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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
Q

Cauda Equina is found where?

A

-L5-S5

26
Q

What does the Dorsal region of the spinal cord do? Ventral region?

A
  • Dorsal = Entering sensory information

- Ventral = Outgoing motor information

27
Q

The central “H” shaped grey region of the spinal cord contains what?

A
  • Neuronal cell bodies

- Unmylinated fibers

28
Q

What surrounds the grey matter in the spinal cord? What does it contain?

A

-White matter which contains fiber tracts

29
Q

The grey matter is divided in 12 regions called what?

A

-Laminae of Rexed

30
Q

Laminae of Rexed 1-6 are responsible for what?

A

-Afferent tracts that receive information from the periphery

31
Q

What are the ventral tracks of the Laminae of Rexed? and what do they do?

A
  • 7-9

- Motor function

32
Q

Why is Laminae 2 important? And what is it called?

A
  • Involved in pain sensation

- Substancia Gelitinosa

33
Q

What is the role of the Dorsal white matter?

A

-Ascending sensory tracts

34
Q

What 2 things can the lateral and ventral white columns do?

A
  • Ascend to the brain

- Originate and terminate within the spinal cord (Reflexes)

35
Q

Lateral and ventral are primarily what?

A

-Descending motor tracts in which most cross over

36
Q

The nerves of the sympathetic nervous system are called what? What type of nerves are they?

A
  • Preganglionic neurons

- Small, B Fibers

37
Q

Where do the preganglionic nerves originate?

A

-Intermediolateral grey horn between T1-L2/3

38
Q

Where do Preganlionic neurons exit?

A

-Ventral nerve root called the White Rami

39
Q

What happens when the superior cervical ganglia are damages?

A
  • Miosis (Pupil constriction)
  • Ptosis (droopy eye lid)
  • Anyhdrosis (lack of sweat)
40
Q

What 3 symptoms make up Horner’s syndrome?

A
  • Miosis
  • Ptosis
  • Anyhdrosis
41
Q

The inferior cervical ganglia fuses with what to form what?

A
  • First thoracic

- Stelate ganglia @ C5-C6

42
Q

The sensory / afferent pathways transmit what?

A
  • Pain
  • Pressure
  • Proprioception
  • Temp
  • Touch
  • Vibration
43
Q

Where are pain and temp receptors found?

A

-Epidermis and dermis

44
Q

Where are pressure,touch, vibration and proprioception receptors found?

A

-Dermis

45
Q

What are the two classes of receptors and where are they found?

A
  • Extroceptors (Surface skin and Oral mucosa)

- Proprioceptors (Deep skin, joints, ligaments, tendons, muscles and periostium)

46
Q

What are the 4 sages of pain transmission?

A
  • Transduction (feeling pain)
  • Transmission
  • Modulation (Rexed 2 or gelitanosa)
  • Perception (in the brain)
47
Q

Where are the sensations of pain, temp, touch and pressure interpreted?

A

-Post central gyrus

48
Q

Briefly describe the pain and temp pathway.

A

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
Q

Explain the reflex response to pain known as the spinal arc reflex.

A

-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
Q

Name the dermatome level of the nipple line, Xiphoid process, Belly button, clavicle.

A
  • Nipple line = T4
  • Xiphoid = T6/7
  • Belly Button = T10
  • Clavicle = C4
51
Q

What is the main difference in the pressure and crude touch pathway from the temp and pain pathway?

A

-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
Q

Vibration, proprioception and fine touch pathways have axons, name 2 difernt types and how they travel.

A
  • Lumbar and sacral via the fasciculus gracilis

- Cervical and thoracic via the fasciculus cuneatus

53
Q

Vibration, proprioception and fine touch pathways 2nd order Axons cross the medulla and form a bundle called what? where does it terminate?

A
  • medial lemniscus

- ventral Posterolateral thalamic nucleus

54
Q

What do the motor pathways do?

A

-Take info from brain to the voluntary, smooth and cardiac muscles and some glands

55
Q

What tract do the motor / efferent pathways use? Where does it originate?

A
  • Corticospinal tract

- Precentral gyrus

56
Q

Where are the inhibitory corticospinal neurons located? What do they do? Damage to these can cause what?

A
  • anterior to the precentral gyrus
  • Prevent excessive discharge
  • Hyperreflexia (overfire) or sapsticity (simultaneously fire)
57
Q

Damage to upper motor neurons cause what?

A

-hyperreflexia

58
Q

Damage to lower motor neurons cause what?

A

-Flaccid paralysis

AAN2 (11 decks)

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