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Spinal Cord Quick Hits Flashcards

1
Q

Where does the Artery of Adam usually arise from?

A

Left side, T8-T12

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2
Q

What is the artery of Adam? What does the Artery of Adam supply?

A

Most important radicular artery

Anterior Spinal artery which serves the anterior two thirds of the spinal cord

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3
Q

What is preserved of there is damage to the artery of adam?

A

Touch and proprioception which is controlled by the dorsal column

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4
Q

What are the two sources of blood for the spinal cord?

A

Spinal arteries: 2 posterior and 1 anterior (These run along the entire spinal cord)

Radicular arteries: 6-8 (Does not run the entire length)

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5
Q

What areas does the posterior spinal artery perfuse?

A

Posterior 1/3 of the spinal cord \

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6
Q

What areas does the anterior spinal artery perfuse?

A

Anterior 2/3 of the spinal cord

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7
Q

What is Beck’s triad?

A

Flaccid paralysis of the lower extremities

Bowel and bladder dysfunction

Preserved touch and proprioception

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8
Q

What three spinal pathways are supplied by the anterior spinal artery?

A

Corticospinal tract

Autonomic motor fibers

Spinothalamic tract

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9
Q

What is one spinal tract supplied by the posterior spinal artery?

A

Dorsal column

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10
Q

What are laminae 1-6?

A

Dorsal gray matter - Sensory

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11
Q

What are laminae 7-9?

A

Ventral gray matter - Motor

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12
Q

What is the tract of Lissauer?

A

Pain and temperature

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13
Q

What is the lateral spinothalamic tract?

A

Pain and temperature

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14
Q

What is the ventral spinothalamic tract?

A

Crude touch and pressure

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15
Q

What is the dorsal column control?

A

Fine touch and proprioception

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16
Q

What is the lateral corticospinal tract?

A

Limb motor

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17
Q

What is the ventral corticospinal tract?

A

Posture motor

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18
Q

What are the corticospinal tracts?

A

Travel from cortex to spine

Motor pathways

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19
Q

What are the spinothalamic tracts?

A

Spine to thalamus

Sensory pathways

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20
Q

Proprioperception is controlled by?

A

Ruffini’s endings

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21
Q

Two point discrimination is controlled by?

A

Meissner’s corpuscles

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22
Q

Continuous touch is controlled by?

A

Merkel’s discs

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23
Q

Vibration is controlled by ?

A

Pacinian corpuscles

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24
Q

Which pathway transmits afferent nociceptive input to the brain?

A

Anterolateral system

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25
Which column has large myelinated fibers?
Dorsal
26
Which column transmits vibration?
Dorsal
27
Which column has small unmyelinated fibers and transmits pain?
anterolateral system
28
Which column transmits vibration, pressure and proprioception?
Dorsal
29
Which column has two point discrimination and rapid conducting fiebrs?
Dorsal
30
Which column transmits sex and temperature
anterolateral
31
What are two types of 1st order neurons within the anterolateral system?
A delta fibers and C fibers
32
Where do nociceptive neurons primarily synapse with second order neurons?
Substantia gelatinosa of the dorsal horn
33
Where do second order neurons synapse with third order in the anterolateral system?
Reticular activating system and thalamus
34
What does the corticospinal tract carry?
Motor signals from the cerebral cortex to the muscles of the body
35
What is seen when an injury is above decussation?
Spastic paralysis on the contralateral side
36
What is seen when an injury is below decussation?
Flaccid paralysis on the ipsilateral side
37
What do SSEP's monitor?
Sensory and integrity of the dorsal column
38
What do MEP's monitor?
integrity of the corticospinal tract (Motor) Anterior spinal artery perfuses this region of the cord
39
What does the Babinski test assess? What is considered a positive test?
Integrity of the corticospinal tract An upward extension of the big toe - indicates an injury
40
Where does the upper motor neuron begin and end?
Begins in the cortex and ends in the ventral horn of the spinal cord
41
Where does the lower motor neuron begin and end?
Begins in the ventral horn and ends at the neuromuscular junction
42
What neuro drug can cause thrombocytopenia?
Valproic Acid
43
What neuro drug may cause aplastic anemia?
Phenytoin
44
What is the order of flow of CSF?
1. Lateral ventricles 2. Foramen of Monro 3. Aqueduct of Sylvius 4. Foramen Magendie
45
What forms the grey matter?
Cell bodies
46
What forms the white matter?
Axons
47
What neuron is the most abundant in the CNS?
Multipolar
48
What neuron is located in the dorsal root ganglion and cranial ganglion?
Pseudounipolar
49
What neuron is located in the retina and ear?
Bipolar
50
Critical thresholds of CBF?
CBF 20mL - evidence of ischemia CBF 15mL - complete cortical suppression CBF <15mL -cell death
51
5 determinants of CBF?
CMRO2 Venous pressure PaCO2 PaO2 CPP
52
What is normal CMRO2?
3mL/O2/100g brain tissue
53
What temp does EEG suppression occur?
18-20 degrees C
54
4 ways that impair venous drainage?
Vena cava syndrome Vena cave thrombosis Increased intrathoracic pressure Jugular compression
55
A fixed and dilated pupil suggests herniation of what?
Temporal uncus CN3
56
What drugs reduce CSF production?
Acetazolamide and lasix
57
What artery does not have a pair?
Basilar
58
Most important risk factor for a stroke?
HTN others smoking diabetes HLD alcohol Elevated homocysteine
59
First line treatment for acute ischemic stroke?
Aspirin
60
When should an embolectomy be performed?
Within 6 hours
61
What should intraop BP be between for aneurysm ?
120-150
62
What is cerebral salt wasting syndrome?
Patients who suffer a subarachnoid hemorrhage Hyponatremia from the release of natriuretic peptide Treat with isotonic fluids
63
What should CPP be held at with TBI? What fluids should be used
>70 Hypertonic

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