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PRIYA NEURO > neuro cortex - spine > Flashcards

neuro cortex - spine Flashcards

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1
Q

when does the spinal cord terminate

A

L1/L2

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2
Q

what does the dorsal posterior horn recieve?

A

somatosensory information

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3
Q

what does the ventral anterior horn contain?

A

motor neurones for the innervation of muslces

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4
Q

what does the lateral horn contain?

A

autonomic neurones (sympathetic system T1-L2)

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5
Q

what is DCML responsible for?

A

fine touch, pressure and vibration

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6
Q

in the DCML pathway, where do the primary sensory fibres travel and synapse?

A

via the posterior root ganglion, travel up the spinal cord and synapse with secondary neurones in. the medulla (then nucleus cuneatus or gracillis)

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7
Q

where do fibres decussate in the DCML pathway?

A

medial leminiscus

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8
Q

what is the spinothalamic tract responsible for?

A

pain and temperature

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9
Q

what is the spinothalamic pathway?

A

the primary sensory axons enter the spinal cord via the posterior root ganglion then travel upwards for one or two segments at the periphery of the spinal cord through the tract of Lissuaer to synapse in the dorsal horn
they then cross to the contralateral side of the spinal cord to ascend and synapse in the thalamus
sensory signals are then related from the thalamus to the ipsilateral somatosenosry cortex

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10
Q

what is the function of the spinocerebellar pathway?

A

provides unconcious proprioceptive info to the cerebellum, in order to coordinate posture and the movement of the lower and upper limb musculature

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11
Q

what are the 3 types of spinocerebellar pathways?

A

dorsal/posterior spinocerebellar
cuneocerebellar
ventral / anterior spinocerebellar

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12
Q

what is the dorsal/posterior spinocerebellar pathway?

A

it carries unconcious proprioceptive info form muscle spindles from the lower limbs and synapses in the dorsal nucleus of clarke
secondary neuron fibres then ascend to the ipsilateral cerebellum

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13
Q

what is the cuneocerebellar pathway?

A

it carries unconcious proprioceptive info from the upper limbs to the ipsilateral cerebellum

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14
Q

what is the ventral / anterior spinocerebellar pathway?

A

carries unconious proprioceptive info (golgi tendon organs mainly) from the lower limbs then decussate twice to reach the ipsilateral cerebellum

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15
Q

does the spinocerebellar tract decussate?

A

no

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16
Q

does the spinothalamic tract deccusate?

A

yes

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17
Q

does the DCLM tract deccusate?

A

yes

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18
Q

what are the pyramidal corticospinal tracts responsible for?

A

voluntary movements

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19
Q

what is the pathway for the corticospinal tracts?

A

originates from the motor cortex (precentral gyrus) and travels down to the pyramid of the medulla
majority of fibres decussate at the pyramid of the medulla and descend via the lateral corticospinal tract to supply distal extremities
the minority undecussates fibres travel down via the nateiror corticospinal tract and then wehn they reach the required destination they decussate at that level via the anterior white comissure (they fibres supply proximal and axial muscles)

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20
Q

in the corticospinal pathway, which fibres supply the distal muscles?

A

those which travel via the lateral corticospinal tract

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21
Q

what is the function of the corticobulbar tracts?

A

the contain the upper motor neurones and cranial nerves, to provide innervation of the face, head and neck

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22
Q

what is the rule about innervation and the exception for the corticobulbar tract?

A

they innervate cranial motor nuclei bilaterally

- but hypoglossal nuclei and lower facial nuclei are innervated contralaterally only

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23
Q

what is the clinical significance around the innervation of the facial nerve? - facial palsy

A

an upper motor lesion affecting the facial nerve causes paralysis of the lower half of one side of the face only and the forehead muscles remain unaffected (this is called facial palsy)

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24
Q

what is the clinical significance around the innervation of the facial nerve? - bell’s palsy

A

a lower motor neurone lesions would cause a paralysis of the ipsilateral one-half of the face including the forehead

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25
what are the 4 extra-pyramidal tracts?
vesibulospinal reticulospinal rubrospinal tecto-spinal
26
what does the vestibulospinal tract control?
balance and posture by innervating anti-gravity mucsles (exetensors for leg and flexors for arms)
27
where does the vestibulospinal tract originate from?
the vestibular nucleus in the pons
28
what does the reticulospinal tract control?
pontine - faciculates voluntary / reflex responses and increases tone medullary - inhibits voluntary / reflex and decreases tone
29
where does the reticulospinal tract originate from?
from the reticular formation in the medulla and pons
30
where does the rubrospinal tract originate from
the red nucleus in the midbrain
31
what does the rubrospinal tract coordinate?
excites flexor muscles and inhibits extensor muscles of the upper body
32
what is the innervation and nerve of the knee reflex?
L3/4 + femoral
33
what is the innervation and nerve of the biceps reflex?
c5 / C6 + musculocutaneous
34
what is the innervation + nerve of the triceps reflex?
C7/8 + radial
35
what is the innervation + nerve of the ankle reflex?
S1/2 + tibial
36
dermatome of nipple
T4
37
dermatome of umbilicus
T10
38
dermatome of thumb and index finger
C6
39
dermatome of middle finger
C7
40
dermatome of 4th and 5th finger
C8
41
dermatome of upper thigh
L1
42
dermatome of knee
L3
43
dermatome of medial malleolus
L4
44
dermatome of dorsum of the foot and toes 1-3
L5
45
dermatome of toe 4 + 5 + lateral malleolus
S1
46
dermatome of perineal region
S3,4,5
47
cervical vertebrae
C1-C7 - 7
48
thoracic vertebrae
12 T1-T12
49
lumbar vertebrae
5 L1-L5
50
saccral vertebrae
5 S1-S5
51
coccygeal vertebrae
4 Co1-Co4
52
what is the ventral body and what does it do?
- anterior portion - responsible for weight bearing function of spine - covered superiorly and inferiorly with hyaline cartilage and articulates with the intervertebral disc at the outer epiphyseal rim of the body
53
what is the vertebral arch and what does it do?
- formed be pedicles and laminae of a vertebrae which create the foramen through which the spinal cord travels through (aka the vertebral foramen) - the pedicles extend posteriorly from the ventral body to meet the laminae which meet in the midline
54
what is the spinous process and what does it do?
- posterior bony projection in the midline which continues from the point where the laminae meet - serves as a point of attachment for the muscles of the back providing a point of leverage for movement of the spine
55
what are the transverse processes?
posterolateral bony projections which arise form the points where the pedicles meet the laminae
56
what are the articular processes and what do they do?
- arise from the point where the pedicles meet the laminae and form a hyaline surface of articulation between adjacent vertebrae - 2 superior and 2 inferior - inferior processes of the vertebrae articular with the superior articular processes of the vertebrae below
57
what's special about C1 atlas?
has no spinous process or body
58
what's special about C2 axis?
only vertebrae to have an ondontoid process (dens)
59
what special about C3-C5?
have short and bifid spinous processes
60
what is the annulus fibrosis and what is it made of?
outer ring | consists of concentric lamellae of fibrocartilage
61
what is the nucleus pulposus and what is it made from?
contained within annulus fibrosis consists of water dehydrates with age and loses elastin and proteoglycans while gaining collagen (eventually becoming more dry and granular)
62
what does the anterior longitudinal ligament do?
connects the anterolateral aspects of the verteral bodies and IV discs
63
what does the posterior longitudinal ligaments do?
runs within the certebral canal posteiror to the ventral bodies
64
what does the ligamentum flavum do?
- rich in elastin (yellow) - runs vertically, connecting the lamina of adjacent vertebrae, helps to maintain an upright posture and assist straightening the spine after flexion
65
where does the supraspinous ligament run?
along the tips of the spinous processes
66
where do the interspinous ligaments run?
between the spinous processes
67
which layers does a needle pass through in a lumbar puncture?
skin, fascia, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura e
68
which vertebrae and the most common for disc herniation?
L4/5 and L5/S1
69
what are the 3 directions of prolapse and what do they cause?
paramedian - compresses the transversing nerve eg the nerve below the level of prolapsed disc extradoraminal - compresses te exiting nerve central / medial - causes lumbar stenosis or if it is large enough it can cause cauda eqiune
70
what is the definiton of radiculopathy?
dysfunction of a nerve root causing a dermatomal sensory deficit with weakness of the muscle groups supplied by that nerve
71
which test is used for sciatica?
straight leg raise - patient lies on back, lift their leg while the knee is striaght, if the leg can't be moved passed 45degrees, the test is said to be positive
72
what are the symptoms of L5/S1 prolapsed intervertebral disc (root involved is S1) ?
- pain along the posterior thigh with radiation to the heel - weakness of plantar flexion - sensory loss in the lateral foot - reduced or absent ankle jerk
73
what are the symptoms of L4/5 inervertebral disc (root involved is L5) ?
- pain along the posterior or posterolateral thigh with radition to the dorsum of the foot an dgreat tow - weakness of dorsiflection of the tow or foot - paraesthesia and numbness of the dorsum of the foot and great tow
74
what are the symtpoms of L3/L4 prolapsed intervertebral disc (root involved is L4) ?
- pain in anterior thigh - wasting of the quadriceps muscle - weakness of the quadriceps function and dorsiflexion of foot - diminished sensation over anteroir thigh, knee, medial aspect of lower leg - reduced knee jerk
75
what is the treatment of cauda equina?
if due to herniated disc - discetomy if due to a fracture - decompression +- ixiation if due to haematoma - evacuation
76
what is spinal stenosis?
narrowing of the spinal canal which compresses the lowest most spinal cord (conus medullaris) - hypertrophy of facet joints and ligamentum flavum
77
what are the symptoms of spinal stenosis?
unilateral / bilateral pain or burning sensation precipitated by standing / back extension and relieved by sitting, lumbar flexion or walking uphill
78
what is cervical sponylosis?
degenerative arthritic process involving the cervical spine and affecting the intervertebral disc nad zygapophyseal joints
79
what is the 1st line investigatoin for degenerative cervical myelopathy?
MRI of cervical spine
80
what is anterior cord syndrome?
- cord infarction by the area supplied by the anterior spinal artery - produces paralysis and LO pain and temperature below the level of injurt with preseved proprioception and vibration sensation
81
what is cord transection (complete spinal cord lesion)?
- complete lesion - all motor and senosory modalities affected below the lesion - initially a flaccid arrflexic paralysis "spinal shock" - upper motor neurone signs appear later
82
what is brown-sequard syndrome?
- ipsilateral upper motor neurone paralysis and loss of proprioception below the lesion - contralateral loss of pain and temperature sensation beginning at 1 or 2 segments below the lesion
83
what is central cord syndrome?
- caussed by acute extension injury to already stenotic neck or syringomyelina or tumour - bilateral upper limb weakness> lower limb - capelike spinothalamic sensory loss (pain and temperature) - dorsal columns preserved

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