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Neuo Block 1 > Spinal Cord > Flashcards

Spinal Cord Flashcards

1
Q

At the cervical thoracic border, what is the change in the vertebral level?

A

C1-C7 nerves exit superior to their vertebrae

C8 and T1-L5 nerves exit inferior to their vertebrae

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2
Q

The sacral cord ends at what level?

A

L2

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3
Q

What is the coccygeal ligament?

A

Dural sac terminates and gives rise to the ligament. It runs down the coccyx and attaches here

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4
Q

What does the dural sleeve cover? Why?

A

-cover spinal cord, roots, and the dorsal root ganglia due to their position with the intervetebral foramen

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5
Q

What do arachnoid trabeculae do?

A

They run from arachnoid to pia mater on the cord

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6
Q

What are denticulate ligaments?

A

-run from dura to pia/cord and help stabilize the spinal cord in the horizontal plane

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7
Q

The cord tapers down to _______________ at what level? Then after that it becomes what?

A
  • tapers down to the conus medullaris at level L2

- cauda equina

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8
Q

What stabilizes the spinal cord in the vertical plane?

A

-filum terminale and coccygeal ligament outside of the dural sac

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9
Q

Where does the lumbar cistern begin?

A

L3

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10
Q

Is the subarachnoid space the same through every vertebral level?

A

Nope. They vary a lot!

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11
Q

What are the layers of the spinal cord in order from deep to superficial?

A
  • spinal cord
  • pia
  • CSF
  • arachnoid
  • dural sheath
  • epidural space
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12
Q

In the brain, the dura mater in directly attached to the skull. Is this different with the spinal cord?

A
  • oh yea

- there is epidural space in the spinal cord filled with vessels and fat

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13
Q

What does the central canal do?

A

It runs the entire length of the cord and has a little bit of CSF since the cord developed from a fluid filled tube

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14
Q

What is primarily found in grey matter?

A

Primarily cell bodies! Neurons and glia

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15
Q

What is found in white matter?

A
  • glia

- myelinated axons

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16
Q

Are there neuron cell bodies in white matter>

A

Nope

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17
Q

Why is there SOME stain for myelin in grey matter?

A

Neuron cell bodies have some myelin because some are myelinated and some are not.

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18
Q

In rostral-caudal order, where is there an enlargement of grey matter? Why?

A
  • brachial plexus (C5-T1)
  • Lumbar PLexus (L1-L4)
  • Sacral Plexus (L4-S4)

-where you control extremities, you need more cells!

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19
Q

What is substantia gelatinosa?

A

-incoming sensory fibers carrying pain and temperature synapse

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20
Q

What is the lamina number where pain/temp fibers terminate and synapse?

A

II (2)

-in posterior/ dorsal horn

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21
Q

Which lamina are in the posterior/dorsal horn?

A
  • Substantia gelatinosa (II)

- Crude(III and IV and V)

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22
Q

Which laminae are in intermediate grey matter?

A
  • VII
  • preganglionic sympathetic neurons
  • intermediomedial cell column
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23
Q

Which laminae are in the anterior/ventral horn?

A

VIII, IX motor neurons

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24
Q

What laminae do crude touch fibers terminate and synapse?

A

III,IV,V

-in posterior/dorsal horn

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25
Q

Where are the preganglionic sym and para neurons located?

A

Intermediomedial cell column (intermediate grey space)

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26
Q

What are the 3 funiculi of the white matter?

A
  • posterior
  • lateral
  • anterior
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27
Q

What is the posterior funiculus divided into?

A
  • posterior median sulcus
  • posterior median septum
  • posterior intermediate sulcus
28
Q

What is the anterior median fissure?

A

Basically the spinal cord version of a sulcus

29
Q

What is the fasciculus cutaneous?

A

-part of the posterior funiculus that carries fine touch information for the arms and hands (T6 and above)

30
Q

What is the fasciculus gracilis?

A

Sensory information from dorsal roots of T7 and below (legs)

31
Q

What does the posterior/dorsal column system do?

A

-fine touch and conscious proprioception

32
Q

What does the anteolateral system do?

A

Pain/temp/crude touch

-not spatially specific

33
Q

Sensory information for the face comes from what?

A

Trigeminal

34
Q

What are upper motor neurons?

A
  • in precentral gyrus

- project down through the brain and spinal cord and synapse onto a lower motor neuron

35
Q

What are lower motor neurons>

A
  • in ventral/anterior horn

- send out information from upper motor neurons to the muscle

36
Q

What is the ganglia that brings touch information into the cord?

A

The posterior root ganglion

37
Q

Which kind of touch goes straight to the brain and which ones synapse in the dorsal horn and then to a tract?

A
  • fine touch in posterior column system goes straight to the brain
  • crude tough and temp in anterolateral system synapse in the cord then go to a tract
38
Q

Loss of sensation in a dermatomal pattern signifies what?

A

-segmental pathology of the spinal cord, dorsal root or proximal spinal nerves at the same corresponding level.

39
Q

Voluntary movement is controlled by what 2 consecutive neurons?

A
  • upper motor neurons

- lower motor neurons

40
Q

Motorneurons are ______________ cell body with what kind of dentrite?

A
  • multipolar

- large dendritic arbor

41
Q

Additional descending tracts onto motorneurons do what?

A

-modify lowermotor neurons to the upper motor neuron for motor coordination

42
Q

When testing the corticospinal system, what are you testing?

A

Strength and reflex, not coordination!

43
Q

What is the rating scale for corticospinal system?

A

5-normal and can overcome resistance
3-cant overcome resistance, but can overcome gravity
1-muscle contraction, but no movement
0-nothin

44
Q

Describe the patellar reflex

A
  • tap on tendon to stretch patellar tendon and create stretch sensation (mimics what happens when knee flexes)
  • stretch sensation goes through dorsal root to the cord
  • activates quad muscle to cause EXTENSION at the knee
  • also inhibits FLEXION

-extend the knee and simultaneously inhibit the muscle that would flex

45
Q

When testing stretch reflex, you are testing different ____________ regions of the spinal cord

A

Horizontal

46
Q

The patella response is mediated at what level?

A

L4

47
Q

What are some deep tendon reflexes?

A
  • biceps
  • triceps
  • patellar
  • ankle
48
Q

For stretch reflex/deep tendon reflex, where is normal on the rating scale?

A

In the middle! 2/4

-clinical problems can be caused by too much and too little

49
Q

What is clonus? Where is it on the reflex scale?

A
  • when you flex, you get activation of extension muscles, but an alternating of activation of opposing flexion muscles, so you get a back and forth response
  • it is a 4/4 on scale. (Normal is 3/4)
50
Q

What muscles actually do the movement?

A

Extrafusal! Intramural are just sensory (inside the muscle spindle)

51
Q

Sensory arc

A

Secnroy fibers from intrafusal. Stretch when muscle is stretched and act as mechanoreceptors and pick up the stretch to take to the spinal cord

52
Q

Motor arc

A

Projections to extrafusal muscle (not to spindle) actually causes movement

53
Q

Muscle spindles detect what?

A
  • velocity(how fast or slow is the stretch)

- amplitude( how much the muscle is stretched)

54
Q

What do gamma motor neurons do?

A
  • innervate intrafusal muscles miners and cause them to contract when extrafusal muscles do even though they do not actually do movement
  • it helps spindle maintain sensitivity to stretch
55
Q

What is the influence of the descending projections to motor neurons on the stretch reflex?

A
  • usually inhibitory

- disruption of the inhibitory regulation results in exaggerated reflexes

56
Q

What is muscle tone?

A

The degree of resistance to passive stretch of a specific muscle

57
Q

What are some major factors that influence muscle tone?

A
  • over excitability of lower motorneurons
  • hypersensitivity of lower motorneurons
  • status of upper motor neurons to synapse on lower
58
Q

What is nociceptive reflex?

A
  • pain
  • normal reflex happens with leg that experiences pain, but does opposite things to the other leg to make sure it stays stable
  • useful for testing arousability and motor system of a patient with impairment of consciousness
59
Q

What does the sympathetic NS do for urinary function?

A

Urinary storage

  • inhibits detrusor
  • activates external sphincter
60
Q

What does the parasympathetic NS do for urinary function?

A
  • activates detrusor

- inhibits external sphincter

61
Q

Describe the short reflex voiding urine

A

-stretch receptor neurons (from bladder filling) activate parasympathetic neurons and stimulate detrusor

62
Q

Describe the long reflex of voiding urine

A
  • stretch receptor neurons activate brain stem centers and THEn activate parasympathetic neurons to stimulate detrusor
  • also inhibits onuf nucleus motorneurons to relax external sphincter
63
Q

What arteries supply the cervical region? Thoracic? Lumbar? Sacral?

A
  • Cervical: vertebral arteries
  • Thoracic: posterior intercostal arteries
  • Lumbar arteries
  • Sacral: Lateral/medial sacral arteries
64
Q

Where is the median spinal vein located?

A

Inside of the dura

65
Q

Where is the internal venous plexus?

A

-between the dura and the vertebrae

66
Q

Where is the external venous plexus located?

A

-outside of the dura AND the vertebrae

Neuo Block 1 (10 decks)

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