ANS and spine Flashcards by Sophie Gibson

Meninges

Protective coverings for the spinal cord

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Layers of meninges

Dura mater
Arachnoid mater
Pia mater

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Dura mater

Surrounds the spinal cord, each segment forms the epineurium
Outer layer of meninges that is dense collagenous tissue

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Arachnoid mater

Middle layer of meninges

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Arachnoid space

Deep to arachnoid mater, contains web like projections and CSF

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Pia mater

Loose CT that is connected to the spinal cord and forms dentate ligaments and filum terminale

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Epineurium

Surrounds the entire nerve projection

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Dentate ligament

Runs along the spinal cord and stabilizes

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Filum terminale

Fibrous band that extends from conus medullaris and connects to the coccyx, stabilizes the spinal cord

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Vertebral levels of the spinal cord

C-7
T-12
L-5
S-5

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Where does the spinal cord end

L1/L2

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Why is there a vertebrosegmental discrepancy between spinal cord and vertebral column

Vertebral column grew faster than the spinal cord during development

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Spinal cord levels of the spine

C-8
T-12
L-5
S-5

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Cervical vertebra and spinal cord level discrepancy

Occipital bone is technically C1, and the C1 spinal nerve exits below that
So the spinal nerves leaving the cervical spine exit above the associated vertebral segment

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Vertebrosegmental discrepancies in Cervical

Nerve exits above associated vertebra
Nerve exits horizontally

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Vertebrosegmental discrepancies in thoracic

Nerve exits below the associated vertebra
In upper T nerve exits horizontally to assoc. vertebrae
Lower T, nerve is descending more vertically to get to associated vertebrae

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Vertebrosegmental discrepancies in lumbar

Spinal nerve goes down vertically to reach the associated vertebrae

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Vertebrosegmental discrepancies in sacral

Since in the cauda equina, all spinal nerves come from L1-L2 and descend to associated vertebrae

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Gray matter

Synapses of cell bodies

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Parts of the gray matter

Ventral horn
Lateral horn
Dorsal horn

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Ventral horn

Somatic motor neuron cell body

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Lateral horn

Visceral motor neuron
Found in T1-L2

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Dorsal horn

Receive sensory info (somatic and visceral)

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Why is there swelling in the cervical and lumbar vertebral regions

More synapsing (cell bodies) in the parts of the spine where the limbs are

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White matter

Axons surrounded by myelin sheath Sending and receiving signals

Amount of white matter matter as you go from sacral to cervical

Increases, more neurons entering in to go to the brain

Dorsal column tract

Between posterior horns (dorsal horns) Ascending ipsilateral sensory, fine touch, vibration, proprioception

Anterolateral tract

Ascending contralateral tract for pain and temperature

Corticospinal tract

Located between lateral horn and dorsal horn Descending ipsilateral tract contain motor neurons

Cervical spine looks like

High amount of white matter Wide and flat Increase ventral horn enlargement for arm and hand motor

Thoracic spine looks like

Small ventral horns Lateral horn

Lumbar spine looks like

Increase in size of ventral horn for lower limbs synapsing Round shape

Sacral spine looks like

Large ventral horn Small amount of white matter

Ventral root

Efferent motor from spine to body

Dorsal root

Afferent sensory from body to spine

Myotome

Group of muscles that are innervated by a single spinal nerve root Ventral root that innervates section of muscles

Dermatome

Region of skin that sends sensory information to single spinal nerve root (1 dorsal root to 1 area of skin)

Intervertebral space

Where the dorsal and ventral roots form spinal nerve trunk

Dorsal rami

Skin and muscles of back Sensory and motor

C5 dermatome and myotome

Lateral elbow Shoulder adbuction

Ventral ramus

Body wall and limbs Motor and sensory

C6 dermatome and myotome

Tip of thumb Elbow flexion

C7 dermatome and myotome

Tip of middle finger Elbow and wrist extension

C8 dermatome and myotome

Tip of pinky Finger and wrist flexion

T1 dermatome and myotome

Medial elbow Finger add/abduction

T4 dermatome and myotome

Nipples

T10 dermatome and myotome

Bellybutton

L1 dermatome and myotome

Inguinal ligament

L2 dermatome and myotome

Hip flexion

L4 dermatome and myotome

Medial ankle Knee extension

L5 dermatome and myotome

Top of foot Dorsiflexion

S1 dermatome and myotome

Lateral ankle Plantar flexion

S2 dermatome and myotome

Popliteal fossa

S4-5 dermatome and myotome

Perianal and anal sphincter

Autonomic nervous system

Component of the peripheral nervous system that regulates involuntary physiological processes like HR, BP, R, digestion

3 components of the ANS

Sympathetic Parasympathetic Enteric

Origination of sympathetics and relation to symp chain

T1-L2 White ramus for exciting spinal cord and entering symp chain to send signals above and below Gray ramus for exciting chain At levels above or below this section there is only a grey ramus because no innervation leaving the spinal cord

Parasympathetics location

Medulla S2-4

2 neuron pathway sympathetics

Preganglionic - sympathetic ganglion (chain or pre-aortic) - postganglionic - target organ

2 neuron pathway parasympathetic

Preganglionic - intramural ganglion - postganglionic - target organ

Notocord

Becomes intervertebral discs

Neural crest cells

Become dorsal root ganglia Sympathetic chain ganglia Pre-aortic ganglia Intramural ganglia

Sympathetics to abdominal cavity

Bypass the sympathetic chain ganglia and instead synapse in the pre-aortic ganglia

Sympathetics to heart and lungs

Synapse in the sympathetic chain and then go out to the heart and lungs as cardiopulmonary splanchnic nerve

Where medulla parasympathetics innervate

Eyes Salivary glands Heart Bronchial tree Foregut Midgut

Where sacral parasympathetics innervate

Hindgut Pelvic perineum (penis/clitoris)

Where does the preganglionic neuron synapse in the sympathetic chain

On the level where the postganglionic neuron exits the sympathetic chain

Visceral sensation

Organs sending info to your brain

Visceral sensory neurons

Conduct impulses from organs, glands, to CNS and are parallel to their visceral motor counterparts (except they enter dorsal root) Can caused referred pain

Referred pain

Occurs when sensory info comes to the spinal cord from one location (appendix) but is interpreted by the CNS as coming from another location (skin) which is innervated by the same spinal cord level