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Neuroanatomy
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341
Anatomy
Graduate
01/13/2015

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Term
white matter
Definition
Located in the spinal cord

myelinated axons
Term
dorsal column funiculus
Definition
Located in the spinal cord
exclusively ascending pathways
Term
lateral column funiculus
Definition
Located in the spinal cord
bidirectional pathways
Term
anterior column funiculus-
Definition
Located in the spinal cord
primarily descending pathways
Term
ventral white commissure
Definition
Located in the spinal cord
pain and temperature fibers cross midline here
Term
dorsal horn
Definition
Located in the spinal cord
neurons that have primarily a sensory role
Term
ventral horn-
Definition
Located in the spinal cord
neurons that have primarily a motor role
Term
intermediate gray and intermediate horn-
Definition
Located in the spinal cord
neurons of the sympathetic nervous system
Term
anterior median and lateral fissure-
Definition
Located in the spinal cord
AMF is home to the anterior spinal a.
Term
posterior median and intermediate sulcus-
Definition
Located in the spinal cord
posterior median and intermediate sulcus-
Term
posterior lateral sulcus
Definition
Located in the spinal cord
sensory information gain accès to SC
Term
ventral root
Definition
motor and autonomic fibers to periphery
Located in the spinal cord
Term
dorsal root-
Definition
Located in the spinal cord
sensory fibers from the periphery
Term
dorsal root ganglion-
Definition
Located in the spinal cord
sensory neurons
Term
white pre-ganglionic ramus-
Definition
Located in the spinal cord
short, presynaptic sympathetic fibers
Term
gray post-ganglionic ramus-
Definition
Located in the spinal cord
long, postsynaptic sympathetic fibers
Term
posterior ramus of spinal nerve-
Definition
mixed nerve to skin and muscles of backLocated in the spinal cord
Term
anterior ramus of spinal nerve
Definition
Located in the spinal cord
mixed nerve to skin and muscles of remainder of body
Term
cervical enlargement (C5-T1)-
Definition
Located in the spinal cord
innervation to the arms
Term
lumbar enlargement (L1-S2)-
Definition
Located in the spinal cord
innervations to the legs
Term
lumbar enlargement (L1-S2)-
Definition
Located in the spinal cord
innervations to the legs
Term
conus medularis-
Definition
Located in the spinal cord
tapered end of spinal cord
Term
filum terminale
Definition
Located in the spinal cord
fixes the spinal cord distally to the coccyx
Term
cauda equina
Definition
Located in the spinal cord
very long spinal roots after L2 level
Term
pia matter-
Definition
Located in the spinal cord
innermost meningeal layer
Term
arachnoid-
Definition
Located in the spinal cord
intermediate meningeal layer
Term
dura matter-
Definition
Located in the spinal cord
outermost meningeal layer
Term
dentate ligament
Definition
Located in the spinal cord
pial extensions that anchor the cord laterally
Term
fasciculus gracilis
Definition
Located in the spinal cord
pathway for sensation of light touch and vibration from below T7
Term
fasciculus cuneatus
Definition
Located in the spinal cord
pathway for sensation of light touch and vibration from above T7
Term
4 components of the Brain stem
Definition
Medulla
Pons
Mid-Brain
Cerebellum
Term
pyramids and pyramidal decussation-
Definition
Found in the Medulla

descending motor pathway and site of motor fiber crossing
Term
olive
Definition
Found in the Medulla
motor nuclei that connects with cerebellum
Term
gracilis tubercle-
Definition
Found in the Medulla
indicates location of nucleus associated with sensation of light touch and proprioception from below T7
Term
cuneate tubercle-
Definition
Found in the Medulla
indicates location of nucleus associated with sensation of light touch and proprioception from above T7
Term
inferior cerebellar peduncle-
Definition
Found in the Medulla
major pathway of sensory input from spinal cord to cerebellum
Term
foramen luschka and magendie
Definition
Found in the Medulla
- passageway for CSF to flow out of brain
Term
CNs found on the Medulla
Definition
Glossopharyngeal Nerve IX
Vagus Nerve X
Spinal accessory nerve XI
Hypoglossal nerve XII
Term
basilar sulcus
Definition
Found on the Pons
home of basilar artery
Term
middle cerebellar peduncle (brachium pontis)-
Definition
Found on the Pons
major pathway for motor information from cerebral cortex to cerebellum
Term
CNs found on the Pons
Definition
Trigeminal nerve V
abducens nerve VI
Facial nerve VII
Vestibular cochlear nerve VIII
Term
cerebral peduncle
Definition
Found on the Mid-brain

continuation of medullary pyramid/ descending motor pathways
Term
substantia nigra
Definition
Found on the Mid-brain
major production site of dopamine
Term
red nucleus-
Definition
Found on the Mid-brain
motor nucleus that connects to upper extremity flexors
Term
cerebral aqueduct-
Definition
Found on the Mid-brain
connects the third and fourth ventricles
Term
superior colliculus-
Definition
Found on the Mid-brain
integration of visual information
Term
inferior colliculus
Definition
Found on the Mid-brain
integration of auditory information
Term
superior cerebellar peduncle
Definition
Found on the Mid-brain
major efferent pathway from cerebellum to cerebral cortex
Term
superior medullary velum-
Definition
Found on the Mid-brain
the roof of the fourth ventricle
Term
CN found on the Mid-brain
Definition
oculomotor nerve III
trochlear nerve IV
Term
Cerebellum structure
Definition
anterior lobe
posterior lobe
primary fissure
posterolateral fissure
floccular nodular lobe
vermis and para-vermis
lateral hemisphere
Term
4 parts of the Diencephalon
Definition
Thalamus
Hypothalamus
Subthalamus
Term
masa-intermedia-
Definition
Found on the Thalamus
non-functional anatomical landmark that indicates the fusion of the two thalami
Term
septum pellucidum and third ventricle
Definition
Found on the Thalamus
Term
medial and lateral geniculate bodies
Definition
Found on the Thalmus

relay station for auditory (medial) and visual (lateral) information
Term
CN found on the Thalmus
Definition
Optic nerve
Term
infundibulum and pituitary-
Definition
Found on the Hypothalamus
major site of hormone production
Term
mammillary bodies-
Definition
Found on the Hypothalums
limbic site that helps with formation of memories as well as integration of smell with memories
Term
fornix-
Definition
Found on the Hypothalamus
part of the limbic system, pathway that connects the hippocampus to the mammillary bodies
Term
Subthalamus-
Definition
part of the basal ganglia, has a role in motor refinement
Term
Pineal body
Definition
Epithalamus
producer of melatonin, has role in regulating sleep/ wake cycles
Term
Posterior commissure
Definition
Epithalamus
interhemispheric communication, role in bilateral pupillary light reflex
Term
Telencephalon lateral sulcus
Definition
defines temporal lobe
Term
Telencephalon central sulcus
Definition
separates frontal and parietal lobes
Term
Telencephalon calcarine sulcus
Definition
medial part of occipital lobe
Term
Telencephalon parieto-occipital notch and fissure
Definition
divides occipital and parietal lobes
Term
Telencephalon longitudinal fissure
Definition
separates the two hemispheres
Term
limbic lobe
Definition
(parahippocampal, uncus, and cingulate gyrus)
a. hippocampus deep to parahippocampal
b. amygdala deep to uncus
Term
corpus callosum and anterior commissure
Definition
recognize
Term
external capsule-
Definition
minor pathway into and out of cerebral cortex
Term
Basal ganglia parts
Definition
putamen
globus pallidus
caudate nucleus
Term
falx cerebri
Definition
dura structure that separates the two hemispheres
Term
tentorium cerebelli-
Definition
dura structure that separates occipital lobe from cerebellum
Term
Recognize these structures
Definition
3. dura matter
4. arachnoid and arachnoid granulations
5. sub-arachnoid space
6. superior sagittal sinus
7. inferior sagittal sinus
8. straight sinus
9. transverse sinus
10. sigmoid sinus
11. confluence of sinuses
12. cavernous sinus
13. two lateral ventricles
14. interventricular foramen (foramen of monroe)
15. choroid plexus
Term
cribriform plate
Definition
ethmoid bone (CN I)
Term
optic foramen
Definition
(CN II)
Term
superior orbital fissure
Definition
CNs III, IV, VI, V1)
Term
foramen rotundum
Definition
V2)
Term
foramen ovale
Definition
(V3)
Term
foramen lacerum
Definition
(internal carotid and sympathetics)
Term
foramen spinosum
Definition
(middle meningeal artery)
Term
internal acoustic meatus
Definition
(CNs VII VIII)
Term
jugular foramen
Definition
(venous drainage, CNs IX, X, XI)
Term
hypoglossal canal
Definition
(CNXII)
Term
foramen magnum
Definition
(cervical roots of XI)
Term
stylomastoid foramen
Definition
(CN VII exit)
Term
Branches of the vertebral artery
Definition
a. anterior spinal artery
b. posterior inferior cerebellar artery
c. posterior spinal artery
Term
basilar artery branches
Definition
a. labyrinthine artery (internal auditory)
b. anterior inferior cerebellar artery
c. superior cerebellar artery
d. posterior cerebral artery
e. pontine artery
Term
branches of internal carotid
Definition
. internal carotid artery
2. ophthalmic artery
3. middle cerebral artery
4. anterior cerebral artery
5. posterior communicating artery
6. anterior communicating artery
7. anterior choroidal artery
Term
tonic receptors
Definition
Respond as long as the stimulus is present.
Example: muscle stretch
Term
Phasic receptors:
Definition
Respond initially to the stimulus. If stimulus remains constant, the receptor will stop transmitting.
Example: wrist watch
Term
Speed of transmission is determined by:
Definition
Axon diameter
Axon myelination
Number of synapses – lesser synapses = faster
Term
Where are the majority of cell receptors located? Body and Head
Definition
Body - dorsal root ganglion
Head - cranial nerve ganglia
Term
Structure of a peripheral sensory nerve
Definition
Distal axons conduct messages from receptor to the cell body
Proximal axons project from the cell body into the spinal cord or brainstem, some proximal axons extend all the up into the medulla.
Term
receptive field
Definition
area of skin innervated by a single afferent neuron
smaller distally and larger proximally
Term
Fine touch receptor types
Definition
Meissner's corpucels - light touch and vibration Merkel's disks, pressure Hair folicles Subcutaneous - ruffini and pacinian corpuscles stretch and light touch A-betta afferents
Term
crude touch receptors
Definition
free endings, tickle and scratch
Term
What type of afferent fiber are involved in muscle spindles
Definition
1a
Term
Tonic stretch noted by what type effect pathway
Definition
Type II
Term
Gamma motor neurons
Definition
maintain the sensitivity of intrafusal fibers
Term
Dorsal column tract
Definition
transmit information about light touch and vibration
Term
Anterolateral tracts
Definition
transmit införmation about pain and temperature
Term
Dorsal Column/Medial Lemniscus System (DCML) from periphery to Medulla,
Definition
- Primary neuron is stimulated, goes up the distal axon to the dorsal root ganglion, where the cell body resides, - then the signal goes to the proximal axon into the spinal cord through the dorsal root to the dorsal column where it travel Ipsilateraly up the spinal cord, - Lower extremity neurons are in the fasciculus gracilis, Upper extremity neurons are in the fascicles cuneatus, - Synapse in the medulla at the nucleus gracilis, nucleus cuneatus
Term
Second order neuron in the DCML pathway
Definition
Cell body the second order neuron is in the ispilateral medulla, (nucleus gracilis and cutaneous)
Crosses over quickly after synapse to contralateral side as internal arcuate fibers,
They ascend to the thalamus as the medial lemniscus,
Second neuron end the Ventral posterior lateral nucleus (VPL)
Term
Third Order neuron of DCML
Definition
Start at the VPL of the thalamus going to the cortex. Travel through the internal capsule
Term
Sensory information from the face goes through what nerve
Definition
trigeminal
Term
First order neuron in face sensation
Definition
Their cell body reside in the trigeminal ganglion, the proximal neuron ends at the pons in the trigeminal main sensory nucleus.
On the ipsilateral side
Term
second order neuron of facial light touch sensation
Definition
Cell body found in the trigeminal main sensory nucleus in the pons, immediately cross midline, called trigeminal lemniscus and end in the ventral posteromedial (VPM) nucleus of the thalamus.
Third-order axons continue to the cerebral cortex
Term
Homunculus
Definition
map of the body in the cortex
Term
Temperature sensation
Definition
Cold - A-delta fiber
Hot C-delta fiber

First order goes to dorsal horn and synapse with with the second order
2nd order cross midline, then goes up the spinal cord to the VPL nucleus of the nucleus of the thalamus. Third order goes from the the thalamus to the sensory cortex
Term
Fast pain
Definition
spinothalamic pain
first order- brings information into the dorsal horn through dorsalateral tract (lissauer's maginal) of the spinal cord
2nd order crosses midline at the anterior commissure and goes up the spinal cord up the Lateral thalamus
3rd order starts at the VPL thalamus to the cerebral cortex

A-delta fibers
Term
A lesion in the VPL nucleus
Definition
interrupts the pain pathway to the cortex, causing inability to localize painful stimuli feeling the affective (emotional) aspects of pain
Term
DCML vs Spinothalamic System
Definition
spino - ascends contra laterally in the spinal cord
Dorsal - crosses in the medulla
both crosses at the 2nd order

both 2nd order ends at VPL nucleus of the thalamus to th
Term
Fast pain from the face
Definition
1st order - enter the pons travel down to the the medulla and upper cervical cord in the descending tract of the trigeminal nerve before synapsing in the spinal cord
Second fiber crosses the midlne and ascend in the trigeminal lemniscus to the VPM nucleus of the thalamus
Term
What is located in the Dorsal root ganglia?
Definition
cell bodies of peripheral sensory neurons
no synapse occurs in the DRG
Term
Coarse touch
Definition
mediated by free nerve endings
percieve crudely localized touch, pressure and sensation of tinkle and itch
Term
Dermatome:
Definition
Area of skin innervated by all axons found within a single DRG.
Term
Peripheral Nerve Distribution:
Definition
Peripheral nerves are made up of axons from multiple DRGs, therefore, the distribution will be different.
Term
Golgi tendon organs is transmitted by what type of neuron
Definition
Ib afferents
Term
In sensory pathways where does the second order neuron cell body reside?
Definition
in the medulla
Nucleus gracilis
Nucleus cuneatus
Term
Where are the cell bodies of 3rd oder neurons in the sensory pathway
Definition
Thalamus
Relay to the cortex
Term
Where are the cell bodies of the 3rd order neuron located in the DCML
Definition
Ventral posterior lateral of the Thalamus
Term
Where do 1st order enter the spinal cord for the spinothalamic tract
Definition
lissaur's tract
Term
Spinomesencephalic (spino midbrain) Tract:
Definition
Carries nociceptive info to superior colliculus and PAG (peri aqueductal gray).
Involved in orienting head to source of noxious input as well as activating descending pain control systems.
Term
Spinoreticular Tract:
Definition
Reticular formation is neural network in the brainstem that controls arousal, attention and sleep/wake cycles.
Severe pain commands attention and disrupts sleep.
Control our back ground system
Term
Spinolimbic Tract:
Definition
Involves emotional response to injury or pain.
Term
Trigeminal sensory neurons
Definition
The majority of the first order neurons are found in the Trigeminal ganglion (equivalent to the DRG).
The second order neurons are found in one of the sensory nuclei associated with the trigeminal nerve.
The third order neurons are located in the VPM nucleus of the thalamus.
Term
Facial Pain, Crude Touch and Temperature
Definition
First order neurons found in the trigeminal ganglion.
Central processes enter the brainstem and descend within the spinal trigeminal tract.
Synapse with second order neurons in the ipsilateral spinal trigeminal nucleus.
Fibers cross, ascend in the ventral trigemino-thalamic tract to synapse in the VPM.
Term
Spinocerebellar
Definition
4 of them,
LE pathways: Dorsal Spinocerebellar Tract (DSCT), Ventral Spinocerebellar Tract (VSCT)
UE:: cuneocerebellar tract and rostral spino-cerebellar tract relay
, enter ascend and end up on the same side, right half of cerebellar, go into inferior cerebellar peduncle, where they travel lower half of the spinal cord,
Term
Sensory Extinction
Definition
Test: Alternate unilateral and bilateral stimuli

Interpretation:when you touch both bilaterally you can’t feel one side, but you can feel both sides unilaterally
Term
Complete Somatosensory Examination: Graphesthesia
Definition
Test: What letter am I tracing on your hand?

Interpretation: Intact vs supra-thalamic lesion
Term
Complete Somatosensory Examination: Stereognosis
Definition
Test: Place a common object in the pt’s hand
Interpretation: Normal- able to ID the object.
Abnormal: Lesion in contralateral association areas.
Term
Complete Somatosensory Examination: Sharp vs Dull
Definition
Test: Use paperclip- randomly alternate between pointy end and blunt end.
Interpretation: Able to differentiate between two stimuli.
PNL= no detection
ALS lesion= cannot differentiate
Term
Electrodiagnostic Studies
Definition
Nerve Conduction Studies (NCS)
Only tests peripheral nerves

Somatosensory Evoked Potentials (SEP)
Tests both PNS and CNS
Typically not performed by PTs
Term
Sensory Ataxia
Definition
Caused by lesions in peripheral sensory nerves, DRG, dorsal columns or medial lemnisci.
Romberg test can distinguish between sensory and cerebellar ataxia. How?
People with sensory ataxia can do pretty well with reliable visual cues.
Term
Demyelination affects proprioception and vibratory senses more severely. Why?
Definition
more myelinated, first ones to go
Term
Brainstem Lesions affect sensory
Definition
Sensory signals from the body and face cross midline at various levels of the brainstem. Therefore, brainstem lesions will cause a mix of ipsilateral and contralateral deficits. All tracts have crossed by the time we get to the upper midbrain- therefore all sensory loss will be contralateral.
Term
Cerebral Lesions: Thalamus
Definition
Lesions of the VPL result in decreased somatosensation from conralateral body.
What about sensation from the face?
Term
Cerebral Lesions: Somatosensory Cortex
Definition
Contralateral loss of discriminative sensations.
Crude awareness of sensation may be present at thalamic level.
Term
Feedforward:
Definition
anticipatory use of sensory information preceeding a movement
Hamstring firing in advance of taking a step post ACL repair
Term
Feedback:
Definition
use of sensory information during or after a movement to improve accuracy
Term
Picking up pen process
Definition
Decision - anterior portion of frontal lobe
Planning - fontal lobe
Control centers - basal ganglia and cerebellum
Action - Motor neuron + spinal interneurons
Term
Where are the cell bodies of lower motor neurons?
Definition
anterior horn of the spinal cord
Term
Organization of the Anterior horn
Definition
Anterior - extensors
Posterior - flexors
Medial - proximal muscles
lateral - distal muscles
Term
Phasic Reflexes:
Definition
Muscle contraction following brief stretch (think DTR)
Term
Tonic Reflexes
Definition
Refers to response that lasts as long as the stretch stimulus is applied.
Example of clonus
Injury of damage to the CNS
Term
Medial Upper Motor Neurons
Definition
Signal LMN that innervate posture/ girdle muscles (antigravity muscles)
Term
Lateral UMN
Definition
Signal LMN that serve fine/distal movements. (upper-lower extremity neural highways)
Term
Nonspecific Upper Motor Neurons
Definition
Synapse throughout ventral horn and contribute to background activity and facilitate local reflex arcs (emotional motor)
Term
4 major upper motor neurons highways
Definition
-Tectospinal *** (posterior midbrain)
-Reticulospinal (nebulas
-Medial and lateral vestibulospinal (vestibular system Pons and medulla)
-Medial corticospinal (cortex)
Term
Reticulospnal motor
Definition
Orients head towards a visual or auditory stimulus
Term
MVST motor
Definition
Afferents from vestibular organs. Project to Bilateral cervical and thoracic mm, for proximal , goes to upper thoracic
Term
LVST motor
Definition
Afferents from vestibular organs. Facilitate ipsilateral extensors and inhibit ipsilateral flexors. Project throughout length of spinal cord. Antigravity, extremity extensors
Term
MCST motor
Definition
From cortex to ipsilateral cervical and thoracic LMNs. Controls neck, shoulder and trunk muscles
Term
Where do motor tracts that control posture and proximal limb movements begin?
Definition
- Start in the Brain stem (x MCST, start in cortex)
- bi , ipsi, contra, lateral
- With the lesion of the brain one side, trunk gets milder deficits than limbs, because of these redundant pathways
Term
Lateral UMNs
Definition
Control limb flexion and fine movements.
Two tracts control movements of the limbs:
-Lateral Corticospinal Tract
-Rubrospinal Tract
One series of tracts controls facial muscles:
-Corticobulbar (Corticobrainstem)Tract go to cranial nerves
Term
LCST pathway
Definition
Originates in primary motor, premotor and supplemental motor cortex.
Goes down the lateral finiculus, distal control, cross overa at the decusation of the pyramids at the bottom of the medulla
Term
Rubrospinal Tract
Definition
Rubro means red, - originates in the red nucleus of the midbrain
Term
Nonspecific UMNs
Definition
Two bilateral nuclei (locus ceruleus, raphe nucleus) enhance the activity of LMNs and spinal interneurons.
These tracts (ceruleospinal and raphespinal) are not related to specific movements and have been called part of the emotional motor system.
Examples: wall climbing and postural sway on platform.
Term
Paresis:
Definition
Partial loss of voluntary contraction.
Hemi: Half the body
Para: Below the arms
Tetra: All extremities
LMN lesions cause paralysis as there is nothing else talking to the muscle
UMN lesions typically cause paresis as some tracts may still be intact
Term
Decerebrate vs Decorticate Rigidity
Definition
If I damage the cortical brain and all is left is lower midbrain, all I can do is extension because of medial projecting tracts (Decerebral)


If red nucleus is concerved (rubrospinal stract), UE flexion starts becoming more noticeable (Decorticate)

Decerebratte – pointing down to the cerebellum
Decorticate – pointing up to the cortical
Term
Loss of Fractionated Movement
Definition
Inability to activate muscle independent of other muscles.
Interruption of LCST (boss man)
Movements are awkward and inefficient
Term
UMN Syndromes: Abnormal Cutaneous Reflexes
Definition
Babinski sign: Normal in infants younger than 7 months secondary to absence of myelin in LCST.
Indicates damage in corticopsinal tracts via mechanisms that are poorly understood.
Muscle stretch hyper-reflexia: Loss of descending presynaptic inhibition
Clonus: Lack of UMN influence over spinal interneurons.
Term
: Abnormal Tone
Definition
Tone: Resistance to stretch in resting muscles
Following chronic UMN lesion, hypertonia (unusually strong resistance to stretch) is present.
Acute UMN lesion may present with hypotonia.
As cerebral/ spinal shock resolve, LMN and interneurons resume activity but without UMN influence.
Term
Spasticity
Definition
Poorly used term as research and clinical definitions vary.
Research: Increase in muscle tone due to hyperexcitability of tonic stretch reflex
Clinical: Much broader: Includes entire UMN syndrome of paresis, muscle hyperstiffness, co-contraction and hyperreflexia
Term
SCI
Definition
Complete SCI: loss of all descending neuronal control.
Incomplete- presentation is variable depending on location and extent.
Term
Parts of the Basal Ganglia
Definition
Caudate, Putamen, Globus Pallidus, Subthalmic Nucleus, Substantia Nigra
Term
Lentiform Nucleus
Definition
Globus Pallidus
Putamen
Term
Striatum
Definition
Putamen
Caudate
Term
What are the major output structures of the Basal Ganglia
Definition
Striatum communicates with Globus Pallidus interns and Substntia Ngria Reticularis

This action is inhibitory
Term
Direct Pathway of the Basal Ganglia
Definition
give distal control over proximal
The motor thalamus, is our thermostat (controlled by output is determining proximal input
Term
substantia nigra compacta
Definition
(home of domamine), basal ganglia doesn’t work without dopamine,
Dopamine helps drive distal control at the expense of practical control
Without dopamine, parkinstons
Term
Dopamine on the Basal ganglia
Definition
Dopamine facilitates the direct pathway and inhibits the indirect pathway. In each case, the net effect is enhancement of motor cortex output.
Term
Thalamus involvement in hypokinetic and hyperkinetic movement
Definition
Hypokinetic: Excessive inhibition of motor thalamus
Hyperkinetic: Insufficient inhibition of motor thalamus
Term
Parkinson’s Disease symptoms and signs
Definition
Rigidity, hypokinesia, Resting tremor(hyper movement), shuffling gait, freezing, visuoperceptive deficits, postural instability, and dementia
Term
Substangtia nigra compact produces what?
Definition
produces dopamine
Term
Parkinson's Disease effects BG output
Definition
Inhibits Motor Thalamus, which limits stimulation of motor cortex and corticospinal tracts, limits LMNs tracts

Increased stimulation of RST and VST tracts leading to Postural and Girdle tracts
Term
Progresive supranuclear palsy
Definition
Caused by loss of descending neurons that synapse on cranial nerve nuclei that control eye movements.
Term
Progressive supranuclear palsy signs and symptoms
Definition
Early onset of gait instability (backwards falls)
Axial rigidity
Freezing of gait
Depression, psychosis, rage attacks
Gaze palsy (eyes can’t move)
Term
General input into the Cerebellum
Definition
Intended informtion - from the Motor cortex, through the Pons

Interneuron excitability through the spinal interneurons - Ventral spinocerebellar tract VSPT, Rostral spinocerebellar Tract

Actual movement proprioceptors - DSCT Dorsal spinocerebellar tract, CST
Term
Part of the Cerebellum that receives information
Definition
purkinje cell bodies
Term
Deep Cerebellar Nuclei
Definition
Output of the cerebellum
Term
Vermis and paranormal action
Definition
proximal control
Major outputs to the vestibular organs and reticular formation.
Controls and adjusts antigravity postural corrections and postural muscle tone
Term
cerebral cerebellum
Definition
refine movement
Term
vestibulocerebellum controls
Definition
Equilibrium
Term
spinocerebellum control
Definition
Gross movements of limbs
Term
cerebrocerebellum controls
Definition
Fine, distal movements
Term
Inferior Cerebellar Penduncles
Definition
Afferents from the spinal cord and brainstem
- knowledge of actual movement - proprioceptors
Term
Middle cerelebellar penducles
Definition
Afferents from the pontine nuclei of the contralateral side, Intentions of movement from the cerebrum
Term
Superior Cerebellar Peduncles
Definition
Major efferents from the cerebellum
going out of the cerebellum
Term
lateral hemispheres of the cerebellum
Definition
are involved in planning movements.
Particularly learned, skillful movements that become more automatic and precise with practice.
Term
Destruction of one half of the cerebellum lead to
Definition
Ipsilateral defecits
Term
Intermediate zone of the cerebellum
Definition
Can influence LMN vis CST and RuST
Compares actual movements with intended movements
Term
Damage to the midline of the cerebellum
Definition
causes postural instability
Term
lateral damage to the cerebellum
Definition
causes limb ataxia
Term
Flocculonodular damage of the Cerebellum
Definition
affects eye movement
Term
Midline Damange, cerebellum causes and effects
Definition
Malnutrition associated with alcoholism causes degeneration of cerebellar cortex that starts in midline of anterior lobe (anterior lobe syndrome).
The anterior lobe occupies a large part of vermis and paravermis
Gait is broad based and stiff with marked postural instability
Term
Lateral Damege of the cerebellum signs and symptoms
Definition
Lateral hemispheres make up majority of cerebellum.
Most frequently damaged portion of cerebellum
Results in alterations in muscle tone (hypotonia), reflexes (hyporeflexia) and voluntary movements (dysmetria, dysdiadochokinesia).
All deficits are ipsilateral to lesion
Term
Dysmetria
Definition
inaccurate movement, (distance, direction, force), picking up a cup (too short, miss the cup, too much force)
Term
Damage to Floculonodular Lobe
Definition
Affects eye movements
Medulloblastomas are most common cause of damage
Loss of equilibrium and postural control
Difficulty with eye pursuits, maintaining eccentric gaze, making voluntary accurate eye movements.
Term
Where is the primary control of posture
Definition
Brainstem
Term
Ambulating is primarily controlled by
Definition
brainstem and spinal cord regions
Term
reaching and grasping are controlled
Definition
cerebral cortex
Term
Postural control
Definition
Provides orientation (adjustment of body and head to vertical) and balance (ability to maintain COM over BOS)
Achieved by central commands directing LMNs
Central commands include: TST, MRST, VST, MCST.
Term
Postural control Parkinson's Disease
Definition
Flexed posture, lack of protective reactions and weak anticipatory postural adjustments
Term
Ambulation cerebral cortex effects
Definition
goal orientation and control of ankle movements
Term
Ambulaiton Basal Ganglia
Definition
Force generation
Term
Ambulaiton cerebellum effects
Definition
Timing, coordination and error correction
Term
Ambulation Brainstem Descending Tracts
Definition
Adjusts strength of muscular contractions
Term
Spinal Cord effect of Ambulation
Definition
Controls pattern of muscle activation
Term
How do afferent pathways of the ANS enter the CNS
Definition
Into the spinal cord via the dorsal roots
Into the brainstem via CN VII, IX and X
Term
Where do visceral information converge in the CNS?
Definition
Solitary Nucleus in the Medulla

From here, information is routed to visceral control centers in the Pons, Medulla and to modulatory areas in the Hypothalamus, Thalamus and Limbic system
Term
ANS synapse in the spinal cord
Definition
visceral afferents entering the spinal cord synapse with efferents (autonomic reflexes) and with neurons that ascend to regions of the brainstem, hypothalamus and thalamus.

Visceral nociceptive information additionally connect with:
Somatosensory pain efferents (referred pain)
Somatic efferents (muscle guarding)
Term
what is the role of the medulla and pons in the ANS
Definition
- Regulation of heart rate, respiration, vasoconstriction/vasodilation
Term
Role of hypothalamus in ANS
Definition
Control homeostasis by influencing caridorespiratory, metabolic, water reabsorption and digestive activity
Term
Thalamus role in ANS
Definition
Information reaching thalamus is projected mainly to limbic areas to produce:
Increased HR with anxiety, blushing with embarrassment, crying
Term
How many neurons are present in efferent ANS pathways
Definition
2-neuron chain

The primary neuron lives in the CNS (presynaptic or preganglionic)

The secondary neuron is the periphery (Postsynaptic or postganglionic)
Term
What is location of primary neurons in the Sympathetic system
Definition
lateral horns of T1-L2 (spinal cord) thoracolumbar system
Term
Where does the sympathetic system innervate
Definition
adrenal medulla, vasculature, sweat glands, erector hair cells, viscera
Term
Sympathetic efferent to the adrenal medulla
Definition
Primary neuron is directly connected to the medulla causing a release of the epinephrine directly into the blood stream
Term
Symphathetic efferents to the face, limbs, body wall, heart, and lungs
Definition
Primary neuron synapse in the parabertebral chain then a secondary neuron goes to the specific tissue
Term
Sympathetic efferents to the abdominal and pelvic viscera
Definition
travel to through paravertebral chain without synapsing, they travel with the splanchnic nerves, and synapse in the pre vertebral ganglia
Term
FUNCTIONS OF SYMPATHETIC SYSTEM
Definition
Prime job is to maintain optimal blood supply to the organs
Sympathetic activity causes vasoconstriction- decreasing blood flow
Think about fear-
Vasoconstriction in skin and gut increases blood flow to active muscles
Blood glucose increases, bronchi and coronary vessels dilate, BP and HR increase, digestion is halted
Term
REGULATION OF BLOOD FLOW IN SKELETAL MUSCLE
Definition
Skeletal muscle veins and venules allow blood to pool during relaxation
If pooling is not prevented when a person stands, BP will drop (syncope)
Normally, the pooling is prevented by contraction of the vessels prior to standing
Accomplished by systemic release of norepinephrine
Term
Additional action sympathetic control in the head
Definition
In addition; pupil dilation, elevation of upper eyelid, production of thick saliva (cotton mouth)
Levator palpebrae superioris contains both smooth muscle and skeletal muscle
Term
Parasympathetic efferent neuron chain
Definition
Neuron 1- contained within the CNS (CN III, VII, IX, X and S2-4)
Neuron 2- in a peripheral ganglion located near the target tissue
Term
Parasympathetic CN III
Definition
pupil constriction and lens thickening
Term
Parasympathetic CN VII
Definition
cry, spit and snot
Term
Parasympathetic CN IX
Definition
Spit
Term
Parasympathetic CN X
Definition
Heart, lungs and upper GI system
Term
Parasympathetic S2-4
Definition
lower GI, pelvic and perineal viscera
Term
Does the PNS innervate the limbs or body wall
Definition
no
the Sympathetic does though
Term
Horner's Syndrome
Definition
- Interruption of sympathetic pathways to the head
- lesion of the descending sympathetic signals, upper thoracic spine, vertical sympathetic chaing
- Ptosis, myosis, anhydrosis

Myosis – size of the pupil, cant dilate
Anhydrosis – lack of sweating
Term
Severing a peripheral nerve, ANS implication
Definition
Severing a peripheral nerve interrupts sympathetic efferents, causing loss of vascular control, temperature regulation, sweating in the region supplied.
These may lead to trophic changes in the skin
Term
Brainstem injury ANS implications
Definition
May interfere with descending control of heart rate, blood pressure and respiration.
May also interfere with CN nuclei affecting pupil size, tear production, mucus production, salivation or regulation of thoracic and abdominal viscera
Term
Cerebral damage: ANS implications
Definition
Damage to certain parts of the hypothalamus can disrupt homeostasis with consequent metabolic and behavioral dysfunctions
Term
Neural Tube Formation (18-26 days)
Definition
Nervous system begins as a longitudinal thickening of the ectoderm called the neural plate.
The plate begins to fold, creating the neural groove.
When the ends of the fold touch, the neural tube forms.
The groove zips closed leaving openings at each end (medial to lateral).
Term
Neural crest
Definition
Cells adjacent to the neural tube separate from the tube to form neural crest cells.
Neural crest cells creates clusters are outside the tube – part of our peripheral nervous system
Term
When does the neural tube close
Definition
27-30 days
Term
gray and white matter formation
Definition
The tube differentiates into two concentric rings.
The mantle layer (inner wall) will become gray matter.
The outer marginal layer will develop into white matter.
Term
somites
Definition
adjacent tissue to the neural tube that is divided into spherical clusters
Term
somite sclerotoe
Definition
Becomes skull and vertebrae
Term
somite myotome
Definition
Becomes skeletal muscle
Term
somite dermatome
Definition
Becomes dermis
Term
Therefore, myotome has two meanings:
Definition
An embryologic section of the somite. Post-embryonic stage: a group of muscles that are innervated by a segmental spinal nerve.
Term
the dorsal section of the neural tube
Definition
is the association (alar) plate
neurons here will become sensory neurons
Term
Basal plate of the neural tube
Definition
Neurons whose cells bodies are in the basal plate become motor neurons which innervate skeletal muscle and interneurons.
Term
neural crest development
Definition
The neural crest separates into two columns, one on each side of the tube.
The columns break into segments that correspond to the dermal areas of the neighboring somite.
These neural crest cells will become peripheral sensory neurons, myelinating cells, autonomic neurons and endocrine organs.
Term
peripheral sensory nerve development
Definition
The cells that become peripheral sensory nerves grow two processes; one connects to the spinal cord and the other innervates the region of the somite that will become the dermis.
Term
Spinal column development
Definition
Until the 3rd month, spinal cord segments are adjacent to corresponding vertebrae and the spinal nerves project laterally.
As the fetus matures, the spinal column grows faster than the spinal cord.
The adult spinal cord ends at the L2/L3 vertebral level.
Within the adult spinal cord, the neural tube cavity persists as the central canal.
Term
Following closure of the superior neuropore, the brain region of the tube expands to form three enlargments.
Definition
- Forebrain
- Midbrain
- Hindbrain
Term
Forebrain development
Definition
The forebrain continues to develop rapidly and will begin to fold in on itself thereby burying many nuclear structures:
Thalamus
Hypothalamus
Basal Nuclei
Term
Epithelial cell development
Definition
Epithelial cells that line the neural tube will differentiate into neurons and glial cells.
These cells migrate into their final positions via multiple methods.
Once in the final position, the cells will differentiate into a specific type of cell, depending on its location.
Therefore, daughter cells of a specific mother cell may assume very different functions based on their final location.
Term
Cellular processes (growth cone)
Definition
Cellular processes (growth cone) grow out from the neuron which slowly samples the cellular environment along the way.
The growth cone continuously samples other neurons and chemical signals until it finds a region that has compatible growth cone characteristics.
Term
When the growth cone has found chemical signals that it likes
Definition
synapses begin to form between the neuron and its target.
By the fourth month, axons undergo a process called myelination.
This process will continue until the third year of life.
Term
Oligodendrocytes and Schwann: Cellular-Level Development
Definition
Oligodendrocytes in the CNS are able to myelinate several different axons.
Schwann cells in the PNS can only myelinate a single axon.
Term
Myelination rates
Definition
Myelination occurs at different rates.
Motor neurons in the spinal cord are myelinated by 1 month after birth.
However, the cortical neurons that extend down to reach the spinal cord may not be myelinated until age 2.
Implications of perinatal nerve injury? – you wont see the injury, and can go undetectad for a couple of years because no CNS control yet, grow into their defecits
Term
when is the cps most susceptible to major malformation
Definition
The CNS is most susceptible to major malformations between day 14 and week 20.
After this period, growth and remodeling continue.
However, insults cause functional disturbances and/ or minor malformations.
Term
Anencephaly
Definition
Anencephaly occurs when the cranial end of the neural tube fails to close and the forebrain does not develop.
The skull fails to close over the top of the brain.
Not compatible with life.
Term
Arnold-Chiari malformations.
Definition
Developmental malformations of the hindbrain include Arnold-Chiari malformations.
The inferior cerebellum and medulla are elongated and protrude into the foramen magnum.
The deformity is associated with enlarged cranium 2° to CSF blockage.
Term
Arnold-Chiari malformations. symptoms and problems
Definition
Problems may include: tongue and facial weakness, deafness, weakness of lateral eye movements and coordination of movements due to cerebellar and cranial nerve involvement.
May require surgical enlargement of foramen magnum.
Term
spina bifida
Definition
Failure of the inferior neuropore to close results in spina bifida.
Developing vertebrae do not close around the incomplete neural tube.
Associated with maternal nutritional deficits.(folic acid)
Term
Spina bifida occulta:
Definition
neural tissue does not protrude and function is usually normal.
Term
Meningocele:
Definition
Meninges protrude and spinal cord function may be impaired. Mild deficits de to a slight defecits of the cord
Term
Meningomyelocele:
Definition
Neural tissue protrudes and involves varying degrees of lower extremity and bowel/ bladder dysfunction.
Similar to a L4 spinal cord injury
Term
Fetal Alcohol Syndrome (FAS)
Definition
results in impaired nervous system development, growth deficiencies and facial abnormalities.
Cognitive impairments are typical.
Children will have abnormally small heads and eyes will be very far apart.
Behavioral issues are prevelant.
Term
cocaine in fas
Definition
Cocaine can easily cross the placenta and remains in the fetal blood stream for prolonged periods secondary to immaturity of metabolic and excretory processes.
Results in impaired nervous system development.
Term
Cerebral Palsy
Definition
CP is a movement and postural disorder caused by permanent and non-progressive damage to the developing brain.
Caused by diminished oxygen delivery to the developing brain.
Term
Spastic CP:
Definition
Damaged neurons around the ventricles.
Muscle shortening often results in toe walking and scissor gait patterns.
Term
Athetoid CP:
Definition
Neuronal damage in the basal nuclei. hyperkinetic
Results in slow, writhing movements of the trunk or extremities.
Term
Ataxic CP:
Definition
Damage in the developing cerebellum.
Results in incoordination, weakness and shaking during voluntary movements.
Cognitive, somatosensory, visual, auditory and speech problems are also frequently seen in all types of CP.
Term
What do the posterior rami innervate
Definition
deep back muscles and overlying skin
Term
Anterior rami innervates..
Definition
skeletal, muscular and cutaneous areas of the limbs and anterior lateral trunk
Term
Endoneurium
Definition
surrounds individual axons
Surrounds individual fibers
If intact following injury, may help guide nerve fiber during regrowth
Term
Perineurium
Definition
bounds axons into groups of fascicles
Thin layer of concentrically arranged collagen
Forms a blood-nerve barrier
Continues as the capsule of some endings (Pacinian corpuscles, spindles, GTO)
However, at NMJ, perineurium is deficient, allowing endoneurial space around the nerve to communicate with extracellular space
Certain toxins and viruses gain access to the nervous system here
Term
Epineurium
Definition
encloses the entire nerve trunk
Loose CT surrounding each peripheral nerve
Forms substantial covering over nerve trunk then thins to incomplete layer at terminal end
Responsible for the tensile strength of the nerve
Continuous centrally with Dura mater
Term
What insulates axons from each other
Definition
Within the nerve, axons are insulated from each other by endoneurium and a myelin sheath (Schwann cells)
Term
Efferent large myelinated
Definition
name: Aa
innervates: Extrafusal muscle fibers
Term
Efferent medium my
Definition
NameL A-gamma
Intrafusal muscle fibers
Term
Efferent small efferent
Definition
name: B
Presynaptic autonomic
Term
efferent Unmyelinated
Definition
C
Postsynaptic autonomic
Term
Afferent large myelinated
Definition
name: Ia, Ib, II

Spindle, GTO, touch and pressure
Term
Afferent small myelinated
Definition
name A-delta

Pain, temp, visceral receptors
Term
Afferent unmyelinated
Definition
Name C
Pain, temp, visceral receptors
Term
Cervical Nerve Plexus
Definition
Anterior rami of C1-4
Found deep to SCM
Provides sensation from posterior scalp to clavicle, innervates anterior neck muscles and diaphragm
Term
Brachial plexus
Definition
Anterior rami of C5-T1
Emerges between Anterior and Middle Scalene, passes deep to clavicle to enter axilla
Provides sensation and motor to entire UE
Term
Lumbar Plexus
Definition
Anterior rami of L1-4
Forms within Psoas Major
Provides sensation and motor to entire anterior and medial thigh
Term
Neural Movement
Definition
Movement improves health of nerve by promoting blood flow and the flow of axoplasm
Fascicles glide within the nerve and nerves glide relative to other structures
In the absence of movement, axoplasm thickens and becomes more resistant to flow (anterograde and retrograde transport)
Nerves elongate with the support of CT and axonal folding
Term
Neuromuscular Junction
Definition
Nerve-muscle synapse requires only depolarization of the motor axon, releasing ACh (always excitatory) which binds with receptors on muscle membrane.
No summation is required and no inhibition is possible.
In normal motor unit, every depolarization of the motor axon releases sufficient ACh to initiate AP in the muscle
Even when LMN is inactive, it spontaneously releases minute amounts of ACh causing mini end-plate potentials (needed for muscle health)
Term
Sensory changes post PN dysfunction
Definition
Sensory changes (decreased or absent) or abnormal sensations (hyperalgesia, dysesthesia, paresthesia)
Term
Autonomic changes post-dysfunction of PN
Definition
may include lack of sweating, loss of sympathetic control of smooth muscle in arteries (edema). If many nerves included- impotence, difficulty regulating BP, HR, B/B function
Term
Dysfuntion PNs: motor
Definition
Motor changes may lead to paresis or paralysis. Denervated muscle EMG activity may show fibrillation after 1 week post injury
Term
Denervation: Trophic Changes
Definition
Muscle atrophy, skin becomes shiny, nails become brittle and subcutaneous tissue thickens.
Ulceration and poor healing of wounds is common as is neurogenic joint dysfunction 2/2 blood supply changes, loss of sensation and lack of movement
Term
Traumatic myelinopathy
Definition
Caused by trauma,
myelination
Recovery: complete and rapid by remylination
Term
Traumatic axonopathy
Definition
usual cause: trauma
axonal damage
recovery: slow, by regrowth of axons. But gooth
Term
Traumatic Severance
Definition
trauma, axon and myelin damage

Slow, with poor results secondary to inappropriate reinnervation
Term
Mutliple Mononeuropathy
Definition
causes: DM, blood vessel inflammation
pathology: Iscemia of neuron
Recovery: Slow, by regrowth of axons. Usually good
Term
Polyneuropathy
Definition
cause: DM, autoimmune syndrome (GBS) or genetic

Metabolic or inflammary pathology

recovery Variable
Term
Mononeuropathy
Definition
Traumatic injury including repetitive stimuli, prolonged compression or stretch, wounds:
Traumatic myelinopathy
Traumatic axonopathy
Severance
Term
Traumatic Myelinopathy
Definition
Loss of myelin limited to site of injury
Involves large-diameter axons leading to motor, light touch/ proprioceptive, phasic stretch deficits and neuropathic pain
Autonomic function typically sparred (C fibers, don’t have mylein anywhere)
Axons are NOT damaged
Recovery is typically complete and rapid
Term
Progressive monoaxonal damage
Definition
1) Repeated mechanical Stimulation
2) Decresed epineural blood flow/axonal transport
3) Edema of endo/epineurium (also causes 2)
4) Thickening of epi/perineurium
5) Myelin Damage
6) Development of entropic foci
7) REpeted stimulation of nociceptors (cause by 4)
8) Sensitization of nociceptors
9) Excessive sensitivity to mechanical and chemical stimuli
Term
Ectopic foci
Definition
unmyelination causes adjacent unwanted stimuli because of touching
Term
Myelin damage progression
Definition
1) axonal damage
2) Decreased NCV
3) Impairered light touch, proprioception (also results from 4)
4) Decreased amplitude of nerve conduction potentials (caused by 1)
Term
common compression of median nerve
Definition
(Pronator Teres (syndrom), Carpal Tunnel)
Term
Ulnar nerve compression sites
Definition
(Cubital tunnel, Guyon’s canal)
Term
Radial nerve compression site
Definition
(Spiral groove)
Term
Common fibular compression
Definition
(Fibular head)
Term
Pronator Teres Syndrome.
muscles affected
Definition
Compression of Anterior Interosseous Nerve:
FPL, FDP (Index finger), Pronator Quadratus
Term
Carpal tunnel syndrome
Definition
atrophy and sensory changes to the medial part of the hand
Term
Guyon Canal Compression
Definition
Ulna nerve
Handlebar Paslsy
Term
Spiral groove
Definition
sleeping on an IR humerus
saturday night palsy
Term
Crutch palsy
Definition
Radial nerve compression in the axial region
Term
Fibular head compression
Definition
Maybe cause by casting or bracing
Common fibular nerve,
DF and Eversion defecits
Term
Traumatic Axonopathy
Definition
Disrupts axons and wallerian degeneration occurs distal to lesion
Typically occur from crushing injuries
Affects all sizes of axons: reflexes, somatosensation, motor function lost
Myelin and CT remains intact so regeneration and retargeting are possible
Axon regrowth at rate of 1mm/day
Term
Severance of a nerve
Definition
Excessive stretch or laceration leading to axon and CT destruction
Axons in proximal stump begin to sprout
If the 2 ends miraculously meet, there may be some restoration of function, not guranteed
Term
Multiple Mononeuropathy
Definition
Two or more nerves in different body parts.
Typically caused by DM or vasculitis.
Random, asymmetric presentation
Term
Polyneuropathy
Definition
Symmetric involvement of sensory, motor and autonomic fibers
Distal to proximal progression (stocking & glove)
May occur 2/2 poor axonal transport or demyelination
Causes are toxic, metabolic or autoimmune
Etoh, DM and autoimmune diseases

Socking & glove – start at the feet and hands and may progress proximal
Term
Diabetic Polyneuropathy
Definition
Axon and myelin damage with sensation most affected
Impaired vibratory sensation typically the first sign
Decreased autonomic function, muscle weakness and loss of pain often lead to Charcot deformity
Term
Guillain-Barré Syndrome
Definition
Greater sensory involvement with greater paresis proximally
Very rapid onset
Autoimmune disorder
Term
Charcot-Marie-Tooth Disease
Definition
AKA: Hereditary Motor and Sensory Neuropathy (HSMN)
Paresis of muscles distal to knee- foot drop and steppage gait
Progresses to involve muscles of the hands
Genetic mutations affecting structure and function of peripheral axons and myelin
Term
Myasthenia Gravis
Definition
Autoimmune disorder damaging ACh receptors at NMJ
Circulating antibodies competitively bind to the ACh receptors- ACh has no where to go.
Repeated contractions leads to easy muscular fatigue
Treated with acetylcholinesterase inhibitors
Term
Botulism
Definition
Interference with ACh release from motor axon leading to acute, progressive weakness
Sensation remains intact
Botox is used therapeutically to manage spasticity to weaker overactive muscles
Term
Myopathy
Definition
Disorders intrinsic to muscles
The nervous system is healthy and intact- sensory and autonomic functions are normal
Coordination, muscle tone and reflexes are unaffected until atrophy becomes too severe
Major myopathy is Muscular Dystrophy
Term
Muscular Dystrophy
Definition
Duchennes MD is most common
Typically occurs in boys vs girls
An inherited condition leading to random muscle fiber degeneration
Motor units are now much smaller than normal leading to decreased force production
Term
Electrodiagnostic Studies can be used to differentiate the following
Definition
Myelinopathy (slowed velocities) vs axonopathy (decreased amplitudes and possibly decreased velocity) UMN lesions (normal NCS) vs LMN lesions (abnormal NCS) Mononeuropathy vs polyneuropathy Local block (only at a specific site) vs wallerian degeneration (entire exam distal to lesion)
Term
PNS vs CNS: Distribution of s/s
Definition
PNS - peripheral nerve pattern
CNS - Dermtomal or mytomal pattern (spinal cord)
Term
PNS vs CNS: NCS
Definition
PNS: Slowed or blocked conduction, decreased amplitude
CNS: Normal
Term
Muscle tone: PNS vs CNS
Definition
PNS: Hypotonia if LMN involved
CNS: Hypertonina if UMN involved
Term
Muscle atrophy: CNS vs PNS
Definition
PNS: rapid atrophy indicates denervation
CNS: Progresses slowly
Term
Phasic stretch reflexes CNS vs PNS
Definition
PNS: Reduced or absent
CNS: Hyperactive or normal
Term
Praspinal Sensation or Motor
Definition
PNS: Normal
CNS: Involved
Term
Draw the Brachial plexus
Definition
Term
Musculocutaneous (C5-C7)
Definition
mm: Coracobrachialis, Biceps Brachii, Brachialis

skin: lateral forearm
Term
Median (C6-T1)
Definition
mm: pronator teres, FCR, Palmaris longus,
anterior interosseus: FDS, FDP (radial side), FPL, Pronator Quadratus,
Median: APB, FPB, Opponents Pollicis, Lumbricals 1,2

Snsation: medial hand palmar side, tips of thumb, index and ring dorsal side
Term
Ulnar N (C8-T1)
Definition
mm: FCU, FDP (ulnar side) ADM, ODM, FDM, All interossei, Lumbricals 3,4, Add Policis, Palmaris Brevis

Sensation: lateral hand dorsal and ventral
Term
Axial n C5-6
Definition
Deltoid, Teres Minor
Term
Radial nerve C5-8
Definition
Triceps, Brachioradialis, ECRL, ECRB, Supinator, APL, EPB, Extensor Indices
EPL, ECU, EDM, ED, Anconeus

Sesation, posterior arm, dorsal lateral hand
Term
Femoral (L2-4)
Definition
Psoas Major
Iliacus
Pectineus
Sartorius
Vastus Lateralis
Rectus Femoris
Vastus Intermedius
Vastus Medialis

sensation quad midial shin
Term
Common Fibular (L4-S2)
Definition
Biceps (short head)
Fibularis Longus
Fibularis Brevis
Tibialis Anterior
EDL
EHL
Fibularis Tertius
Extensor Hallicis
EDB

lateral calf, dorsal foot
Term
Obturator (L2-4)
Definition
Obturator Externus
Adductor Magnus
Adductor Brevis
Adductor Longus
Gracilis

Skin: medial thigh
Term
Tibial (L4-S3)
Definition
Biceps (long head)
Semitendinosus
Semimembranosus
Adductor Magnus
Plantaris
Gastrocnemius
Popliteus
Soleus
FHL
FDB
Tibialis Posterior
Most foot intrinsics

Posterior latareal calf, plantar foot
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