TEST 1- CNS/PNS Flashcards
(269 cards)
1
Q
We have 33 vertebra. How are they separted? (# and segments)
A
7 cervical 12 thoracic 5 lumbar 5 fused sacral 3-5 coccygeal
2
Q
4 main curvatures
A
Cervical curves anteriorly
Thoracic curves posteriorly
Lumbar anteriorly
Coccygeal/sacral posteriorly
3
Q
This faces anteriorly, and is the weight bearing portion of the vertebra
A
Body
4
Q
Extends posteriorly on both sides
A
Pedicle
5
Q
Posterior to the pedicle is the _______ which joins with the pedicle to form the transverse process
A
Lamina
6
Q
Forms the spinous process (faces posteriorly)
A
2 lamina formed together
7
Q
Attachment site for many of the muscles of the back and the neck
A
Spinous process
8
Q
Where vertebra articulate with one another (located on superior articular process)
A
Facet
9
Q
What sits inside the vertebral foramen?
A
Spinal Cord
10
Q
The ________ articular process articulates with the _________ articular process of the vertebra just below it.
A
Inferior articular process articulates with the superior articular process of the vertebra below it
11
Q
What forms the intervertebral foramen?
A
Inferior intervertebral notch
Superior intervertebral notch
12
Q
What passes through the intervertebral foramen?
A
Blood vessels and spinal nerves
13
Q
C1 is also called ______
A
Atlas
Greek mythology–atlas holding world on shoulders
14
Q
The vertebral foramen is WIDE/NARROW at C1
A
Wide
15
Q
C1 has NO body and no spinous process associated with it. TRUE/FALSE.
A
TRUE
16
Q
What articulates with the superior articular facets of C1
A
Occipital condyles
17
Q
C2 is also knows as the _____
A
Axis
18
Q
This is a structure on C2, fractured frequently with neck fx’s, also known as ondontoid process.
A
Dens
19
Q
What is the purpose of the dens articulating with the atlas?
A
Allows head to rotate left and right; provides pivot for head to rotate.
20
Q
The superior articular facet of C2 will articulate with what??
A
Inferior articular facet of C1 (atlas)
21
Q
Most of the spinous processes of the cervical vertebra are ________,or have a split in them.
A
Bifid
22
Q
Why are the spinous processes of the cervical vertebra bifid?
A
So muscles of the neck can attach to the spinous processes.
23
Q
What articulates with the superior articular facet of C5?
A
Inferior articular facet of C4
24
Q
What does the inferior articular facet of C5 articulate with?
A
Superior articular facets of C6
25
At C5, the spinous processes are more VERTICAL/HORIZONTAL.
HORIZONTAL.
26
Openings in transverse processes are characteristic of ___________ vertebra.
Cervical vertebra
27
In most ppl, the vertebral prominance (when bend head down) is _______ vertebra.
C7
28
Why is C7 important for us as anesthesia providers?
Good landmark for us to start with if need to work our way down to find vertebra intended for spinal anesthesia.
29
2 characteristics of cervical vertebra ?
Bifid spinal processes
Openings in transverse processes
30
Spinous processes are very SHORT and FAT in the thoracic vertebra. TRUE/FALSE.
FALSE
Long and thin spinous processes
31
The body of vertebra INCREASES/DECREASES in size as you go down the vertebra, because of weightbearing.
Increases in size as weightbearing increases
32
The vertebral foramen is smaller in the thoracic vertebra than it is in the cervical. TRUE/FALSE
TRUE
33
In the first 10 thoracic vertebra, there are articulations for the ______.
Ribs
34
When doing spinal in the thoracic region, you have to aim the needle more _________ bc of the way the spinous processes are angled.
Cephalad
35
What are the floating ribs?
Ribs 11 and 12
36
Thoracic vertebra are the ONLY vertebra that have articulations for the ribs. TRUE/FALSE
TRUE
37
The head of the rib articulates with the ________ articular facet of the superior vertebra and the _______ articular facet of the inferior vertebra
Inferior; superior
38
Tubercle of the rib sets against the articular facet on the __________ of the inferior vertebra.
Transverse process
39
Lumbar vertebra are the LARGEST nonfused vertebra. TRUE/FALSE
TRUE
40
What would the inferior articular facet of L5 articulate with?
Superior articular facet of S1
41
Spinous processes of the _______ vertebra are very wide, thick, and horizontal.
Lumbar vertebra
42
This is at S1, important for determining width of the birth canal.
Sacral promontory
43
Opening at S5. Clinical significance?
Sacra hiatus
Caudal block for pediatrics (for urologic procedures)
44
Which 2 sets of vertebra are fused together?
Sacral vertebra
| Coccyx
45
On average, we have _______ coccyx vertebra.
3-5
46
There is a _________ area where the sacrum and coccyx meet.
Flexible
47
There are NO vertebral foramina or transverse processes associated with the coccyx. TRUE/FALSE
TRUE
48
Fibrocartilagenous discs between adjacent vertebral bodies
Intervertebral discs
49
Intervertebral discs allows for what in the vertebral column
Cushioning and flexibility
50
Where do vertebral discs start and end?
From (axis) C2 to the sacrum (between L5 and S1)
51
There are NO vertebral discs between which cervical vertebra.
No vertebral discs between the Atlas and the skull; and none between the Atlas and the Axis
52
Vertebral discs provides for ~ ___% of the length of the vertebral column
25 %
53
As we get older, the vertebral discs _______, and they are shortened
Dehydrate (shrink)
54
2 main parts that compose a vertebral disc
```
Nucleus pulposus (center)
Annulus fibrosis (outer fibrous rings)
```
55
Condition when nucleus pulposus herniates through annulus fibrosus
Herniated disc
56
Discs usually herniate ANTERIORLY/POSTERIORLY
POSTERIORLY
57
What is compressed with posterior herniated disc?
Spinal nerve root in the intervertebral foramen
58
With posterior herniated disc, there is usually _______ deficit first with _______ root compressed.
Sensory deficit with dorsal root compressed
59
When ventral root is compressed in the spinal nerve from herniated discs, you will see _______ deficits
Motor
60
What part of the vertebral column must the surgeon remove to get to the herniated disc?
Lamina (laminectomy)
61
This ligament runs down the anterior part of the vertebral column from the atlas to the sacrum
Anterior longitudinal ligament
62
The anterior longitudinal ligament DECREASES in size as goes down the spinal column. TRUE/FALSE
FALSE
INCREASES in size and goes downward
63
Ligament that runs along posterior surface of vertebral bodies from axis to the sacrum
Posterior longitudinal ligament
64
What happens to the size of the posterior longitudinal ligament as runs down vertebral column?
Starts large at the top and gets smaller at the bottom
65
Connects the lamina to each other on both the L and R.
Ligamenta flava
66
Needle goes in this opening for spinal
Space between L/R ligamenta flava
67
Runs from C7 to sacrum; connects tips of spinous processes.
Supraspinal ligament
68
Above C7, what connects spinous processes?
Ligamentum nuchae
69
Connects the roots and apexes of spinous processes
Interspinal ligaments
70
Connects adjacent transverse processes
Intertransverse processes
71
Spinal cord is a continuation of the _______
Medulla or brainstem
72
In the avg adult the SC is ~ ____ cm long
46 cm
73
SC extends from the foramen magnum to the ____________ (endpoint of SC)
Conus medullaris
74
In most adults, SC ends at Lumbar vertebra ______
L1
75
What space do we typically put in a spinal/epidural?
L3/L4
76
Fibrous structure extending from conus medullaris to coccyx and anchors SC in place
Filum terminale
77
What are the two enlargements of the SC?
What's the purpose of the enlargements?
Cervical enlargement
Lumbosacral enlargement
Large # of nerves that need to exit these areas to innervate the upper/lower body
78
Where do the nerves originate in the spinal column that innervate the upper limbs
C4-T2
79
Where do the nerves enter and exit to innervate the lower limbs?
L3-S3
80
Nerves from the lower part of the spinal cord that extend in a tail fashion.
Cauda equina
81
SC is bilaterally symmetrical. TRUE/FALSE
TRUE
82
Divides SC down the middle anteriorly
Anterior median fissure
83
Divides the SC posteriorly down the middle.
Posterior median sulcus
84
Part of the spinal cord that holds CSF; continuous with 4th ventricle.
Central canal of SC
85
Outer part of SC is composed of what?
White matter (bundles of axons and their myelin sheaths)
86
What type of information will be transmitted in ascending tracts of the white matter?
Sensory information up to the brain
87
What type of info is sent in descending tracts of the SC? (3)
Somatic motor
Autonomic pathways
Pain modulation
88
3 columns of the white matter?
Dorsal (posterior)
Ventral (anterior)
Lateral column
89
Central part of SC is composed of what?
Gray matter
90
Nerve cell bodies and their dendrites; where axons synapse with those dendrites
Gray matter
91
Gray matter is divided into _______.
Horns
92
What are the horns of the gray matter
Posterior horn
Anterior horn
Lateral horn
93
What segments have a lateral horn of gray matter?
T1-L2
| S2-S4
94
Lateral horns of the gray matter are associated with ___________ output.
Autonomic
95
Anterior horns of the gray matter are associated with _______ output
Motor
96
Posterior horns associated with _________ INPUT/OUTPUT?
Sensory INPUT
97
Thin strip of white matter behind posterior horn of the gray matter.
Tract of lissaeur
98
__________ pathways must enter through tract of lissaeur before synapsing with posterior horn of the gray matter.
Sensory
99
Where pathways cross over from one side of the SC to the other side.
Anterior white commisure
100
Surrounds the central canal of the SC; pathways can also cross over from one side of the SC to the other here
Gray commisure
101
One of the few places in the gray matter where tracts are passing through
Gray commisure
102
Where anterior and posterior root join together
Common spinal nerve
103
What type of fibers are in the common spinal nerve?
Sensory
Motor
Autonomic
104
Sensory fibers out in the periphery come through the common spinal nerve, enters the _________ root, ______ rootlets, and synapses _______.
Dorsal root
Dorsal rootlets
Posterior horn of gray matter
105
Where do lower motor neurons/nerve cell bodies of lower motor neurons originate?
Anterior horn of the gray matter
106
Where do nerve cell bodies of upper motor neurons originate?
Primary motor cortex; frontal lobe
107
Upper motor neuron passes through brainstem and SC to synapse with ________ in the anterior horn of the gray matter
Lower motor neuron
108
After lower motor neuron is excited, what is its path from anterior horn to the skeletal muscle?
Sends impulses out through ventral rootlets; ventral root; common spinal nerve; synapse on skeletal muscle fibers; contraction.
109
Autonomic pathways start in the ________ horns, exit through the ______ rootlets, ________ root, common spinal nerve, and synapse on various tissues/organs with the autonomic innervation.
Start in the lateral horns, exits through ventral rootlets, ventral root..
110
Sensory fibers enter through the ______ root.
Dorsal root
111
Motor and autonomic fibers pass out through the _______ root.
Ventral
112
All the nerve cell bodies of the sensory pathways that are entering dorsal root and clustered where?
Dorsal root ganglion
113
The gray matter is divided into these divisions
Lamina of rexed
114
There are ___ different zones, bilaterally, of laminae of rexed.
10
115
These laminae of rexed are located on the dorsal horn of the gray matter and receive sensory input from peripheral afferent sensory neurons
Laminae of Rexed I - VI
116
Lamina of rexed _____ is where primary sensory neurons that transmit fast pain synapse.
Lamina of rexed 1
| Lamina marginalis
117
Laminae of rexed II and III are collectively referred to as what?
Substantial gelatinosa
118
Primary sensory neurons that transmit slow pain synapse here
Laminae of Rexed II and III
119
Type of fibers and NT for fast pain?
Type A delta
| Glutamate
120
Type of fibers/NT for slow pain?
Type C unmyelinated
| Substance P
121
All sensations besides fast/slow pain terminate here (vibration, tickle, itch)
L of R IV, V, and VI
122
These Lamina of rexed are located in the anterior horn of the gray matter; contain nerve cell bodies of efferent somatic motor neurons.
LofR VII, VIII, IX
123
If lateral horns are present, which LofR are associated with them?
What type of output?
LofR VII
Autonomic output
124
Where is laminae of rexed 10 located?
Around central canal of SC (gray commisure)
125
The meninges of the of the SC are continuous with the ______
Brain
126
The dura mater of the SC has 2 layer. TRUE/FALSE.
FALSE.
| SC only has ONE layer of dura mater.
127
How far does the dura mater extend down the spinal column?
S2
| Longer than SC: ends blindly in pouch
128
The dura mater extends out to the dorsal roots, ventral roots and common spinal nerve, creating the covering of the common spinal nerve which is the ____________.
Epineurium
129
Dura mater is separated from the vertebral bodies which creates the __________ space.
Epidural space
130
Below the dura mater; potential space; thin film of fluid present.
Subdural space
131
Arachnoid mater extends past the SC, where does it end?
S2
132
Contains CSF, space around spinal cord that is continuous with the brain.
Subarachnoid space
133
Inseparable and attached directly to SC
Pia mater
134
Extension of the pia mater after the conus medullaris; anchors the SC down by piercing the arachnoid mater and dura mater and attaching to coccyx.
Filum terminale
135
Connects the pia mater to the dura mater; anchors SC down laterally. (22 of them)
Denticulate ligaments
136
31 spinal nerves. How many pairs and where?
```
8 pairs of cervical
12 pair of thoracic
5 lumbar
5 sacral
1 coccygeal
```
137
How are spinal nerves named?
Named form the spinal segment from which they originate
138
How are spinal cord segments named?
Vertebral column segments from which the originated in fetal development
139
As we get older, the vertebral column grows FASTER/SLOWER than the SC.
Column grows FASTER than SC
140
SC segments do NOT lay adjacent to vertebral column segments that they originated from during fetal development. TRUE/FALSE
TRUE
141
Upper SC segments sit adjacent with the corresponding vertebra from which they were named. TRUE/FALSE.
TRUE
142
Lower cervical regions, the vertebra are _______ lower in number than the corresponding SC segment.
One lower
143
Upper thoracic region, the vertebra are ____ lower in number than the corresponding SC segment
2 lower
144
Lower thoracic region, vertebra are _____ lower in number than corresponding SC segment
3 lower
145
Lumbar, sacral and coccygeal SC segments occupy the space opposite of what vertebra?
T9 - L1
146
Spinal nerves exit through the same vertebral foramen that they always exited from (creates cauda equina) TRUE/FALSE
TRUE
147
Spinal Cord segments and corresponding adjacent vertebra (adults) for spinal nerve C1-C8
SC - VERTEBRA
```
C1 - C1
C2 - C2
C3 - C 2-3
C4 - C 3-4
C5 - C 4-5
C6 - C5
C7 - C6
C8 - C6-7
```
148
SC segments and adjacent vertebra for T1 - T12 spinal nerves
SC - VERTEBRA
```
T1 - C7-T1
T2 - T1-2
T3 - T2
T4 - T3
T5 - T3-4
T6 - T5
T7 - T6
T8 - T7
T9 - T8
T10 - T9
T11 - T10
T12 - T10-11
```
149
SC segments and adjacent vertebra for L1-S5; Coc-1
SC - VERTEBRA
```
L1 - T11-12
L2 - T11-12
L3 - T12
L4 - T12-L1
L5 - T12-L1
```
```
S1 - L1
S2 - L1
S3 - L1
S4 - L1-2
S5 - L1-2
Coc1 - L1-2
```
150
Areas of the skin supplied by the various spinal nerves
Dermatomes
151
Dermatome level appropriate for spinal with an abdominal procedure
T4; nipple line
152
Dermatome level for gynecological/urologic procedures
T10; around umbilicus
153
Innervates the skin, muscles, and other structures of the back of the neck and the trunk. (Branch off of common spinal nerve)
Dorsal Ramus (rami)
154
Innervate the anterior and lateral neck, trunk, perineum, and the limbs. (Branch of spinal nerve)
Ventral ramus
155
This ramus does NOT form plexuses
Dorsal rami
156
This ramus forms various nerve plexuses
Ventral rami
157
From what spinal nerves does the cervical plexus receive contributions from?
C1, C2, C3, C4
158
Spinal nerves contributing to brachial plexus
C5, C6, C7, C8, T1
Most ppl C4, T2 as well
159
Spinal nerves contributing to lumbar plexus
L1, L2, L3, most of L4
160
Spinal nerves contributing to sacral plexus
Remainder of L4,
| L5, S1, S2, S3
161
Spinal nerves contributing to sacrococcygeal plexus
S4, S5, and coccygeal nerve
162
How is the brachial plexus divided up?
```
5 Roots
3 Trunks
6 Divisions (3V/3D)
3 Cords
5 terminal Branches
```
163
What are the 5 (or 7) roots of the brachial plexus?
C5, C6, C7, C8, T1
| C4, T2
164
Phrenic nerve is a branch off of the ____ root; innervated the diaphragm.
C5
165
What are the 3 trunks?
Superior
Middle
Inferior
166
The roots of the brachial plexus divide into ___ divisions, ______ dorsal and _____ ventral.
6 divisions
3 ventral
3 dorsal
167
How do the 6 divisions form into the 3 cords?
3 dorsal divisions form the posterior cord
2 ventral divisions form the lateral cord
1 ventral division forms the medial cord
168
6 Cords of the brachial plexus give way to what 5 terminal branches
```
Musculoskeletal
Axillary
Radial
Median
Ulnar
```
169
Musculocutaneous branch gets contributions from what roots?
C(4), C5, C6, C7
170
Axillary branch gets contributions from what roots?
C5, C6
171
Radial branch gets contributions from what roots?
C5, C6, C7, C8, T1
172
Median branch gets contributions from what roots?
C(5), C6, C7, C8, T1
173
Ulnar branch gets contributions from what roots?
C(7), C8, T1
174
Cutaneous sensory innervation of axillary nerve
Interior lateral shoulder
175
Cutaneous sensory innervation of radial nerve
Posterior surface of the arm and forearm, lateral 2/3 of the dorsum of the hand
176
Cutaneous sensory innervation of musculocutaneous nerve
Lateral surface of the forearm
177
Cutaneous sensory innervation of ulnar nerve
Medial third of the hand, little finger, and medial half of ring finger
178
Cutaneous sensory innervation of median nerve
Lateral 2/3 of Palm of hand, thumb, index and middle fingers, and the lateral half of ring finger and dorsal tips of the same fingers.
179
What nerve is most commonly damaged under general anesthesia? Why?
Ulnar nerve bc of compression from positioning arms wrong
180
Hands should be PRONATED/SUPINATED to prevent ulnar nerve injury.
SUPINATED
181
How many spinal arteries are there anteriorly?
One
182
How many posterior spinal arteries?
Two
183
The anterior spinal artery perfuses the anterior _______ of the SC
Ant 2/3 of the SC
184
The two posterior spinal arteries perfuses the posterior _______ of the spinal cord on each side.
Posterior 1/3 on each side.
Right posterior artery supplies posterior 1/3 Rt SC, visversa.
185
Arteries that are outside the vertebral column; run through intervertebral foramen; most only supply the nerve roots, but some perfuse parts of the meninges and ant/post SC.
Radicular arteries
186
Artery that runs the entire length of the SC, in front of the anterior median fissure.
Anterior spinal artery
187
What forms the most superior part of the anterior spinal artery?
Branches from the vertebral arteries
188
In most ppl, there are ~ ______ radicular arteries that supply blood to the anterior spinal artery
6-10
189
From cervical region, down to ~ T2, SC is perfused by radicular arteries from the __________ arteries.
Subclavian arteries
190
This segment of the SC has only one radicular artery, making it an area at risk for hypoperfusion.
T3 - T7
191
Supplies blood to anterior spinal artery from spinal segment T8, all the way down to the conus medullaris.
Artery of adamkiewicz
192
Artery of adamkiewicz is also called major anterior radicular artery, and in most ppl, rises from the Left ________ artery.
L posterior intercostal artery
193
The descending branches from the artery of adamkiewicz form an anastamosis around the conus medullaris and helps provide blood flow to what arteries.
Posterior spinal Arteries
194
Perfuses more SC segments than any other radicular artery
Artery of adamkeiwicz
195
Supplied blood by the lumbar, lateral sacral, and medial sacral arteries.
Cauda equina
196
Posterior spinal arteries do NOT run entire length of SC. TRUE/FALSE
FALSE
Posterior spinal arteries DO run the entire length of the SC.
197
Like anterior spinal artery, the posterior spinal arteries recieve blood from the _______ arteries.
Vertebral arteries
198
In most ppl ______ radicular arteries contribute to posterior spinal arteries.
10-23
199
Branch off of the anterior spinal artery and run along ant median fissure; supply many of the inner SC.
Central branches
200
Arteries that run along the surface of the SC and supply outer SC
Pial (arterial) plexus
201
Both the central branches and pial plexus have __________ branches that supply the inner SC
Penetrating branches.
202
3 concentric rings of the SC and what arteries supply them?
Inner ring: zone sup;inked by the central branches
Middle ring: zone supplied by both the central branches and branches from pial plexus
Outer ring: supplied by pial plexus branches only
203
The posterior spinal arteries have branches that give rise to the posterior pial plexus, but DO NOT have __________ branches
Central branches
204
Midline structures from posterior skin to epidural space.
```
Skin- post. Body
Subcutaneous tissue
Supraspinal ligament
Interspinal ligament
Gap: L and R ligamenta flava
Epidural space
```
205
Midline structures from epidural space to central canal of SC.
```
Epidural space
Dura mater
Subdural space
Arachnoid mater
Subarachnoid space/CSF
Posterior median sulcus
Pia mater
Posterior column white matter
Posterior gray commisure
Central canal of SC
```
206
Midline structures posterior from central canal of SC to epidural space on anterior side.
```
Central canal
Anterior gray commisure
Anterior white commisure
Pia mater
Subarachnoid space
Arachnoid mater
Subdural space
Dura mater
Epidural space
```
207
Midline structures (from posterior) from anterior epidural space to anterior longitudinal ligament.
```
Epidural space
Posterior longitudinal ligament
Anulus fibrosus
Nucleus pulposus
Anulus fibrosus
Anterior longitudinal ligament
```
208
Dorsal column of the SC contains fasciculus ______ and fasciculus _______
Gracilis
| Cuneatus
209
What spinal artery would supply the R fasciculus gracilus and R fasciculus cuneatus?
R posterior spinal artery
210
Which artery perfuses most of the posterior and anterior spinocerebellar tracts?
Anterior spinal artery
211
What artery supplies the anterolateral system
Anterior spinal artery
212
Composed of more than 1 pathways
System
213
Begins in the periphery, enters SC, runs up SC to brain; this sequence is called a __________
Pathway
214
Part of the pathway that is in the white matter of the SC or the white matter of the brain
Tract
215
Ascending sensory spinal pathways have _____ neurons in sequence up to the brain from the periphery. They are?
3
Primary
Secondary
Tertiary
216
Pain (fast and slow), temperature, light touch, pressure, tickle and itch are all info transmitted through ________ pathways
Spinothalamic pathway
217
Spinothalamic pathways begin in the ________ with free nerve endings
Periphery
218
With what two sensations, does the primary neuron of the spinothalamic tract cross over at the exact spinal segment it enters at?
Pain
| Temperature
219
Primary neuron synapses with secondary neuron where?
Posterior horn of the gray matter
220
Pathway of secondary tract up to synapsing with tertiary neuron:
Crosses over and enters spinothalamic tract; ascends up SC, medullar, pons, midbrain, and terminates in one of the nuclei of the thalamus
221
Where does the secondary neuron synapse with the tertiary neuron in a sensory spinothalamic pathways
Thalamus
222
Tertiary neuron travels up to the primary sensory cortex according to the __________
Sensory humunculus
223
Why are all other sensations difficult for the brain to localize, other than pain and temp?
When primary neuron enters, gives off collaterals that can ascend/descend a few spinal segments before entering the dorsal column of the gray matter
224
If interrupted tx in the primary neuron, what side would be affected? What area would be affected?
Same side/ipsilateral
Just the areas of the skin innervated by that primary neuron
225
If spinothalamic tract was interrrupted, which side affected? How much area affected?
Contralateral
Effects everything below the level of the lesion
226
What composes the dorsal column/medial lemniscal system? (2)
Fasciculus cuneatus
| Fasciculus gracilis
227
Type of information transmitted through dorsal column/medial lemniscal system?
Proprioception (conscious)
2 point discrimination
Pressure
Vibration
228
2 point discrimination; how close until feels like only one point: hand _____ mm; back: ______ mm
Hand 2-5 mm
Back ~ 20 mm
More sensory receptors on fingers
229
Dorsal column/medial lemniscal system begins with modified nerve ending called ________
Pacinian corpuscle
230
When primary neuron enters dorsal column of gray matter, it directly enters fasciculus cuneatus OR gracilis. TRUE/FALSE.
TRUE
231
Sensations from the midthorax, up to the neck are tx through fasciculus ___________
Cuneatus
232
Sensations from midthorax to the toes is tx through fasciculus ________
Gracilis
233
Primary neuron synapses with secondary neuron in the nucleus gracilis or cuneatus in the ___________ of the brain.
Medulla
234
The secondary neuron in the dorsal column/medial lemniscal system, crosses over at the ________ and enters the ___________ (runs up through pons/midbrain)
Crosses over at the medulla
Enters the medial lemniscus
235
2ndary neuron travels up medial lemniscus and terminates and synapses with the tertiary neuron where?
In a nucleus of the thalamus
236
What is the pathway of the tertiary neuron after medial lemniscus and thalamus?
Ascends up to primary sensory cortex, postcentral gyrus, according to the layout of the humonculus
237
Spinocerebellar pathways transmit primarily what type of info?
Unconscious proprioceptive
238
Spinocerebellar pathways start in the periphery with what two things?
Golgi tendon bodies
| Primary muscle spindles
239
Primary neuron of the spinocerebellar tract enters into dorsal horn of gray matter, synapses with nerve cell body of secondary neuron which enters into the posterior spinocerebellar tract on the SAME SIDE of the SC. TRUE/FALSE?
TRUE
240
The secondary neuron travels up posterior spinocerebellar tract, inbetween the medulla and pons, it goes back and synapses in the cerebellum on the SAME SIDE. TRUE/FASLE?
TRUE
241
The posterior spinocerebellar tract crosses over. TRUE/FALSE.
FALSE
Posterior DOES NOT cross over
242
Posterior spinocerebellar pathways do not cross over and have only 2 neurons in sequence; but the tertiary neuron is actually located where?
In the cerebellum
243
What is different about the anterior spinocerebellar tract?
It crosses over twice; ends up on the same side it entered
244
What two places does the neuron cross over in anterior spinocerebellar pathways.
Crosses over after synapsing with 2ndary in posterior gray horn into ant whit commisure of the opposite side
Crosses over again between medulla and pons
245
Descending motor pathways start where?
In the brain
246
Corticospinal pathways are part of the _________ pathways bc they pass through the pyramids on the ant/inf surface of the medulla.
Pyramidal pathways
247
Pathways that provide muscle movement from the neck, all the way down to the toes
Corticospinal pathways
248
Corticospinal pathways have to do with CONSCIOUS/UNCONSCIOUS muscle movement
CONSCIOUS
249
Corticospinal pathways start where?
Frontal lobe, precentral gyrus, primary motor cortex
250
Descending motor pathways are composed of _______ neurons in sequence
2
Upper motor neuron
Lower motor neuron
251
Lateral corticospinal pathways cross over the SC to the other side and enter the lateral corticospinal tracts on the opposite side at the medullar, at the pyramids; this composes ~ ____% of descending motor pathways.
80%
252
The remaining 20% of (anterior) corticospinal tracts, upper motor neurons travel down SC and cross over where?
At the spinal segment where the lower motor neuron will exit
253
Which ar the more important motor pathways of the corticospinal pathways?
Lateral corticospinal tracts
254
Interrupted tx in the anterior corticospinal tract will have __________ side effects.
Contralateral
255
Interruption of lateral corticospinal tract will affect __________ side
Ipsilateral
256
These pathways are for control of conscious skeletal muscle movements of the head and face
Corticobulbar pathways
257
Upper motor neurons of corticobulbar pathways originate in the ___________ according to the layout of the homunculus
Cerebral motor cortex
258
Lower motor neurons of corticobulbar pathways are _____________ with a motor component
Cranial nerves
259
Which cranial nerves have a motor component; acting as lower motor neurons in corticobulbar pathways?
```
III (oculomotor)
IV (trochlear)
V (trigeminal)
VI (abducens)
VII (facial)
IX (glossopharyngeal)
X (vagus)
XI (spinal accessory)
XII (hypoglossal)
```
260
The upper motor neurons of most (not all) corticobulbar motor pathways originate in both left and right primary motor cortices of the cerebral hemispheres. TRUE/FALSE
TRUE
261
Corticobulbar pathways contain only crossed fibers. TRUE/FALSE
FALSE
Pathways contain crossed and uncrossed fibers
262
These pathways do not cross through the pyramids of the medulla and are responsible for unconscious skeletal muscle movement
Extrapyramidal pathways
263
Extrapyramidal pathways integrate with what 2 things to bring about smooth muscle movement
Basal nuclei
| Cerebellar hemispheres
264
What type of drugs caused lots of extrapyramidal manifestations?
Old antipsychotic drugs
265
Extrapyramidal side effects include what?
```
Unsteady gait
Ataxia
Writhing arm movements
Lip smacking
Tongue rolling
```
266
What drug can we give to control extrapyramidal manifestations?
Benadryl
267
Hemisection, or incomplete, SC lesion.
Brown-sequard syndrome
268
With Brown-Sequard syndrome, there is CONTRALATERAL/IPSILATERAL upper motor neuron damage and loss of proprioception.
Ipsilateral
269
With Brown-Sequard syndrome, there is CONTRALATERAL/IPSILATERAL loss of pain and temperature sensation.
CONTRALATERAL
