Back Angiology and Neurology Flashcards
Branching of Aortic Arch
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
Importance of vertebral A.
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.
Spinal arteries
1 anteriorly, 2 posteriorly that travel inferiorly on spinal cord = TINY
What does the subclavian A. become?
The axillary A. once it passes the 1st rib
Axillary A.
Branches to become the subscapular A - Thoracodorsal A – innervates the Latissimus Dorsi m.
What do paraspinal arteries do?
Make many different branches that supply vertebrae, meninges and spinal cord directly
3 paraspinal A. that are NOT spinal branches
Equatorial branch (supplies vertebral body), periosteal branch (supplies outer bone of vertebrae), Dorsal branch (supplies spinous processes)
Spinal branch
Enters vertebral foramen to interact with spinal cord via posterior and anterior spinal A. and branch
Posterior and Anterior radicular A.
DO NOT meet up with spinal arteries
Spinal branch becomes
Anterior/posterior vertebral canal branch, Anterior/posterior radicular A., Anterior/posterior segmental medullary A. = all supply blood to vertebral column and spinal cord
Posterior and Anterior segmental medullary A.
DO interact with the spinal arteries
8 blood vessels that produce paraspinal arteries
Vertebral, Ascending Cervical, Deep cervical, posterior intercostal, subcostal, lumbar, iliolumbar, lateral sacral A.
Spinal cord injury at C1-C3
Cannot use any limbs, on ventilator to breath manually
Spinal cord injury at C4-5
Cannot use any limbs, can breathe on their own
Spinal cord injury at C6-7
Limited upper extremity function
Spinal cord injury at T1-9
No lower extremity function
Spinal cord injury at T10-L1
Limited lower extremity function
Spinal cord injury at L2-L3
Can more than likely walk with assistance
Spinal cord length
2/3 of vertebral column then tapers off at L2/3 to form medullary cone(tapered spinal cord)
Spinal cord swelling
Larger at cervical and lumbar regions
What are meninges
Coverings that surround brain and spinal cord
3 most common meninges
Dura matter, Arachnoid matter, Pia matter
Dura matter
Outermost, and toughest material, right inside the epidural matter
Arachnoid matter
Membrane that holds cerebrospinal fluid in subarachnoid space
Pia matter
Directly on spinal cord
Lumbar cistern
Space after spinal cord stops, still houses cerebrospinal fluid - best place for lumbar punctures
Filum Terminale Internum
Pia matter thread that continues even after spinal cord stops. Surrounded by lumbar cistern.
Filum Terminale Externum
Pia matter thread plus a dura matter shield around it, after lumbar cistern stopped
Denticulate ligament
made of pia matter
Posterior horn
Posterior rootlets - posterior root - spinal ganglion - combines with anterior root to form spinal nerve
Anterior horn
Anterior rootlets - Anterior root - spinal ganglion - combines with posterior root to form spinal nerve
spinal nerve
exits vertebral foramen and branches into posterior rami and anterior rami
Posterior Rami superiorly becomes
Suboccipital nerve (C1), Greater occipital nerve (C2), Least occipital nerve (C3)
Posterior Rami inferiorly becomes
Superior (L1-3) and Middle Cluneal nerves (S1-3)
Posterior Rami innervates
skin and muscles of back
Articular branch(off of medial branch) of posterior rami
innervates zygapophyseal joints
Medial and lateral branches of posterior rami
Both have muscular and cutaneous branches to innervate the back muscles and skin of back
5 most common causes of back pain
Fibroskeletal structures (ligaments), synovial joints, meninges, intrinsic back muscles, spinal nerves and nerve roots
