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Advanced anesthesia 2 > spinal anatomy > Flashcards

spinal anatomy Flashcards

1
Q

how many vertebra are in the spine

A

33

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2
Q

portion of the spinal cord that allows for passage of the spinal cord

A
  • vertebral foramen
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3
Q

what are lateral notches

A
  • know as intervertebral foramina
  • allows for passage of the nerves
  • if discs become damaged pressure is exerted on them
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4
Q

what is the sacral cornu

A
  • the bony process used to identify the sacral hiatus
  • good for caudal block
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5
Q

scoliosis

A
  • lateral curvature
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6
Q

kyphosis

A
  • posterior curvature
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7
Q

lordosis

A
  • anterior curvature
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8
Q

what are the 3 ligaments of the spine

A
  • supraspinous
  • intraspinous
  • ligamentum flavum
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9
Q

where is the epidural space

A
  • between the ligamentum flavum and dura mater
  • runs from base of cranium to sacral sulcus
  • average depth is 5 cm (2.5 - 8cm)
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10
Q

where does the spinal cord stop in adults and peds

A
  • starts at medulla oblongata
  • L2 in adults
  • L3 in peds
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11
Q

what are the 3 layers of the meninges

A
  • dura mater
  • arachnoid mater
  • pia mater
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12
Q

which meninge layer holds CSF

A
  • arachnoid mater
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13
Q

how many spinal nerves are there

A
  • 31 pairs
  • 8 cervical
  • 12 thoracic
  • 5 lumbar
  • 5 sacral
  • 1 coccygeal
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14
Q

where in the spine are the nerves located

A
  • 1st is between base of skull and atlas
  • cervical correlate with vertebra below
  • after T1 they correlate with vertebra above
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15
Q

where is the cord enlarged

A

C5 - C7 and L2 - S3

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16
Q

where is the brachial plexus located

A

C4 - T1

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17
Q

where is the lumbar and sacral plexus

A

L2 - S3

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18
Q

where is the cauda equina

A

L1 - S5

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19
Q

what is the dorsal root

A
  • sensory neurons, incoming
  • laminae 1-6
20
Q

what is the ventral root

A
  • motor neurons, outgoing
  • laminae 7-9
21
Q

what regions make up the spinal cord

A
  • dorsal
  • lateral
  • ventral
22
Q

what is the grey matter subdivided into

A

10 laminae of Rexed

23
Q

what is laminae 2 called

A
  • substancia gelatinosa
24
Q

what is the substancia gelatinosa

A
  • is where first order neurons of the spinothalamic tract synapse
  • mu and k opioid receptors, presynaptic and post synaptic are found of these nerve cells
  • are targets to manage pain
25
Q

what does the dorsal white matter consist of

A
  • ascending sensory fibers tracts
26
Q

what do the lateral and ventral white matter consist of

A
  • descending motor tracts
  • can ascend to the brain or
  • association tracts originate and terminate entirely within the spinal cord (reflexes)
27
Q

what do sensory/ afferent fibers do

A
  • ascend
  • transmit pain, temp, pressure, touch, vibration, and proprioception
28
Q

where are sensory/ afferent fibers located

A
  • in the epidermis and dermis
29
Q

what are the 2 classifications of sensory fibers and where are they

A
  • exteroceptors (near surface of skin and oral mucosa)
  • proprioceptors (deep in skin, joints, ligaments, tendons, muscles, periostium)
30
Q

what are the two main sensory tracts

A
  • dorsal column - medial lemniscus
  • anterolateral pathway
31
Q

dorsal column - medial lemniscus pathway

A
  • sensory signal enters dorsal root
  • ascends through dorsal column on same side
  • arrives at medulla and crosses over (1st order to 2nd order synapse)
  • ascends via medial lemniscus tract through brainstem (2nd order neuron)
  • arrives at thalamus (2nd to 3rd order neuron)
32
Q

anterolateral pathway

A
  • sensory enters through dorsal horn (1st order)
  • immediately crosses, synapses in the dorsal horn of grey matter (rexed laminae)(1st to 2nd order)
  • ascends to thalamus (2nd order)
  • synapses in brainstem or thalamus (2nd to 3rd)
  • interpreted in brain (3rd order)
33
Q

fiber and details of dorsal column medial lemniscus

A
  • large myelinated fibers
  • discrete types of mechanoreceptive sensations
  • very specific
  • vibration, movement against skin, position of joints, fine touch
34
Q

fibers, sensations and details of anterolateral system

A
  • small myelinated
  • slower speeds
  • broad spectrum of sensory modalities (pain, touch, warm, cold)
  • non-specific
  • sexual sensations
35
Q

SNS preganglionic fibers

A
  • b fibers
  • originate in the intermediolateral gray horn between T1-L2
  • exit the spinal cord via ventral nerve root (white rami)
  • paired segmental paravertebral ganglia form sympathetic trunk
36
Q

what are the cervical ganglia divided into

A
  • superior ganglia
  • medial ganglia
  • inferior ganglia
37
Q

stimulation of the SNS superior ganglia causes

A
  • mydriasis (dilation, contraction of radial muscle)
  • constriction of ciliary muscles of the head
38
Q

damage to the cervical paravertebral ganglia causes what

A
  • horner syndrome
39
Q

what are the signs of horner syndrome

A
  • miosis (pupil constriction)
  • ptosis (drooping eyelid)
  • anhydrosis (lack of sweating)
40
Q

inferior ganglia forms what

A
  • fuses with first thoracic to form the stellate ganglia
  • located C5-C6
41
Q

what are the 4 stages of pain

A
  • transduction
  • transmission
  • modulation
  • perception
42
Q

T-4 correlates with what

A
  • nipple line
43
Q

T6/7 correlates with what

A
  • xiphoid process
44
Q

T- 10 correlates with what

A
  • umbilicus
45
Q

corticospinal tract

A
  • supplies voluntary muscles of the trunk and extremities
  • originates in the large, upper motor neurons in the precentral gyrus
  • most neuromuscular disorders originate here (cerebral palsy and ALS)

Advanced anesthesia 2 (10 decks)

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