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MD4001 > Neuroanatomy revision > Flashcards

Neuroanatomy revision Flashcards

1
Q

Draw the cross section of the spinal cord.

A

look at slide 4

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2
Q

where is the grey matter in the spinal cord and what does it involve?

A

H-shaped grey matter in the middle of the spinal cord contains neuron cell bodies

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3
Q

Where is the white matter in the spinal cord and what does it contain?

A

columns containing a number of ascending and descending tracts (axons)

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4
Q

what exists in the dorsal/posterior horn of the spinal cord?

A

cell bodies of interneurons

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5
Q

what exists in the lateral horn of the SC?

A

visceral (autonomic) motor cell bodies - but the lateral horn only exists in the thoracic region (T1-L2)

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6
Q

what exists in the central/anterior horns of the SC?

A

somatic motor cell bodies

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7
Q

what are the divisions of the white matter in the spinal cord?

A

ventral (ant) column
lateral columns
dorsal (pos) columns

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8
Q

was is carried in the posterior/dorsal root

A

sensory fibres only

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9
Q

what is carried in the anterior/ventral root

A

motor fibres only

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10
Q

what is a spinal nerve composed of?

A

spinal nerve is within the intervertebral foramen and is a mixed nerve composed of a sensory branch, motor and autonomic branch

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11
Q

where does the C1 nerve pass through and what does it carry?

A

between occipital bone (C0) and C1 and only motor fibres (no sensory)

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12
Q

where does the C8 nerve pass through?

A

between C7 and T1 (all thoracic spinal nerves follow suit)

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13
Q

at what vertebral level does the spinal cord end and what procedure can u perform below this level?

A

between L1/2

lumbar puncture

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14
Q

what is the cauda equina?

A

bundle of spinal nerves below L1/2 vertebrae

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15
Q

where do the cell bodies of the sympathetic system lie in the spinal cord?

A

lateral horn of T1-L2 segments

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16
Q

what is the sympathetic chain?

A

post ganglionic cell bodies lie in the paravertebral sympathetic ganglia. all these ganglia are connected making the sympathtic chain (hence if there is a sympathetic response it affects the whole body)

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17
Q

where do the left and right sympathetic chains/trunk meet?

A

ganglion impar

18
Q

what spinal nerves make up the following:

  • superior cervical ganglia
  • middle cervical ganglia
  • inferior cervical ganglia
A

C1-4
C5-6
C7-8

19
Q

what is the stellate ganglion made up of?

A

inferior cervial (C7-8) + T1 –> also known as cervicothoracic ganglion

20
Q

describe the possible courses of a sympathetic nerve fibre

A

from lateral horn it leaves the SC through ventral horn and then passes through the WRC to enter the sympathetic ganglion.

  1. it can either synapse here (at its own level) and the postganglionic axons pass through the GRC (because it is now demyelinated) to join T1-L2 spinal nerves - supplying the thoracic region organs
  2. rather than synapsing at own level it can travel up the sympathetic chain and synapse in a cervical ganglion, postganglionic axons pass through the GRC to join the cervcial spinal nerves - supplying head and neck and also heart

look at diagrams on slides 10 and 11

21
Q

why does the cervical ganglion not have an area of WRC?

A

because it is not possible for preganglionic axons to enter at the cervical ganglion but GRC is present as post-ganglionic axons can pass through this to join cervical spinal nerves

22
Q

where do cell bodies of the parasympathetic system lie?

A

cell bodies in midbrain and S2-4 segments

23
Q

what happens to the grey matter as you go from spinal cord up to the brain stem?

A

central grey matter opens up dorsally and becomes more horizontal. However the nuclei order remains the same.
So for example if there is a somatomotor issue you know there is a problem in the midline somewhere.

Look at image on slide 16

24
Q

what could cause peripheral nerve impairment?

A

compression
trauma
disease

25
Q

state the nerve roots for knee and ankle reflex

A

knee relfex = L3-4

ankle reflex = S1

26
Q

what can you do to check the L5 neve root

A

extension of big toe (supplies extensor hallucis longus)

27
Q

what protects the spinal cord and name its 3 layers

A

meninges

(outer -> inner) = dura, arachnoid, pia

28
Q

between which layer is CSF circulating

A

between pia and arachnoid, known as subarachnoid space

29
Q

what is the arterial supply of the spinal cord and where do they come from?

A
  • paired posterior spinal arteries (from vertebral artery or post inferior cerebellar artery)
  • single anterior spinal artery (from a contributory branch from each vertebral artery)
30
Q

what do the ant and pos spinal arteries divide into?

A

ant and pos radicular arteries

31
Q

which artery may be the major source of blood to the lower two thirds of the spinal cord and where does it arise form?

A

great anterior medullary artery of Adamkiewicz - arises from the aorta in the lower thoracic or upper lumbar vertebral levels

32
Q

what is the venous drainage of the spinal cord and where does it lie

A

internal vertebral venous plexus (ant and pos)

  • lies in the epidural space (between dura and vertebrae)
  • do not have valves and pressure gradient permits blood flow
  • communicates with cranial dural venous sinuses and pelvic veins –> infection and metastatic spread is easy
33
Q

name two types of injury to the spinal nerves

A
  • herniated disc (herniates posterolaterlly compressing the nerve)
  • bony spurs
34
Q

name the white matter tracts in the spinal cord, where they exist and what they do.

A
  • fasciculus gracilis (dorsal column - sensory (fine touch, vibration, proprioception) from ipsilateral lower limb)
  • fasciculus cuneatus (dorsal column - sensory (fine touch, vibration, proprioception) from ipsilateral upper limb)
  • spinocerebellar tract (lateral column - proprioception from limbs to cerebellum)
  • lateral corticospinal tract (lateral column = motor to ipsilateral ant horn (mostly limb muscles))
  • spinothalamic tract (lateral column - pain and temp from contralateral side)
  • anterior corticospinal tract (ant column - motor to ipsi and contralateral ant horn (mostly trunk muscles))

look at image on slide 25

35
Q

how would you test the dorsal column

A

joint position

36
Q

describe a spinal reflex (sensory stage)

A
  • starting in the dorsal root ganglion the 1st order sensory neuron detects stimulus from periphery (e.g. fire, etc.)
  • 1st order sensory neuron synapses with 2nd order sensory neuron in the dorsal horn
  • 2nd order sensory neurons cross the midline to go to the spinothalamic tract (in the lateral column) but instead of synapsing here they just change course and travel upwards to the thalamus
  • here they synapse with the 3rd order sensory neurons which travel to the primary somatosensory cortex
37
Q

describe a spinal reflex (motor stage)

A
  • upper motor neurons (UMN) - neuron cell bodies in the cortex
  • UMN travel through the midbrain to the medulla where most axons cross over in the lower medulla (hence we say left cortex controls right side)
  • descend in the lateral corticospinal tract
  • synpase with LMN (neuron cell bodies in the ant horn) in the anterior horn of the SC
38
Q

describe feature of upper motor neuron lesion

A
  • hypertonia (spacticity)
  • hyperflexia
  • abnormal reflex (positive babinski - unless <6 months old)
39
Q

describe features of lower motor neuron lesions

A
  • hypotonia/flaccidity
  • hyporeflexia/areflexia
  • fasciculations
  • atrophy/wasting of muscles
40
Q

where is CSF produced and where doe sit end up?

A

choroid plexus of all the ventricles

ends up in the subarachnoid space

41
Q

what is the arterial supply of the brain ?

A

anterior circulation = internal carotids
posterior ciculation = vertebral arteries

branches of these form the circle of Willis

MD4001 (5 decks)

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