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AAN2 > Class 7 Spinal Anatomy > Flashcards

Class 7 Spinal Anatomy Flashcards

1
Q

What allows for passage of nerves from spinal cord?

A

-intravertebral foramina

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2
Q

How do colapsed discs affect spinal nerves?

A

-Intervertebral foramina collapse pinching nerve, causing pain and parasthesias

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3
Q

What bony structure overlaps each other to protect the spinal cord?

A

-Spinous process

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4
Q

______ and ______ spinous processes are more ________ and require more ________ angle approach.

A
  • Cervical
  • Throacic
  • Angled
  • Cephelad
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5
Q

Lamina of the last vertebra is ______ and bridged by only ______. This is known as the _______.

A
  • Incomplete
  • Ligaments
  • Sacral Hiatus
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6
Q

How is the sacral hiatus identified?

A

-in between 2 bony process called the sacral cornu

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7
Q

What block is performed through the sacral hiatus?

A

-Caudal

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8
Q

What allows for passage and protection of the spinal cord?

A

-Vertebral foramen

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9
Q

How many Cervical vertebrae are there? Thoracic? Lumbar? Sacral? Cocyx?

A
  • Cervical = 7
  • Thoracic = 12
  • Lumbar = 5
  • Sacral = 5
  • Cocyx = 1
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10
Q

Name the 3 types of abnormal curvatures and they curve.

A
  • Scoliosis = Lateral Curve
  • Kyphosis = Posterior Curve
  • Lordosis = Anterior Curve
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11
Q

Name the 3 ligaments you will pass through when delivering spinal anesthesia and the 2 onthe other side of the spinal canal.

A

-Supraspinous → Intraspinous → Ligamentum flavum → Posterior longitudinal → Anterior longitudinal.

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12
Q

Where is the epidural space?

A

-Between ligamentum flavum and dura mater.

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13
Q

Where does the epidural space begin and end?

A
  • Begins at base of cranium

- Ends at sacral sulcus

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14
Q

What is the average distance from skin to epidural space?

A
  • 2.5-8 cm

- avg. 5

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15
Q

What 5 things can be found in the epidural space?

A
  • Veins
  • Lymphatics
  • Segmental arteries
  • Nerve roots
  • Fat
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16
Q

When are epidural veins engorged?

A

-Pregnancy and obesity

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17
Q

What is the potential space for the epidural in the Midlumbar? Thoracic? Cervical?

A
  • Midlumbar = 5-6mm
  • Thoracic = 3-5mm
  • Cervical = 1.5-2mm
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18
Q

The spinal cord extends from the medulla oblongata to what level in adults? Peds?

A
  • Adults = L2

- Peds = L3

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19
Q

What are the 3 layers of the meninges?

A
  • Dura mater (outermost)
  • Arachnoid Mater (middle)
  • Pia Mater (covers spinal cord)
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20
Q

What meningial layer holds the CSF?

A

-Arachnoid

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21
Q

Thoracic nerves run along the _______ margin of the rib. Thus you would place a chest tube on the _______ aspect of the rib.

A
  • Inferior

- Superior

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22
Q

Cervical nerves correlate with the vertebrae _____, while the rest correlate to the vertebrae _______.

A
  • Below

- Above

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23
Q

The spinal cord how much shorter then the vertebral canal?

A

-25cm

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24
Q

What two spots along the spinal chord is the cord enlarged and to what does it correlate?

A
  • C5-C7 = Brachial Plexus

- L3-S2 = Lumbar and Sacral Plexus

25
Cauda Equina is found where?
-L5-S5
26
What does the Dorsal region of the spinal cord do? Ventral region?
- Dorsal = Entering sensory information | - Ventral = Outgoing motor information
27
The central "H" shaped grey region of the spinal cord contains what?
- Neuronal cell bodies | - Unmylinated fibers
28
What surrounds the grey matter in the spinal cord? What does it contain?
-White matter which contains fiber tracts
29
The grey matter is divided in 12 regions called what?
-Laminae of Rexed
30
Laminae of Rexed 1-6 are responsible for what?
-Afferent tracts that receive information from the periphery
31
What are the ventral tracks of the Laminae of Rexed? and what do they do?
- 7-9 | - Motor function
32
Why is Laminae 2 important? And what is it called?
- Involved in pain sensation | - Substancia Gelitinosa
33
What is the role of the Dorsal white matter?
-Ascending sensory tracts
34
What 2 things can the lateral and ventral white columns do?
- Ascend to the brain | - Originate and terminate within the spinal cord (Reflexes)
35
Lateral and ventral are primarily what?
-Descending motor tracts in which most cross over
36
The nerves of the sympathetic nervous system are called what? What type of nerves are they?
- Preganglionic neurons | - Small, B Fibers
37
Where do the preganglionic nerves originate?
-Intermediolateral grey horn between T1-L2/3
38
Where do Preganlionic neurons exit?
-Ventral nerve root called the White Rami
39
What happens when the superior cervical ganglia are damages?
- Miosis (Pupil constriction) - Ptosis (droopy eye lid) - Anyhdrosis (lack of sweat)
40
What 3 symptoms make up Horner's syndrome?
- Miosis - Ptosis - Anyhdrosis
41
The inferior cervical ganglia fuses with what to form what?
- First thoracic | - Stelate ganglia @ C5-C6
42
The sensory / afferent pathways transmit what?
- Pain - Pressure - Proprioception - Temp - Touch - Vibration
43
Where are pain and temp receptors found?
-Epidermis and dermis
44
Where are pressure,touch, vibration and proprioception receptors found?
-Dermis
45
What are the two classes of receptors and where are they found?
- Extroceptors (Surface skin and Oral mucosa) | - Proprioceptors (Deep skin, joints, ligaments, tendons, muscles and periostium)
46
What are the 4 sages of pain transmission?
- Transduction (feeling pain) - Transmission - Modulation (Rexed 2 or gelitanosa) - Perception (in the brain)
47
Where are the sensations of pain, temp, touch and pressure interpreted?
-Post central gyrus
48
Briefly describe the pain and temp pathway.
Receptors → dorsal root ganglia → 1st order neurons → gray mater → 2nd order neurons → cross in ventral white commisure → lateral white column → ascend lateral spinothalmic tract → posterolateral thalamic nucleus → 3rd order neurons → internal capsule → postcentral gyrus
49
Explain the reflex response to pain known as the spinal arc reflex.
-Some branches of the dorsal horn synapse with internucal (messenger ) neurons, these synapse with motor neurons in the ventral horn. And can illicit a motor response w/o traveling to the brain.
50
Name the dermatome level of the nipple line, Xiphoid process, Belly button, clavicle.
- Nipple line = T4 - Xiphoid = T6/7 - Belly Button = T10 - Clavicle = C4
51
What is the main difference in the pressure and crude touch pathway from the temp and pain pathway?
-Pressure and crude touch will bifurcate with one branch going to the dorsal gray and synapsing with 2nd order neurons, while the other branch ascends 10 spinal segments then synapses w/ 2nd order neurons.
52
Vibration, proprioception and fine touch pathways have axons, name 2 difernt types and how they travel.
- Lumbar and sacral via the fasciculus gracilis | - Cervical and thoracic via the fasciculus cuneatus
53
Vibration, proprioception and fine touch pathways 2nd order Axons cross the medulla and form a bundle called what? where does it terminate?
- medial lemniscus | - ventral Posterolateral thalamic nucleus
54
What do the motor pathways do?
-Take info from brain to the voluntary, smooth and cardiac muscles and some glands
55
What tract do the motor / efferent pathways use? Where does it originate?
- Corticospinal tract | - Precentral gyrus
56
Where are the inhibitory corticospinal neurons located? What do they do? Damage to these can cause what?
- anterior to the precentral gyrus - Prevent excessive discharge - Hyperreflexia (overfire) or sapsticity (simultaneously fire)
57
Damage to upper motor neurons cause what?
-hyperreflexia
58
Damage to lower motor neurons cause what?
-Flaccid paralysis

AAN2 (11 decks)

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