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Neuroscience > Ch. 13: Spinal Region > Flashcards

Ch. 13: Spinal Region Flashcards

1
Q

The spinal cord extends from the _____________ down to _______________.

A

The spinal cord extends from the Foramen Magnum down to L1 or L2 level.

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2
Q

Cauda Equnia

A

Collection of nerve roots and spinal nerves that are outside the spinal cord but inside the spinal ring

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3
Q

What are the two thickest parts of the spinal cord?

A

Cervical and Lumbar

(The MOST gray mater → Contain cell bodies for all the movement of our arms & legs)

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4
Q

What root controls motor?

A

Ventral root

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5
Q

What root controls sensory?

A

Dorsal root & dorsal root ganglion

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6
Q

How many spinal nerves are there?

A

31 spinal nerves

(31 spinal segments)

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7
Q

What are the segments of the Spinal Cord made up of?

A

Areas of spinal cord associated with axons in a single spinal nerve

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8
Q

Where are all white matter columns the biggest in the spinal cord?

A

Cervical cord

(lateral corticospinal tract is biggest here)

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9
Q

Where are all white matter columns the smallest in the spinal cord?

A

sacral cord

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10
Q

Spinal nerve

A

All motor and sensory axons of a single spinal segment

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11
Q

Where do all spinal nerves exit from C7 & rostral?

A

ABOVE corresponding vertebra

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12
Q

Where do all spinal nerves exit from T1 & caudal?

A

BELOW corresponding vertebra

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13
Q

Where does C8 exit the spinal cord?

A

Between C7 & T1

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14
Q

How many Rami are there and what are they called?

A
  1. Dorsal primary rami
  2. Ventral primary rami
  3. White communicating rami
  4. Gray communicating rami
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15
Q

Where is the lateral motor division located in the spinal cord?

A

The lateral spinal cord

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16
Q

In the white matter of the spinal cord, where is the somatotopic organization?

A

Somatotopic organization of major sensory and motor tracts

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17
Q

In the Gray matter of the spinal cord, what does each horn do?

A
  • Dorsal horn: senroy
  • Lateral horn: autonomic
  • Ventral horn: LMN cell bodies
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18
Q

What are Rexed’s Laminae?

A

Histologically and functionally distinct areas of gray matter

(the right half of the attached pictures with the Roman Numerals)

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19
Q

What are the functiosn of the spinal cord?

A
  • Integrate information (synapse = opportunity for processing and modification of signals).
  • Transmit information (“vertically” and “horizontally”)
    • Info to and from the brain
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20
Q

How does afferent input and descending commands affect movement?

A
  • Reflexes (afferent input) can modify motor plan
  • Motor plan (descending commands) can modify reflexes
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21
Q

What are central pattern generators?

A

Pre-existing group of neurons → make walking more automatic

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22
Q

What is the Phasic Stretch Reflex?

A
  • Quick stretch of MUSCLE SPINDLE
  • Synapse is in the spinal cord
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23
Q

What is the Withdraw Reflex?

A

Multisynaptic, mutliple muscle withdraw

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24
Q

What is the Crossed Extension Reflex?

A
  • More complex - Multisynaptic, multiple muscle withdrawal
  • Leg in pain FLEXES (blue), other EXTENDS (red)
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25
Q

What is Reciprocal Inhibition?

A
  • Agonist facilitated → Antagonists inhibited
    • (ex: hamstrings inhibited when quads facilitated).
  • Occurs both through voluntary movement (thought) and reflex.
  • Can be suppressed (ex: to allow voluntary cocontraction).
26
Q

What type of muscle and control level are in the bladder?

A
  • Smooth muscle
  • Autonomic control
27
Q

What are the different control centers of the bladder?

A
  • Frontal control center
    • “Modulatory”
  • Pontine control center
    • “Control”
  • Spinal cord centers (lumber & sacral)
    • “Efferent” (pre-ganglion)
    • “Afferent” (bladder wall)
28
Q

What is the sympathetic systems effect on the baldder?

What spinal levels?

A
  • T11-L2
  • Prevents emptying
    • Relaxes bladder wall and contracts internal sphincter
29
Q

What is the parasympathetic systems effect on the baldder?

What spinal levels?

A
  • S2-S4
  • System of Elimination
    • Contracts bladder wall and relaxes internal sphincter
30
Q

What is the autonomic systems effect on the baldder?

What spinal levels?

A
  • S2-S4
  • Voluntarily opens external sppincter
    • Consciously tell you bladder “I can’t go here, I have to hold it”
31
Q

What facilitates voiding reflex?

A

Stretch of bladder

(this can get our of wack with neuro impairments)

32
Q

What are the systems and their spinal levels that control the bladder?

A
  • T11-L2: Sympathetic - fill
  • S2-S4: Parasympathetic - empty
  • S2-S4: Somatic - conscious opening of external sphincter
33
Q

What systems consciously open the external sphinter and allow voiding reflex to occur?

A

Descending somatic and autonomic axons

34
Q

What happens in the higher centers when it is “OK” to go?

A
  • Higher centers
    • Allow emptying reflex
    • Relax external sphincters
35
Q

What happens in the higher centers when it is “Not OK” to go?

A
  • Higher centers
    • Try to stop emptying reflex
    • Contract external sphincter
36
Q

What happens to the bladder when the lines of communication get cut?

A

It reflexes on its own.

(Picture is normal neural control of bladder)

37
Q

What are the SNS and PNS effects on external genitalia?

A
  • Erection = parasympathetic nerves.
  • Ejaculation = sympathetic and pudendal nerves.
38
Q

What is damaged in a Segmental Lesion?

A

Damage to one spinal nerve

39
Q

What is the pattern of loss with a Segmental Lesion?

A
  • Segmental Pattern: at level of lesion ONLY
  • Dermatomal Sensory loss: no sensory can get it
  • Myotomal Motor loss: no motor can get out
  • Autonomic loss in one segment
40
Q

What are the signs and symptoms with a Segmental Lesion?

A
  • Weakness of many muscles
  • Hyporeflexia (LMN) - reflexes will be weaker or gone
  • Hypotonia (LMN)

*Vertical tracts can easily go up and down passed lesion

41
Q

What is damaged in a Vertical Tract Lesion?

A
  • Damage completely across spinal cord
42
Q

What is the pattern of loss with a Vertical Tract Lesion?

A
  • Sensory loss: ALL segments below lesion
  • Motor loss: ALL segments below lesion
  • Autonomic loss: ALL segmetns below lesion
43
Q

What are the signs and symptoms with a Vertical Tract Lesion?

A
  • Paralysis (UMN)
  • Hyperreflexia (UMN)
44
Q

What are the signs and symptoms of segmental + vertical tract dysfunction?

A
  • Stereotype of complete spinal cord injury
    • Loss of segmental function AT level of injury
    • Loss of verticl tract functions at ALL levels BELOW level of injury
45
Q

How do you differentiate between a peripheral region legion and a spinal region lesion?

A
  • Peripheral
    • Sensory & motor loss in peripheral nerve pattern
    • No vertical tract signs
  • Spinal
    • Senation loss: dermatome
    • Motor loss: myotome
    • Dec/loss phasic stretch reflex
    • Dec/loss of sensation or control below level of lesion
46
Q

What is Anterior Cord Syndrome?

A
  • Front 2/3 of spinal cord is damaged
    • MOI: Blockage in ant spinal artery
    • NO: voluntary function below level of the injury; pain & temp gone
    • YES: light touch and proprioception
47
Q

What is Central Cord Syndrome?

A
  • Center of spinal cord fills up like a balloon
    • NO: pain & temp where central canal has swelled up
  • No damage to columns or horns - damage to pain message where it crosses in the spinal cord
  • Prox & core muscles will weeken at whatever levels there is swelling
  • COMMON in the cervical spinal cord
48
Q

What is Brown-Sequard Syndrome?

A
  • Half Injured
    • Ipsilateral loss
      • Dorsal Column: discrinative touch
      • Corticospinal: motor function
    • Contralateral loss
      • Anterolateral column: pain & temp
49
Q

What is Cauda Equina Syndrome?

A
  • Injury to peripheral sensory neurons & LMN’s
  • Pain, all sensations impaired, muscle weakness, altered bladder and bowel control

(Spinal nerves outside spinal cord but inside bony spinal column)

50
Q

What is a Spastic Bladder and what causes it to happen?

A
  1. No autonomic control of reflex emptying loop
    • Hyperreflexic bladder - reflex loop intact, can not consciously control
    • Empties with less stimulus and exaggerated response
  2. Lesions ABOVE sacral cord - similar to UMN lesion
51
Q

What is a Flaccid Bladder and what causes it to happen?

A
  1. Bladder fills w/ no reflex to empty it
    1. ex: Cauda Equina
  2. Lesions OF sacral segements - similar to LMN lesion
52
Q

What is spinal shock?

A
  • Inital loss or impairment of:
    • Spinal level reflexes
    • Autonomic reflexes
  • Wheres off in a couple weeks/months
53
Q

What is Tetraplegia/Quadriplegia?

A

4 limbs effected

(both arms, both legs)

54
Q

What is Paraplegia?

A

2 limbs effected

(typically, 2 legs)

55
Q

What is the difference between Complete vs. Incomplete SCI?

A
  • Complete: All vertical tracts cut
  • Incomplete: Spares lowest sacral segments (S3-S5)
    • preserves sensory &/or motor function here
56
Q

What is the Neurological Level?

A

Most caudal level with normal motor and sensory function bilaterally

{key muscle tests (3+/5) or “Normal”}

57
Q

Abnormal interneuron activity in chronic spinal cord injury takes place where?

What are the effects?

A
  • Below level of injury
  • Plastic changes bias toward both muscle stretch & cutaneous reflexes
    • Hyperreflexia
    • Enhanced withdrawal response to cutaneous simuli
58
Q

What are the mechanical changes in affected muscles in a traumatic spinal cord injury?

A
  • Atrophy, becomes fibrotic, may lose sarcomeres (develop contractures)
    • Typical contractures: plantarflexion, knee flexion & hip flexion
59
Q

What are the autonomic dysfunction in tramumatic spinal cord injury?

A
  • Loss of sympathetic control above T1
    • Sympathetics DON’T leave spinal cord until T1
60
Q

What is autonomic dysreflexia/hyperreflexia?

A
  • Spinal cord cut = NO autonomic control of bladder = reflex emptying
  • Send enough “I have to empty” messages that is generates fight or flight response (SNS = inc heart rate, constricts blood vessels)
    • Anticipate fight/flight but no fight comes - so the high blood pressure can end up being fatal
  • Initiates flight/flight that cannot be controlled/stopped
61
Q

What are the impaired body temperature regulations associated with traumatic SCI?

A
  • Impaired shunting: cant conserve body heat
  • Impaired sweating: cant release body heat
62
Q

Why is orthostatic hypOtension associated with traumatic SCI?

A
  • Impaired “capacitance” - vessels stay dilated - blood pools in abdomen
  • Fine when laying down - but when you stand up it is not ok

Neuroscience (18 decks)

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