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Apex > Spinal Cord > Flashcards

Spinal Cord Flashcards

1
Q

Spinal cord circulation consists of _____ anterior and ______ posterior arteries

A

2 posterior
1 anterior

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2
Q
A
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3
Q

The anterior spinal artery perfuses:

A

The anterior 2/3 of the spine

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4
Q

The posterior spinal arteries perfuse:

A

The posterior 1/3 of the spine

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5
Q

In the cervical region, spinal arteries are perfused by:

A

the vertebral arteries

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6
Q

In the thoracic and lumbar regions, spinal arteries are perfused by:

A

Radicular and lumbar arteries

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7
Q

What is the Artery of Adamkiewicz?

A

The greatest radicular artery

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8
Q

What is a “watershed” region in the spine?

A

regions of the spinal cord that only have one blood supply and no collateral, so they’re particularly vulnerable to ischemia

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9
Q

Where does the artery of adamkiewicz typically arise?

A

On the left side between T11 and T12

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10
Q

An aortic cross clamp ABOVE the artery of adamkiewicz can cause:

A

Anterior spinal artery syndrome

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11
Q

What is Beck’s syndrome?

A

Anterior spinal artery syndrome

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12
Q

What are the classic signs and symptoms of Beck’s syndrome?

A
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13
Q

The corticospinal tract is perfused by:

A

anterior blood supply

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14
Q

Autonomic nerve fibers are perfused by:

A

anterior blood supply

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15
Q

The spinothalamic tract is perfused by:

A

Anterior blood supply

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16
Q

The dorsal column is perfused by:

A

posterior blood supply

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17
Q

The corticospinal tract is responsible for:

A

primary motor activity for the somatic system from the neck to the feet

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18
Q

The spinothalamic tract is responsible for:

A

carrying pain and temperature sensation toward the brain

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19
Q

The dorsal column is responsible for:

A
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20
Q
A
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21
Q

Sensory neurons exit the spinal cord via _________

A

the dorsal nerve root

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22
Q

Motor AND autonomic neurons exit the spinal cord via ______________

A

the ventral nerve root

23
Q

Where are laminae located?

A

In the gray matter of the spinal cord

24
Q

The white matter of the spinal cord contains:

A

the axons of the ascending and descending tracts

gray matter is for receiving and modulating. White matter is for travelling.

25
Q

What is the role of laminae 1-6? Where are they located?

A
26
Q

What is the role of laminae 7-10? Where are they located?

A
27
Q

How can you figure out the purpose of a tract based on its name?

A

The first half of the name indicates where the tract begins

The second half indicates where the tract terminates

28
Q
A
29
Q
A
30
Q

How does damage to upper motor neurons manifest?

A
31
Q

The babinski test assess integrity of which tract?

A

corticospinal

32
Q

Is a positive babinski sign present with upper or lower motor neuron injuries?

A

Upper, not lower

33
Q

Lower motor neuron injury results in:

A

Impaired reflexes and flaccid paralysis

34
Q

SSEPs monitor which tract?

A

Dorsal column, posterior spinal artery

35
Q

MEPs monitor which tract?

A

ventral corticospinal,
anterior spinal artery

36
Q

What is another name for the corticospinal tract?

A

pyramidal tract

37
Q

What is a positive babinski sign?

A

upward extension of the big toe with fanning of the other toes

38
Q

Where do upper motor neurons begin and end?

A

They begin in the cortex and end in the ventral horn of the spinal cord

39
Q

Where do lower motor neurons begin and end?

A

They begin in the ventral horn of the spinal cord and terminate at the neuromuscular junction

40
Q

What is the most common site of spinal cord injury?

A

C7

41
Q

What are the symptoms of neurogenic shock?

A

Bradycardia, hypotension, hypothermia with warm extremities

42
Q

Are spinal reflexes present with a full spinal cord injury?

A

Initially, no. They will have flaccidity. But later these reflexes will return, leading to spasticity

43
Q

Why does spinal shock involve bradycardia?

A

Knocking out the cardioaccelerators leads to unopposed vagal tone

44
Q

Can you use Succinylcholine in a patient with a spinal cord injury?

A

Technically you can for the first 24 hours, but forcing fasciculations may worsen outcomes. Best to not.

45
Q

When are patients at risk for autonomic hyperreflexia?

A

Once spinal shock ends (about 1-3 weeks out) BECAUSE spinal sympathetic reflexes return BELOW the level of injury

46
Q

Which patients develop autonomic hyperreflexia?

A

86% of patients with a lesion above t6 will develop it

47
Q

Which situations have the highest risk for triggering autonomic hyperreflexia?

A

Bladder Cath
Cysto, Colonoscopy
bowel movement
childbirth

48
Q

How is autonomic hyperreflexia treated?

A

Removing the stimulus
Deepening the anesthetic
Administering a rapid-acting vasdilator

49
Q

How is bradycardia from autonomic hyperreflexia best treated?

A

With an anticholinergic

50
Q

If a woman with a spinal cord injury is laboring without pain, do they still need analgesia?

A

YES!! Stimulation can still trigger hyperreflexia. Spinal is better than epidural, which doesn’t as reliably anesthetize the roots

51
Q

What is ALS?

A

progressive degeneration of motor neurons in the corticospinal tract, leaving sensation intact

52
Q

What is another name for the dorsal column?

A

Medial lemniscal tract

53
Q
A

Apex (46 decks)

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