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Neuro Block 1 > Spinal Cord 1 > Flashcards

Spinal Cord 1 Flashcards

1
Q

What is the level most commonly injured in the spinal cord?

A

mid-low cervical spine followed by thoracolumbar junction (T9-L2)

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2
Q

Name the spinal vertebrae categories

A
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3
Q

The spinal cord is continuous with…

The spinal cord is ends where?

A

the medulla superiorly

around the 1st lumbar vertebra

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4
Q

The spinal cord occupies how much space of the vertebral canal?

A

anterior 2/3

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5
Q

the spinal cord is protected by what?

A

the meningeal layers and CSF

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6
Q

where do we see enlargement in the spinal cord?

A

Cervical : 3rd Cervical to 2nd Thoracic vertebrae.

Lumbar : 10th to 12th Thoracic vertebrae.

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7
Q

why are there enlargments of the spinal cord?

A

To maintain sensory motor requirements of the extremities, i.e. arms and legs.

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8
Q

what part of the spinal cord is this?

A

cervical portion

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9
Q

what part of the spinal cord is this?

A

Thoracic

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10
Q

what part of the spinal cord is this?

A

Sacral

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11
Q

what part of the spinal cord is this?

A

Lumbar

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12
Q

What connects the right and left sides of the spinal cord gray matter?

A

gray commissure

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13
Q

In thoracic nerve regions there is a lateral horn, also known as what?

A

intermediate gray horn or intermediolateral cell column.

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14
Q

on the left answer the type of nerve segment of the spinal cord and on the right fill, answer the name of the structure

A
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15
Q

Name what level of the cord

Identify the exeternal and internal features of the cord

A
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16
Q

What is a herniated disc?

A

When the outer layer of the disc ruptures, allowing the

softer inner layer to ‘leak’ and press up against the

spinal cord or nerves.

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17
Q

What symptoms can result from a herniated disc?

What is the most common regions for herniated discs to occur?

A
  • pain,
  • numbness,
  • tingling

Most common in lumbar/cervical regions.

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18
Q

Where do spinal nerves enter/exit the vertebra?

A
  • C1-C7 exit above their respective vertebra.
  • C8 exits below the C7 vertebra.
  • Thoracic, Lumbar and Sacral all exit below their respective vertebra
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19
Q

What does a ‘spinal segment’ consists of?

What do you call the spaces in the vertebra where the nerves pass through?

A
  1. two vertebra and the ligaments
  2. disc that join them

Neural foramina

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20
Q

How many spinal nerves are there and how are they arranged?

A

31 pairs of spinal nerves:

  • 8 Cervical
  • 12 Thoracic
  • 5 Lumbar
  • 5 Sacral
  • 1 Coccygeal
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21
Q

dorsal roots relay what type of information from the body?

ventral roots relay what type of information from the body?

A

sensory

motor output

22
Q

What are the functional Components of Spinal Nerve Fibers divided into? Define each.

A
  • GSA: General Somatic Afferent: transmits sensory input from skin, muscle, bone and joints to CNS.
  • GVA: General Visceral Afferent: sensory input from visceral organs to CNS.
  • GSE: General Somatic Efferent: conveys motor output from ventral (anterior) horn motor neurons to skeletal muscle.
  • GVE: General Visceral Efferent: conveys motor output to smooth muscle and visceral organs.
23
Q

identify the parts and where the corticospinal tract is

Also, tell if the H part is grey or white matter

A

H part = grey matter

24
Q

The anterior grey horn contains what type of neurons and for what? where do they exit through?

A
  • motor neurons to innervate skeletal muscle these exit through the anterior roots of the spinal nerves as alpha efferents.
  • Smaller motor neurons in this region leave via the same route, and innervate intrafusal muscle fibers. These are gamma efferents.
25
Q

the fasciculus gracilis is needed for what?

and the fasciculus cuneatus

A

control of legs

control of arms

26
Q

Identify the Medial and lateral groups of motor neurons (anterior horn)

A

Medial motor neuron = 12

Lateral motor neuron = 6

27
Q

Identify the areas

A
28
Q

which controls appendicular musculature and which controls axial musculature?

A

L = appendicular musculature

M = axial musculature

29
Q

What are lower motor neurons (LMN)?

A

The motor neurons with cell bodies in the anterior

horns that innervate musculature

30
Q

What are Upper Motor Neurons (UMN)?

A

The motor neurons that connect the ‘brain’ to the

LMN’s are called

31
Q

What are the nerve cell groups of the Posterior grey horn? what do each control?

A
  • Marginal layer: receives type A fibers, pain.
  • Substantia gelatinosa: receives information on pain, temperature, and touch, predominantly C type fibers.
  • Nucleus proprius: Receives both A and C fibers from spinothalamic tracts.
  • Nucleus dorsalis (Clark’s column): proprioception from spinocerebellar tracts, and also from dorsal columns.
  • Visceral afferent nucleus: receive visceral afferents.
32
Q

The White Matter of the Spinal Cord is divided into what? Name them,

A

funiculi

anterior, lateral, and posterior white columns.

33
Q

What is the Spinal cord blood supply?

how much does each part contribute to supplying the cord?

A
  • Anterior spinal artery for anterior 2/3 of cord.
  • Posterior spinal arteries (2) for posterior 1/3 of cord.
  • Segmental/radicular arteries: branches from vertebral/subclavian supplement blood supply in cervical regions, branches from descending aorta for thoracic/lumbar regions. The great anterior radicular artery supplies most of the blood in the lower cord.
34
Q

Anastomosis of radicular/spinal arteries is widespread and is called what?

A

arterial vasocorona.

35
Q

what are Spinal Cord Reflexes?

A
  • are ‘spinally mediated’, meaning they occur at the level of the spinal cord.
  • remain intact below the level of a spinal cord lesion (altered, but intact).
36
Q

name 3 spinal cord reflexes?

A
  1. Stretch (deep tendon) reflex
  2. Flexor withdrawal reflex:
  • Protective Reflex
  • pain) causes withdrawal of limb
  • may happen with crossed extensor reflex
    3. Crossed extensor reflex:
  • contralateral limb is extended to help support body
37
Q

What damage or lesions are the anterior and posterior roots prone to?

A

Due to their entry/exit points through the vertebral foramina, the anterior and posterior roots are susceptible to:

  • compression of the spinal cord,
  • herniated discs,
  • fractures,
  • dislocation,
  • vertebral tumors,
38
Q

what can we expect to see in a posterior root lesion?

A

Sensory loss from the corresponding dermatome…but could initially cause pain in the affected area, both skin and muscle.

39
Q

what can we expect to see in a anterior root lesion?

A

paralysis of the muscle innervated by that root, with possible partial paralysis of muscle(s) partially innervated by that root. Muscle atrophy (due to wasting) will occur.

40
Q

What is Tabes Dorsalis?

A

Syphilis or neurosiphilitic lesion that can cause damage/lesion to the dorsal root at the point of entry into the spinal cord.

41
Q

Tabes dorsalis occurs mostly in what regions?

How do patients with Tabes dorsalis walk?

A

thoracic/lumbar regions = lower extremities

with a slapping gait or by slapping the foot on the ground

42
Q

what are the symptoms of Tabes Dorsalis?

A
  1. Stabbing pains in lower limbs (beginning of disease)
  2. Hypersensitivity to touch, heat, cold (beginning of disease)
  3. Loss of sensation in skin and trunk
  4. Loss of awareness of a full bladder
  5. Loss of proprioceptive information
  6. Loss of deep pain sensation
  7. Ataxia of lower limbs
  8. Hypotonia of lower limbs
  9. Loss of reflexes
43
Q

What is Ataxia?

what is Hypotonia?

A
  • Difficulty in coordinating muscle movements
  • Reduced muscle tone
44
Q

Why will there be hypotonia and ataxia in tabes dorsalis?

A

due to loss of proprioceptive information from skeletal muscles, joints, and tendons.

45
Q

what is a tabetic gait?

A

Loss of reflexes: Stretch and tendon reflexes (biceps, knee-jerk, etc) have both a sensory and motor component. The syphilitic lesion in Tabes Dorsalis interrupts the afferent (sensory) part of this reflex arc.

46
Q

What is ALS (Amyotrophic Lateral Sclerosis)?

What symptoms can be expected with ALS?

The majority of ALS cases start with what type of symptoms?

Most patients die of what?

A
  • Degeneration of both UMN (specifically the corticospinal tract) and LMN’s.
  • Loss of voluntary control of muscles,
  • loss of bowel and bladder control.
  • Eye muscles usually, but not always, spared.
  • Cognition and ANS usually intact.
  • 75% start with limb onset
  • respiratory distress
47
Q

What is Poliomyelitis?

what are the symptoms?

A

Degeneration of LMN’s (mostly spinal, onlyoccasionally bulbar)

  • ‘flaccid’ paralysis
  • atrophy.
48
Q

ALS patients have a pseudobulbar effect, what is this?

A

they will have uncontrollable crying or laughing for no reason whatsoever

“reflexive tear or laughing”

49
Q

What is the romberg test?

A

tell patient to close eyes, and if they have dorsal column problems or cerebellar, they have no propioception and fall; can also be tested in dark rooms

50
Q

argyl robertson pupil’s are usually found in what disease?

A

in tabes dorsalis

51
Q

sudden symptoms are usually related to what problem?

when there is bilateral symptoms what arteries could explain it?

A

vascular

Anterior Spinal Artery or basilar

Neuro Block 1 (9 decks)

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