Lecture 5: Back Angiology and Neurology

Question 1

What is different about the right and left subclavian / common carotid arteries?

Answer 1

The right Subclavian and Common Carotid Artery come off of an intermediate structure called the Brachiocephalic Trunk.

The left Subclavian Artery and Common Carotid Arteries come directly off of the Aorta

Question 2

How does the Subclavian Artery supply the trapezius?

Answer 2

via the Thyrocervical Trunk, which becomes the Transverse Cervical Artery

Question 3

How does the Subclavian Artery supply the Latissimus Dorsi?

Answer 3

Subclavian -> Axillary Artery -> Thoracodorsal Artery -> Latissimus Dorsi

Question 4

How does the Subclavian Artery supply the rhomboid and levator scapulae muscles?

Answer 4

Subclavian Artery –> Dorsal Scapular Artery –> Layer 2 muscles

*can also get supplied by deep branch of Transverse Cervical Artery

Question 5

Where does the Vertebral Artery travel through?

Answer 5

Transverse foramen of C1-C6

-Can also see it in suboccipital triangle

Question 6

How does the vertebral artery supplie the spinal cord (vertically)?

Answer 6

1. Anterior Spinal Artery
2. Posterior Spinal Arteries

Question 7

What are the 8 paraspinal arterial sources?

Answer 7

1. Vertebral Artery
2. Ascending Cervical A.
3. Deep Cervical A.
4. Posterior Intercostal A.
5. Subcostal A.
6. Lumbar A.
7. Iliolumbar A.
8. Lateral Sacral A.

Question 8

What are the branches of the Paraspinal Arteries?

Answer 8

Anterior / Posterior Vertebral Canal Branches (Runs along the periphery of the interior of the vertebral canal)

Anterior / Posterior Radicular Ateries (Don’t make it to the Spinal A.)

Anterior / Posterior Segmental Medullary Arteries (Do make it to the Spinal A)

Question 9

What happens if you injure C1-C3?

What happens if you injure C4-C5?

What happens if you injure C6-C8?

What happens if you injure T1-T9?

What happens if you injure T10-L1?

What happens if you injure L2-L3?

Answer 9

C1-C3: In a coma

C4-C5: quadraplegic

C6-C8: Some loss of hand use and lower lody

T1-T9: No lower body movement

T10-L1: Some loss of lower body movement

L2-L3: minor loss of lower body movement

Question 10

Where are there swellings in the spinal cord, and what are they called?

Answer 10

Cervical Region - Cervical Enlargement

Lumbar Region - Lumbar Enlargement

Question 11

How many cervical nerves are there?

Answer 11

8 Cervical nerves

Cervical Nerve 1 exits above the Atlas bone

Question 12

How many Sacral Nerves are there?

Answer 12

5 sacral nerves

Question 13

How many Coccygeal Nerves are there?

Answer 13

Just 1

Question 14

What is the name for the terminal cone of the spinal cord?

Answer 14

Medullary Cone

Question 15

What is the Cauda Equina?

Answer 15

A “mess of nerve roots” inferior to the Medullary Cone

Question 16

Where does CSF circluate in the spinal cord?

Answer 16

The Subarachnoid Space

Question 17

What do we call the protrusions of Pia Mater into the Subarachnoid Space?

Answer 17

Denticulate Ligaments

Question 18

What is the Dural Arachnoid Interface?

Answer 18

The theoretical space between the Dura Mater and the Arachnoid Mater. In reality, these are pressed together by the pressure of the CSF.

Question 19

What do we call the fat filled space exterior to the Dura Mater?

Why is this clinically relevant?

Answer 19

The Epidural Space

It is the site of Epidural Administration (Anesthetics, contrast dyes, etc)

Question 20

What is the Lumbar Cistern?

What is its clinical relevance?

Answer 20

The space inferior to the medullary cone where there is a swelling of the Subarachnoid Space for pooling of CSF

It is the site of spinal taps

Question 21

What two Vertebrae do you go through to perform a spinal tap?

Answer 21

L3/L4 or L4/L5

Question 22

What feeds into the spinal ganglion/dorsal root ganglion?

Answer 22

Posterior roots (sensory info) and Anterior roots (motor info)

Question 23

Where is the Spinal Ganglion and what does it do?

Answer 23

On the Dorsal Spinal Root (aka Dorsal Root Ganglion)

-does general sensory information processing

Question 24

What do the spinal nerves do?

Answer 24

• They exit Vertebral Foramen and immediately split, into Posterior or Anterior Rami (very short)
• Mix of sensory and motor info

Question 25

What does the Posterior Ramus do?

Answer 25

Innervation of the Intrinsic Muscles of the back

Innervation of the Zygapophyseal joint

Innervation of the skin of the mid-back through the Cutaneous Branches

Question 26

What does the Anterior Ramus do?

Answer 26

Motor information

Ex: Brachial Plexus

Question 27

The Suboccipital Nerve is the Posterior Ramus of what nerve?

Answer 27

C1 Spinal Nerve

Question 28

The Greater Suboccipital Nerve is the Posterior Ramus of what Spinal Nerve?

Answer 28

C2 Spinal Nerve