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Neuroscience > Chapter 19 Spinal Cord > Flashcards

Chapter 19 Spinal Cord Flashcards

1
Q

filum terminale

A

bundle of connective tissue and glia that connects the end of the cord to the coccyx

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2
Q

cauda equina

A

horselike tail
long roots exiting the lumbosacral vertebral column

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3
Q

dorsal root

A

contains sensory axons, brings information into the spinal cord

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4
Q

spinal nerves

A

carry all of the motor, autonomic, and sensory axons of a single spinal segment

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5
Q

dorsal rami

A

innervate the paravertebral muscles, posterior parts of the vertebrae, and overlying cutaneous areas

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6
Q

ventral rami

A

innervate the skeletal, muscular, and cutaneous areas of the limbs and of the anterior and lateral trunk

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7
Q

propriospinal

A

neurons that begin and end within the spinal cord
adjacent to gray matter

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8
Q

tract cells

A

cells with long axons that connect the spinal cord with the brain

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9
Q

dorsal horn

A

primarily sensory, contains endings and collaterals of first-order sensory neurons, interneurons, and dendrites and somas of tract cells

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10
Q

Nucleus Dorsalis
Clarke’s Column

A

receives proprioceptive info
relays unconscious proprioceptive info to cerebellum
from T1-L3 anterior to dorsal horn

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11
Q

lateral horn

A

contains cell bodies of preganglionic sympathetic neurons
present only at T1-L2

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12
Q

ventral horn

A

consists of LMN cell bodies

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13
Q

stepping pattern generators

A

adaptable neural networks that produce rhythmic output
contribute to stepping by activating LMN, eliciting alternating flexion and extension at the hips and knees

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14
Q

crossed extension reflex

A

interneuronal circuit that prevents falling when one is standing and lower limb is abruptly withdrawn by adjusting the muscle activity in the stance limb

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15
Q

reciprocal inhibition

A

decreases activity in an antagonist when an agonist is active, allowing the agonist to act unopposed

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16
Q

recurrent inhibition

A

inhibition of agonists and synergies, with disinhibition of antagonists
Renshaw cells produce recurrent inhibition

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17
Q

sacral spinal cord controls

A

urination, bowel function, and sexual function

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18
Q

reflexive bladder function requires

A

afferents
T1-L2 and S2-S4 cord levels
somatic, sympathetic, and parasympathetic efferents

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19
Q

psychogenic process

A

involves erotic thoughts and is mediated by L1-L2 sympathetic fibers

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20
Q

reflexogenic erection/engorgement and lubrication results from

A

direct sensory stimulation of the genitals and is mediated by S2-S4 afferents and S2-S4 parasympathetic fibers

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21
Q

what elicits ejaculation and contraction of pelvic floor

A

sympathetic nerves L1-L2 and pudendal nerve with cell bodies in S2-S4

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22
Q

vertical tract lesion

A

results in loss of communication to and from the spinal levels below the lesion

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23
Q

peripheral region lesions

A

produce deficits in the distribution of a peripheral nerve
-altered or lost sensation in peripheral nerve distr.
-decrease or loss of muscle power in pn distri.
-no vertical tract signs
-decreased or lost phasic stretch reflex

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24
Q

spinal region segmental signs

A

occurs when a spinal segment, nerve root, and/or spinal nerve is compromised
-altered or lost sensation in a dermatome
-decreased or lost muscle power in a myotome
-decreased or lost phasic stretch reflex
-UMN signs: loss of muscle power, spasticity, hypertonia, babinski sign, clonus

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25
Q

Anterior cord syndrome

A

caused by disruption of blood flow to anterior spinal artery
interferes with nociceptive and temp sensation and motor control

26
Q

Central cord syndrome

A

occurs at cervical level due to trauma
small lesion: loss of nociceptive and temp info occurs at the level of the lesion
large lesion: additionally impair upper limb motor function

27
Q

Brown-Sequard Syndrome

A

occurs at hemisection of cord
segmental losses are ipsilateral includes loss of LMN and all sensations, voluntary motor control, conscious proprioception, and light touch are lost ipsilaterally
contralaterally: loss of nociception and temperature

28
Q

Cauda equina syndrome

A

damage to lumbar or sacral spinal roots causing sensory impairment and flaccid paresis or paralysis of lower limb muscles, bladder, and bowels

29
Q

Tethered cord syndrome

A

spinal cord becomes attached to surrounding structures during early development
low back and lower limb pain, difficulty walking, scoliosis, issues with bowel/bladder control, foot deformities
associated with spina bifida

30
Q

Traumatic SCI is due to

A

crush, hemorrhage, edema, and infarction

31
Q

spinal shock

A

immediately after injury functions are depressed or lost due to leakage of potassium into extracellular matrix
below lesion: paralysis, loss of sensation, somatic reflexes are lost, autonomic reflexes are lost, blood pressure is impaired, control of sweating lost

32
Q

reflexes mediated by S2 to S4

A

clitoroanal reflex
bulbocavernosus reflex
anal reflex

33
Q

people with lesions above C4

A

can’t breathe independently

34
Q

paraplegia

A

damage to spinal cord below cervical level, sparing arm function

35
Q

complete injury

A

lack of sensory and motor function in the lowest sacral segment

36
Q

incomplete injury

A

preservation of sensory and/or motor function in the lowest sacral segment

37
Q

Neurologic Level

A

the lowest, most caudal, level with normal sensory and motor function bilaterally
4 neurologic segments: right sensory, left sensory, right motor, left motor

38
Q

ASIA classification form

A

evaluates neurologic level in SCI
28 bilateral points are tested with a safety pin

39
Q

lesions above T6 result in 3 dysfunctions

A

orthostatic hypertension
poor thermoregulation
autonomic dysreflexia

40
Q

autonomic dysreflexia

A

medical emergency with SCI above T6
causes sympathetic overactivity that constricts blood vessels causes abrupt increase in blood pressure
-pale skin, sweating, pounding headache, reduced heart rate

41
Q

poor thermoregulation

A

interferes with the ability to maintain homeostasis

42
Q

orthostatic hypotension

A

20mm Hg fall in systolic bp and 10mm Hg fall in diastolic bp or greater than 20 bpm increase in heart rate within 3 min after getting up

43
Q

Barriers to regeneration in SCI

A

inhibitory molecules on oligodendrocytes
impenetrable glial scars
decreased rate of growth in mature neurons

44
Q

secondary changes in SCI

A

bleeding, edema, ischemia, pain, and inflammation

45
Q

highest rate of recovery with SCI

A

people with incomplete paraplegia

46
Q

complications after SCI

A

UTI, spasticity, chills and fever, contractures, penumonia, decubiti, autonomic dysreflexia, ossification

47
Q

locomotor training

A

using repetitive motions and epidural stimulation to elicit activity-dependent neuroplasticity

48
Q

radiculopathy

A

lesion of a nerve root

49
Q

avulsion or severance of dorsal root causes

A

loss of sensation in the dermatome

50
Q

avulsion or severance of ventral root causes

A

deprives the muscles in its myotome of motor innervation resulting in muscle atrophy and fibrillation

51
Q

traumatic avulsion of C5 and C6 motor nerve roots causes

A

Erb’s Palsy
result of forceful separation of the head and shoulder

52
Q

Klumpke’s paralysis

A

due to avulsion of motor roots of C8 to T1
results in paralysis and atrophy of the hand intrinsic muscles and long flexors and extensors of fingers

53
Q

sciatica

A

pain radiating from the lower back down to the lower limb along the path of the sciatic nerve

54
Q

Multiple Sclerosis

A

demyelination of the CNS
Lhermitte’s sign, numbness, paresthesia

55
Q

Lhermitte’s sign

A

radiation of a sensation similar to electric shock down the back or limbs, elicited by neck flexion

56
Q

Spinal region tumors

A

tumors outside dura or in subarachnoid space may compress spinal cord, nerve roots, spinal nerves, or their blood supply
pain aggravated by coughing or sneezing

57
Q

vertebral canal stenosis

A

narrowing of vertebral canal results in compression of neural and vascular structures

58
Q

cervical stenosis

A

narrowing of intervertebral foramina compresses spinal nerves resulting in dermatomal distribution of abnormal sensations, pain, numbness, weakness and atrophy in upper limbs
causes cervical spondylotic myelopathy

59
Q

cervical spondylotic myelopathy

A

affected somatosensation and motor function in both the upper and lower limbs
axial neck pain and or scapular pain
abnormal gait
incoordination
babinski sign
clonus

60
Q

lumbar stenosis

A

produces lower limb and lower back pain that may be aggravated by walking and improves with rest

61
Q

syringomyelia

A

progressive & congenital but may occur to trauma or tumor
a syrinx (CSF fluid-filled cavity) develops in the spinal cord in cervical region
loss of sensitivity to nociceptive signals and temp stimuli, paresis and muscle atrophy

62
Q

Red Flags for the Spinal Region

A

bilateral loss of somatosensation
incoordination
decreased muscle power
spasticity
muscle hypertonia
Babinski’s sign
clonus
difficulty urinating/deficating
saddle anesthesia
low back pain
unilateral/bilateral sciatica
lower limb paresis and sensory deficits
lost lower limb reflexes
pain in buttock, lower limb, and foot while walking that diasappears after rest
decreased pulse in lower limb
cyanosis (bluish color of skin)

Neuroscience (19 decks)

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