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AP B3 > Spinal Cord/Nerves > Flashcards

Spinal Cord/Nerves Flashcards

1
Q

The spinal cord begins as a continuation of _____ (the most inferior portion of the brain stem) extending from the foramen magnum of the ____ bone to its termination as the ____ between L1 - L2

A

the medulla oblongata

occipital

conus medullaris

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2
Q

Three meninges, from outer to inner:

A

Dura Mater (only 1 layer, unlike brain dura mater)

Arachnoid mater

Pia Mater

The spinal meninges surround the spinal cord, and are continuous with the cranial meninges, which encircle the brain

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3
Q

Forms a sac from the level of the foramen magnum to the second sacral vertebra

A

Dura mater

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4
Q

____ between the dura mater and the wall of the vertebral canal contains a cushion of fat and connective tissue further cushioning the spinal cord

A

Epidural space

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5
Q

Between the dura mater and the arachnoid mater is the thin ____ space, which contains interstitial fluid

A

subdural

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6
Q

Contains blood vessels that supply oxygen and nutrients to the spinal cord

A

Pia mater

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7
Q

thin transparent connective tissue layer that adheres to the surface of the spinal cord and brain

A

Pia mater

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8
Q

Between the arachnoid mater and the pia mater is a space filled with cerebrospinal fluid called the ____

A

subarachnoid space

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9
Q

Membranous, thickened extensions of the pia mater that project laterally and fuse with arachnoid mater and inner surface of dura mater

A

Denticulate ligaments

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10
Q

Suspend the spinal cord within its dural sheath, protecting it against sudden displacement

A

Denticulate ligaments

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11
Q

Delicate strands of tissue emanating from the arachnoid mater

A

Arachnoid trabeculae

slide 9

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12
Q

Span the subarachnoid space, connecting the arachnoid and the pia

A

Arachnoid trabeculae

slide 9

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13
Q

In adults the spinal cord extends from the medulla oblongata to the superior border of the ___ lumbar vertebra

A

second

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14
Q

The ___ enlargement and ___ enlargement accommodate nerves to and from the upper and lower limbs, respectively

A

cervical

lumbar

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15
Q

Inferior to the lumbar enlargement the spinal cord tapers to a conical-shaped portion termed the ___, which in adults ends at the level of the IV disc between vertebrae L1 & L2

A

conus medullaris

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16
Q

The ___ is an extension of the pia mater that arises from the conus medullaris to anchor the spinal cord to the coccyx

A

filum terminale

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17
Q

Nerves that arise from the inferior part of the spinal cord do not immediately leave the vertebral column, but rather continue in the vertebral canal in fine strands collectively termed the ___

A

cauda equina

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18
Q

___ are the paths of communication between the spinal cord and the nerves innervating specific regions of the body

A

Spinal nerves

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19
Q

Two bundles of axons connect each spinal nerve to a segment of the cord. Each bundle is called a root, which in turn is composed of smaller bundles of axons called ___

A

rootlets

The roots are posterior (or dorsal) root and anterior (or ventral) root

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20
Q

Each posterior root has a swelling, the posterior (dorsal) root ganglion, which contains the cell bodies of ___ neurons

A

sensory

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21
Q

The ___ root and rootlets contain axons of motor neurons, which conduct nerve impulses from the CNS to effectors (muscles and glands)

A

anterior (ventral)

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22
Q

The gray matter of the spinal cord is shaped like the letter H, or a butterfly, and is surrounded by white matter. The gray ___ forms the crossbar of the H.

A

commissure

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23
Q

Anterior horns contain cell bodies of somatic ___ neurons and ___ nuclei that provide nerve impulses for the contraction of skeletal muscles.

A

motor

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24
Q

___ gray horns contain somatic and autonomic sensory nuclei. The gray commissure connects gray matter of the right and left sides.

A

Posterior

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25
Q

The central canal extends the length of the spinal cord, and is continuous with the ____ in the medulla oblongata of the brain

A

fourth ventricle

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26
Q

Anterior to the gray commissure is the anterior (ventral) ___ commissure, which connects the white matter of the right and left sides of the spinal cord

A

white

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27
Q

Lateral gray horns contain cell bodies of ____ motor neurons that regulate activity of smooth muscle, cardiac muscle, and glands.

A

autonomic

slide 22

Lateral gray horns are present only in the thoracic and upper lumbar, (T1 – L2 or T1 – L3) and sacral (S2 – S4) segments of the spinal cord.

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28
Q

___ matter receives and integrates incoming and outgoing information

A

Gray

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29
Q

Bundles of myelinated axons, called ___, have a common origin or destination, and carry similar information up or down the spinal cord

A

tracts

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30
Q

Sensory tracts comprise axons that conduct nerve impulses toward the brain

A

(ascending)

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31
Q

Motor tracts carry nerve impulses down the spinal cord

A

(descending)

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32
Q

___ matter tracts ascend to or descend from the brain. Gray matter processes information input and output

A

White

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33
Q

There are __ pairs of spinal nerves

A

31

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34
Q

Spinal nerves are named and numbered according to the region and level of the ____ from which they emerge

A

vertebral column

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35
Q

The first cervical pair emerges between the

A

occipital bone and the atlas

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36
Q

All other spinal nerves emerge through ____ between adjoining vertebrae

A

intervertebral foramina

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37
Q

Most spinal nerves exit inferior to the vertebra of the same number, the exception being cervical nerves due to the fact that C1 exits superior to the __ (which is the first cervical vertebra)

A

atlas

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38
Q

Spinal nerves do not necessarily exit the spinal cord in the same plane as their corresponding vertebrae

A

slide 32

Illustrated: spinal nerve L1 exits the vertebral column inferior to L1 vertebra, but it exits the spinal cord on a plane between T11 & T12 vertebrae

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39
Q

The dorsal and ventral nerve roots unite at their points of exit from the vertebral canal to form a ___

A

spinal nerve

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40
Q

The dorsal and ventral nerve roots unite at their points of exit from the vertebral canal to form a ___

A

spinal nerve

Spinal nerves technically comprise only that brief interval between union of the dorsal and ventral roots, and subsequent division into dorsal and ventral rami

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41
Q

After the spinal nerve exits the intervertebral foramen, each spinal nerve divides almost immediately into a dorsal primary ___ and a ventral primary ___,

A

ramus

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42
Q

Each nerve divides into several branches just after passing through its ___

A

intervertebral foramen

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43
Q

___ are the terminal branches of spinal nerves

A

Rami

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44
Q

The ____ ramus innervates deep muscles and skin of the dorsal surface of the trunk

A

posterior (dorsal)

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45
Q

The ____ ramus serves muscles and structures of the upper and lower limbs and the skin of the lateral and ventral surfaces of the trunk

A

anterior (ventral)

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46
Q

The _____ of each spinal nerve reenters the vertebral canal to supply the vertebrae and associated structures

A

meningeal branch

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47
Q

Other branches form the ____ and contribute to the trunk ganglia of the autonomic nervous system

A

rami communicantes

slide 40

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48
Q

Except for most thoracic nerves, the ANTERIOR RAMI of spinal nerves do not go directly to the body structures they supply. Rather, they form networks on both the left and right sides of the body by joining with other axons from anterior rami of adjacent nerves, called a ____

A

plexus

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49
Q

Cervical plexus
Brachial plexus
Lumbar plexus
Sacral plexus

A

Principal plexuses

Also, a smaller coccygeal plexus

(no thoracic plexus)

50
Q

Anterior rami of spinal nerves T2 – T12 are called ___ nerves. Another name for them is thoracic nerves

A

intercostal

51
Q

Intercostal nerves/thoracic nerves connect directly to the structures they supply, which are:

A

intercostal muscles

abdominal muscles

skin overlying the muscles

52
Q

The ___ rami of the intercostal nerves supply the deep back muscles and skin of the posterior aspect of the thorax

A

posterior

53
Q

Plexuses are formed from the ___ rami of spinal nerves

A

anterior

They are paired (left and right)

Plexuses have subunits of varying numbers, depending on the complexity of the plexus

They contain both motor and sensory neurons

54
Q

Trunks are formed by union of roots (fortunately this is only in the brachial plexus), e.g.,

A

Superior trunk
Middle trunk
Inferior trunk

55
Q

Divisions are the consequence of branching of trunks

A

Anterior division

Posterior division

56
Q

The ____ supplies the skin and muscles of the head, neck, superior portion of the shoulders and chest, and the diaphragm

A

cervical plexus

57
Q

The ____ arise from the cervical plexuses and supply motor fibers to the diaphragm

A

phrenic nerves

Complete severing of the spinal cord above the origin of the phrenic nerves (C3, C4, and C5) causes respiratory arrest. Breathing stops because the phrenic nerves no longer send impulses to the diaphragm.

58
Q

The _____ supplies the shoulders and upper limbs

A

brachial plexus

59
Q

The ____ arises from the brachial plexus and supplies muscles on the posterior aspect o the arm/forearms

A

radial nerve

slide 49

60
Q

The ____ supplies the anterolateral abdominal wall, external genitals, and part of the lower limbs

A

lumbar plexus

61
Q

The ____ supplies the buttocks, perineum, and lower limbs

A

sacral plexus

62
Q

lumbar plexus

A

supplies the anterolateral abdominal wall, external genitals, and part of the lower limbs

63
Q

sacral plexus

A

supplies the buttocks, perineum, and lower limbs

64
Q

sciatic nerve is the largest nerve in the body. It is actually two nerves bound by a common sheath of connective tissue, arising from the ____ plexus

A

sacral

Various branches of the sciatic nerve supply muscles of the leg, foot, and toes

65
Q

Sciatic supplies muscles of?

A

Leg, foot, toes

66
Q

Injury to the sciatic nerve results in sciatica, pain that may extend from the buttock down the posterior and lateral aspect of the leg and into the foot

A

Injury may be due to herniated disc, dislocated hip, osteoarthritis, pressure from the uterus during pregnancy, or an improperly administered gluteal intramuscular injection

67
Q

Sensations that arise in the skin , and include tactile sensations (touch, pressure, vibration, tickling), thermal sensations (warmth, coolness), and pain?

A

Cutaneous sensation

68
Q

Maps of the afferent nerves that convey cutaneous sensations toward the CNS are of two types:

A

Dermatomes

Peripheral nerve fields (cutaneous nerves)

69
Q

The area of the skin that provides sensory input to the CNS via one pair of spinal nerves

A

Dermatomes

The skin is supplied by somatic sensory neurons that carry nerve impulses from the skin into the spinal cord and brain stem

70
Q

Each spinal nerve contains sensory neurons that serve a specific segment of the body

A

Dermatomes

71
Q

The area of the skin that provides sensory input to the CNS via one pair of spinal nerves or cranial nerve V is called a ___ (cranial nerve V is the trigeminal; it serves most of the skin of the face and the scalp)

A

dermatome

Knowing which spinal cord segments supply each dermatome makes it possible to locate damaged regions of the spinal cord

Nerves supplying a specific dermatome may be damaged if the sensation is not perceived when the skin in a particular region is stimulated

72
Q

Adjacent dermatomes typically overlap, except at the ____, which is the line of junction of dermatomes supplied from discontinuous spinal levels

A

axial line

73
Q

spinal cord has two principal functions in the maintenance of homeostasis

A

Nerve impulse propagation

Information integration (processing)

74
Q

___ receives and integrates incoming and outgoing information

(spinal cord)

A

Gray matter

75
Q

___ tracts carry sensory impulses toward the brain, and motor impulses from the brain toward effectors

(spinal cord)

A

White matter

76
Q

Name of a tract indicates . . .

A

Its position in the white matter

Where it begins and ends

By extension, the direction of information flow

77
Q

Example: lateral corticospinal tract

A

A lateral white column

Begins in the cortex (of the brain

Ends in the spinal cord

Since flow is away from the brain, it is a motor (descending) tract

78
Q

ability to feel exactly what part of the body is touched

A

Discriminative touch

79
Q

ability to distinguish the touching of two different points on the skin which are close together

A

Two-point discrimination

80
Q

Sensory systems provide input to the CNS regarding the environment. ___ in several areas of the brain and spinal cord integrate the input

A

Interneurons

81
Q

The ___ has a major role in controlling precise, voluntary muscular movements

A

cerebral cortex

82
Q

Motor output to skeletal muscles travels down the spinal cord in two types of descending pathways

A

Direct

Indirect

83
Q

These nerve impulses originate in the cerebral cortex

They cause precise, voluntary movement of skeletal muscles

A

Direct pathways

84
Q

Direct pathways include:

A

Lateral CORTICOspinal

Anterior CORTICOspinal tract

CORTICObulbar tract

85
Q

These impulses originate in the brain stem or other parts of the brain that govern automatic movements

A

Indirect pathways

86
Q

They help coordinate body movements with visual stimuli, maintain skeletal muscle tone and contraction of postural muscles, regulate muscle tone in response to movements of the head

A

Indirect pathways

87
Q

Indirect pathways include:

A

Rubrospinal tract

Tectospinal tract

Vestibulospinal tract

Lateral reticulospinal tract

Medial reticulospinal

88
Q

a fast, involuntary, unplanned sequence of actions that occurs in response to a particular stimulus

A

reflex, may be Innate (inborn) or Learned

89
Q

when integration takes place in spinal cord gray matter

type of reflex

A

spinal reflex

90
Q

when integration occurs in brain stem

type of reflex

A

cranial reflex

91
Q

___ reflexes involve contraction of skeletal muscles

A

Somatic

92
Q

Visceral reflexes . . .

A

Involve contraction of smooth muscle, cardiac muscle, and glands

Are not usually consciously perceived

Are not easy to initiate by clinical processes

Are also termed autonomic reflexes, since they are mediated by the autonomic nervous system

93
Q

The pathway followed by nerve impulses that produce a reflex is termed a ____ (or reflex circuit)

A

reflex arc

94
Q

___ comprise very specific pathways as they propagate into, through, and out of the central nervous system

___ are of diagnostic value due to the property of having specific pathways

A

Reflex arcs

95
Q

A reflex arc includes the following five functional components:

A 
Sensory receptor
Sensory neuron
Integrating center
Motor neuron
Effector
96
Q 
Sensory receptor
Sensory neuron
Integrating center
Motor neuron
Effector
A

components of a reflex arc

97
Q

The dendrite or sensory structure of the sensory neuron responds to a specific stimulus by producing a graded potential called a generator (or receptor) potential. If the potential reaches threshold, it will trigger one or more nerve impulses in the sensory neuron

A

reflex arc step 1,2

98
Q

The gray matter within the central nervous system is the integrating center. The simplest reflex consists of the integrating center comprising just one synapse between sensory neuron and motor neuron, called a monosynaptic reflex arc. Most reflex arcs are polysynaptic, involving more than two types of neurons and more than one CNS synapse

A

step 3

Reflex arcs

99
Q

The integrating center sends impulses out of the CNS along a motor neuron to the part of the body that will respond

A

step 4

Reflex arcs

100
Q

The effector is the part of the body that responds, generally a muscle or gland. The responsive action of the effector is called a reflex. If the effector is skeletal muscle, the reflex is a somatic reflex. If the effector is smooth muscle, cardiac muscle, or a gland, the reflex is an autonomic reflex (or visceral reflex)

A

step 5

Reflex arcs

101
Q

If the effector is skeletal muscle, the reflex is a ___ reflex. If the effector is smooth muscle, cardiac muscle, or a gland, the reflex is an autonomic reflex (or___)

A

somatic

visceral reflex

102
Q

operates as a feedback mechanism to control muscle length by causing muscle contraction

Prevents injury from over-stretching, because muscle contracts when it is stretched

A

Stretch Reflex

103
Q

Monosynaptic, ipsilateral reflex arc

A

Stretch Reflex

104
Q

muscle spindle (stretch receptors) in the muscle signals stretch of muscle

motor neuron activated & muscle contracts

A

Events of stretch reflex

105
Q

___ sets muscle spindle sensitivity as it sets muscle tone (degree of muscle contraction at rest)

(for stretch reflex)

A

Brain

106
Q

Reciprocal innervation (polysynaptic- interneuron): ___ muscles relax as part of reflex

A

antagonistic

107
Q

operates as a feedback mechanism to control muscle tension by causing muscle relaxation when muscle force becomes too extreme

A

Tendon Reflex

108
Q

Tendon vs. Reflex

A

Causing muscle relaxation or contraction slide 78

109
Q

Polysynaptic, ipsilateral reflex

Golgi tendon organs (tension receptors) are in tendon, at the musculotendonous junction of skeletal muscles

A

Tendon Reflex

110
Q

activated by stretching of tendon

inhibitory neuron is stimulated (polysynaptic)

motor neuron is hyperpolarized and muscle relaxes

A

Tendon Reflex

111
Q

Both tendon & muscle are protected

Reciprocal innervation (polysynaptic)

A

Tendon Reflex

112
Q

ipsilateral and is a protective withdrawal reflex that moves a limb to avoid pain (also known as nociceptive withdrawal reflex (NWR))

A

flexor (withdrawal) reflex

113
Q

This reflex results in contraction of flexor muscles to move a limb to avoid injury or pain

A

flexor (withdrawal) reflex

114
Q

contralateral, helps to maintain balance during the flexor reflex

A

crossed extensor reflex

115
Q

This is a balance-maintaining reflex that causes a synchronized extension of the joints of one limb and flexion of the joints in the opposite limb

A

crossed extensor reflex

116
Q

This reflex results from the gentle stroking of the lateral outer margin of the sole

A

Plantar flexion reflex

Babinski sign

117
Q

Autonomic reflexes are not practical diagnostic tools since it is difficult to stimulate most visceral receptors because they are deep inside the body (one exception being the

A

pupillary light reflex—pupils of both eyes decrease in diameter when either is exposed to light)

118
Q

Damage or disease anywhere along a ____ can cause the reflex to be absent or abnormal

A

reflex arc

119
Q

___ reflexes suggest central nervous system disease

A

Hyperactive

120
Q

Decreased reflexes are found in

A

Damage to relevant spinal segments

Diseases of muscles

Diseases of the
neuromuscular junction

Loss of sensation

AP B3 (6 decks)

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