Anatomy Final Flashcards
brain, brain sagittal, spinal cord, and eye
What is the function of the foramen transversarium?
to allow the vertebral artery to exit
How many vertebrae are there?
7 cervical
12 thoracic
5 lumbar
5 fused sacral
1-2 coccygeal
What is the function of the superior and inferior articulate processes on the vertebrae and what is unique about them
stabilize spine; they are true facet joints, lined this goblet cells that secrete synovial fluid that aid in mobility of joint
Why are vertebrae shaped/formed differently?
allows nerves to exit in different areas of the body
What is a frequent cause of low back pain and what block helps relieve this pain?
inflammation of facet joint due to motion; quadratus lumborum block
What ligament supports/attaches head to spine?
Ligamentum nuchae
What structure causes there to be resistance immediately after passing needle through the skin during an epidural?
supraspinous ligament
________ ligament is a continuation of the _________ ligament.
supraspinous, nuchea (ligamentum)
What is the order of penetration of the 3 ligaments during an epiural?
- supraspinous ligament
- interspinous ligament
- ligamentum flavum
Which ligament is not commonly “felt” during an epidural placement and why?
interspinous ligament (it is so thin the needle will most likely miss it)
Which ligament gives a “popping” sensation during epidural placement and why?
Ligamentum flavum, because it is thick and fibrinous
also called intertransverse ligament
What structures are held together by the ligamentum flavum and what is it’s function?
stabilizes spine by connecting/supporting the vertebrae by lamina of inferior/superior vertebrae assists with posture
What are the three layers of the meninges and their functions?
outermost first
- Dura Mater superficial, fibrinous
tough mother: primarily protective function - Arachnoid Mater middle
similar to saran wrap, close apposition to dura
forms SA space to aid in regulation of CSF, contains vessels - Pia Mater deep
tightly adhered to brain and spinal cord
What structure separates the dorsal root from it’s ganglion?
They are separated by the dura mater
The dorsal root ganglia (spinal ganglia) are usually located within the intervertebral foramina, immediately outside the points where the nerve roots perforate the dura mater
Where is the subarachnoid space, what is in it, and it’s function?
It is located between the arachnoid mater and the pia mater, it contains cerebral spinal fluid (CSF) and aids in the elimination process of CSF. Vessels are also in this space, cushioned by the CSF to prevent injury to them intelligently designed
What layer(s) of the meninges are affected by Spinal Meningitis?
ALL 3 layers: pia, arachnoid, and dura
How much cerebral spinal fluid is in the body at all times and how much is produced daily?
150 cc, 600cc produced daily
What structure is tightly adhered to the spinal cord?
Pia Mater
What is the “tapered point” of the spinal cord called?
Conus Medullaris conus = pointed like an ice cream cone
Where does the spinal cord end and what occurs to the pia that was covering it?
SC terminates around L1-L2 very important
pia collapses on self and continues all the way down to the coccygeal vertebrae does not terminate with spinal cord
What is the functional purpose for the pia matter extending to the coccygeal vertebrae?
to “anchor” spinal cord in place and prevent vertical movement.
What is the pia cord referred to inferior to L1-L2 and what are the two sections of this cord?
Filum terminale: differentiation refers to outermost layer of the internal cord
Pial part made of pure pia mater
Dural part occurs after arachnoid mater ends around S1-S3
Where does the dura terminate and what causes this to occur?
S2, usually but can be anywhere from S1-S3
dura “terminates” due to end of the subarachnoid space (+ lack of CSF). dura then continues down and covers the pia cord = results in the dural part of the filum terminale
How many layers are in the final portion of the filum terminale?
debatable, some speculate that the arachnoid mater ends around S1-S3 which is what forms the dural part of the filum terminale.
Most correct answer: at least 2 layers, but possibly 3 (AM most likely terminates with arachnoid space, so most likely only 2 layers of meninges in FT)
T/F there is nervous tissue in the filum terminale
False, nervous tissue stops when spinal cord ends at at L1-L2
What is the order of termination of spinal structures, moving down the spinal cord?
- Spinal cord @ L1-L2
- Arachnoid mater @ S1-S3
- Dura mater & Pia mater @ coccygeal vertebrae point of attachment
- spine @ end of coccygeal vertebrae
The _____ matter in the spinal cord is deep to the ______ matter; while in the brain the _______ matter is deep to the _______ matter.
SC: gray, white
Brain: white, gray
What is the functional purpose of the gray matter being deep in the spinal cord?
it contains neurons that choose what “decision” should be made, then transmits that impulse through the white matter which is made of myelinated axons that speed signal transmission to target tissue
The cerebral cortex is made of ______ matter which consists of:
gray matter, cell bodies and dendrites
What is in white matter and what is it’s purpose?
myelinated nerve fibers called axons.
purpose is to aid in rapid conduction of signals from gray matter
Where do pain impulses originate from in the spinal cord?
dorsal horn - then travel up through columns that end in white matter
Which spinal cord root has a ganglion and why? What is the function of a ganglion?
dorsal/posterior because it sends sensory impulses
ganglion is gray matter (neurons) outside CNS
What are the two types of spinal cord roots?
dorsal/posterior and ventral/anterior
What is the important concept to remember when considering Spinal Cord blood supply?
There are multiple blood supplies to the spinal cord
The more superior arteries are more major
this is why ppl with lower SCI can still have some function
How many anterior and posterior arteries supply blood to the spinal cord?
anterior: 1, arise from the vertebral
posterior: 2, arise from the aorta
What is notable about the internal vertebral plexus (venous)?
it’s a web-like structure in the extradural fat pad, so it is easy to hit and collapse with a epidural needle
if you attempt an epidural and get fluid return, what space are you post likely in?
subarachnoid space, receiving CSF. If left here would be considered a spinal block
What is a major side effect of a spinal block?
can block diaphragmatic intervention causing apnea.
What is the denticulate ligament and its purpose?
the denticulate ligament is an extension of folded pia mater, it goes between the anterior and posterior roots at attaches to dura mater to secure the spinal cord from moving laterally
What space contains CSF and vessels?
subarachnoid space
what are the structures passed through when placing an epidural? (begin with skin)
- Supraspinous Ligament
- Interspinous Ligament
- Ligamentum Flava
- Fat Pad & Venous Plexus (Epidural space)
- Dura Mater
- Arachnoid Mater
- Subarachnoid Space
- Pia Mater
- Spinal Cord
______ roots are purely somatic sensory, while the ______ roots are purely somatic motor.
dorsal/posterior, ventral/anterior
The spinal accessory nerves become ______ nerves when the exit the Dura mater.
Periphrial
What is the Cauda Equina?
Peripheral nerves after the spinal cord ends around L1-L2 (tail horse)
What two areas of the spinal cord have enlargements?
cervical and lumbosacral (to supply the limbs)
How are there a C8 when there are only 7 cervical vertebrae?
because there is a cervical nerve between the head and their first cervical vertebrae
After the Spinal Cord ends at ____ the pia mater continues to _______ and what is it called?
L1-L2, the coccygeal vertebrae to terminate. This structure is called the filum terminale
The Filum Terminale begins at _____ and is pure _____ mater, then when the arachnoid mater ends at ____ this forms the beginning of the _____ portion of the Filum Terminale.
L1-L2, Pia, S1-S3, Dural
The preganglionic nerves of the Sympathetic nervous system are _____, while the postganglionic nerves are _____.
Short, Long
consider where the ganglion are in relation to the target tissue
The preganglionic nerves of the Parasympathetic nervous system are ______, while the postganglionic nerves are _____.
Long, Short
consider where the ganglion are in relation to the target tissue
The folding of the dura in the middle of the brain forms a space called _______. While the actual folded dura is called ______.
Superior sagittal sinus, falx cerebri
What structures allow CSF to be exchanged into the superior sagittal sinus?
Arachnoid granulations (protrusions of the subarachnoid space)
Why is the superior sagittal sinus not considered a vein since veins AND CSF dump into it?
Because the space is formed by dura
What two things dump into the superior sagittal sinus?
Venous blood and CSF
What vein do all the cerebral sinuses end up dumping into?
Internal Jugular Veins
How much Cerebral spinal fluid is produced daily and what structures produce it?
600mL daily, produced by the choroid plexus
What is the primary factor the drives CSF out of the arachnoid granulations, into the superior sagittal sinus?
Pressure
The cerebral arteries and veins are in the ______ space.
Subarachnoid
The layer of dura that separates the two halves of the cerebrum is called:
Falx Cerebri
The layer of dura that separates the two halves of the cerebellum is called:
Falx Cerebelli
The layer of dura that separates the cerebrum cerebellum is called:
Tentorium Cerebelli
What is the function of the layers of dura that separate the areas of the brain?
prevents the brain from so freely bumping against the skull
What is the diaphragma sellae and its purpose?
it is a continuation of dura that covers the pituitary gland and prevents it from popping out of the sella turcica.
What structure does the pituitary gland sit in and what is it covered by?
Sella Turcica (turkish saddle)
Diaphragma Sella
The Pons of the brain is responsible for controlling what 3 things?
- Heart rate
- Respirations
- Swallowing
What divides the Temporal lobe from the Frontal lobe?
Lateral Sulcus (of Silvia)
The raises parts of the brain are called ______, while the ditches between them are ______.
gyri, sulci
What is the name of the sulcus that separates the frontal and parietal lobes?
Central sulcus
What sulcus separates the parietal and occipital lobe?
Pre-occipital sulcus
What structure lies directly under the temporal lobe?
the Insula- this is where a women’s intuition originates from
What is the only sulcus that extends all the way down?
the Central Sulcus
The Precentral gyri is _____ while the postcentral gyri is _____.
motor, sensory
just like spinal cord roots
The pituitary gland comes off the:
Hypothalamus
The thalamus routes messaging of ______ stimuli, while the hypothalamus route messaging of _____ stimuli.
external, internal
What is the primary function of the cerebellum?
coordination of movements
What is the primary function of the midbrain?
Midbrain, pons, and medulla oblongata
regulates heart rate, respirations and swallowing
What is the interthalamic adhesion and its function?
connects right and left thalamus to allow movement of messages between the two halves
What is the open space between the right and left thalamus called?
third ventricle
How many ventricles are in the brain?
4
1. & 2. Right and left Lateral ventricles
3. 3rd ventricle formed by the thalamus
4. 4th ventricle
What structure connects the third ventricle to the fouth?
Cerebral Aqueduct
What is the purpose of the anterior commissure?
It forms the anterior wall of the third ventricle
Which sinus must be entered to do surgery on a pituitary tumor?
Sphenoidial sinus
What is the purpose of the posterior commissure?
makes up posterior wall of third ventricle
What structure produces Cerebral spinal fluid?
Choroid Plexus (present in all ventricles)
What is the function of the ventricles of the brain?
to contain CSF