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S&F 1 > Spinal N. & PNS > Flashcards

Spinal N. & PNS Flashcards

Dr. Wilson lecture

1
Q

Peripheral nerve lesions may produce?

A

Sensory symptoms and/or motor symptoms

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2
Q

What are sensory symptoms?

A

Anesthesia (no sensation)

Hypothesis (partial reduce of sensation)

Parathesisa (abnormal sensation)

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3
Q

What are examples of parathesia?

A

burning, tingling, and or pins & needle

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4
Q

What are examples of motor symptoms?

A

Flaccid Parlysis (low motor neuron injury/no tone) Paresis (partial paralysis or muscle weakness

Muscle atrophy (wasting of muscle)

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5
Q

How do lesions form?

A

Compression

Cutting and tearing

Evulsion (avulsion) - being pulled out

Repetitive motion

Bacterial/viral infections (polio or leprosy)

Neuropathy (diabetes)

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6
Q

How does a nerve become compressed?

A

Entrapment syndromes

joint dislocation

fractures

Vessel aneurism

Herniated discs

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7
Q

How does a nerve get cut?

A

Stab, bullet, shrapnel, fractures

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8
Q

What an example of a repetitive motion that can damage a nerve?

A

Carpel tunnel

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9
Q

How many pairs of spinal nerves do we have?

A

31 (come of each vertebral level) 8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal

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10
Q

What is the functional unit of the nervous system?

A

Neuron

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11
Q

Where is the action potential being initiated?

A

Axon hillock

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12
Q

Propagation of an action potential along an axon

A

Resting axon - inside negative charge and outside positive charge (negative resting potential)

action potential - charges change position (reverse)/membrane is leaky

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13
Q

Myelin producing cells

A

Schwann cells (PNS) - myelinate one portion of one axon

Oligodendrocytes (CNS) - myelinate one portion of multiple axons

Myelin Insulate axons and increase conduction velocity; impulse propagation is more energy efficient

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14
Q

T/F Size a myelin sheath plays no role in speed of AP

A

False

Thicker the myelin sheath the faster the AP

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15
Q

What is Guillian- Bare Disease?

A

PNS demyelinating disease that affects Schwann cells?

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16
Q

What is Multiple Sclerosis (MS)?

A

CNS demyelinating disease that affects oligodendrocytes

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17
Q

What are the three type of neurons that you can identify anatomically?

A

Multipolar: motor neuron (many dendrites/one axon) - found in spinal cord

bipolar: special sensory neuron (one dendrite/one axon)
psudounipolar: general sensory neuron found in ganglia (single process giving rise to axon) - found in PNS

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18
Q

Schwann cells and connective tissue sheaths are important for what?

A

regeneration of damaged axons in PNS When a nerve becomes damage -> stump forms -> schwann cells in area die but connective tissue/endoneurium stays in place-> axon regeneration occurs from the stump (guided by the myelin sheath from the live Schwann cells)

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19
Q

Why do axons not regenerate in the CNS?

A

Because there is no connective tissue in the CNS Glial scars form instead so it prevents regeneration

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20
Q

What are characteristics of the nerves in the PNS

A

contain hundreds to millions of nerve fibers or axons function of each fiber in a nerve may differ therefore, lesions of the nerve may produce a range of motor and/or sensory symptoms.

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21
Q

What are the three ways you can classify an axon?

A
  1. . Efferent or Afferent
  2. Somatic or visceral
  3. General or special
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22
Q

Which classification is based on the direction the axon potential travels

A

Efferent - CNS to periphery- motor/ventral (to skeletal muscle/myotome)

Afferent - PNS to CNS -sensory/dorsal (from skin/dermatome)

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23
Q

Somites give rise to?

A

Sclerotomes - vertebra

Myotome - muscles (motor innervation)

dermatome - skin (sensory innervation)

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24
Q

The axon leaving the vertebral column at the level of T10 innervates which dermatome?

A

The umbilicus

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25
Q

The axon leaving the vertebral column at the level of T5(T4) innervates which dermatome?

A

Nipples

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26
Q

How the axons distributed throughout the body?

A

Somatic - surface

Visceral - organs

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27
Q

How are nerves embryologically classified ?

A

General - functions that you find in spinal cord nerves as well as cranial nerves (example is pain) Special - functions found only cranial nerves (example is seeing)

28
Q

Spinal cord only has which type of function

A

General function

Which are GSE, GVE, GSA, GVA

29
Q

GSE (High yield) General Somatic Efferent

A

somitic skeletal muscle (from myotomes)

30
Q

GVE General Visceral Efferent

A

smooth and cardiac muscle and glands ANS

31
Q

GSA (high yield) General Somatic Afferent

A

pain, touch, temperature & proprioception (from dermatomes)

32
Q

GVA General Visceral Afferent

A

pain, stretch & distention ANS

33
Q

SVE

A

branchio- meric skeletal

34
Q

SSA

A

vision, hearing & balance

35
Q

SVA

A

smell & taste

36
Q

Grey matter

A

Cell bodies of neurons

37
Q

White matter

A

Axons and myelin sheaths

38
Q

Parts of gray matter?

A

Dorsal horn - sensory

Ventral horn - motor

39
Q

Typical spinal nerve

A

dorsal horn -> dorsal rootlets and roots

sensory -> dorsal root ganglion/cell bodies

(psuedounipolar)

Ventral horn -> ventral rootlets and roots

motor

Ventral root + dorsal root -> mixed spinal nerve (mixed of sensory and motor fibers/at the level of intervertebral foramen) -> dorsal primary rami (true back muscle) + ventral rami (follow ribs anteriorly)

40
Q

What are the true back muscles formed by?

A

Epimere (from myotome) Innervated by dorsal primary rami

41
Q

What are muscles in the body wall and limbs formed by?

A

Hypomere (from myotome) Innervated by ventral primary rami

42
Q

Which spinal nerves do not join other spinal nerves as they run beneath the ribs?

A

T2-T12

43
Q

What happens if T2-T12 become lesioned?

A

There will be changes in a sensory dermatome

44
Q

At the level of the limbs what changes about the nerves?

A

Plexus are formed by ventral primary rami (VPR) only Cervial plexus: C1-C4

Brachial Plexus: C5-T1

Lumbosacral plexus: L1-S4

45
Q

The plexus divide into what?

A

They divide into anterior and posterior divisions that innervate flexors and extensors, respectively.

46
Q

Dorsal muscle mass, during embryology formation of the limb bud, gives rise to what?

A

Extensor muscle (posterior division)

47
Q

Ventral muscle mass, during embryology formation of the limb bud, gives rise to what?

A

Flexor muscles (anterior division)

48
Q

What are lower motor neurons?

A

GSE fibers

They are the final common pathway to skeletal muscle

Innervated skeletal muscle: cell bodies found in ventral horn

49
Q

Lesion of a lower motor neuron causes what?

A

deprives skeletal muscle of motor control resulting in flaccid paralysis, a loss of reflexes, and muscle atrophy.

50
Q

Damage to the axillary nerve?

A

Atrophy of deltoid

51
Q

At what level does the spinal cord end in an adult?

A

L2 (in fetus a nerve comes out at every level of the vertebrae/spinal cord extends the length of entire canal)

52
Q

What are the layers of the meningies?

A

dura mater - thickest layer

arachnoid mater - denticular ligament attached here

pia (outer layer of cord)

53
Q

What is the purpose of the lenticular ligament?

A

Anchor spinal cord

54
Q

Continuation of the spinal cord past L2?

A

Filum Terminalis

Formed by Pia mater that continues to the coccyx

55
Q

What forms the cauda equina?

A

Growth of vertebrae is faster than spinal cord -> nerves stretch down -> spinal roots form the cauda equina

56
Q

At what level does the subarachnoid space ends?

A

S2

57
Q

What is the function of the filum terminals?

A

Anchor the spinal cord

58
Q

What is the space between bone and the dura mater?

A

Epidural space

59
Q

What does the epidural space contain?

A

filled with extradural fat and vertebral venous plexus (that lack values) Only around spinal cord, no epidural space in skull

60
Q

What do the veins of the epidural space anastomose with?

A

venous sinuses in skull and body, allowing metastasis from pelvic structures prostate gland) to the CNS

61
Q

Cerebral spinal fluid is located where?

A

Subarachnoid space

62
Q

Spinal Tap

A

Needle inserted into subarachnoid space to either insert drugs or extract CSF

63
Q

At what level is spinal tap performed at?

A

L3/L4

64
Q

What are the components of a reflex arc?

A

1) Sensory receptor: dendrites on afferent nerve
2) Afferent nerve: afferent fiber takes in info to CNS 3) Central integration* (sensory fiber integration in ganglion and motor fiber integration in ventral horn) 4) Efferent nerve: efferent fiber takes informal away from CNS 5) Effector

65
Q

What does a reflex arc describe and how is it detected?

A

Fundamental circuit of NS

Detected through reflexes

66
Q

What is an example of a monosynaptic reflex?

A

Knee jerk, biceps reflex (C5, C6), brachioradialis reflex (C5, C6), triceps reflex (C7, C8)

afferent synapses directly on the efferent neuron

67
Q

Reflex grading

A

S&F 1 (25 decks)

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