MSK Session 4 Flashcards

0
Q

What does a sclerotome give rise to?

A

Vertebrae and ribs

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1
Q

What are the ventral somites called?

A

Sclerotomes

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2
Q

Which somites are found dorsally?

A

Dermamyotomes

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3
Q

What do dermamyotomes give rise to?

A

Dermis and muscle

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4
Q

What does a dermamyotome develop in association with?

A

A specific neural level of the neural tube tissue

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5
Q

What does the neural tube eventually become?

A

Adult spinal cord

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6
Q

Why does the differentiated skin and muscle units from a common dermamyotome have a common source of nervous supply?

A

They take their neural supply with them irrespective of where they end up in the adult

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7
Q

What is the common source of nervous supply to the muscle and skin units of a dermamyotome?

A

Spinal segmental nerve

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8
Q

What are the parts of the spinal cord from head to tail end?

A
Medulla of brain ends
Nerve cell bodies
Neuronal axons
Conus medullaris
Film terminae
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9
Q

What makes up the grey matter of the spinal cord?

A

Nerve cell bodies

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10
Q

What makes up the white matter of the spinal cord?

A

Neuronal axons

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11
Q

How does the length of the spinal cord vary during growth?

A

In the baby it effectively extends its whole length

In the adult it is shorter than the vertebral column

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12
Q

What is a vertebral segment?

A

A single vertebra

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13
Q

How many vertebral segments are there in the spinal column?

A

33

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14
Q

What do the vertebral foramen form?

A

Spinal canal

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15
Q

What can be seen when looking at the spinal column from the side?

A

Inter-vertebral foramen

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16
Q

Describe the path of the spinal cord in the spinal column.

A

Runs through vertebral foramina

Gives off a pair of nerves at each vertebral level (L+R)

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17
Q

Where do the left and right spinal segmental nerves exit the vertebral column?

A

Intervertebral foramina

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18
Q

Where do spinal nerves emerge in the cervical cord?

A

Superior to their corresponding vertebral level

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19
Q

Which area of the body does the bulge in the cervical spinal cord provide innervation for?

A

UL

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20
Q

Why is there a bulge in the lumbar spinal cord?

A

To provide innervation to the LL

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21
Q

Along which axis does the distribution of sensory and motor neurones in the spinal cord vary?

A

Rostro-caudal

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22
Q

What can be seen in cross section of the spinal cord?

A

Specialisations that match the 4 vertebral regions

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23
Q

Where do spinal nerves emerge in the non-cervical spinal cord?

A

Inferior to their corresponding vertebral levels

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24
Q

What is a vertebral level?

A

Level of vertebra itself

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25
Q

How are the intervertebral foramina arranged in relation to the spinal cord?

A

Heavily offset

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26
Q

What is a fundamental feature of the design of the CNS?

A

Segmented throughout its extent

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27
Q

What does each segment of nervous tissue have?

A

Independence of connection to the periphery

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28
Q

What does each neural level have?

A

R + L sides

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29
Q

What are discrete territories of skin innervated by?

A

Sensory nerves

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30
Q

What do motor nerves innervate?

A

Myotomal territories

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31
Q

What is the function of the dorsal root of a segmented nerve?

A

Sensory/afferent

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32
Q

What is the function of a ventral root of a segmental nerve?

A

Motor and autonomic/efferent

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33
Q

Where can the spinal segmental nerves become strangulated?

A

Where they exit the vertebral column

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34
Q

What is a spinal segmental nerve?

A

One of the L or R branches given off at a vertebral level by the spinal cord

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35
Q

What is known as a mixed spinal nerve?

A

A vertebral level and a neuronal spinal level

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36
Q

What does a neurovascular bundle consist of?

A

Mixed spinal nerve
Equivalent segmental spinal nerves
Veins

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37
Q

What is a ramus?

A

A branch containing all functional modalities for that segmental level

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38
Q

What happens to the missed spinal nerve when it emerges from the vertebral column?

A

Branches into large and small

39
Q

What does the large branch of a mixed spinal nerve do?

A

Supply posture muscles and some cutaneous supply

40
Q

What can be said about the level of emergence in comparison to the site of innervation by the anterior/ventral ramus of a mixed spinal nerve?

A

Stay at approximately the same level

41
Q

What happens to the small/posterior/dorsal ramus of a mixed spinal nerve?

A

Divides into medial and lateral branches to give one sensory and one non-sensory branch

42
Q

Where does the nerve supply to the UL originate?

A

Mostly cervical spinal segments C5-T1

Rest from T2 roots

43
Q

Which spinal nerves form the brachial plexus?

A
C5
C6
C7
C8
T1
44
Q

What are the roots of the brachial plexus?

A

Neural level - anterior rami of C5-T1

45
Q

What are the nerve roots of the three trunks in the brachial plexus?

A
Upper = C5 + C6
Middle = C7
Lower = C8 + T1
46
Q

What are the divisions of the brachial plexus?

A

Anterior and posterior which supply respective compartments

47
Q

What are the three cords of the brachial plexus?

A

Medial
Lateral
Posterior

48
Q

Which nerves other than the brachial plexus supply the UL?

A
Lateral pectoral
Upper and lower subscapular 
Dorsal scapular
Suprascapular
Long thoracic
Axillary
49
Q

Which spinal segments provide nerve supply to the lower limb?

A

L1-S4

50
Q

Where does the nerve supply to the lower limb originate from?

A

Lumbar plexus: L1-L4

Sacral plexus: L4-S4

51
Q

Where does the lumbar plexus form?

A

Behind psoas minor muscle

52
Q

Which nerves does the medial emergence of the lumbar plexus give rise to?

A

Obturator

Lumbosacral trunk

53
Q

Which nerves does the lateral emergence of the lumbar plexus give rise to?

A

Femoral
Iliohypogastric
Ilioinguinal
Lateral cutaneous nerve of thigh

54
Q

Why does the sacral plexus have an anterior/posterior emergence?

A

Due to vertebral fusion

55
Q

Where does the sacral plexus form?

A

W/in pelvic cavity

56
Q

Where does the sacral plexus lie in relation to?

A

Piriformis

57
Q

Which regions does the sacral plexus supply?

A

Pelvic
Gluteal
Perineal
LL

58
Q

Via which nerve does the sacral plexus provide its innervation?

A

Sciatic

59
Q

What spinal outflow gives rise to the sacral plexus?

A

1/2 L4
L5
Sacral spinal segmental

60
Q

What division of the spinal cord gives innervation to dermatomes?

A

Sensory (inflow) division of the somatic branch

61
Q

What allows the disruption of nervous supply to be accurately pinpointed?

A

Organised examination of the integrity and sensory function of the skin

62
Q

What is a Dermatome?

A

Area of skin supplied by sensory nerve fibres from a single neural level

63
Q

What does 1 spinal nerve root supply?

A

1 Dermatome

64
Q

Why is there no C1 dermatome level?

A

There is no cutaneous innervation

65
Q

Why are some sections of the skin served by 2 successive spinal nerves?

A

Due to overlap b/w adjacent dermatomes

66
Q

What is the innervation to a typical dermatome sandwiched by 2 others?

A

Served by 3 successive sensory nerves

67
Q

What does dermatomal overlap reduce the probability of?

A

Patches of skin being left w/out natural sensory neural supply

68
Q

What can be said to mark the boundaries between the flexor and extensor compartments?

A

Anterior and posterior to pre and post axial borders

69
Q

What is the axial line?

A

Line of junction between two of the dermatomes that appear to be missing from the trunk

70
Q

Which dermatomes appear to be missing from the trunk?

A

C4-8

71
Q

Why do C4-8 dermatomes appear to be missing from the trunk?

A

Skin enveloping UL is taken from the trunk and lies out along the limb

72
Q

What marks the boundaries between the flexor and extensor compartments in the upper and lower limb?

A
UL = cephalic and basilic veins
LL = great and small saphenous veins
73
Q

Describe the dermatome locations on the UL.

A
C4 = shoulder tip
C5 = radial side of upper arm
C6 = radial side of forearm
C7 = skin of the hand
C8 = ulnar side of forearm
T1 = ulnar side of upper arm
T2 = skin of the axilla
74
Q

Describe the sensory supply of the LL.

A

Front limb = lumbar segments
Back limb = sacral segments
Saddle area = sacral segments
Perineal area = sacral segments

75
Q

What do sensory divisions of terminal nerves of the brachial plexus supply?

A

Skin in nerve territories

76
Q

What supplies the skin in the LL in territorial domains?

A

Sensory divisions of terminal nerves of the lumbar plexus

77
Q

What is the sensory innervation of the hand usually considered in?

A

Nerve territories

78
Q

What three groups can the muscles of the posterior compartment of the forearm be organised into physiologically?

A

Muscles that extend and adduct/abduct hand at wrist joint
Muscles that extend medial 4 fingers
Muscles that extend/abduct the thumb

79
Q

What are the muscles of the superficial layer of the posterior forearm?

A
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
80
Q

What is the general function of muscles in the posterior compartment of the forearm?

A

Extension

81
Q

What is the main action of brachioradialis?

A

Weak flexion which is maximum when forearm is mid-pronator

82
Q

What innervates all muscles in the posterior compartment of the forearm?

A

Radial nerve and its branches

83
Q

What is the main action of ECRL?

A

Extend and abduct hand at wrist

84
Q

What is the main action of ECRB?

A

Extend and abduct hand at wrist

85
Q

What is the main action of extensor digitorum?

A

Extends medial 4 digits primarily at metacarpopharyngeal joints and secondarily at interphalangeal joints

86
Q

What is the main action of EDM?

A

Extend 5th digit primarily at metacarpophalangeal joint and secondarily at interphalangeal joint

87
Q

What is the main action of extensor carpi ulnaris?

A

Extend and adduct hand at wrist

88
Q

Which are the muscles of the deep layer of the posterior forearm?

A

Supinator

Extensor indicis

89
Q

What is the main action of supinator?

A

Supinates forearm - rotates radius to turn palm

90
Q

What is the main action of extensor indicis?

A

Extend 2nd digit

Extend hand at wrist

91
Q

Which are the outcropping muscles of the deep layer of the posterior forearm?

A

Abductor pollicis longus
Extensor pollicis longus
Extensor pollicis brevis

92
Q

What is the main action of APL?

A

Abducts thumb

Extends thumb at carpometacarpal joint

93
Q

What is the main action of EPL?

A

Extend distal phalanx of thumb at interphalangeal joint

Extend metacarpophalangeal and carpometacarpal joints

94
Q

What is the main action of EPB?

A

Extend proximal phalanx of thumb at metacarpophalangeal joint
Extend carpometacarpal joint