Exam 1 Flashcards
(229 cards)
1
Q
What is neuropathy?
A
*pathology of nerves, pain (paresthesia, anesthesia) that you feel that results from damage to nerve compressed
2
Q
What type of damage causes neuropathy?
A
*compressed nerve or viral infection to nerve
3
Q
What is neuropathy a result of?
A
*incorrect signal to brain that makes it think its pain (brain interprets it as pain)
4
Q
What type of pain is neuropathy?
A
*often deep pain
5
Q
What are dermatomes involved in?
A
*outbreaks of certain diseases
6
Q
How do people get shingles/ where does the virus live?
A
*they had chicken pox and then the virus migrated into axons of spiral nerves and live there in the spinal ganglion
7
Q
At what age do people get shingles?
A
*40’s to early 50s
8
Q
What can shingles lead to?
A
*blindness on face or 2nd bacteria infection (rare)
9
Q
How can you cure shingles?
A
- resolve in number of weeks, can take antiviral
* zostavex vaccine available
10
Q
What is post herpetic neuroigia?
A
*pain remains after shingle sores go away (13% or people)
11
Q
Can you get shingles more than once?
A
*yes, but not common
12
Q
What cushions the spinal cord?
A
*cerebrospinal fluid
13
Q
What is inside the vertebral canal?
A
*spinal cord
14
Q
Where does the spinal cord end?
A
*L2 vertebral level
15
Q
What is held in the lumbar enlargement?
A
*cell bodies of motor neurons
16
Q
How many spinal nerves are there?
A
31
17
Q
Where can variation in the number of spinal nerve occur?
A
*sacral region
18
Q
What is a peripheral nerve?
A
*every spinal nerve
19
Q
What is a spinal nerve?
A
*somatic motor and sensory and visceral motor (has al of these)
20
Q
What is a named nerve?
A
*fibers from different spinal segments (ex. Thoracolumbar nerve)
21
Q
Where is the Dural Sac located?
A
*L2-S2
22
Q
What is a plexus?
A
*fibers from different spinal segments that blend together
23
Q
What are the 4 plexus of spinal nerves?
A
*cervical, brachial, lumbar, sacral
24
Q
Where is the cervical plexus located?
A
*C1-C4
25
Where is the brachial plexus located?
*C5-T1
26
Where is the lumbar plexus located?
*L1-L4
27
Where is the sacral plexus located?
*L4-S4
28
What fluid is in the lumbar cistern?
*cerebrospinal fluid
29
Where does the lumbar cistern go to?
*S2
30
Where do the cervical and lumbar plexus emerge from?
*cervical enlargement and lumbar enlargement
31
What is the cauda equine?
*spinal nerve roots (from lumbar and sacral part)
32
What is the Pia mater bound to and how thick is it?
* tightly bound to neural tissues
| * 1-2 cell layers thick
33
What are meninges?
*CT coverings of CNS
34
Where is CSF made?
*in ventricle of brain in choroid plexus
35
Where does CSF circulate?
*in sub-arachnoid place and gets reclaimed in A. granulations
36
What blends into the epineuron?
*dural root sheath
37
What covers the arachnoid space and is where CSF flows (circulates around)?
*arachnoid trabeculae
38
What is the Dura-arachnoid interface (subdural space)?
*potential space (empty) or fluid can fill it up (real space)
39
What does the dura mater cover?
* very tough, doesn't stretch much
| * covers entire spinal cord and wraps it in dural sheath
40
What does the dura mater flare and attach to?
* bump of intervertebral foramen
| * attached inside vertebral column
41
How is the spinal cord held?
*lateral by denticulate ligaments
42
What is the dura mater tightly bound to?
*bone (anchored to skull)
43
What is the BS to the spinal cord?
*spinal artery (1 anterior and 2 posterior)
44
The spinal branch ends as?
* radicular artery
| * segmental medullary artery
45
What does the radicular artery supply blood to?
*spinal nerves of cell and spinal cord proper
46
What supplies the spinal branches of the thoracic region?
*posterior intercostal artery
47
What supplies blood to the spinal branches of the cervical region?
*vertebral artery, ascending cervical and deep cervical
48
What supplies the blood to the spinal branches of the lumbar region?
* lumbar artery
| * median sacral artery
49
What supplies the blood to the spinal branches of the sacral region?
*lateral sacral artery
50
What is the filum terminal externum part of and what does it anchor?
*end of dural sac, anchores it to the coccyx
51
What is in the filum terminal internum?
*pia mater, and neural tissue
52
What does the vertebral column do?
*takes weight of head and upper limb and distributes it to vertebrae, protects spinal cord, restrict/allow movement
53
How many vertebrae are there?
*33
54
What is the curvature of the cervical, thoracic, lumbar and sacral region?
* C: convex
* T: concave anteriorly
* L: convex
* S: concave
55
Only primary curvatures are?
*concave
56
What are primary curvature due to?
*wedge shape of vertebrae (concave anteriorly)
57
What are secondary curvature due to?
*different growths of vertebrae disk (anterior vs posterior parts
58
Convex anteriorly is called?
*Lordosis
59
Where is excessive kyphosis typically found and due to?
* thoracic spine in elderly women
| * due to osteoporosis
60
Where/what is excessive lordosis typically found?
* ant. pelvic tilt
* found in obese people (who lack muscle tone in abdominal)
* temporarily found in pregnancy
61
What is scoliosis and what causes it?
* left or right slant of spine
| * hemivertebrae and imbalance in muscle tone (myopathic)
62
What are the parts of the vertebral foramen?
*pedicle, lamina, and post. body
63
What are some things that compress spinal nerves and where are they found?
* osteophytes, herniated disk, osteoporosis
| * zygopophyseal joing
64
Where do spinal nerves originate?
*intervertebral foramen
65
What passes through the intervertebral foramen?
*spinal branches, fibers that innervate zygopophyseal joing, DRG
66
What limits spinal flexion?
* ligamentum flavum
| * longitudinal ligament
67
The nucleus pulposus is?
*85% water
68
What is a fibrocartilage joint?
*intervertebral disc
69
What is more than half of the vertebrae covered in?
*anterior longitudinal ligament
70
What is the anterior longitudinal ligament and what does it limit and cover?
* heavy band of CT
* limit of extension
* covers IVD, keeps it from failing
71
Where are the interspinous/ supraspinous ligaments heaviest in and what do they do?
* cervical region
| * limit flexion
72
The pelvic girdle is there for?
*stability, not designed to move freely though
73
What links the anterior most halves of hip bone?
*pubic symphysis
74
What is the anterior part of the thigh for?
*flex hip, extend knee
75
What is the medial part of the thigh for?
*adduction of lower limb
76
What is the posterior part of the thigh for?
*extend hip, flex knee
77
What does the gluteal region do?
* abduct lower limb
78
What holds down the tendons of dorsiflexors?
*retinacula
79
The sciatic nerve is divided into 2 division?
*fibular and tibial
80
What are the BS of the medial comp. of thigh?
*obturator artery, and perforating art
81
What is the name of an artery that enters a bone?
*nutrient artery
82
What is the regional BS of the spinal cord?
*lumbar artery
83
The internal and external vertebral venous plexus goes from?
*sacrum to large veins (in. dural venous sinus) in skull
84
What drains the brain?
*int. dural venous sinus
85
What is a valveless network of veins that is probably how prostate cancer spreads to the brain?
*int. dural venous sinus
86
Where can you access the sacral hiatus route?
*S4-S5
87
What is the route the needle travels during a lumbar puncture?
*interspinous route (midline route)
88
Where does the spinal cord end in most people?
*L2
89
Where should you do a lumbar puncture and where can it never be above?
* L3 or L4
| * L2 or above
90
Why would you obtain a sample of CSF?
*check for infection, diagnosis sub arachnoid hemorrhage, and check pressure
91
Where would you introduce epidural anesthetic?
*into lumbar cisterne or in around nerve roots (cauda equine, into fat)
92
What are the risks of a lumbar puncture?
* epidural hematoma (can cause sensory deficit)
| * subdural hematoma (in potential space or real space, sensory or motor deficit)
93
What do you go through during a lumbar puncture to take out CSF and inject anesthesia?
*dura
94
During a herniated disk, what can the nucleus pulposus do?
*blast into vertebral body
95
What is the typical herniated disk?
*postural lateral
96
What can a herniated disk cause?
*sensory and motor deficit (pinches both roots)
97
Why do disk herniate?
* degeneration of disk with age (height decreases)
| * traumatic (accident, lift and twist)
98
Where do most herniated disk happen?
*in cervical and lumbar spine (L4-L5 disk, and L5-S1 disk)
99
What are the symptoms of the herniated disks?
* cervical and lumbar pain (intensify when cough and sneeze)
| * neuralgia, numbness, pain, pins and needles
100
If the IV disc L4/L5 is herniated what does it affect?
*L5 nerve root
101
If the IV disc L5/S1 is herniated what does it affect?
*S1 nerve root
102
What are the treatments for herniated disk?
* nothing (goes away in 6-8 weeks)
* antinflamatory, cortisone injection
* spinal fusion (helps 50%)
* framamectomy- grind out vertebral foramen so its large
103
How many hip bones do we have until puberty?
*3
104
What attaches to the ischial tuberosity?
*sacral tuberous ligament
105
What holds the lesser sciatic notch?
*sacral spinous
106
What are lined up on the hip bone?
*ASIS and pubic tubercle
107
What are the artery/vein/nerve of the gluteal region?
*superior/inferior gluteal artery/vein/nerve
108
What is the innervation of the superior gluteal nerve?
*sup. glut max, med, min, and tensor of fascia
109
What delivers blood to the superior gluteal nerve?
*superior gluteal artery
110
What is the innervation of the inferior gluteal nerve?
*inferior glut max
111
What delivers blood to the inferior gluteal nerve?
*inferior gluteal artery
112
Where does the sciatic nerve arise from?
*L4 to S4 (lumbarsacral plexis)
113
Where does the sciatic nerve emerge from?
*inferior to piriformis
114
Where does the sciatic nerve split at?
*popliteal region
115
What is the main hip abductor and keeps the hips level?
*glut medius
116
What is an inconstant muscle?
*not everyone has them
117
What are the superficial muscles of the gluteal region?
*glut. max, med, tensor fascia
118
What do the superficial muscles of the gluteal region do?
*extend hip, laterally rotate hip, abduct hip (glut med, glut min, and tensor fascia)
119
What do the deep muscles of the gluteal region do?
* lateral rotators of hip
| * often fused
120
What are the muscles of the deep muscles of the gluteal region?
*piriformis, sup gemellus, inf gemellus, quadratus femoris
121
What do 12% of people have and what is it blamed for?
* fibular division separates and pierces the piriformis
| * blamed for piriformis syndrome
122
What do fewer than 1% of people have?
*fibular division superior to piriformis
123
What do 87% of people have?
*fibular division below the piriformis
124
What is sciatica?
*neuropathy of the path itself (from L4 to S4)
125
Where is Sciatica felt?
*pain in butt that goes down posterior thigh and can go down to foot
126
What can sciatica cause?
*foot drop
127
How is sciatica diagnosed?
*straight leg raise
128
What causes sciatica?
* lumbar disc trauma/degeneration
* piriformis syndrome
* idiopathic (don't know what causes it)
* improper intergluteal injection
129
What are the treatment of Sciatica?
* do nothing (go away in 6-8 weeks)
* antiinflamatory
* surgical alt (discectomy, remove bulge part of disc)
* spinal fusion (space out vertebrae)
* stenosis (narrowing of passageway )
130
What happens if you hit the sciatic nerve during a intragluteal injection?
* damage nerve
| * destroys axons and glia cells
131
What is an improper intragluteal injection also called?
*accidental interneural injection (most common injury)
132
What are the signs and symp of hiting the sciatic nerve?
* pain and numbness
* felt in whole projection of sciatic nerve
* difficulty walking, foot drop
133
What is foot drop?
*can's dorsiflex the foot
134
What are the treatment after hitting the sciatic nerve?
* immediate surgical correction
* neurosis- cut nerve and flood drug out
* transacral nerve block (to help with pain)
135
What is gluteus medius paralysis?
*hip drops from opp side of injury
136
How do people with a gluteus medius paralysis compensate?
*gluteal gate- swing leg out as walk
137
What is a trendelengurg sign?
*dropping of hip
138
What is held by the rotator cuff muscles?
*glenohumeral join (shoulder joint)
139
What is the elbow joint like?
* a hinge joint
| * almost like bone to bone joint that locks
140
What is the glenohumeral joint like?
*planar and ball joint
141
What is the elbow joint for?
*stability, but not a lot of movement
142
What kind of fascia is at the wrist?
*flexor/extensor retnaculae
143
What is the anterior compartment of the arm?
*flexor compartment
144
What is the BS and innervation of the anterior part of the arm?
* BS: brachial art
| * inn: musculocutaneous nerve
145
What are the muscles of the anterior compartment of the arm?
*brachialis, coracoid brachialis, and biceps brachii
146
What does the posterior compartment of the arm?
*extensor of elbow
147
What is the BS and inn of the posterior compartment of the arm?
* BS deep art of arm
| * inn: radial nerve
148
What are the muscles of the posterior comp. of the arm?
*triceps brachii (3 heads)
149
What is the BS and inn of the anterior part of the forearm?
* BS: radial and ulnar art
| * inn ulnar and median nerves
150
What does the anterior part of the forearm do?
*flexor and pronator
151
What does the posterior part of the forearm do?
*extensor
152
What is the BS and inn of the posterior part of the forearm?
* BS: post interosseous art
| * inn: radial nerve
153
What is lymphedema?
*removing lymph nodes
154
How does lymph flow and where does it end up?
* to trunk
| * ends up in axillary lymph nodes (collect from pectoral region)
155
Where does the radial nerve run close to?
*humerus
156
What does the ulnar nerve innervate?
*muscles of forearm and hand
157
What is the innervation of the musculocutaneous nerve?
* motor innervation
| * cutaneous inn to lateral forearm
158
What is the innervation of the median nerve?
* motor inn to forearm and hand
| * superficial in elbow
159
What are the lateral and medial rotator of the scapular region?
* L: teres minor
| * M: teres major
160
What are the rotator cuff muscles?
*subscapularis, supraspinatus, infraspinatus, teres minor
161
What do mesenchyme cells do and can convert to?
* loosely organized
* migrate to different parts of body
* can convert to epithelium
162
What is differential gene expression also called?
*differential cell lineage
163
What is transduction?
*when an external signal is changed to an internal signal
164
What is paracrine?
*diffuse over short distance
165
What is juxtacrine?
* signal doesn't leave cell membrane
166
What can transduction be?
*mechanical (stretch or squish) or it can be electrical
167
What is a paracrine morphogen?
*shape changer
168
What does a nodocord release and induce?
*a sign and induces tissues above it to roll up in a tube which becomes brain and spinal cord
169
What is induction?
*chem signal of some cells influence the rate of nearby cells (often are reciprocal)
170
What is a ligand?
*signal
171
What are the signaling gene families?
* hedgehog (nerv and vert column)
* TGF (transforming growth factor)
* WNT (wingless and integrated)
* FGF (fibroblast growth factor)
* neurotransmitter (serotonin)
172
When is the embryo most likely to get a malformation?
*week 3-8 (embryogenesis)
173
What are the causes of malformation during pregnancy?
* environmental things (teratogens)
| * alcohol, VPA (acts like estrogen), drugs, plant toxins, charred meat, poor diet
174
What are the big events in embryogenesis?
*formation of the blastocyst, bilaminar germ disc, trilaminar disc, and nervous system
175
What are the 3 germ layers and what are they derived from?
* sensing layer (ectoderm)
| * movement layer (mesoderm) *absorbing layer (endoderm)
176
What does the sensing layer give rise to?
*epidermis and derivatives, melanocytes, facial skelet.
177
What does the sensing layer become?
*nervous system and enamel of teeth, adrenal medulla
178
What does the movement layer give rise to?
*muscle, bone, cartilage, ligaments, tendons, fascia, urogenital system, membrane lining the body cavity, blood and immune cells
179
What does the endoderm give rise to?
*lining of gut, accessory organs of gut (liver), glands lining GI tract
180
Why do half of blastocyst not implant?
*chromosomal abnormalities
181
What is everything we recognize as us?
*inner cell mass
182
What is trophoblast?
*tissues that contact mother, placenta
183
What do trophoblast differentiate into and when does it happen ?
* syncytrotrophoblast
* cytotrophoblast
* week 2
184
The inner cell mass turns into?
*epiblast and hypoblast
185
What does the epiblast become and give rise to and when?
* amniotic cavity and gives rise to "derm" layers
| * week 3
186
What forms in the yolk sac?
*first blood cells and gomads
187
What does the hypoblast become?
*yolk sac
188
What cavities form in week 2?
* chorionic cavity
| * amniotic cavity
189
What do you have at the end of week 2?
*head and tail end
190
What is the future mouth and anus of the fetus?
* A: cloacal membrane
| * M: oropharyngeal membrane (buccopharyngeal membrane)
191
What is the primitive streak induced and maintained by?
*NODAL from TGFB
192
What is gastrulation and how long does it last and when does it happen?
* stomach making, start with bilaminar germ disk and end with trilaminar germ disk
* last 2 weeks, happens in week 3
* epiblast cells migrate toward primitive streak and they drop through it, makes 3 layer (mesoderm)
193
Where don't mesoderm go?
*oropharyngeal and cloacal membrane, goes everywhere else
194
What happens in week 3?
* gastrulation
* neural crest cells migrate to form PNS
* somite development
* get 3 layers and cavities
*primitive streak disappears
195
What is a precursor to vertebrae, covering of deep back muscles and skin?
*somites
196
What induces neurulation (formation of neural tube)?
*induction of notochord
197
What becomes the brain and spinal cord?
*neural tube
198
What happens during neurulation?
* begins in week 3, ends week 4
| * rolls up and pinches off into a tube (has ectoderm on top)
199
What chemical sign induces neurulation?
*sonic hedgehog
200
When is the critical period for the nervous system?
*week 3-11
201
What does the neural crest go from?
*epithelium cells to mesenchyme cells
202
What is the inducer of the prefrontal brain?
*prechordal mesoderm
203
What does the prechordal plate mesoderm become?
*heart and central tendon of diaphragm
204
What becomes somites?
*paraxine mesoderm
205
What does the intermediate mesoderm become?
*urogenital structures
206
What does the lateral plate mesoderm become?
*lining of body cavity
207
What does the extraembryonic mesoderm become?
*surrounds yolk sac and becomes part of umbilical cord
208
When does the cranioneural pore and caudal neuro pore close?
* CR: day 25
| * CA: day 28
209
What causes somite differentiation?
*signals from notochord
210
What does the dorsal part of somites and ventral and middle part become?
* D: deep back muscles
* V: trunk muscles
* M: dermis
211
What does sclerotome become?
*vertebrae and migrate around neural tube and meninges
212
What is Raschisis and what does it lead to?
* meninges don't form prop
* anencephaly (not enough tissue in brain)
* amniotic fluid destroys neural tissue
213
What is spina bifida occulta?
* post vertebrae don't form ( vertebral foramen not complete)
* sometimes with cutaneous market
214
What is spina bifida cystica?
* development of sac or disk
| * meninges herniate outside V. canal
215
What is meningocoele and where is it most common?
* part of neural tissues is herniated outside V. canal
| * most common in lumbar (any higher more serious problem)
216
What is holoprosencephaly?
*missing midline structures (external and internal)
217
What surrounds the oropharengeal membrane and induces forebrain development?
*prochordal
218
What is convergent extension?
*lateral cells migrate inward which results in lengthening of embryo
219
What genes are necessary for convergent extension and what interferes with it?
* planar cell polarity
| * alcohol (also interferes with sonic hedgehog)
220
What is a body cavity?
*potential space
221
What has a musculoskeetal wall and what does it do?
* thoracic
| * protect organs, anchor for upper limb, and muscles necessary for ventilation
222
What is even with the 2nd rib?
*sternal angle
223
What surrounds the superior thoracic aperture?
*body of T1, 1st rib, sup. margin of manubrium, costal cart. of 1st rib
224
How are the floating ribs connected?
*through soft tissue
225
What is between ribs?
*intercostal muscles
226
What are the borders of the inferior thoracic aperture?
*body of T12, 12th and 11 rib, costal margin, and xiphoid
227
What depresses and elevates the ribs?
* E: external intercostal, and innermost intercostal
| * D: internal intercostal
228
What is active during inhalation, and relaxes during exhalation?
*intercostal muscles
229
What is the pectoralis minor and major innervated by?
*medial and lateral nerves
