Mcw: Clinical Human Anatomy, Block 1

Front 1

Describe the "Anatomic Position".

Back 1

- Erect or lying supine
- Arms at sides
- Palms face forward
- Legs together
- Feet directed forward

Front 2

What are the four "Anatomic Planes"?

Back 2

1. Median (Midsagittal) Plane
2. Sagittal Plane
3. Frontal (Coronal) Plane
4. Transverse (Horizontal) Plane

Front 3

Describe the "Median (Midsagittal) Plane".

Back 3

- Vertical plane
- Divides body equally into left and right

Front 4

Describe the "Sagittal Plane".

Back 4

- Vertical plane
- Parallel to "Median (Midsagittal) Plane"
- Off of midline

Front 5

Describe the "Frontal (Coronal) Plane".

Back 5

- Vertical plane
- Perpendicular to "Median (Midsagittal) Plane"
- Divides body into anterior and posterior sections

Front 6

Describe the "Transverse (Horizontal) Plane".

Back 6

- Perpindicular to "Median (Midsagittal) Plane" and "Frontal (Coronal) Plane"
- Divides body by cross sections

Front 7

Define the difference between the terms "Superficial" and "Deep".

Back 7

- Superficial is close to the surface of the body
- Deep is close to the center of the body

Front 8

Define the difference between the terms "Medial" and "Lateral".

Back 8

- Medial is toward the median (midline / midsagittal plane)
- Lateral is away from the median

Front 9

Define the difference between the terms "Anterior" and "Posterior". What are the interchangeable terms for these?

Back 9

- Anterior, or Ventral, is toward the front aspect of the body
- Posterior, or Dorsal, is toward the back aspect of the body

Front 10

Define the difference between the terms "Palmar" and "Plantar".

Back 10

- Palmar is the ventral side of the hand; Dorsal is used for the back of the hand
- Plantar is the sole of the foot; Dorsal is used for the top of the foot

Front 11

Define the difference between the terms "Superior" and "Inferior". What other terms can be interchanged for these?

Back 11

- Superior, or Cephalic, or Rostral, is toward the head
- Inferior, or Caudal, is toward the feet

Front 12

Define the difference between the terms "Proximal" and "Distal".

Back 12

- Proximal is close to the median or near the origin of a structure
- Distal is away from the origin of a structure

Front 13

Define the difference between the terms "Prone" and "Supine". Provide examples for clarification.

Back 13

- Prone is anterior surface down (e.g. laying on your stomach)
- Supine is anterior surface up (e.g. laying on your back)

Front 14

Define the difference between the terms "Extrinsic" and "Intrinsic".

Back 14

- Extrinsic originates outside of a part
- Intrinsic is located entirely within a part

Front 15

Define the difference between the terms "Varus" and "Valgus".

Back 15

- Varus - angulation of a body segment towards the midline
- Valgus - angulation of a body segment away from the midline

Front 16

What are the four terms of laterality?

Back 16

1. Bilateral
2. Unilateral
3. Ipsilateral
4. Contralateral

Front 17

Which term for laterality is used to describe paired structures?

Back 17

Bilateral

Front 18

Which term for laterality is used to describe structures that only occur on one side of the body?

Back 18

Unilateral

Front 19

Which term for laterality is used to relate two structures on the same side as each other?

Back 19

Ipsilateral

Front 20

Which term for laterality is used to relate two structures on the opposite side as each other?

Back 20

Contralateral

Front 21

Define the difference between the terms "Flexion" and "Extension". Provide examples.

Back 21

- Flexion decreases the angle between body parts (e.g. bending arm at elbow)
- Extension increases the angle between body parts (e.g. straightening leg at knee)

Front 22

Define the difference between the terms "Abduction" and "Adduction".

Back 22

- Abduction is movement away from the median
- Adduction is movement towards the median

Front 23

Define the difference between the terms "Medial Rotation" and "Lateral Rotation". Provide examples.

Back 23

- Medial rotation is movement of the anterior surface toward the median (e.g. bringing flexed arm across chest)
- Lateral rotation is movement of the anterior surface away from the median (e.g. directing the head to the side)

Front 24

Define the difference between the terms "Elevation" and "Depression".

Back 24

- Elevation raises or moves a structure superiorly
- Depression lowers or moves a structure inferiorly

Front 25

Define the difference between the terms "Protraction" and "Retraction". Provide examples.

Back 25

- Protraction moves a structure anteriorly (e.g. stick tongue out of mouth)
- Retraction moves a structure toward the median (e.g. withdrawing tongue)

Front 26

What terms of movement does "Circumduction" combine?

Back 26

- Flexion / Extension
- Abduction / Adduction

Front 27

Which joint specific terms of movement refer to rotations of the forearm? What do these terms specifically describe?

Back 27

- Pronation - medial rotation so that palm faces posteriorly
- Supination - lateral rotation so that palm faces anteriorly

Front 28

Which joint specific terms of movement refer to rotations of the foot? What do these terms specifically describe?

Back 28

- Inversion - rotates the plantar surface inward
- Eversion - rotates the plantar surface laterally

Front 29

Which joint specific terms of movement refer to rotations of the ankle joint? What do these terms specifically describe?

Back 29

- Plantar flexion - downward flexion (flexion) of the foot
- Dorsiflexion - upward flexion (extension) of the foot

Front 30

Which joint specific terms of movement refer to rotations of the temporomandibular joint? What do these terms specifically describe?

Back 30

- Protrusion - anterior movement of the mandible
- Retrusion - posterior movement of the mandible

Front 31

Which joint specific terms of movement refer to rotations of the hand at the wrist? What do these terms specifically describe?

Back 31

- Radial deviation - abduction of the hand (movement away from median)
- Ulnar deviation - adduction of the hand (movement towards the median)

Front 32

Which joint specific term of movement refers to rotation of the thumb?

Back 32

Opposition / Reposition - rotation about a complex axis (uniquely human characteristic)

Front 33

What are the four ways that bones can be classified?

Back 33

1. Shape
2. Location
3. Structure
4. Development

Front 34

What are the types of bone shapes?

Back 34

1. Long bones
2. Short bones
3. Flat bones
4. Irregular bones
5. Sesamoid bones

Front 35

What are the two portions of the skeleton?

Back 35

- Axial (skyll, vertebral column, ribs, sternum, and hyoid)
- Appendicular (limbs and pectoral and pelvic girdle)

Front 36

What are the two ways bones can be differentiated based on structure?

Back 36

- Compact
- Spongy

Front 37

What are the two ways that bones can be distinguished based on development?

Back 37

- Membranous bone
- Endochondral (cartilaginous) bone

Front 38

Joints can be classified by the substances that unite the bones; what are the three categories?

Back 38

1. Fibrous - bones connected by fibrous tissue
2. Cartilaginous - bones connected by cartilage
3. Synovial - joint cavity lined by synovial membrane

Front 39

What kind of movement occurs at a fibrous joint? Give two examples of this kind of joint.

Back 39

- Minimal or no movement
- Syndesmoses (inferior tibiofibular)
- Sutures (skull)

Front 40

What kind of movement occurs at a cartilaginous joint? Give two examples of this kind of joint.

Back 40

- Movement depends upon the compressibility of the intervening fibrocartilage (no gliding)
- Primary - located between epiphysis and diaphysis (disappear with age)
- Secondary (aka symphyses) - strong, slightly movable joints (e.g., intervertebral discs)

Front 41

What kind of movement occurs at a synovial joint?

Back 41

- Bones slide across one another

Front 42

What is the most common type of joint?

Back 42

Synovial joint (bones slide across one another)

Front 43

What are the components of a synovial joint?

Back 43

1. Articular Cartilage
2. Fibrous Capsule
3. Synovial Membrane

Front 44

Describe the "Articular Cartilage" that contributes to the structure of a Synovial Joint?

Back 44

- The areas of the bone that come in contact, the articular surfaces, are usually covered with "Hyaline Cartilage"
- This receives no blood vessels or nerves

Front 45

Describe the "Fibrous Capsule" that contributes to the structure of a Synovial Joint?

Back 45

- Attached to the bones away from the site of contact
- Completely encases the joint

Front 46

Describe the "Synovial Membrane" that contributes to the structure of a Synovial Joint?

Back 46

- Thin membrane inside of the fibrous capsule
- Secretes a thin film of fluid within the synovial cavity that permits smooth movements between bones

Front 47

What are the six types of Synovial Joints?

Back 47

1. Plane
2. Hinge
3. Saddle
4. Condyloid
5. Ball and Socket
6. Pivot

Front 48

Describe a "Plane" Synovial Joint and give an example.

Back 48

- Articular surfaces are flat; joint permits gliding motions
- e.g., intercarpal

Front 49

Describe a "Hinge" Synovial Joint and give an example.

Back 49

- Permits flexion and extension only
- e.g., elbow

Front 50

Describe a "Saddle" Synovial Joint and give an example.

Back 50

- Permits ab/adduction and flexion/extension
- e.g., carpometacarpal joint of thumb

Front 51

Describe a "Condyloid" Synovial Joint and give an example.

Back 51

- Permits ab/adduction and flexion/extension, although movement in one plane is usually greater
- e.g., wrist

Front 52

Describe a "Ball and Socket" Synovial Joint and give an example.

Back 52

- Allows movement in multiple axes and planes
- e.g., shoulder

Front 53

Describe a "Pivot" Synovial Joint and give an example.

Back 53

- Permits rotation around a central axis
- e.g., superior radioulnar

Front 54

What is Hilton's Law (re: nerve supply to joints)?

Back 54

Innervation of joints is generally by branches of nerves that either supply the muscles acting at that joint or the skin covering the joint

Front 55

How many vertebrae are there at birth compared to how many there are as an adult?

Back 55

- 33 vertebrae at birth (5 sacral and 4 coccygeal fuse)
- 26 vertebrae as adult (7 cervical, 12 thoracic, 5 lumbar, 1 sacrum, and 1 coccyx)

Front 56

What separates the individual vertebrae? Function?

Back 56

Intervertebral discs - fibrocartilage acts as shock absorbers

Front 57

What is the structure of the intervertebral discs?

Back 57

- Tough outer "Annulus Fibrosus"
- Inner "Nucleus Pulposus"

Front 58

What does the spinal cord run through?

Back 58

Vertebral Foramina

Front 59

What are the spinal cord and brain bathed in?

Back 59

Cerebrospinal Fluid (CSF)

Front 60

Between what layers is the cerebrospinal fluid (CSF) found?

Back 60

- Pia mater
- Arachnoid mater

Front 61

What passes through the intervertebral foramina?

Back 61

Spinal Nerves (31 pairs)
(Intervertebral foramina are formed by successive vertebrae)

Front 62

What are the two types of curvatures of the spine and how are they differentiated?

Back 62

- Primary Curvatures - develop during fetal period; concave anteriorly (thoracic and sacral)
- Secondary Curvatures - develop in response to forces generated by holding head (cervical) and walking (lumbar); convex anteriorly

Front 63

What are the three types of abnormal curvatures of the spine?

Back 63

- Kyphosis
- Lordosis
- Scoliosis

Front 64

What is "Kyphosis"?

Back 64

- "Hunchback" - increase in posterior curvature of spine

Front 65

What causes "Kyphosis"?

Back 65

- Most commonly "postural kyphosis" (due to bad posture)
- Also caused by resorption of the anterior parts of the thoracic vertebral bodies from osteoporosis

Front 66

What is "Lordosis"?

Back 66

Abnormal increase in the anterior curvature of the spine; can lead to lower back pain

Front 67

What causes "Lordosis"?

Back 67

- May be caused by weakening of anterior abdominal wall musculature as a result of weight gain
- Or may be transiently manifested in pregnant women due to anterior fetal protrusion in abdomen

Front 68

What is "Scoliosis"?

Back 68

Abnormal lateral curvature of spine

Front 69

What causes "Scoliosis"?

Back 69

May be caused by an absent half of a vertebra or a wedge-shaped vertebra, or by an asymmetric weakness in back musculature

Front 70

What are the five important ligaments to know for the vertebral column?

Back 70

- Anterior Longitudinal Ligament
- Posterior Longitudinal Ligament
- Supraspinous Ligaments
- Ligamentum Flavum
- Interspinous Ligaments

Front 71

Where does the Anterior Longitudinal Ligament run?

Back 71

- Superior to Inferior in front of vertebral bodies
- Connects adjacent vertebrae
- Runs from occipital bone (skull) to sacrum

Front 72

What is the function of the Anterior Longitudinal Ligament?

Back 72

- Helps secure intervertebral discs
- Prevents hyperextension of vertebral column

Front 73

What can happen during whiplash to a specific ligament of the vertebral column?

Back 73

Cervical hyperextension of the anterior longitudinal ligament

Front 74

Where does the Posterior Longitudinal Ligament run?

Back 74

- Runs on posterior aspect of vertebral bodies (inside the vertebral canal)
- Runs from axis (C2) to sacrum
- Continuous with tectorial membrane (which attaches to occipital bone superiorly)

Front 75

What is the function of the Posterior Longitudinal Ligament?

Back 75

Helps prevent hyper-flexion of vertebral column and posterior protrusion of discs (herniation)

Front 76

Which ligament of the vertebral column helps prevent herniation?

Back 76

Posterior Longitudinal Ligament (if hyper-flexed, disc may protrude)

Front 77

Where does the Supraspinous Ligament run?

Back 77

Attaches to tips of adjacent vertebral spines (posterior side of vertebrae)

Front 78

In the cervical region, what two ligaments combine and thicken to form the Ligamentum Nuchae?

Back 78

Supraspinous and Interspinous Ligaments

Front 79

What does the Ligamentum Flavum connect to?

Back 79

Connects to lamina of adjacent vertebrae

Front 80

Which ligament of the vertebral column is yellowish in color?

Back 80

Ligamentum Flavum

Front 81

What does the Interspinous Ligament connect?

Back 81

Connects adjacent vertebral spines

Front 82

Spinal arteries supply blood to what areas?

Back 82

- Vertebral column
- Nerve roots
- Spinal cord

Front 83

The spinal arteries take origin from what other arteries?

Back 83

Many:
- Cervical region: occipital, vertebral, deep cervical, and ascending cervical
- Thoracic region: posterior intercostals
- Lumbar region: subcostal and lumbars
- Sacral region: iliolumbar and lateral sacrals

Front 84

If the blood supply is disrupted to the spinal cord, what can result?

Back 84

- Paresis (weakness)
- Paralysis (loss of function)

Front 85

Which veins are important for returning blood to the heart from the back? Where are they located, generally speaking?

Back 85

- External vertebral venous plexus (external to vertebral column)
- Internal vertebral venous plexus (within vertebral canal)

Front 86

What do the vertebral venous plexuses drain into?

Back 86

- Vertebral vein
- Intercostal vein
- Lumbar vein
- Lateral sacral vein

Front 87

Why is it important to note that the vertebral venous plexuses connect freely between the neck, thorax, abdomen, and pelvis?

Back 87

May provide a route for the spread of infection or cancerous cell metastasis to the vertebrae, spinal cord, and/or brain

Front 88

What are the three layers of muscle in the back?

Back 88

- Superficial (extrinsic muscles)
- Intermediate (extrinsic muscles)
- Deep (intrinsic muscles)

Front 89

What muscles should be known from the "superficial" muscle group of the back?

Back 89

- Trapezius
- Latissimus dorsi
- Levator scapulae
- Rhomboids major and minor

Front 90

Where do the "superficial" muscles of the back connect to?

Back 90

Shoulder girdle; connect appendicular to axial skeleton

Front 91

What muscles should be known from the "intermediate" muscle group of the back?

Back 91

- Serratus posterior superior
- Serratus posterior inferior

Front 92

What are the "serratus posterior superior and inferior" muscles used for?

Back 92

Respiration

Front 93

Injury to what muscles would hinder respiration?

Back 93

Serratus posterior superior and inferior muscles

Front 94

What muscles should be known from the "deep" muscle group of the back?

Back 94

- Erector spinae: spinalis (medial), longissimus (intermediate), iliocostalis (lateral)
- Splenius
- Semispinalis
- Multifidus
- Rotatores

Front 95

What is the function of the deep erector spinae muscles?

Back 95

Extension of the vertebral column

Front 96

Injury to which muscles usually causes "back strain" due to excessive extension and/or lateral rotation of the vertebral column?

Back 96

Erector spinae muscles (spinalis, longissimus, and iliocostalis)

Front 97

Which area of the back is easiest to hear breath sounds from from a stethoscope?

Back 97

"Auscultatory Triangle" - bounded by the latissimus dorsi, trapezius, and medial border of scapula; rhomboid major forms the floor

Front 98

Where does the spinal cord run to and from?

Back 98

- Starts at the foramen magnum with the medulla oblongata of the brain
- Terminates at the L1 or L2 vertebra with the "Conus Medullaris"

Front 99

What surrounds and protects the spinal cord?

Back 99

- Three meninges: dura mater, arachnoid mater, and pia mater
- CSF in subarachnoid space

Front 100

Where are the enlargements of the spinal cord? What comes off of these enlargements?

Back 100

- Cervical and lumber enlargements
- Gives origin to the brachial and lumbar plexuses

Front 101

The spinal cord tapers off to form what structure?

Back 101

Conus medullaris

Front 102

The pia mater extends past the conus medullaris (inferior end of spinal cord) to form what?

Back 102

- Filum terminale
- Extends from the conus medullaris to the posterior surface of the coccyx

Front 103

How many spinal nerves are there? How do they connect to the spinal cord?

Back 103

- 31 pairs of spinal nerves
- Attach to spinal cord by ventral (motor) and dorsal (sensory) roots

Front 104

Which of the two "roots" of the spinal nerves has a ganglion?

Back 104

Dorsal root (ganglion) - contains sensory information

Front 105

The lumbar and sacral nerves extend downward to form what structure?

Back 105

"Cauda Equina" = horse's tail; vertical leash of nerves around the filum terminale (extension of pia mater)

Front 106

After the spinal nerve emerges from the intervertebral foramen, it divides into what structures?

Back 106

- Large ventral ramus
- Smaller dorsal ramus
- Both contain motor and sensory fibers

Front 107

Which of the three meninges of the spinal cord is the most external? What is it made of?

Back 107

Dura mater - made of dense fibrous tissue

Front 108

Which of the three meninges of the spinal cord is in the middle?

Back 108

Arachnoid mater - delicate, impermeable membrane

Front 109

What separates the arachnoid mater from the pia mater?

Back 109

A wide space called the subarachnoid space, which is filled with CSF

Front 110

Which of the three meninges of the spinal cord is closest to the spinal cord?

Back 110

Pia mater - vascular membrane

Front 111

What structure represents the thickened pia mater between the nerve roots?

Back 111

Denticulate Ligament

Front 112

How can you distinguish a cervical vertebrae from the other types of vertebrae?

Back 112

- Smallest vertebral body
- Foramen within transverse process (foramen transversarium)

Front 113

How can you distinguish a thoracic vertebrae from the other types of vertebrae?

Back 113

- Medium sized vertebral body
- Facets for rib tubercle on transverse process

Front 114

How can you distinguish a lumbar vertebrae from the other types of vertebrae?

Back 114

- Largest vertebral bodies
- Short vertebral spines
- No foramen or facet for rib on the transverse process

Front 115

What are the two special vertebrae?

Back 115

- Atlas (C1) - holds up the head
- Axis (C2) - contains "dens" or "odontoid process" on which atlas turns

Front 116

Which of the cervical vertebrae is the strongest?

Back 116

Axis (C2)

Front 117

What is the bump on the back of the skull called above the nape of the neck? (Surface Anatomy)

Back 117

External Occipital Protuberance

Front 118

Along the midline of the back, what structures can be felt? (Surface Anatomy)

Back 118

Spinous processes of vertebrae

Front 119

What bony structure can be felt running diagonally from the back of the shoulder towards the middle of the back on either side? (Surface Anatomy)

Back 119

Spine of Scapula

Front 120

What structure on the top of the shoulder can be felt that the clavicle articulates with? (Surface Anatomy)

Back 120

Acromion of Scapula

Front 121

What pointy structure can be felt on the middle of either side of the back (bottom of the "shoulder blade")? (Surface Anatomy)

Back 121

Inferior angle of scapula

Front 122

Heading medially and superiorly from the "inferior angle of the scapula" what structure can be felt? (Surface Anatomy)

Back 122

Medial Border of the Scapula

Front 123

Which superficial back muscle can be felt extending from the upper back through the neck? (Surface Anatomy)

Back 123

Trapezius

Front 124

Which superficial back muscle covers the ribs? (Surface Anatomy)

Back 124

Latissimus dorsi

Front 125

The top of the hip bone that can be felt on the lower back is called what? (Surface Anatomy)

Back 125

Iliac Crest

Front 126

What are the two important joints to know between vertebrae?

Back 126

- Intervertebral Joint / Symphysis
- Zygapophyseal Joint / Facet

Front 127

The Intervertebral Joint / Symphysis is found where? What does it consist of?

Back 127

In between the bodies of adjacent vertebrae; Filled with intervertebral disc for additional weight support (secondary cartilaginous joints)

Front 128

The Zygapophyseal Joints / Facets are found where?

Back 128

In between the inferior articular process of the superior vertebrae and the superior articular process of the inferior vertebrae

Front 129

What is the purpose of the zygapophyseal joint?

Back 129

- Assists in keeping adjacent vertebrae aligned
- In particular, prevents one vertebra from slipping anteriorly on the vertebra below

Front 130

What makes up the intervertebral disc?

Back 130

- Pads of fibrocartilage
- Anulus fibrosus (outer fibrous portion)
- Nucleus pulposus (watery for absorbing shock)
- Permit movement between adjacent vertebrae

Front 131

Which arteries supply the spinal cord with blood?

Back 131

- 1 anterior and 2 posterior spinal arteries arise from the vertebral arteries (these only sufficient to supply the upper cervical spinal cord levels)
- Reinforced by radicular arteries (branch off of the posterior intercostal arteries)

Front 132

Where do the spinal nerves run? How does this make them vulnerable?

Back 132

- They leave the spinal cord via the ventral and dorsal root where they combine to form the spinal nerve
- This runs through the space between intervertebral foramina (between adjacent pedicles, vertebral bodies, intervertebral discs, and articular processes)
- Herniation of the disc, fracture of vertebral bodies, and osteoarthritis of neighboring joints can put pressure on the nerves

Front 133

Spinal nerves are above/below which vertebrae?

Back 133

- C1-C7 spinal nerves go above the vertebra of the corresponding number
- C8 and inferior spinal nerves go below the vertebra of the corresponding number (although C8 goes below C7 vertebra)

Front 134

Based on where spinal nerves are positioned relative to the corresponding vertebrae, when a herniated disc appears, which spinal nerve will it affect? Provide an example.

Back 134

- E.g., if the intervertebral disc between L4 and L5 herniates, the L5 spinal nerve will be affected
- Spinal nerves beyond C8 go laterally above the intervertebral disc below their corresponding vertebrae

Front 135

Where does the spinal cord end (in terms of which vertebrae) in the adult?

Back 135

- At Conus Medullaris (vertebral level L1-L2)
- Cauda Equina (extension of spinal nerves beyond L1/L2 level which descend inferiorly until their respective exits

Front 136

Where does the spinal cord end (in terms of which vertebrae) in the infant?

Back 136

- Beyond L1-L2 (adult)
- Approximately at L3
- The difference is due to the spinal cord halting growth in early childhood while the skeletal system continues to grow

Front 137

What does "bifidus" (as seen in the disorder Spina Bifida?

Back 137

Cleft in two parts

Front 138

What occurs abnormally in the disorder Spina Bifida?

Back 138

- Vertebral laminae fail to fuse
- Lack of spinous process
- Usually at lower lumbar or sacral levels

Front 139

What are the four specific types of Spina Bifida?

Back 139

- Spina bifida occulta
- Spina bifida cystica
- Spina bifida cystica with meningocele
- Spina bifida cystica with meningomyelocele

Front 140

What occurs in the specific disorder "Spina Bifida Occulta"?

Back 140

- "cultus" = to cover or hide
- One or more spinus processes fail to form at lumbar or sacral levels
- Usually asymptomatic
- Often goes unrecognized and may be marked by a tuft of hair in skin over the defect
- Mildest form of spina bifida

Front 141

What occurs in the specific disorder "Spina Bifida Cystica"?

Back 141

- "kystis" - bladder
- A cyst protrudes through the defect in the vertebral arch
- Can be diagnosed in utero based on elevated levels of alpha-fetoprotein and amniocentesis and by ultrasound imaging
- May result in hydrocephalus ("water in the brain") and neurological deficits

Front 142

What occurs in the specific disorder "Spina Bifida Cystica with Meningocele"?

Back 142

- "meninx" - membrane; "kele" - tumor
- Protrusion of the membranes of the spinal cord through a defect in the spinal column
- The "cyst" is lined by the meninges and contains CSF

Front 143

What occurs in the specific disorder "Spina Bifida Cystica with Meningomyelocele"?

Back 143

- "meninx" - membrane; "kele" - tumor; "myelos" - marrow
- Protrusion of the membranes and spinal cord through the defect in the vertebral column
- Displacement of the cord stretches lumbosacral spinal nerves and results in bladder, bowel, or lower limb weakness

Front 144

What is the route in which malignant diseases can be spread from the pelvis to the skull?

Back 144

Vertebral Venous Plexus

Front 145

What tissues are passed through when giving a spinal tap?

Back 145

- Skin
- Fascia
- Interspinous Ligament
- Ligamentum Flavum
- Fatty Tissue
- Internal Vertebral Venous plexus
- Dura Mater
- Arachnoid Mater (into subarachnoid space where CSF is taken)

Front 146

What is the procedure for giving a spinal tap?

Back 146

- Fourth lumbar spine is identified by passing an imaginary line between the highest points on the iliac crests
- Patient lies on side with vertebral column well flexed (hunched like cat)
- Lumbar puncture needle is passed through vertebral canal either above or below 4th lumbar spine

Front 147

What occurs in the specific disorder "Spinal Cord Ischemia"?

Back 147

- Blood supply to the spinal cord is meager
- Anterior and posterior spinal arteries have small and variable diameters
- Reinforcing segmental arteries vary in number and size
- Ischemia of spinal cord can easily follow minor damage to the arterial supply as a result of regional anesthesia, pain block procedures, or aortic surgery

Front 148

What occurs in the specific disorder "Spondylitis"?

Back 148

- "spondylos" = vertebra; "itis" = inflammation
- Inflammation of one or more of the vertebrae
- Can result in additional bone growth by osteoblasts at margins of vertebral bodies
- Anterior longitudinal ligament and the sacroiliac joints may undergo calcification
- Ankylosis = joint stiffening

Front 149

What occurs in the specific disorder "Spondylolysis"?

Back 149

- "lysis" = loosening
- A loosening of the firm attachment of the contiguous vertebrae
- Involves degenerative changes in intervertebral disks
- Additional bone growth by osteoblasts at margins of vertebral bodies

Front 150

What occurs in the specific disorder "Spondylolisthesis"?

Back 150

- "olisthesis" - a slipping and falling
- Forward movement of the body of a lower lumbar vertebra on the vertebra below it, or upon the sacrum
- "Scotty dog appears decapitated" - lengthened isthmus or "neck"

Front 151

What does the Central Nervous System (CNS) consist of? What is its function?

Back 151

- Brain and Spinal Cord
- Center of perception
- Site of integration of sensory information
- Initiation and coordination of motor activity

Front 152

What does the Peripheral Nervous System (PNS) consist of? What is its function?

Back 152

- Includes cranial nerves and spinal nerves
- Conveys neural impulses to the CNS as input from sense organs/receptors
- Receives output from CNS to go to muscles and glands of body

Front 153

What's the difference between a nerve and a tract?

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- Nerve is a collection of nerve fibers that carry information toward and away from the CNS (within the PNS)
- Tract - collection of nerve fibers within the CNS

Front 154

Where is a "nerve" found?

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Within the PNS

Front 155

Where is a "tract" found?

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Within the CNS

Front 156

What's the difference between a ganglion and a nucleus?

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- Ganglion - collection of cell bodies outside the CNS (within the PNS)
- Nucleus - collection of cell bodies within the CNS

Front 157

What is the difference between afferent and efferent neurons?

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- Efferent = motor neurons, carry nerve impulses away from the CNS to effectors such as muscles and glands (via ventral root)
- Afferent = sensory or receptor neurons, carry nerve impulses from receptors or sense organs toward the CNS (via dorsal root)

Front 158

Afferent neurons go towards or away from the CNS?

Back 158

Towards (carrying sensory information)

Front 159

Efferent neurons go towards or away from the CNS?

Back 159

Away (carrying motor impulses)

Front 160

Describe the Somatic Nervous System.

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- External part of body
- Afferent portion includes the neural structures of the CNS and PNS that are involved in conveying and processing conscious and unconscious sensory information
- Efferent portion includes the neural structures of the CNS and PNS that are involved in motor control of voluntary muscle

Front 161

Describe the Visceral Nervous System?

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- Internal part of body
- Afferent portion includes the neural structures that convey sensory information from the splanchnic (visceral) part of body
- Autonomic NS (motor only) - contains neural structures of CNS and PNS that are involved in motor activities influencing the involuntary (smooth) and cardiac musculature and glands of viscera and skin

Front 162

What are the two branches of the Visceral Nervous System?

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Autonomic NS (motor only):
- Parasympathetic NS
- Sympathetic NS

Front 163

Describe the Sympathetic Nervous System.

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- A branch of the Visceral NS / Autonomic NS
- Stimulates activities that are mobilized by the organism during emergency and stress situations
- Fight, fright, and flight response
- AKA thoracolumbar or adrenergic system

Front 164

Describe the Autonomic Nervous System.

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- A branch of the Visceral NS / Autonomic NS
- Stimulates activities that are associated with conservation and restoration of body resources
- AKA craniosacral system or cholinergic system

Front 165

What are the four "general neural modalities"?

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- GSE = general somatic efferent
- GSA = general somatic afferent
- GVE = general visceral efferent
- GVA = general visceral afferent

Front 166

Describe the basic function of GSE neuron(s).

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- General Somatic Efferent
- Innervate voluntary striated muscles of the head, body wall, and extremities

Front 167

Describe the basic function of GSA neuron(s).

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- General Somatic Afferent
- Conveys sensory input regarding pain, temperature, touch, and proprioception from the head, body wall, and extremities to the CNS

Front 168

Describe the basic function of GVE neuron(s).

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- General Visceral Efferent
- Innervates smooth muscles, cardiac muscles, and glands to provide motor input

Front 169

Describe the basic function of GVA neuron(s).

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- General Visceral Afferent
- Conveys sensory information from the visceral organs to the CNS

Front 170

How many neurons are needed to carry a signal from the periphery to the CNS (GSA and GVA)? Describe the pathway.

Back 170

- Two: one peripheral and one central
- Peripheral - cell body in dorsal root; pseudounipolar; distal end is a free nerve ending or in contact with a receptor; proximal end enters spinal cord through dorsal root; synapses with central neuron
- Central neuron - lies completely in the gray matter of spinal cord or brain stem; sends axons to higher centers of brain

Front 171

How many neurons are needed to carry a signal from the CNS to the periphery (GSE)? Describe the pathway.

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- One: only a peripheral neuron
- Peripheral - cell bodies of motor neurons lie in gray matter of brain stem (cranial nerves) or ventral horns of spinal cord gray matter (spinal nerves); axon courses through a cranial nerve or spinal nerve to make synaptic connections with voluntary muscle fibers at NMJ

Front 172

Where are the nerve cell bodies for GSA and GVA pathways?

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- Peripheral neuron cell body in dorsal root ganglion
- Central neuron cell body in gray matter of spinal cord or brainstem

Front 173

Where are the nerve cell bodies for GSE pathways?

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- Peripheral neuron cell body in gray matter of brain stem (cranial nerves)
- Peripheral neuron cell body in gray matter of ventral horn (spinal nerves)

Front 174

Through which root do the sensory (GSA and GVA) nerves enter the spinal cord / brainstem?

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Dorsal root

Front 175

Through which root do the sensory (GSE and GVE) nerves exit the spinal cord / brainstem?

Back 175

Ventral root

Front 176

How many neurons are needed to carry a signal from the CNS to the periphery (GVE)? Describe the pathway.

Back 176

- Two peripheral neurons
- Preganglionic neuron - originates in gray matter of brain stem or lateral horn of spinal cord gray matter; myelinated axon courses through a cranial/spinal nerve; terminates by synapsing on postganglionic neuron located in a ganglion outside CNS
- Postganglionic Neuron - cell body in postganglionic neuron; unmyelinated axon extends peripherally to terminate in smooth muscles, cardiac muscle, or glands

Front 177

Where are the nerve cell bodies for GVE pathways?

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- Preganglionic neuron - cell body located in gray matter of brain stem or lateral horn of spinal cord gray matter
- Postganglionic neuron - cell body in autonomic ganglion

Front 178

In what case are preganglionic and postganglionic neurons found?

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- General Visceral Efferent (GVE)
- Preganglionic neuron starts in gray matter and is myelinated
- Postganglionic neuron starts in autonomic ganglion and is unmyelinated and ends on smooth muscle, cardiac muscle, and glands

Front 179

Describe a typical spinal nerve.

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- Leaving the spinal cord are two branches, the dorsal root and ventral root
- Dorsal root contains sensory neurons returning to the CNS; dorsal root ganglion contains cell body of sensory neurons
- Ventral root contains motor neurons leaving the CNS
- Dorsal and ventral roots come together to form "spinal nerve" containing both sensory and motor fibers
- The spinal nerve divides into the dorsal and ventral rami
- Dorsal ramus contains mixed fibers going to the deep back muscles/skin
- Ventral ramus contains mixed fibers going to the trunk and limbs

Front 180

What are the two types of GVE neurons?

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- Sympathetic
- Parasympathetic

Front 181

Specifically, how do sympathetic fibers leave the spinal cord to reach their targets?

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- Sympathetic preganglionic fibers start in cell bodies in spinal levels T1-L2 ("thoracolumbar") and pass through:
- Ventral roots and into spinal nerve
- Ventral primary rami
- Myelinated white rami communicans
- Sympathetic chain (synapses at paravertebral ganglia)
- Postganglionic fibers pick up at sympathetic chain (paravertebral ganglia) and pass through:
- Unmyelinated gray rami communicans
- Spinal nerve
- Destination: skin, blood vessels, arrector pili muscles, glands, muscles of body wall and extremities

Front 182

What is meant by the "thoracolumbar outflow"?

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- Exit of sympathetic preganglionic fibers through the ventral roots
- These fibers enter the spinal nerves and then go on to their destinations

Front 183

If a sympathetic preganglionic nerve does not synapse at the paravertebral ganglia, where can it also synapse?

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- Pass through sympathetic chain to form a splanchnic nerve
- This leads to a prevertebral ganglion from the cervical to coccygeal regions

Front 184

What is the difference between the kinds of transmitters the sympathetic preganglionic and postganglionic nerves use?

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- Preganglionic: cholinergic they release acetylcholine
- Postganglionic: adrenergic they release norepinephrine

Front 185

Where do the postganglionic fibers that came from the prevertebral ganglion (as opposed to the normal paravertebral ganglion) lead to?

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Splanchnic nerves and perivascular plexuses lead to the visceral structures of the head, neck, thorax, abdomen, and pelvis

Front 186

When are the white rami communicans and gray rami communicans used?

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- White rami communicans: sympathetic PREganglionic fibers pass through here after leaving the ventral rami; this leads to the sympathetic chain with the paravertebral ganglia (myelinated)
- Gray rami communicans: sympathetic POSTganglionic fibers pass through here after leaving the paravertebral ganglia; this leads back to the spinal nerve and off to the destination of the nerve (not myelinated)

Front 187

What is a dermatome?

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- An area of skin that is mainly supplied by a single spinal nerve (there is some overlap)
- Each of these nerves relays sensation from a particular region of skin to the brain

Front 188

What is a myotome?

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- The muscles served by a single nerve root
- Motor equivalent of a dermatome