Neurological System Pt.1 Flashcards
Regions of the vertebral column
cervical (C1-C7) thoracic (T1-T12) lumbar (L1-L5) sacrum (S1-S4) coccyx
Spinal curvature in an early embryo
primary curvature
Spinal curvatures in an adult
secondary (c) > primary (t) > secondary (l) > primary (s)
define excessive kyphosis
abnormality of the spine causing excessive curvature with pain and stiffness (too rolled forward)
define excessive lordosis
excessive inward curvature of the spine in the lower back.
define scoliosis
condition characterised by sideways curvature of the spine or back bone
label image of typical vertebra
body, arch, pedicle, transverse process, lamina, spinous process, sup/inf articular process, sup/inf vertebral notch
Compare vertebral bodies of cervical thoracic and lumbar vertebra.
C: rectangular w/ concave sup + convex inf surface
T: columnar, heart shaped in sup view
L: massive columnar, kidney shaped in sup view
Compare vertebral foramen of cervical thoracic and lumbar vertebra.
C: triangular
T: circular, relatively small compared to the body
L: triangular, intermediate size
Compare spinous processes of cervical thoracic and lumbar vertebra.
C: bifid
T: long + sloping, overlaps inferior vertebra
L: short, broad, blunt
Compare transverse processes of cervical thoracic and lumbar vertebra.
C: perforated (foramen transversarium) w/ ant/pos tubercles
T: long, strong, extend posterolaterally
L: long, slender, directed laterally
Where is uncinate process found?
found bilaterally C3-C7
Compare articular facets of cervical thoracic and lumbar vertebra.
C: oblique, relatively horizontal, directed primarily super/inf
T: costal x2 on each side of body, x1 on each trans process, nearly vertical articular facets primarily directed pos/ant
L: nearly vertical directed primarily medially and laterally
label an image of atlas and axis
x
Which ligament limits the amount of rotation of the head?
alar ligament
YES and NO joints?
YES atlanto-occipital
NO atlanto-axial
What stabilises the atlanto-axial joint?
cruciate ligament
cruciate ligament made up of?
superior longitudinal band
transverse ligament of atlas
inferior longitudinal band
List typical ligaments of the spinal column, label them on a diagram.
posterior longitudinal anterior longitudinal supraspinous ligament ligamentum flavum interspinous ligament
Label a cross section of the intervertebral disc.
concentric lamellae
nucleus pulposus
anulus fibrosus
Number of spinal segments
31
number of pairs of spinal nerves
31
spinal nerve numbers by spinal region
c 8 t 12 l 5 s 5 c 1
nerves leave the vertebral column through?
intervertebral foramina
C1-C7 leave the vertebral column above or below vertebrae?
above
C8-coccygeal leave the vertebral column above or below vertebrae?
below
List the enlargements for the innervation of the limbs.
cervical (C3-T1) > upper limbs
lumbar (L1-S2) > lower limbs
Describe the parts of the spinal nerve from the spinal cord
anterior/posterior horns of grey matter > posterior (sensory)/anterior (motor) roots > /sensory ganglion/ > spinal nerve > anterior/posterior rami (mixed sensory/motor axons
Which of the periosteal or meningeal layer of the dura mater is closest to the skull?
periosteal
Name the meningeal layers from superficial to deep.
dura mater
arachnoid mater
pia mater
No epidural space within the _________ but one in the _____________.
cranial cavity
vertebral column
Spinal dura mater is continuous with what layer meningeal or periosteal?
meningeal
What is the epidural space?
true space between the dura and the vertebral periosteum filled with fat and venous plexus
Subarachnoid space
filled with CSF
What happens to the dura mater in the spinal cord?
continuous with inner sheet of dura in cranium, forms dural sac, extends to S2
What happens to the arachnoid mater in the spinal cord?
ballooned up against the dura
What happens to the pia mater in the spinal cord?
adheres tightly to the surface of the spinal cord
What is the denticulate ligament?
extensions of the pia that anchor the spinal cord to the dura, lateral denticulate ligaments separate posterior and anterior roots
Posterior roots enters the spinal cord in?
posterolateral sulcus
Posterior roots exits the spinal cord in?
anterolateral sulcus
How is epidural/spinal anaesthesia administered?
into subarachnoid/epidural space
What is the lumbar cistern?
exists at about L2/S2, reservoir of CSF, enlargement of the subarachnoid space
List examples of spinal pathology.
Fractures of vertebral column
Prolapsed intervertebral disc - sciatica
Spondylosis (degeneration)
Spondylolysis (stress fracture of pars interarticularis)
Spondylolisthesis (forward displacement of vertebra)
Spondylitis (inflammation of vertebrae)
Spinal cord injury
Factors affecting severity of spinal lesions
loss of neural tissue, vertical level (higher the lesion the greater the disability), transverse plane (no of tracts involved)
The intermediate upper and lower limb examinations can be subdivided into the following categories:
tone
power
reflexes
sensations
What steps should you include prior to starting an examination?
ensure you are wearing correct PPE, hand wash, introducing yourself, confirm patient’s name and DOB, patient consent, ensure adequate exposure and positioning of the patient
When doing a neurological exam of the upper and lower limbs, what are you checking for?
tone
power
reflexes
sensation
