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SMP - Neurophysio Exam 1 > Lecture 8 - Spinal Cord, Spinal Nerves, and Cranial Nerves > Flashcards

Lecture 8 - Spinal Cord, Spinal Nerves, and Cranial Nerves Flashcards

1
Q

How does the organization of grey and white matter differ in the brain and spinal cord?

A

Brain: grey matter on the outside

Spinal cord: white matter on the outside

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2
Q

What are the ventral and dorsal horns of the spinal cord?

A

Butterfly like structure that exists in the center of the spinal cord and contains grey matter

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3
Q

What is another name for the spinal cord dorsal horns?

A

Sensory horns

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4
Q

What is another name for the spinal cord ventral horns?

A

Motor horns

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5
Q

What is another name for sensory neurons?

A

Ascending neurons

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6
Q

What is another name for motor neurons?

A

Descending neurons

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7
Q

How to recognize ventral and dorsal horns?

A

Ventral horns are larger

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8
Q

Where is the ascending white matter located in the spinal cord?

A

Dorsal column

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9
Q

Where is the descending white matter located in the spinal cord?

A

Lateral and anterior columns

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10
Q

What are the 2 major enlargements of the spinal cord? Purpose?

A
  1. Cervical
  2. Lumbar

Control over limb and sensory functions resulting from the abundance of cell bodies in the cervical and lumbar vertebrae

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11
Q

What is the main function of the thoracic spinal cord? What does this mean for the composition of this part?

A

Posture

Less cell bodies

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12
Q

List the 4 parts of the spinal cord from top to bottom.

A
  1. Cervical
  2. Thoracic
  3. Lumbar
  4. Sacral
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13
Q

Describe the input and output of information in the spinal cord.

A
  1. Dorsal root has afferent sensory fibers with cell bodies in dorsal root ganglia (semiunipolar neurons)
  2. Ventral root has efferent motor fibers with cell bodies situated in the ventral horn
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14
Q

Describe the nature of spinal nerves.

A

Mixed: carry both sensory and motor information

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15
Q

How many pairs of spinal nerves?

A

31

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16
Q

List the 31 pairs of spinal nerves and their abbreviations. Note?

A
  1. Cervical nerves: C1-8
  2. Thoracic nerves: T1-12
  3. Lumbar nerves: L1-5
  4. Sacral nerves: S1-5
  5. Coccygeal nerve: Co

Note: numbered from top to bottom on spinal cord

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17
Q

Where do the C1-C7 nerves exit?

A

Superior to the namesake vertebra

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18
Q

How many cervical vertebra are there?

A

7

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19
Q

Where does the C8 nerve exit?

A

Inferior to C7 vertebrae

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20
Q

Where do spinal nerves inferior to C8 exit?

A

Inferior to namesake vertebra

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21
Q

What are the 2 ways of classifying the neurons of the spinal cord?

A
  1. Sensory or motor

2. Somatic or visceral

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22
Q

What are nerves?

A

Bundles of neurons

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23
Q

What types of neurons does the dorsal root of the spinal cord contain?

A
  1. Somatic sensory

2. Visceral sensory

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24
Q

What types of neurons does the ventral root of the spinal cord contain?

A
  1. Somatic motor

2. Visceral motor

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25
Q

What cell bodies are included in the dorsal horns of the spinal cord?

A

Cell bodies of interneurons

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26
Q

Where are the visceral neurons located compared to the somatic ones?

A

More central to the spinal cord canal

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27
Q

How does each spinal nerve attach to the spinal cord?

A

Via dorsal and ventral roots

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28
Q

Where do the dorsal roots of the spinal cord synapse? Onto what?

A

In the dorsal horn onto second order sensory neurons

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29
Q

Where do the ventral roots of the spinal cord synapse? Onto what?

A

Project into body to directly or indirectly control muscle

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30
Q

Where are the sympathetic chain ganglia located? How many of them?

A

Parallel to the spinal cord

2: one on each side

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31
Q

What is the role of the sympathetic chain ganglia? How?

A

Control autonomic functions by interacting with the spinal nerves or their anterior rami

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32
Q

What does histology of the human spinal cord show? What are these called?

A

Layers of neurons (Rexed lamina) in both the ventral and dorsal horns:

Dorsal: horizontal layers
Ventral: columns

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33
Q

Describe the connective tissue compartmentalization of the PNS nerves.

A

Endoneurium surrounds individual axon fibers

Perineurium surrounds fascicles = bundles of axon fibers

Epineurium surrounds nerves (which are composed of many fascicles) and the vasculature

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34
Q

What are spinal cord nerve rootlets?

A

Several of them form a dorsal or ventral root

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35
Q

What is a spinal nerve root?

A

Where the dorsal and ventral roots come together

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36
Q

What do the spinal nerve roots divide in?

A

Rami (branches)

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37
Q

What do the anterior rami supply?

A

Limbs and ventral portion of the body

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38
Q

What do the posterior rami supply?

A

Back muscles and skin covering them

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39
Q

What do the nerves become after the rami? 3 options

A
  • Anterior rami => plexuses formed by the combination of rami from neighboring anterior rami
  • Anterior rami of the thoracic nerves => intercostal nerves
  • Posterior rami: directly innervate deep muscles and skin of the back
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40
Q

What are the 4 basic plexuses?

A
  1. Cervical
  2. Brachial
  3. Lumbar
  4. Sacral
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41
Q

Can nerves get to the body from all levels of plexuses?

A

YUP

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42
Q

Where is the cervical plexus located?

A

Neck

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43
Q

From what anterior rami is the cervical plexus formed?

A

Anterior rami of C1-C5

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44
Q

What 3 parts of the body does the cervical plexus innervate?

A
  1. Back of head
  2. Neck
  3. Diaphragm
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45
Q

Which specific nerves innervates the diaphragm? What 3 cervical nerves does it come from?

A

2 phrenic nerves (right and left)

Come from C3, C4, C5

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46
Q

What happens if you severe one of the 2 phrenic nerves?

A

Partial diaphragmatic paralysis

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47
Q

What happens if you severe both phrenic nerves? Would you loose the ability to breathe completely?

A

Complete diaphragmatic paralysis

NOPE because you would still have the intercostal muscle functioning

48
Q

What happens if you have an upper cervical cord transection?

A

Loose all sensory and motor functions caudal to the transection

49
Q

Where is the brachial plexus located?

A

Muscles of the shoulder

50
Q

From what anterior rami is the brachial plexus formed?

A

Anterior rami of C5-T1

51
Q

What 2 parts of the body does the brachial plexus innervate?

A
  1. Skin and muscles of upper limbs

2. Muscles that help control upper limbs (in back and shoulders)

52
Q

What are the 5 brachial plexus nerves?

A
  1. Axillary nerve
  2. Musculocutenous nerve
  3. Radial nerve
  4. Median nerve
  5. Ulnar nerve
53
Q

What 2 parts of the body does the axillary nerve innervate? What 2 cranial nerves does it come from?

A
  1. Deltoid muscle (shoulder)
  2. Skin of shoulder

Comes from C5 and C6

54
Q

What 2 parts of the body does the musculocutaneous nerve innervate? What 3 nerves does it come from?

A
  1. Biceps brachii
  2. Skin of lateral forearm

Comes from C5, C6, and C7

55
Q

What 3 parts of the body does the radial nerve innervate? What 5 nerves does it come from?

A
  1. Triceps
  2. Posterior forarm muscles
  3. Overlying skin of both

Comes from C5-C8 and T1

56
Q

What 3 parts of the body does the median nerve innervate? What 5 nerves does it come from?

A
  1. Anterior forearm muscles (flexors)
  2. Lateral 2/3rds of the hand
  3. Overlying skin

Comes from C5-C8 and T1

57
Q

What 2 parts of the body does the ulnar nerve innervate? What 2 nerves does it come from?

A
  1. Muscles of 4th and 5th digits
  2. Overlying skin

Comes from C8 and T1

58
Q

What nerve is affected when you bump your funny bone?

A

Ulnar nerve

59
Q

What are the 4 types of plexus injuries? Explain each

A
  1. Avulsion = tearing the nerve from the spinal cord
  2. Rupture = tearing the nerve, but not at the spinal cord
  3. Neuroma = scar tissue when an injured nerve has tried to heal putting pressure on the nerve and disrupting signals to the muscles
  4. Praxis = stretching (but no tearing) of the nerve
60
Q

Is the nerve able to heal itself from a praxis?

A

YUP

61
Q

What are some causes of superior brachial plexus injuries (C5-6)? How do we classify these?

A

Excessive increase in the angle between the neck and the shoulder: either trauma or obstetrics

62
Q

What is Erb’s palsy?

A

Injury to superior brachial plexus (nerves C5-C6) causing paralysis of limbs which hang by the side with hands flexed upward

63
Q

What is another name for Erb’s palsy?

A

Waiter’s tip

64
Q

Can you have Erb’s palsy on only one side of your body?

A

YUP

65
Q

What are causes of inferior brachial plexus injuries (C8-T1)? How do we classify these?

A

Occurs when upper limb is suddenly pulled superiorly: either trauma or obstetrics

66
Q

What is ulnar claw? What is it caused by?

A

4th and 5th finger drawn toward the back of the hand at the first knuckle and curled toward the palm at the 2nd and 3rd knuckles

Caused by injury to the inferior brachial plexus

67
Q

What is carpal tunnel syndrome (CTS) caused by? Symptoms?

A

Injury to the median nerve due to narrowing/inflammation of the carpal tunnel

Symptoms: pain, paresthesia, difficulty moving fingers

68
Q

What is the carpal tunnel?

A

Narrow, tunnel-like structure in the wrist with median nerve and flexor tendons in the center:

  • Dorsal and lateral sides of the tunnel formed by wrist bones
  • Ventral side of the tunnel covered by a strong band of connective tissue: transverse carpal ligament
69
Q

What is paresthesia?

A

Abnormal sensation, typically tingling or pricking (“pins and needles”), caused chiefly by pressure on or damage to peripheral nerves

70
Q

How are the intercostal nerves arranged?

A

Segmentally between ribs

71
Q

What 2 parts of the body do the intercostal nerves innervate?

A
  1. Skin of thoracic wall

2. Muscles of thoracic wall

72
Q

What is the subcostal nerve? Where is it found?

A

Nerve formed by anterior ramus of T12

Project inferior to 12th rib

73
Q

What rami form the lumbar plexus?

A

Anterior rami L1-L4

74
Q

Where is the lumbar plexus located?

A

Underneath the psoas major muscle

75
Q

What 3 parts of the body does the lumbar plexus innervate?

A
  1. Lower limbs
  2. Abdominal wall (small branches)
  3. Inguinal region (small branches)
76
Q

What can injury to the lumbar plexus cause? What can be the origin?

A

Deficits in movements and sensation of the lower limbs

Cause: trauma (compression injury to spinal cord) or diabetes

77
Q

What are the 2 nerves of the lumbar plexus?

A
  1. Femoral nerve

2. Obturator nerve

78
Q

What 3 parts of the body does the femoral nerve innervate? What 3 nerves does it come from?

A
  1. Quadriceps muscles of anterior thigh
  2. Muscles in medial lower leg (toward inside)
  3. Overlying skin

Comes form L2-4

79
Q

What 2 parts of the body does the obturator nerve innervate? What 3 nerves does it come from?

A
  1. Adductor muscles of the medial thigh
  2. Overlying skin

Comes from L2-4

80
Q

What does adduction mean? What’s the opposite?

A

Movement of a body part toward the body’s midline

Opposite: abduction

81
Q

Where is the sacral plexus located?

A

Caudal to the lumbar plexus

82
Q

What anterior rami form the sacral plexus?

A

Anterior rami L4-S4

83
Q

What sacral nerve forms the coccygeal nerve?

A

S5

84
Q

What does the coccygeal nerve innervate?

A

The muscle of the pelvic floor

85
Q

What 3 parts of the body does the sacral plexus innervate?

A
  1. Pelvis
  2. Buttocks
  3. Posterior lower limbs
86
Q

What do we call the lumbar and sacral plexuses together?

A

Lumbosacral plexus

87
Q

What are the 2 nerves of the sacral plexus?

A
  1. Sciatic nerve

2. Pudendal nerve

88
Q

What are the 2 branches of the sciatic nerve and what does each innervate?

A
  1. Tibial nerve:
    - Muscles of posterior thigh
    - Muscles and skin of lower leg (mainly the back of the lower leg)
    - Intrinsic muscles and skin of foot (plant of foot)
  2. Common fibular nerve:
    - Muscles and skin of anterolateral lower leg
    - Muscles and skin of top of foot
89
Q

What 4 nerves does the sciatic nerve come from?

A

L4-S3

90
Q

What 3 parts of the body does the pudendal nerve innervate?

A
  1. Bladder sphincter
  2. Rectum sphincter
  3. Skin of external genitals
91
Q

What 3 nerves does the pudendal nerve come from?

A

S2-S4

92
Q

What are dermatomes and myotomes? What can they be used for?

A

They represent the segmental innervation of the body by somatic fibers (afferent and efferent) in spinal nerves

Can be used as diagnostic tools

93
Q

What is a dermatome?

A

Area of the skin supplied by a single spinal nerve

94
Q

Where is the chicken pox virus located in the body? In what form?

A

Dormant in the dorsal root ganglia

95
Q

How are chicken pox and herpes zoster related?

A

Both are caused by the same virus

Chicken pox is the primary infection and herpes zoster is a reactivation at a later time

96
Q

What 4 things can cause a herpes zoster outbreak? What is this called? Where does it happen?

A

HIV, stress, old age, chemotherapy

Happens on a dermatome

Shingles

97
Q

What is referred pain? Example?

A

Pain that is evident in a visceral organ but the body feels it in the skin or musculature

Example: heart attack will feel pain in left arm because the ganglia that contains heart sensory nerves also innervates that arm

98
Q

What is a myotome?

A

Collection of skeletal muscles that share a common spinal nerve(s)

99
Q

What can vertical compression of the spinal cord cause?

A

A disk can bulge out causing nerve pressure, which can cause sciatica and a lot of pain

100
Q

What are cranial nerves numbered according to?

A

Rostral - caudal extent

101
Q

List the 12 cranial nerves from rostral to caudal.

A
  1. Olfactory
  2. Optic
  3. Oculomotor
  4. Trochlear
  5. Trigeminal
  6. Abducens
  7. Facial
  8. Acoustic
  9. Glossopharyngeal
  10. Vagus
  11. Accessory
  12. Hypoglossal
102
Q

What cranial nerves are found in the forebrain?

A

1 and 2

103
Q

What cranial nerves are found in the midbrain?

A

3 and 4

104
Q

What cranial nerves are found in the pons?

A

5, 6, 7, and 8

105
Q

What cranial nerves are found in the medulla?

A

9, 10, 11, 12

106
Q

How to remember the function of each cranial nerve?

A

Some say marry money but my brother says big brains matter more

S: sensory (olfactory nerve - CN I)
S: sensory (optic nerve - CN II)
M: motor (oculomotor nerve - CN III)
M: motor (trochlear nerve - CN IV)
B: both (trigeminal nerve - CN V)
M: motor (abducens nerve - CN VI)
B: both (facial nerve - CN VII)
S: sensory (vestibulocochlear nerve - CN VIII)
B: both (glossopharyngeal nerve CN IX)
B: both (vagus nerve - CN X)
M: motor (spinal accessory nerve - CN XI)
M: motor (hypoglossal nerve - CN XII)
107
Q

Cranial nerve mnemonic?

A

Oh, Oh, Oh, To Touch And Feel A Girls’ Vagina and Hymen

108
Q

What are the 3 extraocular nerves and what does each innervate?

A
  1. Abducens nerves innervate lateral rectus muscle which allow side movement
  2. Trochlear nerve innervates superior oblique muscles which allows upper eye movement
  3. Oculomotor nerve innervates all other extraocular muscles
109
Q

What are the 3 branches of the trigeminal nerve? Where does the branching start? What do they give rise to?

A
  1. Opthalmic branch
  2. Maxillary branch
  3. Mandibular branch

Branching starts at the trigeminal ganglion

3 dermatomes on the face of the same names

110
Q

What is the external part of the ear known as?

A

Pina

111
Q

What 2 nerves is the pina innervated by?

A
  1. Vagus nerve

2. Facial nerve

112
Q

Where are the efferent somas of the cranial nerves found?

A

Brainstem nuclei

113
Q

Where are the afferent somas of the cranial nerves found?

A

Cranial ganglia or sensory epithelium (olfactory epi or retina)

114
Q

What is another name for second order sensory neuron?

A

Interneuron

115
Q

What is “drop foot”?

A

Patients with common fibular nerve damage will lose the ability to dorsiflex the foot at the ankle joint. Hence the foot will appear permanently plantarflexed – known as footdrop

116
Q

Nerves affect by superior brachial plexus injuries?

A

C5 and C6

117
Q

Nerves affect by inferior brachial plexus injuries?

A

C8 and T1

SMP - Neurophysio Exam 1 (13 decks)

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