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AP1 Neuro & Spinal pathway 24 > Lecture 5 Test 3 > Flashcards

Lecture 5 Test 3 Flashcards

1
Q

3 main arteries in the spinal cord

A

Anterior spinal artery
Left posterior spinal artery
Right posterior spinal artery

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2
Q

Anterior median fissure

A

holds the anterior spinal artery

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3
Q

75% of the spinal cord health is provided by the

A

Anterior spinal artery

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4
Q

25% of cord health is provided by the

A

Bilateral Posterior spinal arteries

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5
Q

The vertebral artery splits into the PICA (posterior inferior cerebelar artery), AICA (anterior inferior cerebelar artery) connects to

A

Posterior spinal arteries

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6
Q

Branches of intercostal arteries feed into…

A

Radicular artery, either anterior or posterior connects to the posterior and anterior spinal artery (not simultaneous)

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7
Q

Branching pattern of feed arteries/vessels are

A

irregular, varies per person

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8
Q

Can feed arteries come from both side and front and back of the cord?

A

No, it varies per person

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9
Q

Coronal arteries

A

Found on the outer surface of the cord.

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10
Q

Other names for Radicular arteries

A

Segmental arteries
Medullary arteries

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11
Q

4 possible pathways of cord circulation

A

Anterior radicular artery
Posterior radicular artery
spinal branch
Dorsal branch

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12
Q

Which arteries keep the rib cage healthy and perfused?

A

Intercostal arteries

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13
Q

What supplies blood to the small intestines?

A

Mesenteric artery

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14
Q

Supplies blood to the kidneys

A

Renal artery

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15
Q

Renal artery and mesenteric artery connects to the …

A

Aorta

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16
Q

Risks when performing surgery/repair/cross clamping of the aorta

A

Ischemia downstream from the clamping (ie. acute renal failure, spinal cord health)

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17
Q

How many feed arteries are found in the anterior neck/cervical area?

A

2 feed arteries

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18
Q

How many feed arteries are found in the thorax area?

A

2-3 feed arteries

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19
Q

How many feed arteries are found in the anterior lumbar area?

A

1-2 feed arteries

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20
Q

Are posterior feed arteries/vessels as important as the anterior feed arteries/vessels?

A

No, they don’t need as much as the anterior feed vessels.

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21
Q

What is the most important feed artery that provides 2/3 of arterial blood, specially lower part of the cord?

A

“Artery of Adamkiewicz”

the Left GREAT Radicular Artery (GRA) found in T10!!!

75% of people (range T9-T12)

Absolute Range (T5-L5)

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22
Q

Risk for aortic aneurysm repair?

A

Placement of the repair, if it’s under the GRA, you’re ok because perfusion is not affected when the aorta is clamped.

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23
Q

What if there’s a blockage of the GRA or the cross clamp is above the GRA?

A

Worried about the lower part of the being unperfused and leading to paralysis or loss of motor function post op.

24
Q

Often times aortic aneurysm repair is emergent but if it’s caught earlier on what preventive measures can you do?

A

Imaging to see where exactly is the aneurysm or blockage. Prepare for the surgery and gather equipment (bypass machine) needed to prevent adverse effects of the surgery.

25
Q

Normal perfusion pressure in the spinal cord is

A

50mmHg- 150mmHg

26
Q

Cerebral Perfusion Pressure calculation

A

MAP-ICP
NML 10 mmHg

27
Q

What effects does cross clamping the aorta have on the CSF (ICP)?

A

Raises the pressure by 10mmHg

28
Q

During cross clamping procedures, how can you help lower ICP?

A

By placing a drain to remove CSF pressure

29
Q

What is ischemia reperfusion injury?

A

If a Pt has been ischemic for a long time with sudden reperfusion, massive increase in blood flow and o2 to the tissues causes oxygen induced damage. Try to reperfuse slowly to prevent this issue.

30
Q

Process of the corticospinal pathway

A

1) Motor cortex > internal capsule > thalamus > decussation of pyramids (x-over) > lateral corticospinal tract (pyramidal) > anterior horn > contract or relax based on signal

2)Motor cortex > internal capsule > thalamus > descends on same side of origination (anterior corticospinal tract) > x-over at the level of the cord > anterior horn > contract/relax

31
Q

Feedback to cerebellum (sensory pathway)

A

Bilateral
- Posterior/dorsal spinocerebellar tract
- Anterior/ventral spinocerebellar tract

Information originates from anterior horn

32
Q

What is a tract?

A

Bundle of axons in the CNS

33
Q

Where do you receive motor sensory information from the anterior horn in the cerebellum?

Via which tract?

A

Anterior/ventral spinocerebellar tract into

  • Superior cerebellar peduncle - Coordinate motor movements
34
Q

Feedback from tendons and muscle spindle to the cerebellum to confirm contractions via (tract)

A

Dorsal spinocerebellar tract
into
- Inferior cerebellar peduncle

35
Q

What is the cerebellum in charge of?

A

Complex movement

36
Q

Lactic acid (Metabolic) build up, Ischemia can cause

Prostaglandins can…..

A

-Pain
-Augment pain sensation

37
Q

Tissue pain is known as

A

Parietal pain
(Fast pain; A(d) fibers; localized)

38
Q

Organ pain via autonomic nervous system

A

Visceral pain
(Appendix; difficult to localize; (c) fibers; dull/slow pain)

39
Q

Point at which someone identifies pain r/t membrane potentials

A

Pain threshold varies per person

40
Q

Due internal organs have tactile sensors?

A

No, but they have pain sensors

41
Q

What’s referred pain?

A

Ex, kidney pain causes low back pain.

42
Q

Soft tissues in the lungs and liver have pain sensors where?

A

They don’t have pain sensors

43
Q

Appendix pain can cause parietal and visceral pain

“rebound tenderness” - compression makes it better.

A

Parietal - RLQ (sharp stabbing)

Visceral - Umbilical pain (T10) autonomic ganglia jumps 2-3 levels

44
Q

Heart pain is diverted to left side of the body because

A

Pressure on the left side of the heart is higher than the right. Ischemia causes pain to the left side of the body.

45
Q

Heartburn causes pain sensation to

A

upper abdomen/chest. People think they’re having a heart attack

46
Q

Kidney pain referred to

A

Lower back pain

47
Q

Limbic system is found in (3 parts)

A

Above the brain stem (Amygdala, hypothalamus, cingulate gyrus)

48
Q

Slow pain affects what part of the brain?

A

Limbic system

49
Q

Where do you find the cingulate gyrus?

A

above the corpus callossum

50
Q

A fibers

A

Myelinated

51
Q

B fiber

A

Lightly myelinated

52
Q

C fibers

A

Unmyelinated

53
Q

Motor neurons, muscle spindle, tendons, pressure sensors (DCML) travel through what type of fibers?

A

A fibers

54
Q

Lateral inhibition travels through which fibers?

A

A (b) fibers

55
Q

Aching/dull pain, nausea transmitted to what type of fibers?

A

C fibers

56
Q

Sharp stabbing; fast pain sensors travel through what kind of fibers?

A

A (d) fibers

57
Q

Does the brain have direct pain sensors?

A

No

AP1 Neuro & Spinal pathway 24 (9 decks)

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