Exam 3 Lecture 5 Flashcards
How does the Posterior Spinal Vein differ than the artery?
1 Large vein in the middle and 2 Large veins on either side [similar to artery placement]
- Right vertebral artery
- Left vertebral artery
- Anterior Spinal Artery
- Great Radicular Artery [Artery of Adamkiewicz]
- L side
- R side
Heart Pain
L side of body b/c R side has lower pressures
Appendix Pain
RLQ parietal pain; umbilicus [T10] visceral/referred pain
Parietal Pain:
Sharp, high localized; Connective Tissue Pain; Lateral Inhibition works
Ways to help the cord during Aortic clamping?
Give Anti-inflammatory and slow metabolic rate of the cord
Pathway of Ventral Spinocerebellar Tract?
*What type of info
Ventral Spinocerebellar Tract - Superior Cerebellar Peduncle - Cerebellum
*Motor/Sensory Info
What is Ischemic Reperfusion Injury?
*How do we get this
*How do we prevent this
When the Aorta has been clamped too long, it becomes ischemic; the clamp is let go too quickly and blood rushes to the arteries, causing for blood to pour in and hyper-oxygenation
*Prevent by assessing O2 status of Pt before and by unclamping the Aorta slowly
How many Anterior Spinal Arterial Feed Vessels in the thorax do we have?
2-3
Your hand is hit with a hammer. List what you would feel in order
Pressure of hammer - Sharp Pain - Dull/Achy pain
How many Radicular Arteries do we have per cord level?
4 [post/ant] x L and R side
Anterior Corticospinal Tract, again..
*% of motor pathway
Motor Cortex - Internal Capsule - Ventrobasal Complex - Brainstem - Anterior Corticospinal Tract - XOVER at level of cord to talk to motor neuron
*17%
Stomach Pain
Heartburn [referred to heart]
Equation for CPP with values
MAP - ICP [10 mmHg]
*Normal: 50-100 mmHg
Where do Posterior Spinal Arteries get their Blood From?
* 1-2 are Upper
*3 is Lower
- Vertebral Arteries
- Anterior Inferior Cerebellar Artery/ Posterior Inferior Cerebellar Artery
- Intercostal Arteries
In to Out, Radicular Artery connections
Aorta - Intercostal Arteries - Radicular Arteries - Spinal Cord
What % of Spinal Blood Supply is from Posterior Spinal Arteries
*Per each artery?
25%; 12.5% each
- Amygdala
- Hypothalamus [diencephalon]
- Cingulate Gyrus
Kidney Pain
Back [referred]
How many Anterior Spinal Arterial Feed Vessels total do we have?
5-7 total
Visceral Pain:
Dull, Achy; NO lateral inhibition; internal organ pain [usually referred]; poor localization
What % of Spinal Blood Supply is from Anterior Spinal Artery
75%
How many sets of Intercostal arteries do we have?
*How many total?
12; 24 total
Referred Pain:
Pain felt in body that is remote from actual pain site [usually visceral pain]
Where is the Abdominal Aorta located?
Abdominal Cavity
- Basilar Artery
- Vertebral Artery
- Anterior Spinal Artery
- Posterior Spinal Artery
- Anterior Radicular Artery
- Posterior Radicular Artery
At what level is the GRA?
*Range? 75%
*Absolute Range? 25%
T10
75%: T9-T12
25% T5-L5
What is the mesenteric artery attached to?
The Aorta
To repair an AA, what must the surgeon do?
*What must you be aware of: 2 things
*How to fix 2nd issue
Clamp the Aorta; watch for ischemia and increased CSF pressure by 10 mmHg [insert a drain]
At every level, we do not have 4 arteries feeding the cord; we are lucky to have _ artery/arteries?
1
Where does the Spinal Branch Sit?
On the Dorsal Root Ganglia
What is the Most important Anterior Feed Vessel?
*What is it branched off of, and which direction?
*Fraction of Spinal cord perfusion
Great Radicular Artery [Artery of Adamkiewicz]/GRA
*Branched off Aorta on L side
*2/3 spinal cord perfusion
Pathway of Dorsal Spinocerebellar Tract?
*What type of info
Dorsal Spinocerebellar Tract - Inferior Cerebellar Peduncle - Cerebellum
*Golgi Tendon Reflex/Muscle Spindles Information
How many Posterior Spinal Arteries do we have?
*Location
2; sits on either side of Posterior Median Fissure
The higher the GRA anatomically, the _ the AA repair will be?
Safer
- Thoracic Aorta
- Abdominal Aorta
- Intercostal Arteries
- Cingulate Gyrus
How many Anterior Spinal Arterial Feed Vessels in the neck do we have?
2
Where is the Anterior Spinal Artery Located?
Anterior Median Fissure/Sulcus
- Posterior Spinal Arteries
- Anterior Spinal Artery
- Vasocorona Artery [inferior is coronal arteries]
- Posterior Segmental Medullary Artery [Posterior Radicular]
- Anterior Segmental Medullary Artery [Anterior Radicular]
- Intercostal Artery
Top part of the aorta is called?
Thoracic Aorta
- Posterior/Dorsal SpinoCerebellar Tract
- Anterior/Ventral SpinoCerebellar Tract
3.
4. - Superior Cerebellar Peduncle
- Ventral Spinocerebellar Tract
- Inferior Cerebellar Peduncle
- Ventral SpinoCerebellar Tract
- Dorsal Spinocerebellar Tract
- Anterior Radicular Artery
- Posterior Intercostal Artery
- Thoracic Aorta
- Dorsal Branch
- Spinal Branch
Another name for Radicular Arteries? [anterior/posterior]
Segmental, Medullary
What is inferior to the Abdominal Aorta?
Renal Arteries
Liver Pain
From liver Capsule; liver does not pain sensor
3 Parts of the Limbic System, in Order
- Amygdala
- Hypothalamus [diencephalon]
- Cingulate Gyrus
What kind of Fibers are Skeletal Muscle, Muscle Spindles, and Tendons?
A, Alpha fibers
What sensors can DCML pathway contain?
A to D fibers
Biggest risk for Aortic X-clamp above the GRA?
Paralysis/ Loss of Motor Function
What fibers are located in the ANS?
B, C fibers
How many Anterior Spinal Arterial Feed Vessels in the lumbar do we have?
1-2
Lateral CorticoSpinal Tract, again..
*% of Motor Pathway
Motor Cortex - Internal Capsule - Thalamus [Ventrobasal Complex] - Brainstem - Decussation of Pyramids - Lateral Corticospinal Tract
*80%
What sensors are the DCML Lateral Inhibition
A, Beta Fibers
From In to Out, Intercostal Arteries
Intercostal Arteries - Dorsal Branch - Spinal Branch - Cord
