spinal nerve

Question 0

nerve exit?

Answer 0

C1-C7exit above the corresponding vertebral

all other nerve exit below

Question 1

spinal cord

Answer 1

8cervial, 12 thoracic, 5 lumbar, 5sacral, 1 coccygeal

Question 2

herniation of nucleus pulposus

Answer 2

发生在5&7点的位置
C5 goes between C4 and C5
T4 exit between T4 and T5
L5 exit between L4 and L5

Question 3

lumbar puncture position

Answer 3

L3 and L4,
L4 and L5
younger children lower

Question 4

spinal artery blood supply watershed zone?

Answer 4

anterior horn

especially thoracic and lumbar

Question 5

lamina I

Answer 5

Ia muscle spindle
Ib tension Golgi
Posterior marginal nucleus, primary afferent, pain & temp

Question 6

lamina ii

Answer 6

substantia gelatinosa

afferent from Lissauer’s fasciculus(pain/touch/temp)

Question 7

lamina III and IV

Answer 7

nucleus proprius, touch and pressure

Question 8

lamina v

Answer 8

painful / nonpainful

Question 9

lamina VI

Answer 9

central process&primary sensory neuron

Question 10

lamina VII

Answer 10

intermediate ANS cerebellum sensory neuron

Question 11

lamina VIII

Answer 11

axon of descending tracts synapse here

Question 12

lamina IX

Answer 12

motor neurons

Question 13

lamina X

Answer 13

gray matter commissure

Question 14

dorsal column

Answer 14

pressure, vibration, fine touch&proprioception
sensory nerve ending->cell body in dorsal root ganglion->ascend ipsi
–>synapse with nucleus cuneatus or gracilis in medulla
–>decussates in medulla->ascending contra in medial lemniscus
–>synapse VPL in thalamus->sensory cortex

Question 15

spinothalamic tract

Answer 15

lateral: pain, temp; Anterior: crude touch, pressure
sensory nerve ending (A delta and C)(cell body in dorsal root ganglion)
–>enter spinal cord–>synapse with ipsilateral gray matter in spinal
–>decussates at anterior white commissure–>ascends contralateral
–>synapse VPL in thalamus
–>sensory cortex

Question 16

Lateral corticospinal

Answer 16

descending voluntary movement of contralateral limbs
UMN: cell body in primary cortext–>descends ipsi (internal capsule)
–>decussation at caudal medulla(pyramidal decussation)
–>descends contra–>synapse cell body of anterior horn in spinal
–>LMN: leaves spinal cord
–>synapse NMJ

Question 17

UMN and LMN differentiation
strophy
fasciculation
reflexes
tone
babinski
spastic paralysis
clasp knife spasticity

Answer 17

atro, fascicu, reflexes, tone, babinski, paralysis, clasp knife
-, -, increase, increase, +, spastic, +
+, +, decrease,decrease,-, flaccid, -

Question 18

muscle stretch and Golgi tendon reflex pathway

Answer 18

tab on tendon–>afferent–>dorsal horn–>Ib–>synapse motor

tab on muscle spindle–>afferent–>dorsal horn–>Ia–>synapse motor

Question 19

poliomyelitis and Werdnig-hoffman disease

Answer 19

anterior horn damage
LMN lesions only due to destruction of anterior horns;flaccid paralysis
areflexia
muscle atrophy
fasciculation
common at lumbar level

Question 20

MS

Answer 20

white matter of cervical region, cuneatus and gracilis,
random and asymmetric lesions, due to demylination,
scanning speech intention tremor, nystagmus

Question 21

Amyotrophic lateral sclerosis

ALS

Answer 21

anterior horn+corticospinal track
combined UMN and LMN deficits with no sensory cognitive or oculomotor deficits; both UMN and LMN signs
caused by defect in superoxide dismutase I
fasciculations with eventual atrophy;progressive and fatal
treat with Riluzole–>decrease presynaptic glutamate release

Question 22

complete occlusion of anterior spinal artery

Answer 22

spares dorsal columns and Lissauer’s tract, 知道你在动手指

upper thoracic ASA territory is a watershed area, as a artery of Adamkiewicz supplies ASA below T8

Question 23

tabes dorsalis

Answer 23

3 syphilis
degeneration of dorsal columns and rots–>impaired sensation and proprioception and progressive sensory ataxia(cant feel leg)
Charcot’s joint, shooting pain, Argyll R pupil
exam will demonstrate absence of DTR and + Romberg

Question 24

Syringomyelia

Answer 24

syrinx expands and damages anterior white commissure of spinothalamic tract(2nd order) -->bilateral loss of pain and temp sensation (C8-T1) seen with Chiari I malformation expand and affect other tracts

Question 25

Vit B12 or Vit E deficiency

Answer 25

subacute combined degeneration-demyelination of dorsal columns, Lateral corticospinal tracts and spinocerebellar tracts ataxia gait paresthesia impaired position and vibration sense

Question 26

Werdnig-Hoffman dusease

Answer 26

AR, spinal muscle atrophy type I turn off perinatal programmed cell death dysfunction congenital degeneration of anterior horn of spinal cord--> LMN lesion"floppy baby" with marked hypotonia and tongue fasciculations, infantile type has median age of death of 7 months

Question 27

Friedreich's ataxia

Answer 27

AR, (efG, ataxia,AA)GAA repeat-frataxin leads to impairment in mitochondrial functioning staggering gait, freq falling nystagmus, dysarthria, pes cavus hammer toes, hypertrophic cardiomyopathy-DEATH present in childhood with kyphoscoliosis

Question 28

Brown-Sequard syndrome

Answer 28

hemisection of spinal cord ipsi UMN signs below the level of the lesion (corticospinal tract) ipsi loss of tactile, vibration, proprioception sense below lesion(dorsal) contra pain and temp loss below the level of the lesion (spinothalamic) ipsi loss of all sensation at the level of lesion ipsi LMN signs at the level of the lesion

Question 29

Horner's syndrome

Answer 29

``` lesion above T1: pancoast tumor, Brown-Sequard, syringomyelia SANS of face ptosis:drooping of eyelid anhidrosis: sweating miosis, pupil contriction ```

Question 30

pupil dilation pathyway

Answer 30

hypothalamus: paraventricular--> spinal cord: T1/T2(Cillospinal center of Budge)--> superior cervical ganglion--> Termination: Radial muscle of iris&muscle of muller&face sweat

Question 31

landmark dermatomes for C2

Answer 31

posterior half of skull cap

Question 32

landmark dermatomes for C3

Answer 32

high turtleneck shirt

Question 33

landmark dermatomes for C4

Answer 33

low-collar shirt

Question 34

landmark dermatomes for T4

Answer 34

at the nipple

Question 35

landmark dermatomes for T7

Answer 35

at the xiphoid process

Question 36

landmark dermatomes for T10

Answer 36

at the umbilicus | important for early appendicitis pain referral

Question 37

landmark dermatomes for L1

Answer 37

at the inguinal ligament

Question 38

landmark dermatomes for L4

Answer 38

includes the kneecaps

Question 39

landmark dermatomes for S2,S3,S4

Answer 39

erection and sensation of penile and anal zone

Question 40

Bicep reflex

Answer 40

C5 nerve root

Question 41

Tricep reflex

Answer 41

C7 nerve root

Question 42

Patella reflex

Answer 42

L4 nerve root

Question 43

Achilles reflex

Answer 43

S1 nerve root

Question 44

Babinski reflex

Answer 44

dorsiflexion of the big toe and fanning of other toe

Question 45

primitive reflexes

Answer 45

CNS reflexes that are present in a healthy infant, but are absent in a neurologically intact adult normally disappear within 1st yr of life primitive reflexes are inhibited by a mature/developing frontal lobe frontal lobe lesion-->loss of inhibition of these reflex

Question 46

moro reflex

Answer 46

hang on life reflex | abduct/extend limbs when startled and then draw together

Question 47

rooting reflex

Answer 47

movement of head toward one side if cheek or mouth is stroked(nipple seeking)

Question 48

sucking reflex

Answer 48

sucking response when roof of mouth is touched

Question 49

palmar reflex

Answer 49

curling of fingers if palm is stroked

Question 50

plantar reflex

Answer 50

dorsiflexion of large toe and fanning of other toes with plantar stimulation babinski sign if present in adult UMN lesion

Question 51

Galant reflex

Answer 51

stroking along one side of the spine while newborn is in ventral suspension(face down) causes lateral flexion of lwer body toward stimulated side.