Back angiology and neurology

Question 1

Back sprain, what is it?

Answer 1

ligamentous tissue or attachment of ligament to bone is involved caused by excessive extension or rotation

Question 2

Back strain, what is it?

Answer 2

overly strong muscular contraction causes microtears in muscle tissue

Can cause muscle spasm

Question 3

what is Internal Vertebral Venous Plexus, what is its flow, why is it relevant?

Answer 3

In epidural space, receives tributaries from spinal cord and vertebrae, vertebral veins, basilar plexus, dural sinuses

Drains into segmental veins via intervertebral veins

Communicates superiorly with cranial dural sinuses, inferiorly with pelvic vein, in thorax and abdomen with azygos vein

EARLY METASTASIS OF CARCINOMA

Question 4

External Vertebral Venous plexus, what is the flow?

Answer 4

Anterior and posterior parts, lies in front of vertebral column and on vertebral arch

Communicates with vertebral venous plexus via intervertebral, basivertebral, vertebral, intercostal , lumbar and lateral sacral v

Question 5

Vertebral veins, significance?

Answer 5

Comes from venous plexuses around foramen magnum and occiptal region

Empties into brachiocephlic vein

Question 6

Occipital a, what is the flow and what does it travel with? branches and what does it supply?

Answer 6

Comes from external carotid a, lies on obliquus capitis and semispinalis capitis

Accompanied by greater occipital n

Supplies scalp of occipital region

Branches into superficial and deep branches

Question 7

Superficial branch of occipital a anastomoses with what?

Answer 7

transverse cervical a

Question 8

deep branch of occipital a anastomoses with what?

Answer 8

deep cervical a

Question 9

Transverse cervical A: where does it come from and what does it supply? what does it travel with?

Answer 9

comes from thyrocervical trunk of subclavian

Dividies into superficial and deep branches

• Ascending superficial: supplies upper trapezius
• Descending superficial: accompanies spinal accessory nerve on trapezius

Deep branch accompanies dorsal scapular nerve

Question 10

Accessory nerve: what does it travel with and what does it supply?

Answer 10

Cranial portion that joins vagus n

Spinal portion that runs deep to sternocleidomastoid, lies on levator scapulae and deep to traps

Supplies traps and sternocleidomastoid

Question 11

Dorsal Scapular n, what does it run with and what does it supply?

Answer 11

Runs with transverse cervical a, supplies rhomboids and levator scapulae

Question 12

Greater occipital n: where does it run, what does it supply?

Answer 12

C2 posterior ramus

Crosses obliquus inferior and semispinalis capitis, pierces semispinalis and trapezius,

appears below suboccipital triangle

cutaneous innervation to posterior occipital region

Question 13

Least occipital n : what does it supply?

Answer 13

Derived from C3 posterior ramus

Cutaneous innervation to occipital region

Question 14

Lesser occipital n: what does it supply? what does it run with

Answer 14

Cutaneous branch of cervical plexus,

ascends along posterior border of sternocleidomastoid to scalp behind auricle

innervates scalp

C2

Question 15

what supplies blood to trapezius?

Answer 15

Transverse cervical a

Question 16

what supplies blood to Latissimus dorsi?

Answer 16

Thoracodorsal a.

Question 17

what supplies blood to rhomboid major and minor?

Answer 17

Dorsal scapular a

Question 18

what supplies blood to levator scapulae?

Answer 18

Dorsal scapular a

Question 19

what supplies blood to serratus posterior superior and inferior?

Answer 19

Intercostal a

Question 20

what supplies blood to splenius capitis?

Answer 20

Intercostal a

Question 21

what supplies blood to splenius cervicis?

Answer 21

Intercostal a

Question 22

what supplies blood to semispinalis?

Answer 22

Intercostal a

Question 23

what supplies blood to erector spinae?

Answer 23

Lateral sacral a

Question 24

what is the source for the vertebral a?

Answer 24

Subclavian A.

Question 25

what is the source for the Ascending Cervical A?

Answer 25

Inferior Thyroid A

Question 26

what is the source for the Deep Cervical A?

Answer 26

Costocervical Trunk

Question 27

what is the source for Posterior Intercostal A.?

Answer 27

Descending Aorta

Question 28

what is the source for subcostal A.?

Answer 28

Descending Aorta

Question 29

what is the source for lumbar A.?

Answer 29

Descending Aorta

Question 30

what is the source for Iliolumbar A?

Answer 30

Internal Iliac A

Question 31

what is the source for lateral sacral A?

Answer 31

Internal Iliac A.

Question 32

what are the meninges and what do they do?

Answer 32

connective tissue membranes that line the neurocranium and vertebral canal, and enclose the central nervous system provide protection to the brain and spinal cord, accompany blood vessels to and from the CNS tissues, channel the cerebrospinal fluid (CSF) around the surfaces of the brain and spinal cord

Question 33

Dura Mater , what is it?

Answer 33

Most superficial, protective layer High collagen content, with layers of flattened fibrocytes

Question 34

arachnoid mater, what is it?

Answer 34

2nd layer of meninges named because of its spider web-like appearance Cerebrospinal fluid is located in the subarachnoid space between the arachnoid mater and the pia mater

Question 35

Pia Mater, what is it?

Answer 35

3rd and most deep of the three meningeal layers envelope that firmly adheres to the surface of the brain and spinal cord, following all of the brain's contours

Question 36

Suboccipital N, significance?

Answer 36

Posterior Ramus of C1 Innervates suboccipital musculature Travels through suboccipital triangle

Question 37

Medial branch of C4-C8, what does it supply?

Answer 37

Muscular Branches (to Transversospinalis M.) Articular Branches (to zygapophyseal joints) Cutaneous Branches (to skin of dermatome)

Question 38

lateral branch of C4-C8, what does it supply?

Answer 38

Muscular Branches (to erector spinae and splenius Ms.) Cutaneous Branches (to skin of dermatome)

Question 39

what is the vasculature of the suboccipital triangle?

Answer 39

Vertebral A. Suboccipital venous plexus

Question 40

what are the nerves of the suboccipital triangle?

Answer 40

Greater Occipital N. Suboccipital N

Question 41

describe the flow of the vertebral a in the suboccipital region, flow and all

Answer 41

The vertebral arteries branch from the subclavian A. and ascend through the foramina in the transverse processes of the upper six cervical vertebrae, entering the skull through the foramen magnum. At the lower border of the pons, each unites with the vertebral A. of the opposite side to form the basilar A. The basilar A. divides into R & L posterior cerebral As., which are connected to the middle cerebral As. by the posterior communicating arteries.

Question 42

what does c3-c8 transection cause

Answer 42

paralysis below head level

Question 43

what does c4-c5 transection cause

Answer 43

quadriplegic

Question 44

what does c6-c8 transection cause

Answer 44

loss of hand and some upper limb function

Question 45

what does t1-t9 transection cause

Answer 45

paraplegic, some trunk control

Question 46

what does t10-l1 transection cause

Answer 46

some thigh function

Question 47

what does l2-l3 transection cause

Answer 47

most leg function retained

Question 48

Explain where lumbar puncture procedures are safest to administer and why?

Answer 48

Safest between L4 & L5 CSF is drawn there because below L1 or L2 the spinal cord terminates (conus medularis) nerves continue down the spine below this but in loose bundles of nerve fibers called cauda equina. Done at the L4/L5 site because the loose fibers move out of the way of the needle without being damaged.

Question 49

what are the five varieties typically associated with back pain?

Answer 49

Fibroskeleton Meninges Synovial joints Intrinsic back muscles Spinal nerves or nerve roots

Question 50

what is Fibroskeleton pain caused by? what does it feel like?

Answer 50

periosteum, ligaments, annuli fibrosi of IV discs (meningeal sn) Localized back pain Fracture pain=periosteum Dislocation pain=ligaments

Question 51

what is meninges pain caused by?

Answer 51

covering of spinal cord

Question 52

what is synovial joints pain caused by? what does it feel like?

Answer 52

capsules of zygapophysial joints (dorsal rami) Localized back pain Joint pain associated with aging or disease

Question 53

what is Intrinsic back muscles pain caused by? what does it feel like?

Answer 53

(dorsal rami) Localized back pain Related to ischemia and guarding

Question 54

what is spinal nerves pain caused by?

Answer 54

referred to dermatome innervated by that nerve