Back Angiology and Neurology Flashcards

1
Q

What arteries branch off the arch of the aorta

A

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

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2
Q

Branches of the left subclavian artery include

A
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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3
Q

Branches of the vertebral artery include

A

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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4
Q

Branches of thyrocervical trunk include

A

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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5
Q

Explain the path of the vertebral artery

A

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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6
Q

Branches of costocervical trunk include

A

Deep cervical

Supreme intercostal

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7
Q

Branches of axillary artery include

A
Superior thoracic
Thoracoacromial trunk
Lateral thoracic
Subscapular->circumflex scapular, thoracodorsal
Anterior/posterior circumflex humeral
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8
Q

Branches of the thoracic (descending) aorta

A

Posterior intercostal

Subcostal

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9
Q

Branches of abdominal (descending) aorta

A

Lumbar
Common iliac–>
-Internal iliac
-External iliac

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10
Q

Explain internal iliac artery

A

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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11
Q

Which arteries produce paraspinal arteries

A
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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12
Q

Paraspinal arteries feed directly into what

A

Anterior and posterior spinal arteries

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13
Q

Branches of paraspinal arteries

A

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

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14
Q

Describe the spinal branches of the paraspinal arteries

A

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

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15
Q

Anterior/posterior vertebral canal branches supply

A

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

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16
Q

Anterior posterior radicular arteries supply

A

Anterior- Supply ventral roots of spinal nerves

Posterior- Supply dorsal roots of spinal nerves

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17
Q

Spinal veins main branches

A

External/internal vertebral venous plexus

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18
Q

External vertebral venous plexus

A

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

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19
Q

Internal vertebral venous plexus

A

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

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20
Q

Intervertebral veins

A

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

21
Q

C1-3 injury

A

No function below head, respirator necessary to live

22
Q

C4-5 injury

A

No function of limbs, capable of respiration

23
Q

C6-8 injury

A

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

24
Q

T1-9 injury

A

Paralysis of both lower limbs

25
Q

T10-L1 injury

A

Some thigh muscle function, may allow walking with leg braces

26
Q

L2-3 injury

A

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

27
Q

Dura mater layers

A

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

28
Q

Spinal arachnoid mater layers

A

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

29
Q

Pia mater layers

A

Denticulate ligament- suspend spinal cord in dural sac

Filum terminale internum- becomes filum terminale externum

30
Q

Cervical enlargement

A

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

31
Q

Lumbosacral enlargement

A

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

32
Q

Spinal cord segment

A

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

33
Q

Anterior root

A

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

34
Q

Posterior root

A

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

35
Q

Cervical plexus and brachial plexus are which vertebrae levels?

A

Cervical- C1-4

Brachial C5-T1

36
Q

Recurrent meningeal branches of cervical spinal nerves supply what

A

Sensory and sympathetic fibers to dura mater

37
Q

Fibroskeletal structures and meninges are innervated by

A

Recurrent meningeal nerves

38
Q

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

A

Posterior rami

39
Q

Branches of posterior rami of cervical spinal nerves

A

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

40
Q

Branches of C4-C8 posterior rami

A

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

41
Q

Thoracic spinal nerve anterior rami branches

A

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

42
Q

Thoracic spinal nerve posterior rami branches

A
Medial branch:
-Muscular to transversospinalis and longissimus thoracis
-Articular to zygopophyseal joint
-Cutaneous
Lateral branch:
-Muscular to erector spinae group
-Cutaneous
43
Q

Lumbar spinal nerves anterior rami branches

A

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

44
Q

Lumbar spinal nerves posterior rami branches

A
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
45
Q

Sacral spinal nerve anterior rami branches

A

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

46
Q

Sacral spinal nerve posterior rami branches

A

Medial
Lateral:
-Middle cluneal nerve S1-3

47
Q

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

A
Cervical-8
Thoracic-12
Lumbar-5
Sacral-5
Coccygeal-1
48
Q

Medullary cone

A

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

49
Q

Cauda equina

A

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