0b Spinal Cord Crash Course Flashcards

1
Q

What type of cell bodies are sensory neurons?

A

pseudounipolar

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2
Q

name the 2 types of GSA sensory receptions

A

ProprioceptionExteroception

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3
Q

Track how GVA enters the spinal cord beginning with the peripheral process

A

peripheral process (runs back with GVEs), sympathetic chain ganglia, white rami communicantes, spinal nerve, DRG, dorsal roots

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4
Q

What type of cell bodies are motor neurons?

A

multipolar

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5
Q

What type of cell bodies are autonomic nerves?

A

multipolar

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6
Q

Where are cell bodies of the sympathetic nervous system located? (specific location within spinal cord & segments)

A

IMLCC; T1-L2

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7
Q

Where are cell bodies of the parasympathetic nervous system located?

A

S2-S4 & cranial nerves

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8
Q

What is the difference between monosynaptic vs polysynaptic reflexes?

A

interneurons in polysynaptic reflexes;monosynaptic reflex is direct conversion of sensory input to motor neurons

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9
Q

List spinal cord segments and the number of nerves each segment contains.How many nerves are there compared to vertebrae?

A

8 cervical nerves12 thoracic nerves5 lumbar nerves5 sacral nerves1 coccygeal nerve31 spinal nn. : 33 vertebrae

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10
Q

Dermatome C2/C3

A

posterior head and back

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11
Q

Dermatome C4-T2

A

adjacent in upper thorax

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12
Q

Dermatome T4

A

Nipple

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13
Q

Dermatome T10

A

Umbilicus

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14
Q

Dermatome S3/Co1

A

anus

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15
Q

Which spinal cord segments are part of the cervical enlargement? why?

A

C4-T1; brachial plexus & upper limbs

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16
Q

Which spinal cord segments are part of the lumbosacral enlargement? why?

A

L2-S3; lumbosacral plexus and lower limbs

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17
Q

Define Funiculi

A

bundle of nerve fibers forming a tract

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18
Q

list the 3 main Funiculi and their components

A
  1. Posterior Funiculus: Dorsal Column (medial leminiscus)
  2. Lateral Funiculus: Lateral Corticospinal Tract
  3. Anterior Funiculus: Spinothalamic Tract (anterolateral system)
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19
Q

Which 2 fasciculi & 2 nuclei are located in the dorsal medial leminiscus tract?

A
Fasciculus Gracilis (medial)
Fasciculus Cuneatus (lateral)

Nucleus Gracilis
Nucleus Cuneatus

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20
Q

Lamina I

A

Posteromarginal Nucleus

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21
Q

Lamina II

A

Substantia Gelatinosa

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22
Q

Lamina III & IV

A

Nucleus Proprius

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23
Q

Lamina V + VI

A

Base of Dorsal Horn

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24
Q

Lamina III

A

Nucleus Proprius

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25
Q

Lamina IV

A

Nucleus Proprius

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26
Q

Lamina V

A

Base of Dorsal Horn

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27
Q

Lamina VI

A

Base of Dorsal Horn

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28
Q

Which laminae are located in the dorsal horn?

A

I-VI

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29
Q

Which lamina is located in the intermediate zone?

A

VII

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30
Q

Which laminae are located in the ventral horn?

A

VIII & IX

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31
Q

Where is lamina X located?

A

around the spinal central canal

32
Q

Lamina VII (T1-L2)

A

Dorsal Nucleus of Clark

33
Q

Lamina VII (T1-L2/3)

A

IMLCC

34
Q

Lamina VII (S2-S4)

A

Sacral Parasympathetic Cell Column

35
Q

Lamina VIII

A

interneurons and tracts receiving descending information

36
Q

Lamina IX

A

Lower Motor Neurons

37
Q

In Lamina IX, where are neurons that control axial muscles located?

A

medial

38
Q

In Lamina IX, where are neurons that control extremities located?

A

lateral, only in spinal enlargements (cervical and lumbosacral)

39
Q

Where is the Accessory Nucleus located? (lamina + spinal segment)

A

Lamina IX, medulla - C5

40
Q

Where is the Phrenic Nucleus located? (lamina + spinal segment)

A

Lamina IX, C3-C5 (phrenic nerve – essential for breathing)

41
Q

What is the difference between an intrasegmental and intersegmental reflex?

A

intrasegmental - occurs within the same spinal cord segment & intersegmental - involves multiple spinal cord segments

42
Q

What occurs during Reciprocal Inhibition?

A

one group of muscles is excited (ipsilateral synergists) while the antagonist group is inhibited (ipsilateral antagonists)

43
Q

What is Autogenic Inhibition (inverse myotactic reflex)? and why does this exist?

A

Protective inhibitory response to excessive tension in muscle fibers (monitored by Golgi Tendon Organ); exists so that muscles do not exert more force than bones and tendons can tolerate.

44
Q

What is the Withdrawal/Flexor/Nociceptive Reflex?

A

a complex, intersegmental, polysynaptic reflex initiated by cutaneous receptors that involved the WHOLE LIMB. This enables withdrawal from painful or nociceptive stimulus.

45
Q

How does the Crossed Extension Reflex occur? What does it do?

A

The Crossed Extension Reflex builds on the Withdrawal Reflex. It accompanies it with a simultaneous and opposite action in the contralateral limb. This maintains postural integrity during the withdrawal reflex.

46
Q

Track the Dorsal Column/Medial Lemniscal System.

A

Primary Neuron: cell bodies in DRG –> Fasiculus gracilis/cuneatus –>synapse on nucleus gracilis/cuneatus (ipsilateral), Secondary Neurons called Internal Arcuate Fibers–> CROSS OVER in Medulla –> become Medial Lemniscus Fibers –> synapse on Ventral Posterolateral Nucleus VPL of Thalamus, Tertiary Neurons –> Somatosensory Cortex

47
Q

What type of system is the Dorsal Column/Medial Lemniscal? What sense(s) does it transmit?

A

sensory/ascending; proprioception, touch, vibration, 2 point discrimination/fine touch

48
Q

Track the Anterolateral/Lateral Spinothalamic Tract.

A

Primary Neuron: cell bodies in DRG –> ascend 2-3 segments & enter Zone of Lissauer –> synapse on Dorsal Horn Laminae 1, 2, 5, & become Secondary Neurons –> CROSSES OVER at the anterior white commissure & called Anterolateral System –> synapse on Ventral Posterolateral Nucleus VPL of thalamus, tertiary neurons –> Somatosensory Cortex

49
Q

What type of system is the Anterolateral/Lateral Spinothalamic Tract? What sense does it transmist?

A

sensory/ascending; exteroception, nociception, crude touch

50
Q

Define Somatotopical Organization?

A

most medial is rostral, most lateral is caudal

51
Q

Deficits of a Peripheral Nerve Lesion.

A

motor & sensory

52
Q

Deficits of a Dorsal Root Lesion.

A

sensory deficits only

53
Q

Deficits of a Ventral Root Lesions.

A

motor deficits only

54
Q

Deficits of a Motor Neuron Lesion of the Ventral Horn.

A

motor deficits only

55
Q

Which types of lesions (peripheral, dorsal, ventral, motor neuron of ventral horn) are consistent with Lower Motor Neuron Lesions?

A

peripheral, ventral, & motor neuron lesion of ventral horn

56
Q

What are the signs of Lower Motor Neuron Lesion?

A

Areflexia, Flaccid Paralysis, Muscle Wasting, Fasiculations

57
Q

In order to damage Lower Motor Neurons, what areas does the lesion occur?

A

damage to axons in spinal or peripheral nerves

58
Q

Define Areflexia

A

absent deep tendon reflexes

59
Q

Define Flaccid Paralysis

A

complete loss of muscle tone, & voluntary/reflex movements

60
Q

Define Fasiculations

A

spontaneous contractions of motor units

61
Q

In a Lower Motor Neuron Lesion, signs occur on which side when compared to the damaged neuron?

A

All signs occur ipsilateral to the lesion AND in muscles supplied by the affected LMN

62
Q

In an Upper Motor Neuron Lesion, signs occur on which side compared to the damaged neuron?

A

It depends. If Rostral to pyramidal decussation, CONTRALATERAL signs will mainly be seen (~85% of fibers cross at pyramidal decussation * form the LATERAL corticospinal tract). If Caudal to pyramidal decussation, signs will be IPSILATERAL.

63
Q

What are the signs of an Upper Motor Neuron Lesion?

A

Paresis, Spastic Paralysis, Little Muscle Atrophy, Exaggerated Deep-Tendon Reflexes (Hyperreflexia), Babinski Sign

64
Q

Define Paresis

A

Muscle weakening – difficulty moving; can lead to paralysis

65
Q

Define Spastic Paralysis

A

Spasticity, increased muscle tone, increased resistance to passive stretching

66
Q

Define Babinski Sign

A

Abnormal superficial plantar reflex

67
Q

Dorsal Column Lesion Signs

A

IPSILATERAL loss of vibration, position, fine touch, & 2 pt discrimination

68
Q

Lateral Corticospinal Tract Lesion Signs

A

IPSILATERAL UMN symptoms: Paresis, Spastic Paralysis, Little Muscle Atrophy, Exaggerated Deep-Tendon Reflexes (Hyperreflexia), Babinski Sign

69
Q

Spinothalamic Tract Lesion Signs

A

CONTRALATERAL loss of pain, temp sense, crude touch

70
Q

Spinal Motor Neuron Lesion Signs

A

IPSILATERAL LMN signs: Areflexia, Flaccid Paralysis, Muscle Wasting, Fasiculations

71
Q

Autonomic Neuron Lesion Signs

A

IPSILATERAL miosis, ptsosis, anhydrosis; urinary incontinence; bow incontinence

72
Q

High Cervical Transection Signs (above/at phrenic n.)

A

Respiratory Insufficiency, quadriplegia, spinal shock (period of areflexia), autonomic symptoms, spasticity below level of lesion; hyperreflexia (injury to lateral corticospinal tract), bilateral anesthesia (loss of pain/temp sense due to injury of spinothalamic tract), loss of proprioception (injury of dorsal column)

73
Q

Low Cervical Transection Signs

A

paraplegia (NOT quadriplegia), Spinal Shock (period of areflexia), Autonomic Symptoms spasticity below level of lesion.
Hyperreflexia (lateral corticospinal tract), bilateral anesthesia (loss of pain/temp sense due to injury of spinothalamic tract), Loss of proprioception (injury of dorsal column)

74
Q

High Thoracic Transection Signs

A

Quadriplegia, Spinal Shock (period of areflexia), Autonomic Symptoms spasticity below level of lesion.
Hyperreflexia (lateral corticospinal tract), bilateral anesthesia (loss of pain/temp sense due to injury of spinothalamic tract), Loss of proprioception (injury of dorsal column)

75
Q

Brown-Sequard Syndrome (spinal cord hemisection)

A
  1. Ipsilateral Signs (dorsal column, lateral corticospinal tract, anesthesia at level of lesion [due to damage of primary afferent fibers]).
  2. Contralateral Signs (spinothalamic tract, beginning 1-2 segments below hemisection).
  3. Bilateral Signs (segmental loss of pain/them 1-2 segmetns below level of hemisection).
  4. Ventral Horn Signs (LMN signs by affected spinal cord segments)