5. Back Angiology / Neurology

Question 1

What is different about the right and left subclavian / common carotid arteries?

Answer 1

The right Subclavian and Common Carotid Artery come off of an intermediate structure called the Brachiocephalic Trunk.

The left Subclavian Artery and Common Carotid Arteries come directly off of the Aorta

Question 2

What branch of the Subclavian Artery eventually supplies the Latissimus Dorsi?

Answer 2

The Axillary Artery

(Subclavian -> Axillary Artery -> Thoracodorsal Artery -> Latissimus Dorsi)

Question 3

What branch of the Subclavian Artery eventually supplies the Trapezius?

Answer 3

The Thyrocervical Trunk (becomes the Transverse Cervical Artery)

Question 4

What 8 Arteries supply the Spinal Arteries?

(Themselves called “Paraspinal Arteries”)

Answer 4

Vertebral A.

Ascending Cervical A.

Deep Cervical A.

Posterior Intercostal A.

Subcostal A.

Lumbar A.

Iliolumbar A.

Lateral Sacral A.

Question 5

What are the branches of the Paraspinal Arteries?

Answer 5

Anterior / Posterior Vertebral Canal Branches (Runs along the periphery of the interior of the vertebral canal)

Anterior / Posterior Radicular Ateries (Don’t make it to the Spinal A.)

Anterior / Posterior Segmental Medullary Arteries (Do make it to the Spinal A)

Question 6

How many Cervical Nerves are there?

Answer 6

There are 8

Cervical Nerve 1 exits above the Atlas B.

Question 7

Where are there swellings in the spinal cord, and what are they called?

Answer 7

Cervical Region - Cervical Enlargement

Lumbar Region - Lumbar Enlargement

Question 8

What is the name for the terminal cone of the spinal cord?

Answer 8

Medullary Cone

Question 9

How many Sacral Nerves are there?

Answer 9

There are 5

Question 10

How many Coccygeal Nerves are there?

Answer 10

Just 1

Question 11

What is the Cauda Equina?

Answer 11

A “mess of nerve roots” inferior to the Medullary Cone

Question 12

What might the symptoms be of damage to the spinal cord at C6-8?

Answer 12

Variable upper limb function, loss of hand function, loss of lower body function.

(Damage to the spinal nerve eliminates sensation and function of muscles below the lesion)

Question 13

Where does CSF circluate in the spinal cord?

Answer 13

The Subarachnoid Space

Question 14

What do we call the protrusions of Pia Mater into the Subarachnoid Space?

Answer 14

Denticulate Ligaments

Question 15

What is the Dural Arachnoid Interface?

Answer 15

The theoretical space between the Dura Mater and the Arachnoid Mater. In reality, these are pressed together by the pressure of the CSF.

Question 16

What do we call the fat filled space exterior to the Dura Mater?

Why is this clinically relevant?

Answer 16

The Epidural Space

It is the site of Epidural Administration (Anesthetics, contrast dyes, etc)

Question 17

What is the Lumbar Cistern?

What is its clinical relevance?

Answer 17

The space inferior to the medullary cone where there is a swelling of the Subarachnoid Space for pooling of CSF

It is the site of spinal taps

Question 18

What two Vertebrae do you go through to perform a spinal tap?

Answer 18

L3/L4 or L4/L5

Question 19

What do the spinal nerves do?

Answer 19

They exit the Vertebral Foramen and immediately split, ceasing to exist. After that, they are either Posterior or Anterior Rami

Question 20

Where is the Spinal Ganglion?

Answer 20

On the Dorsal Spinal Root

(It’s also called the Dorsal Root Ganglion)

Question 21

What three things do the Posterior Rami of the Spinal Nerves do?

Answer 21

Innervation of the Intrinsic Muscles of the back

Innervation of the Zygapophyseal joint

Innervation of the skin of the mid-back through the Cutaneous Branches

Question 22

The Suboccipital Nerve is the Posterior Ramus of what nerve?

Answer 22

C1 Spinal Nerve

Question 23

The Greater Suboccipital Nerve is the Posterior Ramus of what Spinal Nerve?

Answer 23

C2 Spinal Nerve