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ANAP 510 > TEST 1- CNS/PNS > Flashcards

TEST 1- CNS/PNS Flashcards

1
Q

We have 33 vertebra. How are they separted? (# and segments)

A 
7 cervical
12 thoracic
5 lumbar
5 fused sacral
3-5 coccygeal
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2
Q

4 main curvatures

A

Cervical curves anteriorly
Thoracic curves posteriorly
Lumbar anteriorly
Coccygeal/sacral posteriorly

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3
Q

This faces anteriorly, and is the weight bearing portion of the vertebra

A

Body

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4
Q

Extends posteriorly on both sides

A

Pedicle

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5
Q

Posterior to the pedicle is the _______ which joins with the pedicle to form the transverse process

A

Lamina

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6
Q

Forms the spinous process (faces posteriorly)

A

2 lamina formed together

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7
Q

Attachment site for many of the muscles of the back and the neck

A

Spinous process

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8
Q

Where vertebra articulate with one another (located on superior articular process)

A

Facet

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9
Q

What sits inside the vertebral foramen?

A

Spinal Cord

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10
Q

The ________ articular process articulates with the _________ articular process of the vertebra just below it.

A

Inferior articular process articulates with the superior articular process of the vertebra below it

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11
Q

What forms the intervertebral foramen?

A

Inferior intervertebral notch

Superior intervertebral notch

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12
Q

What passes through the intervertebral foramen?

A

Blood vessels and spinal nerves

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13
Q

C1 is also called ______

A

Atlas

Greek mythology–atlas holding world on shoulders

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14
Q

The vertebral foramen is WIDE/NARROW at C1

A

Wide

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15
Q

C1 has NO body and no spinous process associated with it. TRUE/FALSE.

A

TRUE

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16
Q

What articulates with the superior articular facets of C1

A

Occipital condyles

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17
Q

C2 is also knows as the _____

A

Axis

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18
Q

This is a structure on C2, fractured frequently with neck fx’s, also known as ondontoid process.

A

Dens

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19
Q

What is the purpose of the dens articulating with the atlas?

A

Allows head to rotate left and right; provides pivot for head to rotate.

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20
Q

The superior articular facet of C2 will articulate with what??

A

Inferior articular facet of C1 (atlas)

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21
Q

Most of the spinous processes of the cervical vertebra are ________,or have a split in them.

A

Bifid

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22
Q

Why are the spinous processes of the cervical vertebra bifid?

A

So muscles of the neck can attach to the spinous processes.

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23
Q

What articulates with the superior articular facet of C5?

A

Inferior articular facet of C4

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24
Q

What does the inferior articular facet of C5 articulate with?

A

Superior articular facets of C6

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25
Q

At C5, the spinous processes are more VERTICAL/HORIZONTAL.

A

HORIZONTAL.

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26
Q

Openings in transverse processes are characteristic of ___________ vertebra.

A

Cervical vertebra

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27
Q

In most ppl, the vertebral prominance (when bend head down) is _______ vertebra.

A

C7

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28
Q

Why is C7 important for us as anesthesia providers?

A

Good landmark for us to start with if need to work our way down to find vertebra intended for spinal anesthesia.

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29
Q

2 characteristics of cervical vertebra ?

A

Bifid spinal processes

Openings in transverse processes

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30
Q

Spinous processes are very SHORT and FAT in the thoracic vertebra. TRUE/FALSE.

A

FALSE

Long and thin spinous processes

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31
Q

The body of vertebra INCREASES/DECREASES in size as you go down the vertebra, because of weightbearing.

A

Increases in size as weightbearing increases

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32
Q

The vertebral foramen is smaller in the thoracic vertebra than it is in the cervical. TRUE/FALSE

A

TRUE

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33
Q

In the first 10 thoracic vertebra, there are articulations for the ______.

A

Ribs

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34
Q

When doing spinal in the thoracic region, you have to aim the needle more _________ bc of the way the spinous processes are angled.

A

Cephalad

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35
Q

What are the floating ribs?

A

Ribs 11 and 12

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36
Q

Thoracic vertebra are the ONLY vertebra that have articulations for the ribs. TRUE/FALSE

A

TRUE

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37
Q

The head of the rib articulates with the ________ articular facet of the superior vertebra and the _______ articular facet of the inferior vertebra

A

Inferior; superior

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38
Q

Tubercle of the rib sets against the articular facet on the __________ of the inferior vertebra.

A

Transverse process

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39
Q

Lumbar vertebra are the LARGEST nonfused vertebra. TRUE/FALSE

A

TRUE

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40
Q

What would the inferior articular facet of L5 articulate with?

A

Superior articular facet of S1

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41
Q

Spinous processes of the _______ vertebra are very wide, thick, and horizontal.

A

Lumbar vertebra

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42
Q

This is at S1, important for determining width of the birth canal.

A

Sacral promontory

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43
Q

Opening at S5. Clinical significance?

A

Sacra hiatus

Caudal block for pediatrics (for urologic procedures)

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44
Q

Which 2 sets of vertebra are fused together?

A

Sacral vertebra

Coccyx

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45
Q

On average, we have _______ coccyx vertebra.

A

3-5

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46
Q

There is a _________ area where the sacrum and coccyx meet.

A

Flexible

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47
Q

There are NO vertebral foramina or transverse processes associated with the coccyx. TRUE/FALSE

A

TRUE

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48
Q

Fibrocartilagenous discs between adjacent vertebral bodies

A

Intervertebral discs

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49
Q

Intervertebral discs allows for what in the vertebral column

A

Cushioning and flexibility

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50
Q

Where do vertebral discs start and end?

A

From (axis) C2 to the sacrum (between L5 and S1)

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51
Q

There are NO vertebral discs between which cervical vertebra.

A

No vertebral discs between the Atlas and the skull; and none between the Atlas and the Axis

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52
Q

Vertebral discs provides for ~ ___% of the length of the vertebral column

A

25 %

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53
Q

As we get older, the vertebral discs _______, and they are shortened

A

Dehydrate (shrink)

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54
Q

2 main parts that compose a vertebral disc

A 
Nucleus pulposus (center)
Annulus fibrosis (outer fibrous rings)
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55
Q

Condition when nucleus pulposus herniates through annulus fibrosus

A

Herniated disc

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56
Q

Discs usually herniate ANTERIORLY/POSTERIORLY

A

POSTERIORLY

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57
Q

What is compressed with posterior herniated disc?

A

Spinal nerve root in the intervertebral foramen

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58
Q

With posterior herniated disc, there is usually _______ deficit first with _______ root compressed.

A

Sensory deficit with dorsal root compressed

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59
Q

When ventral root is compressed in the spinal nerve from herniated discs, you will see _______ deficits

A

Motor

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60
Q

What part of the vertebral column must the surgeon remove to get to the herniated disc?

A

Lamina (laminectomy)

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61
Q

This ligament runs down the anterior part of the vertebral column from the atlas to the sacrum

A

Anterior longitudinal ligament

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62
Q

The anterior longitudinal ligament DECREASES in size as goes down the spinal column. TRUE/FALSE

A

FALSE

INCREASES in size and goes downward

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63
Q

Ligament that runs along posterior surface of vertebral bodies from axis to the sacrum

A

Posterior longitudinal ligament

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64
Q

What happens to the size of the posterior longitudinal ligament as runs down vertebral column?

A

Starts large at the top and gets smaller at the bottom

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65
Q

Connects the lamina to each other on both the L and R.

A

Ligamenta flava

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66
Q

Needle goes in this opening for spinal

A

Space between L/R ligamenta flava

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67
Q

Runs from C7 to sacrum; connects tips of spinous processes.

A

Supraspinal ligament

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68
Q

Above C7, what connects spinous processes?

A

Ligamentum nuchae

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69
Q

Connects the roots and apexes of spinous processes

A

Interspinal ligaments

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70
Q

Connects adjacent transverse processes

A

Intertransverse processes

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71
Q

Spinal cord is a continuation of the _______

A

Medulla or brainstem

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72
Q

In the avg adult the SC is ~ ____ cm long

A

46 cm

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73
Q

SC extends from the foramen magnum to the ____________ (endpoint of SC)

A

Conus medullaris

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74
Q

In most adults, SC ends at Lumbar vertebra ______

A

L1

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75
Q

What space do we typically put in a spinal/epidural?

A

L3/L4

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76
Q

Fibrous structure extending from conus medullaris to coccyx and anchors SC in place

A

Filum terminale

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77
Q

What are the two enlargements of the SC?

What’s the purpose of the enlargements?

A

Cervical enlargement
Lumbosacral enlargement

Large # of nerves that need to exit these areas to innervate the upper/lower body

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78
Q

Where do the nerves originate in the spinal column that innervate the upper limbs

A

C4-T2

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79
Q

Where do the nerves enter and exit to innervate the lower limbs?

A

L3-S3

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80
Q

Nerves from the lower part of the spinal cord that extend in a tail fashion.

A

Cauda equina

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81
Q

SC is bilaterally symmetrical. TRUE/FALSE

A

TRUE

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82
Q

Divides SC down the middle anteriorly

A

Anterior median fissure

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83
Q

Divides the SC posteriorly down the middle.

A

Posterior median sulcus

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84
Q

Part of the spinal cord that holds CSF; continuous with 4th ventricle.

A

Central canal of SC

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85
Q

Outer part of SC is composed of what?

A

White matter (bundles of axons and their myelin sheaths)

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86
Q

What type of information will be transmitted in ascending tracts of the white matter?

A

Sensory information up to the brain

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87
Q

What type of info is sent in descending tracts of the SC? (3)

A

Somatic motor
Autonomic pathways
Pain modulation

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88
Q

3 columns of the white matter?

A

Dorsal (posterior)
Ventral (anterior)
Lateral column

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89
Q

Central part of SC is composed of what?

A

Gray matter

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90
Q

Nerve cell bodies and their dendrites; where axons synapse with those dendrites

A

Gray matter

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91
Q

Gray matter is divided into _______.

A

Horns

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92
Q

What are the horns of the gray matter

A

Posterior horn
Anterior horn
Lateral horn

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93
Q

What segments have a lateral horn of gray matter?

A

T1-L2

S2-S4

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94
Q

Lateral horns of the gray matter are associated with ___________ output.

A

Autonomic

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95
Q

Anterior horns of the gray matter are associated with _______ output

A

Motor

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96
Q

Posterior horns associated with _________ INPUT/OUTPUT?

A

Sensory INPUT

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97
Q

Thin strip of white matter behind posterior horn of the gray matter.

A

Tract of lissaeur

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98
Q

__________ pathways must enter through tract of lissaeur before synapsing with posterior horn of the gray matter.

A

Sensory

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99
Q

Where pathways cross over from one side of the SC to the other side.

A

Anterior white commisure

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100
Q

Surrounds the central canal of the SC; pathways can also cross over from one side of the SC to the other here

A

Gray commisure

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101
Q

One of the few places in the gray matter where tracts are passing through

A

Gray commisure

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102
Q

Where anterior and posterior root join together

A

Common spinal nerve

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103
Q

What type of fibers are in the common spinal nerve?

A

Sensory
Motor
Autonomic

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104
Q

Sensory fibers out in the periphery come through the common spinal nerve, enters the _________ root, ______ rootlets, and synapses _______.

A

Dorsal root
Dorsal rootlets
Posterior horn of gray matter

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105
Q

Where do lower motor neurons/nerve cell bodies of lower motor neurons originate?

A

Anterior horn of the gray matter

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106
Q

Where do nerve cell bodies of upper motor neurons originate?

A

Primary motor cortex; frontal lobe

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107
Q

Upper motor neuron passes through brainstem and SC to synapse with ________ in the anterior horn of the gray matter

A

Lower motor neuron

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108
Q

After lower motor neuron is excited, what is its path from anterior horn to the skeletal muscle?

A

Sends impulses out through ventral rootlets; ventral root; common spinal nerve; synapse on skeletal muscle fibers; contraction.

109
Q

Autonomic pathways start in the ________ horns, exit through the ______ rootlets, ________ root, common spinal nerve, and synapse on various tissues/organs with the autonomic innervation.

A

Start in the lateral horns, exits through ventral rootlets, ventral root..

110
Q

Sensory fibers enter through the ______ root.

A

Dorsal root

111
Q

Motor and autonomic fibers pass out through the _______ root.

A

Ventral

112
Q

All the nerve cell bodies of the sensory pathways that are entering dorsal root and clustered where?

A

Dorsal root ganglion

113
Q

The gray matter is divided into these divisions

A

Lamina of rexed

114
Q

There are ___ different zones, bilaterally, of laminae of rexed.

A

10

115
Q

These laminae of rexed are located on the dorsal horn of the gray matter and receive sensory input from peripheral afferent sensory neurons

A

Laminae of Rexed I - VI

116
Q

Lamina of rexed _____ is where primary sensory neurons that transmit fast pain synapse.

A

Lamina of rexed 1

Lamina marginalis

117
Q

Laminae of rexed II and III are collectively referred to as what?

A

Substantial gelatinosa

118
Q

Primary sensory neurons that transmit slow pain synapse here

A

Laminae of Rexed II and III

119
Q

Type of fibers and NT for fast pain?

A

Type A delta

Glutamate

120
Q

Type of fibers/NT for slow pain?

A

Type C unmyelinated

Substance P

121
Q

All sensations besides fast/slow pain terminate here (vibration, tickle, itch)

A

L of R IV, V, and VI

122
Q

These Lamina of rexed are located in the anterior horn of the gray matter; contain nerve cell bodies of efferent somatic motor neurons.

A

LofR VII, VIII, IX

123
Q

If lateral horns are present, which LofR are associated with them?

What type of output?

A

LofR VII

Autonomic output

124
Q

Where is laminae of rexed 10 located?

A

Around central canal of SC (gray commisure)

125
Q

The meninges of the of the SC are continuous with the ______

A

Brain

126
Q

The dura mater of the SC has 2 layer. TRUE/FALSE.

A

FALSE.

SC only has ONE layer of dura mater.

127
Q

How far does the dura mater extend down the spinal column?

A

S2

Longer than SC: ends blindly in pouch

128
Q

The dura mater extends out to the dorsal roots, ventral roots and common spinal nerve, creating the covering of the common spinal nerve which is the ____________.

A

Epineurium

129
Q

Dura mater is separated from the vertebral bodies which creates the __________ space.

A

Epidural space

130
Q

Below the dura mater; potential space; thin film of fluid present.

A

Subdural space

131
Q

Arachnoid mater extends past the SC, where does it end?

A

S2

132
Q

Contains CSF, space around spinal cord that is continuous with the brain.

A

Subarachnoid space

133
Q

Inseparable and attached directly to SC

A

Pia mater

134
Q

Extension of the pia mater after the conus medullaris; anchors the SC down by piercing the arachnoid mater and dura mater and attaching to coccyx.

A

Filum terminale

135
Q

Connects the pia mater to the dura mater; anchors SC down laterally. (22 of them)

A

Denticulate ligaments

136
Q

31 spinal nerves. How many pairs and where?

A 
8 pairs of cervical 
12 pair of thoracic
5 lumbar
5 sacral
1 coccygeal
137
Q

How are spinal nerves named?

A

Named form the spinal segment from which they originate

138
Q

How are spinal cord segments named?

A

Vertebral column segments from which the originated in fetal development

139
Q

As we get older, the vertebral column grows FASTER/SLOWER than the SC.

A

Column grows FASTER than SC

140
Q

SC segments do NOT lay adjacent to vertebral column segments that they originated from during fetal development. TRUE/FALSE

A

TRUE

141
Q

Upper SC segments sit adjacent with the corresponding vertebra from which they were named. TRUE/FALSE.

A

TRUE

142
Q

Lower cervical regions, the vertebra are _______ lower in number than the corresponding SC segment.

A

One lower

143
Q

Upper thoracic region, the vertebra are ____ lower in number than the corresponding SC segment

A

2 lower

144
Q

Lower thoracic region, vertebra are _____ lower in number than corresponding SC segment

A

3 lower

145
Q

Lumbar, sacral and coccygeal SC segments occupy the space opposite of what vertebra?

A

T9 - L1

146
Q

Spinal nerves exit through the same vertebral foramen that they always exited from (creates cauda equina) TRUE/FALSE

A

TRUE

147
Q

Spinal Cord segments and corresponding adjacent vertebra (adults) for spinal nerve C1-C8

A

SC - VERTEBRA

C1 - C1
C2 - C2
C3 - C 2-3
C4 - C 3-4
C5 - C 4-5
C6 - C5
C7 - C6
C8 - C6-7
148
Q

SC segments and adjacent vertebra for T1 - T12 spinal nerves

A

SC - VERTEBRA

T1 - C7-T1
T2 - T1-2
T3 - T2
T4 - T3
T5 - T3-4
T6 - T5
T7 - T6
T8 - T7
T9 - T8
T10 - T9
T11 - T10
T12 - T10-11
149
Q

SC segments and adjacent vertebra for L1-S5; Coc-1

A

SC - VERTEBRA

L1 - T11-12
L2 - T11-12
L3 - T12
L4 - T12-L1
L5 - T12-L1
S1 - L1
S2 - L1
S3 - L1
S4 - L1-2
S5 - L1-2
Coc1 - L1-2
150
Q

Areas of the skin supplied by the various spinal nerves

A

Dermatomes

151
Q

Dermatome level appropriate for spinal with an abdominal procedure

A

T4; nipple line

152
Q

Dermatome level for gynecological/urologic procedures

A

T10; around umbilicus

153
Q

Innervates the skin, muscles, and other structures of the back of the neck and the trunk. (Branch off of common spinal nerve)

A

Dorsal Ramus (rami)

154
Q

Innervate the anterior and lateral neck, trunk, perineum, and the limbs. (Branch of spinal nerve)

A

Ventral ramus

155
Q

This ramus does NOT form plexuses

A

Dorsal rami

156
Q

This ramus forms various nerve plexuses

A

Ventral rami

157
Q

From what spinal nerves does the cervical plexus receive contributions from?

A

C1, C2, C3, C4

158
Q

Spinal nerves contributing to brachial plexus

A

C5, C6, C7, C8, T1

Most ppl C4, T2 as well

159
Q

Spinal nerves contributing to lumbar plexus

A

L1, L2, L3, most of L4

160
Q

Spinal nerves contributing to sacral plexus

A

Remainder of L4,

L5, S1, S2, S3

161
Q

Spinal nerves contributing to sacrococcygeal plexus

A

S4, S5, and coccygeal nerve

162
Q

How is the brachial plexus divided up?

A 
5 Roots
3 Trunks
6 Divisions (3V/3D)
3 Cords
5 terminal Branches
163
Q

What are the 5 (or 7) roots of the brachial plexus?

A

C5, C6, C7, C8, T1

C4, T2

164
Q

Phrenic nerve is a branch off of the ____ root; innervated the diaphragm.

A

C5

165
Q

What are the 3 trunks?

A

Superior
Middle
Inferior

166
Q

The roots of the brachial plexus divide into ___ divisions, ______ dorsal and _____ ventral.

A

6 divisions
3 ventral
3 dorsal

167
Q

How do the 6 divisions form into the 3 cords?

A

3 dorsal divisions form the posterior cord

2 ventral divisions form the lateral cord

1 ventral division forms the medial cord

168
Q

6 Cords of the brachial plexus give way to what 5 terminal branches

A 
Musculoskeletal
Axillary
Radial
Median
Ulnar
169
Q

Musculocutaneous branch gets contributions from what roots?

A

C(4), C5, C6, C7

170
Q

Axillary branch gets contributions from what roots?

A

C5, C6

171
Q

Radial branch gets contributions from what roots?

A

C5, C6, C7, C8, T1

172
Q

Median branch gets contributions from what roots?

A

C(5), C6, C7, C8, T1

173
Q

Ulnar branch gets contributions from what roots?

A

C(7), C8, T1

174
Q

Cutaneous sensory innervation of axillary nerve

A

Interior lateral shoulder

175
Q

Cutaneous sensory innervation of radial nerve

A

Posterior surface of the arm and forearm, lateral 2/3 of the dorsum of the hand

176
Q

Cutaneous sensory innervation of musculocutaneous nerve

A

Lateral surface of the forearm

177
Q

Cutaneous sensory innervation of ulnar nerve

A

Medial third of the hand, little finger, and medial half of ring finger

178
Q

Cutaneous sensory innervation of median nerve

A

Lateral 2/3 of Palm of hand, thumb, index and middle fingers, and the lateral half of ring finger and dorsal tips of the same fingers.

179
Q

What nerve is most commonly damaged under general anesthesia? Why?

A

Ulnar nerve bc of compression from positioning arms wrong

180
Q

Hands should be PRONATED/SUPINATED to prevent ulnar nerve injury.

A

SUPINATED

181
Q

How many spinal arteries are there anteriorly?

A

One

182
Q

How many posterior spinal arteries?

A

Two

183
Q

The anterior spinal artery perfuses the anterior _______ of the SC

A

Ant 2/3 of the SC

184
Q

The two posterior spinal arteries perfuses the posterior _______ of the spinal cord on each side.

A

Posterior 1/3 on each side.

Right posterior artery supplies posterior 1/3 Rt SC, visversa.

185
Q

Arteries that are outside the vertebral column; run through intervertebral foramen; most only supply the nerve roots, but some perfuse parts of the meninges and ant/post SC.

A

Radicular arteries

186
Q

Artery that runs the entire length of the SC, in front of the anterior median fissure.

A

Anterior spinal artery

187
Q

What forms the most superior part of the anterior spinal artery?

A

Branches from the vertebral arteries

188
Q

In most ppl, there are ~ ______ radicular arteries that supply blood to the anterior spinal artery

A

6-10

189
Q

From cervical region, down to ~ T2, SC is perfused by radicular arteries from the __________ arteries.

A

Subclavian arteries

190
Q

This segment of the SC has only one radicular artery, making it an area at risk for hypoperfusion.

A

T3 - T7

191
Q

Supplies blood to anterior spinal artery from spinal segment T8, all the way down to the conus medullaris.

A

Artery of adamkiewicz

192
Q

Artery of adamkiewicz is also called major anterior radicular artery, and in most ppl, rises from the Left ________ artery.

A

L posterior intercostal artery

193
Q

The descending branches from the artery of adamkiewicz form an anastamosis around the conus medullaris and helps provide blood flow to what arteries.

A

Posterior spinal Arteries

194
Q

Perfuses more SC segments than any other radicular artery

A

Artery of adamkeiwicz

195
Q

Supplied blood by the lumbar, lateral sacral, and medial sacral arteries.

A

Cauda equina

196
Q

Posterior spinal arteries do NOT run entire length of SC. TRUE/FALSE

A

FALSE

Posterior spinal arteries DO run the entire length of the SC.

197
Q

Like anterior spinal artery, the posterior spinal arteries recieve blood from the _______ arteries.

A

Vertebral arteries

198
Q

In most ppl ______ radicular arteries contribute to posterior spinal arteries.

A

10-23

199
Q

Branch off of the anterior spinal artery and run along ant median fissure; supply many of the inner SC.

A

Central branches

200
Q

Arteries that run along the surface of the SC and supply outer SC

A

Pial (arterial) plexus

201
Q

Both the central branches and pial plexus have __________ branches that supply the inner SC

A

Penetrating branches.

202
Q

3 concentric rings of the SC and what arteries supply them?

A

Inner ring: zone sup;inked by the central branches

Middle ring: zone supplied by both the central branches and branches from pial plexus

Outer ring: supplied by pial plexus branches only

203
Q

The posterior spinal arteries have branches that give rise to the posterior pial plexus, but DO NOT have __________ branches

A

Central branches

204
Q

Midline structures from posterior skin to epidural space.

A 
Skin- post. Body
Subcutaneous tissue
Supraspinal ligament
Interspinal ligament
Gap: L and R ligamenta flava
Epidural space
205
Q

Midline structures from epidural space to central canal of SC.

A 
Epidural space
Dura mater
Subdural space
Arachnoid mater
Subarachnoid space/CSF
Posterior median sulcus
Pia mater
Posterior column white matter
Posterior gray commisure
Central canal of SC
206
Q

Midline structures posterior from central canal of SC to epidural space on anterior side.

A 
Central canal
Anterior gray commisure
Anterior white commisure
Pia mater
Subarachnoid space
Arachnoid mater
Subdural space
Dura mater
Epidural space
207
Q

Midline structures (from posterior) from anterior epidural space to anterior longitudinal ligament.

A 
Epidural space
Posterior longitudinal ligament
Anulus fibrosus
Nucleus pulposus
Anulus fibrosus
Anterior longitudinal ligament
208
Q

Dorsal column of the SC contains fasciculus ______ and fasciculus _______

A

Gracilis

Cuneatus

209
Q

What spinal artery would supply the R fasciculus gracilus and R fasciculus cuneatus?

A

R posterior spinal artery

210
Q

Which artery perfuses most of the posterior and anterior spinocerebellar tracts?

A

Anterior spinal artery

211
Q

What artery supplies the anterolateral system

A

Anterior spinal artery

212
Q

Composed of more than 1 pathways

A

System

213
Q

Begins in the periphery, enters SC, runs up SC to brain; this sequence is called a __________

A

Pathway

214
Q

Part of the pathway that is in the white matter of the SC or the white matter of the brain

A

Tract

215
Q

Ascending sensory spinal pathways have _____ neurons in sequence up to the brain from the periphery. They are?

A

3

Primary
Secondary
Tertiary

216
Q

Pain (fast and slow), temperature, light touch, pressure, tickle and itch are all info transmitted through ________ pathways

A

Spinothalamic pathway

217
Q

Spinothalamic pathways begin in the ________ with free nerve endings

A

Periphery

218
Q

With what two sensations, does the primary neuron of the spinothalamic tract cross over at the exact spinal segment it enters at?

A

Pain

Temperature

219
Q

Primary neuron synapses with secondary neuron where?

A

Posterior horn of the gray matter

220
Q

Pathway of secondary tract up to synapsing with tertiary neuron:

A

Crosses over and enters spinothalamic tract; ascends up SC, medullar, pons, midbrain, and terminates in one of the nuclei of the thalamus

221
Q

Where does the secondary neuron synapse with the tertiary neuron in a sensory spinothalamic pathways

A

Thalamus

222
Q

Tertiary neuron travels up to the primary sensory cortex according to the __________

A

Sensory humunculus

223
Q

Why are all other sensations difficult for the brain to localize, other than pain and temp?

A

When primary neuron enters, gives off collaterals that can ascend/descend a few spinal segments before entering the dorsal column of the gray matter

224
Q

If interrupted tx in the primary neuron, what side would be affected? What area would be affected?

A

Same side/ipsilateral

Just the areas of the skin innervated by that primary neuron

225
Q

If spinothalamic tract was interrrupted, which side affected? How much area affected?

A

Contralateral

Effects everything below the level of the lesion

226
Q

What composes the dorsal column/medial lemniscal system? (2)

A

Fasciculus cuneatus

Fasciculus gracilis

227
Q

Type of information transmitted through dorsal column/medial lemniscal system?

A

Proprioception (conscious)
2 point discrimination
Pressure
Vibration

228
Q

2 point discrimination; how close until feels like only one point: hand _____ mm; back: ______ mm

A

Hand 2-5 mm
Back ~ 20 mm

More sensory receptors on fingers

229
Q

Dorsal column/medial lemniscal system begins with modified nerve ending called ________

A

Pacinian corpuscle

230
Q

When primary neuron enters dorsal column of gray matter, it directly enters fasciculus cuneatus OR gracilis. TRUE/FALSE.

A

TRUE

231
Q

Sensations from the midthorax, up to the neck are tx through fasciculus ___________

A

Cuneatus

232
Q

Sensations from midthorax to the toes is tx through fasciculus ________

A

Gracilis

233
Q

Primary neuron synapses with secondary neuron in the nucleus gracilis or cuneatus in the ___________ of the brain.

A

Medulla

234
Q

The secondary neuron in the dorsal column/medial lemniscal system, crosses over at the ________ and enters the ___________ (runs up through pons/midbrain)

A

Crosses over at the medulla

Enters the medial lemniscus

235
Q

2ndary neuron travels up medial lemniscus and terminates and synapses with the tertiary neuron where?

A

In a nucleus of the thalamus

236
Q

What is the pathway of the tertiary neuron after medial lemniscus and thalamus?

A

Ascends up to primary sensory cortex, postcentral gyrus, according to the layout of the humonculus

237
Q

Spinocerebellar pathways transmit primarily what type of info?

A

Unconscious proprioceptive

238
Q

Spinocerebellar pathways start in the periphery with what two things?

A

Golgi tendon bodies

Primary muscle spindles

239
Q

Primary neuron of the spinocerebellar tract enters into dorsal horn of gray matter, synapses with nerve cell body of secondary neuron which enters into the posterior spinocerebellar tract on the SAME SIDE of the SC. TRUE/FALSE?

A

TRUE

240
Q

The secondary neuron travels up posterior spinocerebellar tract, inbetween the medulla and pons, it goes back and synapses in the cerebellum on the SAME SIDE. TRUE/FASLE?

A

TRUE

241
Q

The posterior spinocerebellar tract crosses over. TRUE/FALSE.

A

FALSE

Posterior DOES NOT cross over

242
Q

Posterior spinocerebellar pathways do not cross over and have only 2 neurons in sequence; but the tertiary neuron is actually located where?

A

In the cerebellum

243
Q

What is different about the anterior spinocerebellar tract?

A

It crosses over twice; ends up on the same side it entered

244
Q

What two places does the neuron cross over in anterior spinocerebellar pathways.

A

Crosses over after synapsing with 2ndary in posterior gray horn into ant whit commisure of the opposite side

Crosses over again between medulla and pons

245
Q

Descending motor pathways start where?

A

In the brain

246
Q

Corticospinal pathways are part of the _________ pathways bc they pass through the pyramids on the ant/inf surface of the medulla.

A

Pyramidal pathways

247
Q

Pathways that provide muscle movement from the neck, all the way down to the toes

A

Corticospinal pathways

248
Q

Corticospinal pathways have to do with CONSCIOUS/UNCONSCIOUS muscle movement

A

CONSCIOUS

249
Q

Corticospinal pathways start where?

A

Frontal lobe, precentral gyrus, primary motor cortex

250
Q

Descending motor pathways are composed of _______ neurons in sequence

A

2
Upper motor neuron
Lower motor neuron

251
Q

Lateral corticospinal pathways cross over the SC to the other side and enter the lateral corticospinal tracts on the opposite side at the medullar, at the pyramids; this composes ~ ____% of descending motor pathways.

A

80%

252
Q

The remaining 20% of (anterior) corticospinal tracts, upper motor neurons travel down SC and cross over where?

A

At the spinal segment where the lower motor neuron will exit

253
Q

Which ar the more important motor pathways of the corticospinal pathways?

A

Lateral corticospinal tracts

254
Q

Interrupted tx in the anterior corticospinal tract will have __________ side effects.

A

Contralateral

255
Q

Interruption of lateral corticospinal tract will affect __________ side

A

Ipsilateral

256
Q

These pathways are for control of conscious skeletal muscle movements of the head and face

A

Corticobulbar pathways

257
Q

Upper motor neurons of corticobulbar pathways originate in the ___________ according to the layout of the homunculus

A

Cerebral motor cortex

258
Q

Lower motor neurons of corticobulbar pathways are _____________ with a motor component

A

Cranial nerves

259
Q

Which cranial nerves have a motor component; acting as lower motor neurons in corticobulbar pathways?

A 
III (oculomotor)
IV (trochlear)
V (trigeminal)
VI (abducens)
VII (facial)
IX (glossopharyngeal)
X (vagus)
XI (spinal accessory)
XII (hypoglossal)
260
Q

The upper motor neurons of most (not all) corticobulbar motor pathways originate in both left and right primary motor cortices of the cerebral hemispheres. TRUE/FALSE

A

TRUE

261
Q

Corticobulbar pathways contain only crossed fibers. TRUE/FALSE

A

FALSE

Pathways contain crossed and uncrossed fibers

262
Q

These pathways do not cross through the pyramids of the medulla and are responsible for unconscious skeletal muscle movement

A

Extrapyramidal pathways

263
Q

Extrapyramidal pathways integrate with what 2 things to bring about smooth muscle movement

A

Basal nuclei

Cerebellar hemispheres

264
Q

What type of drugs caused lots of extrapyramidal manifestations?

A

Old antipsychotic drugs

265
Q

Extrapyramidal side effects include what?

A 
Unsteady gait
Ataxia
Writhing arm movements 
Lip smacking
Tongue rolling
266
Q

What drug can we give to control extrapyramidal manifestations?

A

Benadryl

267
Q

Hemisection, or incomplete, SC lesion.

A

Brown-sequard syndrome

268
Q

With Brown-Sequard syndrome, there is CONTRALATERAL/IPSILATERAL upper motor neuron damage and loss of proprioception.

A

Ipsilateral

269
Q

With Brown-Sequard syndrome, there is CONTRALATERAL/IPSILATERAL loss of pain and temperature sensation.

A

CONTRALATERAL

ANAP 510 (5 decks)

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