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► Med Misc 47 > Clinical correlates/notes from lecture > Flashcards

Clinical correlates/notes from lecture Flashcards

1
Q

sensory nervous system

A

afferent information conveyed from receptors in the periphery to the CNS

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2
Q

Motor nervous system

A

efferent information conveyed from the CNS to the skeletal, smooth and cardiac muscle

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3
Q

Somatic

A

body surface and musculoskeletal structures

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4
Q

Visceral

A

vessels, glands or organs containing smooth or cardiac muscle (ANS)

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5
Q

Efferent systems

A

Motor systems:

1) anatomically distinct sets of neurons
2) somatic is innervation of skeletal muscle
3) autonomic (Visceral) relates to innervation of smooth or cardiac muscle

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6
Q

Afferent systems

A

Sensory system

1) characterized by automically overlapping sets of neurons
2) somatic sensations are well localized
3) visceral sensations are poorly localized

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7
Q

LMN

A

have cell body in CNS and axon in PNS to innervate muscle fibers

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8
Q

Primary sensory neurons

A

have cell body in PNS with proximal process axon in CNS and distal process in PNS

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9
Q

Glia

A

the supportive cells

1) astrocytes in CNS
2) oligodendrocytes in CNS
3) microglia in CNS
4) Schwann cells in PNS

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10
Q

what are oligodendrocytes

A

Glia in CNS

myelin forming cells of the CNS

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11
Q

what are schwann cells

A

myelin forming cells of the PNS

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12
Q

Layers of the meninges

A

(closest to spinal cord) 1) pia mater

2) arachnoid matter (and subarachnoid space (CSF)
3) Dura Mater (underneath is potentail subdural space)
4) Epidural space for fat and veins
5) vertebra

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13
Q

Where are primary sensory neurons located in spinal cord?

A

Dorsal root (not cell bodies though)

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14
Q

What is the collect of PSC bodies located

A

Dorsal root ganglion

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15
Q

What is a spinal nerve?

A

combination of lower motor nuerons and primary sensory neurons.

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16
Q

what is the blood supply for the spinal cord?

A

Radicular arteries

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17
Q

Flexor withdrawal reflex

A

1) touch stimuli with primary sensory neuron
2) signal travels back to dorsal horn of spinal column
3) signal transfers to internuron that connects PSN to LMN in ventral horn
4) the LMN innervates the biceps to flex and withdraw hand

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18
Q

Fascicle

A

bundle of fibers by connective tissue

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19
Q

Epineurium

A

thick connective tissue that encloses the fascicles of the nerve

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20
Q

Endoneurium

A

delicates connective tissue the surrounds the nuerilemma cells

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21
Q

Perineurium

A

dense connective tissues that surround the axons of a single fasiicle. formed by flattened fiberglass like structures that act as a good barrier; tight junctions

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22
Q

what do the perinureim and epienurim form

A

a root sheath, or continuous barrier to the nerve bundles

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23
Q

what surrounds the ventral root in real life?

A

the dorsal root ganglion

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24
Q

Meningitis - possible diagnosis

A

patient refuses to raise leg

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25
Q

why is painful leg raising sign of meningitis?

A

raise leg you are stretching the sciatic nerve and also the epirnuerium and dura mater. you are tugging the dura matar. And in meningitis, the dura matar is inflamed.

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26
Q

The developing spinal cord

A

spinal cord is same length as developing vertebrate.
but when fetus grows, vertebrate grows and spinal cord stays same length. thus there is a relative downward displacement of the nerves

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27
Q

What would damage at L2 do?

A

damage all nerves inferior to L2, but not L2 itself

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28
Q

white vs grey matter

A

depends on the number of neurons. increased neurons = increased white matter.
white matter increases from sacral to cervial
Grey matter increases in the areas where there are extremities. (cervial and lumbar)

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29
Q

dermatome

A

area of skin innervated by a single spinal nerve

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30
Q

t4 dermatome

A

Nipple

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31
Q

t10

A

level of umblicus

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32
Q

Shingles

A

herpes virus, blood borm. infects skin and primary sensory neruons
transported by axoplastic transport to various areas of the skin, thus only certain segments appear and banded infections appear

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33
Q

Gray matter

A

Cell bodies

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34
Q

White matter

A

extended myelinated fibers

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35
Q

Cervical enlargement

A

C3-T2

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36
Q

lumbar enlargment

A

L1-S2

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37
Q

Spinal cord developent

A

neural plate (epidermis) flows and grows into a tube and gives rise to spinal cord and brain.

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38
Q

What do nueral crest cells give rise to?

A

primary sensory nuerons and schwann cells

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39
Q

If there is damage in dermatome (DRG), what would you expend in upper arm?

A

sensory loss along that single dermatome

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40
Q

If there is damage in periphery, what would you expect in upper arm?

A

if there is damage to both medial and lateral side of the skin. thus it is not damage to spinal cord.

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41
Q

sensory cutaenous field

A

when an area of skin is innervated by a single peripheral nerve, ie. lateral cutaneous femoral, which has nerve roots from multiple spinal levels.

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42
Q

myotome

A

the unilateral muscle mass receiving innervation from the fibers conveyed by a single spinal nerve

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43
Q

stretch reflex

A

hitting the tendon, stretches the tendon, muscle and spindle. Monosynpatic

1) this pulls the receptors springlike attachment appart and sends signal through primary sensory neuron through dorsal horn to ventral horn
3) synapases with lower motor neuron in ventral horn
4) signal transmits to bichep and causes muscle contraction

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44
Q

Calcaneal tendon spinal location

A

S1-2

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45
Q

Patellar tendon spinal location

A

L3-4

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46
Q

Biceps tendon spinal location

A

C5-6

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47
Q

Triceps tendon spinal locations

A

C7-8

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48
Q

Joint innervation

A

muscle or tendon crosses a joing, then the nerve that innervates the muscle also innervates the joint

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49
Q

what is referred pain?

A

when one area of the body is damaged, but pain occurs in other areas. This is due to joint innervation. For example, the knee is innervated by the obturator n. because of its contact with the gracilis. But the obturator also innervates the hip joint, so it could be referred pain with hip joint.

50
Q

Organization of ANS

A

Two neuron chain from CNS to target structure
2) preganglionic neuron will cell body in CNS
3) post ganglionic nueron with cell body in PNS
always motor neurons
innervates smooth or cardiac muscle

51
Q

where do post-ganglionic neurons come from?

A

Neural crest

52
Q

Where do pre-ganglionic neurons reside in the spinal cord

A

lateral horn

53
Q

sympathetic vs parasympathetic

A

sympathetic is fight or flight

parasympathetic is vegetative state

54
Q

where do sympathetic nervous system exit spinal cord

A

T1-L2

55
Q

where do parasympathetic nerves exit spinal cord

A

brainstem

56
Q

where does sympathetic NS axon originate?

A

lateral horn of spinal cord

57
Q

What is the path of a sympathetic NS signal?

A

origiantes in the lateral horn, passes through spinal nerve into ventral Sympathetic Chain Ganglion. synapses on post-ganglionic sympathetic neuron, where it joints and splits with the appropriate ventral and dorsal rami to innervate smooth or cardiac muscle.

58
Q

what is white ramus?

A

sympatheic NS path from spinal nerve to sympathetic chain ganglion.
myelinated axons.

59
Q

what is grey ramus?

A

past from sympathetic chain ganglion to ramus branches. (post-ganglion neuron)
unmyelinated

60
Q

Which is faster LMN or sympatheic nervous system

A

LMN becuase axons are myelinated

Post-Ganglionic axons have unmeylinated areas in gray ramus.

61
Q

where do preganglionic neurons originate

A

T1-L2 and migrate either upward or downward to synapse in sympathetic chain ganglia

62
Q

Parasympathetic NS

A

cranial and sacral outflow

63
Q

Erb- Duchenne palsy

A

upper brachial plexus injury (C5-C6)
increased angle between neck and shoulder
limb hangs to side in medial rotation, adducted shoulder, extended elbow
paralysis of deltoid, biceps, brachialis

64
Q

Klumpke paralysis

A

injury to lower brachial plexus
when limb is pulled upward
damage to C8 T1
claw hand

65
Q

Long thoracic nerve injury

A

serratus anterior pralysis

medial border of scapuls moves laterally and posteriorly from thoracic wall, winged appearance

66
Q

Spinal accessory nerve injury

A

ipsilateral weakness when shoulders are elevated

67
Q

thoracosdorsal nerve injury

A

nerve innervating latissimus dorsi

unable to raise trunk with upper limbs (climbing)

68
Q

suprascapular n. injury

A

due to fractures of clavial.
loss of lateral rotation of humerus
arm appears medially rotated, unable to abduct

69
Q

axillary n. injury

A

deltoid atrophies

70
Q

types of bones

A

Compact (cortical) or spongy bone

71
Q

cartilagineous bone

A

earliest bone structure

72
Q

primary ossification center

A

also known as diaphysis.

blood vessels along shaft that turns to cartilage

73
Q

secondary ossification center

A

epiphysis
osification at parts after birth.
right around epiphysial plate

74
Q

traction epiphysis

A

when growth happens outward due to the pulling of a muscle

75
Q

Synovial joint components

A

1) a fibrous joint capsule
2) synovial membrane lines joint
3) hyaline cartilage surrounds the bones in that area for protection
4) there is sometimes an articular disc between bones (meniscus)
Provides free movement and locomotion

76
Q

Plane joint:

A

gliding or sliding

77
Q

hinge joint

A

flextion or extension only, single axis

elbow joint

78
Q

saddle joint

A

abduction, adduction, flexion and extension, 1 planes (carpometacarpal joint)

79
Q

ball and socket joint

A

multiple axis and plans, AA, ML rotation, FE

80
Q

differences between skeletal, smooth, and cardiac muscle

A

skeletal: multinucleated, striated, voluntary contraction quick
cardiac, strong quick, involuntary contraction, intercalated discs
smooth: weak, slow, involuntary contraction

81
Q

skeletal muscle functions

A

stabalize joints, movement, generate heat

82
Q

perimysium of muscle

A

surrounds muscle fascicle

83
Q

epimysium

A

deep fascia that sorrounds groups of fascicles

84
Q

parallel arramgement

A

transverse cross-section for individual fibers

85
Q

pennate arrangement

A

oblique cross section

86
Q

sex differences of pelvis

A

females have wider pelvis., so they have a narrower femoral notch.
males have narrower pelvis with a wider femoral notch

87
Q

When does the innominate bone fuse?

A

ischiopubic ramus at 7-8 years

full fushion at 15-25 years

88
Q

what stabalizes the SI joint?

A

sacrospinous ligament, sacrotuberous ligament

89
Q

greater sciatic foramen boundaries

A

anterior sacroiliac lig.
sacrotuberous lig.
sacrospinous lig.
greater sciatic notch

90
Q

lesser sciatic foramen boundaries

A

spine of sichium, sacrotuberous lig., tuberosity of ischium

91
Q

contents of greater sciatic foramina

A

piriformis, sciatic n., posterior femoral cutaneous, superior gluteal vessels n., inferior gluteal n., internal pudendal vessels, pudendal n.

92
Q

contents of lesser sciatic foramen

A

obturaor internus, internal pudendal vessels, pudendal n.

93
Q

what is the covering on the acetabulum

A

lunate surface

94
Q

Genu valgum

A

knock knee,

95
Q

genu varum

A

bow-legged

96
Q

normal angle of inclination for hip joint

A

125° between neck of femur and shaft of femur

97
Q

coxa valga

A

inclination of hip joint greater than 125°
leads to genu varum
lengthens lower extremity
increased load on femoral head, decreases load on femoral neck

98
Q

coxa vera

A

angle below 125°
leads to genu valgum
shortens lower extremity
increased load on femoral neck

99
Q

Q angle

A

quadriceps angle

angle betwen shaft of femur and tibia.

100
Q

Q angle men vs women

A

Men is 12° and women is 17°

101
Q

angle of torsion

A

axis of femoral head compared to femoral condyles at knee.

noraml is 8-15°

102
Q

anteversion

A

increased angle of torsion, (anteriorly rotated) pigeon toed

103
Q

retroversion

A

decreased angle of torsion (postierly rotated) duck feet.

104
Q

hip disloaction

A

most commonly posteriorly due to MVA. could impact the sciatic nerve!

105
Q

Trendelenburg gait

A

weaked or ineffective gluteal medius or minimus muscle
if small weakness, pelvis tilts towards in swing leg.
if persistent weakness, shift center of gravity to overcompensate for weakness

106
Q

blood supply to femur neck

A

children is through obturator

adults through MCF

107
Q

what ligament does genu valgum stress?

A

Medial collateral lig.

108
Q

what ligament does genu varum stress?

A

lateral collateral lig.

109
Q

Menisci blood supply

A

blood supply is greatest in pheirpheral 1/3

110
Q

compartment syndrome

A

due to trauma, overuse, hemorrhage, or infection to produce edema or hemorrage within compartments
increased pressure on nerves and vessels
fasciotomy is performed

111
Q

anterior compartment syndrome

A

weakness in dorisflexion or toe extension, parasthesias over dorsum of foot

112
Q

ankle sprains

A

90% are inversion injuries

113
Q

grade 1, 2, 3

A

1: ligament streth
2: partial tear
3: complete rupture

114
Q

plantar fascitis

A

inflammaion by overuse or overstretch

115
Q

glenohumeral disloaction

A

inferior (anterior) joint capsule is not reinfrced by rotator cuff, so its is most vulnerable
could affec the art. n. and v. of brachial plexus

116
Q

olecranon bursitis

A

inflammed brusa around elbow

117
Q

colles fracture

A

fracture of distal radius and broken off styloid process of ulna

118
Q

volkmann’s sichemis contracture

A

results of compartment syndrome in hand if not releived.

119
Q

scaphoid fracture

A

most common carpal fracture

120
Q

carpal tunnel

A

median n. entrapment neuropathy

121
Q

what does the median recurrent innervate?

A

abductor pollicis brevis, flexor pollicis brevis, opponens brevis

122
Q

what nerves are at risk during axillary node removal

A

Lateral thoracic n. and thoracodorsal n.

► Med Misc 47 (11 decks)

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