Chapter 12 Flashcards
Part 1 and 2
1
Q
the spinal cord is part of the pns or cns
A
cns
2
Q
the spinal cord is the major communication between
A
brain and pns
3
Q
the spinal cord extends from base of brain to
A
2nd lumbar vertebrae level
4
Q
where does the spinal cord taper from
A
conus medullaris
5
Q
is the spinal cord wider or thinner at the top ? and how many enlargements
A
wider , 2 enlargements
6
Q
what does the spinal cord separate into
A
cauda equina (horses tail)
7
Q
cervical enlargement has
A
nerve fibers to/ form upper limb
8
Q
lumbosacral enlargement has
A
nerve fibers to/ from lower limb
9
Q
the spinal cord is shorter than? and not grow as rapidly during
A
vertebral column
development
10
Q
what components does the spinal cord have
A
cerviccal, thoracic, and sacral
11
Q
CT strand anchors conus medullaris to 1st coccygeal vertebra (limits superior movement)
A
filium terminale
12
Q
the spinal cords gives rise to 31 pair of spinal nerves, and exit vertebrae via
A
intervertebral and sacral foramina
13
Q
3 thin ct membranes that cover and protect cns
A
meninges
14
Q
what encloses venous sinuses and contains csf dura, arachnoid and pia mater
A
meningees
15
Q
what is the epidural space, “tough mother” strong
A
dura mater
16
Q
how many layers does the dura mater have
A
2
17
Q
deeper meningeal layer. separate to enclose dural venous sinuses
A
superficial periosteal layer
18
Q
what dura mater layer forms dural septa
A
meningeal dura
19
Q
longitudunal fissure between cerebral hemispheres
A
falx cerebri
20
Q
between cerebellar hemisphere
A
falx cerebelli
21
Q
transverse fissure between cerebrum U and cerbellum
A
tentorium cerebelli
22
Q
subdural space in meninges
A
arachnoid mater
23
Q
subarchnoid space
A
pia mater
24
Q
spiderweb-like. BV’s and CSF here. what meninge layer
A
pia mater
25
what meninges layer absorb CSF into venous blood of sinus
arachnoid mater
26
"gentle mother" that clings to brain is what meninge layet
pia mater
27
meningeal inflammation
meningitis
28
what is meningitis causes by
bacteria or virus
29
what removes CSF from subarachnoid space
lumbar puncture
30
antibiotics/ support to prevent spread to CNS
encephalitis
31
injections into the subarachnooid space go into what
L3/4 and L4/5
32
where is L3/4 and L4/5
below conus medullaris of spinal cord in cauda equina
33
subarachnoid space goes to level
S2 of vertebral column
34
needle is inserted with CSF present and then
nerve fibers move away from needle
35
meds block AP transmission inject into subarachnoid space
spinal anesthesia (block)
36
what injection is used to prevent pain in lower body region
spinal anesthesia
37
advantage of spinal anesthesia block
stronger anesthesia into CSF, faster effect
38
needle not through dura mater, drugs diffuse into CSF
epirudral anesthesia
39
advantage of epidural anesthesia
readminister drugs via catheter
40
spinal cord X-section consists of outer and and deep what
outer white matter
deep gray matter
41
white matter consists of
myelinated axons-> nerve tracts
42
gray matter consists of
neuron cell bodies, dendrites and axons
43
anterior mediam fissure and posterious median sulcus=
separate halves
44
white matter= 2 columns which are
ventral, dorsal, and lateral
45
the 3 columns are subdivided into
tracts
46
collection of axons in CNS, PNS equivalent= nerve
tract
47
gray matter=
dorsal, ventral, and lateral horn
48
what connects halves, central canal
gray commisure
49
what arises from ventral and dorsal root
spinal nerves
50
dorsal root ganglion house the
sensory cell bodies, afferent
vental is efferent
51
automatic response to stimulus, no conscious through drives it
reflex
52
painful stimuli response to minimize damage
protective (somatic reflexes)
53
what maintains homeostasis= stable BP
autonomic reflexes
54
reflex arc is in
spinal cord
55
whats a basic functional unit of NS
reflex
56
5 steps of AP
stimulus
sensory afferent neuron
integration center
motor efferent neuron
effector
57
monosynaptic
1 synapse
58
polysynaptic
>1 synapse, interneuron
59
simplest reflex
stretch reflex
60
patellar tap causes what to stretch
quads
61
patellar tap causes quads to stretch. muscle spindle receptors in muscles stretch, activating stretch reflex
knee jerk reflex
62
how is the knee jerk reflex tested
reflex hammer
63
exaggerated knee jerk reflex response indicated
possibly injury to the brain
64
diminished knee jerk reflex response indicated
possible injury in spinal cord
65
what attaches to ends of spindle to allow it to reset to detect further stretch
gamma motor neuron
66
how does polysynaptic reflex prevent falls
shifting weight
67
flexor response to painful stimulus
withdrawl reflex
68
remove body part from stilumus by excitatory interneurons sending message to flexor muscles in lower extremity
withdrawal reflex
69
simultaneously, the opposite leg has excitatory interneurons stimulating extensor muscles to support the body on 1 leg as injured foot Is withdrawn
crossed extensor relfex
70
axon is surrounded by what
endoneurium
71
what kind of CT is endoneurium
delicate loose ct (areolar)
72
axons are packaged into
fascicle
73
the fascicle is surrounded by
perineurium
74
what kind of CT is the peruneurium
dense irregular ct
75
what is in concentric cell layers, up to 15 layers thick
perineurium
76
what binds fasicles together to form nerve
epineurium
77
what CT is epineurium
dense irregular CT
78
what makes peripeheral nerves tough
CT coverings
79
spinal nerves are part of the PNS, 31 pair, emanate from the
spinal cord
80
spinal nerves are named according to where they
emerge from
81
all except 1st pair and sacral exit vertebrae through
intervertebral foramina (between vertebrae)
82
C1 exit between
skull and C1 vertebrae
83
how many nerves in cervical
8
84
how many nerves are in thoracic
12
85
how many nerves are in the lumbar
5
86
how many nerves are in sacral
5
87
how many nerves are in coccygeal
1
88
all spinal nerves are mixed what
sensory and motor
89
spinal nerve roots connect
PNS to spinal cord
90
spinal roots arise from
longitudial rows or rootlets attached to each side of spinal cord
91
spinal nerves leave the spinal cord at
anterolateral and posterolateral sulci
92
spinal nerves become increasingly longer from
superior to inferior cord
93
cervical=
short, run horizontal
94
lumbar and sacral=
run inferiorly as cauda equina pre exit of vertebral column
95
spinal cord has about how many rootlets
8
96
the 8 rootlets unite to form
ventral or dorsal root of spinal nerve
97
ventral root=
motor (efferent)
98
where do ventral roots arise from
ventral horn motor neurons- skeletal muscle
99
dorsal root=
sensory (afferent)
100
where do dorsal roots arise from
sensory neurons in dorsal root ganglion- spinal cord
101
how short are spinal nerves
1-2 cm
102
spinal nerves quickly branches into
dorsal, ventral ramus, and meningeal branch
103
what innervates deep muscles of dorsal trunk and also innervates CT and skin near midline back
dorsal rami
104
ventral rami have how many ways of distribution
2
105
thoracic region forms what
intercostals nerves, and innervates intercostal muscles and skin of thorax
106
the remaining spinal nerves from ventral rami form
5 major plexuses
107
also communicating rami=
thoracic and upper lumbar
108
spinal cord carry axons asSOCIATED WITH
sympathetic ANS
109
what is a plexus
intermingling of nerves formed by ventral rami and other spinal nerves
110
each muscle in limb receives nerve supply from
more than 1 spinal nerve
111
advantage of plexus
damage 1 spinal segment does not result in complete paralysis
112
overlap from multiple spinal cord levels minimize
loss of control and feeling to specific body area after a spinal cord injury
113
ventral rami of spinal cord includes
cervical, brachial, lumbar, sacral, coccygeal
114
C1-C4
cervical
115
C5-T1
brachial
116
L1-L4
lumbar
117
S5-Co
coccygeal
118
cervical plexus is deep
in the neck
119
spinal nerves what for cervical plus
c1-c4
120
what does the cervical plexus innervate
superficial neck skin and hyoid bone muscle
121
phrenic nerve is what nerves
C3-C5
122
what does the phrenic nerve innervate
diaphragm
123
irritation of the phrenic nerve results in
diaphragm spasms or hiccups
124
severing of the diaphragm results in
paralyzed diaphragm and respiratory arrest
125
bracial plexus has how many roots
5
126
the 5 roots in brachial plexus are deep in
sternocleidomastoid
127
the 5 roots form
3 trunks, 6 divisions, 3 cords, 5 upper limb nerves
128
what is in the brachial plexus
axillary, radial, musculocutaneous, ulnar, and median nerve
129
most easy to damage in brachial plexus
ulnar
130
is damage to ulnar perm or temp
temp usually
131
ulnar is what bone
funny bone
132
severe damage to ulnar results in
unable to male fist, grip= claw hand
133
numb entire upper limb and inject near plexus is what
brachial anesthesia
134
injury due
xs arm pull or bloe to superior shoulder
135
severe injury to brachial plexus =
weaken or paralyze upper limb
136
what is thoracic outlet syndrome
condition due to compression of brachial plxus or subclavian artery or vein
137
TOS compression of nerves and vessels in thoracic outlet syndrome is where
lower neck and upper chest
138
causes of TOS
MVA
repetitive action
pregnancy
anatomical differences
139
risk factor for TOC
women
age 20-50
140
S&S for TOC
numbness in arms and fingers
shoulder neck pain
arm fatigue
weak grip
141
diagnosis for TOC
utrasound, X-ray, MRI
142
treatment for TOC
PT, antiinflammatory, steriod, surgery
143
complication for TOC
repetition injury
long term- chronic pain and disability
144
prevention for TOC
avoid carrying heavy backpack
daily stretch
exercise to keep shoulders strong
145
lumbosacral plexus spinal nerves l1-l4 lies within
psoas major muscle
146
femoral nerve is under
inguinal ligament
147
femoral nerve motor branches to
quads, cutaneous to anterior thigh and medial lower leg
148
obturator nerve innervates
adductors
149
sciatic nerve =
tibial and common peroneal nerve L4-S3
150
whats the largest nerve in the body
sciatic nerve
151
tinging sensation due to
pressure on sciatic nerve
152
damage to sciatic nerve is from
herniated disc, hip injury, or bad hip injection
153
pudenal nerve
innervates area of perineum
154
what does the pudenal nerve stimulate what and controls what
erection and controls urination
155
coccygeal innervation
pelvic floor muscles and sensory cutaneous over coccyx skin area
156
dermatomes of skin innervated by
cutaneous branches of single spinal nerve
157
all except what contribute to dermatomes
C1
158
dermatomes help identify
nerves damaged with spinal cord injury
159
what is spinal stenosis
spinal canal/ nerve root narrowing that causes compression of nerves
160
spinal stenosis is usually in what area
cervical and lumbar
161
S&S of spinal stenosis
pain
weak
numbness in back
worse w standing
162
treatment of spinal stenosis
PT
maintain activity
strengten muscle
steroids
laminectomy= decompression
spinal fusion (last resort)
