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Spine > anatomi > Flashcards

anatomi Flashcards

1
Q

vad ingår i disco-ligamentous complex?

A

ALL- anterior longitudinal ligament
PLL - posterior longitudinal ligament
Ligamentum flavum
facet capsule - the strongest posterior component
intER and supra-spinosus ligament

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2
Q

how do I see if an MRI is T2 weighted?

A
  • 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.
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3
Q

Muskel och funktion associerad till C6, C7

A

musculus extensor carpi radialis
- extension av handled
-supination av handled

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4
Q

EN ELLER FLERA
*Nedströms Perifer Nerv,
-Muskel och
– funktion/reflex
ASSOCIERAD TILL L5

A
  • Kolla upp
  • EHL =
    – Extension (dorsiflexion) of the big toe ( and sometimes dorsiflexion of the wrist)
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5
Q

EN ELLER FLERA
*Nedströms Perifer Nerv,
-Muskel och
– funktion/reflex
ASSOCIERAD TILL C5, C6

A
  • Axillary nerve
  • Deltoid muscle
    –Abduction of arm over 90 degrees.
  • Musculocutaneous nerve
  • Bicep Brachii
    – Flection of elbow and reflex of bicep tendon.
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6
Q

EN ELLER FLERA
-Muskel och
– funktion/reflex
ASSOCIERAD TILL C3, C4 och C5 samt en av CN.

A

Diaphragm
- breathing. Together with CN X, Vagal nerve.

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7
Q

EN ELLER FLERA
*Nedströms Perifer Nerv,
-Muskel och
– funktion/reflex/sensorik
ASSOCIERAD TILL S1

A
  • Kolla upp -
  • gastrocnemius
    – plantar flexion of ankle (sträcka ut foten).
    – inversion of the ankle (går på utsidan av foten)
    –
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8
Q

What is ending at the level of L2?

A

The conus medullaris

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9
Q

What is terminating at S2 level?

A

the tecal sac

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10
Q

how to test C5?

A

Flexion of elbow

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11
Q

How to test C6?

A

Extension of wrist

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12
Q

how to test C7?

A

elbow extension

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13
Q

how to test C8?

A

m flexor digitorum profundum - flexa distala falangen isolerat.

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14
Q

how to test Th1

A

Hand intrinsics - Abducera lillfinger.

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15
Q

how to test L2? what muscle is innervated?

A

hip flexion. -Iliopsoas.

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16
Q

how to test L3? what muscle?

A

Straighten the knee. Quadricep muscle.

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17
Q

how to test L4? - muscle

A

Dorsiflect the foot (mot skenbenet -uppåt) -Tibialis anterior

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18
Q

what spinal nerve lacks a corresponding vertebra?

A

C8

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19
Q

how to test C7 and C8 together?

A

elbow and finger extension. ( tricpe and extensor digitorum

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20
Q

What muscles are inervated by Th2-th9?

A

The intercostals. Use sensory levels to evaluate injuries.

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21
Q

What is innervated by S2-S3?

A
  • pedis flexor digitorum
    samt
    *flexor hallusis
22
Q

What is innervated by S1, S2?

A
  • musculus gastrocnemius - plantar flexion
  • Soleus - achilles reflex
23
Q

what is innervated by L5, S1?

A
  • big toe extension (dorsiflexion) - EHL
  • ankle plantar flexion (gastrocnemius)
24
Q

what does EHL stand for?

A

Extensor hallucis longus

25
Q

How to test L3?

A

straighten the knee - Quadricep tendon. + reflex.

26
Q

Test of L2?

A

Hip flexion - ileopsoas.

27
Q

Reflex mediated via S2-S4 nerves?

A

Bulbocavernous reflex. - contraction of the anal sphincter in response to squeezing the glans penis or tugging on a foley cathether in both sex.

28
Q

Inconus medullaris.what 3 scenarios might the bulbo cavernous reflex be gone?

A
  • spinal shock ( might be the first sign of subsiding spinal shock that the reflex returns)
  • injuries to cauda equina
  • injuries to conus medullaris
29
Q

What nerve innervate the sensation of the level of nipples?

A

C5.

30
Q

What nerves innervate diaphragm?

A
  • C3-C5 phrenic nerve
    and parasymathically - the vagal nerve.
31
Q

The intervertebral joints are the articulations between the adjacent vertebrae of the vertebral column. Each intervertebral joint is composed of three separate joints. Which?

A
  • intervertebral symphysis (intervertebral disc joint)
  • 2 zygapophyseal (facet) joints.
32
Q

Vertebral bodies of the cervical region C3-C7 also has another joint. what is it called?

A

The uncovertebral joint. “Joints of Luschka”

33
Q

Except for the articular capsule of the joints there are other ligaments extending between different bony processes of the vertebra. Namely?

A
  • intertransverse ligament
  • interspinous ligament
  • supraspinous ligament.
34
Q

when has the spinal cord finished its growth?

A

At the age of 4

35
Q

When has the vertebral column finished its growth?

A

At the age of 14-18 yp

36
Q

What is the PCML?

A

posterior column medial lemniscus pathway - sensory pathway of CNS for fine touch, 2point disrimination, proprioception and b vibration sensation.

37
Q

Two major structures comprise PCML. Which?

A

Posterior column and medial lemniscus

38
Q

Where does the dorsal column (posterior column) terminate?

A

In medulla oblongata

39
Q

the posterior column is formed by two great nerve fibre bundles. WHich?

A
  • fasciculus gracilis and
    *faciculus cuneatus.
40
Q

What thalamic nucleus does the medial lemniscus relay through?

A

The VPL - ventral posteriolateral

41
Q

To where does the nerves from VPL project?

A

To the postcentral gyrus.

42
Q

where is the gracile nucleus and the cuneate nucleus situated?

A

In the superior, posterior medulla oblongata. The gracile nucleus is medial to the cuneate nucleus.

43
Q

what is internal arcuate fibers?

A

Fibers from The gracile and arcuate nuclei in medulla oblongata that cross over to the medial lemniscus, posteriomedially in the same plane of medulla.

44
Q

Why is it possible to get bilateral pain, temp, crude touch and pressure disruption from medio-ventral lesions of the spinal cord?

A

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.

45
Q

What structures are affected in a central medullary lesion?

A

From the ventral to dorsal side:
* anterior white commissure
* anterior (grey) horn
* Lateral corticospinal tract
* Descending autonomic fibers
* Dorsal horn

46
Q

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)

A
  • -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
47
Q

What structures are affected in “posterior cord syndrome”?

A
  • 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.
48
Q

What structures are affected in “anterior cord syndrome”?

A

2/3 of the anterior cord.

  • ventral horn
  • anterior white comissure
  • Spinothalamic tract - lateral and medial column
  • lateral corticospinal tract
  • descending autonomic fibers
49
Q

What is the “usual” cause of anterior cord syndrome?

A
  • Adam Kiewitz injury/trombosis at Th10.
50
Q

What are the clinical signs of anterior cord syndrome?

A
  • 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.
51
Q
A

Spine (17 decks)

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