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Y2 Neuroscience and Mental Health > Spinal cord function and dysfunction > Flashcards

Spinal cord function and dysfunction Flashcards

1
Q

Where do nerves leave the vertebral column

A

Through intervertebral foramina

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2
Q

What are the enlargements for innervation of the limbs

A

Cervical - C3-T1

Lumbar - L1-S3

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3
Q

Describe the organisation of the spinal cord

A 
31 spinal segments and pairs of spinal nerves
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
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4
Q

What are the meningeal coverings from outside in

A

Epidural space - Filled with fat and venous plexus. Between dura and periosteum (only vertebral column)
Dura mater - continuous sheet of dura, extends to S2
Arachnoid mater - Ballooned against the dura
Subarachnoid space - CSF
Pia mater - Adheres tightly to the surface of the spinal cord

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5
Q

Where is spinal anaesthetic and an epidural injected

A

L3-4 into the subarachnoid space

L4-5 into the epidural space

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6
Q

What are the grey and white matter made up of

A

Grey - cell bodies of interneurons and motor neurons, neuroglia cells and unmyelinated axons.
White - tracts, myelinated motor and sensory axons

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7
Q

Define dermatome

A

Area of skin innervated by one single spinal nerve or spinal segment

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8
Q

Define myotome

A

Muscles innervated by one single spinal nerve or spinal segment

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9
Q

What is the exit point for the anterior (motor) root

A

Anterolateral sulcus

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10
Q

What divides the anterior surface of the spinal cord in two halves

A

anterior median fissure

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11
Q

What is the entry point of the posterior (sensory) root

A

Posterolateral sulcus

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12
Q

What divides the posterior surface of the spinal cord in two halves

A

Posterior median sulcus

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13
Q

Describe motor neurones in the grey matter

A

Motor neurones exit and travel to the target muscle via ventral horn
(interneuron circuits to filter descending motor information)

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14
Q

What is the substantia gelatinosa

A

Spinothalamic pathway primary neurones enter the spinal cord and ascends to synapse here
Lamina II of the grey matter
First modulation for pain and temperature

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15
Q

What is the posterolateral fasciculus

A

Lissauer tract
Sensory fibres carrying pain and temp will ascend or descend several spinal cord levels here before synapsing in the dorsal horn

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16
Q

Describe the pain and temperature tract in the spinal cord

A

Fibres enter the dorsal horn
Synapse in the nucleus proprius
Fibers cross in the anterior commissure and then ascend in the spinothalamic tract
Spinothalamic

17
Q

Describe the discriminative touch and proprioception tract

A

Sensory fibres enters the dorsal horn and travel in dorsal columns, ascends and then crosses in the medulla
(does not synapse in the posterior horn)
Dorsal column

18
Q

What are the major tracts of the spinal cord

A 
Fasciculus gracilis
Fasciculus cuneatus
Spinocerebellar tract
Lateral corticospinal tract
Spinothalamic tract
Anterior corticospinal tract
19
Q

What is the role of the Fasciculus gracilis

A

Sensory (fine touch, vibration, proprioception) from the ipsilateral lower limb

20
Q

What is the role of the Fasciculus cuneatus

A

Sensory (fine touch, vibration, proprioception) from the ipsilateral upper limb

21
Q

What is the role of the Spinocerebellar tract

A

Proprioception from limbs to cerebellum

22
Q

What is the role of the Lateral corticospinal tract

A

Motor fibre to ipsilateral anterior horn (mostly limb musculature movement)

23
Q

What is the role of the Spinothalamic tract

A

Pain and temperature from contralateral side of the body

24
Q

What is the role of the Anterior corticospinal tract

A

Motor fibre to ipsi- and contralateral anterior horn (mostly axial musculature movement)

25
Q

Describe the main voluntary movement pathway

A

Via the corticospinal tracts
Motor cortex in the brain sends a fibre to the medulla, where it crosses to the other side (85%) to travel to limb muscles or remains on the same side to travel to axial muscles (15%)

26
Q

Compare the main sensory pathways

A

Discriminative touch synapses in the medulla and crosses to the other side
Pain and temp. will synapse in the spinal cord and cross to the other side

27
Q

Describe autonomic outflow

A

Thoracic and lumbar spinal cord has an intermediate horn for motor neurones of the sympathetic system
T1-L2 = sympathetic
cranial and S2-4 = parasympathetic

28
Q

What factors affect severity of spinal lesions

A

Loss of neural tissue
Vertical level
Transverse plane (location of lesion)

29
Q

Explain how loss of neural tissue affects lesions

A

Usually small if due to trauma

Can be more extensive (metastases, degenerative, demyelination)

30
Q

Explain how vertical level affects lesion

A

The higher the lesion, the greater the disability

31
Q

What are the main tracts involved in spinal lesions

A

Dorsal colums
Lateral corticospinal
Spinothalamic

32
Q

What are the stages of injury to lateral corticospinal tract

A

Stage 1. Spinal shock: loss of reflex activity below the lesion, lasting for days or weeks = flaccid paralysis

Stage 2. Return of reflexes: hyperreflexia and/or spasticity = rigid paralysis

33
Q

What are denticulate ligaments

A

Lateral projections of the Pia mater which extend to the dura mater to stabilise the spinal cord

34
Q

Describe the horns of the spinal cord

A

Ventral horns - motor neurones, axons control the muscles of the body via the ventral roots and spinal nerves

Dorsal horns - receive sensory information from the body via spinal nerves and dorsal roots

Intermediate horns (T&L) - sympathetic preganglionic motor neurones, axons control visceral functions via ventral roots and spinal nerves

35
Q

Why is damage to the white matter more likely to be more severe

A

A lesion may damage the ascending/descending tracts, therefore every part of the body supplied by nerves below the lesion will be damaged.

36
Q

What is the difference between the roots, a ramus and the spinal nerve

A

Root - only contains nerve fibres of one type (V=motor, D=S)
Spinal nerve - combination of the root nerve fibres
Ramus - contains mixture of motor and sensory

37
Q

Describe the reflex pathway

A
  1. Sensory elements in the muscle stretch
  2. Signal sent to the spinal cord via the sensory neurone
  3. Synapse with a motor neurone
  4. Impulse comes back to the muscle and causes contraction
    Reflex actions occur on the same side of the body to remove form the danger, but also cross to the other side to stabilize the body
38
Q

Where does the dura mater extend to

A

S2

Y2 Neuroscience and Mental Health (22 decks)

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