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Neuro > Spinal Cord Quick Hits > Flashcards

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
Q

Which column has large myelinated fibers?

A

Dorsal

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26
Q

Which column transmits vibration?

A

Dorsal

27
Q

Which column has small unmyelinated fibers and transmits pain?

A

anterolateral system

28
Q

Which column transmits vibration, pressure and proprioception?

A

Dorsal

29
Q

Which column has two point discrimination and rapid conducting fiebrs?

A

Dorsal

30
Q

Which column transmits sex and temperature

A

anterolateral

31
Q

What are two types of 1st order neurons within the anterolateral system?

A

A delta fibers
and
C fibers

32
Q

Where do nociceptive neurons primarily synapse with second order neurons?

A

Substantia gelatinosa of the dorsal horn

33
Q

Where do second order neurons synapse with third order in the anterolateral system?

A

Reticular activating system and thalamus

34
Q

What does the corticospinal tract carry?

A

Motor signals from the cerebral cortex to the muscles of the body

35
Q

What is seen when an injury is above decussation?

A

Spastic paralysis on the contralateral side

36
Q

What is seen when an injury is below decussation?

A

Flaccid paralysis on the ipsilateral side

37
Q

What do SSEP’s monitor?

A

Sensory and integrity of the dorsal column

38
Q

What do MEP’s monitor?

A

integrity of the corticospinal tract (Motor)

Anterior spinal artery perfuses this region of the cord

39
Q

What does the Babinski test assess? What is considered a positive test?

A

Integrity of the corticospinal tract

An upward extension of the big toe - indicates an injury

40
Q

Where does the upper motor neuron begin and end?

A

Begins in the cortex and ends in the ventral horn of the spinal cord

41
Q

Where does the lower motor neuron begin and end?

A

Begins in the ventral horn and ends at the neuromuscular junction

42
Q

What neuro drug can cause thrombocytopenia?

A

Valproic Acid

43
Q

What neuro drug may cause aplastic anemia?

A

Phenytoin

44
Q

What is the order of flow of CSF?

A
  1. Lateral ventricles
  2. Foramen of Monro
  3. Aqueduct of Sylvius
  4. Foramen Magendie
45
Q

What forms the grey matter?

A

Cell bodies

46
Q

What forms the white matter?

A

Axons

47
Q

What neuron is the most abundant in the CNS?

A

Multipolar

48
Q

What neuron is located in the dorsal root ganglion and cranial ganglion?

A

Pseudounipolar

49
Q

What neuron is located in the retina and ear?

A

Bipolar

50
Q

Critical thresholds of CBF?

A

CBF 20mL - evidence of ischemia

CBF 15mL - complete cortical suppression

CBF <15mL -cell death

51
Q

5 determinants of CBF?

A

CMRO2
Venous pressure
PaCO2
PaO2
CPP

52
Q

What is normal CMRO2?

A

3mL/O2/100g brain tissue

53
Q

What temp does EEG suppression occur?

A

18-20 degrees C

54
Q

4 ways that impair venous drainage?

A

Vena cava syndrome
Vena cave thrombosis
Increased intrathoracic pressure
Jugular compression

55
Q

A fixed and dilated pupil suggests herniation of what?

A

Temporal uncus

CN3

56
Q

What drugs reduce CSF production?

A

Acetazolamide and lasix

57
Q

What artery does not have a pair?

A

Basilar

58
Q

Most important risk factor for a stroke?

A

HTN

others

smoking
diabetes
HLD
alcohol
Elevated homocysteine

59
Q

First line treatment for acute ischemic stroke?

A

Aspirin

60
Q

When should an embolectomy be performed?

A

Within 6 hours

61
Q

What should intraop BP be between for aneurysm ?

A

120-150

62
Q

What is cerebral salt wasting syndrome?

A

Patients who suffer a subarachnoid hemorrhage

Hyponatremia from the release of natriuretic peptide

Treat with isotonic fluids

63
Q

What should CPP be held at with TBI? What fluids should be used

A

> 70

Hypertonic

Neuro (7 decks)

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