The Back Nerves and Vessels Flashcards

1
Q

Where does the spinal cord lie?

A

Lies in vertebral canal (not intervertebral canal)

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2
Q

Where does the spinal cord end?

A

Ends as conus medullaris at L1 (adult); L3 (child)

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3
Q

What forms the cauda equina?

A

Lumbar, sacral nerves and the coccygeal nerve

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4
Q

Where does the pia extend and attach to?

A

coccyx as filum terminale

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5
Q

What is between the Arachnoid and the pia

A

subarachnoid space, filled with CSF

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6
Q

Where is the lumbar puncture?

A

Lumbar puncture at L3/4 or L4/5.

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7
Q

Where do the Dural and arachnoid extend to?

A

S3 vertebra = dural sac

The dural sac is the membranous sheath of dura mater that surrounds the spinal cord and the cauda equina. Contains CSF.

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8
Q

What are Cervical and Lumbar enlargements for?

A

(for brachial and lumbar, plexus nerves, resp.)

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9
Q

What does the lateral horn contain?

A

Cell bodies of the sympathetic neurons.

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10
Q

Where is the lateral horn present?

A

Between levels T1-L2/3 vertebrae (thoracolumbar/sympathetic outflow), and between levels S2-S4 vertebrae (sacral/parasympathetic outflow).

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11
Q

Do sympathetic nerves synapse before reaching the muscle/ tissue?

A

Yes

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12
Q

Is the grey ramus myelinated?

A

No

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13
Q

Is the white ramus myelinated?

A

Yes

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14
Q

What is the position of the paravertebral (sympathetic trunk) ganglia?

A

Lie parallel to the spinal cord

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15
Q

What is the travel of the sympathetic nerve impulses?

A

They emerge in the ventral root via a white ramus (preganglionic fibres). After synapsing in the sympathetic chain ganglion, they re-enter the spinal nerve via a grey ramus and are distributed in both dorsal and ventral rami of the spinal nerve (postganglionic fibres).

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16
Q

Where do post ganglionic sympathetic nerve impulses travel to?

A

Skin and body wall structures such as arrector pili muscles, blood vessels and glands

17
Q

How do parts of the body above and below T1-L2/3 receive sympathetic innervation?

A

The sympathetic chain - A paired set of paravertebral ganglia stretching from C1 o the end of the coccyx.

18
Q

What are the three options of travel for the sympathetic fibres leaving the spinal cord?

A

They can synapse at the level of entry.

They can run up or down the chain and synapse.

They can pass straight through and synapse in a prevertebral/preaortic ganglion.

19
Q

Where do sympathetic preganglionic fibres to the thoracic viscera (heart and lungs) synapse?

A

Synapse IN the chain, then go to the cardiopulmonary plexus, and then on to the heart and lungs.

20
Q

Where do sympathetic preganglionic fibres to the abdominal viscera (heart and lungs) synapse?

A

They pass THROUGH the chain with out synapsing there and synapse instead on prevertebral/preaortic ganglia in the abdomen and then on to the abdominal viscera.

21
Q

Where are prevertebral / preaortic ganglia located?

A

Anterior to abdominal aorta, in plexuses surrounding its major branches

22
Q

What are splanchnic nerves?

A

They are sympathetic nerves which:

  • Do not re-enter the spinal nerve
  • Supply only the viscera
23
Q

Where do the thoracic splanchnic nerves come from? And where do they synapse?

A

Come from T1-T4

They synapse in the sympathetic chain before they run to the organ concerned (contained within the thoracic viscera).

24
Q

Where do the abdominal splanchnic nerves come from? And where do they synapse?

A

They come from T5-T12 and L1-L2(3)

They synapse outwith the chain in preaortic or prevertebral ganglia and then run to the organ concerned (in the abdominal viscera)

25
Q

What do the splanchnic nerves T5-T12 have to pass through in order to reach the abdominal organs?

A

The diaphram

26
Q

Where does general sensory information from organs run?

A

With parasympathetic fibres

27
Q

Where do pain impulses normally run?

A

Normally run with the sympathetic fibres, (in the pelvis also with parasympathetic fibres)

28
Q

What is the travel of the sensory afferents from both the sympathetic fibres and the parasympathetic fibres?

A

Both enter the dorsal root and synapse in the dorsal root ganglion before entering the lateral horn and travelling up the spinal cord to the brain.

29
Q

Where do parasympathetic nerve fibres arise from?

A

S2, S3 and S4 spinal nerves

From the 3rd, 7th, 9th and 10th cranial nerves

30
Q

What name is given to the S2, S3 and S4 nerves?

A

The pelvic splanchnic nerves- they supply the pelvic organs

31
Q

Where do the pelvic splanchnic nerve cell bodies reside?

A

In the lateral horn of the spinal cord at the T12-L2(3) vertebral levels

32
Q

Where do the bilateral preganglionic parasympathetic nerve axons runing through the lumbosacral plexus travel to?

A

The sacral foramina

33
Q

Where do the preganglionic parasympathetic nerve axons exit the vertebral column?

A

They exit the vertebral column in the cauda equina as S2- S4 spinal nerves.

34
Q

What is the pelvic/inferior hypogastric plexus?

A

A mixed sympathetic and parsympathetic distributing network.

After the parasympathetic axons have left the vertebral canal they run through here to synapse at a parasympathetic ganglion close to or within the target organ.

35
Q

What is the sentinal lymph node?

A

The hypothetical first lymph node or group of nodes draining a cancer.

36
Q

Where are the Axillary lymph nodes?

A

They lie along the walls of the the axilla in close association with the auxillary vessels

37
Q

What are the names of the auxilary lymph nodes?

A

apical, central, lateral, anterior and posterior nodes

38
Q

What is significant about the auxilliary lymph nodes?

A

They have particular significance in the spread of breast cancer

39
Q

Label the lymph nodes A-E

A