anatomi Flashcards
vad ingår i disco-ligamentous complex?
ALL- anterior longitudinal ligament
PLL - posterior longitudinal ligament
Ligamentum flavum
facet capsule - the strongest posterior component
intER and supra-spinosus ligament
how do I see if an MRI is T2 weighted?
- Bone is just a little bit darker than CNS
- CSF is brighter than CNS
- If CSF is dark, it is due to turbulence or movement.
Muskel och funktion associerad till C6, C7
musculus extensor carpi radialis
- extension av handled
-supination av handled
EN ELLER FLERA
*Nedströms Perifer Nerv,
-Muskel och
– funktion/reflex
ASSOCIERAD TILL L5
- Kolla upp
- EHL =
– Extension (dorsiflexion) of the big toe ( and sometimes dorsiflexion of the wrist)
EN ELLER FLERA
*Nedströms Perifer Nerv,
-Muskel och
– funktion/reflex
ASSOCIERAD TILL C5, C6
- Axillary nerve
- Deltoid muscle
–Abduction of arm over 90 degrees. - Musculocutaneous nerve
- Bicep Brachii
– Flection of elbow and reflex of bicep tendon.
EN ELLER FLERA
-Muskel och
– funktion/reflex
ASSOCIERAD TILL C3, C4 och C5 samt en av CN.
Diaphragm
- breathing. Together with CN X, Vagal nerve.
EN ELLER FLERA
*Nedströms Perifer Nerv,
-Muskel och
– funktion/reflex/sensorik
ASSOCIERAD TILL S1
- Kolla upp -
- gastrocnemius
– plantar flexion of ankle (sträcka ut foten).
– inversion of the ankle (går på utsidan av foten)
–
What is ending at the level of L2?
The conus medullaris
What is terminating at S2 level?
the tecal sac
how to test C5?
Flexion of elbow
How to test C6?
Extension of wrist
how to test C7?
elbow extension
how to test C8?
m flexor digitorum profundum - flexa distala falangen isolerat.
how to test Th1
Hand intrinsics - Abducera lillfinger.
how to test L2? what muscle is innervated?
hip flexion. -Iliopsoas.
how to test L3? what muscle?
Straighten the knee. Quadricep muscle.
how to test L4? - muscle
Dorsiflect the foot (mot skenbenet -uppåt) -Tibialis anterior
what spinal nerve lacks a corresponding vertebra?
C8
how to test C7 and C8 together?
elbow and finger extension. ( tricpe and extensor digitorum
What muscles are inervated by Th2-th9?
The intercostals. Use sensory levels to evaluate injuries.
What is innervated by S2-S3?
- pedis flexor digitorum
samt
*flexor hallusis
What is innervated by S1, S2?
- musculus gastrocnemius - plantar flexion
- Soleus - achilles reflex
what is innervated by L5, S1?
- big toe extension (dorsiflexion) - EHL
- ankle plantar flexion (gastrocnemius)
what does EHL stand for?
Extensor hallucis longus
How to test L3?
straighten the knee - Quadricep tendon. + reflex.
Test of L2?
Hip flexion - ileopsoas.
Reflex mediated via S2-S4 nerves?
Bulbocavernous reflex. - contraction of the anal sphincter in response to squeezing the glans penis or tugging on a foley cathether in both sex.
Inconus medullaris.what 3 scenarios might the bulbo cavernous reflex be gone?
- spinal shock ( might be the first sign of subsiding spinal shock that the reflex returns)
- injuries to cauda equina
- injuries to conus medullaris
What nerve innervate the sensation of the level of nipples?
C5.
What nerves innervate diaphragm?
- C3-C5 phrenic nerve
and parasymathically - the vagal nerve.
The intervertebral joints are the articulations between the adjacent vertebrae of the vertebral column. Each intervertebral joint is composed of three separate joints. Which?
- intervertebral symphysis (intervertebral disc joint)
- 2 zygapophyseal (facet) joints.
Vertebral bodies of the cervical region C3-C7 also has another joint. what is it called?
The uncovertebral joint. “Joints of Luschka”
Except for the articular capsule of the joints there are other ligaments extending between different bony processes of the vertebra. Namely?
- intertransverse ligament
- interspinous ligament
- supraspinous ligament.
when has the spinal cord finished its growth?
At the age of 4
When has the vertebral column finished its growth?
At the age of 14-18 yp
What is the PCML?
posterior column medial lemniscus pathway - sensory pathway of CNS for fine touch, 2point disrimination, proprioception and b vibration sensation.
Two major structures comprise PCML. Which?
Posterior column and medial lemniscus
Where does the dorsal column (posterior column) terminate?
In medulla oblongata
the posterior column is formed by two great nerve fibre bundles. WHich?
- fasciculus gracilis and
*faciculus cuneatus.
What thalamic nucleus does the medial lemniscus relay through?
The VPL - ventral posteriolateral
To where does the nerves from VPL project?
To the postcentral gyrus.
where is the gracile nucleus and the cuneate nucleus situated?
In the superior, posterior medulla oblongata. The gracile nucleus is medial to the cuneate nucleus.
what is internal arcuate fibers?
Fibers from The gracile and arcuate nuclei in medulla oblongata that cross over to the medial lemniscus, posteriomedially in the same plane of medulla.
Why is it possible to get bilateral pain, temp, crude touch and pressure disruption from medio-ventral lesions of the spinal cord?
Because the white tract with 2nd nerves that have synaped in the posterior grey horn cross over in the ANTERIOR WHITE COMMISSURE from both sides.
What structures are affected in a central medullary lesion?
From the ventral to dorsal side:
* anterior white commissure
* anterior (grey) horn
* Lateral corticospinal tract
* Descending autonomic fibers
* Dorsal horn
What functions are in the central medulla:
From the ventral to dorsal side:
* anterior white commissure (only one)
* anterior (grey) horn (bilateral)
* Lateral corticospinal tract (bilateral, possibly only the medial part)
* Descending autonomic fibers (bilateral)
- -crossing bilateral aschening pain, temp, crude touch and pressure -
-bilateral diminished sense of that at and below that level. - cellbodies of 1st (lower) motor neurons.
- flaccid paralysis
- hypOreflexes
-Fasciculation fibrillations (later)
Only in the affected segment. - UMN, deschending white matter only medial segment involved =upper extremities.
- UMN signs of all segments below lesion - first upper than lower limbs depending on how wide the lesion is.
- HypER reflexia
- spastic paralysis
- Depending on what segment is affected. In cervical and thoracic levels, Horner might be found -ptos, mios, anhydros
What structures are affected in “posterior cord syndrome”?
- Dorsal white columns -aschending tracts.
ATAXIA - sensory ataxia due to destruction of spino-cerebellar tract. - loss of proprioception, vibration sense and fine discriminative touch at the level and below.
- (posterior grey horn = synapses from 1st to 2nd sensory fibers of crude touch, pain, temperature and pressure) - affected only in that level.
What structures are affected in “anterior cord syndrome”?
2/3 of the anterior cord.
- ventral horn
- anterior white comissure
- Spinothalamic tract - lateral and medial column
- lateral corticospinal tract
- descending autonomic fibers
What is the “usual” cause of anterior cord syndrome?
- Adam Kiewitz injury/trombosis at Th10.
What are the clinical signs of anterior cord syndrome?
- UMN injury from site and below .
- urinary bladder dysfunction and fecal incontinence
- LMN signs at the level of injury
- crude touch and pressure sense lost from the level and below
- temperature and pain lost from the anterior white comissure and lateral and anterior spinothalamic tracts.
