Spinal Anat II Unit IV (FINAL), Spring 2012, Palmer 151

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This is an ongoing collection of quizzie questions that are administered by our notorious professor here at Palmer College of Chiropractic, Mr. Morter. I have added some study helps that I hope actually do help and not just annoying. Let's CRUSH this exam!!! Anyone with me?

What are the generic parts of a spinal nerve? (Pg.147;Q:4)

1. Ventral & Dorsal Verve RootLETS, 2. Ventral & Dorsal Nerve Roots, 3. Dorsal Nerve Root Ganglion, 4. Mixed Spinal Nerve, 5. Ventral & Dorsal Primary Nerve Rami OR Divisions

What are the Primary Neuronal Projections observed in a nerve? (Pg.148;Q:5)

1. Peripheral Sensory Process, & 2. Motor Nerve Fibers

What specific types of nerve fibers may be associated with Spinal Nerves? (Pg.148;Q:8)

1. Somatic Efferent Fibers, 2. PREganglionic Visceral OR involuntary OR Autonomic Efferent Fibers, 3. POSTganglionic Visceral, OR Involuntary OR Autonomic Efferent Fibers

What part of the Primary Afferent Neuron will be located in each of the five parts of the peripheral nerve system as stressed in class? (Pg.150;Q:19)

A. Peripheral Sensory Process: 1. Mixed Spinal Nerve, 2. Ventral Primary Rami/Division, 3. Dorsal Primary Rami/division; B. Central Sensory Process: Dorsal Nerve Root

List, in order, the parts of the peripheral nerve system through which somatic motor fibers pass from their origin in the spinal cord to the target cell. (PG.151;Q:15)

1. Ventral Nerve Rootlets, 2. Ventral Nerve Roots, 3. Mixed Spinal Nerve, 4. Either Dorsal Primary Rami/division OR Ventral Primary Rami/division

What skeletal muscles are innervated via the ventral primary rami/divisions? (Pg.151;Q:18)

All muscles of the 1. Neck, 2. Trunk, 3. Extremities, 4. Abdominal Parietal Wall, & 5. Pelvic Parietal Wall WITH THE EXCEPTION OF... Muscles innervated by Cranial Nerves IX, X, XI in the neck, and the a. Splenius, b. Erector Spinae, c. Transversospinalis, d. Suboccipital, e. Interspinalis, f. Levator Costarum

What are the subdivisions of the Visceral division of the peripheral nerve system? (Pg.152;Q:8)

1. Sympathetic, 2. PARASympathetic, & 3. Enteric **(Don't forget that Visceral is synonymous with Autonomic as well as Involuntary!!!)**

What is the function of the Enteric Nerve System? (Pg.152;Q:10)

1. Control of motility, 2. EXocrine & ENDocrine secretions, 3. microcirculation, 4. Regulation of the immune & Inflammatory processes of the GastroIntestinal Tract

What Enteric Plexus lies between the longitudinal & circular muscle layers of the gut? (Pg. 152;Q:14)

MYenteric Plexus of AUERBACH

Which specialized type of smooth muscle is associated with the MYenteric Plexus of AUERBACH? (Pg.153;Q:16)

The interstitial cell of Cajal (think A + B = C)

What is the presumed role of the interstitial cell of Cajal? (Pg.153;Q:17)

They act as PACEMAKERS for the SLOW wave, continuous PERISTALTIC activity of the gut

Which enteric plexus lies between the circular muscle layer and the muscularis mucousa layer of the gut wall? (Pg.153;Q:21)

Submucosal Plexus of Meissner PLEXUS

Other than ganglia or plexus, in what additional location will neural crest cells associated with the sympathetic division be located? (Pg.154;Q:13)

Adrenal Medulla

The Superior Cervical Ganglion is the result of fusion of which PARAvertebral ganglia? (Pg.155;Q:12)

C1-C4 PARAvertebral Ganglia (last paragraph pg.172 in noteset)

The Stellate Ganglion is the result of fusion of which PARAvertebral Ganglion? (Pg.156;Q:23)

C7, C8, & T1 PARAvertebral ganglion (pg. 173 in noteset, 2nd paragraph)

The ganglion IMPAR will communicate with which spinal nerve? (Pg. 156;Q:33)

VENTRAL Primary Rami/division of S5 & Co1 spinal nerves of BOTH sides (3rd paragraph, pg. 173 in noteset)

What are the names of the the most consistent PREvertebral ganglia? (Pg.157;Q:4)

1. Celiac Ganglion, 2. Superior Mesenteric Ganglion, 3. Inferior Mesenteric Ganglion

Which of the PREvertebral Nerve Plexuses are more likely to contain secondary Sympathetic Neuron Cell Bodies? (Pg. 157;Q:7)

1. Cardiac Plexus, 2. Pulmonary Plexus, 3. Celiac Plexus, 4. Inferior Hypogastric (Pelvic) Plexus (Remember... POSTGanglionic Axons is synonymous with secondary Neuron)

Based on the target cell innervated, what are the classifications given to POSTganglionic Sympathetic Efferent Fibers? (Pg.157;Q:2(Bottom))

1. VASOMOTOR Fiber: innervates Blood Vessel Smooth Muscle; 2. PILOMOTOR Fiber: Innervate Erector Pili Smooth Muscle of Hair Follicles; 3. SUDOMOTOR: Innervate Specialized Cells of Sudorific/Sweat Glands; 4. SECRETOMOTOR Fiber: Innervate Glandular Myoepithelial Cell (HINT: Non-muscle tissues that do not contain POSTganglionic parasympathetic innervation)

What rami will communicate with the PARAVertebral Ganglion? (Pg.161;Q:25)

1. White Rami Communicans, 2. Gray Rami Communicans, 3. Interganglionic Rami Communicans, 4. Splanchnic Nerves **(NOTE: WInGS: The Vertebral bodies have WInGS to communicate with the ganglion right next to it... PARAvertrbral Ganglion)**

In the Horizontal Pathway, what is the fate of the PREganglionic Sympathetic Efferent Fiber in the PARAvertebral Ganglion of Origin?(Pg.161;Q:2)

It will synapse on the Second Order Sympathetic Efferent Neuron (see page 178 for horizontal Pathway explanation)

In the ascending pathway, what is the location of synapse of the PREganglionic Sympathetic Efferent Fiber? (Pg.162;Q:3(Bottom))

In a PREvertebral Ganglion higher than the PARAvertebral Ganglion of Origin (NOTE: A little common sense with this one-> Preganglionic Sympathetic Neuron is fairly short and does not want to travel a long distance)

Upper and Lower Extremities are innervated with Sympathetics EXCLUSIVELY derived from which Ramus/Division? (Pg.164;Q:11)

Ventral Primary Ramus

In the Splanchnic Pathway, what is the location of synapse of the PREganglionic Sympathetic Efferent Fiber? (Pg.164;Q:3)

In the PREvertebral Ganglion OR PREvertebral Plexus (REMEMBER, Preganglionic Sympathetics do not want to travel for a long distance)

Where will PREganglionic Sympathetic Efferent Fibers synapse in the pathway to the vertebral artery? (Pg.165;Q:2)

Inferior Cervical Ganglion (Remember: 1. Sympathetics STOP at T1; #2. PREganglionic Sympathetics Do NOT Travel Long distances... therefore it will innervate Early on in the ascension to the cervicals (Inferior Cervical Ganglion))

POSTganglionic Sympathetic Efferent Fibers will become incorporated in what neuronal structure in the pathway to the eye? (Pg.165;Q:7)

Internal Carotid Artery Nerve Plexus

POSTganglionic Sympathetic Efferent Fibers will become incorporated in what neuronal structure in the pathway to the lungs? (Pg.166;Q:15)

1. Cardiac Splanchnic Nerves, 2. The Pulmonary Plexus

What is the cord level origin of the Sympathetic Neuronal Pathway to the head? (Pg.166;Q:25)

Upper Thoracic Spinal Cord Levels T1-T2 Typically

Where will PREganglionic Sympathetic Efferent Fibers synapse in the pathway to the head? (Pg.166;Q:26)

SUPerior Cervical Ganglion (HINT: They need to go a little further than the vertebral artery which was supplied by the INFerior Cervical Ganglion

Where will PREganglionic Sympathetic Efferent Fibers synapse in the pathway to the HEART? (Pg.166;Q:28)

1. PARAVertebral Ganglia of Origin from T1-T4,T5; 2. Any Cervical PARAvertebral Ganglion; 3. The Cardiac Plexus

What cell population of the Adrenal Medulla Represents Neural Ectoderm? (Pg.167;Q:35)

Chromaffin Cells (to Release Catecholamines: epinephrine (75%) and Norepinephrine (25%))

Where will PREganglionic Sympathetic Efferent Fibers Synapse in the Adrenal Gland Pathway? (Pg.167;Q:38)

Chromaffin Cells of the Adrenal Medulla (REMINDER: They are both (ANS and Adrenal Medulla) derived from the Neuron Crest Cells and thus there is no need for a "mediator" or POSTganglionic Fiber) (See BOXED area in noteset pg. 184)

What products are released from the adrenal gland following sympathetic pathway? (Pg.167;Q:39)

Catecholamines such as Epinephrine (75%) and Norepinephrine (25%)

What is the location for a spinal nerve secondary PARAsympathetic Efferent Neuron? (Pg.168;Q:4)

Tropically an Intramural Ganglion OR Neural Plexus

Which Splanchnic Nerves contain PREganglionic PARAsympathetic Efferent Fibers? (Pg.168;Q:11)

Nervi Erigentes OR Pelvic Splanchnic Nerves

Do Spinal Nerves typically contain POSTganglionic PARAsympathetic Efferent Fibers? (Pg.168;Q:14)

NO, they are in the wall of the target organ and therefore NOT in Spinal Nerves

What is the name of the largest medullary feeder artery? (Pg.170;Q:21)

The Artery of Adamkiewicz (adamKeViTZ) OR the Arteria Radicalis Magna Anterior (take your pick on which one to memorize, eh?)

What are the characteristics of the Artery of Adamkiewicz (or Arteria Radicalis Magna Anterior)? (Pg.170;Q:27)

1. It is on the LEFT side (77% of the time); 2. Anterior Medullary Feeder artery; 3. LOCATED in the T9/T10 Intervertebral Foramen; 4. Primary Vascular Supply for the Lumbar Enlargement. (Pg. 190 in noteset)

What will the intervertebral veins drain into? (Pg.171;Q:45)

The External Vertebral Venous Plexus or BATON's Plexus (Pg. 193 in noteset)

What is a unique histological feature of the veins of the vertebral column? (Pg.171;Q:46)

They Lack Valves (abnormal for veins, see pg. 193 in noteset... BOLDED BOX!!!)

What parts of the cervical vertebra will modify the intervertebral Foramen? (Pg.172;Q:3)

1. The Lateral Groove, 2. Uncinate Process

What is the relationship between aging and cervical spine nerve root? (Pg.172;Q:7)

The length of the nerve root increases as it descends from its' apparent origin on the spinal cord, BUT the cross-sectional area of the nerve root decreases

What are the specific attachment sites for a cervical spinal nerve? (Pg.172;Q:9)

1. The sulcus for the ventral primary ramus on the costotransverse bar, 2. The Vertebral Artery

What contributes to the anterior boundary of the thoracic intervertebral foramen? (Pg.172;Q:11)

The Costocentral Joint

Which are the largest spinal nerves? (Pg.173;Q:17)

L5 & S1 Spinal Nerves

What increases the length of the intervertebral foramen at L5? (Pg.173;Q:18)

The Lumbosacral Tunnel (Pg.197 BOX in noteset)

What forms the lumbosacral tunnel? (Pg.173;Q:19)

1. The Lumbosacral Ligament, 2. Transverse process of L5, & 3. Sacral Ala

What condition is the result of encroachment on the L5 Spinal Nerve? (Pg.173;Q:20)

The "Far Out Syndrome" (Box on pg.197 in noteset)

What are some examples of destructive lesions of the vertebral body? (Pg.173;Q:28)

1. Tuberculosis, 2. Hemangiomas, 3. Osteoporosis

What may reduce the impact of intervertebral disc loss of integrity on the intervertebral foramen in the cervical and thoracic spine? (Pg.173;Q:29)

CERVICALS: The Joint of Luschka; THORACIC: Costocentral joint

What are examples of acquired alterations of the spinal curves identified in class? (Pg.173;Q:31)

1. Obesity, 2. Pregnancy, 3. The use of Backpacks

What is the reason that NINE common ligaments are identified but only eight will be attached at any specific vertebral couple? (Pg.174;Q:5)

The Ligamentum Nuchae and Supraspinous ligaments attach to the spinous tubercles, BUT only one of these will be identified at a single vertebral couple.

What is the number of TRUE intervertebral discs identified in the adult? (Pg.175;Q:2)

Twenty-three (23; Michael Jordan!)

What is the organizational pattern for glycosaminoglycans in the Lumbar Nucleus Pulposus? (Pg.176;Q:4)

Thy typically lack a binding site for hyaluronic acid and are thus non-aggregated

Which type of collagen is dominant in the nucleus pulposus? (Pg.176;Q:8)

Collagen Type II

What is the unusual about the cervical annulus fibrosus? (Pg.176;Q:1)

It lacks any lamellar or layered organization

What is the organizational pattern for glycosaminoglycans in the lumbar annulus fibrosis? (Pg.177;Q:9)

They typically have a binding site for hyaluronic acid and are thus aggregated

Which type of collagen is dominant in the annulus fibrosus? (Pg.177;Q:11)

Collagen Type I

What is the organization of collagen fibers between lamellae? (Pg.177;Q:13)

Collagen fibers will be angled in the opposite direction such that a spiral - counterspiral organization is observed

What are the sources of innervation of the intervertebral disc? (Pg.179;Q:8)

1. The Sinu-vertebral nerve (sinus vertebral nerve, recurrent meningeal nerve), 2. Fibers from the ventral primary ramus, 3. Fibers from the white ramus communicans, 4. fibers from the paradiscal ramus communicans, 5. fibers from the gray ramus communicans (Pg.207 in noteset)

What structure is formed following migration of sclerotomes to surround the notochord? (Pg.182;Q:7)

The Perichordal Blastema (Pg.210 in noteset)

What does the intrasclerotomal fissure OR fissure of von Ebner become? (Pg.182;Q:10)

The Perichordal Disc

What part of the intervertebral disc will the notochord form? (Pg.183;Q:16)

The Nucleus Pulposus

What is the earliest indicator of the position of the adult intervertebral disc? (Pg.183;Q:18)

The intrasclerotomal fissure OR fissure of von Ebner

What was ossification of the Anterior Longitudinal Ligament in the lumbar region identified as? (Pg.184;Q:10)

Forestier's Disease

What is the ossification of the Anterior Longitudinal Ligament in the lumbar region now identified as? (Pg.184;Q:11)

Diffuse Idiopathic Skeletal Hyperotosis OR "DISH"

Where is ossification of the Posterior Longitudinal Ligament most commonly identified? (Pg.185;Q:14)

The Cervical Spine with an 80% incidence

What is the gender, age, and ethnic bias associated with ossification of the Posterior Longitudinal Ligament? (Pg.185;Q:18)

It is greater in Males over 50 & has a higher incidence in the Japanese

What is the name given to the ligamentum flavum based on appearance and histology? (Pg.186;Q:11)

It is a Yellow Elastic Ligament

If the Zygapophyseal Capsular Ligament is not significantly involved in restricting motion what is it's function? (Pg.187;Q:9)

It is probably involved in proprioceptive feedback to the muscles stabilizing the vertebral couple during movement

What is the name given to the SUPERFICIAL layer of the ligamentum nuchae? (Pg.188;Q:5)

The Funicular Layer OR Part

What is the name given to the DEEP layer of the Ligamentum Nuchae? (Pg.188;Q:6)

The Lamellar Layer OR Part

What is the termination level inferiorly for the ligament according to current literature? (Pg.189;Q:4)

Primarily at L4 (73%); Between L4 & L5 (5%) (See Pg.215 in noteset, bottom third of page)

What motion is best accommodated by the Atlanto-Occipital Joint? (Pg.192;Q:24)

Flexion-Extension (Pg.218 in noteset; boxed information)

What is ADI? (Pg.193;Q:17)

The Atlanto-Dental Interspace: a radiographic distance between the surfaces of the anterior bursa of the median Atlanto-Axial Joint (Pg. 219 in noteset; Boxed in information)

What is the ADI of Children? (Pg.193;Q:19)

About 4.5mm (Boxed information on pg. 219. Remember the comparison between Children and adults. Also, what population of adults resembled an ADI of children?)

What are the attachment sites for the accessory ligament of the LATeral Atlanto-Axial Joint? (Pg.194;Q:24)

The base of the Odontoid Process AND Vertebral body of the Axis (C2) to the tubercle for the Transverse Atlantal Ligament of Atlas (C1) (Pg. 219, under subheading of capsular ligament)

The Occiput-C1-C2 Joint complex accounts for what percent of all cervical axil rotation? (Pg.195;Q:45)

About 60% (Pg.220; Boxed information of Atlanto-Axial Motion)

What is the embryonic derivative of the apical ligament of the dens OR the apicodental ligament? (Pg.195;Q:4)

The Notochord (**Mr. Morter hit this one home a little more than usual*)

Which vertebral couples of the thoracic spine have the greatest motion? (Pg.200;Q:44)

T11/T12 AND T12/L1 (Pg.224 in noteset: The last group of bullets within the Motion Analysis Boxed information)

Which of the current ligaments from the Iliolumbar Ligament complex represents the Iliolumbar Ligament of classical descriptions? (Pg.201;Q:14)

The Superior Iliolumbar Ligament (Pg.225 of the noteset)

Which vertebral couple of the lumbar spine has the greatest range of motion? (Pg.202;Q:23)

L5/S1 (Pg.226 in noteset)

What ligament represents the closure of the spinal canal at the intercoccygeal joint? (Pg.204;Q:5)

The Dorsal Sacrococcygeal Ligament (Pg.227 in Noteset)

What is the auricular surface of the ilium composed of? (Pg.204;Q:5)

Articular Cartilage interspersed with Fibrocartilage (First bullet point on Pg. 228)

Which is the strongest of the sacroiliac ligaments? (Pg.205;Q:25)

The Interosseous sacro-iliac ligament (Pg. 229 in noteset, very top)

What separates the greater sciatic and lesser sciatic foramina? (Pg.206;Q:7)

The Sacrospinous Ligament (**National Board directed question** Pg.230 in Noteset)

What is the classification of the first sternocostal or sternochondral joint? (Pg.207;Q:7)

Amphiarthrosis Synchondrosis (pg. 230 in noteset, and adults only have a few of these joints)

Which of the sternocostal or sternochondral ligaments is unique to the second sternocostal or sternochondral joint? (Pg.207;Q:13)

The Intra-articular Ligament (Pg. 231 in noteset)

What is the classification of the sixth through the ninth interchondral joints? (Pg.208;Q:25)

Diarthrosis Arthrodia (Pg. 231 in Noteset, last bullet point)

What points on the skull are used to measure the skull size? (Pg.211;Q:40)

1. Nasion, 2. Vertex, 3. Inion, 4. Gnathion (VING)

What is unique about the Ophthalmic Artery and Veins? (Pg.214;Q:27)

Unlike other artery-vein combinations they will not share that same opening: the Ophthalmic Artery is in the Optic Canal (OC-OA); Ophthalmic Veins are in the Superior Orbital Fissure (SOF-OV)

What are the contents of the foramen spinosum? (Pg.214;Q:38)

1. The nervus spinosus from the mandibular division of the trigeminal nerve, 2. The Middle Meningeal Artery

What forms the roof of the Posterior Cranial Fossa? (Pg.216;Q:3)

Tentorium Cerebelli

What part of the cerebrum occupies the Posterior Cranial Fossa? (Pg.216;Q:4)

NONE!; the tentorium cerebelli separates the cerebrum into a space above the Posterior Cranial Fossa

What is the jugular body/jugular glomus? (Pg.219;Q:40)

A Chemoreceptive Organ located in the wall of the jugular bulb (Pg.236 in noteset; the function is similar to that of the Carotid body)

What are the major constituents of the five layers of the scalp? (Pg.220;Q:3)

1. Skin, 2. Neurovascular, 3. Muscular, 4. Loose Connective Tissue, 5. Periosteum (Pg.237-8 in noteset; Remember SCALP: Skin, Connective tissue (neuro-vascular), Aponeurosis (muscular; epicranius), Loose connective tissue ("scalping"), Periosteum (pericranium) )

What is the third layer of the scalp associated with? (Pg.221;Q:26)

Muscular component of the scalp (Pg.238 in noteset)

Which muscles lack any attachment to bone? (Pg.222;Q:9)

1. Orbicularis Oris, 2.Procerus, 3. (Pg.238 in noteset)

What is the name given to the medial wall of the orbit? (Pg.223;Q:13)

Lamina Papyracae (Thin Paper)

What are the names given to the modified sebaceous glands of the palpebra? (Pg.225;Q:10)

1. Tarsal Gland OR Meibomian Gland & 2. Ciliary Gland

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