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Yr2 Control - Term 2 and 3 > Workbook - Spinal cord and spinal nerves > Flashcards

Workbook - Spinal cord and spinal nerves Flashcards

1
Q

What are the 3 layers of meninges surrounding the spinal cord?

A
  • Dura mater
  • Arachnoid mater
  • Pia mater
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2
Q

How many layers does the dura mater consist of in the spinal cord?

A

One.

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3
Q

What are the denticulate ligaments?

A

Expansions of pia mater in cervical and thoracic regions.

-provide stability for the spinal cord against movement

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4
Q

What is the functional difference between the dorsal and ventral nerve roots?

A

Dorsal roots - sensory.

Ventral roots - motor.

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5
Q

Where do the dorsal and ventral nerve roots unite to form the spinal nerves?

A

Within the intervertebral foramen.

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6
Q

What do dorsal rami of the spinal nerves supply?

A

Intrinsic back muscles (epaxial) and a small strip of skin.

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7
Q

What do the ventral rami of the spinal nerves supply?

A

Most other skeletal muscles (hypaxial), limbs, trunk and skin.

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8
Q

Where is the epidural space located?

A

Between the dura mater and bone of the vertebral canal.

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9
Q

What is the filum terminale?

A

A delicate strand of fibrous tissue extending from the conus medullaris to the coccyx.
-pia mater modification

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10
Q

What is the conus medullaris?

A

Cone-shaped end of the spinal cord.

-around L1-2

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11
Q

Which spinal nerves does the cauda equina consist of?

A
  • L2-5
  • S1-5
  • Co
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12
Q

What does the cauda equina descend through?

A

Lumbar cistern.

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13
Q

What is the lumbar cistern?

A

Enlargement of the subarachnoid space between the conus medullaris (~L2) and the inferior end of subarachnoid space and dura mater (~S2).

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14
Q

What does the lumbar cistern contain?

A
  • Cauda equina
  • Filum terminale
  • CSF
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15
Q

What is the lumbar cistern used for clinically?

A
  • Lumbar puncture

- Spinal anaesthesia

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16
Q

Where does the spinal cord terminate in the foetus?

A

Coccyx.

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17
Q

Where does the spinal cord terminate in newborns (neonates)?

A

~L3.

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18
Q

Where does the spinal cord terminate in adults?

A

~L1-2.

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19
Q

Where does the subarachnoid space terminate inferiorly?

A

Lower S2.

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20
Q

Where does the subarachnoid space terminate superiorly?

A

Cranial cavity.

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21
Q

What does the subarachnoid space contain?

A

CSF.

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22
Q

What are the diagnostic purposes of obtaining CSF samples?

A
  • Meningitis
  • Subarachnoid haemorrhages
  • Guillain-Barre syndrome
23
Q

Where is a needle normally inserted for lumbar puncture?

A

In the midline, between vertebrae L3/L4.

24
Q

What surface landmarks are used to identify the site of lumbar puncture (between L3/L4)?

A

Horizontal line between the superior border of the posterior iliac crests&raquo_space; L4 spinous process.

25
Q

What are the layers pierced by a lumbar puncture needle?

A
  • Skin
  • Fascia/subcutaneous fat
  • Ligaments
  • Epidural space
  • Dura mater
  • Arachnoid mater
26
Q

What are the signs and symptoms of L5/S1 nerve root compression?

A
  • Leg pain (sciatica)
  • Numb/weak legs
  • Lower back pain
  • Cauda equina syndrome
27
Q

What are the nerve roots of the sciatic nerve?

A

L4-S3.

28
Q

What is cauda equina syndrome?

A

Compression/damage to the cauda equina.

|&raquo_space; lower back pain, leg pain/weakness, urinary incontinence

29
Q

Which section of the spinal cord has the most white matter?

A

Cervical.

-all the fibres to the body travel here

30
Q

What is the white matter of the spinal cord?

A

Paler tissue around the outside.

-consists of mainly nerve fibres and there myelin sheaths

31
Q

What is the grey matter of the spinal cord?

A

Darker, butterfly-shaped centre.

-consists of mainly cell bodies and branching dendrites

32
Q

What is confusing about the grey/white matter of the spinal cord?

A

When stained, the white matter appears dark and the grey matter appears light.

33
Q

What are the main factors that help to determine the level of a spinal cord segment? (3)

A
  • ratio of grey to white matter
  • size of the ventral horns
  • presence/absence of lateral horns
34
Q

How does the ratio of grey to white matter differ throughout the cord?

A

General a larger proportion of white matter near the top of the cord.
-very little in the sacral region

35
Q

At which spinal cord levels are the ventral grey horns enlarged, and why?

A

Cervical and lumbosacral enlargements.

-motor innervation to arms and legs

36
Q

At which spinal cord levels is a lateral grey horn/column present, and what is it involved with?

A

T2-L1.

-contain cell bodies of the sympathetic division of the autonomic system

37
Q

Where in the spinal cord is the dorsal white matter divided into 2 columns on each side?

A

Above T6.

  • Gracile fascicle (med)
  • Cuneate fascicle (lat)
38
Q

What are the main 2 ascending sensory pathways from the body?

A
  • Spinothalamic tract

- Dorsal column pathway

39
Q

What type of information does the spinothalamic tract contain?

A

Pain and temperature.

-some touch

40
Q

Does the spinothalamic pathway runs ipsilaterally or contralaterally in the cord?

A

Contralaterally.

-synapses at level of entry

41
Q

In which region of the cerebral cortex does the spinothalamic pathway terminate?

A

Brainstem.

-venteromedial medulla

42
Q

What does the spinothalamic pathway become at the medulla?

A

Spinal lemniscus.

43
Q

Where does the 2* sensory area for somaesthetic information lie?

A

In the parietal lobe.

-posterior to the PCG

44
Q

What type of information is carried in the dorsal column pathway?

A
  • Discriminative tough (2-point)

- Proprioception

45
Q

Where do the fibres of the dorsal column pathway run at the level of the spinal cord?

A

Ipsilaterally.

-in gracile/cuneate fascicles

46
Q

Where do the fibres of the dorsal column pathway run at the level of the closed medulla?

A

Ipsilaterally (/contralateral).

-gracile/cuneate nuclei

47
Q

Where do the fibres of the dorsal column pathway run at the level of the open medulla?

A

Contralaterally.

-medial lemniscus

48
Q

Where do the fibres of the dorsal column pathway synapse and cross over?

A

At the level of the closed medulla.

49
Q

What does the dorsal column pathway become at the medulla?

A

Medial lemniscus.

50
Q

Where does the gracile fascicle carry information from?

A

Below T6 & lower limb.

51
Q

Where does the cuneate fascicle carry information from?

A

Above T6 & upper limb.

52
Q

If there is a lesion below T6 involving one side of the spinal cord, why might light touch and pressure sensitivity still be present over the whole body?

A

Both pathways do a bit of touch and pressure.

-compensation

53
Q

CASE STUDY

  • proprioception and vibration sense lost in left leg
  • analgesia and thermoanaesthesia in right leg

Where is the lesion?

A

Left side of spinal cord below T6.

  • dorsal column runs ipsilaterally
  • spinothalamic tract runs contralaterally
54
Q

What effect would a left sided hemisection below T6 have on leg movements?

A

Upper motor neuron deficit&raquo_space; loss of proprioception on LHS.
-Can move legs, but don’t know how

Yr2 Control - Term 2 and 3 (17 decks)

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