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A/P > Lecture 10/7: Spinal Arterial Circulation > Flashcards

Lecture 10/7: Spinal Arterial Circulation Flashcards

Test 2

1
Q

How many arteries run longwise on the spine? What are they called?

A

3 total

2 posterior spine A

1 anterior spine A

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2
Q

What do the posterior spinal artieries feed into?

A

Vertebral arteries
Arterior inferior cerebellar arteries
posterior inferior cerebellar arteries

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3
Q

Where are the posterior arteries located?

A

L/R sides of the posterior sulcus

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4
Q

How much blood flow to the cord are the posterior spinal arteries reposible for?

A

25%

12.5% each

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5
Q

Compare the anterior median fissure to the posterior median sulcus

A

Anterior median fissure is much larger/wider and able to hold a larger artery

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6
Q

How much blood flow to the cord is the anterior artery reposible for?

A

75%

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7
Q

What artery feeds into the anterior and posterior spinal arteries?

A

Radicular arteries

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8
Q

Where does radicular arteries get blood from?

A

Intercostal arteries

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9
Q

What are the interchangeable names for radicular arteries?

A

Segmental Arteries
Medullary Arteries
Radicular Arteries

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10
Q

What are the Coronal Arteries?

A

“Crown” = Coronal

On the outer surface of the cord, similar to collateral circulation but NOT LIKE CIRCLE OF WILLIS not not accommodate for blockage

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11
Q

How many anterior radicular Arteries do you have in the C-spine?

A

2

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12
Q

How many anterior radicular Arteries do you have in the T-spine?

A

2-3

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13
Q

How many anterior radicular Arteries do you have in the L-spine?

A

1-2

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14
Q

T/F: You will have at least 1 radicular artery at level level of the spine

A

F

They are irregular
You will have 1 on the L or R or Front or Back every few levels and it varies per person

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15
Q

Where there are arteries there are likely________

A

veins

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16
Q

How many spinal veins do we have longwise?

A

4

3 posterior (1 is midline)

1 anterior

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17
Q

You have a ________ at every level of the spine

A

Spinal branch

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18
Q

Describe the spinal branch

A

They are at every level in the spine but they branch off in different way around the ribs

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19
Q

Where is the spinal branch?

A

Sits on top of the dorsal root ganglia

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20
Q

What feeds all the spinal arteries associated with the ribcage?

A

Thoracic Aorta

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21
Q

What do the Mesenteric Arteries supply blood to?

A

Small intestines

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22
Q

What are the 2 parts of the aorta?

A

Thoracic aorta
Abdominal aorta

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23
Q

What do the intercostal arteries do?

A

Keeps ribcage healthy & perfused

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24
Q

Where do you clamp when you have an aortic aneurysm?

A

Right above it

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25
Q

What is the source of blood for ALL the radicular arteries?

A

Aorta

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26
Q

What happens you clamp the cord to repair an aneurysm?

A

Cuts off circulation to the radicular arteries in spine

Can lead to death of neurons in the cord

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27
Q

What artery supplies a majority of blood to the cord?

A

Great radicular artery

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28
Q

What is another name for the Great radiculary artery?

A

Artery of adamkiewicz

GRA

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29
Q

How much blood does the Great radicular artery supply to the cord?

A

Supplies blood to 2/3 of the lower cord

30
Q

What side of the cord is the Artery of adamkiewicz?

31
Q

Where can the Great radicular artery be?

A

On L side of the cord at:

T10

T9-T12 ——— 75% of the time

T5-L5 ———– Absolute range

32
Q

What happens if you have to clamp the cord above the Great radicular artery?

A

Lower part of spine is going unperfused === paralysis

If you have time to do imaging to find out where the GRA is please do

33
Q

The _______ your GRA is, the safer it is if you need to clamp it.

34
Q

Equation for perfusion pressure?

A

PP = MAP - ICP

35
Q

What should ICP be?

36
Q

What are ways to reduce cell death in the cord when clamped?

A

Reduce inflammation

Reduce metabolic rate

These help slow down ischemia

37
Q

What effect does aortic cross clamping have on CSF?

A

It increases CSF pressure on the cord by 10 mmHg

drains can help with this

38
Q

What does the spinocerebellar tracts do?

A

coordinate complicated movements

39
Q

What does the posterior dorsal spinocerebellar tract do?

A

Gives info about tendons and muscle spindles

40
Q

What does the anterior ventral spinocerebellar tract do?

A

Tells how much motor activity is happening in the ventral horn

41
Q

Describe the Anterior ventral spinocerebellar tract pathway

A
  1. Info comes from the ventral horn to the anterior ventral spinocerebellar tract
  2. Info ascends to Superior cerebellar peduncle
  3. From there info goes to the superior part of the cerebellum
42
Q

Describe the Posterior dorsal spinocerebellar tract pathway

A
  1. Info comes from the dorsal horn to the Posterior dorsal spinocerebellar tract
  2. Info ascends to inferior cerebellar peduncle
  3. From there info goes to the inferior part of the cerebellum
43
Q

What is a tract?

A

Bundle of axons

44
Q

T/F: Ischemia doesn’t cause pain

45
Q

Describe Parietal pain

A

Superficial tissue pain

direct conduction into spinal cord

Highly localized

46
Q

Describe visceral pain

A

Organ pain

Autonomic nerves

Referred pain (hard to pinpoint or think its somewhere else)

47
Q

T/F: Organs have tactile sensors

A

F

They dont

48
Q

If the pain is close it’s ______; if it’s far it’s __________

A

Parietal

Visceral

49
Q

Where is parietal pain on organs?

A

Superficial parts

50
Q

Since the soft tissue in lungs and the liver doesn’t have pain sensors, what type of pain do you feel from it?

A

Visceral pain

51
Q

T/F: Pain is related to membrane potential

52
Q

Where is heart pain felt?

A

L shoulder/arm

53
Q

What gives synaptic activity in the anterior horn?

A

Superior cerebellar peduncle

54
Q

Describe Appendix pain

A

Dual pain from surrounding tissue: sharp & stabbing

Visceral and parietal pain

55
Q

Where is appendix pain felt?

A

Parietal pain: Lower R quadrant
You can apply pressure here

Visceral pain: T10 at umbilicus

56
Q

Why cant you apply pressure with visceral pain?

A

There are no tactile sensors

57
Q

Where is kidney pain felt?

A

Lower back

58
Q

Where is stomach pain felt? What can it be mistaken for?

A

High umbilicus

Heartburn can be mistaken for a MI

59
Q

Where is the limbic system mostly?

A

Deep brain structres on top of brainstem

60
Q

What is the limbic system?

A

Emotional center of brain

61
Q

What are the 3 areas of the limbic system?

A

Hypothalamus
Cingulate gyrus
Amygdala

62
Q

Where is the Cingulate gyrus?

A

Superior to corpus callosum
Buried in the middle of the brain
part of the cerebral cortex

63
Q

What fibers are part of lateral inhibition?

A

A-beta fibers

64
Q

What fibers do slow pain use?

65
Q

What utilizes C-fibers?

A

Slow pain
touch/pressure
tickle
aching pain
cold
warmth

66
Q

What fibers do fast pain use?

A

A-Delta fibers

67
Q

What fibers do skeletal muscle use?

A

A-alpha & beta fibers

68
Q

What fibers do tendons use?

A

A-alpha & beta fibers

69
Q

What fibers do muscle spindles use?

A

A-alpha, beta, gamma fibers

A/P (33 decks)

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