Exam 2 - Brain and Spine Anatomy Flashcards
Directional Nomenclature
What are superior and inferior?
- Superior - higher in altitude or towards head
- Inferior - lower in altitude or towards feet
Directional Nomenclature
What is dorsal and ventral?
- Dorsal (posterior) - back of body (dorsal fin on a shark)
- Ventral (anterior) - front of the body
Directional Nomenclature
What are medial and lateral?
- Medial - towards midline
- Lateral - away from midline
Directional Nomenclature
What are rostral and caudal?
- Rostral - up and to the front (beak)
- Caudal - down and to the rear (tail)
Directional Nomenclature
What is distal and proximal?
- Distal - further from CNS
- Proximal - closer to the CNS
Directional Nomenclature
What is superficial and deep?
- Superficial - towards skin
- Deep - away from skin, towards tissue
Directional Nomenclature
What is the sagittal plane?
Seperates the left and right sides of the body
Directional Nomenclature
What is the coronal plane?
Seperates the anterior and posterior parts of the body
Directional Nomenclature
What is the horizontal plane?
Seperates superior and inferior
Directional Nomenclature
What is the oblique plane?
Any plane this is at an odd angle.
What region is indicated by 1 on the figure below?
The Telencephalon
Consists of cerebral cortex
What region is indicated by the 2 in the figure below?
The Diencephalon
Thalamus and hypothamalus
What is the function of the thalamus?
Relay center, sends communication signals
What is the function of the hypothalamus?
Osmoreceptors, temperature sensors, infection sensors
What region is indicated by the 6 on the figure below?
The midbrain (mesencephalon)
What are the components of the brain stem?
- Midbrain (mesencephalon)
- Pons
- Medulla oblongata
What is a groove and deep groove called in the brain?
Sulcus and fissure
What is a gyrus?
A lump of tissue that is seperated by sulcus
What structure is denoted by 2 on the image?
Central Sulcus
Seperates frontal and parietal lobes
What lobe does thinking occur in?
Frontal lobe
What lobe does sensation occur in?
Parietal lobe
What structure is denoted by 9 in the image below?
The Temporolateral Sulcus
Seperates temporal lobe from frontal and parietal lobes
What structure is denoted by purple line on the image below?
The Longitudinal Fissure
Seperates left and right hemispheres
What lobe does vision processing occur in?
Occipital lobe
What lobe does auditory processing happen in?
Temporal lobe
What structure is indicated by 6 on the image below?
Diencephalon
What structure is indicated by 9 on the image below? What is its function?
Corpus Callosum.
The corpus callosum connects the left and right sides of the brain.
What region is indicated by 7 on the image below?
Wernicke’s area; language comprehension and intelligence.
What region is indicated by 9 on the image below? What lobe is this located in? Why is that important?
Broca’s area; word formation.
Broca’s area is in the frontal lobe. Decision making regarding what words to say occurs in the front lobe because you have to “think before you speak”.
What structure is denoted by 1 on the picture? What is this areas function?
Precentral Gyrus
Primary motor cortex
What structure is denoted by 3 on the image?
Post Central Gyrus
Somatosensory cortex
What region is indicated by 8 on the image below?
Limbic Association Area
Behavior, emotions, and motivation region
What is contained in white matter?
Myelinated neurons and axons (sending and recieving messages)
What is contained in grey matter?
Unmyelinated neurons and cell bodies of multipolar neurons (decision makers)
What structure of the brain is being indicated by 7 on the image below?
White matter
What structure is indicated by 8 on the image below?
The cerebral cortex (aka gray matter)
Blood supply is close to grey matter
What structure is indicated by the green box in the figure below? What does this structure do?
- Lamina X (10)
- This structure is the “crossover” point of the spinal cord. Similar to the Corpus Callosum of the Brain.
What structure is indicated by the pink box in the figure below? What does this structure do?
Anterior White Commissure (This is a crossover for communication between left and right sides of the CNS).
What is the structure that seperates the posterior left and right sides of the spinal cord?
Posterior median fissure
What is the structure seperates the left and right sides of the anterior spinal cord? Why is it wider than its posterior counterpart?
Anterior median fissure
Much wider than posterior median fissure due to presence of anterior spinal artery.
What structure is indicated by the blue arrow in the figure below? What does this structure do?
The central canal of the spinal cord. This structure carries CSF through the cord via cilliated cells from the brain to the end of the cord.
What are the areas circled below? What is important about this?
Dorsal horns of the spinal cord
Sensory information enters here from posterior rootlets
What are the areas circled below? What is important about these?
Ventral horns of spinal cord
Motor function exits here
Where does the blood supply to the spinal arteries come from?
Branches of the intercostal arteries
What structure is noted by 1 below?
How many of these are there?
How much of the spinal cord is perfused by these?
- Posterior Spinal Artery
- Two
- 25%
What structure is noted by 5 below?
What is the name of the fissure that this artery runs in?
What percent of blood flow to the spinal cord flows from here?
- Anterior Spinal Artery
- Anterior Median Fissure
- 75% of Blood Flow
What structure is indicated by 1 on the figure below?
Posterior Rootlets
What direction does information travel in the blue shaded spinal tracts? What information is carried? Is this efferent or afferent?
- Ascending spinal tracts (PNS → CNS)
- Sensory information is carried
- These are afferent
Information enters the dorsal horn (grey matter) and then moves over to the white matter to ascend to the brain
What structure is indicated by 3 on the figure below?
Spinal Nerve
Anterior and posterior information combined
What structure is indicated by 4 on the figure below?
Anterior root
What structure is indicated by 5 on the figure below?
Anterior Rootlets
What structure is indicated by 2 on the figure below? What is it comprised of?
- Posterior Root Ganglion
- Collection of pseudounipolar cell bodies
Why is there no anterior spinal root ganglion?
Because they are comprised of motor neurons whose cell bodies are within the ventral horn of the spinal cord.
What direction does information travel in the red/orange shaded spinal tracts? What information is carried? Is this efferent or afferent?
- These are descending spinal tracts (CNS → PNS)
- Motor information
- These are efferent
How many cervical vertebrae are there? How many cervical spinal nerves are there and where are they located?
- 7 vertebrae
- 8 spinal nerve pairs
- C1 nerve above C1 vertebrae, C2 below C1, C3 below C2, etc.
How many thoracic vertebrae are there? How many spinal nerves are there and where are they located?
- 12 vertebrae
- 12 spinal nerve pairs
- Each nerve underneath each vertebrae
How many lumbar vertebrae are there? How many spinal nerves are there and where are they located?
- 5 vertabrae
- 5 pairs of spinal nerves
- Each nerve is located underneath each vertebrae
How many sacral vertebrae are there? How many spinal nerves are there and where are they located?
- 5 vertebrae at birth that fuse into 1
- 5 pairs of spinal nerves
- Located underneath where each vertebrae origanlly was
Where in the spine do we have lordosis or anterior curvature (convex)?
Cervical and lumbar spine
Where in the spine do we have kyphosis or posterior curvature (concave)?
Thoracic and sacral spine
What structure is indicated by 1 on this figure?
Vertebral Body
Smaller in cervical than lumbar (not supporting as much weight)
What structure is the arrow pointing to?
Lamina
What structure is the arrow pointing to?
Pedicle
What is the brown structure within the box?
Vertebral arch
Encases the spinal cord
What structure is indicated by 5 on this figure?
Spinous Process
What structure is indicated by 4 on this figure?
Transverse Process
What structure is indicated by 2 on this figure?
Superior Articular Process
Connect vertebrae
What structure is indicated by 7 on this figure?
Inferior Articular Process
Connect vertebrae
What is the circled structue? What is its function?
Vertebral notch, where spinal nerves exit spine
What structure is indicated by 6 on this figure? What is the grey section?
- Inferior Articular Facet
- Cartiledge inside of the joint
What structure is indicated by 7 on the figure below?
Superior Articular Facet
What is the circled structure?
Vertebral foramen
Larger at the top of the spine than at the bottom
What is the name of the circled structure? Where are these located?
- Bifid spinous process
- C2-C5, C6 (50% of people), C7 (0.3% of people)
What is the name of the circled structures? What goes through these? What is the exception?
- Transverse foramen
- Vertebral arteries
- C7 has transverse foramen but the vertebral arteries do not pass through them
What is the circled structure? What is its purpose?
- Transverse process sulcus
- Spinal nerves pass through
What structure is indicated by 4 on the figure below? Which vertebrae is this?
Anterior Arch
C1, has no vertebral body
What structure is indicated by 5 on the figure below?
Anterior Tubercle
What structure is indicated by 6 on the figure below?
Facet for Dens
What is the name of the structure indicated in the picture below? What structure is indicated by 1 on the figure? What is this structures function?
- C2 (Axis)
- The Dens Process
- Connects C1 and C2, acts a swivel
What structure is indicated by 2 on the figure below?
The Posterior Arch
What structure is indicated by 3 on the figure below?
The Posterior Tubercle
C1 does not have spinous process
What structure is indicated by 7 on the figure below? What does this connect to? What does this structure allow to happen?
- Superior Articular Facet
- The occiptal condyles
- Nodding of the head
What is the indicated structure?
Foramen Magnum
What are the indicated structures?
Occipital condyles
What is the indicated structure?
Occiptal bone
What structure is indicated by 4 on the figure below?
Inferior Articular Facet of the Axis
What structure is indicated by 8 on the figure below?
Superior articular facet of the Axis
What structure is indicated by 9 on the figure below?
Anterior Articular Facet of the Dens
What structure is indicated below?
Posterior articular facet of C2
What structure is indicated by 7 on the figure below?
The Transverse Foramen of the Axis
What structure is indicated by the 1 on the figure below? What should be known about this structure?
Anterior Longitudinal Ligament
This structure runs the length of the spinal cord, adding strength and stability to the vertebral bodies.
What is the indicated structure?
Posterior longitudinal ligament
What structure is indicated by the 4 on the figure below?
Intertransverse Ligaments
What structure is indicated by the 5 on the figure below?
Supraspinous Ligament
What structure is indicated by the 3 on the figure below?
Interspinous ligaments
What structure is indicated by the 2 on the figure below? What sets this ligament apart from the other spinous ligaments? What procedure involves this ligament?
- Ligamenta Flava
- This ligament is stretchy and made of elastin as opposed to collagen.
- Epidurals pierce this ligament to reach the epidural space of the spinal cord.
What is significant about the indicated structure?
Many people have incomplete fusion of the ligamentum flava at midline. This can make it hard to determine needle depth if going midline, may be better to approach at an angle of 15.
What structure is indicated by the 10 on the figure below? What is it comprised of?
- Nuchal Ligament
- Interspinous ligaments
What is the indicated structure?
Anterior alanto-occipital ligament
What is the indicated structure?
Posterior alanto-occipital ligament
What is the indicated structure? What connects here?
- External occipital protuberance
- The nuchal and supraspinous ligaments
What is the marker called? What creates it?
- Vertebral prominens
- C7 spinous process (textbook answer), T1 spinous process is larger and probably contributes more
What 2 structures are circled?
Superior and inferior costal facets
What is the indicated structure?
Manubrium
What is the indicated structure?
Xiphoid process
What is the indicated structure?
Body of the sternum
What is the circled structure?
The costotransverse joint. The costal tubercle of the rib connects to the costal facet on the transverse process.
Describe the shape of the thoracic vertebral bodies?
They are heart shaped, the left side is flatter because of the aorta.
What is the circled structure? What runs through this?
- Intervertebral foramen
- spinal nerves exit
What structure is indicated by 1 in the figure below?
The Sacral Promontory
What structure is indicated by 3 in the figure below? What is indicated by these structures?
Transverse Lines of the Sacrum
This is where the vertebrae were prior to fusion
What structure is indicated by the 1 below?
The Sacral Canal
What structures are indicated by 4 in the figure below? What should be known about these structures?
These are the Anterior Sacral Foramina
The spinal nerves exit here
What structure is indicated by the 11 below? What should be known about these structures?
Posterior sacral foramina
The spinal nerves that exit here
What structure is indicated by the 6 below? How was this formed?
- Median Sacral Crest
- Fusion of the spinous processes
What structure is indicated by the 5 below? How is it formed?
- The Lateral Sacral Crest
- Fusion of the transverse processes
What structure is indicated by the 7 below? How is it formed?
- Medial Sacral Crest
- Fusion of the superior and inferior articular processes
What structure is indicated by the 8 below? What comes out of this structure? What is important to know about this structure for anesthesia?
Sacral Hiatus
Coccygeal nerves and S5 nerves exit here
Anesthetics can be given here to block lower body innervation
What structures are indicated by the 9 below?
Sacral Cornua
What structure is indicated by 1 on the figure below? If a line was drawn between this structure on the identical structure on the right, what landmark would be indicated?
Iliac Crest
A line drawn from crest-to-crest would sit right on the L4 vertebral body, used for epidurals
What structure is indicated by the 3 below? What is this marker used for?
- Posterior-Superior and Inferior Iliac Spines
- Find marker, drop down and over 1 cm to access S2 sacral foramina
These are easily visible
S1 foramina is opened to the side and more difficult to hit
What structure is indicated by the 1 below?
Anterior Superior Iliac Spine
What structure is indicated by the 2 below?
Anterior Inferior Iliac Spine
What structure is indicated by the 8 below?
Pubic Tubercle
Not really palpable
What structure is indicated by the 11 below? What should be known about this ligament? Where at the attachments for this ligament?
Inguinal Ligament
This ligament is palpable even in obese patients, obese patients may have fold over this.
This ligament connects the anterior-superior iliac spine and the pubic tubercle
What structure is indicated by the 2 below? What does it connect?
- Iliolumbar Ligament
- L4 and L5 transverses to posterior pelvis
What structure is indicated by the 5 below?
Pubic Symphysis
What ligament is represented by 1 on the figure below?
Supraspinous Ligament
What structure is indicated by the 1 on the figure below? Where is it stronger?
Anulus Fibrosus
Stronger anteriorly due to crosshatch pattern
What structure is indicated by the 2 below? What is it’s purpose?
Nucleus Pulposus
Gel-like providing shock absorption and flexibility
What structure is indicated by the 3 below?
Hyaline Cartilage End-Plate
What structure is indicated by the 1 below? What should be known about the anterior of this structure?
Anterior Anulus Fibrosus
It is much stronger than the Posterior Anulus Fibrosus
What pathophysiology is indicated below? Why do these usually occur postero-laterally? How can this be fixed?
- Disc Herniation (Nucleus pulposus herniation out of anulus fibrosus) with impinged nerve
- The anulus fibrosus is weaker postero-laterally.
- Discectomy, vertebral fusion, or laminectomy (creates more space in intervertebral foramen for impinged nerve)
