Back Angiology/Neurology Flashcards
What branches off from the Arch of the Aorta?
- Right Side:
- Brachiocephalic Trunk
- Right Subclavian A.
- Right Common Carotid A.
- Brachiocephalic Trunk
- Left Side:
- Left Common Carotid A.
- Left Subclavian A.
What is the path of the Vertebral A. from the L. Subclavian A.?
Travels superiorly in Transverse Foramina of C6-C1; Exits Foramen at Atlas; Crosses Posterior Arch of Atlas; Branches anteriorly and posteriorly to meet contralateral branch forming Anterior Spinal N. (1) & Posterior Spinal N. (2)
What is the Anterior Spinal A.?
What is it supplied by?
Formed by two branches from L & R Vertebral A; Travel inferiorly in Anterior Median Fissure producing Sulcal A.
Anterior Segmental Medullary As.
What are the Posterior Spinal As.?
What are they supplied by?
Paired arteries from Vertebral A; Travel inferiorly along spinal cord
Posterior Segmental Medullary As
Where are Equatorial branches and what do they supply?
Every level of the vertebral column
Supply the Vertebra
Where are Periosteal Branches and what do they supply?
Every level of vertebral column
Supply Periosteum of Vertebrae
Where are Spinal Branches and what additional arteries branch off of the Spinal A.?
What do they supply?
- Every level of the Vertebral Column; Travel through intervertebral foramen
- Anterior Vertebral Canal Branch (Ascending/Descending branches communicating with other Anterior Vertebral Canal Branches
- Posterior Vertebral Canal Branch (Supply Vertebral Arch)
- Anterior/Posterior Radicular As. (Supplies Ventral/Dorsal Roots of Spinal Nerves)
- Anterior/Posterior Segmental Medullary As. (Feed directly into Anterior/Posterior Spinal As.)
What first branches inferiorly from the Subclavian A.?
What does it supply?
Internal Thoracic A.
Supplies posterior aspect of Anterior Thoracic Wall
Describe the branching from the Thyrocervical Trunk
-
Thyrocervical Trunk
- Suprascapular A. (over scapula to Supraspinatus & Infraspinatus)
-
Transverse Cervical A. (if no branching, travels to deep surface of Trapezius)
- Superficial Branch (travel with Spinal Accessory N. to deep surface of Trapezius)
- Deep Branch (replaces Dorsal Scapular A. if present, supplying Levator Scapulae & Rhomboid Major/Minor)
-
Inferior Thyroid A. (superiorly to Thyroid Gland)
- Ascending Cervical A. (Paraspinal A.)
What branches off of the Costocervical Trunk (from Subclavian A.)?
Deep Cervical A. (Paraspinal A.)
Supreme Intercostal A. (travels inferior to 1st rib)
Variably arising from the 3rd part of the Subclavian A., what does it supply?
Where can this vessel also arise from, and what is it called then?
Superior to scapula then along the medial border supplying Levator Scapulae & Rhomboid Major/Minor Ms.
Deep Branch of the Transverse Cervical A.
Describe the Branching of the Axillary A.
-
Axillary A.
- Superior Thoracic A. (Anterior Thoracic Wall)
-
Thoracoacromial Trunk
- Clavicular Branch, Acromial Branch, Pectoral Branch (Pectoral Ms.), Deltoid Branch (Deltoid M.)
- Lateral Thoracic A. (Serratus Anterior M.)
-
Subscapular A.
- Circumflex Scapular A.
- Thoracodorsal A. (Latissimus Dorsi M.)
- Anterior Circumflex Humeral A.
- Posterior Circumflex Humeral A.
What are the 8 Paraspinal Arteries?
Vertebral A.
Ascending Cervical A.
Deep Cervical A.
Posterior Intercostal A.
Subcostal A.
Lumbar A.
Iliolumbar A.
Lateral Sacral A.
What are the two spinal vein complexes?
External Vertebral Venous Plexus
Internal Vertebral Venous Plexus
Where are the two enlargements of the spinal cord?
Cervical Enlargement (C4-T1 segments of SC corresponding with Brachial Plexus & Upper Extremity)
Lumbosacral Enlargement (T11-S1 segments of SC corresponding with Lumbar and Sacral Plexuses & Lower Extremity)
Spinal Dura Mater
What area is occupied by Internal Vertebral Venous Plexus & Spinal Roots?
What is the potential space (no natural space exists) often erroneously referred to as Subdural Space?
What is the long tube-shaped sheath surrounding the SC lining the vertebral canal?
What is the lateral tapering extension of Spinal Dura Mater surrounding Anterior/Posterior Roots?
What is the continuation of Filum Terminale Internum inferior to the Dural Sac with additional layer of Dura that travels through the Sacral Hiatus and inserts on the Coccyx?
Epidural Space
Dura-Arachnoid Interface
Spinal Dural Sac
Dural Root Sheath
Filum Terminale Externum
Spinal Arachnoid Mater
What is the area filled with CSF between Arachnoid and Pia Mater?
What are the delicate strands of CT spanning the CSF filled space that join the Arachnoid and Pia Mater?
What is the enlargement of the Subarachnoid Space inferior to the Conus Medullaris continaing the Cauda Equina?
Subarachnoid Space
Arachnoid Trabeculae
Lumbar Cistern
Spinal Pia Mater
What is the lateral extension of fibrous Pia Mater at regular intervals between Spinal Roots attaching to the Dura Mater?
What is the inferior continuation of Pia Mater inferior to the Conus Medullaris?
Denticulate L.
Filum Terminale Internum
Describe the Spinal Cord Segment
How many Spinal Nerves in each area of the back?
- Anterior Rootlets –> Anterior Root
- Posterior Rootlets –> Posterior Root + Spinal Ganglion (Collection of sensory nerve cell bodies)
- Anterior Root + Posterior Root –> Spinal Nerve (Exit Intervertebral Foramen)
- Spinal Nerve –> Anterior Rami + Posterior Rami
- 31 Total (8 CS, 12 TS, 5 LS, 5 Sac, 1 Coc)
Posterior Rami
C1
C2
C3
L1-3
S1-3
C1: Suboccipital Nerve
C2: Greater Occipital Nerve
C3: Least Occipital Nerve
L1-3: Superior Cluneal Nerve (Lateral Branch)
S1-3: Middle Cluneal Nerve (Lateral Branch)
Anterior Rami
C1-4
C5-T1
T1-11
T12
L1-4
L5-S5
Cervical Plexus
Brachial Plexus
Intercostal Nerves
Subcostal N.
Lumbar Plexus
Sacral Plexus
Posterior Rami of Spinal Nerves
Describe the General Branching Pattern
- Posterior Ramus
- Medial Branch
- Articular Branch (Zygopophyseal Joint)
- Muscular Branch (Intrinsic Back Muscles)
- Cutaneous Branch (Skin)
- Lateral Branch
- Muscular Branch (Intrinsic Back Muscles)
- Cutaneous Branch (Skin)
- Medial Branch
What is the distal cone shaped terminal end of the SC that begins tapering off at T12 and ends at L2?
What is the bundle of Anterior/Posterior Roots from the Lumbosacral Enlargement?
Medullary Cone
Cauda Equina