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Levi's Class 2014 > Week 9 Spinal Anatomy > Flashcards

Week 9 Spinal Anatomy Flashcards

1
Q

How many vertabra are there in the spinal column:

A

33

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2
Q

The spinal column has two pedicles that join with two lamina completing an arch creating _______ faramen.

A

oval-triangular

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3
Q

What does the vertebral foramen allow passage of:

A

Spinal cord

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4
Q

What part of the spine do we feel on the back of some one:

A

Spinous process

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5
Q

What does the intervertebral foramina allow passage of:

A

nerves

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6
Q

A neuroaxial block at the cervical or thoracic region will require the angle of the needle in what direction:

A

Cephelad

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7
Q

Why is a neuroaxial needle easier to place in the lumbar region:

A
  • larger vertebra

- less overlap

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8
Q

What is the sacral hiatus?

A

Lamina of the last vertebra that is incomplete and bridged only by ligaments.

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9
Q

How do you ID the sacral hiatus?

A

Palpate for the SACRAL CORNU

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10
Q

If a block is done at the sacral hiatus the block is called:

A

-caudal block

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11
Q

Categorize and number the vertebrae in the back

A 
Cervical - 7
Thoracic - 12
Lumbar - 5
Sacrum - 5 (Fused)
Coccyx - 4 (Fused)
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12
Q

Scoliosis will have what type of curvature of the back?

A

Lateral

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13
Q

Kyphosis will have what type of curvature of the back?

A

Posterior

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14
Q

Lordosis will have what type of curvature of the back:

A

Anterior

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15
Q

T/F: The interlaminar foramen will always be anterior to the spinous process.

A

FALSE

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16
Q

List the three ligaments that run parallel with the spinous process:

A
  • Supraspinous
  • Intraspinous
  • Ligamentum Flavum
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17
Q

Characteristics of the supraspinous:

A
  • Strong cord like ligament
  • Connects apices of spinous processes
  • Major ligament of cervical and upper thoracic regions
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18
Q

Charecteristic of the intraspinous:

A
  • Thin
  • Runs between adjacent spinous processes
  • Absent or poor quality in cervical region
  • Can be extremely thin in lumbar
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19
Q

Charecteristic of the ligamentum flavum:

A
  • Strongest
  • Thin on lateral edge, thick midline, like a V
  • Can be 3-5 mm thick at L2-3
  • Join the Vertebral arches through vertical extensions from adjacent lamina
  • Paired flat ligaments between each lamina and overlap
  • Creates appearance of a contiguous ligament
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20
Q

Describe where the epidural space lies:

A

-between the ligamentum flavum and the dura mater

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21
Q

Where does the epidural begin and end:

A
  • Base of the cranium

- Sacral sulcus

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22
Q

Approximate the depth of the epidural space in the lumbar region:

A

2.5 - 8 cm (average is 5 cm)

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23
Q

What is found within the epidural space:

A
  • veins
  • fat
  • lymphatics
  • segmental arteries
  • nerve roots
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24
Q

Epidural veins are _____, form a plexus being most prominent laterally, they become engorged during ____ or when people are ____.

A
  • valveless
  • pregnant
  • obese
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25
Q

The epidural depth at the cervical region is:

A

1.5 to 2 mm

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26
Q

The epidural depth at the thoracic region is:

A

3 to 5 mm

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27
Q

The epidural depth at the lumbar region is:

A

5 to 6 mm

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28
Q

The spinal cord begins at the ______ and end at __ in adults or ___ in pediatric patients.

A
  • medulla oblongata
  • L2
  • L3
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29
Q

Name the three layers of the meninges surrounding the spinal cord:

A
  • Dura matar
  • Arachnoid matar
  • Pia Mater
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30
Q

Which layer of the meninges hold the cerebral spinal fluid:

A

Arachnoid

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31
Q

How many pairs of spinal nerves are there and how many in each region:

A 
-31 pairs of spinal nerves
Cervical - 8 
Thoracic - 12
Lumbar - 5
Sacral - 5
Coccygeal - 1
32
Q

The thoracic nerve runs along the ___ margin of the rib and a chest tube would be placed along the ____ margin.

A
  • Inferior

- Superior

33
Q

Level C-8 is found between what two vertebra:

A

-C7 and T1

34
Q

Level T-1 is found between what two vertebra:

A

T1 and T2

35
Q

The cord is approximately __ shorter than the vertebra canal.

A

25 cm

36
Q

Between C4 and T1 the spinal forms the ____ plexus.

A

brachial

37
Q

Between L2 and S3 the spinal cord forms the __ and ___ plexus.

A
  • lumbar

- sacral

38
Q

The cauda equina is features are:

A

-long roots from the lumbar and sacral
nerves
-Extends from L5 to S5

39
Q

The spinal cord is divided into three sections:

A
  • Dorsal
  • Lateral
  • Ventral
40
Q

T/F: The dorsal roots of the spinal cord are outgoing motor nerves.

A

FALSE

41
Q

T/F: The ventral roots of the spinal cord are entering sensory nerves.

A

FALSE

42
Q

The H-shaped gray region of the spinal cord are ____ cell bodies and are ______ fibers.

A
  • neuronal

- unmyelinated

43
Q

The white matter within the spinal cord are ____ tracts.

A

fiber

44
Q

What tracts of the laminae of rexed receive sensory information from the periphery:

A

1 to 6

45
Q

What tracts of the laminae of rexed receive motor function:

A

7 to 9

46
Q

Which Laminae of Rexed is important to anesthesia:

A

Laminae 2

47
Q

What is another name of Laminae of Rexed 2:

A

Substancia Gelitinosa

48
Q

The dorsal white matter of the the spinal has what kind of tracts:

A

Ascending sensory fiber tracts

49
Q

The ventral and lateral white tracts of the spinal cord has what kind of tracts:

A

-Descending motor tracts

50
Q

The preganglionic neurons of the sympathetic nervous system have what kind of nerve fiber and size?

A
  • B fibers

- Small

51
Q

The preganglionic neurons of the sympathetic nervous system originate where:

A

-intermediolateral gray horn between T1 - L1(L2)

52
Q

The ventral root exit the spinal column where:

A

-White rami communicans

53
Q

What do paired segmental paravertebral ganglia form:

A

-Sympathetic trunk

54
Q

The cervical ganglia are divided into:

A
  • superior
  • medial
  • inferior
55
Q

What would stimulation do to the sympathetic nervous system in the superior cervical ganglia:

A
  • Mydrias (contraction of the radial muscle of the iris) -LARGE PUPIL
  • Relaxation of the ciliary muscle of the eye
  • Constriction of the blood vessel in the head
56
Q

Damage to the superior cervical ganglia, central SNS damage, or injury to cervical paravertebral ganglia cause:

A

-miosis (small pupil)
-ptosis (drooping eyelid)
-anhydrosis (lack of sweating)
HORNER’S SYNDROME

57
Q

The stellate ganglia if found between what two vertebrae:

A

C5-C6

58
Q

Sensory pathways transmit:

A
  • pain
  • temp
  • pressure
  • touch
  • vibratory sense
  • proprioception
59
Q

What receptors are found in the epidermis and dermis:

A
  • pain

- temp

60
Q

What receptors are found in the dermis:

A
  • pressure
  • touch
  • vibration
  • proprioception
61
Q

The extroceptor are found near the _____ and _______.

A
  • surface of the skin

- oral mucosa

62
Q

The proprioceptors are found:

A
  • deeper skin layers
  • joint capsules
  • ligaments
  • tendons
  • muscles
  • periostium
63
Q

Name the stages of pain transmission starting at the stimulus:

A
  1. transduction
  2. transmission
  3. modulation
  4. perception
64
Q

List in order the pain and temp pathway:

A
  1. Pain hits the receptors
  2. Signals goes to the fibers to dorsal root ganglia and synapse with 1st order neurons
  3. Signal enters the dorsal horn gray and synapse with 2nd order neurons
  4. Signal crosses in the ventral white commissure and enter lateral white columns
  5. Signal ascends as lateral spinothalmic tract to ventral posterolateral thalamic nucleus and synapse with 3rd order neurons
  6. Signal travels via the internal capsul and synapse in postcentral gyrus.
65
Q

Where is pain, temp, touch, and pressure interpreted:

A

Postcentral gyrus

66
Q

How do reflexes work:

A
  1. Fibers in the dorsal horn give off branches that synapse with internuncial neurons (messages)
  2. These synapse with motor neurons in the ventral horn
  3. Can cross over and travel up or down before synapsing
67
Q

What is the dermatone level of the nipple line:

A

T4

68
Q

What is the dermatone level of the xiphoid process:

A

T6/7

69
Q

What is the dermatone level of the belly button:

A

T10

70
Q

List the route for pressure and crude touch:

A
  1. Receptors to dorsal root ganglion
  2. Leave dorsal root ganglion and enters dorsal white on the ipsilateral side and bifurcates
    -One branch enters the dorsal gray and synapses with 2nd
    order neurons
    -Other ascends for up to 10 spinal segments before
    synapsing with 2nd order neurons in the dorsal gray
    -Explains feelings of crude touch and pressure after spinal
  3. 2nd order neurons from both cross over and enter the ventral white column forming the ventral spinothalmic tract
  4. Ascend up to the thalamus and synapse with 3rd order neurons in the ventral posterolateral nucleus
  5. Travel via the internal capsule to the postcentral gyrus
71
Q

List the route for vibratory sense, proprioception, and discriminatory touch:

A

Synapse with neuronal cell bodies in the dorsal root ganglion
1st order axons enter the dorsal white column and ascend to the medulla
Axons
Lumbar and sacral travel medially in the fasciculus gracilis
Cervical and thoracic travel in the fasciculus cuneatus
Each terminates in its respective medullary nucleus (nucleus gracilis or nucleus cuneatus)
2nd order axons the cross in the medulla and form a bundle called the medial lemniscus
Medial lemniscus terminates in the ventral posterolateral thalamic nucleus and 3rd order fibers terminate in the central gyrus

72
Q

List the motor/efferent end points:

A

Info from brain to voluntary muscles, smooth and cardiac muscles and some glands

73
Q

List the corticospinal tract end points:

A

Supplies the voluntary muscles of the trank and extremities

74
Q

Where does the corticospinal tract originate:

A

precentral gyrus

75
Q

Describe the route of the corticospinal tract from the start:

A
  1. Travels from precentral gyrus through the internal capsule (anterior limb) through the midbrain to the medulla
  2. 90% cross in medulla forming pyramids of medulla (corticospinal tract sometimes referred to as pyrimidal tract)
    -After crossing form the lateral corticospinal tract and
    descend the spinal cord and leave at designated level
    -Enter the ventral horn gray and synapse with lower motor
    neurons
    !!!!!!! 10% that don’t cross continue down as the ventral !!!!!!! corticospinal tract.
    !!!!!!! Then cross over before synapsing with lower motor !!!!!!! neurons in the gray matter
    !!!!!!! Travel in spinal nerves to innervate voluntary muscle

Levi's Class 2014 (16 decks)

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