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APA 3 - Wolfe > Spinal Anatomy > Flashcards

Spinal Anatomy Flashcards

1
Q

The spine has ___ vertebrae separated by intervertebral discs

A

33

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2
Q

The vertebral body is ____ and ____

A

Solid and cylinderical

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3
Q

2 pedicles join with 2 lamina to complete and arch known as

A

(oval shape) vertebral foramen

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4
Q

What is the purpose of the vertebral foramen?

A

Allows for passage and protection of spinal cord

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5
Q

What process is on each side laterally?

What process is posteriorly?

A

laterally - transverse process

posteriorly - spinous process

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6
Q

When feeling for a a spinal or epidural placement, what are we feeling for?

A

The spinous process

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7
Q

Why do the spinous process overlap?

A

To protect the spinal cord

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8
Q

There are lateral notches superiorly and inferiorly (larger), it creates a space known as ______, and allows for passage of _____.

A

intervertebral body

nerves

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9
Q

If the discs in-between the intervertebral lamina become damaged, pressure on the nerves can result in what?

A

pain and paresthesias

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10
Q

Pedicles have superior and inferior articular surfaces and lateral notches
When vertebrae are stacked the notches and surfaces form the ____

A

facet joint

guides and restricts the movement of the vertebral column

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11
Q

Cervical and Thoracic
Spinous processes are more ____
Require more ____ angle for needle

A

angled

cephalad

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12
Q

Lumbar
The vertebra are ____
Less overlap =
Allows for easier

A

Larger
Larger gaps
needle placement

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13
Q

Sacrum

This part of the vertebra is ____

A

Fused

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14
Q

Sacrum

Lamina of last vertebra is incomplete and bridged only by ligaments, what is this known as

A

Sacral hiatus

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15
Q

What is the bony process used to ID the sacral hiatus?

What is this good for?

A

Sacral Cornu

Caudal block

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16
Q 
How many
Cervical:
Thoracic:
Vertebral:
Sacral:
Coccygeal:
A 
Cervical: 7
Thoracic: 12
Vertebral: 5 
Sacral: 5 fused
Coccygeal: 4 fused
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17
Q

Scoliosis –
Kyphosis –
Lordosis –

A

Scoliosis – lateral curvature
Kyphosis – posterior curvature
Lordosis – Anterior curvature

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18
Q

Is the interlaminar foramen always directly anterior to the spinous process

A

NO

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19
Q

What are the 3 ligaments that connect the spinous process (in order of how you hit them with a needle)

A

Supraspinous
Intraspinous
Ligamentum Flavum

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20
Q

Supraspinous Ligament
Weak or strong?
What does it connect?
Where is this a major ligament at?

A

Strong cord like ligament
Connects apices of spinous processes
Major ligament of cervical & upper thoracic regions

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21
Q 
Intraspinous ligament 
Thin or thick?
Where is it located?
What is it like in the cervical region?
What is it like in the lumbar region?
A

Thin
Runs between adjacent spinous processes
Absent or poor quality in cervical region
Can be extremely thin in Lumbar

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22
Q

Ligamentum Flavum

  • Strongest or weakest?
  • Where is it thin and thick at?
  • How thick at L2-L3?
  • Join the _____ through vertical extensions from adjacent lamina
  • Paired flat ligaments between each lamina and overlap
  • Creates appearance of a
A
  • Strongest
  • Thin on lateral edge, thick midline, like a V
  • Can be 3-5 mm thick at L2-3
  • Join the Vertebral arches through vertical extensions from adjacent lamina
  • Paired flat ligaments between each lamina and overlap
  • Creates appearance of a contiguous ligament
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23
Q

Where is the epidural space located?

A

Lies between ligamentum flavum and dura mater

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24
Q

Where does the epidural space originate and end?

A

Contiguous from base of cranium to sacral sulcus

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25
Q

What is the distance of the epidural space from the skin?

A

Varies with level and loosely correlated with weight (heavier they are, the deeper it is)

Midline Lumbar approach 2.5-8 cm, average 5 cm

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26
Q

What are the contents of the epidural space?

A

veins, fat, lymphatics, segmental arteries, and nerve roots

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27
Q

Epidural veins are _____, form a plexus being most predominantly _____, become engorged during ____&_____

A

valveless
Lateral
Pregnancy & obesity

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28
Q

What is the depth of the epidural space at
Cervical:
Thoracic:
Lumbar:

A

Cervical: 1.5-2mm
Thoracic: 3-5mm
Lumbar: 5-6mm

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29
Q

The spinal cord extends from the medulla oblongata to where in adults vs Peds?

A

Adults: L2
Peds: L3

30
Q

The spinal cord has 3 layers of meninges, what are they in order from posterior to anterior

A

Dura Mater
Arachnoid Mater
Pia Mater

31
Q

Which meningeal layer holds the CSF?

A

Arachnoid Mater

32
Q 
The spinal cord has \_\_\_ pairs of spinal nerves
Cervical:
Thoracic:
Lumbar:
Sacral:
Coccygeal:
A 
31 pairs
Cervical: 8
Thoracic: 12
Lumbar: 5
Sacral: 5
Coccygeal: 1
33
Q

Thoracic nerves run along what margin of the rib?

Where would you want to place a chest tube?

A

Inferior

Superior aspect of the rib

34
Q

The level of spinal nerve does not always correlate with vertebra.
Where does the 1st nerve exit?
Where does C8 exit?

Cervical correlate with vertebrae ___, after T1 correlates with vertebrae ____.

A

Base of skull and atlas
Between C7 and T1

below
above

35
Q

The spinal cord is approx _____ shorter than the vertebral canal

A

25 cm

36
Q

Where is the spinal cord enlarged at?

A

C5-C7 and L2-L3

C4-T1 – brachial plexus
L2-S3 – lumbar and sacral plexus

37
Q

What is the Cuada Equine?

Where does it extend?

A

Long roots of lumbar and sacral nerves

Extends from L1-S5

38
Q

Dorsal root contains _____ fibers

Ventral root contains _____ fibers

A

Sensory (dorsal entering sensory)

Motor (ventral outgoing motor)

39
Q

The spinal cord contains ___ shaped central grey region. What does it contain?

A

H-shaped

Neuronal cell bodies and unmyelinated fibers

40
Q

The spinal cord is surrounded by ____ matter. What does it contain?

A

white matter

Fiber tract

41
Q

Grey matter is subdivided into:

What are the afferent and efferent tracts?

A

12 Laminae of Rexed

Afferent I-VI (receives sensory information from the periphery)

Efferent VII-IX (Ventral tracts - motor neurons)

42
Q

In the grey matter, the _____ is very important to anesthesia. What is it called?

A

Laminae II

Substanca Gelatinosa

43
Q

What is dorsal white matter?

A

Almost exclusively ascending sensory fiber tracts

44
Q

What are lateral and ventral white matter?

A

Descending motor tracts

Can do two things:
Ascend to the brain
Association tract originate and terminate entirely within the spinal cord (reflexes)

45
Q

What do sensory (afferent/ascending) transmit?

A

Transmit pain, temp, pressure, touch, vibratory sense, and proprioception

46
Q

Where are sensory afferent receptors located?

A

Epidermis & Dermis = pain and temp

Dermis = Pressure, touch, vibration, proprioception

47
Q

What are 2 classifiactions of sensory receptors?

A

Extroceptors –> near surface of skin and oral mucosa (why kids put things in their mouth)

Proprioceptors –> Deeper skin layers, joint capsules, ligaments, tendons, muscles, and periostium

48
Q

There are 2 main sensory tracts, what is the Dorsal Column-Medial Lemniscus

Carries signals ______ in dorsal column tract
Cross over at _____
Carried through ___ in medial lemniscus tract
To area of brain to ____

A

upwards towards the medulla
medulla
brainstem to thalamus
interpret

(look at slide 29)

49
Q

There are 2 main sensory tracts, what is the Anterolateral Pathway

Originate in dorsal horn to ____ where they synapse

____ cross over in anterior commissure to anterior and lateral white columns

Ascend to brain through associated tract
Anterior spinothalmic or lateral spinothalmic

Go to brainstem or thalmus

To area of brain to interpret

A

Laminae I, IV, V, VI

Immediately

(look at slide 31)

50
Q

Where do IV and Neuraxial opioids work?

A

Substancia Gelatinosa

51
Q 
Dorsal Column-Medial Lemniscus:
Fibers:
Conduction Speed:
Spatial Orientation:
Types of mechanoreceptive sensations:
A

Fibers: Large/mylinated
Conduction Speed: 30-110 m/sec (fast)
Spatial Orientation: high respect to organ
Types of mechanoreceptive sensations: discrete

52
Q 
Anterolateral System:
Fibers:
Conduction Speed:
Spatial Orientation:
Types of mechanoreceptive sensations:
A

Fibers: smaller/mylinated
Conduction Speed: Few – 40 m/sec (slow)
Spatial Orientation: low respect to origin
Types of mechanoreceptive sensations: broad

53
Q

What sensations does the anterolateral sensation transmit?

A 
Pain
Thermal (hot and cold)
Crude touch and pressure
Tickle and itch sensation
Sexual sensation
54
Q 
Sympathetic Nervous System
\_\_\_\_\_\_ neurons
What type of fibers?
Where does it originate?
Where does it exit the spinal cord?

Series of _____ segmental paravertebral ganglia form sympathetic trunks

A

Preganglionic Neurons
Small B fibers

Originate in the intermediolateral gray horn between? T1-L2/L3

Exit the spinal cord via the ventral nerve root
(White rami communicans)

Paired

55
Q

What is the cervical ganglia divided into?

A

superior, medial, and inferior ganglia

56
Q

What does stimulation of the SNS in the superior ganglia cause?

A

Mydriasis (contraction of the radial muscle of the iris)
Relaxation of the ciliary muscle of the eye
Constriction of the blood vessels of the head

57
Q

Damage to the superior cervical ganglia causes:

A

Miosis (small pupil)
Ptosis (drooping eyelid)
Anhydrosis (lack of sweating)

HORNERS SYNDROME

58
Q

The inferior cervical ganglia fuses with first thoracic to form what?

A

Stellate Ganglia

C5-C6

59
Q

What are the 4 stages of pain transmission?

A

Transduction
Transmission
Modulation
Perception

60
Q

Pain and temp pathway

A

need to read book to understand this…

61
Q

Spinal reflex arc

A

need to read book to understand this…

62
Q

Dematomes:
T4
T6/T7
T10

A

T4 - nipple line
T6/T7 - Xiphoid process
T10 - Belly Button

63
Q

Dermatomes: Hand
C6
C7
C8

A

C6 - thumb
C7 - index/middle finger
C8 - ring/pinky finge

64
Q

Motor pathways:

Motor/Efferent (Exit) transmits info from brain to…

A

voluntary muscles, smooth and cardiac muscles and some glands

65
Q

Motor pathways:

Corticospinal tract supplies the…

A

voluntary muscles of the trunk and extremities

66
Q

Where does the corticospinal tract originate?

A

Originates in large, upper motor neurons locate in the precentral gyrus

67
Q

Corticospinal tract:

Damage can cause lower motor neurons to..

A

Overfire – Hyperreflexia

Fire simultaneously – spasticity

68
Q

Corticospinal tract:

With upper motor neuron paralysis..

A

Reflexes intact
Suppressor fibers impeded
Hyperreflexia occurs

69
Q

Corticospinal tract:

Damage to lower motor neurons produce..

A

flaccid type paralysis

70
Q

What disease effect the corticospinal tract?

A

Cerebal Palsy and ALS

APA 3 - Wolfe (11 decks)

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