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spinal cord and nerves Flashcards

1
Q

how would a lesion in Broca’s left side present and why?

A

fainting, unconscious, loss of speech, able to print with left hand but right hand paralysed and arm weak. This is because in most people the left Broca’s area is responsible for articulation of speech and the lateral inferior pre central gyrus near L Broca is for motor control initiation and controls the RHS meaning that a lesion could spread here

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2
Q

what supplies Brocas area and pre-central gyrus?

A

the middle cerebral artery

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3
Q

which areas of the pre-central gyrus control the face and hands?

A

lateral is the hands and inferior is the face

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4
Q

what comprises a) the CNS and b) the PNS?

A

a) brain and spinal cord

b) spinal nerves and cranial nerves

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5
Q

what are the divisions of the peripheral nervous system?

A

there is the somatic nervous system which controls the external actions of the skin and muscles and the autonomic which controls the internal activities of the glands and organs

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6
Q

how is the autonomic nervous system divided?

A

parasympathetic and sympathetic

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7
Q

what is grey matter?

A

it is made of cell bodies of neurons and therefore in the CNS is nuclei and outside is ganglia - it contains many synapses

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8
Q

what is the cortex?

A

it is the outer layer of the hemispheres that is columns of grey matter neurons with white matter underneath

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9
Q

where else in the CNS is grey matter found?

A

inside of the spinal cord

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10
Q

why is white matter white?

A

due to myelination

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11
Q

what is white matter in the CNS and PNS?

A

CNS is tracts or fasciculi and PNS is bundles or nerves

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12
Q

where else in the brain is grey matter?

A

it is where there are lots of collections of cell bodies in the deep brain such as the putamen, caudate nucleus and the globus pallidus

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13
Q

what is myelin?

A

it is a glial sheath

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14
Q

what is the function of the vertebral column?

A

to contain and protect the spinal cord and the beginning of the spinal nerves

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15
Q

what is unique to C1 and 2?

A

C1 - atlas

C2 - dens and axis

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16
Q

what is the structure of the column?

A 
7 cervical 
12 thoracic 
5 lumbar 
5 sacral fused 
3/4 coccygeal fused 
body anterior and the spinous process is posterior
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17
Q

what is a vertebral arch made of?

A

spinous process, pedicle and lamina

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18
Q

what happens with the spinous process of thoracic vertebrae?

A

they overlap with the inferior vertebrae

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19
Q

what happens towards the caudal end of the vertebral column?

A

the spinal cord narrows and ends before the column does

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20
Q

what is the function of the spinal cord?

A

a means of transmitting information between the periphery and the brain

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21
Q

what is the origin and insertion of spinal cord?

A

it runs from the medulla of the brainstem which is attached to the cerebrum to LI/LII at the conus medullaris

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22
Q

how does the spinal cord exit the skull?

A

at the level of the foramen magnum of the occipital bone

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23
Q

what happens at the level of the medullary cone?

A

there is a bunch of spinal nerves leaving from that region - Lumbosacral enlargement

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24
Q

what are enlargements?

A

they are where the cord gives rise to nerves that innervate the upper and lower limbs such as the LSE

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25
what happens at the LSE?
cords hangs lower due to the cauda equina
26
what is the filum terminale?
it is an extension of pia mater that attaches the cord to the coccyx
27
how would the spinal cord be seen?
dissect the dural sac and meninges inside
28
how many segments and spinal nerves do we have?
31 - pair of nerves defined by segments
29
where is the conus medullaris?
from L1 to L2
30
where does the dural sac extend to?
it is a sac of meninges that extends to S1
31
what is a cistern?
it is an expansion of subarachnoid space with CSF in it - lumbar surrounds the cauda equina
32
how does CSF reach the spinal cord?
it leaves the brain through the medial and lateral apertures of the fourth ventricle and travels through subarachnoid space to bathe the spinal cord
33
what innervates the upper limb?
the brachial plexus
34
what innervates the lower limb?
lumbosacral enlargement from L1-S4
35
what is the transition point?
spinal nerves leave above their corresponding vertebrae until C7 - spinal nerve 8 must leave below this and from then downwards the spinal nerves leave below their vertebrae
36
what is the intervertebral foramen for?
exit point for all spinal nerves
37
what is at C1-C8?
brachial plexus
38
what is the cauda equina made of?
dorsal and ventral roots of the lower lumbar, sacral and coccygeal spinal nerves
39
what are the meningeal layers of the spinal cord?
dura, arachnoid and pia mater
40
what are potential spaces?
when they are not really real spaces - only something contained there when pathological - epidural in cranium (bleeding = pathological) and subdural in both
41
what is the subarachnoid space and epidural space in SC?
in SC epidural is fat filled so is a real space | subarachnoid is filled with CSF in both parts so real
42
what are denticulate ligaments?
they are extensions of pia mater that attach the spinal cord to the outer meninges and secure it laterally
43
where are lenticular ligaments?
they are between exits of spinal nerves
44
what secures the SC inferiorly?
the filum terminale
45
what happens as spinal nerves leave the cord?
they acquire layers of meninges - pia then arachnoid then dura
46
what are the components of dura?
in cranium there is outer periosteal and inner meningeal and in the SC there is only inner meningeal as a layer of dura around the spinal cord
47
what is the epineurium?
a protective outer sheath of connective tissue that is made of meningeal coverings over the spinal nerves
48
what is the periosteal layer of the cranial dural mater continuous with?
the periosteum exterior
49
where does S1 travel with respect to the vertebrae?
below the vertebrae
50
why is the column longer than the cord?
bones grow faster than the cord and the cord also regresses continuously
51
how does the S1 nerve travel dow?
within the dural sac in the lumbar cistern to exit below the respective spinal vertebrae
52
what is the cauda equina?
it is all the spinal nerves that exit below the sacral level collectively
53
why do the cervical nerves leave close to their origin respectively?
because the cervical segment at the top is close to the vertebrae
54
what happens with the dural sac during development?
the dural sac will grow along the vertebrae but not the spinal cord resulting in changes in cord length
55
what is lumbar puncture?
it is inserting a needle into the ligamentum flavum through the space in between the vertebrae lamina to reach the foetal sac and acquire a sample of CSF
56
why is lumbar puncture done?
to identify infectious diseases, RNC in the CSF due to subarachnoid haemorrhage and meningitis
57
where is the safest place for a lumbar puncture?
between L4 and L5 however there are anatomical variations and therefore must be aware of where the cord ends
58
where is the needle for lumbar puncture inserted?
into the lumbar cistern - the nerves will move away
59
what is epidural anaesthesia?
when the needle is inserted into the epidural space and does not pierce the epidural layer - goes through the sacral hiatus
60
what are the posterior and anterior lateral sulci?
they are exit routes for the spinal nerves
61
what are the anterior and posterior median fissure and sulci?
they are grooves along the anterior or posterior spinal cord that separate them into parts
62
what do the vertebral arteries give rise to?
the posterior and anterior spinal arteries
63
where do segmental arteries come ffrom?
the aorta
64
how do medullary arteries arise?
the aorta reaches a level of the spinal nerve and branches segmental which branches into medullary
65
what do the medullary arteries supply?
the nerves and give rise to the radicular for the roots of the nerves
66
what does the segmental artery branch into?
the lateral sacral, vertebral, posterior intercostal, lumbar and deep cervical arteries
67
where is the grey matter in the brain and SC?
brain on the outside and inside in the spinal cord
68
what horns of grey matter are there in the SC?
dorsal, ventral and lateral
69
where is lateral grey matter in the SC?
between T1 and L2 and S2 and S4
70
how is white matter organised in the SC?
into columns | dorsal lateral and ventral white columns
71
what is the ventral white commissure?
the SC equivalent of the brains corpus callosum | it is a area of white matter fibres that connect the left and the right
72
what is the PNS?
it is all connections outside of the brain and spinal cord
73
what are sensory fibres?
they are afferent fibres that send information into the CNS
74
what are motor fibres?
they are efferent fibres that send information away from the CNS
75
how are nerves made?
rootlets form roots form nerves
76
where do the ventral and dorsal rootlets come from?
ventral from the anterolateral sulcus and dorsal from the posterolateral sulcus
77
how is a segmental spinal nerve made?
each spinal level gives rise to one pair of spinal nerves - the ventral rootlets make the ventral root and dorsal the dorsal root and ganglion, these roots join to make a segmental spinal nerve
78
how is the CNS attaches to the PNS?
via its nerve rootlets
79
how does information from a sensory receptor result in an action?
sensory information from a peripheral receptor travels via a spinal nerve fibres (afferent sensory) to cell bodies in the dorsal root ganglion. Central processes here extend using the dorsal root to enter the grey matter dorsal horn in spinal cord. Motor information is then sent to cell bodies in the ventral horn (somatic motor) via spinal nerves using the ventral root to the muscle
80
where are visceral cell bodies found and what does this use?
in the lateral horn - also grey matter and also makes use of the ventral horn
81
why is a reflex arc important?
we may need to move immediately and therefore there is not enough time for the entire spinal communication and need to use the reflex arc.
82
what happens in the reflex arc?
the sensory neuron travels using the spinal nerve and enters the cord dorsally. It then uses interneurons which communicate one neuron with another and goes straight to cell body for motor neuron and then immediately to axon using ventral root to contact muscle
83
where is there a high amount of white matter?
as you go up the SC - all white matter has to pass through cervical segments to reach the cortex
84
where is there a high amount of grey matter?
ventrally in the cervical and lumbar enlargements compared to thoracic - need cell bodies to innervate limbs
85
what are the two dorsal columns of grey matter?
above T6 there is the cuneate and gracile fascicle
86
where is the gracile fascicle in relation to cuneate?
cuneate is lateral and gracile is medial
87
what is the grey matter structure in the thoracic segments?
small ventral grey horn and lateral grey horn
88
how does the medulla oblongata end?
as a tubercle
89
how does sensory information reach brain?
travels from SC into medulla
90
what do fascicles and tubercles contain?
fascicles contain axons and tubercles cell bodies
91
how is spinal cord grey matter organised?
regionally specialised | Rexed's Laminae - sites of sensory or motor nuclei
92
how long do the rexed lamina extend for?
varying length of cord
93
where is the marginal zone nucleus?
it is in the whole cord and is lamina I - it is for spinothalamic tract cells
94
what is the substantia gelatinosa?
it is throughout the whole cord and is lamina II - it is for pain and temperature
95
what is the nucleus proprius?
it is lamina III-IV and is throughout the whole cord - it is for general sensory processing
96
how is rexed lamina VII arranged?
``` into three nuclei intermedio-lateral nucleus; 1. from T1-L3 - sympathetic neurons 2. from S2-S4 - parasympathetic neurons third nucleus is Clarke's nucleus and this is from C8-L3 for dorsal spinocerebellar tract cells VII lamina is for visceral motor ```
97
how is rexed lamina IX arranged?
three nuclei 1. motor nuclei - extends throughout the whole cord and is for motor neurons 2. phrenic nucleus - from C3-C5 for motor for the diaphragm 3. accessory nucleus - medulla to C5 - motor - SCM and the trapezius
98
how does voluntary information travel?
from the brain down the spinal cord
99
where does specific sensory information travel through?
the dorsal columns
100
what is the spinothalamic tract for?
specific sensory information specific to crude touch, pain and temperature
101
what are the four columns of major ascending and descending tracts in the SC?
dorsal column, spinothalamic tract, then ventral, and the lateral corticospinal tract
102
what is the dorsal column for?
joint position sense, pressure, vibration and fine touch
103
what is the spinothalamic tract for?
crude touch, pain and temperature
104
what are the ventral and lateral corticospinal tracts for?
voluntary movement
105
are the four columns ipsilateral or contralateral for sensory/motor to body?
the lateral corticospinal and dorsal column is ipsilateral | the ventral corticospinal tract and the spinothalamic is contralateral

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