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Emma H&N > Spinal Cord I/II > Flashcards

Spinal Cord I/II Flashcards

1
Q

blood supply of anterior (ventral) 2/3 of spinal cord

A

single anterior spinal artery

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2
Q

blood supply of posterior (dorsal) spinal cord

A

pair of posterior spinal arteries

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3
Q

_____ and _____ arteries give rise to anterior and posterior spinal arteries

A

VERTEBRAL and RADICULAR arteries give rise to anterior and posterior spinal arteries

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4
Q

CSF

A

surrounds spinal cord (shock absorber)

made by choroid plexus in the ventricles

350 microliters/min
1/2 L/day

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5
Q

blood vessels and CSF location

A

subarachnoid space (between arachnoid and pia)

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6
Q

which structures anchor the spinal cord to the dura?

A

denticulate ligaments and filum terminale

specializations of the pia

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7
Q

3 layers of meninges surrounding spinal cord

A

dura mater
arachnoid
pia mater

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8
Q

conus medullaris

A

end of the spinal cord

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9
Q

at birth the spinal cord ends between

A

L2/L3

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10
Q

in adults the spinal cord ends between

A

L1/L2

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11
Q

spinal taps can be safely performed by inserting the needle…

A

below the 2nd lumbar vertebrae.

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12
Q

the length of nerve roots becomes progressively longer from ______ to ______ levels of spinal cord

A

the length of nerve roots becomes progressively longer from CERVICAL to LUMBAR levels of spinal cord.

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13
Q

Which regions of the spinal cord is the diameter increased? why?

A

cervical and lumbar regions.

accommodates neurons required for upper and lower extremities.

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14
Q

levels of the cervical enlargement

A

C5-T1

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15
Q

levels of the lumbar (lumbosacral) enlargement

A

L3-S2

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16
Q

the spinal cord has both _______ and _______ organization

A

the spinal cord has both SEGMENTAL and LONGITUDNAL organization

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17
Q

What defines a spinal cord segment?

A

a pair of spinal nerves

dorsal and ventral rootlets give rise to one pair of spinal nerves

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18
Q

cell bodies for primary sensory neurons are all located ….

A

in ganglia of spinal cord and ganglia of cranial nerves in the brainstem.

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19
Q

ventral root

A

collection of axons motor neurons heading to striated muscle or visceral motor neurons heading to ANS.

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20
Q

white matter

A

axons

divided into funiculi (dorsal, ventral, lateral).

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21
Q

gray matter

A

collection of neuronal cell bodies including secondary sensory neurons, interneurons and motor neurons.

divided into dorsal and ventral horns.

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22
Q

2 branches of primary sensory neuron

A
  1. peripheral branch (coming in from skin)

2. central branch (going to spinal cord)

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23
Q

myotome

A

muscles innervated by a single nerve root

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24
Q

patellar reflex

A

an exp of segmental organization.

striking the patellar tendon activates muscle spindle primary endings, which then monosynaptically excite alpha motor neurons that innervate the stretched muscle.

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25
Q

reciprocal inhibition

A

an exp of segmental organization.

striking the patellar tendon initiates stretch reflex (excitation of quads) and also causes inhibition of motor neurons to antagonist hamstrings.

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26
Q

flexor reflex

A

an exp of segmental organization.

Exp. –> stepping on a tack

involves several segments, all connections=polysynaptic.

nociceptive fiber from the foot enters spinal cord at S1, activates motor neurons to illopsoas and hamstrings.

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27
Q

crossed extension

A

an exp of segmental organization.

stepping on a tack initiates flexor reflex + excitation of contralateral antagonist m.

contraction of contralateral quadriceps helps unaffected leg support the body.

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28
Q

funiculus

A

a bundle of nerves.

name given to white matter.

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29
Q

substantia gelitanosa

A

region that caps dorsal horn.

contains neurons modulating pain and temperature.

poorly myelinated so WHITE.

found at all levels of spinal cord.

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30
Q

preganglionic sympathetic cell bodies are located in…

A

intermediolateral cell column.

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31
Q

Axial muscles are controlled medially. How do ventral horns appear in transverse cross sections?

A

Axial muscles are controlled MEDIALLY.

ventral horns appear less expanded

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32
Q

Limb muscles are controlled laterally. How do ventral horns appear in transverse sections?

A

Limb muscles are controlled laterally.

ventral horns appear more expanded

33
Q

Which areas of the spinal cord have more white matter?

A

Higher levels of cord have more (lower down the nerves have already split off).

34
Q

preganglionic sympathetic neurons stem from which levels of spinal cord?

A

T1-L2

35
Q

preganglionic parasympathetic neurons stem from which levels of spinal cord?

A

S2-S4

36
Q

subdivisions of spinal cord gray matter

A
  • Substantia gelatinosa
  • Body of posterior horn
  • Clarke’s Nucleus
  • Intermediolateral column
  • Parasympathetic nucleus
  • Accessory nucleus
  • Phrenic nucleus
37
Q

Body of posterior horn

levels of spinal cord, function?

A

all levels.

function: sensory processing.

38
Q

Clarke’s nucleus

levels of spinal cord, function?

A

T1-L2

function: posterior spinocerebellar cells (proprioception)

39
Q 
Intermediolateral column
(levels of spinal cord, function?)
A

T1-L3

function: preganglionic sympathetic.

40
Q 
parasympathetic nucleus
(levels of spinal cord, function?)
A

S2-S4

function: preganglionic parasympathetic.

41
Q 
accessory nucleus
(levels of spinal cord, function?)
A

medulla-C5

function: motor neurons (SCM, trapezius)

42
Q 
phrenic nucleus
(levels of spinal cord, function?)
A

C3-C5

function: motor neurons (diaphragm)
* LESION –> respiratory issue

43
Q

Long tracts bringing information to or from must decussate during their ascent/descent. What does this mean?

A

Long tracts must cross to the other side of the neuraxis during their ascent/descent.

Left cortex deals w/ right side of body.
Right cortex deals w/ left side of body.

44
Q

Ascending spinal cord paths are 3 neuron pathways.

What is the location of the 3 neurons?

A

1st neuron: dorsal root ganglion (receptor to brainstem/spinal cord)

2nd neuron: brain stem or spinal cord (crosses to other side of NS) (to thalamus)

3rd neuron: thalamus (to cerebral cortex)

45
Q

Everything stops at the _____ before reaching the cortex.

A

Everything stops at THALAMUS before reaching the cortex.

46
Q

Posterior Column (Dorsal Column) Pathway

Modalities? Components?

A
  • position sense
  • vibration sense
  • 2 point discrimination
Fasciculus gracilis (lower body).
Fasciculus cuneatus (upper body).
47
Q

Fasiculus Gracilis

A

Info from T6 and BELOW enters the spinal cord here and travels medially.

48
Q

Fasiculus Cuneatus

A

Info from T5 and ABOVE enters spinal cord here and travels laterally.

49
Q

Spinothalamic Pathway

Modalities?
Mechanism?

A

localization of pain and temperature

dorsal root ganglion central processes synapse ON sensory neurons (2nd order neurons) in dorsal horn of the cord

then those neurons cross to other side and head up to thalamus/cortex CONTRALATERALLY.

50
Q

If you lesion spinothalamic pathway in spinal cord, where will deficit be seen?

A

Affected on side of body OPPOSITE from lesion. (contralateral)

51
Q

If you lesion dorsal column pathway in spinal cord, where will deficit be seen?

A

Affected on SAME side of body as lesion. (ipsilateral)

52
Q

Posterior Column (Dorsal Column) Pathway

General mechanism?

A

dorsal root ganglion sensory neurons transmit signal through central processes up the column IPSILATERALLY.

@ brainstem, meet nuclei of same name (2nd order neurons) and THEN cross over to other side of NS and head to cortex.

53
Q

ventral white commissure

A

keeps left and right part of spinal cord apart.

the only place where information can pass from one side of the cord to the other.

54
Q

describe neurons/axons of posterior column (dorsal column) Pathway

A

large neurons, heavily myelinated axons

55
Q

describe neurons/axons of spinothalamic pathway

A

small, poorly myelinated or non-myelinated axons

56
Q

long tract lesions

A

deficit at the level of lesion and below.

57
Q

suspended sensory loss

A

lesions do not involve long tracts, so reveal a band-like distribution of deficit at level of lesion.

58
Q

primary sensory neuron

A

Pseudounipolar.
Peripheral and central branches.
Cell body in dorsal root ganglion.

59
Q

referred pain

A

Pain seeming to originate from a specific area of the body as a result of a damaged internal organ.

The area to which the referred pain projects corresponds to the dermatome innervated by the spinal segment to which the visceral afferents project.

60
Q

dermatomes where pain from diaphragm is felt

A

C3-C4

61
Q

dermatomes where pain from heart is felt

A

T1-T4 (mainly left)

62
Q

dermatomes where pain from stomach is felt

A

T6-T10 (mainly left)

63
Q

dermatomes where pain from gallbladder is felt

A

T7-T8 (right)

64
Q

dermatomes where pain from duodenum is felt

A

T9-T10

65
Q

dermatomes where pain from appendix is felt

A

T10 (right)

66
Q

dermatomes where pain from reproductive organs is felt

A

T10-T12

67
Q

dermatomes where pain from kidney/ureter is felt

A

L1-L2

68
Q

other ascending pathways

A

Dorsal spinocerebellar pathway.
Ventral spinocerebellar pathway (double crosser).
Cuneocerebellar pathway.

all end IPSILATERALLY in cerebellum

69
Q

corticospinal pathway (modalities)

A

voluntary fine movement of distal extremities

70
Q

corticospinal pathway (path of neurons)

A

Upper motor neuron (UMN) cell body in cerebral cortex (precentral gyrus).

Decussation in caudal medulla (85%) [other 15% decussate in anterior corticospinal pathway]

Lower motor neuron (LMN) cell body in ventral horn of spinal cord.

LMN axon heads to skeletal muscle.

71
Q

where do corticospinal tract fibers cross?

A

85% - caudal medulla - form lateral corticospinal pathway

15% - travel in anterior corticospinal pathway - cross at level of the LMN they will contact

72
Q

upper motor neuron lesion of corticospinal tract

A

1) hyperreflexia
2) spastic paralysis
3) increased muscle tone
4) clasp knife reflex
5) clonus
6) babinski sign present
7) large area of the body is affected (from level of lesion and below)

73
Q

clonus

A

sign of UMN lesion of corticospinal tract

rapid series of alternating muscle contractions in response to a sudden stretch.

Most common in ankles (tested by rapidly flexing foot upward) .

Can be tested in knees by rapidly pushing patella toward the toes.

74
Q

lower motor neuron lesion of corticospinal tract

A

1) flaccid paralysis
2) loss of deep tendon reflexes
3) decreased muscle tone
4) atrophy
5) fasciculations
6) segmental distribution of deficit

75
Q

fasciculations

A

sign of LMN lesion of corticospinal tract

Spontaneous contractions of muscle fibers visible thru skin as small twitches.
Seen in anterior horn cell disease.

76
Q

deep tendon reflex testing - exaggerated? diminished?

A

-exaggerated: UMN lesion
[do not require supraspinal input, but cortex/brainstem modulate intensity of reflex]

-diminished: LMN lesion

77
Q

clasp knife reflex

A

sign of UMN lesion of corticospinal tract.

In response to passive movements of the limbs.

Collapse of resistance seen when a spastic, hypertonic limb is forcibly flexed or extended.

78
Q

babinski’s sign

A

sign of upper motor neuron lesions anywhere along corticospinal tract

test by scraping heel toward big toe –> big toe goes up, others fan

Emma H&N (49 decks)

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