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A&P Fall '24 > Test 3 - 10/7 lecture > Flashcards

Test 3 - 10/7 lecture Flashcards

1
Q

Cerebral circulation does a good job _____

A

auto regulating

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2
Q

Running longitudinally along the spine we have ____ main arteries. They are called _____

A
  1. (1) Anterior spinal artery
    (2) Posterior spinal arteries
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3
Q

The anterior spinal artery is located within the _____

A

anterior median fissure

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4
Q

The superior portion of the posterior arteries get their blood supply from?

A

mainly vertebral and (anterior inferior and posterior) cerebellar arteries.

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5
Q

The three main cerebellar arteries are

A

Superior cerebellar artery
anterior inferior cerebellar artery
posterior cerebellar artery

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6
Q

Radicular arteries are

A

Branches of the intercostal arteries

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7
Q

Radicular arteries feed into

A

the anterior or posterior spinal arteries

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8
Q

______ arteries are found in the neck and are the rear posterior source of blood going into the COW

A

Vertebral

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9
Q

Intercostal arteries are found _______ and we have _____ sets of them

A

Between each of our ribs.
12 sets.

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10
Q

What is the source of blood supply for the spinal arteries in the lower portion of the cord?

A

Primarily intercostal arteries that branch into radicular arteries.

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11
Q

What does the typical branching of radicular arteries is _____ and will feed into the spinal cord every ____ vertebral levels

A

Irregular
5 or 6 levels

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12
Q

What are the three different names for the feed arteries?

A

Radicular (our primary focus)
Medullary
Segmental

Sometimes used in combination.

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13
Q

The posterior segmental medullary artery is what?

A

The feed artery that feeds into the posterior spinal artery.

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14
Q

The arteries found on the outer surface of the cord that are not continuous

A

Coronal arteries “crown”

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15
Q

What is different between the arteries in the spine vs the brain?

A

The brain (COW) has collateral circulation, if one part gets blocked blood will still move through. The spinal arteries dont have that feature

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16
Q

The difference between the posterior spinal vein and the posterior spinal arteries is what?

A

The vein is midline, the arteries are on each side

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17
Q

True/False. Veins typically follow the same pattern that arteries do.

A

True

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18
Q

Intercostal arteries come off of the _______ and majority will wrap around the sides of the rib cage.

A

Thoracic aorta

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19
Q

From the Thoracic aorta what route would arterial blood take to feed the anterior spinal artery

A

1- Intercostal artery
2- Dorsal branch
3- Spinal branch
4-Anterior radicular artery
5- Anterior spinal artery

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20
Q

At every level of the spinal cord, regardless of having radicular arteries we will have a

A

Spinal branch

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21
Q

The spinal branch sits on top of

A

dorsal root ganglion

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22
Q

Intercostal arteries are responsible for

A

keeping the ribcage healthy and perfused

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23
Q

Artery that perfuses the small intestines

A

mesenteric artery

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24
Q

When clamping the aorta, we worry about anything _____ to the clamp

A

distal/inferior

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25
Q

The anterior spinal artery perfuses _______ of the spinal cord

A

75%

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26
Q

Both posterior spinal arteries perfuse _____ of the cord combined

A

25%

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27
Q

There are usually _____ feed vessels to the anterior spinal artery in the cervical potion

A

2

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28
Q

Usually _____ feed vessels in to the anterior spinal artery in the thorax

A

2-3

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29
Q

Usually ______ feed vessels into the anterior spinal artery in the lumbar potion

A

1-2

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30
Q

Typically the posterior spinal arteries have _______ feed vessels than the anterior spinal artery

A

more

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31
Q

The arterial flow of the lower 2/3 of the anterior spinal cord is fed by the

A

Great Radicular Artery (GRA)
(Artery of Adamkiewicz)

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32
Q

The most common place to find the Great Radicular artery would be the

A

Left side of T10

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33
Q

A typical range for the location of the great radicular artery (75% of patients)

A

T9-T12

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34
Q

What are the possible levels that the greater radicular artery could be found?

A

T5-L5

35
Q

Surgery requiring an aortic clamp above the level of the artery of Adamkiewicz puts the patient at a much greater risk of

A

paralysis or loss of motor function

36
Q

Surgery requiring aortic clamping blow the GRA would?

A

likely have less issues

37
Q

Normal perfusion pressure for the cerebral circulation is typically

A

50-150mmHg

38
Q

Perfusion pressure is measured by

A

taking MAP - ICP

39
Q

Normal healthy patient ICP should be

A

10 mmHg

40
Q

Aortic cross clamping will increase your CSF pressure that surrounds the spinal cord ______

A

~10 mmHg

41
Q

If we have low MAP and our ICP is doubled following aortic cross clamp we would worry about what? What could we do to help?

A

The pressure being so high that the cord isn’t being perfused.
We could put in a drain to relieve some of the pressure

42
Q

The damage of ischemia reperfusion injury is done by

A

Excess Oxygen levels

43
Q

A typical defense mechanism to keep oxygen induced damage in check

A

antioxidants

44
Q

Oxidative potential of oxygen in the immune system?

A

immune system uses oxygen to destroy stuff

45
Q

spinocerebellar tracts

A

carry information about muscle or tendon stretch to the cerebellum

46
Q

The cerebellum helps us

A

coordinate complicated movements (walking)

47
Q

We have 4 sections of the spinocerebellar tracts. What are they called and what kind of information do they carry?

A

1- Posterior/Dorsal Cerebellar tract (located bilaterally on the lateral portions of the cord)
2- Anterior/Ventral Cerebellar tract (located bilaterally on the lateral portions of the cord)
They carry sensory information to the cerebellum

48
Q

The anterior/ventral spinocerebellar tract is responsible for information about

A

The level of motor activity at that level of the spinal cord

49
Q

The anterior/ventral spinocerebellar tract ascends and passes through the

A

Superior Cerebellar Peduncle

50
Q

The posterior/dorsal spinocerebellar tract is responsible for information about

A

tendons and muscle spindle (stretch sensors)

51
Q

The posterior/dorsal spinocerebellar tract ascends and passes through the

A

Inferior cerebellar peduncle

52
Q

The two categories of things that can cause us pain are

A

Chemical and mechanical

53
Q

Examples of chemical that can cause pain (9)

A
  1. Bradykinin
  2. Serotonin
  3. Histamine
  4. K
  5. ACh
  6. H+
  7. Proteolytic enzymes
  8. Ischemia/muscle spasm
  9. PG’s
54
Q

How do PG’s relate to pain?

A

not directly painful but augments pain

55
Q

How does ischemia relate to pain?

A

build up of metabolic waste products (lactic acid)

56
Q

pain threshold

A

amount of stimulation required before a person experiences the sensation of pain

57
Q

Chronic pain will have what effect on pain threshold?

A

It will typically reduce pain threshold, meaning it will be easier to stimulate a pain response than it was before.

58
Q

In regards to pain, if we have a lower threshold potential it would be _____ to stimulate and we would experience _____ pain. If we have a higher threshold potential it would be ______ to stimulate and we would experience ______ pain.

A

easier; more
harder; less

59
Q

Visceral pain

A

Internal organ pain transmitted by the autonomic nerve bundles.

60
Q

Visceral pain is difficult to ________ and is usually ________

A

localize; referred

61
Q

Parietal pain is pain of

A

connective tissue

62
Q

Parietal pain is highly

A

localized

63
Q

Why do we have poor localization of visceral pain?

A

Because organs lack tactile sensors

64
Q

The liver and the soft tissue of the lungs do not

A

have pain sensors

65
Q

Parietal pain is described as being ____ and uses ____ fibers

A

sharp. A delta

66
Q

Visceral pain is described as being ____ and uses ____ fibers

A

dull/achy. C

67
Q

Appendix can have _____ pain.

A

Dual

68
Q

If you are having an appendicitis attack and have pain in the RLQ this is a ______ pain

A

Parietal pain (it is localized to the actual location of the tissue)

69
Q

If you are having and appendicitis attack and have pain above your umbilicus this is a ______ pain

A

Visceral pain (it is referred to a site other than the actual site of the painful stimuli)

70
Q

Why is visceral appendix pain higher up? Where is it located?

A

The visceral pain fibers are routed up to the sympathetic chain and gets fed into autonomic ganglia and then ascends 2-3 levels and then enters cord.

T10/umbilicus

71
Q

Because it is not localized well visceral pain will not decrease via ______ like other more localized painful stimuli can be.

A

lateral inhibition

72
Q

Referred pain: Ischemia in the heart would cause pain in ____. Bad heartburn could cause pain in _____. Kidney pain is referred to _____

A

L arm.
higher than umbilical region
Lower back

73
Q

Slow pain signals that terminate in the brain stem make up the

A

reticular formation

74
Q

The limbic system is made up of what deep brain structures? (3)

A

Amygdala (the MVP)
Hypothalamus
Cingulate gyrus

75
Q

Cingulate gyrus is located

A

superior to the corpus callosum

76
Q

Motor neurons are typically _______ fibers

A

A-alpha

77
Q

What kind of fibers are used in the autonomic nervous system

A

Non or Lightly myelinated fibers

78
Q

What part of the cerebral cortex is involved in slow pain?

A

Cingulate Gyrus

79
Q

Muscle spindle and tendon feedback is likely sent on fibers that can be described as

A

Large and myelinated

80
Q

The DCML pathway typically has neuronal fibers ranging from

A

A-alpha (A-beta) to A-gamma

81
Q

What type of fiber is involved in lateral inhibition

A

A-beta

82
Q

Aching/dull/nausea is sent via ___ fibers

A

C fibers

83
Q

Fast pain usually travels via

A

A-delta fibers

A&P Fall '24 (11 decks)

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