Back Angiology and Neurology Flashcards by Connor Faust

What arteries branch off the arch of the aorta

Brachiocephalic trunk (R. subclavian, R. common carotid)
Left common carotid
Left subclavian
Axillary

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Branches of the left subclavian artery include

Vertebral 
Internal thoracic
Thyrocervical trunk
Costocervical trunk
Dorsal scapular (if this branch arises from transverse cervical, it is known as the deep branch of the transverse cervical artery)

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Branches of the vertebral artery include

Anterior/posterior spinal arteries
Anterior spinal produces sulcal artery which supplies anterior 2/3 of spinal cord
Posterior spinal are paired arteries and may arise from posterior inferior cerebellar artery

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Branches of thyrocervical trunk include

Inferior thyroid->ascending cervical (produces paraspinal arteries)
Suprascapular
Transverse cervical–>superficial branch, deep branch (if deep branch is present, it replaces dorsal scapular)

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Explain the path of the vertebral artery

Travels superiorly in the transverse foramina of cervical vertebrae C6-1, exits transverse foramina of atlas, crosses over posterior arch of atlas, passes through floor of suboccipital triangle, sends branches anterior/posteriorly to form ant/post spinal arteries, then enters posterior cranial fossa through foramen magnum and meets up with contralateral vertebral artery to form basilar artery which produces paraspinal arteries

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Branches of costocervical trunk include

Deep cervical

Supreme intercostal

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Branches of axillary artery include

Superior thoracic
Thoracoacromial trunk
Lateral thoracic
Subscapular->circumflex scapular, thoracodorsal
Anterior/posterior circumflex humeral

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Branches of the thoracic (descending) aorta

Posterior intercostal

Subcostal

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Branches of abdominal (descending) aorta

Lumbar
Common iliac–>
-Internal iliac
-External iliac

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Explain internal iliac artery

It is a branch of the common iliac, and has two branches

Anterior division
Posterior division–> iliolumbar, lateral sacral, superior gluteal

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Which arteries produce paraspinal arteries

Vertebral (from subclavian)
Ascending cervical (from inferior thyroid)
Deep cervical (from costocervical)
Posterior intercostal (from descending aorta)
Subcostal (from descending aorta)
Lumbar (from descending aorta)
Iliolumbar (from internal iliac)
Lateral sacral (from internal iliac)

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Paraspinal arteries feed directly into what

Anterior and posterior spinal arteries

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Branches of paraspinal arteries

Dorsal branches-travel with posterior ramus, supply spinous process
Equatorial branches-supply vertebrae
Periosteal branches- supply periosteum
Spinal branches

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Describe the spinal branches of the paraspinal arteries

Produces anterior/posterior vertebral canal branches, and either anterior/posterior radicular arteries, or anterior/posterior segmental medullary arteries

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Anterior/posterior vertebral canal branches supply

Anterior- produces nutrient artery which supplies marrow cavity
Posterior- supplies vertebral arch

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Anterior posterior radicular arteries supply

Anterior- Supply ventral roots of spinal nerves

Posterior- Supply dorsal roots of spinal nerves

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Spinal veins main branches

External/internal vertebral venous plexus

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External vertebral venous plexus

Drain basivertebral veins, empty into segmental veins, communicates with internal vertebral venous plexus

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Internal vertebral venous plexus

Drains anterior/posterior medullary and radicular veins, also drains basivertebral veins, empties into intervertebral veins or cranial dural venous sinuses

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Intervertebral veins

Drain internal/external vertebral venous plexus, empties into segmental veins

C1-3 injury

No function below head, respirator necessary to live

C4-5 injury

No function of limbs, capable of respiration

C6-8 injury

Loss of hand and variable upper limb function, may be able to propel wheelchair

T1-9 injury

Paralysis of both lower limbs

T10-L1 injury

Some thigh muscle function, may allow walking with leg braces

L2-3 injury

Most lower limb functions present, may be able to walk with short leg braces

Dura mater layers

Epidural space Dura-arachnoid interface Spinal dural sac-lines vertebral canal Dural root sheeth- surround ant/post roots Filum terminale externum- inserts on coccyx

Spinal arachnoid mater layers

Subarachnoid space- CSF Arachnoid trabeculae Lumbar cistern- enlargement of subarachnoid space inferior to conus medullaris, contains cauda equina

Pia mater layers

Denticulate ligament- suspend spinal cord in dural sac | Filum terminale internum- becomes filum terminale externum

Cervical enlargement

Swelling of spinal cord from C4-T1, corresponds with brachial plexus

Lumbosacral enlargement

Swelling of spinal cord from T11-S1, corresponds with lumbar/sacral plexuses

Spinal cord segment

Part of spinal cord that produces spinal rootlets that converge to form spinal root which converge to form spinal nerve and eventually spinal rami

Anterior root

Projections from neuronal cell bodies in anterior horn, converge with posterior root to form spinal nerve

Posterior root

Projections from neuronal cell bodies in spinal ganglion, converge with anterior root

Cervical plexus and brachial plexus are which vertebrae levels?

Cervical- C1-4 | Brachial C5-T1

Recurrent meningeal branches of cervical spinal nerves supply what

Sensory and sympathetic fibers to dura mater

Fibroskeletal structures and meninges are innervated by

Recurrent meningeal nerves

Synovial joints, intrinsic back muscles, spinal nerves and nerve roots are innervated by

Posterior rami

Branches of posterior rami of cervical spinal nerves

Suboccipital nerve- Posterior ramus of C1 Great occipital nerve- C2 Least occipital nerve- C3 C4-C8- Cutaneous and muscular innervation

Branches of C4-C8 posterior rami

Medial branch- muscular (transversospinalis muscles), articular (zygopophyseal joints) and cutaneous branches Lateral branch- muscular (erector spinae and splenius muscles) and cutaneous branches

Thoracic spinal nerve anterior rami branches

Atypical intercostal nerve- T1,2- send branches to brachial plexus T7-11 become thoracoabdominal nerve as they travel over abdomen Typical intercostal nerve T3-6 Subcostal nerve T12 Recurrent meningeal branches- sensory/sympathetic to dura mater

Thoracic spinal nerve posterior rami branches

``` Medial branch: -Muscular to transversospinalis and longissimus thoracis -Articular to zygopophyseal joint -Cutaneous Lateral branch: -Muscular to erector spinae group -Cutaneous ```

Lumbar spinal nerves anterior rami branches

Lumbar plexus L1-4 Lumbosacral trunk- Some L4, all of L5, join with sacral plexus Recurrent meningeal- sensory/sympathetic to dura mater

Lumbar spinal nerves posterior rami branches

``` Medial branch: -Muscular to transversospinalis, interspinalis and intertransversarii muscles -Articular to zygopophyseal joint -Cutaneous Lateral branch -Muscular to erector spinae group -Cutaneous -Superior cluneal nerve L1-3 ```

Sacral spinal nerve anterior rami branches

Sacral plexus- L4-S4 Coccygeal plexus- some S4 all S5 Recurrent meningeal branches

Sacral spinal nerve posterior rami branches

Medial Lateral: -Middle cluneal nerve S1-3

List the 5 groups of spinal nerves and how many pairs each has

``` Cervical-8 Thoracic-12 Lumbar-5 Sacral-5 Coccygeal-1 ```

Medullary cone

Distal cone shaped terminal end of the spinal cord, typically begins tapering off at T12 and ends at L2

Cauda equina

Bundle of anterior and posterior roots from the lumbosacral enlargement and medullary cone Occupies the vertebral canal inside the lumbar cistern from the level of the medullary cone inferiorly