Boards Part 1- Spinal Anatomy

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Boards Part 1- Spinal Anatomy
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2012-02-27 00:27:38
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Boards Part 1- Spinal Anatomy
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  1. what are the derivatives of the endoderm
    • organs
    • gut
    • repiratory tract
    • tubular structures
  2. what are the subgroups of the mesoderm layer
    • paraxial (somatic)
    • paraxial (splanchnic)
    • intermediate
    • head
    • lateral plate
  3. what are the derivatives of the somatic mesoderm
    musculoskeletal (muscles, ligaments, tendons)
  4. what are the derivatives of the splanchnic mesoderm
    smooth muscle of organs
  5. what are the derivatives of the intermediate mesoderm
    • urogenital systems
    • kidneys
  6. what are the derivatives of the head mesoderm
    • skull
    • muscles and CT of the head
    • dentine
  7. what are the derivatives of the lateral plate mesoderm
    • adernal cortex
    • blood and lymph cells
    • CT
    • cardiovascular and lymph
  8. what are the subgroups of the ectoderm
    • surface ectoderm
    • neuroectoderm (neural tube)
    • neuroectoderm (neural crest)
  9. what are the derivatives of the surface ectoderm
    • epidermis
    • anterior pituitary
    • lens of the eye
    • skin
    • enamel
    • hair
    • nails
  10. what are the derivatives of the neural tube
    CNS (brain and spinal cord)
  11. what are the derivatives of the neural crest
    • Sympathetic chain ganglion
    • DRG
    • ANS
    • PNS
    • Schwann cells
    • parafollicular cells of the thyroid
    • adrenal medulla
  12. what is the embrologic order of the notochord
    notochord-> neural plate-> neural groove-> neural tube-> neural crest cells
  13. spina bifida occulta
    when the lamina failed to fuse. tuft of hair growth over the sidt called a "fawn's beard"
  14. what vitamin would help prevent spina bifida occulta
    Folic acid/B9/methyl folate/jtetrahydrofolate
  15. what is a meningocele
    meninges protrude out of spina bifida
  16. what is a myelocele
    spinal cord protrudes out of spina bifida because meninges not developed properly
  17. what is a meningomelocele
    spinal cord and meninges protude out of spina bifida
  18. what is arnold chiari syndrome type 1
    cerebellar peduncles come below foramen magnum
  19. what is arnold chiari syndrome type 2
    cerebellar peduncles come below foramen magnum and a meningomyelocele (usually in the lumbar spine)
  20. what causes a cleft palate
    failure of maxillary and palatine bones to fuse
  21. what does the notochord persist as?
    nucleus pulposus
  22. how many pairs of somites are formed from paraxial mesoderm
    31
  23. what is a sclerotome
    membranous vertabral colume
  24. what is a myotome
    muscle
  25. what is a somatic myotome
    skeletal muscle
  26. what is a splanchnic myotome
    visceral smooth muscle
  27. what is a epimere myotome
    dorsal/posterior muscles (extensors)
  28. what is a hypomere myotome
    ventral/anterior muscles (flexors)
  29. what is a dermatome
    nerves
  30. what is ossification
    cartilage replacement by bone
  31. what is primary ossification
    before birth
  32. what is secondary ossification
    after birth
  33. what is intramembranous/intramedullary ossification
    • mesenchymal tissue into bone
    • clavicle and all flat bones of the skull
  34. what is enchondral ossification
    • cartilage to bone
    • all other bones in the body (besides clavicle and flat bones of the skull)
  35. what does the stomodeum referre to
    the mouth
  36. what are the boundries of the foregut
    back of the throat to the 1st 1/3 of the duodenum
  37. what are the boundries of the midgut
    last 2/3 of duodenum to 1st 2/3 of transverse colon
  38. what are the borders of the hindgut
    last 1/3 of the transverse colon to anus
  39. what does the gubernaculum become in males
    scrotal ligament (gubernacular testis)
  40. what does the gubernaculum become in females
    suspensory ligament of the ovary, ovarian ligament, and the round ligament
  41. what are the three primary vesicles of the brain
    • prosencephalon
    • mesencephalon
    • rhombencephalon
  42. what does the prosencephalon become
    • telencephalon
    • diencephalon
  43. what does the mesencephalon become
    mesencephalon (crazy!!)
  44. what does the rhombencephalon become
    • metencephalon
    • myelencephalon
  45. what parts of the brain does the telencephalon become
    • cerebral cortex
    • basal ganglion
  46. what CN is derived from the telencephalon
    1
  47. what ventricle is derived from the telencephalon
    lateral vesicle
  48. what parts of the brain does the diencephalon become
    • thalamus (hypo, epi, and sub)
    • epithalamus (pineal gland)
  49. what CN is derived from the diencephalon
    2
  50. what ventricle is derived from the diencephalon
    3rd vesicle
  51. what part of the brain does the mesencephalon become
    midbrain
  52. what CN are derived from the mesencephalon
    3 and 4
  53. what ventricle is derived from the mesencephalon
    aqueduct of sylvius
  54. what part of the brain does the metencephalon become
    • pons
    • cerebellum
  55. what CN are derived from the metencephalon
    5-8
  56. what ventricle is derived from the metencephalon
    4th ventricle
  57. what part of brain does the myelencephalon become
    medulla oblongata
  58. what CN are derived from the myelencephalon
    9-12
  59. what ventricle is derived from the myelencephalon
    the obex (fold at the floor of the 4th ventricle)
  60. dendrites
    send impulses towards the cell body
  61. axons
    send impulses away from the cell body
  62. what is the only sense to bypass the thalamus
    smell
  63. what is the resting membrane potential of muscles? neurons?
    • muscles= -85-90 mv
    • neurons= -65-70 mv
  64. how is the resting membrane potential created
    • negative charges inside
    • positive charges outside (mainly sodium)
  65. what causes depolarization of a neuron
    sodium rushing into the cell
  66. what activates pacinian corpuscles
    vibration
  67. what activates ruffini endings
    joint position sense
  68. what activates free nerve endings
    pain and temperature
  69. what activates meissner's and merkels cells
    touch
  70. rheobase
    minimum current for action potential
  71. chronaxie
    time, using 2x rheobase for action potential
  72. inhibitory post-synaptic potential
    Cl rushes in to cell, may also open K+ channels more to leak out K
  73. inhibitory neurotransmitter of the spine
    glycine
  74. inhibitory neurotransmitter of the brain
    GABA
  75. what do the medulla and pons control
    • vasomotor
    • cardiac centers
    • autonomics
    • CN 5-12
  76. what does the midbrain control
    • reflexes to light and sound
    • proximal flexor relay
    • motoric relaxy
    • CN 3 and 4
  77. what does the thalamus control
    • relay station
    • sensory fibers
  78. what does the pulvinar region of the thalamus control
    integration of sensory information
  79. what does VPM stand for and what does it carry
    • ventral posteromedial
    • sensory from the face
  80. what does VPL stand for and what does it carry
    • ventral posterolateral
    • sendory from arms and legs
  81. what does the lateral geniculate carry
    sensory from the eyes
  82. what does the medial geniculate carry
    sensory from the ears
  83. what does the cerebrum control
    intellect and association
  84. what does the parietal lobe control
    sensory- postcentral gyrus (localization "somatic cortex")
  85. what is broadmans area 1,2,3 and what does it control
    • in the parietal lobe
    • abstraction, problem solving
  86. what does the occipital lobe control
    sight
  87. what does the superior lobe of the temporal lobe control
    hearing
  88. what does the middle lobe of the temporal lobe control
    short term memory
  89. what does the inferior lobe of the temporal lobe control
    • long term memory
    • smell
  90. what is memory stored
    hippocampal cells
  91. what happens if there is damage to the hippocampus
    anterograde amneisa
  92. where is smell stored
    parahippocampal cells in the uncal area
  93. where is wernicke's area
    junction of parietal, occipital, and temporal lobe
  94. what does wernike's area control
    • sensory matichin
    • interpretation (does this make sense? if not, fire sympathetics)
  95. how is wernicke's area destroyed
    B1/thiamine deficiency d/t alcoholism (wernicke-korsakoff syndrome)
  96. what is wernicke-korsakoff syndrome
    • sensory aphasia- cant understand language
    • word blindness in angular gyrus. can read, see, but cant understand
  97. what does the frontal lobe control
    • voluntary motor (precentral gyrus)
    • brodmans 4, 4s, 6
    • corticospinal tracts
    • corticobulbar tracts
    • biant cells of betz
    • executive function
    • personality
  98. what is motor aphasia
    • broca's speech area in inferior frontal lobe destroyed on the left
    • from middle cerebral artery stroke
  99. what is broca's area control
    • left side of the frontal lobe
    • controls motor speech and forming words
  100. what does the limbic system control
    • pleasure or pain?
    • do i need to remember this for survival
    • associated with the amygdala
  101. what does the basal ganglia control
    • inhibits the thalamus (stops motor response)
    • provides background muscle control
  102. dysfunction of the basal ganglia
    • parkinson's disease: trivial information elicits motor response. paralysis agitans. exhibits pill-rolling tremor, mask-like face. forward stooped posture, shuffling/propulsive gait. lead pipe/cogwheel rigidity
    • inclusion bodies: lewy bodies. from decreased dopanine in the substantia nigra in the midbrain
  103. what does the caudate do
    secretes GABA
  104. what is a genetic defect of the caudate
    • huntington's chroea
    • in males, fatal by age 50
  105. what is the striatum
    the putamen + the caudate
  106. what is the lentiform
    the globus pallidus + the putamen
  107. what does the hypothalamus control
    • hunger
    • thirst
    • temperature regulation
    • sex
    • rage
    • fear
  108. what does the cerebellum control
    • balance
    • equilibrium
    • involuntary coordination
    • unconscious proprioception
  109. what makes up the blood brain barrier
    astrocytes and tight capillary beds
  110. what is the purpose of the blood brain barrier
    stores glucose
  111. what are microglia
    macrophages (can adapt to gram + or gram -)
  112. what are ependymal cells
    • line the ventricles
    • produce CSF in the choroid plexus in the lateral ventricles
  113. where is CSF resorbed
    in the arachnoid granulations of the superior sagittal sinus
  114. what are oligodendrocytes
    • myelin in the CNS
    • derived from neural tube
  115. what is a problem with oligodendrocytes
    • multiple sclerosis
    • demyelination of the CNS
  116. what are schwann cells
    • myelin in the PNS
    • derived from neural crest
  117. what is a problem with schwann cells
    Guillian-Barre syndrome (post-infectious polyradiculopathy/ ascending paralysis)- due to post-vaccine or post-infection
  118. meissners plexus
    peristalsis of the mucosal layer
  119. auerbachs plexus
    peristalsis of the muscular layer
  120. meissner's and auerbach's plexuses
    from neural crest cells
  121. what if there is no meissner's or auerbach's plexuses
    hirschprung's disease= congenital megacolon
  122. renshaw cells
    • inhibit alpha motor neurons
    • negitive feedback
  123. alpha brain waves
    • quiet, meditative
    • disappear in sleep
  124. beta brain waves
    • intense mental activity
    • REM sleep
  125. delta brain waves
    • deep sleep or coma
    • due to ARAS (ascending reticular activating system)- wakes up the cortex
  126. theta brain waves
    • normal in children, abnormal in adults (stress, suicidal)
    • in 2nd, 3rd stage of sleep, non-REM
  127. association fibers of the cerebrum
    between lobes of the same hemisphere
  128. commissural fibers of the cerebrum
    connect L and R hemispheres
  129. projection fibers of the cerebrum
    connect hemispheres to other areas of the brain
  130. chemo receptors
    • most sensitive to increased pCO2
    • secondarily sensitive to decreased O2
    • found in carotid bodies and aortic bodies
    • if sense increased pCO2 cerebral blood vessels dilate
  131. what is the flow of CSF
    made in choroid plexus in lateral ventricles-> foramen of monroe-> 3rd ventricle-> cerebral aqueduct of sylvius-> 4th ventricle -> foramen of magendie and foramen of Lushka-> central canal and subarachnoid space-> reabsorbed in arachnoid villi in superior sagittal sinus
  132. spidural hemorrhage
    middle meningeal artery
  133. subdural hemorrhage
    damage to venous system
  134. subarachnoid hemorrhage
    beri aneurysm (circle of Willis)
  135. rubrospinal tract
    • from red nucleus of midbrain
    • carries proximal muscle fibers of upper and lower extremity
  136. reticulospinal tract
    • from reticular formation in midbrain
    • carries fibers from extensor muscle of the back and arms
    • EXCEPT: any back muscle innervated by a plexus (dorsal scapular- rhomboids and levator, throacodorsal- lat dorsi ventral primary rami)
  137. tectospinal tract
    tectum (midbrain) to neck muscles
  138. vestibulospinal tract
    • from cerebellum and vestibular nuclei
    • carries fibers from extensor muscles of the back and legs
  139. vestibulospinal tract to the eyes
    • CN 3, 4, 6
    • Medial longitudinal fasciculous for vestibulo-occulor reflex (VOR)
  140. vestibulospinal tract from cerebellum:
    dentate nucleus->anterior horn of spinal cord->gamma motor neurons-> intrafusal fibers for TONE
  141. corticospinal tract
    • precentral gyrus of frontal lobe (giant cells of Betz)
    • for flexors of distal extremities
  142. lateral corticospinal tract
    decussates at medulla at medullary pyamids
  143. ventral corticospinal tract
    decussates at spinal level for flexors of trunk
  144. path of the corticospinal tract
    precentral gyrus->anterior horn->alpha motor neurons->extrafusal fibers->movement
  145. 2nd lamina of rexed
    • substantia gelatinosa blocks pain
    • tract of lissauer
    • for spinothalamic tract
  146. 7th lamina of rexed
    nucleus dorsalis of clark (clarks column)
  147. 8th lamina of rexed
    anterior horn, alpha motor
  148. 9th lamina of rexed
    anterior horm, gamma motor
  149. 10th lamina of rexed
    • gray commissure
    • central canal
  150. lateral spinothalamic tract carries
    pain and termperature
  151. ventral spinalthalamic tract carries
    crude touch and pressure
  152. fiber type and receptors of the spinothalamic tracts
    unmyelinated C fibers, free naked nerve endings
  153. path of lateral spinothalamic tract
    synaps in posterior horn in tract of lissauer (substantia gelatinosa)-> decussates across lamina 7-> travels up lateral spinothalamic tract-> VPL of contralateral thalamus-> contralateral cortex
  154. syringomyelia
    • dilation of central canal (usually C5/6) cuts spinothalamic tracts
    • causes loss of pain and temperature in cape and shawl-like distrobution
  155. what fiber type transmits fast pain
    compression of large A-beta fibers
  156. DCMS
    dorsal columns medial lemniscus
  157. DCML does what
    • conscious proprioception
    • vibration
    • position sense
    • 2 point discrimination
  158. DCML consists of what 2 columns
    • Gracilis- from legs
    • cuneatus- from arms
  159. receptors found in the DCML
    • Ab fibers
    • meissner's and merkels- touch
    • pacinian- vibration
    • ruffini-joints position sense
  160. pathway of gracilis
    legs-> Ab fibers-> spine (fasciculus gracilis)->dorsal columns->medulla (nucleus gracilis)-> decussation (medial lemniscus)-> VPL of contralateral thalamus-> contralateral cortex
  161. pathway of cuneatus
    arms-> Ab fibers-> spine (fasciculus cuneatus)-> dorsal columns-> medulla (nucleus cuneatus)->decussation (medial lemniscus)->VPL of contralateral thalamus-> contralateral cortex
  162. 3 lobes of the cerebellum
    • flocculonodular- midline, balance of the spine
    • anterior lobe- balance from arms and legs
    • posterior lobe- how cerebellum talks to cortex
  163. 4 cerebellar nuclei
    • fastigial-spine
    • Globus- proximal joints (glenohumeral)
    • Emboliform- middle joints (elbow)
    • -globus + emboliform= interpose nuclei
    • Dentate- distal joints (digits)
  164. cerebellar peduncles and connections
    • superior cerebellar peduncle-> midbrain
    • middle cerebellar peduncle-> pons
    • inferior cerebellar peduncle-> medulla
  165. job of the cerebellar peduncles
    • info to the cortex travels via superior cerebellar peduncle
    • info back to cerebellum travels via middle cerebellar peduncle
    • info from SC/body travels via inferior cerebellar peduncle
  166. spinocerebellar pathways
    carry unconscious proprioception
  167. pathway of spinocerebellar pathway
    receptor-> peripheral nerve-> spinal cord-> brainstem-> cerebellum-> superior cerebellar peduncle-> red nucleus-> thalamus-> cortex->middle cerebellar peduncle-> cerebellum
  168. pathway of spino-olivary tract
    spino-olivary tract-> inferior olivary nucleus->climbing fibers->inferior cerebellar peduncle-> ipsilateral cerebellum
  169. pathway of dorsal spinocerebellar tract
    dorsal spinocerebellar tract->inferior cerebellar peduncle-> ipsilateral cerebellum
  170. pathway of ventral spinocerebellar tract
    ventral spinocerebellar tract-> decussates across at spinal level->midbrain-> decussates back through superior cerebellar peduncle-> ipsilateral cerebellum
  171. the tectum of the midbrain
    • posterior portion
    • contains superior and inferior colliculi
    • reflex to light and sount (tectospinal tract)
    • corpora quadrigemina- the 4 colliculi
  172. the tegmentum of the midbrain
    • CN 3 and 4 + axons
    • cerebral aquaduct
    • (CN 4 posterior)
  173. cerebral peduncles of the midbrain
    • anterior portion
    • contains corticospinal tracts
    • red nucleus- rubrospinal tract
    • substantia nigra- dopamine for thalamus (parkinsons)
  174. CN 1 name
    olfactory
  175. CN 1 origin
    frontal lobe
  176. CN 1 foramina and bone
    • cribiform plate
    • ethmoid bone
  177. action of CN 1
    smell (sensory)
  178. CN 2 name
    optic
  179. CN 2 origin
    thalamus
  180. CN 2 foramina and bone
    • optic foamen
    • sphenoid bone
  181. CN 2 action
    • vision (sensory)
    • afferent pupillary light reflex (reflex)
  182. CN 3 name
    opthalmic
  183. origin of CN 3
    midbrain
  184. CN 3 foramina and bone
    • superior orbital fissure
    • sphinoid bone
  185. action of CN 3
    • muscles: superior rectus, inferior rectus, medial rectus, inferior oblique, levator palpebrae superioris
    • reflex: pupillary constriction
    • efferent pupillary light reflex
  186. CN 4 name
    trochlear
  187. CN 4 origin
    midbrain (posterior)
  188. CN 4 foramina and bone
    • superior orbital fissure
    • sphenoid bone
  189. action of CN 4
    superior oblique (SO4)
  190. CN 5 name
    trigeminal
  191. divisions of CN 5
    • V1= opthalmic nerve
    • V2= maxillary
    • V3= mandibular
  192. CN V1 origin
    pons
  193. CN V1 foramina and bone
    • superior orbital fissure
    • sphenoid bone
  194. CN V1 action
    • corner of canthus to bald spot (sensory)
    • afferent corneal and afferent oculocardiac (reflex)
  195. CN V2 origin
    pons
  196. CN V2 foramina and bone
    • foramen rotundum
    • sphenoid bone
  197. CN V2 action
    corner of cantus to corner of mouth (sensory)
  198. CN V3 origin
  199. pons
  200. CN V3 foramina and bone
    • foramen ovale
    • sphenoid bone
  201. CN V3 action
    • corner of mouth to chin (sensory)
    • general sensation to gongue as lingual nerve
    • muscle: temporalis, masseter, medial pterygoid, lateral pterygoid, tensor tympani
    • jaw jerk (reflex)
  202. CN 6 name
    abducens
  203. CN 6 origin
    pons
  204. CN 6 foramina and bone
    • supraorbital fissure
    • sphenoid bone
  205. CN 6 action
    lateral rectus (LR6)
  206. CN 7 name
    facial (chordae tympani in middle ear)
  207. CN 7 origin
    pons
  208. CN 7 foramina and bone
    • internal auditory meatus-> stylomastorid foramen/temporal bone
    • pierces the parotid gland
  209. CN 7 action
    • chordae tympani from middle ear to anterior 2/3 of tongue for taste and gustatory sense (sensory)
    • facial muscle and stapedius (muscle)
    • efferent corneal (reflex)
    • lacrimation, salvation
  210. CN 8 name
    vestibulo-cochlear (auditory)
  211. CN 8 origin
    pons
  212. CN 8 foramina and bone
    • internal auditory meatus
    • temporal bone
  213. CN 8 action
    • balance (vestibulo)
    • hearing (cochlear)
  214. CN 9 name
    glossopharyngeal
  215. CN 9 origin
    medulla
  216. CN 9 foramina and bone
    • jugular foramen
    • temporal/occipital bone
  217. CN 9 action
    • posterior 1/3 tongue for taste and middle ear (sensory)
    • stylopharyngeus (muscle)
    • carotid afferent, gag affarent (reflex)
    • salvation (paratid gland)
  218. CN 10 name
    vagus
  219. CN 10 origin
    medulla
  220. CN 10 foramina and bone
    • jugualr foramen
    • temporal/occipital bones
  221. CN 10 action
    • tympanic membrane (sensory)
    • palate, pharynx, larynx (diaphragm???) (muscle)
    • carotid, gag, and oculocardiac efferent (reflex)
    • palate to 1st 2/3 of transvere colon
  222. CN 11 name
    spinal accessory
  223. CN 11 origin
    medulla
  224. CN 11 foramina and bone
    • jugular foramen
    • temporal/occipital bones
  225. CN 11 action
    SCM (with C2/3) and trap (with C3/4)
  226. CN 12 name
    hypoglossal
  227. CN 12 origin
    medulla
  228. CN 12 foramina and bone
    • hypoglossal foramina
    • occipital bone
  229. CN 12 action
    intrinsic muscle of tongue (muscle)
  230. Dorsal column sensation from face
    • vibration, 2 point discrimination, fine touch
    • face-> synapse-> main trigeminal sensory nucleus (principal nucleus)
  231. pain and temperature from the face
    • down spinal cord to 1st 3 segments, joins spinothalamic tract
    • synapse in spinal nucleus V (subnucleus caudalis)
    • mesencephalic nucleus= DRG of CNV
  232. muscles of mastication
    • temporalis
    • masseter
    • medial pterygoid
    • lateral pterygoid
  233. OIA of temporalis ms
    • O: temporal fossa
    • I: coronoid of the mandible
    • A: close jaw
  234. OIA of masseter ms
    • O: zygomatic
    • I: external angle of jaw
    • A: closes jaw
  235. OIA of medial pterygoid
    • O: medial pterygoid process
    • I: internal angel of jaw
    • A: closes jaw
  236. OIA of lateral pterygoid
    • O: lateral pterygoid process
    • I: disc of TMJ and condyle of mandible
    • A: opens/depresses jaw, protraction of jaw
  237. CN 3 parasymp
    midbrain-> edinger-westphal nucleus-> ciliary ganglion-> pupillary constriction
  238. CN 7 parasymp
    • pons-> superior salivarory nucleus-> sphenopalatine ganglion-> crying/lacrimation
    • pons-> superior salvatory nucleus-> sphenomandibular gangion-> salvation
  239. CN 9 parasym
    medulla-> inferior salivatory nucleus -> otic ganglion-> partoids-> salvation
  240. CN 10 parasymp
    medulla-> vagal-> throat to 2/3 transverse colon
  241. pelvic splanchnic (S2-4) parasymp
    erection, bladder control, bowel control (distal 1/3 colon)
  242. parasympathetics=
    rest and digest
  243. cardiac plexus is which nerves
    T1-4
  244. Greater splanchnic is which nerves
    • T5-8
    • celiac plexus->digestion (to somach, liver, gallbladder, pancreas, and small intestine)
  245. lesser splanchnic
    • T10-11
    • kidney and adrenals
  246. least splanchnic
    • T12
    • colon, some kidney
  247. inferior hypogastric
    • L1-2
    • colon
  248. Sympathetic nervous system
    • fight or flight
    • lateral horn T1-L2
  249. primary neuron of symp system
    intermediolateral horn of spinal cord T1-L2
  250. effects of symp system
    • visceral efferents- vasoconstriction of central arteries
    • vasodilation of arteriols of muscle and capillaries of skin
    • erector pili and pseudomotor (sweating) activity
    • epinephrine breaks down glycogen to glucose
  251. symp system pathway
    IMl-> white rami communicantes (B fibers)-> pre-ganglionic= cholinergic synapse on symp chain ganglion-> leaves via grey rami communicantes (c fibers)-> post ganglionic= releases epinephrine and norepinephrine-> stimulates adrenergic receptors
  252. adrenergic receptors of symp system
    • alpha 1- vasoconstriction of central arteries, dilation of pupils
    • alpha 2- autoinhibitory to alpha 1
    • beta 1- increase heart rate and contractibility
    • beta 2- vasodilation of arteriols of muscles, bronchodilation, glycogenolysis, lipolysis
  253. pheochromocytoma
    gray color cell tumor which causes episodic hypertension d/t epinephrine release
  254. superior symp chain gangion (cervicals)
    • above C4
    • pupil dilation
  255. middle sympathetic chain ganglion (cervical)
    C4-5
  256. inferior sympathetic chain ganglion (cervical)
    C6-8
  257. stellate ganglion
    • C8-T1
    • merger between inferior symp chain gangion and upper T/S gangion
  258. horner's syndrome
    • disruption of cervical chain ganglion
    • ptosis, miosis, anhydrosis
  259. catecholamine pathway
    phenylalanine-> tyrosine-> l-dopa-> dopamine-> norepinephrine-> epinephrine
  260. anterior chamber of the eye
    • cornea to iris
    • filled with aqueous humor
  261. posterior chamber of the eye
    • iris to lens
    • filled with aqueous humor
  262. where is aqueous humor made
    by ciliary epithelium in the ciliary bodies
  263. posterior cavity of the eye
    • lens to retina
    • filled with vitrous humor to maintain shape
  264. embryology of the lens
    lens placodes
  265. embryology of the retina and iris
    optic stalk gives rise to the optic cup
  266. fovea centralis
    • most acute vision
    • has cones- bright light and color vision
    • macular degeneration= cant see light
  267. rods
    • found in the periphery
    • dim light and night vision
  268. what is affected first in glaucoma, rods or cones
    rods
  269. what is the first s/sx of glaucoma
    rings around lights
  270. pigment for vision
    rhodopsin (purple)
  271. vitamin for rods
    vitamin A
  272. vit A deficiency
    • nyctalopia- night blindness
    • keratomalacia- softening of the cornea
  273. where does the optic nerve decussate
    the nasal tracts decussate at the optic chiasm (carrying temporal fields of vision)
  274. damage to the optic chiasm causes?
    bitemporal hemianopsia (tunnel vision)
  275. upper motor neuron lesion
    • clonus because of consatant firing, no inhibition
    • spasticity because increased firing= increased muscle tone
    • hyperreflexia because muscle spindle so tight
  276. lower motor neuron lesion
    • fasciculations= muscle dying, spontaneously firing
    • hypotonia: lose 1b and 1a afferents for tone
    • hyporeflexia: decreased tone on spindles
  277. stretch reflex in musculoskeletal system
    • UMN: from cerebral cortex to but not including anterior horn cells (alpha motor neuron)
    • LMN: from anterior horn cell to muscle
    • myosynaptic: strike tendon-> stimulates muscle spindle cells-> synapses on alpha motor neuron
  278. hearing
    • turns mechanical waves into fluid waves
    • sound pounds tympanic membrane-> malleus-> incus-> stapes-> oval window-> perilymph and endolymph
  279. what is inside the oval window
    • hair cells
    • organ of corti
    • spiral ganglion
    • CN 8
  280. transfer of sound inside the oval window
    hair cells rocked-> depolarization-> Na rushes in. hair cells fire cochlear nucleus-> leaves via trapezoid body to brainstem (superior olive in pons)-> leaves medial geniculate body of thalamus as auditory radiation-> superior gyrus in temoral lobe (gyrus of heschl)
  281. Scala media
    • cochlear canal
    • separated from scala vestibulae by the vestibular membrane
  282. scala vestibuli
    vestibular canal
  283. scala tympani
    • tympanic canal
    • inferior canal
  284. vestibular membrane
    • aka Reissners membrane
    • above tentorial membrane which is above the basilar membrane
  285. utricle
    static equilibrium (standing still)
  286. macula/ Saccula
    • functional part of the utricle
    • linear acceleration (car/elevator)
  287. semicircular canals
    angular acceleration (roller coaster)
  288. crista ampularis
    • dilation of semicircular canals
    • contains crystals
  289. smell pathway
    sensory neuron-> cribriform plate of ethmoid-> olfactory bulb (mitral cells)-> olfactory radiations-> uncus
  290. uncus of parahippocampus
    sense of smell (limbic system)
  291. dentate of hippocampus
    memory of smells (limbic system)
  292. fornix
    midline connections of hippocampus (limbic system)
  293. amygdaloid
    emotional response to smell (limbic system)
  294. superior nasal meatus
    posterior ethmoid recess
  295. inferior nasal meatus
    nasolacrimal duct
  296. middle nasal meatus
    frontal, sphenoid, maxillary sinus drainage
  297. how to remember joint classification
    • SADISM
    • Synarthrosis (Immovable- fibrous)
    • Amphiarthrosis (Slightly movablep-cartilage)
    • Diarthrosis (Movable- synovial)
  298. Syndesmosis
    • type of synarthrosis
    • interosseous membranes
  299. synostosis
    • type of synarthrosis
    • sutures of the skull
  300. gomphosis
    • type of synarthrosis
    • teeth
  301. synchondrosis
    • type of amphiarthrosis
    • temporary, epiphyseal plates, hyaline cartilage
  302. symphysis joint
    • type of amphiarthrosis
    • IVD, pubic symphysis
    • fibrocartilage
  303. uniaxial joint
    type of diarthrosis
  304. ginglymus joint
    • hinge
    • uniaxial
    • cubital/humoeral
    • ulnar joint
    • mortis joint
  305. trochoid joint
    • pivot
    • uniaxial
    • atlas/axis
    • proximal radio-ulnar joint
  306. biaxial joint
    type of diarthrosis
  307. condlymus joint
    • ovoid
    • biaxial
    • radiocarpal
    • MCP
    • TMJ
    • knee
  308. sellar joint
    • saddle
    • biaxial
    • thumb
    • sternoclavicular joint
  309. triaxial joint
    type of diarthrosis
  310. gliding joint
    • triaxial
    • facets
    • AC joint
    • inter-carpal and tarsal joints
  311. spheroidal joint
    • ball and socket
    • triaxial
    • coxofemoral joint
    • glenohumeral joint
  312. schindylesis joint
    perpendicular articulation of ethmoid and vomer bones
  313. spinal ligaments
    • ALL
    • PLL
    • IVD
    • ligamentum flavum
    • capsular ligament
    • intertransverse ligament
    • interspinous ligament
    • supraspinous ligament
    • ligamentum nuchae
  314. ALL
    • anterior longitudinal ligament
    • runs on the front of the vertebral bodies from C2-> sacrum
    • anterior atlanto-occipital lig: from atlas to occiput
    • limits extension
  315. PLL
    • posterior longitudinal ligament
    • runs along the back of the vertebral bodies in the anterior portion of the spinal canal
    • wider in cervicals, thinner in lumbars. thinnist at L5, limits flexion
  316. IVD
    • intervertebral disc
    • fibrocartilage
    • symphysis joint (amphiarthrosis)
    • makes up 25% of the height of the spine
  317. Ligamentum flavum
    • runs lamina to lamina along the posterior portion of the canal
    • posterior atlantoaxial lig: from C2-C1
    • posterior atlanto occipital lig: from C1 to C0
    • high elastic content
    • limits flexion
  318. capsular ligament of the spine
    articular process to articular process
  319. intertransverse ligament
    TP to TP
  320. interspinous ligament
    SP to SP
  321. supraspinous ligament
    from spinous to spinous
  322. ligamentum nuchae
    supraspinous ligament from C7 to C0
  323. Transverse ligament
    holds the dens in the focea dentalis of the atlas
  324. cruciate ligament
    • C0 to the body of C2.
    • cross shaped
    • includes transverse ligament as horizontal portion
  325. alar ligament
    • sides of the dens to occipital condyles
    • "check ligament"
    • limits rotation of C2
  326. apical dental ligament
    • apex of the dens to anterior aspect of foramen magnum
    • limits flexion and extension of C2
  327. dentate ligaments
    21 ligaments connecting the pia mater to the dura mater along the spinal cord
  328. suboccipital muscles
    • obliquous capitus superior
    • obliquous capitus inferior
    • rectus capitus posterior major
    • rectus capitus posterior minor
  329. OIA of obliquous capitus superior
    • O: lateral mass of C1
    • I: occiput above the nuchal line
    • A: extension and ipsilateral rotation of the head
  330. OIA of obliquus capitus inferior
    • O: SP of C2
    • I: lateral mass of C1
    • A: rotation of C1 on C2
  331. OIA of rectus capitus posterior major
    • O: SP of C2
    • I: lateral nuchal line
    • A: extension and roation of the head
  332. OIA of rectus capitus posterior minor
    • O: posterior tubercle of C1
    • I: below nuchal line
    • A: extension and rotation of the head
  333. unique fact about obliquus capitus superior
    • lateral portion of suboccipital triangle
    • not attached to C2
  334. unique fact about obliquus capitus inferior
    • inferior part of suboccipital triangle
    • no C0 attachment
  335. unique fact about rectus capitus posterior major
    • medial part of suboccipital triangle
    • not attached to C1
  336. unique fact about rectus capitus posterior minor
    • not part of suboccipital triangle
    • not attached to C2
  337. now many spinal nerves in each spinal segment
    • 8 cervical
    • 12 thoracic
    • 5 lumbar
    • 5 sacral
    • 1 coccygeal
  338. where are the spinal enlargements
    • largest transverse diameter at C1
    • C3-T2 is cervical enlargement for tracts for arms
    • T10-12 is thoracic enlargement for tracts for legs
  339. sacral landmarks
    • median sacral crest- SPs
    • medial or intermediate crest- fused articular pillars
    • lateral sacral crest- fused TPS
  340. how many IVDs are there
    23
  341. what type of cartilage are IVDs
    fibrocartilage
  342. what type of collagen is the nucleus pulposus
    type 2 collagen
  343. after what age do the discs become avascular
    age 20
  344. how to nutrients make it into the IVDs
    movement of the spine imbibes nutrients
  345. the multifidus spans how many segments
    • 1-2
    • contralateral rotation
  346. the rotatores spans how many segments
    • 2-3
    • contralateral rotation
  347. the semispinalis spans how many segments
    • 3-6
    • contralateral rotation
  348. dural sac
    • from L2-S2
    • contains only the cauda equina
  349. cauda equina
    from conus medullaris at L1-L2 spinal level down to S2
  350. filum terminale
    • from conus medullaris (S2 spinal layer) to the coccyx
    • inner portion made of pia mater
    • outer portion made of dura mater
  351. conus medularis
    the end of the dural sac around S2 spinal level
  352. true ribs
    • ribs 1-7
    • articulate with the sternum
  353. false ribs
    • ribs 8-10
    • articulate with costocartilage of 7th rib
  354. floating ribs
    • ribs 11-12
    • no articulation with the sternum
  355. typical ribs
    ribs 3-9
  356. atypical ribs
    ribs 1,2,10-12
  357. how is rib 1 atypical
    • short and flat
    • groove for subclavian A and V
    • tubercles for anterior scalene and middle scalene muscles
    • full facet and demifacet on T1, doesnt articulate with 2 vertebra
  358. how is rib 2 atypical
    tubercles for posterior scalene and serratus anterior
  359. how is rib 10 atypical
    full facet and superior demifacet on T10
  360. how are ribs 11 and 12 atypical
    • single full facet
    • floating ribs
  361. rib ligaments
    • radiate ligament: on the front of the head of the rib connecting to body of vertebra
    • interarticular lig: on front of rib to body of vertebra
    • costotransverse ligs: connect rib to TVP
  362. suboccipital n
    • from C1
    • motor to suboccipital muscles
  363. greater occipital n
    • from C2
    • medial dorsal primary rami
  364. lesser ocipital n
    • from C2-3
    • sensory behind the ear
  365. least occipital n
    • from C3
    • 1st nerve compressed by a disc
  366. great auricular n
    • C3-4
    • sensory on and around the ear
  367. phrenic n
    • C3,4,5
    • motor to the diaphragm
  368. dorsal scapular n
    • C5
    • motor to rhomboids and levator scap
  369. suprascapular n
    • from C5-6
    • divides into subclavian n, axillary n, and upper and lower subscapular nn
  370. long thoracic n
    • from C5,6,7
    • gives rise to lateral pectoral n and musculocutaneous n
  371. thoracodorsal n
    • from C6,7,8
    • motor to latissimus dorsi
  372. radial n
    • from C5-T1
    • motor to upper extremity
    • brachial plexus
  373. median n
    • from C5-T1
    • brachial plexus
    • motor to upper extremity
  374. ulnar n
    from C8-T1
  375. medial pectoral n
    frome C8-T1
  376. medial antebrachial cutaneous n
    from C8-T1
  377. subcostal n
    • from T12
    • sensory
  378. iliohypogastic n
    • from L1
    • sensory
  379. ilioinginal n
    • L1
    • sensory
  380. genitofemoral n
    • from L1-2
    • afferent and efferent of cremaster reflex
  381. lateral femoral cutaneous n
    • L2-3
    • sensory to lateral thigh
  382. femoral n
    • from L2,3,4
    • leg extension
  383. obturator n
    • from L2,3,4
    • thigh adduction
  384. superior gluteal n
    • from L4-S1
    • motor to gluteus minimus and medius and TFL
  385. sciatic n
    • from L4-S3
    • splits into tibial (L4-S4) and common peroneal (fibular)
  386. inferior gluteal n
    • L5-S2
    • motor to gluteus maximus
  387. Posterior femoral cutaneous n
    • from S1-S3
    • sensory to posterior thigh
  388. pudendal n
    • from S2-4
    • erection and bowel and bladder control

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