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Y2 CONTROL & MOVEMENT > Spinal Cord & Spinal Nerves > Flashcards

Spinal Cord & Spinal Nerves Flashcards

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1
Q

What are the following subdivisions of the nervous system?

A
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2
Q

What is the difference between grey and white matter?

A

Grey matter:

  • collection of nerve cell bodies

White matter:

  • axons with glial sheath (myelin)
  • myelin is a fatty substance that appears white
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3
Q

Where is grey matter located within the CNS and PNS?

A

CNS:

  • in the cortex - the outer layer of the hemispheres
  • in the nuclei deep in the cortex

PNS:

  • within the ganglia
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4
Q

What occurs within the gray matter?

A

Synapses occur within the gray matter

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5
Q

What is the difference between white matter in the CNS and PNS?

A

CNS:

  • it is located in a pathway
  • e.g. Tracts, fascicles, bundles

PNS:

  • peripheral nerves
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6
Q

What is the purpose of the vertebral column?

A

It contains and protects the spinal cord and beginning of the spinal nerves

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7
Q

What are the different types of vertebrae within the vertebral column?

A
  • 7 cervical
  • 12 thoracic
  • 5 lumbar
  • sacrum (5 fused)
  • coccyx (3-4 fused)
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8
Q

What is significant about the spinal cord with respect to the vertebral column?

A

The spinal cord narrows at the end

It ends before the vertebral column ends

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9
Q

What are the roles of the spinal cord?

A
  • Part of the CNS
  • Reflex centre
  • Conduction pathway between the brain and the body
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10
Q

Where does the spinal cord extend from and to?

A

It extends from the foramen magnum of the occipital bone

it is continuous with the medulla oblongata

it runs to the vertebral levels LI - LII, where it terminates as the conus medullaris

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11
Q

What happens when the spinal cord terminates as the conus medullaris?

A

Single nerves leave from the region of the conus medullaris as the cauda equina

this gives rise to spinal nerves (PNS)

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12
Q

Label the components of the spinal cord

A
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13
Q

What is the filum terminale?

A

A small extension of pia mater that attaches the spinal cord to the coccyx

this gives stability

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14
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A
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15
Q
A
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16
Q

What are the roles of the cervical and lumbosacral enlargements?

A

They are thicker, larger regions of the spinal cord

they give rise to nerves that innervate the upper and lower limbs

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17
Q

In order to see the spinal cord, which layer must be opened?

A

The dural sac

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18
Q

What is the composition of the spinal cord like from top to bottom?

A
  • 8 cervical segments (C1 - C8)
  • 12 thoracic segments (T1 - T12)
  • 5 lumbar segments (S1 - S5)
  • 1 coccygeal segment (Co1)
  • conus medullaris
  • cauda equina
  • filum terminale
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19
Q

What is meant by a ‘segment’ of the spinal cord?

How many spinal nerve segments are they and what do they form?

A

A segment refers to a pair of spinal nerves

there are 31 spinal nerve segments, each giving rise to a pair of segmental spinal nerves

31 pairs of spinal nerves form the PNS

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20
Q

Which features of the spinal cord are shown here?

A

Lumbar cistern:

  • expansion of subarachnoid space that surrounds the cauda equina

Dural sac:

  • extends to the level of S1

Filum terminale:

  • this is an extension of the pia
  • it extends to attach to the coccyx
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21
Q

Where is the conus medullaris located?

A

This is the termination of the spinal cord

It is situated between L1 and L2

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22
Q

What nerves are found within the cervical enlargement?

A

The brachial plexus (C1 - C8)

this supplies the upper limb

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23
Q

What nerves are found within the lumbosacral enlargement?

A

The lumbosacral plexus (L1 - S4)

this supplies the lower limb

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24
Q

What nerves are found within the cauda equina?

A

Dorsal and ventral roots of lower lumbar, sacral and coccygeal spinal nerves

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25
What is meant by the spinal nerve transition zone?
At vertebral levels C1 - C7, the spinal nerve leaves **_above_** the corresponding vertebra C8 leaves **_below_** the corresponding vertebra all nerves below this level leave **_below_** their respective vertebra
26
What is the difference in the way the cervical spinal nerves leave the spinal cord?
**Spinal nerves C1 - C7:** * leave the vertebral column **_superior_** to their corresponding vertebra * C1 from above CI, C2 from above CII.... **C8 spinal nerve:** * leaves from above TI * there are only 7 cervical vertebrae
27
How do spinal nerves T1 - C0 leave the spinal cord?
They leave from **_below_** their corresponding vertebra ALL spinal nerves leave the spinal cord via the **intervertebral foramina**
28
Label the meninges and features of the spinal cord
29
What are the denticulate ligaments?
Extensions of pia that attach the spinal cord to the outer meningeal layers this secures the spinal cord laterally
30
What are the subdural and subarachnoid spaces of the spinal cord?
**Subdural space:** * this is a potential space between the dura and arachnoid mater **Subarachnoid space:** * this is a real space between the pia and arachnoid * it is filled with CSF
31
What happens to the spinal nerves as they leave the vertebral canal?
As each spinal nerve leaves the vertebral canal it takes with it the meningeal coverings these go on to form the **epineurium** this is a protective outer sheath of connective tissue
32
What are the main differences between the spinal and cranial dura?
* Cranial dura has an inner meningeal layer and outer periosteal layer * Spinal dura only has a **meningeal layer** * the epidural space in the cranium is a potential space * it can become a pathological space if there is bleeding * the epidural space in the spinal cord is a real space * it is filled with fat
33
Label the differences of the spinal and cranial dura
34
How does the spinal cord change in length during development? Why?
During development, the dural sac grows along the vertebrae but not the spinal cord the bones of the vertebral column grow faster than the spinal cord, leading to regression of the spinal cord
35
36
What is the consequence of changes in spinal cord length on spinal nerve roots?
The spinal nerve roots show disparity between their segmental attachment to the cord and the corresponding vertebral levels within the cervical region, the nerves close to the vertebrae leave close to their point of origin nearer the end of the spinal cord, the nerves travel down to leave below their vertebra these form the cauda equina
37
Label the diagram and the position of the needles for performing certain procedures
38
What is the role of the ligamentum flavum?
It connects the lamina of adjacent vertebrae the needle for lumbar puncture passes between the vertebrae through the ligamentum flavum to reach the dural sac and obtain CSF
39
Where should the needle be inserted for lumbar puncture? How should the patient be positioned?
The needle is inserted between **LIV and LV** the needle is inserted into the **lumbar cistern** due to the cauda equina, the nerve roots move out of the way when the needle is inserted the patient should be hunched over or in the foetal position to stretch the space between the vertebrae
40
Where should the needle be inserted for epidural anaesthesia?
Within the lumbar region or sacral hiatus the needle is only inserted into the epidural space
41
Label the sulci of the spinal cord What structures pass through them?
**Blood vessels** travel in the posterior median sulcus and anterior median fissure **rootlets** that form spinal nerves travel in the posterior lateral sulcus and anterior lateral sulcus
42
Label the arterial supply to the spinal cord Where do the vessels originate from?
The anterior and posterior spinal arteries are branches of the **vertebral artery** the segmental spinal artery arises from a branch of the aorta (depending on the location within the spinal cord) The segmental spinal artery gives rise to the **medullary artery** the medullaris artery give rise to the **anterior & posterior radicular arteries** which supply the roots of nerves
43
What are the different segmental spinal arteries depending on the location within the spinal cord?
* Vertebral artery * deep cervical artery * posterior intercostal artery * lumbar arteries * lateral sacral artery
44
What is the main difference in the grey and white matter in the CNS?
**Brain:** * grey matter is found in the cortex and nuclei - the **outside** * white matter is found on the **inside** **Spinal cord:** * grey matter is found on the **inside** * white matter is found on the **outside** of the spinal cord
45
How is grey matter organised within the spinal cord?
It is organised into **horns** 1. Dorsal horn 2. Ventral horn 3. Lateral horn - only present T1-L2 and S2-S4
46
What is significant about the lateral horn?
It only exists between T1 - L2 and S2 - S4
47
How is white matter organised within the spinal cord?
It is organised into **columns** 1. Dorsal white column 2. Ventral white column 3. Lateral white column 4. Ventral white commisure
48
What is the ventral white commisure?
An area of white matter that connects the left and right sides of the spinal cord
49
What horns/columns are represented in this transverse section of the spinal cord?
50
label the transverse section of the spinal cord
51
What are the 2 types of fibres within the peripheral nervous system?
The PNS is all the connections outside of the brain and spinal cord **sensory (afferent) fibres:** * these send information from the periphery **_towards_** the CNS **motor (efferent) fibres:** * these send information **_away from_** the CNS and towards the periphery
52
How is the spinal cord connected with the PNS?
Via nerve rootlets each spinal level gives rise to 1 pair of spinal nerves these spinal nerves are part of the PNS
53
Label the components of a spinal nerve
54
Where do the dorsal and ventral rootlets of the spinal cord leave from?
**dorsal rootlets:** * leave from posterolateral sulcus **ventral rootlets:** * leave from anterolateral sulcus
55
56
Label the transverse section of the spinal cord and spinal nerve
Somatic and visceral sensory fibres travel through the dorsal root ganglion and dorsal root somatic motor fibres travel through the ventral root visceral motor fibres travels through the ventral horn and into the spinal nerve
57
What is the purpose of the reflex arc?
When there is no time to pass through the normal pathway a sensory neurone connects directly to a motor neurone for a rapid response via an interneurone
58
How does the amount of white matter change as you go through the spinal cord?
The amount of white matter increases as you ascend the cord i.e. there is more white matter in the cervical cord than the lumbar cord
59
60
What is significant about the size of the ventral grey horn in certain locations of the spinal cord?
The ventral grey horn is enlarged where motor fibres to limbs arise these are the cervical and lumbosacral enlargements they contain cell bodies from motor neurones innervating the upper and lower limbs
61
What are the dorsal columns of white matter present on either side of the midline in the spinal cord? How do these change as you ascend the spinal cord?
**Gracile fascicle:** * This is located medially * it runs the entire length of the spinal cord * it carries sensory information from the **lower limb** **Cuneate fascicle:** * this is located laterally * it is only present **_above segment T6_** * it carries sensory information from the **upper limb**
62
Label the sections of the spinal cord
63
What are the functions of the cuneate and gracile tubercles?
Tubercles contain cell bodies The gracile and cuneate fascicles terminate as the gracile and cuneate tubercle these are part of the dorsal column pathway the **cuneate tubercle** carries **sensory information from the upper limb** the **gracile tubercle** carries **sensory information from the lower limb**
64
Is this section from above or below T6? How can you tell?
**Above T6** this is a thoracic vertebral section as the **lateral grey horn** is present here there is also a **small ventral grey horn**
65
How is spinal grey matter divided?
The grey matter is divided into regions called **Rexed's laminae** these are sites of sensory or motor nuclei
66

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