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44 Cards in this Set

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Where does the spinal cord end?

Ends at approximately the distal portion of L1 in the adult.

What does the cervical enlargement contribute to?

brachial plexus

What does the lumbar enlargement contribute to?

lumbosacral plexus

What is the conus medullaris?

Tapering distal end of spinal cord located in the lumbar region, usually ending at the L1-L2 level.

What is the cauda equina?

Collection of nerve roots located distal to the terminal end of the spinal cord within the spinal canal

A (conus medullaris), B (cauda equina), C (filum terminale)

What is grey matter composed of?

Neurons (Motor neurons, interneurons, ascending tract neurons) and glial cells.

What is white matter composed of?

Ascending tract neurons and descending tract neurons.

What is the dorsal horn (grey matter) concerned with?

Processing of sensory information

What is the ventral horn (grey matter) concerned with?

Motor nuclei (organized into columns)

What kind of information does a ventral root carry? Where are it's cell bodies located?

-Carries efferent motor axons to the periphery




-Its cell bodies are found within the ventral horn of the spinal cord grey matter

What kind of information does a dorsal root carry? Where are it's cell bodies located?

-Carries afferent sensory axons to the spinal cord.




-Its cell bodies are located in the dorsal root ganglion which are located in or near the intervertebral foramen.

What makes up a spinal nerve?

At each intervertebral foramen the ventral and dorsal roots unite to form a spinal nerve.

What makes up the cauda equina?

This is a bundle of dorsal and ventral roots extending from terminal end of spinal cord to their appropriate intervertebral foramen.

What happens to the spinal nerve once it emerges from the intervertebral foramen?

It splits into the ventral primary ramus and the dorsal primary ramus.

What do axons of the dorsal ramus innervate?

Axons within the dorsal ramus innervate the intrinsic muscles of the back and skin.

What do axons of the ventral ramus innervate?

Provides innervation for muscles and skin over the anterolateral body wall and all of the muscles and skin of the limbs.

For ventral and dorsal roots of the C1-C7 vertebrae, where must they exit

OVER the vertebrae

For ventral and dorsal roots of the T,L, and S spine, where must they exit?

UNDER the vertebrae.

If the L4-L5 disk is bulging (herniated), what spinal nerve would be damaged.

The L5 nerve

The L5 nerve

Nerve plexuses

Neural structures that permit the mixing of two or more spinal nerves (and/or cranial nerves) to form large peripheral nerve




ex. Radial nerve in upper limb

What are the 3 largest nerve plexuses?

cervical, brachial, and lumbosacral plexi

Dermatome

Area of skin innervated by a single spinal nerve

Myotome

A group of muscles innervated by a single spinal nerve.




(Note, most muscles are innervated by more than one spinal nerve and are associated with more than one myotome.)

Describe the concept of referred pain

When pain is perceived at a location other than the site of the painful stimulus.




Ex. Heart attack, but pain in the shoulder or left arm




Due to the fact that the two sites are served by the same nerve, brain is a little "confused" and receives information that the pain is a little further out from the actual site of the pain.

Where does the subarachnoid space end?

Extends to the S2 vertebral area.

What is the enlarged subarachnoid space between L1 and S2 called?

Lumbar cistern

Where is cerebrospinal fluid found?

In the subarachnoid space (between the arachnoid mater and the pia mater)

Where is the subdural space located?

Between the dura mater and the arachnoid mater

What bleeds into the subdural space?

The subdural hematoma

Where is the epidural space located?

Between the dura mater and bone of the vertebral column.

What fills/bleeds into the epidural space?

fat, venous vertebral plexus, and epidural hematoma

What are the denticulate ligaments?

Flat fibrous bilateral expansions of pia mater that attach via tooth-like projections to arachnoid/dura mater, along with spinal nerves to help anchor the spinal cord within the dural sac. Separate the dorsal and ventral roots as the enter and leave the spinal cord. (Ventral under, dorsal over)

What is the filum terminale?

Fine cord of pia mater that extends from the distal end of the spinal cord. It descends with the cauda equina and attaches to the dural sac internally at its end. An external extension of the filum attaches to the coccyx.

Describe lumbar puncture procedure

-Usually done between the lamina of L3-L4 or L4-L5 during maximal flexion of the vertebral column.




-Iliac crest is used as a guide to the appropriate level for the puncture, below where the spinal cord ends! Iliac crest highest point at L4.

The coverings of the spinal cord are continuous with coverings of the brain via the ?

Foramen magnum

What areas of the body does the subarachnoid space exist in?

-Spinal cord


-brainstem


-cerebellum


-cortex

What arteries supply the spinal cord?

Anterior vertebral artery, posterior vertebral artery, secondary medullary arteries, radicular arteries

Anterior and Posterior Spinal Artery

Unpaired, longitudinal arteries (run anterior and posterior to the spine respectively, that are formed from the vertebral artery.




Only sufficient for the superior cervical segments of the spinal cord.

Segmental Medullary Arteries (anterior and posterior)

Longitudinal arteries that lie on the ventral surface of the spinal cord.




Generally arise from the vertebral artery




Supply blood to the remainder of the spinal cord (that the anterior and posterior spinal artery do not supply)




Enter vertebral canal via intervertebral foramina

What is the name of the segmental medullary artery that supplies circulation to 2/3 of the spinal cord?

Medullary artery of Adamkiewicz




(derived from lumbar artery at L2 vertebral level, but can range T8 to L4)

Radicular arteries

Primarily supply the ventral and dorsal roots with blood.




These are branches of local arteries




Enter vertebral canal via intervertebral foramina

Anterior and Posterior spinal veins

Longitudinally arranged and free to communicate with each other




3 of each type

Internal vertebral venous plexus

Found in epidural space and receives blood from spinal veins. Unlike veins in other regions of the body, they have no valves. The plexus freely communicates with the external vertebral venous plexus (surrounding the vertebrae), the vertebral veins, and through the foramen magnum, with the dural sinuses within the skull. Consequence = alternative route for venous return to the canal and azygos systems in cases of venous obstruction in the body cavities or in the neck. Septic, neoplasm, and emboli can spread from the body cavities to vertebrae and cranial cavity.