Back Angiology and Neurology

Question 1

Branching of Aortic Arch

Answer 1

Aortic arch - subclavian A.
Subclavian A - vertebral A.
Subclavian A - Thyrcervical trunk - Transverse Cervical A. - Trapezius m.
Subclavian A. - Dorsal scapular A. - Layer 2 back muscles

Question 2

Importance of vertebral A.

Answer 2

Travels superiorly in the transverse foramen of C6-C1, exits the foramen at the Atlas, crosses the posterior arch (seen in the floor of occipital triangle), then branches to create spinal arteries and paraspinal arteries.

Question 3

Spinal arteries

Answer 3

1 anteriorly, 2 posteriorly that travel inferiorly on spinal cord = TINY

Question 4

What does the subclavian A. become?

Answer 4

The axillary A. once it passes the 1st rib

Question 5

Axillary A.

Answer 5

Branches to become the subscapular A - Thoracodorsal A – innervates the Latissimus Dorsi m.

Question 6

What do paraspinal arteries do?

Answer 6

Make many different branches that supply vertebrae, meninges and spinal cord directly

Question 7

3 paraspinal A. that are NOT spinal branches

Answer 7

Equatorial branch (supplies vertebral body), periosteal branch (supplies outer bone of vertebrae), Dorsal branch (supplies spinous processes)

Question 8

Spinal branch

Answer 8

Enters vertebral foramen to interact with spinal cord via posterior and anterior spinal A. and branch

Question 9

Posterior and Anterior radicular A.

Answer 9

DO NOT meet up with spinal arteries

Question 10

Spinal branch becomes

Answer 10

Anterior/posterior vertebral canal branch, Anterior/posterior radicular A., Anterior/posterior segmental medullary A. = all supply blood to vertebral column and spinal cord

Question 11

Posterior and Anterior segmental medullary A.

Answer 11

DO interact with the spinal arteries

Question 12

8 blood vessels that produce paraspinal arteries

Answer 12

Vertebral, Ascending Cervical, Deep cervical, posterior intercostal, subcostal, lumbar, iliolumbar, lateral sacral A.

Question 13

Spinal cord injury at C1-C3

Answer 13

Cannot use any limbs, on ventilator to breath manually

Question 14

Spinal cord injury at C4-5

Answer 14

Cannot use any limbs, can breathe on their own

Question 15

Spinal cord injury at C6-7

Answer 15

Limited upper extremity function

Question 16

Spinal cord injury at T1-9

Answer 16

No lower extremity function

Question 17

Spinal cord injury at T10-L1

Answer 17

Limited lower extremity function

Question 18

Spinal cord injury at L2-L3

Answer 18

Can more than likely walk with assistance

Question 19

Spinal cord length

Answer 19

2/3 of vertebral column then tapers off at L2/3 to form medullary cone(tapered spinal cord)

Question 20

Spinal cord swelling

Answer 20

Larger at cervical and lumbar regions

Question 21

What are meninges

Answer 21

Coverings that surround brain and spinal cord

Question 22

3 most common meninges

Answer 22

Dura matter, Arachnoid matter, Pia matter

Question 23

Dura matter

Answer 23

Outermost, and toughest material, right inside the epidural matter

Question 24

Arachnoid matter

Answer 24

Membrane that holds cerebrospinal fluid in subarachnoid space

Question 25

Pia matter

Answer 25

Directly on spinal cord

Question 26

Lumbar cistern

Answer 26

Space after spinal cord stops, still houses cerebrospinal fluid - best place for lumbar punctures

Question 27

Filum Terminale Internum

Answer 27

Pia matter thread that continues even after spinal cord stops. Surrounded by lumbar cistern.

Question 28

Filum Terminale Externum

Answer 28

Pia matter thread plus a dura matter shield around it, after lumbar cistern stopped

Question 29

Denticulate ligament

Answer 29

made of pia matter

Question 30

Posterior horn

Answer 30

Posterior rootlets - posterior root - spinal ganglion - combines with anterior root to form spinal nerve

Question 31

Anterior horn

Answer 31

Anterior rootlets - Anterior root - spinal ganglion - combines with posterior root to form spinal nerve

Question 32

spinal nerve

Answer 32

exits vertebral foramen and branches into posterior rami and anterior rami

Question 33

Posterior Rami superiorly becomes

Answer 33

Suboccipital nerve (C1), Greater occipital nerve (C2), Least occipital nerve (C3)

Question 34

Posterior Rami inferiorly becomes

Answer 34

Superior (L1-3) and Middle Cluneal nerves (S1-3)

Question 35

Posterior Rami innervates

Answer 35

skin and muscles of back

Question 36

Articular branch(off of medial branch) of posterior rami

Answer 36

innervates zygapophyseal joints

Question 37

Medial and lateral branches of posterior rami

Answer 37

Both have muscular and cutaneous branches to innervate the back muscles and skin of back

Question 38

5 most common causes of back pain

Answer 38

Fibroskeletal structures (ligaments), synovial joints, meninges, intrinsic back muscles, spinal nerves and nerve roots