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Neuroanatomy > Lecture 2-spinal cord > Flashcards

Lecture 2-spinal cord Flashcards

1
Q

what are the boundaries of the spinal cord?

A

top/rostral/superior:

  • foramen magnum
  • 1mm caudal to the pyramidal decussation

bottom/caudal/inf
-btwn L1 and L2 vertebrae
site of conus medullaris

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2
Q

what do the cervical enlargements innervate?

what about the lumbar enlargement?

A

upper extremities

lower extremities

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3
Q

which space is CSF in

A

subarachnoid space

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4
Q

what are the differences btwn cranial and spinal meninges?

A
  1. dura in the cord has only 1 layer. in the brain there are 2
    - outer dural layer that is present i nthe brain end at the foramen magnum, so the cord only covered by an inner investing dural layer
  2. epidural space is not a potential space in cord but an actual space filled w/ fat and veins
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5
Q

what do the meninges of the brain and cord have in common

A

shared subarachnoid space bc CSF is able to bathe the cord and spinal nerve roots

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6
Q

CSF heads caudally to the

A

lumbar cistern

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7
Q

how is the spinal cord pairs divided up

A 
8 cervical 
12 thoracic 
5 lumbar 
5 scaral 
1 coccygeal
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8
Q

what does each spinal nerve innervate?

what does each spinal cord segment innervate?

A

a single dermatome and myotome

a dermatome and a myotome

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9
Q

what does the cervical enlargemnt innervate

A

upper extremities from C5 to T1

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10
Q

what does the lumbosacral enlargement innervate

A

lower extremities from L2 to S3

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11
Q

where does the spinal cord end

A

btwn L1 and L2 vertebrae

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12
Q

what is a papilledema

A

the bilateral sweling of both optic discs due to increased intracranial pressure

  • if the pt develops a space occupying lesion (tumor or bleeding) there’s not enough room in skull so the ICP increases and can be transmistted along both optic nerves due to the SHARED SUBARACHNOID SPACE.
  • same CSF that circulates around the brain and cord so its also around the optic nerces
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13
Q

what are the two investigations needed for possible causes of elevated ICP

A
  1. neuroimaging (MRI/MRV) to look for structural lesions
  2. if imaging is normal, next is CSF analysis by lumbar puncture

if LP proves that the ICP is high, then the bilarteral disc edema can be specifically called a papilledema

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14
Q

where is CSF sampled from in a LP

A

lumbar cistern

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15
Q

what does a LP allow documentation of?

the CSF sample is sent to a lab to analyze its…?

A
  1. opening pressure

2. composition

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16
Q

where is the lumbar cistern located

A

just below the spinal cord itself but still within the dural sac (from L1-L2 vert to S2 vert)

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17
Q

where is the needed in an LP for adults placed?

A

L3-L4 or L4-L5

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18
Q

what is the preferred pt position when doing an LP?

A

lateral decubitus

  • lying on side
  • in fetal position
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19
Q

what is the cut-off of the normal range of the opening pressure?

A

> 250 mmH2O

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20
Q

where does the dural sac end

A

S2 (therefore thats where the lumbar cistern ends also)

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21
Q

where is the conus medullaris

what is it

A

just below L1

caudal termination of the cord

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22
Q

where is the cauda eqina

A

spinal nerve roots from the lumbosacral region extending beyond the conus medullaris

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23
Q

what is the filum terminale

A

a thickening of the meninges which anchors the spinal cord around the coccyx

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24
Q

are spinal nerves CNS?

A

no, they are PNS

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25
Q

what are spinal nerves covered by

spinal roots?

A

epineurium

meningies

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26
Q

what are dorsal roots

A

afferent sensory fibers entering the cord.

27
Q

what type of neurons are dorsal root ganglion

A

pseudo-unipolar neurons w/ both central and peripheral processes

28
Q

what are ventral roots

where are their cell bodies or origin

A
  • efferent motor fibers going out to the periphery. probaby to innervate somatic or autonomic muscles
  • inside the spinal cord’s gray matter
29
Q

each spinal nerve if formed by the union of what?

what kind of fibers do they contain?

A

dorsal and ventral root

sensory and motor fibers (mixed nerve(

30
Q

what are the roots and rootlets enclosed in ?

what is the spinal nerve ?

A
  1. dural sleeve

2. epineurium

31
Q

waht do the spinal nerve branch off into? what kind of fibers do they contain?

A

dorsal and ventral rami

motor and sensory fibers, mixed

32
Q

ventral/anterior rami become what because they are so big? between what do they not form those? and why?

A

plexi
T2 and T12
sympathetics

33
Q

what does the smaller dorsal primary ramus innervate?

A

-skin of back,
-deep back muscles,
- joints btwn vertebrae
both sensory and motor

34
Q

what do the ventral rami supply?

A

skin of trunk and limbs

muscles of trunk and limbs

35
Q

Primary rami are….
spinal nerves are……
dorsal roots are….
ventral roots are….

A

mixed
mixed
sensory
motor

36
Q

white rami communicans are only present where….
gray rami?
why?

A
  • T1-L3 bc sympathetic preganglionics are only present thoracolumbar
  • present at all levelts bc all levls of the body get post gagnlionic sympathetic fibers
37
Q

how many pairs of cranial nerves are there? where do they exit from?
how many pairs of spinal nerves are there? where do they exit from/

A

12 pairs, exit through skull foramina

31 pairs, exit through intervertebral foramina

38
Q

do peripheral nerves contain sensory or motor info?

A

it depends-bc spinal nerves are mixed but cranial nerves can be mixed, sensory, or motor.

39
Q

what are the targets of the ANS

how do they innervate their targets

A

cardiac muscle, smooth muscle, and glands

through a 2 neuron chain

40
Q

what are the two neurons in the 2 neuron chain

A

1: pre-ganglionic neuron, originiates inside the CNS , which means the cell bodies of origin are from the brain or spinal cord
2: postganglionic neuron, originates in the ganglion which means cell bodies of origin are in the PNS

41
Q

if the preganglionic cell body is craniosacral (in brainstem or sacral spinal cord), it is…

if the preganglonic cell body is thoracolumbar (located in the thoracic or lumbar spinal cord) it is..

A

parasympathetic , its axons will exit the brainstem as cranial nerves or ventral roots and then spinal nerves

sympathetic, its axons exit via ventral roots

42
Q

what does cranio mean?

what does sacral mean?

A

preganglionic cell bodies are located in cranial nerve nuclei in the brainstem CN nuclei 3, 7, 9, 10

preganglionic cell bodies are located in the sacral region of the spinal cord and are S2 to S4

43
Q

what does it mean to say “thoracolumbar”

A

sympathetic pre ganglionic cell bodies that are located in teh T1-L3 spinal cord segments
in the lateral horn gray segments of T1-L3

44
Q

lateral horns contain ….

A

ANS motor info, specifically sympathetic preganglionic efferents

45
Q

which cranial nerves are parasympathetic in function? sympathetic?

A

3, 7, 9, 10

NONE

46
Q

what are the two types of sympathetic chain ganglia

A
  1. sympathetic chain ganglia (aka paravertebral ganglia)

2. prevertebral ganglia

47
Q

what neurotransmitter is used in preganglionic neurons?
what does the parasympathetic postganglionic neuron use?
what does the sympathetc postganglionic neuron use?

A

acetylcholine
acetylcholine
norepinephrine

48
Q

where are the sympathetic preganglionic cell bodies

A

CNS
thoracolumbar cord at T1-L3
later horns (gray matter)

49
Q

what are the sympathetic preganglionics first couple steps

A
  1. pregagnlionic axons exit the cord ventrally as ventral roots
  2. enter the spinal nerve
  3. go through the ventral primary ramus
  4. travel through the white ramus communicans
50
Q

what are the 3 steps that the sympathetic preganglionics can take

A
  1. synapse there in the sympathetic chain of ganglia
  2. go another area of the chain (up or down) before synapsing
  3. leave to synapse in a prevertebral ganglion
51
Q

what kind of fibers do gray rami communicans have? what about white rami communicans?

A

post-ganglionics (unmyelinated)

pre-ganglionics (thinly myelinated)

52
Q

where are white rami communicans found?

where are gray rami communicans found

A

T1-L3 (thoracolumbar)

all spinal cord levels

53
Q

what do white rami communicans contain?

what do gray rami communicans contain?

A

myelinated preganglionic sympathetic fibers

unmyelinated postganglionic sympathetic fibers

54
Q

where does the oculosympathetic pathway begin? what does it begin w/?

A

in the hypothalamus w/ the “central neuron”

55
Q

what do the first-order fibers do after they leave the hypothalamus

A

descend through the lateral brainstem (midbrain, pons, medulla) and cervical spinal cord

56
Q

when the first order neurons reach the ciliospinal center of budge at spinal cord segments _________, the central neuron synapses onto the preganglionic cell bodies located in the _____

A 
C8, T1, and T2 
lateral horn (intermediolateral cell column)
57
Q

where do the preganglionic neuron (2nd order neuron) eventually terminate/synapse in?

A

superior cervical ganglion

58
Q

what are the 2 routes for postganglionic oculosympathetics

A
  1. hitching a ride w/ nasociliary nerve (V1) in orbit

2. through ciliary ganglion w/o synapse (unlike parasym to sphincter)

59
Q

second preganglionic neurons exit ventral spinal roots and arch over apex of lung to ascend in ___________, synapsing in _______ and exiting as third-order neuron

A

cervical sympathetic chain

superior cervical ganglion

60
Q

third order postganglionic neuron travels w/ _____ artery into ______ w/ ophthalmic branch of of CN5 joining nasociliary branch of CN5 or passes through the ______directly, reaching the eye as ______ and _____ ciliary nerves

A

carotid
cavernus sinus
ciliary ganglion
short and long

61
Q

what do preganglionic parasympathetic fibers arise from
whta do they exit as
what do they synapse at
what do they reach the eye as

A

accessory oculomotor nucleus
oculomotor nerve
ciliary ganglion
short ciliary nerves

62
Q

what kind of tumor causes horners syndrome

A

apical lung tumor (pancoast tumor) bc preganglionic fibers pass by the lung apex (which is near the lower part of the brachial plexus)

63
Q 
parastympathetic brainstem nuclei 
CN3= ? 
CN7 =?
CN9= ? 
CN10=?
A

edinger-westphal
superior salivatory nucleus
inferior salivatory nucleus
dorsal motor nucleus of X

Neuroanatomy (10 decks)

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