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Anat, phys, patho > Exam 2(CNS structures) > Flashcards

Exam 2(CNS structures) Flashcards

1
Q

Fiber classification

A

A- fastest and largest class(myelinated)
descending size of A-alpha>beta>gamma>delta

B- lightly myelinated neuron

C- Slowest and not myelinated
smaller and slower

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2
Q

Soma

A

Cell body of neuron
building and decision making center of the cell

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3
Q

Dendrites

A

Project from cell body to receive stimulus from nerve/or outside sitm
not myelinated
more positive the dendrite, the more excitable/receptive dendrite is

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4
Q

Axon

A

myelinated to send AP quickly
nodes of ranvier(AP jumps npode to node)
presynaptic terminal is the end of axon

hillock for inhibition

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5
Q

Axon Hillock

A

Suppress neuron activity here(only inhibitory)
GABA dependent–receptors on axon hillock increase chloride permeability and increase chloride permeability will inactivate cell

No GABA/no inhibition at the hillock

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6
Q

Glial Cells

A

Large and small, proliferative
astrocytes
ependymal cells
oligodendrocytes/schwann cells
microglia

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7
Q

Microglia

A

Digest what needs to be broken down
macrophage of CNS
smallest glial cell

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8
Q

Astrocytes

A

Big part of BBB/technically not

astrocytes attach to endothelial cells/capillaries(BBB) in CNS and tight junctions keep barrier
helps maintain electrolytes and pH in the CSF

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9
Q

Ependymal Cells

A

CNS cells with cilia
motility structures move CSF down the cns and is pushed up to brain

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10
Q

Oligodendrocytes

A

Myelin producing cells in CNS
Schwann cells are PNS counterpart

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11
Q

Multipolar Neuron

A

Decision making cell
take in a lot of info through the dendrites on one side/then soma/then axon/presynaptic
Will send signal through axon
Decide and communicate

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12
Q

Bipolar

A

specialized sensory cell
Dendrite, axon, soma, axon, presynaptic
no decision making/just sense and send
photoreceptors of retina/optic nerve

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13
Q

psaudounipolar

A

sensory function, send through cell
sensory cells in spinal cord/immediately outside are pseudounipolar
just a messenger
found near spine/cns
soma just for support of structures in cell

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14
Q

Nociceptor

A

pain receptor for transducing pain/sensing pain

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15
Q

mechanoreceptor

A

physical disturbance turns to electrical signal
sense types of pressure

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16
Q

Chemical synapses

A

electrical signal relayed by chemical intermediary called neurotransmitter(ACh)

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17
Q

Planes/cross sections of the body

A

Sagittal–left from right
Coronal–anterior from posterior
horizontal plane–superior from inferior
Oblique–all other angles

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18
Q

CNS divisoins

A

Telencephalon–cerebral hemispheres and cerebral cortex

Diencephalon–inner brain/between telencephalon and brain stem includes
-thalamus-relay center between cerebreal hemispheres and rest of body
-hypothalamus-under thalamus/deep to thalamus/ sensory area and controls
-body temp
-osmol
-infection

Brain stem
-midbrain-mesencephalon(top of brain stem)
-pons-olive big structure
-medulla oblongata

spinal cord

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19
Q

Frontal Lobe

A

thinking/inner thought

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20
Q

Parietal lobe

A

sensation processing behind frontal lobe

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21
Q

Occipital lobe

A

Rear of brain/primary visual cortex

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22
Q

Temporal Lobes

A

lateral sides/processes hearing/comprehension/music

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23
Q

Central sulcus

A

groove between frontal/parietal

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24
Q

temporal/temporolateral fissure

A

below central sulcus/
splits temporal from frontal and parietal lobes

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25
Q

Longitudinal fissure

A

Deep groove splitting left and right/whole outer brain split

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26
Q

Precentral gyrus

A

primary motor cortex/rear part of frontal lobe

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27
Q

Post-central gyrus

A

anterior part of parietal lobe
somatosensory area

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28
Q

Corpus callosum

A

pathway of white matter between right and left brain/important communication

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29
Q

Grey matter/white matter of brain and why

A

grey matter on outside/inner white matter
grey matter has lots of thinking and lots of blood flow/thats why its on outside even though less protected than white matter inside

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30
Q

Lamina 10

A

grey matter in splitting middle of spinal cord
has central canal in middle for CSF movement down cord

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31
Q

Grey matter of spinal cord

A

Dorsal horns of back–recieve sensory information through rear

Ventral horns-front grey matter and sends motor function/wider than the dorsal horn

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32
Q

Anterior white commissure

A

area of white matter in front of lamina 10/middle of spinal cord

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33
Q

Posterior median sulcus/fissure spinal cord
Anterior median sulcus/fissure

A

posterior-deep groove in back very narrow
anterior-front deep grove/wider than back for large arterial blood vessel

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34
Q

Spinal cord arterial blood supply

A

posterior spinal arteries(2) are leteral from central

anterior spinal artery is midline and up anteror central sulcus(sulcal arteries go into sulcus)

Intercostal artery had blood flow directed toward cord

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35
Q

Spinal cord venous drainage

A

posterior spinal vein/anterior spinal vein both midline

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36
Q

Descending pathway of motor function

A

starts in frontal lobe/at precentral gyrus

descends through white matter of brain through midbrain/into lateral spinal cord/then into ventral horn and out of cord/down axons of the anterior rootlet into anterior root and into spinal nerve

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37
Q

Ascending sensory pathway from spinal nerve

A

spinal nerve feeds into posterior root with ganglion/into posterior rootlet/into grey matter of ventral horn/then sent to ascending portions of spinal cord white matter(mostly ventral/posterior and outside edges)/ ends in parietal lobe at postcentral gyrus

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38
Q

Spinal ganglion of posterior root

A

Pseudounipolar sensory neuron bodies create this “lump”
recieve signal and then axon sends through posterior rootlet to dorsal horn of grey matter

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39
Q

Descending spinal tracts

A

motor pathways are in lateral and frontal/anterior aspect of spinal cord

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40
Q

Cervical Nerve anatomy

A

7 vertebrae/8 spinal nerves come off cord above corresponding vertebrae except 8 which comes below C7

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41
Q

thoracic/lumbar spinal nerve anatomy

A

Thoracic has 12 vertebrae/12 spinal nerve pairs that come under corresponding vertebrae

lumbar has 5 vertebrae with 5 spinal nerve pairs under corresponding vertebrae

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42
Q

Sacrum Nerve anatomy

A

5 vertebrae that fuse into one solid bone/5 nerve pairs named for “vertebrae” above

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43
Q

Coccygeal spinal nerve anatomy

A

Starts as 4 vertebrae then fuses into 2 vertebrae/last pair of spinal nerves

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44
Q

Spinal curvature

A

Cervical–convex from front/lordosis

Thoracic–concave from front/kyphosis

Lumbar–convex from front/lordosis

Sacrum/coccygeal–concave from front/kyphosis

Pathologic curvature is scoliosis to R or L/ and could be over curved at any level/kyphoscoliosis is both

babies are born with solely kyphotic curvature

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45
Q

Basic Vertebral Anatomy

A

Vertebral Body

Vertebral Arch(pedicle is base and lamina is arch)

Superior Articular process(fits with inferior)

Inferior articular process

Transverse Process(lateral)

Spinous process(posterior)

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46
Q

Where does the spinal nerve leave vertebrae(generally)

A

Leaves below pedicle in inferior vertebral notch

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47
Q

Unique C-spine vertebrae features

A

Bifid C2-5(50% 6)

Transverse foramen for vertebral arteries(except C7 has foramen but artery doesn’t pass through)

Transverse process has sulcus for spinal nerves(come out above corresponding vertebrae)

Larger vertebral foramen/smaller vertebral body

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48
Q

C1 name and details

A

“Atlas”

No vertebral body (not much weight)/posterior tubercle instead

Anterior tubercle has facet for dens(cylinder structure on C2)

Superior articular facet-fits the base of the skull

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49
Q

Base of skull features

A

Foramen magnum(large opening at base)

Occipital condyles(part of occipital bone) project downward(sit in superior articular facet)

Atlantooccipital ligament–anterior and posterior/both connect through the foramen magnum

50
Q

Skull/Spine Articulation

A

C2 had dens which projects into C1 and sits in anterior tubercle in facet of dens/skull sits on C1 in the superior articular facet

51
Q

C2 special features

A

Dens–projection from anterior side that fits into C1(facet of dens), anterior articular facet on dens sits there

52
Q

Anterior Longitudinal ligament

A

along anterior vertebral bodies from skull to sacrum/strong and not flexible

53
Q

Posterior longitudinal ligament

A

posterior to vertebral body (inside vertebral foramen) and skull to sacrum

54
Q

Inter-transverse ligament

A

Transverse process to transverse process

55
Q

Supraspinous ligament

A

spinous process tip to spinous process tip(superficial edge)

56
Q

Interspinous ligament

A

connects spinous process to spinous process midline/not in lamina portion of vertebral arch

57
Q

ligamentum flava

A

Connects vertebral arch to vertebral arch

stretchier than other ligaments

feels different with a needle because not as fibrous

used as a feel marker for needle access

58
Q

Flava

A

opening between ligamenta flava, this is important because needle approach must be slightly offset to hit ligamentum

59
Q

Neck ligament specialization

A

Expansion of posterior ligaments

Interspinous ligament expansion and is called nuchal ligament/same but bigger

60
Q

Anterior atlantooccipital membrane

A

connects C1 arch to opening of foramen magnum

61
Q

External occipital protuberance connection

A

nuchal ligament connects here at back of head

62
Q

Vertebral Prominenece

A

bump at base of neck

C7 by textbook
T1 spinus process is generally larger

63
Q

T-Spine number of vertebrae
curve
unique features

A

12 vertebrae
kyphotic curve
Ribs come off each of the T spine at costal facets
downward spinal processes
rounded R side of heart vertebrae, flat L side for aorta

64
Q

Parts of the sternum

A

Manubrium
body
xiphoid process

65
Q

Categorize ribs

A

True ribs–1-7 rib to cartilage to sternum

False ribs– 8-10 connect to cartilage of rib 7

Floating ribs–one connection and do not connect to the sternum or cartilage

66
Q

Describe the Rib Vertebrae connection

A

Costal facet on vertebral body
superior sits with matching rib, inferior with rib below/connects to head of rib
transverse process has costal facet/connects to costal tubercle

67
Q

Lumbar spine vertebrae characteristics

A

Spinous process is straight back so can access CNS
large vertebral body because weight
lordodic

68
Q

Sacrum Characteristics

A

Promontory–disk sits here to support L5
fused together so sacral foramina is where nerves come out(as opposed to intervertebral foramina)8 total/4 front/4back
continuous sacral canal
sacral hiatus is hole at bottom where coccygeal spinal nerve leave
sacral conus is projectoins off hiatus

69
Q

Crests of Sacrum

A

Median is middle
lateral is outside formed by transverse processes fusing
medial is superior/inferior process fusing

70
Q

Coccygeal Vertebrae

A

1 stays on own
2-3-4 fuse together to form 2 total vertebrae

71
Q

Iliac crest point on spine

A

L4

72
Q

Posterior superior iliac spines

A

prominent ridges on lower back
marker to access S2 foramens(1cm midline, 1cm down)
blocks of lower limbs

73
Q

Top front of pelvis

A

anterior superior iliac spine

74
Q

Inguinal ligament

A

attaches superior iliac spine to pubic tubrecle

75
Q

Iliolumbar ligament

A

connects L4/5 transverse process to back of pelvis

76
Q

pubic symphysis

A

cartilage between two sides of pelvis

77
Q

Supraspinous ligament

A

tip of spinous process to coccyx

78
Q

bottom set of hips

A

greater trochanter part of femur

79
Q

Parts of intervertebral disk

A

annulus fibrosus is is tough surrounding criss crossed anteriorly, less stable posteriorly

nucleus pulposus–gel like middle of intervertebral disk

no intervertebral disk sacrum once fused

80
Q

Hyaline Cartilage

A

end plate on vertebral body

81
Q

Why are disk herniations possible/why do they hurt so much

A

back nucleus pulposus weaker and spinal nerve in intervertebral foramen is squished by the nucleus pulposus pushing back

82
Q

3 options for disk herneation

A

Discectomy–remove disk

spinal fusion–stabilize vertebral body by connecting two but adds stress to surrounding disks–successful but lasts only 6-7 years

Laminectomy–remove portion of lamina to relieve compression but not very successful

83
Q

Pia mater

A

tight surrounding to neurons/glial cells

84
Q

Arachnoid mater

A

superficial to pia but room for CSF and large blood vessels, possible subarachnoid arterial bleeds

85
Q

Dura layer

A

superficial to arachnoid layer and there is no room between(unless a subdural venous bleed)

86
Q

Where does the dura layer extend to

A

extends to beginning of spinal nerve and down to sacral foramen?

87
Q

Epidural space

A

adipose tissue with venous blood vessels right outside dura

88
Q

Epidural considerations

A

park needle in blood vessel and fatty tissue area to shut down spinal nerves

lipophilic anesthetic could be taken up here which will take longer but will last longer because saturated

use section of spine without spinal cord

89
Q

Spinal Cord goes from medulla to

A

L1, called the conus medullaris

90
Q

two enlargements of spinal cord and locations

A

Cervical enlargement C3-C6
motor sensory input for upper extremities

Lumbar Enlargement- T11-L1
motor and sensory neurons for legs

91
Q

Cauda Equina

A

Inferior nerve roots below conus medullaris

“horses tail”

92
Q

Filum Terminale internum
Filum Terminale externum

A

internum is extension of pia mater and connects end of spinal cord to dural sac to keep cord length

externum–bottom of dural sac (S2) anchor to sacrum bottom

93
Q

dural sac

A

area between conus medullaris and houses cauda equina, extends to S2 from L1

94
Q

Newborn V Adult conus medullaris

A

L1 in adult/L3 in newborn but spine grows faster than cord

95
Q

Lumbar cistern

A

area below conus medullaris

CSF and spinal nerves but no spinal cord, CSF does not refresh as frequently here but is easier to access for lumbar puncture

96
Q

Spinal puncture/procedure areas

A

between L3/L4
or L4/L5

or can access sacral hiatus

Posterior sacral foramina–S2
use posterior superior iliac spine and go 1cm down/1cm midline

97
Q

What degree angle should you approach spine/epidural

A

15 degrees should be enough to catch ligamentum flavum so as to not go to far

98
Q

Connective tissue surrounding CNS

A

pia mater–directly close to glial cells/neurons

arachnoid mater–superficial to pia but has room for large blood vessels in CNS and spinal fluid under it

dura mater-superficial to arachnoid, subdural isnt truly a space. sinus’s of the brain are made from this

99
Q

Contents of epidural space

A

fatty and has venous blood vessels
lipophilic anesthetics will take more and last longer because of adipose tissue

100
Q

Spinal cord start and end

2 enlargements

A

Spinal cord goes from medulla to L1
end of spinal cord is conus medullaris

Cervical enlargement for upper extremities is C3-C6

Lumbar enlargement T11-L1

101
Q

Dura layer covers–

A

Brain, spinal cord, down to bottom of sacrum and to spinal nerves(rootlets covered)

102
Q

Cauda equina

A

Dorsal and ventral nerve roots that come off conus medullaris

103
Q

Arachnoid trabeculae

A

Keep the space between pia and arachnoid/ creating the area for CSF and vasculature

104
Q

CSF pH/buffer system/Na/Cl/K/Mag/Glucose

quantity/how much is produced in a day

A

7.31
Co3- as buffer(lower than plasma)
140 Na
140 Cl(match Na)
40%less K
higher Mag
60 mg/dL glucose(90 in body)
150mL total
produce 500mL in a day mostly refreshing brain while lumbar cistern is slower

105
Q

Ependymal cell

A

Separate CSF from CV system
Na»into cell>pumped into CSF
Cl»into cell>follows Na
H20»into cell>follows Na

all dependent on Na/ATP pump

106
Q

Choroid plexus function and location

A

Many ependymal cells that produce CSF
in each of the 4 ventricles of the brain

107
Q

CSF flow from Lateral ventricles

A

interventricular foramen of monroe

into ventricle 3

into cerebral aqueduct of sylvis
(most likely to be blocked)

into ventricle 4

108
Q

exit points of CSF from brain(ventricle 4)

A

Central canal to spinal cord

Lateral apertures/ foramen of lushka

median aperture/foramen of magendie
goes to cerebellum

109
Q

Communicating v noncommunicating hydrocephalus

A

communicating–pathways are okay but the blockage is outside the ventricles/apertures

non-communicating–blockage within the system

110
Q

Names and location of cranial blood drainage

A

Cranial sinuses

Superior sagittal sinus–top and midline
inferior sagittal sinus–below superio/midline
straight sinus–end of inferior sinus
straight sinus and supeiror sinus form confluence of sinuses
transverse sinus–exit point of confluence of sinus to sigmoid
sigmoid sinus sharp turn to jugular foramen

and down internal jugular

111
Q

Falx cerebri
Tentorium cerebelli

A

Falx cerebri–connective fan like tissue between cerebral hemispheres
Tentorium cerebelli–connective tissue supporting occipital with cerebellum below

112
Q

Arterial blood supply of brain

A

2 vertebral arteries feed back of brain

2 internal carotid arteries feed anterior brain

2 external carotid feed superficial structures

amounts to 750mL/min blood flow
about 15% of CO
50mL/min/100g of tissue
flow will match metabolic demand

113
Q

Distribution of blood flow to brain

A

80% blood flow feeds grey matter 20%feeds white matter

114
Q

Circle of Willis arteries

A

Middle cerebral artery fed by carotid

Anterior cerebral artery/specifically A1 portion/precommunicating
connect left and right with anterior communicating artery

Posterior cerebral artery/specifically P1/precommunicating/
connected to middle cerebral artrey by posterior communicating artery

115
Q

Cerebellar Arterial blood supply

A

Superior cerebellar artery–perfuses front and top of cerebellum/comes of basilar artery

anterior inferior cerebellar artery–comes off basilar artery

posterior inferior cerebellar artery comes off vertebral arteries for lower cerebellum

116
Q

Largest Deep artery of brain

A

middle cerebral artery branches out and would create massive amount of damage

117
Q

Area of bran perfused by anterior, middle, and posterior cerebral artery

A

Anterior–central line
Middle–lateral and central
Posterior
occipital and lower

118
Q

Subarachnoid hemorrhage

A

ruptured aneurism
infiltrate glial and neural cells
progress quickly/ “hemorrhagic strokes”

118
Q

Subdural Hematoma

A

Generally venous/dura wall of sinous rupture
slower to develop

118
Q

Epidural hematoma

A

Above dura mater
most likely traumatic/skull fracture
quick because arterial blood supply in skull

119
Q
A

Anat, phys, patho (3 decks)

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