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OT Anatomy > Term 2- Pt. 1 (spine and nerves) > Flashcards

Term 2- Pt. 1 (spine and nerves) Flashcards

1
Q

Which rami form the plexuses?

A

Ventral Rami

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2
Q

Ventral and dorsal nerve roots combine to create

A

The spinal nerve (which is a mixed nerve)

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3
Q

What type of neurons are sensory neurons (structure)?

A

Pseudounipolar- periphery goes to sensory receptors and central goes to dorsal horn

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4
Q

Dorsal root cell bodies are located where?

A

dorsal root ganglion which is outside the spinal cord

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5
Q

Dorsal rami function?

A

deep muscles of spine
cutaneous input of trunk
proprioception of z joints

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6
Q

Ventral rami function?

A

cutaneous of extremeties
proprioception of trunk and extrememties
ANS to spinal columns

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7
Q

What is a dermatome?

A

area of skin supplied by single dorsal nerve root

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8
Q

What is a myotome?

A

muscle fibres innervated by a single ventral nerve root (only 3 true myotomes)

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9
Q

Do dermatomes vary?

A

Yes they vary between people

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10
Q

Which spinal nerves form the brachial plexus?

A

c5, C6, C7, C8, T1

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11
Q

Explain brachial plexus

A

C5+ C6–> Superior
C7–> Middle
C8+T1–> Inferior
All split into Anterior + Posterior (ex anterior and posterior superior)
Anterior superior + Anterior middle–> Lateral
Posterior superior+Posterior middle+Posterior inferior–> Posterior
Inferior Anterior—> Medial

Medial splits into ulnar and medial aspect of median
Posterior splits into axilliary and radial
Lateral splits into lateral median and musculocutaneous

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12
Q

What is CNS

A

Central nervous system –> Brain and Spinal cord

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13
Q

PNS

A

Peripheral nervous system- everything else

nerve fibers spinal nerves etc.

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14
Q

Functionally how is the nervous system divided?

A

ANS- autonomic- cardiac etc

Sympathetic- skeletal muscle joints

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15
Q

What nerves make up the cervical plexus?

A

C1-C5

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16
Q

What nerves make up the brachial plexus?

A

C6-T1

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17
Q

What nerves make up the lumbar plexus?

A

L1-4

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18
Q

What nerves make up the sacral plexus?

A

L4 on

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19
Q

What does white matter carry in spinal cord? Why is it white?

A

Central sensory and central motor nerves- in periphery. Because of lipids myelin surrounding axons

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20
Q

What does gray matter in spinal cord house?

A

Cell bodies of motor neurons
cell bodies of interneurons
glial cells

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21
Q

Motor neuron cell bodies are in the

A

ventral horn

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22
Q

How do motor neuron axons leave the ventral horn?

A

Grouped as the ventral nerve root

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23
Q

Where are sensory neuron cell bodies?

A

Dorsal root ganglion- outside spinal cord- in PNS

Become the dorsal nerve root and bring signals to the dorsal horn

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24
Q

Draw a sensory neuron

A

See midterm notes

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25
Q

Spinal nerves are _____

A

MIXED NERVES

ventral and dsorsal nerve roots join to create spinal nerves just distal to dorsal root ganglion

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26
Q

Spinal nerves split into

A

Ventral and dorsal Rami

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27
Q

Are ventral or dorsal rami larger?

A

Ventral and they usually have names

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28
Q

The spinal nerves exit through

A

Intervertebral foramen

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29
Q

Do dermatomes overlap?

A

Yes

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30
Q

Anterior or ventral rami merge to form

A

Plexuses

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31
Q

What is the difference between upper and lower motor neurons?

A

Upper motor neurons give input to spinal cord

Lower motor neurons innervated by ventral hornspinal cord

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32
Q

are alpha and gamma neurons upper or lower?

A

Lower motor neurons

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33
Q

What are the four characteristics of muscle?

A

Resting length: length of unstimulated muscle
Contractibility: ability to shoreten in response to nerve input
extensibility: ability to stretch or lengthen when force is applied to its end
Elasticity: the ability of a muscle to return to its resting length after stretching

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34
Q

Explain the layers of muscle

A

Endomysium - deepest- covers myofibril
Perimysium - covers fasicle (middle)
Epimysium- encases muscle (outermost layer)

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35
Q

thick and thin filaments are located in the

A

myofibril

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36
Q

H bands and I bands

A

H bands are thick filaments only

I bands are thin filaments only

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37
Q

Thick filaments are

A

myosin- where ATP binds

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38
Q

Thin filaments are

A

Actin + tropomyosin and troponin complex

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39
Q

What is troponin?

A

Provides region for calcium binding

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40
Q

What is titin?

A

Anchors Z disc to M line- contributes to passive stiffness

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41
Q

What is Nebulin?

A

not sure but thought to act to regulate actin

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42
Q

What is the sliding filmanet theory?

A

Repetetive cycles of crossbridge between actin and myosin
Occurs in the presence of increased Ca 2+ and requires ATP
causes myosin conformation to change as one head binds to ATP and the other binds to Actin
Actin slides over myosin causing shortening and bringing the Z discs closer together, H and I bands become smaller and A band covers more region

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43
Q

What is a rigor state?

A

Myosin bound to ADP and actin - rigor mortis = lack of ATP (replaced by ADP)

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44
Q

What is happening in a muscles relaxed state?

A

Myosin is bound to ATP

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45
Q

What is happening in a muscles bound state?

A

Myosin is bound to Actin

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46
Q

What is a power stroke of a muscle?

A

Binding to actin causes ATPase activity ATP is hydrolyzed and ADP remains bound to myosin head

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47
Q

What controls muscle contraction?

A

Ca 2+ which is released by neuro stimuli

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48
Q

How does muscle contract?

A

Tropomyosin is shielding myosin from actin binding. Ca 2+ bind to toponin which pulls tropomyosin away from Myosin

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49
Q

What organelle monitors and controlls Ca 2+ output? How does this occur?

A

Sarcoplasmic Reticulum

It contains high levels of calsequestrin which mops up Ca 2+ that is floating free to stop muscle contraction

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50
Q

How do the muscle contractions within the sarcomere transfer out of the muscle cell to the membrane?

A 
Dystrophin Glycoprotein complex 
links via actin cytoskeleton 
aka costameres 
anchors to connective tissue 
without this there would be no functional movements 
DCG is linked to collagen
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51
Q

What happens without dystrophin?

A

Muscular Dystrophy

do not form appropriate DCG’s and so do not have exercise tolerance and muscle degenerate

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52
Q

What are the three types of muscle contraction?

A

Concentric: muscle shrotening- forced produced by muscle is greater than external force
Isometric: no length change- force produced is equal to external resistance- no length change
Eccentric: force produced by muscle fails to match external resistance = muscle lengthening

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53
Q

Eccentric example

A

Passive elbow extension

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54
Q

Isometric example

A

Holding are up / stabilizing the arm

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55
Q

Does actin and myosin stay the same for each type of contraction?

A

Yes all muscle contractions are the same at cell level

contraction is determined by balance of force produced

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56
Q

Muscle force depends on____

A

muscle length

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57
Q

Full force is when

A

actin and myosin cross optimally- maximal cross bridges

as they get further apart less acitn binds and muscle force becomes weaker

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58
Q

How do passive elements contribute?

A

they provide resistance to lengthening

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59
Q

High force movements occur at _____ velocity

A

low velocity
high velocity at low force
optimal power is somewhere betwen

60
Q

what are the different types of neurons?

A

Pseudounipolar–> Sensory

Multipolar neuron– Motor

61
Q

Neurons are classified by

A

The number of axons leaving the soma
unipolar-one
bipolar-2
multipolar- 3 or more

62
Q

What is the presynaptic terminal?

A

Holds neurotransmitters that will be released into synpatic cleft w electrical stimuli

63
Q

How is information in the nervous system coded?

A

Frequency of action potentials moving own neuron

amount of neurons firing on a cell

64
Q

Cytoplasm of neurons has a relative_____ charge

A

negative

65
Q

extracellular fluid has a relative ______ charge

A

Positive

66
Q

What is a neurons resting membrance potential?

A

-70mV

67
Q

What are the primary ions in a neuron?

A

Cl, K, Na

68
Q

What is a resting membrane potential?

A

The difference in ion concentration across a neurons cell membrane

69
Q

Stage of an action potential?

A

Reaches threshold–> Depolarization->Repolarization. Hyperpolarization (overshoot). resting

70
Q

How does an action potential occur?

A

Electrical stimulus releases Na + from axon hillock
Negative charge in neuron changes to positive charge as Na+ enters- depolarization
Na+ closes and K+ opens causing hyperpolarization as K+ rushes out of neuron
Na+ K+ pump restores K+ to cytoplasm and Na+ to extracellular
3Na+ are exchaged for 2 K+ creating the negative charge inside the neuron

71
Q

What secretes myelin?

A

Schwaan cells in the PNS

72
Q

What are nodes of ranvier?

A

partial coating of myelin where ions can be exchanged - signal “jumps” from node to node
THE GAP

73
Q

What is ssaltatory conduction?

A

The idea that the electrical signal jumps from node to node in axon

74
Q

What cells in the CNS create myelin sheath?

A

oligodendrocites

75
Q

Do neurons ever touch eachother?

A

NO

76
Q

What is the gap between neurons called?

A

a synapse

77
Q

Neurostransmitters are released from the presynaptic cell and bind ____

A

to receptors on post synaptic cell

78
Q

What is an inhibitory post synaptic potential?

A

When inhibitory neurotransmitters bind to post synaptic cell– hyperpolarization (more negative) of post synpatic cell

79
Q

Depolarization

A

when cell potential becomes more positive as a result of sodium increase

80
Q

hyperpolarization

A

when cell become more negative than resting potential due to loss of K+

81
Q

How can neurotransmitter effect cell? (int :directly?)

A

Directly - through ion channels

indirectly- through intracellular activity

82
Q

What are the three muscle fibre types?

A

Slow oxidative (S,SO)- resistant to fatigue muscles for posture, nto strong but have endurance

Fast glycolytic (FF, FG)- fatigue quickly forceful and quick but quick to tire (for running)

Fast oxidative (FOG,FR (fatigue resistant)) -intermediate

83
Q

What is the Henneman size principle?

A

recruitment of motor units in a muscle proceed from small motor units to large motor units

84
Q

As requirement for force goes up muscles recruit____

A

larger motor units

85
Q

How do motor units contribute to muscle force?

A

Size and frequency

86
Q

When force decreased motor units are let go in ____ order

A

reverse order- largest leave first

87
Q

Force in muscle goes up because

A

more motor units are being receruited and larger ones!

88
Q

Where does th espinal cord end?

A

Around L1/L2- it is shorter than the spinal canal

89
Q

Below C7 (neck) spinal segments are _____ to the vertebrae

A

rostral/ infront of / ventral to

90
Q

What in the spinal cord indicates the number of neurons?

A

X section in gray matter–> largest for spine segments supplying limbs

91
Q

X section of white matter decreases _____

A

caudally-towards the tail

meaning fewer ascending and descending fibres

92
Q

Stretch reflex and gamma reflex loop are supressed by acticity in ________

A

descending pathways

aka Jendrassik Maneuver

93
Q

Segmental level of an SCI is determiend by _______

A

Myotomes, dermatomes and reflexes

94
Q

sensory and motor abnormalities in SCI are appropriate to the functions of ___

A

tracts that have been transected

95
Q

Muscle tone is perceived as

A

resistance to continuous passive stretch

96
Q

How is muscle tone generally assessed?

A

By performing PROM

97
Q

Tone is essential to

A

normal posture, balance and movement

98
Q

Supraspinal, segmental and peripheral should all be _____

A

balanced to get “normal” muscle tone

99
Q

What is peripheral influence on msucle tone?

A

Passive properties such as muscle stretch

100
Q

Segemental control of muscle tone?

A

Monosynpatic reflex

101
Q

Normal relaxed muscle in someone with typical tone should be

A

highly extensible and low stiffness

102
Q

Titin can be thought of as

A

a bungee cord that resets sarcomere length

103
Q

Resistance in passive stretch comes from

A

weak cross bridges

104
Q

Muscle spindles are located in______

A

infrafusal fibres

105
Q

gamma motor neurons are located ___

A

infrafusal fibres

106
Q

Alpha motor neurons are located____

A

Extrafusal fibres

107
Q

How does stretch reflex work?

A

patellar tendon tap. stretch spindles> Ia afferent activity increase>Ia direct connection to alpha motor neuron> increase neuron firing> inccrease contraction to knee extensors > knee extends

108
Q

As muscle contracts spindle activity

A

decreases. It increases when muscles are stretched

109
Q

Spindle contractile elements are innervated via

A

gamma motor neurons (efferent projection to muscle spindle)

110
Q

What do gamma motor neurons do?

A

Maintain spindle sensitivity and inherent muscle activity

111
Q

Draw a spinal circuit of both a monosynpatic reflex and polysynaptic reflex

A

use paper

112
Q

How do proprioceptors contribute to movement?

A

provide info to interneurons in spinal cord which then sum excitatory and inhibitory input (pre motor convergence)

113
Q

What is hypertonia?

A

Muscle tone too high

114
Q

What is hypotonia?

A

Muscle tone too low

115
Q

What is an example of supraspinal input being compromised and how may it affect a person?

A

Stroke, CP, SCI, ABI

Causes hypertonia / spasticity

116
Q

What is an example of the segmental system being compromised?

A

Ventral horn cells–> hypotonia (because motor neurons are here)
Central horn–> hypertonicity ( cant control the stretch reflex )

117
Q

Peripheral nerve injuries always cause _____

A

hypotonia

118
Q

What are the descending pathways we learned?

A

Corticospinal tract
Corticobulbar tract
Reticulospinal tracts
Vestibulospinal tract

119
Q

Corticobulbar tract

A

Directly projects to cranial nerve nuclei (CN III, IV, VI indirectly)
some project to CN from reticular formation
Some fibers bilateral and some crossed
whole set of spinal nerves in brainstem
project to cranial nerves w motor element
Swallowing, speech, dysphagia

120
Q

Lateral Corticospinal tract

A

AKA Pyramidal tract
Fibers originate in frontal and parietal lobes
Dessucates at medullary pyramids
Terminates on interneurons of ventral horn of spinal cord then synapses with motor neurons
efferent fibers originate in motor cortex
projects ALL the way down spinal cord
Efferent
dedicated to hands face, closer to central sulcus is legs and trunk
Cell bodies in cortex- upper motor neurons
terminates on interneurons
Polysynaptic
movement of ipsilateral limbs (still contralateral to motor cortex though)

121
Q

Anterior/ Ventral Corticospinal tract

A 
Does not decussate 
small tract
fibers branch to axial muscles
projects to medial brain stem pathways 
controils trunk muscles
122
Q

Lateral Vestibulospinal tract

A

projects ipsilaterally to all segments of the spinal cord
facilitates extensor motor neurons antigravity muscles (posture and balance)
Inhibits flexor motor neurons
input mediated by interneurons and propriospinal neurons
Nucleus located in mid pons

123
Q

Medial vestibulospinal tract

A

mostly ipsilateral but some bilateral projections
input to motor neurons controlling neck and back
facillitation of extensor motor neurons
inhibits felxor motor neurons

124
Q

Medullary Reticulospinal tracts

A

Monosynaptic inhibitory to MN supplying neck and back
polysynaptic inhibitory connections w extensor MN of appendicular msucles
may also excite flexor MN via interneurons

125
Q

Pontine reticulospinal tract

A

terminates on and facillitates MN of axial muscles and extensors of the limbs
may also inhibit flexor MN

126
Q

Ascending pathways

A 
Dorsal Column pathways
Spinothalmic tract (anterolateral system)
127
Q

Dorsal column pathway

A

major pathway for touch and priprioception
crosses at the medulla
vibration, pressure, discriminative touch
originates in nucleus gracillis (lower limb) and nucleus cuneatus (upper limb) in dorsal horn of spinal cord
teriminates in primary somatosensory cortex

128
Q

Reticulospinal tracts are part of

A

the brain stem

129
Q

Spinothalamic tract (anterolateral system)

A

Neurons lie in dorsal and medial part of spinal gray matter - nucleus proprius
terminates on primary somatosoensory cortex
axons cross at midline and travel along contralateral side
CONVEYS PAIN AND TEMP
contains light touch and pressure
difficult to detect light touch and pressure if dorsal columns intact

130
Q

Draw the dorsal spinal tract vs spinothalamic tract

A

use paper

131
Q

Spinal thalamic tracts decussate at the

A

level of spinal segment

132
Q

What is the relay site before the somatosensory cortex for both sensory pathways

A

thalamus

133
Q

What are the three main myotomes?

A

Cervial - C3-C5 diapharagm,C5-C* arms and hands
Thoracic- T1- muscles of fingers T1-12-muscles of abdonem and chest
Lumbar- S2-S1- feet and legs and hips, S3-S5 bladder, bowel and sex organs

134
Q

Complete vs imcomplete SCI

A

incomolete- some movement and sensation, potential for recover
Complete- not much potential for recovery no movement or sensation

135
Q

Spinal reflexes can be a local sign of

A

CNS dysfunction

136
Q

What is hyperreflexia?

A

brisk jerks with phasic reflexes

137
Q

hypertonia

A

increased resistance to rapid passive stretch

138
Q

Clonus

A

series of multiple muscle contractions elicited by rapidly applied maintained stretch

139
Q

slow development

A

slow time course- develops after spoinal cord injury

140
Q

What is spinal spasticity?

A

exaggerated tendon jerks- can become osscilatory with re-excitation
Flexor spasms
response to input from flexor reflex afferents
lack of moderation by vestibulospinal and reticulospinal tracts

141
Q

What is the clasp knife phenomenon?

A

triggered due to lack of descending control

muscle gives away- initial resistance but then just flaccid

142
Q

What is spinal shock?

A

Initial period of hyporeflexia and flaccid paralysis
probably due to sudden withdrawal of descending drive
affects areas above and below lesion
denerveation (super sensitivity)
increased number of postsynaptic receptors
sprouting of afferent terminals

143
Q

How long does it take to recover from spinal shock?

A

weeks to months

usually recover with hypertonocity

144
Q

Lower motor neurons

A

alpha and gamm motor leurons
found in CNS and PNS - travelling from anterior (ventral) horn
muscle weakness, deminished musce tone,fasiculations, neurogenic atrophy
Guilliame Baure, botulism, polio

145
Q

Upper motor neurons

A

Only in CNS
clonus, exaggerated deep tendonreflexes, muscle weakness
Stroke, MS, TBI

OT Anatomy (6 decks)

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