Lecture 2 Spinal nerve and back musculature

Question 1

Central canal contains what to suspend and protect the spinal cord

Answer 1

Cerebrospinal fluid

Question 2

What do the filum terminale externum/internum do

Answer 2

Fix the spinal cord to coccyx

Question 3

Three types of spaces formed by the meninges

Answer 3

Epidural - between dura and vertebral bony wall
Subdural (POTENTIAL SPACE) - between dura and arachnoid
Subarachnoid- cerebrospinal fluid

Question 4

Ligamenta flava = ?
Facet joint hypertrophy = ?

Answer 4

Flava = spinal stenosis
FJ hypertrophy = nerve root impingement

Question 5

Central vs paracentral disc herniation =

Answer 5

Central = spinal stenosis (flava)
Paracentral = nerve root impingement (Facet joint hypertrophy)

Question 6

Explain a disc protrusion

Answer 6

A little worse than a buldge; can be indicated for extension exercises and traction; annulus fibrosis is still partially functional

Question 7

Explain a disc sequestrian

Answer 7

Buldge->protrusion->extrusion-> sequestrian is the worst. not indicated for any extension exercise or traction, as the annulus fibrosis is completely gone

Question 8

What forms the denticulate ligament and what does that ligament do

Answer 8

Pia mater forms the denticulate ligament and this ligament attaches the pia mater to the spinal cord

Question 9

What are dorsal root ganglia

Answer 9

Cell bodies of sensory neurons

Question 10

Explain the dorsal root and afferent or efferent

Answer 10

Dorsal root (Afferent) = CNS + PNS processes of the sensory neuron axons

Question 11

Explain the ventral root and afferent or efferent

Answer 11

Ventral root (efferent) = rootlets from somatic motor neuron and preganglionic axons

Question 12

How short is the spinal nerve

Answer 12

Very short

Question 13

How many functional components do all spinal nerves contain; what are those components?

Answer 13

4 components= Somatic sensory, somatic motor, visceral sensory, and visceral motor

Question 14

Which nerve contains only somatic motor component?

Answer 14

C1

Question 15

Visceral motor is a…

Answer 15

2 cell system with 2 subdivisions but ONLY sympathetic motor in spinal nerves to somatic wall

Question 16

Sympathetic preganglionic axons …

Answer 16

white ramus communicans and are myelinated (faster)

Question 17

Sympathetic ganglion…

Answer 17

synapse with soma of 2nd ganglionic neuron

Question 18

Postganglionic axons

Answer 18

gray ramus communicans and are slower because they are nonmyelinated

Question 19

Explain the 4 pathways of Preganglionic sympathetic axon

Answer 19

1) synapse in ganglion with 2nd ganglionic neuron (paravertebral ganglia)
- postganglionic axons of 2nd neuron - gray ramus to spinal nerve (slow)
2) Ascending to form sympathetic trunk (myelinated)
3) Descending to form sympathetic trunk (myelinated)
4) Splanchnic nerve (myelinated) directly to abdominal/pelvic cavities

Question 20

What does the lumbar and thoracic splanchnic nerve innervate

Answer 20

abdominal organs

Question 21

Greater, lesser and least splanchnic nerve levels

Answer 21

Greater = T5-T9
Lesser = T10-T11
Least = T12

Question 22

What does the sacral splanchnic nerve innervate

Answer 22

Pelvic organs

Question 23

Parasympathetic preganglionic axons use (blank) splanchnic nerve

Answer 23

Pelvic splanchnic nerve

Question 24

Parasympathetic preganglionic axons are (blank) to target structure while sympathetic pregang axons are (blank) to target structure

Answer 24

close by; far away

Question 25

Parasympathtic is only in

Answer 25

visceral organs

Question 26

Sympathetic activates

Answer 26

sweat glands and arrector pili, and constricts vessels

Question 27

Radial frequency ablation =

Answer 27

Burning medial branch of dorsal ramus to manage chronic pain

Question 28

Ventral ramus trunk spinal nerve =

Answer 28

intercostal nerve

Question 29

Typical trunk spinal nerve in Muscular/collateral branch =

Answer 29

serratus posterior, intercostals, abdominal wall muscles

Question 30

Where does the spinal cord end

Answer 30

Ends at T12-L2 but still divides into 5 regions although they dont match up with the vertebral regions

Question 31

How many pairs of spinal nerves, and which region has 1 more than usual?

Answer 31

31 pairs, cervical has 1 more (8) b/c of the one above atlas

Question 32

Spinal nerve impingement formula =

Answer 32

D+1=P

Question 33

T or F: Extrinsic muscles have different branches following peripheral nerves

Answer 33

T

Question 34

Cutaneous innervation of C2 through greater occipital nerves pierces …

Answer 34

Semispinalis

Question 35

What forms plexus for back/gluteal regions

Answer 35

Ventral rami

Question 36

Serratus posterior innervation=

Answer 36

Intercostal nerve of ventral rami

Question 37

Erector spinae innervation=

Answer 37

dorsal rami of spinal nerves

Question 38

Which specific erector spinae muscles depress the rib cage for expiration?

Answer 38

Iliocostalis lumborum+thoracis and Longissimus thoracis

Question 39

Where does the spinalis thoracis most proximally attach?

Answer 39

Spinous process of L2

Question 40

Function of erector spinae

Answer 40

Back ext (and neck); unilaterally SB/RT

Question 41

Only muscle in laminar groove below L2; also then core of the back

Answer 41

Multifidi

Question 42

Distal attachment of Multifidi ends at

Answer 42

Spinous process of C2

Question 43

Semispinalis starts at (blank) and the thoracis subdivision proximally attaches at …

Answer 43

thoracic region; transverse processes of T10-T6

Question 44

Semispinalis capitis is innervated by

Answer 44

Dorsal rami of spinal nerves

Question 45

Semispinalis fucntion

Answer 45

back ext, ipsilateral SB, contralateral rotation
Cervicis/capitits = neck ext, SB, contra RT

Question 46

T or F: Obliquus capitis inferior produces head movement

Answer 46

No head movement because it is not attached to the head

Question 47

Where do headaches commonly originate

Answer 47

Greater occipital neuralgia; cervicogenic headache