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Med Neuro Block 1 > Spinal Cord > Flashcards

Spinal Cord Flashcards

0
Q

What is the arterial supply of the sp. cord?

A

branches of the ant. spinal a.
post. spinal a.

(also gets supply from multiple radicular aa.)

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1
Q

What is the sp. cord derived from?

A

embryonic neural tube

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2
Q

Where do the ant. & post. spinal aa. branch from?

A

vertebral arteries

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3
Q

The spinal cord extends from the _________ to the _________.

A

medulla at the foramen magnum; lower border of L1

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4
Q

What are the 2 enlargements? What are their functions?

A

Cervical - innervate upper extremities

Lumbar - innervate lower extremities

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5
Q

Conus medullaris

A

L1 & L2 vertebrae

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6
Q

Site for lumbar puncture:

A

L4-L5 vertebrae

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7
Q

Filum terminale

A

pia mater from the conus medullaris to the coccygeal ligament

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8
Q

Cauda equina

A

lumbosacral roots surrounding the filum terminale

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9
Q

How is the sp. cord segmented?

A 
31 pairs of spinal nerves in 31 segments:
8 cervical 
12 thoracic
5 lumbar
5 sacral
1 coccygeal
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10
Q

All spinal nerves innervate a single dermatome except?

A

C1

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11
Q

What is referred pain?

A

convergence of somatic and visceral afferents

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12
Q

Spinal nerves exit the _________ via the ____________ (location of ______).

A

vertebral canal; intervertebral foramina; DRG

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13
Q

Spinal cord indentations:

A

Anterior median fissure
posterior median sulcus/septum
posterolateral sulcus
posterior intermediate sulcus

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14
Q

What lies in the ant. median fissure?

A

ant. spinal artery and vein

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15
Q

____________ (entry of dorsal roots)

____________ (exit of ventral roots)

A

posterolateral sulcus

anterolateral sulcus

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16
Q

The ______________ is found in the ______________ only and is the separation of between 2 major ascending tracts

A

posterior intermediate sulcus; cervical and thoracic

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17
Q

What is the largest area of the spinal cord? The smallest?

A

cervical enlargement

sacral level

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18
Q

White matter is subdivided into:

A 
Posterior funiculus (dorsal column)
Lateral funiculus (column)
Anterior funiculus (column)
19
Q

Posterior funiculus:

A

Ascending somatosensory fibers:

1) Fasciculus gracilis (sacral & lumbar)
2) Fasciculus cuneatus (thoracic & cervical)

20
Q

What is the function of ascending somatosensory fibers?

A

fine touch
vibration
two-point discrimination
proprioception

21
Q

Lateral funiculus:

A

Descending tracts to the spinal cord:
lateral corticospinal tract
rubrospinal tract

22
Q

What is the largest and most important tract? What will happen if this tract is lesioned?

A

lateral corticospinal tract

if lesioned, spastic paralysis will occur on the ipsi lateral side at the spinal cord level

23
Q

The rubospinal tract is a(n) ____________ tract

A

contralateral

24
Q

The posterior funiculus is a(n) __________ tract.

A

ipsilateral

25
Q

What will happen if the posterior funiculus is lesioned?

A

There will be loss of somatosensory sensation on the ipsi side below the level of the lesion

26
Q

Ascending tracts from the spinal cord:

A

spinothalamic tracts = anterolateral tract

posterior spinocerebellar tract

27
Q

Spinothalamic tracts:

A

contralateral tract
pain, temp., crude touch

if lesioned: loss of sensation on the contralateral side

28
Q

Posterior spinocerebellar tract:

A 
ipsilateral tract (from spinal cord to cerebellum)
stretch, touch and pressure sensation

if lesioned: loss of sensation on the ipsilateral side

29
Q

Anterior funiculus:

A

smaller ascending and descending tracts

crossing of the spinothalamic tracts

30
Q

Gray matter is subdivided into:

A

dorsal horn
ventral horn
lateral horn

31
Q

Dorsal horn:

A

Sensory:
receives sensory input
mediates synapses
gives rise to ascending sensory pathways

33
Q

Ventral horn:

A 
Motor:
• α motoneurons
• γ motoneurons
• interneurons
• Neurons innervate extrafusal & intrafusal muscle fibers
34
Q

Lateral horn:

A

Intermediolateral cell column (T1-L2/L3)

Thoracolumbar sympathetic outflow (preganglionic)

35
Q

There are ____ cellular laminae

A

9

36
Q

Dorsal horn: I - VI

A

All sensory:
I - marginal zone (pain & temp)
II - substantia gelatinosa (interneurons)
III - V - mechanical visceral and noxious stimuli
VI - prominent only at enlargements

37
Q

Which laminae give rise to the anterolateral tract?

A

I, V and some VII

38
Q

Intermediate zone: dorsal VII

A

Medial: Clarke’s nucleus (C8-L3)
• gives rise to dorsal spinocerebellar tract

Lateral:
• Intermediolateral cell column (T1-L2/L3) - preganglionic sympathetic
• Sacral autonomic nuclei (S2-S4) - preganglionic parasympathetic

39
Q

Ventral horn:

A

ventral VII, VIII & IX

• Motor neuronal groups in lamina IX: innervate truncal & limb muscles

40
Q

General functional significance of the spinal cord:

A

1) receives the primary sensory afferent inputs from the DRG; relays them to the brain stem, cerebellum or the thalamus; may or may not synapse within the spinal cord
2) α & γ motorneurons that innervate extrafusal & intrafusal muscles
3) mediates spinal reflexes
4) intermediolateral cell column from T1 to L2/L3 that gives rise to preganglionic sympathetic fibers; synapse in the paravertebral & prevertebral ganglia
5) preganglionic parasympathetic neurons in S2-S4; synapse in terminal ganglia within walls of the pelvic viscera
6) major sensory & motor ascending and descending tracts run through it

41
Q

Lesions of the spinal cord:

A 
dorsal root lesions
ventral root lesions
spinal cord hemisection (Brown-Sequard syndrome)
spinal cord transection
syringomyelia
42
Q

Dorsal root lesions:

A

hypesthesia or anesthesia

43
Q

Ventral root lesions:

A

weakness/flaccid paralysis & atrophy of muscles

involvement of autonomic preganglionic fibers may result in autonomic dysfunction

44
Q

Spinal cord hemisection:

A

loss of fine touch, vibration and propioception ipsilateral to & below lesion
loss of pain & temp. contralateral to & below lesion
spastic paralysis ipsi to & below lesion

45
Q

Spinal cord transection:

A

destruction of ascending and/or descending tracts produces sensory, motor & mixed deficits

46
Q

Syringomyelia:

A

damage crossing fibers around the central canal

Med Neuro Block 1 (11 decks)

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