Definition
Lateral Corticospinal
Anterior Corticospinal
Term
This system consists of fibers that arise from cell in the cerebral cortex, pass through the internal capsule, and descend to the brain stem or spinal cord.
Definition
Cortiospinal System
Term
Fibers in the brainstem that provide voluntary control over cranial nerves.
Definition
Corticobulbar Fibers
Term
Cerebral cortex to the corona radiata to the internal capsule to the brainstem or spinal cord.
Definition
Corticospinal System
Term
Where are neurons of the corticospinal system primarily located?
Definition
Lamina V in the primary motor cortex, the premotor and supplementary motor areas and the postcentral gyrus
Term
Mapping of the cerebral cortex in areas of functioning.
Definition
Brodman's Numbers
Term
What brodman's area is in the precentral gyrus
Definition
Area 4
Term
What Brodman's area is in the premotor and supplementary motor areas.
Definition
Area 6
Term
What Brodman's area is in the postcentral gyrus mainly
Definition
Areas 3, 1, 2
Term
TRUE/FALSE: Somatotopic organization of neurons within the primary motor cortex (motor humunculus). Somatotopy is maintained through the midbrain and may be disrupted thereafter.
Definition
TRUE
Term
This system comes from the cerebral cortex, then fibers converge in the corona radiata and travel in the posterior limb (corticospinal) and genu (corticobulbar) of the internal capsule.
Definition
Corticospinal System
Term
The genu of the internal capsule holds what type of fibers?
Definition
Corticobulbar
Term
The posterior limb of the internal capsule holds what type of fibers?
Definition
Corticospinal
Term
The the midbrain levels, the corticospinal fibers form the middle 1/3 of what?
Definition
Crus Cerebri (Cerebral Peduncles)
Term
Where are the corticobulbar fibers located in reference to the corticospinal fibers?
Definition
Just medial
Term
In the pons, the fibers of the corticospinal system are broken up into scattered fiber bundles in what portion of the pons?
Definition
Basilar Portion
Term
Once the fibers of the corticospinal system reach the medulla, they come back together in what portion of the medulla?
Definition
Medullary Pyramids
Term
Around 80-90% of corticospinal fibers cross where?
Definition
at caudal meduallary levels (junction of medullar and spinal cord)
Term
Around 80-90% of corticospinal fibers cross at caudal medullary levels and enter what of the spinal cord?
Definition
The posterior part of the lateral funiculus
Term
Once the corticospinal fibers are in the spinal cord what do they form?
Definition
Lateral corticospinal tract
Term
This tract descend the length of the spinal cord giving off fibers to synapse on interneurons and motor neurons (a few) in the intermediate gray and anterior horn of the spinal cord at all levels of the spinal cord.
Definition
Lateral corticospinal Tract
Term
What does the lateral corticospinal tract control
Definition
Distal flexor musculature. Primarily in the hand but in the feet also.
Term
Twice as many axons from this tract terminate in the cervical as compared to the lumbar enlargement.
Definition
Lateral Corticospinal Tract
Term
The fibers from this tract remain uncrosses into the spinal cord and occupies the area of the anterior funiculus.
Definition
Anterior corticospinal tract
Term
Fibers from this tract do not cross until they reach the anterior white commissure where they will terminate on interneurons in the cord.
Definition
Anterior corticospinal Tract
Term
Present mainly in the cervical spinal cord. Controls axial musculature.
Definition
Anterior Corticospinal Tract
Term
Provides cortical innervation for motor nuclei of cranial nerves V, VII, X, XI, XII
Definition
Corticobulbar fibers
Term
What does the tectum of the midbrain include?
Definition
2 superior colliculi
2 inferior colliculi
Term
Neurons of this tract are located in the deep layers of the superior colliculus of the midbrain
Definition
Tectospinal Tracts
Term
Name the 2 tracts that originate in the midbrain
Definition
Tectospinal
Rubrospinal
Term
Where do axons from the tectospinal tract cross?
Definition
in the midbrain tegmentum just anterior to the PAG
Term
Once the neurons of the tectospinal tract cross where do they descend to?
Definition
medial longitudinal fasciculus (MLF)
Term
In the spinal cord, the tectospinal tract lies in what funiculus near the anterior median fissure?
Definition
Anterior Funiculus
Term
The tectospinal tract is present only in what levels of the spinal cord?
Definition
Cervical
Term
Where do the majority of fibers terminate in the tectospinal tract?
Definition
Upper 4 cervical segments
Term
Fibers from this tract terminate on interneurons in the intermediate gray and anterior horn to influence the motor neurons of neck musculature.
Definition
Tectospinal Tract
Term
What is the function of the tectospinal tract?
Definition
To mediate reflexes turning the head in response to visual and probably auditory stimuli.
Term
This tract controls upper extremity flexors
Definition
Rubrospinal Tract
Term
What does rubro mean?
Definition
Red
Term
The neurons of the rubrospinal tract come from where?
Definition
the red nucleus of the midbrain
Term
Axons from the rubrospinal tract come out of the red nucleus and immediately deccussate where before descending to the spinal cord?
Definition
Midbrain Tegmentum
Term
In the spinal cord, the rubrospinal tract lies anterior to the lateral corticospinal tract in the what?
Definition
Lateral Funiculus
Term
Is the rubrospinal pathway active on its own?
Definition
Yes
Term
This tract has intrinsic activity that occurs in the background when not needed
Definition
Rubrospinal Tract
Term
In the rubrospinal tract, in the spinal cord, the neurons descend primarily to where?
Definition
Cervical enlargement where it has the most influence
Term
Natural facilitory influence modulated (inhibited) through cortical input (corticorubral fibers)
Definition
Rubrospinal Tract
Term
Name the 2 reticulospinal tracts
Definition
Pontine (medial)
Medullary (lateral)
Term
Groups of nuclei located throughout the brain stem
Definition
Reticular Formation
Term
These tracts arise from areas of the brain stem known as reticular formation
Definition
Reticulospinal Tracts
Term
Name 3 functions of the reticulospinal tracts.
Definition
1. Alternative pathways for control of spinal motor neurons
2. Regulate sensitivity of spinal reflexes
3. May initiate some movements
Term
This tracts neurons come from the reticular formation of the pons.
Definition
Pontine Reticulospinal Tract
Term
The axons from this tract descends in the brainstem in association with the MLF. In the spinal cord, this tract lies in the medial part of the anterior funiculus.
Definition
Pontine (medial) reticulospinal tract
Term
Does the pontine reticulospinal tract cross or remain ipsilateral?
Definition
Remains Ipsilateral
Term
Axons from this tract come from the reticular formation of the medulla, particularly the nucleus reticularis gigantocellularis.
Definition
Medullary Reticulospinal Tract
Term
Most fibers of this pathway remain uncrossed and descend in the anterior part of the lateral funiculi.
Definition
Medullary (Lateral) Reticulospinal Tract
Term
Motor neurons located in either the spinal cord or the cranial nerve motor nuclei.
Definition
Lower Motor Neuron
Term
Anterior horn cells and their axons, projecting via the ventral root to striated muscle.
Definition
LMN
Term
Also referred to as the final common pathway
Definition
LMN
Term
Injury or disease of the anterior horn cells or projecting axons results in what 4 things?
Definition
1. Paralysis of muscles innervated by these fibers
2. Loss of muscle tone
3. Atrophy of denervated muscle
4. Hypoactive or absent myotatic reflexes in that segment or segments (hyporeflexia)
Term
Loss of muscle tone
Definition
Hypotonia
Term
Decreased to absent DTR's
Definition
Hyporeflexia
Term
Neurons which are contained within descending motor pathways and influence the alpha motor neuron either directly or indirectly
Definition
Upper motor neuron
Term
These motor neurons do not make connections with muscles but stay completely within the CNS
Definition
Upper motor neuron
Term
Upper motor neuron lesions are characterized by what 5 things?
Definition
1. Paresis of muscles involved
2. Initial loss followed by increased muscle tone
3. Hyperactive myotatic (DTR) reflexes (hyperreflexia)
4. Positive Babinski Sign
5. Mild muscle atrophy not seen initially because segmental innervation of striated muscle remains intact
Term
Increased muscle tone
Definition
Hypertonia
Term
If the corticospinal system is involved will you see a positive or negative babinski sign?
Definition
Positive
Term
Lesion to the brain stem in the area of the midbrain caudal to the red nucleus. Interrupts all descending motor pathways except the reticulospinal. Also interrups modulating influence from the cortex on pontine reticulospinal tract.
Definition
Decerebration
Term
What is the result of Decerebration?
Definition
Decerebrate Rigidity - extensor posturing of all 4 extremities
Term
Lesion rostral to the red nucleus. Leaves the rubrospinal tract intact while interrupting cortical modulation of the rubrospinal system. Still have increased activity of the reticulospinal system.
Definition
Decortication
Term
What is the result of Decortication?
Definition
Decorticate Rigidity - flexor posturing of UE and extensory posturing of LE
Term
It is an ominous sign if the patient progresses from decorticate to decerebrate rigidity. Why?
Definition
this is indicative of the level of damage to the CNS. This means that the area of lesion has spread below the red nucleus area
Term
Difficulty in movement
Definition
Paresis
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