WEEK 3- SCI pt 1 Flashcards
how many planes can we express the view of the body in
3
name the 3 planes
coronal/ frontal
sagittal
transverse
is the cauda equina cns or pns
pns
cns is comprised of
brain and spinal chord
are skeletal muscles activated by cns or pns directly
pns
where does the spinal chord begin and end ?
base of occipital bone (when spinal chord begins after medulla )
TO
space between first and second lumbar vertebral bone
how many spinal nerve segments
31
the 31 segments are divided in how many segments
5
true or false the spinal cord and vertebral column are the same length
false, spinal chord is shorter
which segments do we have enlargements and why
cervical (c3-t1) –> brachial plexus
lumbosacral (l1-s2) -lumbosacral plexus
MORE INFO TO PROCESS WITH THE LIMBS
true or false there are nerves in the cauda equina
true
true or false we can inject drugs and perform lumbar punctures in the cauda equina area
true
name the segments the spinal chord is divided in
cervical 8
thoracic 12
lumbar 5
sacral 5
coccygeal 1
sensroy afferent axons enter via …..
dorsal root roots
mottor efferent axons exit via …..
ventral roots
does spinal nerve contain motor, sensory or mixed info
mixed
motor neurons have their cell bodies in grey or white matter?
grey
where are motor neuron cell bodies located?
lamina 9 in anterior horn
where do axons of motor neurons project to
the periphery (ex to muscles )
where is the cell body of sensory neuron lcated
DRG
what doe sthe spinal cord do?
(trasnmits info from brain to the rest of the body through neural signals
the spinal cord converys motor information to …
the body
the spinal cord conveys sensory info to….
teh brain
the spinal cord contains
independent neural circuits
what are two examples of independednt neural circuits in the spinal cord
-reflexes
-central pattern generators
true or false motor infrom from brain to body is considered an ascending pathway
false = descedning
is info from body to brain ascending or decending pathway
ascending
true or false there is somatotopic organization in the white matter of spinal chord
true
true or false the somatotopic organiation of white maytter in the spinal cord is the same everywher ein the spinal cord
FALSE
dorsal columns are different than anterolateal
in the dorsal columns the somatopic arrangement is ….
lumbar is most medial, cervicalk is most lateral
in the anterior and lateral columns the somatotopic organization is ….
cervical is medial , lumbar is lateral
true or false white matter is myelnated
true
why is gray matetr grey?
due to bundle if cell bodies
grey matter in spinal cord is divided in….
rexxed laminae
how many rexxed laminae are there
10
the rexxed laminae extend from….
dorsal horn to anterior horn
lamina 9 is known for
motor
motor info is most known in which lamina
lamina 9
what is rex lamina ?
rex lamina = TYPE OF ORGANIZATION
The Rexed laminae comprise a system of ten layers of grey matter (I–X), identified in the early 1950s by Bror Rexed to label portions of the grey columns of the spinal cord.
a nissle staining connects to grey or white matter
grey
lateral horns contain what
interneurons & sympathetic preganglionic neurons
genreally , what pathway would be affted if there is a lesion in lamina 9 what is affected
(motor or sensory)
motor pathways
are local circuit neurons located in grey or white matter
grey
long distance neurons supply which region of the spinal cord
medial region of ventral horn
long distance neurons extend over several spinal level and end bilaterally true or false
true
lwhat are ong distance neurons in charge of
posture and locomotion
short distance local circuit neurons are located
lateral aspect of ventral horn
do short distance local circuit neuron extend over many segments or few
few
do short distance local circuit neuron end bilaterally or ipsilaterally
ipsilaterally
what do short distance local circuit neuron mediate
fine control of the distal extremeties
in the grey matter of the spinal chord… lower numbers of rexxed lamina correspond to what
sensory
in the grey matter of the spinal chord… higher numbers of rexxed lamina correspond to what
motor
lamina 1 (name +description)
marginal zone
- Projection neurons that receive input from small-diameter afferents; one source of anterolateral system projections
(primary neurons enter this area )
WHICH LAMINA - Projection neurons that receive input from small-diameter afferents; one source of anterolateral system projections
1
lamina 2 (name +description)
substansia gelatinosa
Interneurons that receive input mainly from small-diameter afferents; integrates feedforward and feedback (descending) inputs that modulate pain transmission (see Chapter 13)
WHICH LAMINA Interneurons that receive input mainly from small-diameter afferents; integrates feedforward and feedback (descending) inputs that modulate pain transmission (see Chapter 13)
2
lamina 3,4 (name +description)
nucleus proprius
Interneurons that integrate inputs from small- and large-diameter afferents
which lamina ?Interneurons that integrate inputs from small- and large-diameter afferents
3,4
lamina 5,6 (name +description)
base of dorsal horn
Projection neurons that receive input from both large- and small- diameter afferents and spinal interneurons; another source of anterolateral system projections
which lamina Projection neurons that receive input from both large- and small- diameter afferents and spinal interneurons; another source of anterolateral system projections
5,6
lamina 7 (name +description)
intermediate gray
Mainly interneurons that communicate between dorsal and ventral horns; in the thoracic cord, also contains projection neurons of the dorsal nucleus of Clarke, a spinocerebellar relay (see Chapter 19), and the sympathetic preganglionic visceral motor neurons of the intermedio- lateral cell column (underlying the lateral horn); in the sacral cord, also contains preganglionic visceral motor neurons
which lamina
Mainly interneurons that communicate between dorsal and ventral horns; in the thoracic cord, also contains projection neurons of the dorsal nucleus of Clarke, a spinocerebellar relay (see Chapter 19), and the sympathetic preganglionic visceral motor neurons of the intermedio- lateral cell column (underlying the lateral horn); in the sacral cord, also contains preganglionic visceral motor neurons
7
lamina 8 (name +description)
motor interneurons
Interneurons in the medial aspect of ventral horn that coordinate the activities of lower motor neurons
which lamina
Interneurons in the medial aspect of ventral horn that coordinate the activities of lower motor neurons
8
lamina 9 (name +description)
motor neuron columns
Columns of lower motor neurons that govern limb musculature
which lamina
Columns of lower motor neurons that govern limb musculature
9
lamina 10 (name +description)
central gray
nterneurons surrounding the rudiment of the central canal
which lamina
nterneurons surrounding the rudiment of the central canal
10
what kiund of neuron is a somatic sensory neuron
pseudounipolar
true or false pseudounipolar neurons receive information from environemnt and bring it into the spianl chord
TRUEEE
what do white matter columns in the spinal chord do?
transmit info from the periphery to tje brain
anterolateral system is comprised of what two spinothalamic tracts
anterior
lateral
lateral spino is in charge of
pain and temp
anterior spino thalamic tract is responsible for
crude tocuh and pressure
laterala nd anterior spinothalmic tracts make up what sensory system
anterolateral
dorsal column is in charge of what
fine touch
vibration
conscious proprioception
the fascivulus gracilis and fasciculus cuneatus are part of which section in the spinal cord
dorsal column
true or false fasciculus gracilis is for upper limbs
false
fasciculus cuneatus is for lower limbs
fasle
true or false the fasciculi in the dorsal column are impritant for pain and temp
FALSE
what isa dermatome
area of skin innervated by sensory fibers at a single spinal level
do dermatomes are cross the midline
no, we have a dermatome on each side of the body at the same level
upper limb dermatome is
c5-t1
nipples are at which dermatome
t4
belly button is which dermatome
t10
lower limbs is which dermatome
l2-s2
repeated question….
in the white matter in the anterior and lateral columns the somatotopic organization is is
cervical = medial
lumbar =lateral
true or false there exists motor pathways in white matter of SC
yes
motor pathways are considereed to be ascending or decsenving
dwon
are distal muscles located more medially or laterally in the anterior horn
lateral
are proximal muscles located more medially or laterally in the nateripor horn
medially
are flexors located dorsal or ventral in the naterior horn
dordal
are extensors located more dorsal or ventral in anterior horn
ventral
corticospinal (pyramidal) tracts are motor or sensory
motor
what is a myotome
group of muscles innervated by motor fibers at a single spinal level
true or false there is no overlap of myotomes in muscle innervation
FALSE
for example biceps are innervated by c5 and c6!
every muscle is innervate dby
a different pool of motor neurons
if i have a lesion at c5 will i lose all mobility inmy biceps
NO
is it true that having a lesion at c5 for example will reduce the force of that muscle but will not lose entire capability ot activat eit
yes
instea dof having two spinal working you have 1
true or false having a lesion at c5 (in white matetr tracts ) will affect every level below it
true
are there more tramatic or non traumatic Spinal cord injuris (SCI) in canada
non traumatic
what is non traumatic SCI
degeneration of vertebral disk = squeexing nerve and lesion
with age = more likely to get non traumatic
what is traumatic spinal chord injury
injury to the spine
what is complete SCI
no sensory and motor function (ability to feel, touch or move) preserved in the last nerves leaving the spinal cord (sacral 4th and 5th nerves)
true or false Symptoms of SCI will vary depending on where the spine is injured and the extent of the injury
true
Cervical (neck) injuries result in…
full or partial tetraplegia
Complete injuries at or below the thoracic spinal levels result in
paraplegia
Injuries to the lumbar or sacral regions
decrease control of the legs and hips, urinary system, and anus
what is tetraplegia
- Tetraplegia (replaces the term quadriplegia): Injury to the spinal cord in the cervical region, with associated loss of muscle strength in all 4 extremities
what is paraplegia
- Paraplegia: Injury in the spinal cord in the thoracic, lumbar, or sacral segments, including the cauda equina and conus medullaris
LOOK AT ASIA SCALE?
…
complete transection is
something that totally ruptured the spinal cord
what happens in the first few days of complete spinal cord transection
spinal shock = everything shuts down
what is spinal shock is (0-1d)
A sudden loss of sensation accompanied by motor paralysis and loss
of reflexes at/below the lesion
what is spinal shock 1-3 d
Slow return of reflexes
what is spinal shock 1-4 weeks
hyperreflexia (concurrent appearance of spcicity = person stcck in a certain muscle tension)
what is spinal shock- longterm
affected below the level of the lesion
name some long term symptoms of complete transection
n Paralysis – loss of voluntary movement n Appearance of spasticity (1–12m)
n Absence of sensation
n Abnormal reflexes (Babinski)
n Loss of control of bladder and bowel n Loss of autonomic function (varies)
partial transection of spinal chord can be divided in
non traumatic
truamtic
non traumatic partial transection is
something that grows or degenerates
does non traumatic partial transection happen with external physical force
no
does non traumatic partial transection continue to worsen with time
yes
is non traumatic partial transection a rapid onset
no = slow
what are specific causes on \non traumatic partial transection
infection or tumor,
syphilis,
metastases,
spondylotic myelopathies
true or false spinal infections are very common
fasle = rarely seen
what is another term for spondylotic myelopathies
spinal chord compression
what is spinal cord compression (non traum)
during aging = intervertebral disk that degenerates
squeeze the nerve an dpotentially the spinal chord
can create tissue death
name ways one can get a a TRAUMATIC partial transection
Falls (most common),
car accidents,
work-related accidents,
sports injuries,
penetrating trauma (stab or gunshot wounds)
are male sor females most likely to have TRAUMATIC partial transection
males (by alot)
falls are common at what age
around 63
transport relate dinjuries are common at what age
46
out of c5 c4 and c6 which is most common to injure (PTRAUMATICTRANS)
c6
examples of lesions are :
Central cord syndrome
Anterior spinal artery syndrome
Brown-Séquard syndrome (cord hemi-section) n Posterior cord syndrome
compresison injuries (traumatic) = another way to get whaty kind of spinal cord injury
incomplete ir complete
compression injuries can happen via
n From vertical blow to the head: diving in shallow water, sports injuries, motor-vehicle injuries
