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NEUROANATOMY > (2) Spinal Cord > Flashcards

(2) Spinal Cord Flashcards

1
Q

what system is the spinal cord a part of?

A

central nervous system

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2
Q

where does the spinal cord continue form

A

the medulla oblongata (of the brainstem)

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3
Q

sympathetic vs parasympathetic nervous system

A

sympathetic= fight or flight (spinal cord)

parasympathetic= rest and digest (brainstem/spinal cord)

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4
Q

dorsal vs ventral spinal cord

A

dorsal/posterior= sensory INTO spinal cord

ventral/anterior= motor OUT OF spinal cord

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5
Q

function of the foramen magnus

A

defines the border of the brainstem and spinal cord

  • part of occipital bone
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6
Q

4 main functions of the spinal cord

A

motor functions

reflex integration

autonomic functions

impulse conduction

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7
Q

motor functions of the spinal cord

A
  • enable us to move and interact with environment

- location of lower motor neurons controlling muscle function in limbs/torso

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8
Q

reflex integration of the spinal cord

A

specific pathways originating from periphery allow for reflexive movements rather than those initiated by brain

(e.g. involuntary movement)

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9
Q

autonomic functions of the spinal cord

A

sympathetic and part of the parasympathetic NS (ANS)

  • internal organ function
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10
Q

impulse conduction of the spinal cord

A

provides means of neural communication to and from the brain

  • ascending tracts and descending tracts
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11
Q

ascending vs descending tracts of the spinal cord

A

ascending= conduct impulses from peripheral sensory receptors to the brain

descending= conduct motor impulses from brain to muscles and glands

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12
Q

where does the spinal cord start and end

A

start: foramen magnum
end: filum terminale

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13
Q

2 enlargements of the spinal cord

A

cervical and lumbar enlargement

  • contain network that control arm/leg movement
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14
Q

cervical enlargement location

A

C5 – T1

controls arm movements

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15
Q

lumbar enlargement location

A

L2 – S3

controls leg movements

  • ends at conus medullaris
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16
Q

central canal of the spinal cord function

A

filled with CSF

  • nurtures spinal cord
  • carries material
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17
Q

dorsal and ventral roots pass through

A

dorsal= dorsal lateral sulcus

ventral= ventral lateral sulcus

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18
Q

how many spinal cord segments?

A

31 in total

8- cervical 
12- thoracic
5- lumbar
5- sacral
1- coccygeal
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19
Q

where is dorsal root ganglia and what does it contain?

A

DRG is in the PNS

contains cell bodies of sensory neurons

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20
Q

spinal cord segments give rise to ….

one exception

A

segments give rise to spinal nerves

exception: No C8 vertebrae

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21
Q

cervical plexus and brachial plexus control what??

A

arm and neck movements

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22
Q

dorsal rootlets enter where

A

enters posterolateral sulcus

  • bears dorsal root ganglia (contain cell bodies of primary sensory neurons)
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23
Q

ventral rootlets leave where?

A

leave from anterolateral sulcus

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24
Q

what is a dermatome?

A

area of skin supplied by nerves from single spinal root

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25
Q

C1 and C3 segment dermatomes

A

C1 segment= no dermatome

C3= neck

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26
Q

does the face have a dermatome?

A

NO

face is innervated by cranial nerves (not spinal!)

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27
Q

spinal cord is located within… (why?)

A

vertebral canal

provides protection

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28
Q

3 protective sheets of the spinal cord are called?

A

Meninges

1) dura mater
2) Arachnoid mater
3) pia mater

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29
Q

dura, arachnoid and pia mater

A

dura= outer, toughest

arachnoid= middle, spiderweb

pia= inner, wrap spinal cord tissue

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30
Q

what is between the arachnoid and pia mater?

A

CSF

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31
Q

what goes between pia mater and dura mater?? (what is the function)

A

denticulate ligaments

  • position spinal cord (centres it in meninge tube)
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32
Q

what segments does the spinal cord end?

A

L1/L2

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33
Q

how long is the spinal cord and vertebral column?

A

spinal cord= 42-45 cm

vertebral column= ~70 cm

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34
Q

caudal/lower end of the cord is anchored to…

A

end of dural tubal by filum terminal

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35
Q

structures at the end of the spinal cord

A

conus medullaris (L1)

lumbar cistern (L2)

filum terminale internum (L3)

dura mater (continues farther than spinal cord) – (L4)

filum terminal externum (coccygeal ligament) – (S2)

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36
Q

what and where is the cauda equina?

A

from L1/L2 –> S2
(above the filum terminale externum)

filled with dorsal and ventral roots

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37
Q

cauda equina is also called

A

horses tail

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38
Q

where to inject epidural needle? Why?

A

dural sac= filled with spinal nerves

able to insert needle without damaging spinal cord

(in lumbar region)

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39
Q

grey matter and white matter in spinal cord

A

grey= cell bodies of interneurons and motor neurons (surrounded by white matter)

white= heavy myelinated axons projecting too and form spinal cord (surrounds grey)

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40
Q

grey matter and white matter are divided into

A

grey= horns

white= funiculi

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41
Q

Lissauer’s tract location and what does it contain

A

between substantia gelatinosa and surface of the cord

contains finely myelinated/unmylinated fibers

left side of body

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42
Q

at what levels is the posterior intermediate sulcus found

A

cervical and upper thoracic levels

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43
Q

anterior median fissure

A

extend almost to centre of cord

  • at apex a thin zone of white matter (anterior white commissure) and thin grey matter zone separates central canal from subarachnoid space
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44
Q

posterior median sulcus

A

(less distinct)

glial septum extend from it all the way to grey matter surrounding central canal

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45
Q

location and function of substantia gelatinosa

A

distinctive region of grey matter, caps the posterior horns

  • deals with finely myelinated and unmyelinated SENSORY fibres that carry PAIN and TEMPERATURE information
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46
Q

2 spinal reflexes

A

patellar (knee-jerk) reflex

flexor and crossed extensor reflex

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47
Q

patellar reflex

A
  • cell body of afferent is in DRG
  • tapping patellar tendon, stretches quadriceps
  • quad muscle spindles excited and excite quad alpha motor neurons
  • causing muscle to contract (completing reflex)
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48
Q

flexor and crosses extensor reflex

A
  • initiated by cutaneous receptor
  • involves whole limb
  • caused by specific network in spinal cord

ex: withdrawal from pain stimuus

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49
Q

somatic nervous system afferents in the spinal cord

  • what is the boss?
A

afferents and info from body goes INTO spinal cord

innervates muscles, causes contraction

Boss= cerebral cortex (generate decisions about how to move, what to do)

50
Q

autonomic nervous system afferent fibers in spinal cord

  • what is the boss?
A

ANS= control gut movements, heart, and internal organs (unaware)

afferent fibers (visceral= internal)- info goes into spinal cord through dorsal root
- innervate interneurons and motor neurons, and project to target organs (muscle/endocrine organs)

Boss= hypothalamus

51
Q

general visceral sensory neurons monitor what 4 sensations in visceral organs

A

stretch
temperature
chemical changes
irritation

52
Q

cell bodies of visceral sensory neurons are located where?

A

dorsal root ganglion

53
Q

visceral pain

A
  • no pain results when visceral organs are cut
  • pain results from chemical irritation or inflammation
  • often perceived to be of somatic origin (referred pain)
54
Q

ex: gall bladder pain

A

visceral pain

  • feel pain in arm, shoulder and stomach
55
Q

where are sympathetic and parasympathetic preganglionic neurons segregated?

A

symp= thoracic and lumbar (intermediate horn)

para= brain stem and sacral

56
Q

radicular vs medullary arteries

A

radicular= posterior/anterior, don’t touch main arteries
- run dorsal and ventral spinal nerve roots

medullary= supply main arteries

57
Q

3 major longitudinal arteries of the spinal crd

A

1 anterior spinal

2 posterior spinal arteries

  • originate from vertebral arteries
  • run length of cord
58
Q

major longitudinal arteries are supplemented by:

A

segmental arteries

  • derived from vertebral, deep cervical, intercostal and lumbar arteries
59
Q

large radicular artery arises from…. and supplies what?

A

arises from intercostal artery on left between T9 and T11

  • often supplies blood for lower spinal cord
60
Q

6 veins in venous drainage

A

3 anterior

3 posterior spinal veins

61
Q

venous drainage

A
  • 3 anterior, 3 posterior spinal veins
  • drained by medullary and radicular veins
  • join internal vertebral venous plexuses in epidural space
62
Q

3 types of nerve fibers in white matter of spinal cord

& where do they project to/from

A

1) long ascending fibers: project to thalamus, cerebellum or brainstem nuclei
2) long descending: project from cerebral cortex or from brainstem nuclei in grey matter
3) shorter propriospinal= interconnecting different spinal cord levels, mostly remain in propriospinal tract

63
Q

what is the fasciculus proprius?

A

thick shell surrounding grey matter

in white matter

64
Q

where are the ascending and descending tracts in the spinal cord located

A

white matter

65
Q

white matter is divided into 3 parts

A

posterior, lateral, anterior fasciculus

66
Q

ascending tracts in spinal cord.. found… function

A

found in all 3 funiculi

bring info TO brain (Right side)

67
Q

descending tracts in spinal cord… found… function

A

found primarily in lateral or anterior funiculi (not posterior)

  • bring info TO BODY (left side)
68
Q

are descending tracts sensory or motor?

A

MOTOR

69
Q

are ascending tracts sensory or motor?

A

SENSORY

70
Q

what do descending motor tracts represent

A

functional pathways that convey signals from brain to periphery/body

generate movement

71
Q

name of descending motor tracts (all similar)

A

ends in spinal

72
Q

cells of origin of descending motor tracts

A

cells of origin (upper motoneurons) are in cerebral cortex
- e.g lateral corticospinal tract

or in brainstem (e.g. rubrospinal tract)

  • and innervate lower motoneurons in brainstem or spinal cord (final target)
73
Q

descending motor tracts can be grouped into….

A

conscious (2) and subconscious tracts (4)

74
Q

2 conscious motor tracts (descending)

A

lateral corticospinal tract

anterior corticospinal tract

– used to consciously move something

75
Q

4 subconscious motor tracts (descending)

A

vestibulospinal tract

tectospinal tract

reticulaspinal tract

rubrospinal tract

76
Q

conscious descending tracts begin where?

A

both in primary motor cortex

precentral gyrus

77
Q

8 parts to the lateral corticospinal tract pathway

descending, motor, conscious

A

1) fibers in cerebral cortex (precentral gyrus/motor cortex)
2) upper motor neuron descends through internal capsule
3) corticospinal tract
4) cerebral peduncle (midbrain)— crux cerebri
5) basal pons
6) CROSS pyramids of medulla oblongata (cross to right)
7) lateral fasciculus
8) terminate in motor neurons in anterior horn (skeletal muscle) – contraction occurs

78
Q

8 parts to the anterior corticospinal tract pathway

descending, motor, conscious

A

1) fibers in cerebral cortex (precentral gyrus/motor cortex)
2) upper motor neuron descends through internal capsule
3) corticospinal tract
4) cerebral peduncle (midbrain)— crux cerebri
5) basal pons
6) medulla oblongata (white matter)
7) CROSS at final segments of spinal cord (anterior white commissure)
8) terminate in motor neurons in anterior/ventral horn (skeletal muscle) – contraction occurs

79
Q

anterior corticospinal tract important for

A

fine movement

80
Q

corticospinal tracts are involved in

A

skilled motor activity, particularly in the limbs

81
Q

cells of origin of corticospinal tracts

A

aka upper motor neurons

  • they are pyramidal cells located in motor, premotor and supplemental motor cortices
82
Q

upper motor neuron controls …

A

lower motor neuron

83
Q

if lose upper motor neuron then what happens?

A

don’t lose all control because still have lower motor neurons

84
Q

if lose lower motor neuron then what happens?

A

lose all control on muscles, cannot contract, lose tone, no reflex

85
Q

upper vs lower motoneuron lesion effect on strength

A

upper lesion= decreased strength

lower lesion= decreased stength

86
Q

upper vs lower motoneuron lesion effect on muscle tone**

A

upper lesion= increase tone*

lower lesion= decreased tone

87
Q

upper vs lower motoneuron lesion effect on reflexes**

A

upper lesion= increased reflex*

lower lesion= decreased reflex

88
Q

upper vs lower motoneuron lesion effect on atrophy**

A
  • decrease in mass of muscle

upper lesion= mild atrophy

lower lesion= increased atrophy *

89
Q

upper vs lower motoneuron lesion effect on other signs

A

upper lesion= clonus (large involuntary muscle contractions usually initiated by reflex)

lower lesion= fasciculations (small, spontaneous twitching)

90
Q

what is brachial monoparesis

A

patient cannot move right arm

91
Q

brachial monoparesis locations rule out

A

unlikely anywhere along corticospinal tract (internal capsule/brainstem)
- b/c the face and lower extremities would be involved

92
Q

brachial monoparesis locatiosn ruled in

A
  • arm area of primary motor cortex

- or peripheral nerve supplying arm

93
Q

brachial monoparesis common causes (3)

A
  • infarct of a small cortical branch of middle cerebral artery
  • compression injury
  • diabetic neuropathy of the peripheral nerve
94
Q

what is hemiparesis?

A

lost control of entire side of body

has control of face

95
Q

hemiparesis locations ruled out (2)

A
  • unlikely corticospinal tract below motor cortex, above the medulla because the corticobulbar fibers are nearby (face would be involved)
  • unlikely peripheral nerve neuropathy (odd entire side is affected)
96
Q

hemiparesis locations ruled in (2)

A
  • arm and leg area of primary motor cortex

- or corticospinal tract lower than the medulla

97
Q

hemiparesis common causes (3)

A
  • watershed infarct of the anterior cerebral artery
  • medial medullary infarct
  • compression of the cervical spinal cord
98
Q

ascending sensory tracts represent

A

functional pathway that convey sensory information from periphery/body to brain

99
Q

name of ascending sensory tracts (all similar)

A

begins with spino

100
Q

ascending sensory tracts usually consist of …

A

3 neurons

- 1st, 2nd and 3rd order neurons

101
Q

first order neurons of ascending sensory tracts are located…

A

always in dorsal root ganglia (DRG)

102
Q

ascending sensory tracts can be grouped into (3)

A

conscious (2) and unconscious (2) tracts

103
Q

2 ascending conscious tracts

A

posterior/dorsal column-medial lemniscus system

anterolateral system (spinothalamis tract)

104
Q

3 ascending unconscious tracts

A

dorsal/posterior spinocerebellar tract

anterior/ventral spinocerebellar tract

cuneocerebellar tract

105
Q

small and large diameter sensory fibers in the ascending conscious tracts

A

small= enter cord laterally, through Lissauer’s tract
- terminating in substantia gelatinosa

large= enter through medial division of white matter, join posterior/dorsal columns

106
Q

posterior/dorsal column medial lemniscus tract transmits what type of information (4)

A

proprioception ***
fine touch *
pressure
vibration

107
Q

2 fasciculi in posterior/dorsal column-medial lemniscus pathway

A

fasciculus gracilis

fasciculis cuneatus

108
Q

fasciculus gracilis vs cuneatus

A

gracilis= more lateral, transmit info coming from areas inferior to T6 segment
- lower limbs to brain (nucleus)

cuneatus= more medial, upper limbs to brain

109
Q

damage to posterior/dorsal column-medial lemniscus pathway

A
  • causes impairment of tactile perception
  • results in ataxia (incoordination of movement)
  • brain unable to direct motor activity properly without sensory feedback of position of limbs/body parts
110
Q

10 parts to posterior/dorsal column-medial lemniscus pathway

ascending, sensory, conscious

A

1) 1st order neuron (cell body DRG)
2) dorsal column spinal cord (Lissauer’s tract)
3) fasciculis gracilis (lower) & cuneatus (upper) in spinal cord axons project to
4) medulla oblongata (reaches nucleus gracilis/cuneatus)
5) 2nd order neuron (cell body medulla oblongata)
6) axons CROSS as internal arcuate fibers in medial lemniscus (medulla)
7) project to thalamus, synapse with VPL nucleus
8) 3rd order neurons (cell bodies VPL nucleus)
9) internal capsule
10) project to somatosensory cortex (postcentral gyrus)

111
Q

2 components of anterolateral/spinothalamic tract

each responsible for

A
  • crude touch, pressure, pain and temperature

lateral spinothalamic tract= crude touch, pressure

anterior spinothalamic tract= pain, temperature

112
Q

10 parts to anterolateral/spinothalamic tract

ascending, sensory, conscious

A

1) 1st order neurons (cell bodies DRG)
2) dorsal column spinal cord
3) branches ascend/descend via Lissauer’s tract
4) synapse interneurons in substantia gelatinosa/nucleus proprius
5) CROSS via anterior white commissure in spinal cord
6) 2nd order neurons (cell bodies nucleus proprius)
7) spinal lemniscus
8) project to thalamus (VPL nucleus)
9) 3rd order neurons (cell bodies thalamus)
10) somatosensory cortex (postcentral gyrus)

113
Q

anterolateral/spinothalamic tract reach out to PAG and spinoreticular trac

A

PAG–> provide natural analgesics (don’t feel pain while panicking)

spinoreticular–> when pain info reaches tract, prepares us to react (inc heart beat, become anxious/nervous)

114
Q

transverse cord lesion results in loss of

A

(lesion whole cord)

  • vibration, position
  • pain, temperature
  • motor

LOWER BODY (waist down)

115
Q

transverse cord lesion common causes (3)

A
  • trauma
  • tumors
  • transverse myelitis (inflammation)
116
Q

hemicord lesions results in loss of

A

(lose right side of spinal cord)

  • lose control fine movement, fine touch/position on RIGHT side LOWER body
  • lost pain info contralaterally, LEFT side LOWER body
117
Q

hemicord lesion aka

A

brown-sequard syndrome

118
Q

hemicord lesion common causes (2)

A
  • penetrating injuries

- lateral compression from tumors

119
Q

posterior cord syndrome results in

A
  • lose dorsal part of spinal cord

- lose fine sensation of touch info (vibration and position) in WHOLE BODY, not face

120
Q

posterior cord syndrome common causes (4)

A
  • trauma
  • tumors
  • MS
  • vitamin B12 deficiency tabes dorsalis (tertiary syphilis)
121
Q

anterior cord syndrome results n

A
  • lose ventral/lower part of spinal cord

- lose pain/temperature and motor loss of muscles in WHOLE BODY, not face

NEUROANATOMY (7 decks)

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