S2_L1: Spinal Cord Flashcards
TRUE OR FALSE: The spinal cord is roughly cylindrical in shape. It begins superiorly at the foramen magnum in the skull, where it is continuous with the medulla oblongata of the brain
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
In adults, the spinal cord terminates at the (1)_______ border of the (2)_______
- lower
- first lumbar vertebra (L1)
In children, the spinal cord terminates at the (1)_______ border of the (2)_______
- upper
- 3rd lumbar vertebra (L3)
Enumerate the 3 meninges part of the spinal cord.
dura mater, arachnoid mater, and pia mater
The spinal cord occupies the upper _______ of the vertebral canal of the vertebral column
two thirds (2/3)
TRUE OR FALSE: Cerebrospinal fluid normally circulates between the dura mater and pia mater
False
It is between the pia and arachnoid mater
The spinal cord gives origin to the (1)_______ plexus and (2)_______ plexus
- brachial
- lumbosacral
TRUE OR FALSE: The lengths of the vertebrae and spinal cord are not equal
True
Determine which spinal nerve is affected.
A pt with a L1-L2 disc problem.
A. T12
B. L1
C. L2
D. L3
E. None of the above
B. L1
NOTE: For the thoracic and lumbar region, follow the upper vertebra.
Determine which spinal nerve is affected.
A pt with a C2-C3 disc problem.
A. C2
B. C3
C. C2 and C3
D. No nerve will be affected
E. None of the above
B. C3
NOTE: In the cervical region, follow the lower vertebra
Determine which spinal nerve is affected.
A pt with a C5-C6 disc problem.
A. C4
B. C5
C. C6
D. C7
E. None of the above
C. C6
Determine which spinal nerve is affected.
A pt with a T1-T2 disc problem.
A. C8
B. T1
C. T2
D. T3
E. None of the above
B. T1
Determine which spinal nerve is affected.
A pt with a C7-T1 disc problem.
A. C8
B. T1
C. T2
D. All are affected
E. None of the above
A. C8
Match the following key structures to its rexed lamina.
- Substantia gelatinosa
- Corticospinal and rubrospinal fibers
- Neurons from corticospinal, rubrospinal, and ascending spinothalamic tracts
A. I
B. II
C. III & IV
D. V
E. VI
- B
- E
- D
Match the following key structures to its rexed lamina.
- Surrounds central canal
- Nucleus dorsalis of Clarke
- Dorsomarginal nucleus
- Nucleus proprius
A. I
B. III & IV
C. VII
D. VIII & IX
E. X
- E
- C
- A
- B
Determine the Rexed Laminae.
Located in ventral horn
A. Lamina 1
B. Lamina 2
C. Lamina 3
D. Lamina 7
E. None
E. None
Determine the Rexed Laminae.
Located in ventral horn
A. Lamina 1
B. Lamina 2
C. Lamina 3
D. Lamina 7
E. None
E. None
NOTE: This is for Lamina 8&9
Determine the Rexed Laminae.
called Lissauer’s tract
A. Lamina 1
B. Lamina 2
C. Lamina 3
D. Lamina 7
E. None
A. Lamina 1
Determine the Rexed Laminae.
Largest rexed lamina
A. Lamina 1
B. Lamina 2
C. Lamina 3
D. Lamina 7
E. None
D. Lamina 7
TRUE OR FALSE: Nucleus proprius and nucleus dorsalis have same function. However, RL3&4 deals with unconscious proprioception, while RL7 deals with conscious proprioception
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
C. Only the 1st statement is true
NOTE: The functions of the second statement is interchanged,
To determine the spinal segment from a vertebra in the cervical region, add _______
1
To determine the spinal segment from a vertebra in the upper thoracic region, add _______
2
To determine the spinal segment from a vertebra in the lower thoracic region, add _______
3
The upper thoracic vertebrae ranges from ____ to ____
T1-T6
The lower thoracic vertebrae that fits in the criteria of adding 3 to determine the spinal segment ranges from ____ to ____ only
T7-T9
This is a ligament attached to the pia mater that supports that - supports rootlets attach to it in the spinal cord.
Denticulate ligament
Match the following vertebra to its spinal segment.
- T10
- L1
- T12
A. T11-T12 cord segments
B. L1-L2 cord segments
C. L3-L4 cord segments
D. L5 cord segments
E. Sacral and coccygeal cord segments
- B
- E
- D
Match the following vertebra to its spinal segment.
- C1
- C3
- C4
A. C1
B. C2
C. C3
D. C4
E. C5
1.B
2.D
3. E
Match the following vertebra to its spinal segment.
- T1
- T3
- T4
A. T2
B. T3
C. T4
D. T5
E. T6
- B
- D
- E
Match the following vertebra to its spinal segment.
- T9
- T7
- T5
A. T10
B. T9
C. T7
D. T11
E. T12
- E
- A
- C
What vertebra is affected if T9 spinal cord segment is damaged?
T6
What spinal cord segment is affected if T6 vertebra is damaged?
T8 spinal cord segment
TRUE OR FALSE: Spinal cord lesion occurs in the gray matter zone.
True
This is a condition that is characterized by loss of power and sensation in arms and hands, but has a preserved motor and sensory on the lower extremity.
Central Cord Syndrome
Central Cord Syndrome is also known as?
Walking Spinal Cord Injury (SCI)
The following is true about the central cord syndrome, EXCEPT:
A. Most common incomplete spinal cord lesion
B. Most common form of cervical spinal cord injury.
C. Injury to the central part of your spinal cord in your neck
D. Manifests with Friedreich’s ataxia during gait
E. None
D. Manifests with Friedreich’s ataxia during gait
NOTE: It manifests with sensory ataxia or tabetic gait
Determine the ataxia.
- Gait becomes good when looking at the floor
- Poor gait despite the use of vision
- Involves damage of the cerebellum
- Involves problematic DCML
- No more coordination function
A. Sensory ataxia
B. Friedreich’s ataxia
- A
- B
- B
- A
- B
The following may cause CCS, EXCEPT:
A. Syringomyelia
B. Motor Vehicle Accident (MVA)
C. Tumor
D. Minor traumas
E. None
E. None
TRUE OR FALSE: CCS usually occurs due to hyperextension injury
True
This is the dilation or expansion of the central canal within the spinal cord, possibly due to a small or deformed skull
Syringomyelia
This occurs when the section of the skull containing a part of the brain (cerebellum) is too small or is deformed, thus putting pressure on and crowding the brain.
Arnold Chiari Malformation type I
NOTE: This causes Syringomyelia d/t the resulting obstruction
What diagnostic tool is used for Syringomyelia?
Spinal MRI
Determine if the following tracts are ascending or descending pathways.
- Rubrospinal
- Cuneocerebellar
- Spinocerebellar
- Spinoreticular
- Anterior spinothalamic tract
A. Ascending
B. Descending
- B
- A
- A
- A
- A
Determine if the following tracts are ascending or descending pathways.
- Dorsal column medial lemniscal
- Lateral spinothalamic tract
- Spino-olivary
- Vestibulospinal
- Tectospinal
A. Ascending
B. Descending
- A
- A
- A
- B
- B
Match the following sensation to their corresponding tracts.
- Postural movements from visual stimuli
- Regulation to voluntary movements and reflexes
- Tactile, painful, and thermal stimuli
A. Reticulospinal
B. Rubrospinal
C. Tectospinal
D. Spinotectal
E. Spinoreticular
- C
- A
- D
Match the following sensation to their corresponding tracts.
- Vibration, proprioception, two-point discrimination
- Promotion of flexor and inhibition of extensor muscle activity
- Crude (light, non discriminative) touch and pressure
A. Lateral spinothalamic tract
B. Anterior spinothalamic tract
C. Dorsal column medial lemniscal
D. Rubrospinal
E. Vestibulospinal
- C
- D
- B
Match the following sensation to their corresponding tracts.
- Pain and temperature
- Additional information to the cerebellum as an accessory pathway
- Inhibition of flexor and promotion of extensor muscle activity
A. Lateral spinothalamic tract
B. Spinoreticular
C. Spino-olivary
D. Tectospinal
E. Vestibulospinal
- A
- C
- E
Which 2 tracts is for proprioception in joints and muscles
Spinocerebellar and Cuneocerebellar Pathways
In CCS, the affectation of the lateral corticospinal tracts will produce
A. UMNL-like symptoms
B. LMNL-like symptoms
C. Both
A. UMNL-like symptoms
In CCS, the affectation of the lateral corticospinal tracts will produce what like of symptoms in the UE?
A. UMNL-like symptoms
B. LMNL-like symptoms
C. Both
B. LMNL-like symptoms
The following are UMNL-like symptoms, EXCEPT:
A. Hypertonia
B. Spastic paralysis
C. Fasciculations
D. (+) Babinski sign
E. None
C. Fasciculations
CCS most commonly occurs in which levels of the spinal cord?
cervical and thoracic
TRUE OR FALSE: Pts with CCS may develop Horner’s syndrome
True
Enumerate the Horner syndrome triad.
Miosis - pupillary constriction
Anhidrosis - loss of sweating
Ptosis - drooping upper eyelid
Generally the loss of pain and temperature is called _______, particularly in syringomyelia
“cape” sign
Losing pain and temperature on the shoulder joints can cause _______.
shark hose joints
This tract forms the Spinal Lemniscus
Anterolateral Spinothalamic Tract
The 1st order neuron of the Anterolateral Spinothalamic Tract is the (1)______ or also called as the (2)_______
- Dorsal root ganglion
- Lissauer’s tract
In sensory pathways, where is the site of decussation?
Second order neurons
This is the major pathway for voluntary movements and is responsible for speed and agility of movements
Lateral Corticospinal Tract
Where does the anterior corticospinal tract decussates?
at the spinal cord level
Where does the lateral corticospinal tract decussates?
at the level of the medulla
The second and third order neurons of the corticospinal tracts are always at the ______ side
contralateral
Corticospinal tracts decussate at the (1)_____ level, not the (2)______
- spinal cord
- medulla
Based on the somatotropic arrange of spinothalamic and corticospinal tracts, which region is most lateral?
Sacral
Based on the somatotropic arrange of the DCML system, which region is most lateral?
Cervical
Where is the destination of the Lateral Spinothalamic tract?
Posterior Central Gyrus
What receptors are used in the Anterior Spinothalamic tract?
Free nerve endings
What sensations are transmitted in the Anterior Spinothalamic tract?
Light touch and pressure
What sensations are transmitted in the Lateral Spinothalamic tract?
Pain and Temperature
What is the 3rd order neuron of the Anterolateral Spinothalamic tract?
Ventroposterolateral (VPL) nucleus or Ventroposteromedial (VPM) nucleus
The sensation head to the ventroposterolateral (VPL) nucleus when the sensation felt is from the (1)______, while it goes to the ventroposteromedial (VPM) nucleus when the sensation comes from the (2)______.
- limbs
- face
What is the 2nd order neuron of the Anterolateral Spinothalamic tract?
Substantia gelatinosa
TRUE OR FALSE: In patients with spinal cord injury,
they can still feel sensations below the lesion. However, this is applicable only to spinothalamic tracts, not to the DCML.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
The 1st order neuron of the dorsal column meidal lemnicus is at the (1)______, via the (2)______ or (3)_______.
- Dorsal root ganglion
- fasciculus cuneatus
- fasciculus gracilis
The DCML pathway decussate at the at the level of the medulla, specifically at the (1)_____ in the LE and (2)_____ in the UE
- Nucleus gracilis
- Nucleus cuneatus
TRUE OR FALSE: The DCML has the same 3rd order neuron as the Anterolateral Spinothalamic Tract.
True
This is the primary somatosensory cortex
BA 3,1,2
This is the primary motor cortex
BA 4
This is the premotor/secondary motor cortex
BA 6