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Anatomy > Nervous System PP > Flashcards

Nervous System PP Flashcards

1
Q

motor neurons

A

-1 axon
-several dendrites- shorter and unsheathed
-axon are myelinated - myelin sheath
-muscle contraction
-control secretion
-efferent
-away from CNS to muscles and glands

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2
Q

sensory neurons

A

-do not have true dendrites
-attached to sensory
-transmit impulses to CNS
-stimulate interneurons -> motor neurons
-afferent

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3
Q

interneurons

A

-entirely in CNS
-transmit signals from sensory to motor neurons

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4
Q

white matter

A

-CNS
-composed of bundles of myelinated axons which connect the various grey matter regions together
-common origin and destination called tracts
-inner
-myelin acts as an insulator and hence nerve signals are transmitted at greater speed

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5
Q

gray matter

A

-CNS
-composed of neuronal cell bodies and dendrites
-2 different arrangements -> laminae and a nucleus
-unmyelinated nerve fibers
-functions in regions of the brain where information is processed
-outer
-laminae- neuron cell bodies in layered arrangement -> cerebral cortex, cerebellar cortex, and spinal cord
-nucleus- tight cluster of neuron cell bodies located deep in cerebral hemispheres, brainstem, and spinal cord
-make up ventral and dorsal horns

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6
Q

spinal cord

A

-gray matter on inside
-white matter outside
-opposite!
-spans from foramen magnum to L1-L2
-conus medullaris- tapered region at the end of the cord
-filum terminale- filament extending inferiorly from the end of spinal cord in the dural sac and attaches to dorsum of coccyx -> anchors the inferior end of the spinal cord

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7
Q

CNS

A

-brain- cerebrum, brainstem, cerebellum
-spinal cord- cervical, thoracic, lumbar, sacral, coccygeal
-meninges- dura mater, arachnoid mater, pia mater

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8
Q

PNS

A

-sensory receptors
-ganglia (collection of neuron cell bodies) and nerves
-cranial (12) and spinal nerves (31)
-brings sensory information to CNS
-carries motor output from CNS to initiate rxn
-able to regenerate
-endoneurium- surrounds neurolemma cells and axons
-perineurium- surrounds bundle of nerve fibers
-epineurium- surrounds a bundle of nerve fibers

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9
Q

cranial nerves

A

-afferent and efferent
-sensory, motor, autonomic
-associated with distinct brain stem nuclei and cortical structures
-most posterior and laternal nuclei -> sensory
-anterior tend to motor
-CN 1,2,8 - afferent
-CN 3,4,6,11,12- efferent
-CN 5,7,9,10- mixed
-CN 1,2 - arise from cerebrum
-remaining 10 arise from brain stem

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10
Q

peripheral nerves

A

-peripheral nerves for a particular region of the body feed into the spinal cord at a particular site -> anatomical dermatome
-injury to a specific part of the spine may affect all body parts by innervated nerves ventral to that area

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11
Q

cervical spinal injury

A

-more severe
-more of the body is affected
-C1-C4 injuries- may impair breathing

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12
Q

somatic nervous system

A

-somatic parts of CNS and PNS
-sensory and motor
-innervates all of body except viscera, smooth muscle and glands
-transmit touch, pain, temp, and position from sensory receptors
-somatic motor fibers stimulate voluntary muscle

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13
Q

dermatome

A

area of the dermis that is mainly supplied by afferent nerve fibers from the dorsal root of any spinal nerve
-C1 has no dermatome

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14
Q

dorsal and ventral roots

A

-multiple rootlets attach to anterior and posterior surfaces of the spinal cord and combine to form anterior and posterior roots
-posterior roots- afferent (sensory) from skin
-cell bodies of axons in posterior roots are in the spinal ganglia (outside the spinal cord) -> posterior root ganglia
-anterior roots- efferent- motor -> presynaptic autonomic fibers
-cell bodies of somatic axons in anterior roots are in the anterior horns in the gray matter of the spinal cords

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15
Q

posterior and anterior ramus supply

A

-Each spinal nerve divides immediately into aposterior (dorsal) ramusandanterior (ventral) ramus
-The posterior rami- supply the zygapophysial joints, deep muscles of the back (intrinsic), and overlying skin, trunk, head, neck
-anterior rami- supply the muscles, joints, and skin of the LIMBS and the remainder of the trunk.(anterolateral trunk)

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16
Q

arterial supply to spinal cord

A

-branches of vertebral, ascending cervical, deep cervical, intercostal, lumbar, and lateral sacral arteries
-3 longitudinal arteries supply the spinal cord
-anterior spinal artery formed by the union of branches of vertebral arteries and paired posterior spinal arteries
-each of which are a branch of a vertebral artery or the posterior inferior cerebellar artery
-spinal arteries run longitudinally from the medulla of the brain stem to the conis medularis of the spinal cord
-anterior and posterior spinal arteries supply only the short superior part of spinal cord
-circulation to spinal cord depends on spinal branches of ascending cervical, deep cervical, vertebral, posterior intercostal, and lumbar arteries that enter the vertebral canal through IV foramina

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17
Q

ANS

A

-sympathetic, parasympathetic, enteric
-have efferent and afferent sensory and motor signals that are sent to CNS
-preganglionic with cell body in CNS
-postganglionic with cell body in periphery that innervates target tissues

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18
Q

enteric

A

-can function independently of nervous system
-digestion
-2 ganglionated plexuses: myenteric and submucosal
-myenteric- between longitudinal and circular smooth muscle of GI tract
-submucosal- present within submucosa
-self contained
-functions off local reflex activity
-receives activity from and provides feedback to sympathetic and para
-may receive from postganglionic sympathetic neurons or preganglionic parasympathetic neurons

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19
Q

sympathetic

A

-cell bodies in enteromediolateral columns or lateral horns on spinal cord
-presynaptic fibers exit through anterior roots and enter anterior rami T1-L2 spinal nerve -> sympathetic trunks by white rami communicates
-fibers can ascend or descend to a superior or inferior paravertebral ganglion
-past to the adjacent anterior spinal nerve rami by grey rami communicates
OR
-cross through the trunk without synapsing and continue through abdominal pelvic splenic nerve to reach prevertebral ganglia
-presynaptic are short than post

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20
Q

ganglia

A

-3 cervical- superior, middle, and inferior
-12 thoracic
-4 lumbar
-5 sacral
-inferior cervical ganglion may fuse with the first thoracic -> form stellate ganglion
-all nerves distal to paravertebral ganglion are splenic

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21
Q
A

-afferent and efferent between CNS and viscera
-cardiopulmonary splenic nerves carry postsynaptic fibers for the thoracic cavity
-abdominopelvic splenic nerves pass through paravertebral without synapse -> greater, lesser, least, and lumbar splenic nerves
-synapse in prevertebral ganglia that are closer to target organ
-prevertebral ganglia are part of nervous plexuses that surround the branches of aorta -> celiac aortic or renal, superior and inferior mesenteric ganglion
-celiac receive input from superior greater splenic nerve -> innervate foregut, distal esophagus, stomach, proximal duodenum, pancreas, liver, biliary system, spleen, adrenal glands
-aortic or renal from the lesser splenic nerve
-superior and inferior mesenteric from the least and lumbar splenic nerves

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22
Q

superior mesenteric ganglion

A

-innervates midgut
-distal duodenum, jejunum, ilium, cecum, appendix, ascending colon, and proximal transverse colon

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23
Q

inferior mesenteric ganglion innervation

A

-hindgut
-distal transverse, descending, and sigmoid colon, rectum, and upper anal canal
-bladder
-externa genitalia and gonadals

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24
Q

parasympathetic fibers

A

-exit by cranial nerve CN 3,7,9,10 and S2-S4 nerve roots
-4 pairs ganglion
-all in head
-CN 3- ciliary ganglion - innervates iris and ciliary muscles of the eye
-CN 7- lacrimal, nasal, palatine, and pharyngeal glands via pterygopalatine ganglion AND submandibular and sublingual glands via submandibular ganglion
-CN 9- parotid glands via otic ganglion
-CN 10- thoracic and abdominal viscera
-sacral- descending sigmoid colon and rectum
-every other parasympathetic preganglionic synapses near or on the wall of target
-pre long than post

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25
Q

vagus nerve

A

-parasympathetic
-innervate abdominal and thoracic viscera
-4 cell bodies in medulla oblongata:
-dorsal nucleus
-nucleus ambiguous- motor fibers and preganglionic neurons that innervate heart,
-nucleus solitaris- receives afference of taste sensation and viscera
-spinal trigeminal nucleus- touch, pain, temperature of outer ear, mucosa of larynx, and part of dura
-conducts sensory information from baroreceptors of the carotid sinus and aortic arch to the medulla

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26
Q

sympathetic vs parasympathetic

A

-contrasting and coordinating affects
-innervate a lot of the same tissue
-preganglionic neuron is in the gray matter of CNS
-cell bodies of postganglionic are outside CNS in the autonomic ganglia
-postsynaptic terminate on the effector organs -> smooth muscle, modified cardiac muscle, glands

27
Q

sympathetic vs parasympathetic

A

-postsynaptic neurons release different neurotransmitters
-norepinephrine for sympathetic (except sweat glands)
-ACh for parasympathetic
-location of the presynaptic cell bodies differentiate and which nerves conduct presynaptic fibers from CNS

28
Q

ventral horn

A

-gray matter
-shorter
-wider
-neuron cell bodies are somatic motor neuron cell bodies
-axons exit via ventral rootlets
-innervate skeletal muscle cells

29
Q

dorsal horn

A

-gray matter
-longer
-narrower
-interneuron cell bodies within
-interneurons receive sensory information from sensory neuron axons that enter the dorsal horn and relay information to motor neurons and/or other interneurons

30
Q

lateral horn

A

-gray matter
-only in T1-L2 (sympathetic)
-neuron cell bodies of autonomic nervous system
-autonomic cell bodies are in other areas of the cord like S2-S4 (parasympathetic) -> but no lateral horn

31
Q

dorsal root ganglion (DRG)

A

-only present in dorsal root

32
Q

dorsal ramus

A

-smaller
-supplies dorsal trunk, neck, head
-visceral motor, somatic motor, and sensory innervation to and from the intrinsic back muscles, joints and vertebral column and skin

33
Q

ventral ramus

A

-larger
-innervate ventrolateral trunk, upper limbs, lower limbs with visceral motor, somatic motor, and sensory information to and from the muscles, joints, and skin

34
Q

rami communicantes

A

-from a ventral ramus to paravertebral (sympathetic) ganglia
-pathway for sympathetic visceral efferent and afferent neurons and visceral

35
Q

white matter spinal cord

A

-anterior column (funiculus)
-lateral column (funiculus)
-posterior column (funiculus)
-tracts- groups of axons within CNS with common origin and destination
-ascending tracts- sensory information from PNS to neurons in brain
-descending tracts- motor information from neurons in CNS to neurons of PNS

36
Q

L2-Co1

A

-must transverse the vertebral canal until they can exit (bc spinal cord ends)
-cauda equina-bundle of ventral and dorsal roots in the canal inferior the end of spinal cord

37
Q

dura mater

A

-dense fibrous connective tissue
-dural sac- long tubular sheath surrounding the spinal cord
-attaches to occipital bone to approx S2
-dural sleeves- lateral extensions that cover the ventral and dorsal roots to the location where they become spinal nerve
-dural sleeves continues to cover the spinal nerve -> becomes epineurium

38
Q

subdural space

A

-potential space between dura mater and arachnoid mater

39
Q

epidural (extradural) space

A

-real space between bone of vertebral column and the dura mater
-contains fat, loose, connective tissue, dorsal and ventral, arteries, roots, internal vertebral venous plexus

40
Q

internal vertebral venous plexus

A

-epidural space is filled with fat and theinternal vertebral venous plexus(Batson’s plexus)
-this plexus drains the entire length of the vertebral column
-This plexusand the external vertebral venous plexus provides a route for metastasis to the vertebrae,spinal cord, or brain from an abdominal (kidney), thoracic (breast and lung), or pelvic (prostate) tumor
-occurs bc vertebral venous plexuses lack valves and are connected with venous channels of organs external to the vertebral column

41
Q

epidural abscess

A

-collection of pus between dura mater of brain or spinal cord and the bones of the spine and skull
-more common in the spine bc epidural space in the vertebral column is a real space.
-cranial cavity- epidural space is a potential space
-medical emergency swelling can cause permanent neurological damage

42
Q

arachnoid mater

A

-attached to dura maters surface that faces the brain/spinal cord
-trabeculae attach to superficial surface of pia mater
-subarachnoid space- real space between arachnoid mater and pia mater that contains CSF

43
Q

lumbar puncture

A

-sample of CSF is obtained by inserting needle into lumbar cistern (inferior to the conus medullaris)
-prevents damage to spinal cord ends @ L1/L2
-small size and mobility of nerve roots in cauda equina -> little risk of puncturing a spinal nerve root

44
Q

supracristal plane

A

-supracristal plane crosses the L4 spinous process and the L4/5 intervertebral disc -> important landmark to find the correct interspinous space when performing a lumbar puncture
-presence of thick, subcutaneous tissue
-palpable supracristal plane is often more superior than the radiological (“actual”) supracristal plane.

45
Q

Spinal Block vs Epidural Block

A

-spinal block- anesthesia injected into CSF of subarachnoid space (below L1/L2)
-takes effect in 1 minute
-headache after due to CSF leakage from the lumbar puncture

-epidural block- catheter placed to deliver continuous anesthetic into epidural space (below L1/L2)
-if done into the sacral canal via the sacral hiatus (caudal epidural block) ->only the S2-S4 nerve roots are anesthetized -> birth canal, pelvic floor, and external genitalia -> spares the lower extremity
-child birth
-must be administered in advance of the actual delivery

46
Q

denticulate ligaments

A

-thickened extensions of pia mater
-traverse the subarachnoid space
-attach to dura mater
-21 pairs
-stabilize spinal cord to prevent side to side motion

47
Q

disc herniation

A

-central herniation -> vertebral canal
-posterolateral herniation -> intervertebral foramen
-posterior/posterolateral herniation-> vertebral column -> cervical spinal cord and nerve roots, thoracic spinal cord and nerve roots, and lumbar (L2 and below) nerve roots

48
Q

posterolateral herniation

A

-most common due to strength of centrally located posterior longitudinal ligament
-cervical posterolateral herniation- nerve impinged = lower vertebra (C5 is impinged at C4-C5) -> bc cervical nerves exit superiorly
-thoracic posterolateral herniation- nerve impinged = upper vertebrae (T3 is impinged at T3-T4)
-lumbar posterolateral herniation- nerve impinged = lower vertebrae

49
Q

extrinsic back muscles

A

-contraction results in movement of upper limb (superficial layer) or elevation/depression of ribs
-do not move the back
-innervated by branches of ventral primary rami except trapezius is innervated by CN 11 (accessory)

50
Q

intrinsic back muscles

A

-maintain posture and move head and vertebral column
-innervated by dorsal rami
-superficial- splenius capitis and splenius cervicis
-intermediate- erector spinae: iliocostalis, longissimus, spinalis
-deep- transversospinalis group (semispinalis)

51
Q

splenius capitis and splenius cervicis

A

-only muscles in the superficial layer of intrinsic back muscles
-fibers are oblique and directed superolaterally
-insertions (distal attachments) are distinct
-originates at nuchal ligament and spinous processes of C7-T6
-capitis inserts on mastoid process and superior nuchal line
-cervicis inserts on transverse processes of upper cervical vertebrae (C1-C3/C4)
-innervated by dorsal rami of spinal nerves
-action- bilateral contraction that extends head and neck, unilateral contraction that laterally flexes and rotates head

52
Q

erector spinae: iliocostalis, longissimus, spinalis

A

-intermediate layer
-from lateral to medial -> iliocostalis, longissimus, spinalis (I Love Spines)
-originates on posterior aspects of iliac crests and sacrum, sacroiliac ligaments and spinous processes of sacral and inferior lumbar vertebrae
-inserts on spinous and transvere processes of vertebrae, ribs, skull
-innervated by dorsal rami
-supplied by dorsal branches of posterior intercostal and lumbar arteries
-action- erect posture, bilateral contraction to extend vertebral column, unilateral contraction for rotation

53
Q

transversospinalis group

A

-form transverse processes (inferiorly) to spinous processes (superiorly)
-between spinous process and transverse process
-rotation and lateral bending movement
-stabilize vertebral column
-semispinalis is the only visible

54
Q

semispinalis

A

-most superficial of transversospinalis
-semispinalis capitis- attaches to occipital bone
-fibers are longitudinal and parallel to vertebral column
-thoracic, cervicis, capitis
-originate on transverse processes of C4-T12
-insert on occipital bone and spinous processes of thoracic and cervical region
-innervated by dorsal rami of spinal nerves
-action- maintain lordosis and balance head on the neck, bilateral contraction- extension of head and neck, unilateral contraction to rotate head and neck

55
Q

greater occipital nerve

A

-dorsal ramus of the C2 spinal nerve
-nerve passes through semispinalis muscle and trapezius
-entirely sensory supplying skin on the back of the head

56
Q

damage to CNS

A

-injured axons dont recover
-stumps begin to regeneration but are stopped by astrocytes
-destruction of tract

57
Q

peripheral nerve degeneration

A

-axons degenerate distal to lesions bc they depend on cell bodies
-crushing- damages axons distal to injury -> no surgery needed bc sheaths guide regenerating axon to destination
-cut- surgery required for apposition of cut ends by suture through epineurium -> regeneration
-ischemia- crushing vasa nervorum cuts off blood supply and cause same effects as crushing or even cut damage

58
Q

ascending tracts

A

-sensory
-dorsal columns- vibration/proprioception
-spinothalamic tract- pain/temperature
-PNS -> CNS

59
Q

descending tract

A

-motor
-corticospinal tract- motor
-CNS -> PNS

60
Q

hemi-cord/brown sequard syndrome

A

-damage to half of spinal cord
-affects dorsal columns, spinothalamic, and corticospinal tract
-dorsal column (proprioception/vibration) and corticospinal tract (motor) lost ipsilaterally
-spinothalamic tract (pain/temperature) lost contralaterally

61
Q

anterior cord syndrome

A

-affects spinothalamic (pain/temperature) and corticospinal (motor) tracts
-loss of pain, temperature, and motor from injury and below
-dorsal column (vibration and proprioception not affected)

62
Q

central cord syndrome

A

-spinothalamic tract affected
-loss of pain and temperature
-higher level of spinal cord -> innervates upper body only
-dorsal column (proprioception/vibration) and corticospinal tract (motor) unaffected

63
Q

posterolateral cord syndrome

A

-dorsal column and corticospinal tract affected
-loss of vibration/proprioception and motor at injury and below
-spinothalamic tract not affected (pain and temperature)

Anatomy (34 decks)

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