17/18. Spinal Cord & Nerves Flashcards

1
Q

Overview of spinal cord

A

Part of CNS, communicates with body by spinal (peripheral) nerves
Link between brain and body through white matter tracks
Major center for reflexes in gray matter
Divided into segments based on associated vertebrae
Ends at the level of L1

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2
Q

Spinal cord protected by

A

Vertebral column (occupies vertebral canal)
Meninges (dura mater, arachnoid mater, pia mater)
Cerebrospinal fluid that flows in subarachnoid space

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3
Q

General features of spinal cord

A

Spinal nerves leave spinal cord through intervertebral foramina to travel to targets
Spinal cord does not extend the full length of vertebral canal
Cauda equina present
Filum terminale also present

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4
Q

Conus medullaris

A

Cone-shaped end of spinal cord

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5
Q

Cauda equina

A

Continuation of nerve roots in vertebral canal

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6
Q

Fillum terminale

A

Continuation of pia mater beyond conus medullaris
Anchors to coccyx and tethers spinal cord

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7
Q

Development of spinal cord

A

After 3 months of development, spinal cord grows more slowly than vertebral column
At birth, ends at L3
Adulthood, ends a L1

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8
Q

Lumbar puncture

A

Clinical correlate performed below L1 where spinal cord does not extend

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9
Q

Regions of spinal cord

A

Spinal cord segments are sections of spinal cord with a pair of spinal nerves attached
Segments: cervical (8), thoracic (12), lumbar (5), sacral (5)
Cervical and lumbar regions are enlarged for innervation for upper and lower extremities, respectively

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10
Q

Naming for spinal cord segments

A

Named for spinal nerve that emerges
Cervical - nerve # corresponds with vertebra below
Thoracic and lower - nerve # corresponds with vertebra above

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11
Q

Features of cross-section of spinal cord

A

Gray matter, white matter, and central canal

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12
Q

Characteristics of gray matter of spinal cord

A

Mostly cell bodies
Interior, looks like butterfly
Posterior wings = dorsal horn
Anterior wings = ventral horn

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13
Q

Characteristics of white matter of spinal cord

A

Mostly myelinated axons
Located on outside
Communication between different parts of cord and brain

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14
Q

Characteristics of central canal in spinal cord

A

Contains CSF

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15
Q

Neurons of spinal cord

A

In the back, out the front (dorsal root for sensory input and ventral root for motor output)
Neurons include sensory neurons, interneurons, and motor neurons
Spinal nerves join ventral and dorsal roots and contain both sensory and motor neurons

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16
Q

Characteristics of sensory neurons of spinal cord

A

Unipolar
Dorsal root ganglion (DRG) is a cluster of cell bodies
Attaches at dorsal root

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17
Q

Characteristics of interneurons of spinal cord

A

Multipolar
Cell bodies in dorsal horn

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18
Q

Characteristics of motor neurons of spinal cord

A

Multipolar
Cell bodies in ventral horn

19
Q

Characteristics of spinal nerves (extremity vs axial)

A

Spinal nerves connect spinal cord to targets of the body
Named and numbered for the vertebral region they emerge (8 cervical spinal nerves but 7 cervical vertebrae)
Nerves to the extremities form nerve plexuses
Nerves to thorax and abdomen follow simple segmented pattern

20
Q

Spinal nerve components

A

Carries both motor and sensory neurons
Sensory neurons enter spinal cord through dorsal root to dorsal horn (cell bodies in DRG)
Motor neurons leave spinal cord through ventral root to join spinal nerve (cell bodies in ventral horn)
Dorsal rami supply deep back and neck
Ventral rami supply rest of body wall and extremities

21
Q

Motor and sensory functions of dorsal rami

A

Motor - muscles of deep back and neck
Sensory - skin over vertebral column

22
Q

Motor and sensory functions of ventral rami

A

Motor- all other skeletal muscles in body wall and extremities
Sensory- rest of skin covering neck, thorax, abdomen, and extremities

23
Q

MS and location of intercostal nerves

A

Travel between ribs
Motor to intercostal muscles
Sensation from segmented regions of thoracic wall

24
Q

Location and MS of nerves of abdominal muscles

A

Travel between layers of abdominal muscles
Somatic motor to abdominal muscles
Sensation from segmented regions of abdominal wall

25
Q

Characteristics of nerve plexuses

A

Network of ventral rami from multiple segments
Muscles of extremities perform complex functions- need sophisticated innervation from multiple SC segments

26
Q

Types of nerve plexuses

A

Brachial plexus= motor and sensory to upper extremity
Lumbosacral plexus= motor & sensory to lower extremity

27
Q

Nerves of upper extremity

A

Axillary nerve
Musculocutaneous nerve
Radial nerve
Median nerve
Ulnar nerve
All coming from brachial plexus

28
Q

Characteristics of brachial plexus

A

Anterior rami of C5-T1
Sensory- skin of upper extremity
Motor- skeletal muscles of upper extremity
5 terminal branches

29
Q

Pathway of extremity nerves

A

Roots from spinal cord
Trunks
Divisions
Cords
Branches

30
Q

Roots and MWS of axillary nerve

A

Roots- C5 and C6
Motor- Teres minor (rotator cuff) and deltoid
Weakness with damage- shoulder abduction and shoulder lateral rotation
Sensory- skin over shoulder

31
Q

Roots and MWS of musculocutaneous nerve

A

Roots- C5, C6, C7
Motor- Coracobrachialis, biceps brachii, brachialis
Weakness with damage- flexion at elbow, supination
Sensory- skin over lateral forearm

32
Q

Roots and MWS of radial nerve

A

Roots- C5, C6, C7, C8,T1
Motor- triceps brachii, posterior forearm compartment
Weakness with damage- extension at elbow, wrist, & fingers, supination
Sensory- skin over posterior arm, forearm, hand

33
Q

Roots and MWS of median nerve

A

Roots- C6, C7, C8, T1
Motor- anterior forearm compartment
Weakness with damage- flexion at wrist & fingers, pronation
Sensory- skin over lateral palm, fingertips of digits 1-3

34
Q

Roots and MWS of ulnar nerve

A

Roots- C8 and T1
Motor- anterior forearm compartment
Weakness with damage- finger abduction and adduction
Sensory- skin over medial hand

35
Q

Nerves of lower extremity

A

Femoral nerve, obturator nerve, gluteal nerves, sciatic nerve consisting of tibial nerve & common fibular nerve, superficial fibular nerve, and deep fibular nerve

36
Q

Components of lumbosacral plexus

A

Lumbar plexus and sacral plexus

37
Q

MWS of femoral nerve

A

Motor- iliopsoas, quadriceps femoris, sartorius
Weakness with damage- flexion at hip, extension of knee
Sensory- skin over anterior thigh, medial leg

38
Q

MWS of obturator nerve

A

Motor- adductor longus, brevis, & magnus, gracilis
Weakness with damage- adduction of thigh at hip
Sensory- skin over medial thigh

39
Q

MW of gluteal nerves

A

Motor- gluteus Maximus, medius, minimus, and tensor fascia lata
Weakness with damage: extension at the hip

40
Q

Characteristics of sciatic nerve

A

Consists of tibial nerve and common fibular nerve
Joined by connective tissue
“Sciatica” = compression of sciatic nerve resulting in pain down back of lower extremity

41
Q

MWS of tibial nerve

A

Motor- hamstring muscles, posterior compartment soft leg (superficial & deep)
Weakness with damage- extension of hip, flexion at knee, plantarflexion at ankle, toe flexion
Sensory- skin over sole of foot

42
Q

MW of common fibular nerve

A

Motor- short head of biceps femoris
Weakness in flexion of knee may not be apparent

43
Q

MWS of superficial fibular nerve

A

Motor- lateral compartment of leg
Weakness with damage- eversion of foot
Sensory- skin over dorsum of foot (not between first 2 toes)

44
Q

MWS of deep fibular nerve

A

Motor- anterior compartment of leg
Weakness with damage- dorsiflexion of foot, extension of toes, inversion of foot
Sensory- skin between first 2 toes