What are the generic parts of a spinal nerve?
ventral and dorsal nerve rootlets, ventral and dorsal nerve roots, dorsal nerve root ganglion, mixed spinal nerve, and ventral and dorsal primary nerve rami
What are the primary neuronal projections from a motor neuron?
peripheral sensory process and motor nerve fiber
What specific types of nerve fibers may be associated with spinal nerves?
a) somatic efferent fibers
b) preganglionic visceral, involuntary or autonomic efferent fibers
c) postganglionic visceral, 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 ?
peripheral sensory process: mixed spinal nerve, ventral primary ramus, dorsal primary ramus
central sensory process: dorsal nerve root
List in order parts of the peripheral nerve system through with somatic motor fibers pass from their origin in cord to target cell
ventral nerve rootlets and root, mixed spinal nerve, either ventral primary ramus or dorsal primary ramus
What skeletal muscles are innervated via the ventral primary rami?
all muscles of neck, trunk, extremities, abdominal parietal wall and pelvic parietal wall WITH THE EXCEPTION of muscles innervated by cranial nerves IX, X, XI in the neck and splenius, erector spinae, transversospinalis, suboccipital, interspinalis and levator costarum
What are the subdivisions of the visceral division of the peripheral nerve system?
sympathetic, parasympathetic and enteric
What is the function of the enteric nervous system?
control motility, exocrine and endocrine secretions, microcirculation and regulation of the immune and inflammatory processes of gastrointestinal tract
What enteric plexus lies between longitudinal circular muscle layers of the gut?
myenteric plexus of Auerbach
What specialized type of smooth muscle cell is associated with the myenteric plexus of Auerbach?
the interstitial cell of Cajal
What is the presumed role of the interstitial cell of Cajal?
they act as pacemakers for slow wave, continuous peristalic activity of the gut
What enteric plexus lies between circular muscular layer and muscularis mucosa layer of the gut wall?
submucosal plexus of Meissner
Other than the ganglia or plexuses, in what additional location will neural crest cell associated with sympathetic division be located?
The superior cervical ganglion is result of fusion of which paravertebral ganglia?
C1-C4 paravertebral ganglia
The stellate ganglion is the result of fucsion of which paravertebral ganglia?
C7, C8 T1 paravertebral ganglia
The ganglion impar will communicate with which spinal nerves?
ventral pirmary rami of S5 and Co1 spinal nerves on both sides
What are the names of the most consistent prevertebral ganglia?
celiac ganglion, superior mesenteric ganglion and inferior mesenteric ganglion
Which of the prevertebral nerve plexuses are more likely to contain secondary sympathetic neuron cell bodies?
cardiac plexus, pulmonary plexus, celiac plexus and inferior hypogastric plexus
Based on the target cell innervated what are the classifications given to postganglionic sympathetic efferent fibers?
vasomotor fiber, pilomotor fiber, sudomotor fiber, secretomotor fiber
What rami will communicate with the paravertebral ganglia?
white rami communicans, gray rami communicans, interganglionic rami communicans and splanchnic nerves
In the horizontal pathway, what is the fate of preganglionic sympathetic efferent fiber in the paravertebral ganglion of origin?
It will synapse on the second order sympathetic efferent neuron
In the ascending pathway, what is the location of synapse of preganglionic sympathetic efferent fiber?
in a paravertebral ganglion higher than the paravertebral ganglion of origin
Upper and lower extremities are innervated with sympathetics exclusively derived from which ramus?
ventral primary ramus
In splanchnic pathway, what is location of synapse of preganglionic sympathetic efferent fiber?
in PREvertebral ganglion or plexus
Where will preganglionic sympathetic efferent fibers synapse in the pathway to the vertebral artery?
inferior cervical ganglion
Postganglionic sympathetic efferent fibers will become incorporated in what neuronal structure in the pathway to the eye?
internal carotid artery nerve plexus
Postganglionic sympathetic efferent fibers will become incorporated in what structure in pathway to the lungs?
cardiac splanchnic nerves and the pulmonary plexus
What is the cord level of origin of the sympathetic neuronal pathway to the head?
upper thoracic spinal cord levels T1-T2 typicaly
Where will preganglionic sympathetic efferent fibers synapse in pathway to head?
superior cervical ganglion
Where will preganglionic symp efferent fibers synapse in pathway to the heart?
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 represent neural ectoderm?
Where will the preganglionic symp efferent fibers synapse in the adrenal gland pathway?
chromaffin cells of the adrenal medulla
What products are released from the adrenal gland following sympathetic stimulation?
catecholamines such as epinephrine and norepinephrine
What is the location for a spinal nerve secondary parasympathetic efferent neuron?
typically an intramural ganglion or neural plexus
What splanchnic nerves contain preganglionic parasympathetic efferent fibers?
nervi erigentes or pelvic splanchnic nerves
Do spinal nerves typically contain postganglionic parasymp efferent fibers?
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?
the artery of Adamkiewicz
What are the characteristics of the Artery of Adamkiewicz?
it is on the left side
it is an anterior medullary feeder artery
its located in T9/T10 intervertebral foramen
it is the primary vascular supply to the lumbar enlargement
What will the intervertebral veins drain into?
the external vertebral venous plexus or Batson's plexus
What is a unique histological features of the veins of the vertebral column?
they lack valves
What parts of the cervical vertebra will modify the intervertebral foramen?
the lateral groove and uncinate process
What is the relationship between aging and the cervical spine nerve root characteristics?
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?
the sulcus for the ventral primary ramus on the costotransverse bar and the vertebral artery
What contributes to the anterior boundary of the thoracic IVF?
the costocentral joint
Which are the largest spinal nerves?
L5 and S1 spinal nerves
What increases the length of the IVF at L5?
the lumbosacral tunnel
What forms the lumbosacral tunnel?
the lumbosacral lig, transverse process of L5 and sacral ala
What condition is the result of encroachment of the L5 spinal nerve
the far out syndrome
What are some examples of destructive lesions of the vertebral body?
tuberculosis, hemangiomas, osteoporosis
What may reduce the impact of the IV disc loss of integrity on the IVF in cervical and thoracic spine?
the joint of Luschka in cervicals
the costocentral joint in thoracics
What are examples of acquired alterations of the spinal curves identified in class?
obesity, pregnangy and the use of backpacks
What is the reason that nine common ligaments are identified but only eight will be attached at any specific couple?
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 IV discs identified in the adult?
What is the organizational pattern for glycosaminoglycans in the lumbar nucleus pulposus?
they typically lack a binding site for hyaluronic acid and are thus non-aggregated
Which type of collagen is dominant in nucleus pulposus?
collagen type II
What is unusual about the cervical annulus fibrosus?
it lacks any lamellar or layered organization
What is the organizational pattern for glycosaminoglycans in lumbar annulus fibrosus?
they have binding site for hyaluronic acid and are thus aggregated
What type of collagen is dominant in the annulus fibrosus?
collagen type I
What is the organization of collagen fibers between lamellae?
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 IV disc?
the sinu-vertebral nerve, fibers from the ventral primary ramus, fibers from white ramus communicans, fibers from paradiscal ramus communicans, fibers from gray ramus communicans
What structure is formed following migration of scleretomes to surround notochord?
the perichordal blastema
What does the intrasclerotomal fissure or fissure of von Ebner become?
the perichordal disc
What part of the intervertebral disc will the notochord form?
the nucleus pulposus
What is the earliest indicator of the position of the adult intervertebral disc?
the intrasclerotomal fissure or fissure of von Ebner
What was ossification of the ALL in lumbar spine called?
What is ossification of the ALL in lumbar region called?
Diffuse Idiopathic Skeletal Hyperostosis
Where is offification of the PLL most commonly found?
the cervical spine with 80% incidence
What is the gender, age and ethnic basis associated with ossification of PLL?
it is greater in males over 50 and has higher incidence in Japanese
What is the name given to the ligamentum flavum based on appearance and histology?
is is a yellow elastic ligament
If the zygapophyseal capsular ligament is not significantly involved in restricting motion what is its function?
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 ligamentum nuchae?
the funicular layer
What is name given to deep layer of ligamentum nuchae?
the lamellar layer
What is the termination level inferiorly for the supraspinous ligament ?
primarily at L4 (73%)
between L4 and L5 (5%)
Which motion is best accommodated by the atlanto-occipital joint?
What is the ADI?
the atlanto-dental interspace: a radiographic distance between the surfaces of the anterior bursa of the median atlanto-axial joint
What is the ADI of children?
about 4.5 mm
What are the attachment sites for the accessory ligament of the lateral atlanto-axial joint?
the base of the odontoid proces and vertebral body of axis to the tubercle for the transverse atlantal ligament of atlas
The occiput-C1-C2 joint complex accounts for what percent of all cervical axial rotation?
What is the embryonic derivative of the apical dental ligament of the dens?
Which vertebral couples of the thoracic spine have the greatest motion?
T11/T12 and T12/L1
Which of the current ligaments from the iliolumbar ligament complex represents the iliolumbar ligament of classical description?
the superior iliolumbar ligament
Which vertebral couple of the lumbar spine has greatest range of motion?
Which ligament represents the closure of the spinal canal at the intercoccygeal joint?
the dorsal sacrococcygeal ligament
What is the articular surface of the ilium composed of?
articular cartilage, interspersed with fibrocartilage
What is the strongest of the sacro-iliac ligaments?
the interosseous sacro-iliac ligament
What separates the greater sciatic and lesser sciatic foramina?
the sacrospinous ligament
What is the classification of the first sternocostal or sternochondral joint?
Which of the sternocostal ligaments is unique to the second sternocostal joint?
the intra-articular ligament
What is the classification of the 6-9 interchondral joints?
What points on the skull are used to meausre cranial vault capacity?
the nasion, vertex, inion and gnathion
What is unique about the opthalmic artery and veins?
unlike other artery-vein combinations they will not share the same opening
- the opthalamic artery is in the optic canal
- opthalamic veins are in the superior orbital fissure
What are the contents of the foramen spinosum?
the nervus spinosus from the mandibular division of the trigeminal nerve and the middle meningeal artery
What forms the roof of the posterior cranial fossa?
the tentorium cerebelli
What part of the cerebrum occupies the posterior cranial fossa?
none; the tentorium cerebelli seperates the cerebrum into a space above the posterior cranial fossa
What is the jugular body/jugular glomus?
a chemoreceptive organ located in the wall of the jugular bulb
What are the major constituents of the five layers of the scalp?
skin, neurovascular, muscular, loose connective tissue, periosteum
What is the third layer of the scalp associated with?
muscular component of the scalp
Which muscles lack any attachment to bone?
orbicularis oris, procerus and risorius
What is the name given to the medial wall of the oribit?
What are the names given to the modified sebaceous glands of the palpebrae?
tarsal gland or Meibomian gland and ciliary gland
In which view of skull would you best view piriform aperture?
One side axial rotation is greatest at which vertebral couple?
Which muscle is not innervated by branch of facial nerve?
Masseter (corrugator supercilii, temporoparietalis and platysma all are)
Which "back" muscle is classically said to atrophy and produce the iliolumbar ligament?
Muscles associated with the expression of smiling are innervated by which motor nerve?
Buccal of VII
Which is not part of the peripheral neural pathways innervating extremities?
Dorsal nerve root
What is the somatic nucleus of origin for the glossopharyngeal nerve?
Which common ligament demonstrates ossification occurring primarily in males, has a high incidence in Japanese and is correlated with DISH?
Posterior Longitudinal Ligament