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39 Cards in this Set
- Front
- Back
Name the Vertebral Canal Contents
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Spinal cord
Spinal meninges Spinal vasculature Spinal nerve roots |
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Name the Two enlargements of the spinal cord
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1. C4-5 to T1-innervate upper limb
2. T11-12 to S3-innervate lower limb |
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Name the Layers of the Spinal Meninges
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Pia Mater
Arachnoid Mater Dura Mater |
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Describe the Dura Mater
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Outermost covering; tough.
Forms dural sac, dural root sheaths, and coccygeal ligament. |
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What are the Leptomeninges?
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arachnoid and pia mater developed together
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Describe the Arachnoid Mater
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Delicate, avascular.
Membranous layer lines dural sac and dural root sheaths. Trabeculae (strands) span subarachnoid space |
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Describe the Pia Mater
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Innermost covering; transparent.
Adheres to spinal cord. Forms denticulate ligaments and filum terminale (internum) |
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Describe the Spinal Cord Spaces
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Subdural Space: “Potential” space at dura-arachnoid interface
Subarachnoid space: Between arachnoid membrane and pia mater Contains CSF Epidural (extradural) space: Between wall of bony vertebral canal and dural sac Contains internal vertebral plexus and fat |
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Describe CSF
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CSF is a serum-like fluid, produced by the choroid plexus in the ventricles of the brain.
CSF circulates within and around the brain and spinal cord in the subarachnoid space. CSF acts like a “shock absorber” for protection of the brain and spinal cord. CSF also contains proteins, glucose, and other important chemical substances. |
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Describe Lumbar Puncture in Adults
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The patient leans forward to separate the spinous processes of the lumbar spine. A needle is introduced into the dural sac (lumbar cistern) between the L3 and L4 vertebrae, and cerebrospinal fluid (CSF) samples are taken. Lumbar anesthesia may be administered in a similar fashion
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Describe Lumbar Puncture in Children
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The patient leans forward to separate the spinous processes of the lumbar spine. A needle is introduced into the dural sac (lumbar cistern) between the L5 and L6 vertebrae, and cerebrospinal fluid (CSF) samples are taken. Lumbar anesthesia may be administered in a similar fashion
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Describe Epidural Anesthesia Administration
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administered by placing a catheter in the epidural space without penetrating the dural sac, or by passing a needle through the sacral hiatus
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Describe Spinal Arteries in the Cervical Region
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Anterior spinal artery in anterior median fissure.
Two Posterior spinal arteries in posterorlateral sulci |
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Describe the Segmental Spinal Arteries
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Segmental medullary arteries supply spinal cord.
Radicular arteries supply nerve roots. |
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Describe the Artery of Adamkiewicz
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the largest anterior segmental medullary artery.
arises from a left posterior intercostal artery, which branches from the aorta, and supplies the lower two thirds of the spinal cord via the anterior spinal artery |
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Name the veins of the Vertebral canal
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Anterior spinal veins.
Posterior spinal veins Segmental medullary veins. Radicular veins Internal vertebral venous plexus: in epidural (extradural) space |
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What is AVM?
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Arteriovenous malformation (AVM) – abnormal tangle of blood vessels where arteries shunt blood directly into veins, with no intervening capillary bed, creating a high pressure shunt.
Cells that normally get oxygen from the capillaries begin to deteriorate. |
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What are some common signs of spinal AVMs?
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Sudden, severe back pain
Weakness in the legs or arms Paralysis |
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Describe Dorsal Root Function in the Spinal Cord
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Sensory
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Describe Ventral Root Function in the Spinal Cord
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Motor
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What is the DRG and where is it found?
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Dorsal Root ganglion, found inthe intervertebral foramen
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List the Spinal Nerve Segments
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31 pairs of spinal nerves:
8 cervical nerves (C1-C8) 12 thoracic nerves (T1-T12) 5 lumbar nerves (L1-L5) 5 sacral nerves (S1-S5) 1 coccygeal nerve (Co) |
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Where does the C1 spinal nerve emerge?
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C1 spinal nerve emerges between skull and C1 vertebra
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Where do the C2-C7 spinal nerves emerge?
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C2 – C7 spinal nerves emerge above their respective vertebrae
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Where does the C8 spinal nerve emerge?
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C8 spinal nerve emerges below C7 vertebra
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Where do the T1-Co spinal nerves emerge?
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T1 – Co spinal nerves emerge below their respective vertebrae
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What would be the result of a cervical cord lesion?
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Quadriplegia
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What would be the result of a thoracic cord lesion?
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Paraplegia
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What would be the result of a lumbar cord lesion?
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Loss of some lower body function
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What would be the result of a conus/cauda equina lesion?
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Variable lower body function loss
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What is Quadriplegia?
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loss of movement and sensation in all four limbs
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What is paraplegia?
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loss of movement and sensation in the lower half of the body
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Describe a laminectomy.
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A laminectomy is a surgical procedure to decrease pain due to lumbar spinal stenosis. The spinous process and the laminae are removed over the area where stenosis is occurring.
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What are the layers pierced in sequence as a needle is used for lumbar puncture?
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Skin
Subcutaneous tissue Thoracolumbar fascia Supraspinous ligament Interspinous ligament Ligamentum flavum Epidural space Dura mater Arachnoid Subarachnoid space |
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Describe Spondylosis
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A degenerative disease of the spinal column, especially one leading to fusion and immobilization of the vertebral bones
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What is Spondylolysis?
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Defect in the pars interarticularis
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What is Spondylolisthesis?
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forward displacement of a vertebra over a lower segment, usually of the fourth or fifth lumbar vertebra (often due to a developmental defect in the pars interarticularis)
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Describe the I’s and T’s organizational approach to differential diagnosis
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I’s
Infection Inflammation T’s Tumor Trauma Other factors: Somatic dysfunction Genetics Psychological Nutrition Environment |
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Name the two enlargements of spinal cord
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1. C4-5 to T1 (innervate upper limb)
2. T11-12 to S3 (innervate lower limb) |