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Neuroanatomy > Spinal Cord Anatomy/Sensory Pathways > Flashcards

Spinal Cord Anatomy/Sensory Pathways Flashcards

1
Q

Number of cervical vertebrae, location of associated cord segments?

A

7, above the vertebral body

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2
Q

Description of the spinal cord in utero and later on in development.

A

Initially matches with the correct vertebral body as the body develops stops matching. End of spinal cord post-development T12/L1.

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3
Q

Where to ideally do a spinal tap.

A

At the level of L3/L4 (into the lumbar cistern, filled with CSF). Landmark for this area is the posterior iliac crest.

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4
Q

Location of Filum Terminale

A

S3/S4

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5
Q

Pathway and site of production: CSF.

A

CSF is created in the choroid plexus in the lateral ventricle. Pathway: Lateral ventricle –> foramen of monroe –> third ventricle –> cerebral aqueduct –> 4th ventricle –> foramen of Magendie/Luschka –> bathe spinal cord –> subarachnoid space (arachnoid villi) –> sagittal sinuses –> back again

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6
Q

Why is CSF testing useful?

A

For infections, immune mediated conditions, tumors, and neurodegenerative conditions.

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7
Q

Where does cervical cord segment 8 exit from?

A

Below the C7 vertebra.

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8
Q

Lordosis vs. Kyphosis

A

Lordosis: arch outwards, found in the cervical and lumbar regions. Kyphosis: dip in found in the thoracic and sacral regions.

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9
Q

What does the vertebral disc allow for?

A

Flexion and extension of the spinal cord/body (extension would be bending backwards).

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10
Q

What do facet joints allow for?

A

For the “full range of movement” of the spinal cord.

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11
Q

What ligaments are most important for spinal stability?

A

The anterior and posterior longitudinal ligaments.

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12
Q

What ligament is found in between the spinous processes and what is it’s significance?

A

The interspinous ligament. It is the ligament that if pierced in order to perform a spinal tap.

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13
Q

What is the ligamentum flavum?

A

It is the ligament found in between vertebral arches.

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14
Q

Describe the atlas and axis.

A

The atlas (C1) allows for nodding, the axis (C2) allows for rotation. This area has quite a few ligaments (which is why, clinically, a patient can seem fine but still have a C1/C2 injury).

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15
Q

What could occur due to hyperextension of the neck?

A

C2 fracture at the pedicles - Hangman’s fracture

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16
Q

What is a Jefferson’s fracture?

A

A fracture between the anterior and posterior arch of C1.

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17
Q

C3, C4, and C5 control what?

A

Breathing - they can be irregularly compressed by the dens

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18
Q

What is the bump at the bottom of your next and it’s clinical significance (for radiology)?

A

The bump is the spinal process of C7 and in order to “clear the spine” you have to see the C7/T1 articulation on a scan.

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19
Q

In order to see C1/C2 on a scan what must you do?

A

Open the mouth wide.

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20
Q

Shape of the spinal cord canal in the different layers of the vertebrae.

A

Cervical - Oval, Thoracic - round, Lumbar - triangular (also there is no spinal cord in this area).

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21
Q

Dorsal root ganglion location?

A

Outside the spinal canal, the corresponding roots travel downwards before leaving the foramen at the proper vertebral bodies.

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22
Q

Dermatomes: T4, T10, C6, C7, C8, C1, S3, L4, L5

A

S4: perianal, L4/L5: split of the big toe, T4: nipples, T10: belly button, C1: doesn’t exist, C6: thumb, index, C8: pinky finger, C7: middle finger, C2-4: neck

23
Q

What is siatica?

A

Slippage between the lumbar and sacral regions (spondilolethesis, due to disc disease). Clinical implications: back pain with radiation down to the big toe.

24
Q

Distribution of grey and white matter in the spinal cord.

A

Cervical segments have the most white matter, lumbar segments have the most grey matter (required to innervate the biggest muscles).

25
Q

What is a lateral horn and where can it be found?

A

The lateral horn is the location for the sympathetic system’s fibers and it is present in the thoracic (and upper lumbar) segments of the spinal cord.

26
Q

Clark’s column?

A

Nucleus dorsalis, T1-L3

27
Q

Intermediolateral cell column?

A

Sympathetic preganglionic neurons T1-L2

28
Q

Relative location of flexors, extensors, distal limb, and proximal limb relay points.

A

Flexors are more dorsal than extensors, proximal limbs are more medial than distal limbs.

29
Q

Blood supply to the spinal cord?

A

Anterior 2/3 are from the anterior spinal artery

30
Q

Two facts about the venous system in the spinal cord.

A
  1. Large veins are intra-dural, extra-axial. 2. Venous hypertension affects the inside of the cord first.
31
Q

Fastest sensory nerves are what?

A

Myelinated and referring to proprioception. (then touch, then pain/temperature).

32
Q

Sensory pathways have how many “orders” and where is the third one always found?

A

Sensory pathways always have three orders, the third one is always found in the thalamus.

33
Q

Where is the cell body for first order sensory neurons?

A

In the dorsal root ganglion.

34
Q

How much of sensory impulses actually reach the cerebrum?

A

1%

35
Q

What are the three major tracts (pathways) found in the somatic sensory nervous system?

A

Posterior column (fasciculus gracilis/cuneatus), spinocerebellar pathway (posterior/anterior), spinothalamic (lateral/anterior pathways).

36
Q

What is important to know about the fasiciculus cuneatus vs. the fasciculus gracilis in terms of location on the spinal cord?

A

The fasciculus cuneatus can really only be seen above T6 because it is not needed for the lower limbs.

37
Q

What is proprioception?

A

Joint position sense (think recognition of the movement of the big toe – without proprioception, in a dark room, with your eyes closed, you would fall).

38
Q

Where are the nucleus cuneatus and nucleus gracilis found?

A

In the midbrian.

39
Q

Three parts of the subconscious sensory pathways?

A
  1. Cuneocerebellar (above C8), 2. Dorsal spinocerebellar (C8-L2), 3. Ventral Spinocerebellar (below L2).
40
Q

Facts about the Cuneocerebellar tract.

A

Subconscious sensory pathway, above C8: Rises with the fasciculus cuneatus, synapses at the medulla, enters the cerebellum at the inferior cerebellar peduncle.

41
Q

Facts about the Dorsal Spinocerebellar Tract.

A

Subconscious sensory pathway, C8-L2, synapses at the nucleus of Clark, rises though the medulla (ipsilaterally), enters the cerebellum at the superior cerebellar peduncle.

42
Q

Facts about the Ventral Spinocerebellar Tract.

A

Subconscious sensory pathway, below L2, fibers cross at entry, rise to the pons, and then cross back, eneter the cerebellum via the superior cerebellar peduncle.

43
Q

What is the main CN for facial sensation, the location of it’s nuclei, the order of it’s nuclei, and the types and general location of said nuclei?

A

CN V (trigeminal), the nuclei is found from the upper cervical cord to the midbrain, the nuclei is second order, there are four types (superior to inferior): mesencephalic, chief sensory, motor, spinal (temperature and pain).

44
Q

What is unique about lesions in the pons?

A

You can get a sensory defect that is on one half for the face and the other half for the body.

45
Q

Facts about the Ventral Trigeminothalamic Tract.

A

The VTTT runs with the media lemniscus.

46
Q

In the somatosensory cortex, where is the sensation for legs and genitalia located and what is the significance of this?

A

The legs/genitalia are medially located next to the falx cerebri. Therefore, is there is a meningioma in that area, the legs will express symptoms first.

47
Q

Describe the pathway: sensory-conscious touch and proprioception, face.

A
  1. Mechanoreceptors, CN V ganglion; 2. Chief sensory nucleus, cross at the trigeminothalamic tract 3. Thalamic neuron: VPM; 4. Post-central gyrus
48
Q

Describe the pathway: sensory-conscious touch and proprioception, body & extremities above T6

A
  1. Mechanoreceptors, dorsal root ganglion, fasciculus cuneatus 2. nucleus cuneatus, cross as internal arcuate fibers, medial lemniscus 2. thalamic neurons, VPL; 4. Post-central gyrus
49
Q

Describe the pathway: sensory-conscious touch and proprioception, body & extremities below T6

A
  1. Mechanoreceptors, dorsal root ganglion. fasciculus gracilis; 2. Nucleus gracilis, cross as internal arcuate, medial lemniscus; 3. thalamic neurons, VPL; 4. Post-central gyrus
50
Q

Describe the pathway: sensory - pain & temperature, face

A
  1. Nociceptors, CN V ganglion, CN V spinal tract; 2. CN V spinal nucleus, cross as trigeminothalamic tract 3. Thalamic neuron, VPM; 4. Post-central gyrus
51
Q

Describe the pathway: sensory - pain & temperature, body and extremities

A
  1. Nociceptors, dorsal root ganglion; 2. spinal cord dorsal horn, cross at spinothalamic tract,; 3. Thalamic nucleus, VPL; 4. Post-central gyrus
52
Q

Describe the pathway: Subconscious proprioception: face

A

Mechanoreceptors –> mesencephalic nucleus CN V

53
Q

Describe the pathway: Subconscious Proprioception (everything but the face)

A

Muscle spindles/golgi tendon organs –> dorsal root ganglion –> Accessory cuneate nucleus/nucleus dorsalis of Clark/border cells –> Cuneocerebellar tract (ipsi)/Dorsal spinocerebellar tract (ipsi)/ventral spinocerebellar tract (both ipsi and contralateral

Neuroanatomy (5 decks)

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