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C&M Neuroanatomy > Week 5 Lecture 11: Spinal cord and spinal nerves > Flashcards

Week 5 Lecture 11: Spinal cord and spinal nerves Flashcards

1
Q

Is the somatic nervous system voluntary or involuntary?

A

voluntary

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2
Q

Is the autonomic nervous system voluntary or involuntary?

A

involuntary

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3
Q

What is white matter made of?

A

axons with glial sheath (myelin)

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4
Q

What is the conus medullaris?

A

the point of termination of the spinal cord

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5
Q

Where does the brainstem become continous with the spinal cord?

A

foramen magnum

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6
Q

What are cauda equina?

A

after the spinal cord ends at conus medullaris, the spinal nerves continue to emerge at lower levels as longer nerves leave below their intravertebral foramina

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7
Q

Which parts of the spinal cord are thinner, and which are thicker?

A
  • cervical cord is thicker
  • thoracic cord is thinner
  • lumbar cord is thicker
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8
Q

What are filum terminale?

A
  • extends from tip of conus medullaris all the way to the coccyx and provides an inferior attachment to the spinal cord
  • secures it into the coccyx to prevent excessive movement of the cord
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9
Q

Which meningeal layers are the spinal cord covered with?

A

all of them - dura, arachnoid, pia

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10
Q

What is the cauda equina bathed in?

A

CSF as dural sac extends lower than the terminaion of the spinal cord so it is continous with the cauda equina and the inside of the dural sac is filled with CSF

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11
Q

What is the lumbar cistern?

A

a region filled with CSF between conus medullaris and filum terminale

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12
Q

How many spinal nerve segments (and therefore how many pairs of spinal nerves) are there?

A

31

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13
Q

What is a spinal nerve segment?

A

each gives rise to 1 pair of segmental spinal nerves

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14
Q

Where in the spinal cord does the dural sac extend to?

A

S1 or S2

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15
Q

Why is the cervical region of the spinal cord thicker?

A

because of all the motor neuronal cell bodies that are going to innervate our upper limbs including all the nerves that go onto form the brachial plexus

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16
Q

Why do we see lumbosacral enlargement in the lumbar region?

A

because of the motor neurones that emerge from the spinal cord to innervate our lower limbs, forming the lumbosacral plexus

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17
Q

Why are there 8 cervical spinal nerves but only 7 cervical vertebrae?

A
  • C1 spinal nerve leaves above C1 vertebrae
  • C2 spinal nerve leaves above C2 vertebrae
  • C8 spinal nerve leaves above the T1 vertebrae
  • at this point there is a transition where the spinal nerves emerge below their corresponding vertebrae
  • e.g T1 spinal nerve emerges below T1 vertebrae
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18
Q

How many pairs of spinal nerves are there in the C-spine?

A

8

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19
Q

How many pairs of spinal nerves are there in the T-spine?

A

12

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20
Q

How many pairs of spinal nerves are there in the lumbar spine?

A

5

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21
Q

How many pairs of spinal nerves are there in the sacral spine?

A

5

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22
Q

How do spinal nerves C1-7 leave the VC with respect to their corresponding vertebrae?

A

superior to their corresponding vertebrae e.g CII from above C2

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23
Q

Where does the C8 spinal nerve leave the column?

A

above T1

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24
Q

How do spinal nerves T1-C0 leave the VC with respect to their corresponding vertebrae?

A

leave from below their corresponding vertebrae

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25
Q

What are denticulate ligaments?

A

lateral extensions of the pia that secure the spinal cord on each side to prevent excessive movement
they are interspersed within spinal nerve roots

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26
Q

What is the epineurium?

A
  • as each spinal nerve leaves the vertebral canal it takes the meningeal coverings with
  • these form the epineurium
  • a protective sheath of connective tissue for each spinal nerve
27
Q

What is the difference between spinal dura and cranial dura?

A
  • cranial dura is made of the meningeal layer and the periosteal layer
  • only the meningeal layer continues through the foramen magnum
  • so the dura around the spinal cord is only the meningeal layer
28
Q

What is between the vertebrae and the dura mater?

A

real epidural space filled with fat

29
Q

Why does the spinal cord end before the vertebral column ends?

A

at birth: vertebral column grows faster than spinal cord, so the spinal cord regresses and grows upward

30
Q

At birth, what vertebral level does the spinal cord end at?

A

L3

31
Q

What is the relationship between the spinal cord and the vertebrae in a 2-3 month foetus?

A

spinal cord extends all the way along the vertebrae

32
Q

What is the clinical significance of the cauda equina?

A

enables us to perform procedures such as lumbar puncture

33
Q

Where do we insert the needle when doing a lumbar puncture?

A

anywhere below L3

34
Q

How does a lumbar puncture allow us to collect CSF?

A

Nerve roots of the cauda equina move out of the way when a needle is inserted

35
Q

Why can an LP not be performed if a patient has increased intracranial pressure?

A

CSF would escape as a jet because a pressure differential is created so the brain could herniate

36
Q

Where is the needle inserted through in an LP?

A

Ligamentum flavum

37
Q

What are the reasons to take CSF?

A
  • shouldn’t be blood in CSF but if there is could indicate subarachnoid haemorrhage
  • can analyse cell composition in CSF for meningitis
  • can inject specific medications and drugs
38
Q

Where would you inject anaesthesia?

A
  • Into the epidural space (not as deep as LP) but you still puncture the ligamentum flavum
  • anything downwards from the point of injection will be anaesthetised
39
Q

How are epidurals used during childbirth?

A

they are injected into the sacral region to numb the nerves around the perineum

40
Q

Where is the anterior spinal artery found and what does it supply?

A
  • along the anterior median fissure of the spinal cord

- descends down to supply the anterior aspect of the spinal cord

41
Q

Which artery is the anterior spinal artery and posterior spinal artery reinforced by?

A

segmental spinal artery

42
Q

As the segmental spinal artery approaches the cord laterally, which artery branches off?

A

medullary artery, which reinforces the ASA

43
Q

Which arteries does the medullary artery give rise too and what do these supply?

A
  • anterior and posterior radicular arteries

- supply the spinal nerve rootlets

44
Q

What is the difference between the arrangement of white and grey matter in the spinal cord and in the brain?

A

in the brain: grey matter generally resides in the outside with white matter underlying
in the cord: grey matter confined to inside of the cord with white matter outside

45
Q

Give 3 features of grey matter inside the spinal cord

A
  • dorsal horn of grey matter
  • lateral grey horn
  • ventral grey horn
46
Q

In which sections does the lateral grey horn of the spinal cord exist?

A

only between T1-L2 and S2-S4

47
Q

What does the ventral grey horn contain?

A

contains somatic neurones that innervate our muscles

48
Q

Give 4 features of white matter that is on the outside of the spinal cord

A
  • dorsal white column
  • lateral white column
  • ventral white column
  • ventral white commisure
49
Q

What is the function of the ventral white commisure in the spinal cord?

A

allows communication between the right and left sides of the cord by crossing fibres

50
Q

What is the PNS?

A

All connections outside the brain and spinal cord

51
Q

What do sensory (afferent) fibres do?

A

send info to the CNS

52
Q

what do motor (efferent) fibres do?

A

send info away from the CNS

53
Q

How is the spinal cord connected to the PNS?

A

Via spinal nerve rootlets

54
Q

Where do ventral rootlets or dorsal rootlets leave the spinal cord?

A

ventral spinal nerve rootlets - leave the anterior lateral sulcus
dorsal spinal nerve rootlets - leave the posterior lateral sulcus

55
Q

Explain a simple reflex arc:
1. touch hot object
…

A
  1. sensory neurones travel towards the CNS using the spinal nerve and dorsal aspect of the nerve, with their axons in the dorsal root ganglion, to enter the dorsal horn of the spinal cord
  2. in the dorsal horn, fibres synapse with an interneuron
  3. interneuron relays the information from the afferent fibres to the efferent fibres
  4. efferent neurone leaves the ventral horn and uses the ventral root of the spinal nerve to go to the periphery
  5. muscle contracts to withdraw finger away from painful stimulus
56
Q

What happens to the amount of white matter as we ascend the cord?

A

it increases - so the cervical cord has the most white matter

57
Q

Why is the ventral horn enlarged in the cervical and lumbosacral regions?

A
  • this is where motor fibres to limbs arise
  • called cervical and lumbosacral enlargements
  • because there is more cell bodies of neurones in these regions to innervate the limbs
58
Q

What is the difference in the column above and below T6?

A

Above T6 - there are two dorsal columns on either side of midline: gracile fascicle medially and cuneate fascicle laterally
Below T6 - just gracile fascicle

59
Q

How is grey matter organised?

A
  • divided into regions (Rexed’s Laminae)

- based on the cellular composition at these levels and relates with function

60
Q

What is proprioception?

A

joint position sense i.e where our limbs are in space

e.g if your eyes are closed and you raise your arm above your head and you know where it is

61
Q

What are dorsal columns responsible for?

A

fine touch
vibration
pressure
proprioception

62
Q

What is the lateral corticospinal tract responsible for?

A

voluntary control of our muscles

63
Q

What is the ventral corticospinal tract responsible for?

A

voluntary movement

64
Q

What is the spinothalamic tract responsible for?

A

crude touch
temperature
pain

C&M Neuroanatomy (44 decks)

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