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Neurology > spinal nerve > Flashcards

spinal nerve Flashcards

0
Q

nerve exit?

A

C1-C7exit above the corresponding vertebral

all other nerve exit below

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1
Q

spinal cord

A

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

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2
Q

herniation of nucleus pulposus

A

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

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3
Q

lumbar puncture position

A

L3 and L4,
L4 and L5
younger children lower

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4
Q

spinal artery blood supply watershed zone?

A

anterior horn

especially thoracic and lumbar

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5
Q

lamina I

A

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

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6
Q

lamina ii

A

substantia gelatinosa

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

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7
Q

lamina III and IV

A

nucleus proprius, touch and pressure

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8
Q

lamina v

A

painful / nonpainful

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9
Q

lamina VI

A

central process&primary sensory neuron

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10
Q

lamina VII

A

intermediate ANS cerebellum sensory neuron

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11
Q

lamina VIII

A

axon of descending tracts synapse here

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12
Q

lamina IX

A

motor neurons

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13
Q

lamina X

A

gray matter commissure

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14
Q

dorsal column

A

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

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15
Q

spinothalamic tract

A

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

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16
Q

Lateral corticospinal

A

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

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17
Q 
UMN and LMN differentiation
strophy
fasciculation
reflexes
tone
babinski
spastic paralysis
clasp knife spasticity
A

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

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18
Q

muscle stretch and Golgi tendon reflex pathway

A

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

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

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19
Q

poliomyelitis and Werdnig-hoffman disease

A 
anterior horn damage
LMN lesions only due to destruction of anterior horns;flaccid paralysis
areflexia
muscle atrophy
fasciculation
common at lumbar level
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20
Q

MS

A

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

21
Q

Amyotrophic lateral sclerosis

ALS

A

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

22
Q

complete occlusion of anterior spinal artery

A

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

23
Q

tabes dorsalis

A

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

24
Q

Syringomyelia

A

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

25
Q

Vit B12 or Vit E deficiency

A

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

26
Q

Werdnig-Hoffman dusease

A

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

27
Q

Friedreich’s ataxia

A

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

28
Q

Brown-Sequard syndrome

A

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

29
Q

Horner’s syndrome

A 
lesion above T1: pancoast tumor, Brown-Sequard, syringomyelia
SANS  of face
ptosis:drooping of eyelid
anhidrosis: sweating
miosis, pupil contriction
30
Q

pupil dilation pathyway

A

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

31
Q

landmark dermatomes for C2

A

posterior half of skull cap

32
Q

landmark dermatomes for C3

A

high turtleneck shirt

33
Q

landmark dermatomes for C4

A

low-collar shirt

34
Q

landmark dermatomes for T4

A

at the nipple

35
Q

landmark dermatomes for T7

A

at the xiphoid process

36
Q

landmark dermatomes for T10

A

at the umbilicus

important for early appendicitis pain referral

37
Q

landmark dermatomes for L1

A

at the inguinal ligament

38
Q

landmark dermatomes for L4

A

includes the kneecaps

39
Q

landmark dermatomes for S2,S3,S4

A

erection and sensation of penile and anal zone

40
Q

Bicep reflex

A

C5 nerve root

41
Q

Tricep reflex

A

C7 nerve root

42
Q

Patella reflex

A

L4 nerve root

43
Q

Achilles reflex

A

S1 nerve root

44
Q

Babinski reflex

A

dorsiflexion of the big toe and fanning of other toe

45
Q

primitive reflexes

A

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

46
Q

moro reflex

A

hang on life reflex

abduct/extend limbs when startled and then draw together

47
Q

rooting reflex

A

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

48
Q

sucking reflex

A

sucking response when roof of mouth is touched

49
Q

palmar reflex

A

curling of fingers if palm is stroked

50
Q

plantar reflex

A

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

51
Q

Galant reflex

A

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

Neurology (7 decks)

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