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Anatomy - Lamenectomy
SUNY Upstate College of Medicine Class of 2015
28
Anatomy
Graduate
09/11/2011

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Cards

Term
Dura Mater
Definition

Outermost, tough connective tissue covering the spinal cord. Extends to the level of the 2nd sacral vertebra where it ends by forming a sheath around the filum terminale.

 

Surrounds and protects the spinal cord.

Term
Arachnoid Layer
Definition

Numerous fine strands of delicate connective tissue that become continuous with the pia mater.

 

Terminates with dura at S2.

 

Subarachnoid space - between arachnoid and pia mater, contains CSF. CSF acts as the "shock absorber" and maintains the CNS in a constant pressure environment.

Term
Pia Mater
Definition

Adheres closely to spinal cord and to nerve rootlets.

 

Forms filum terminale and denticulate ligaments.

Term
Denticulate ligaments
Definition

Triangular extensions of the pia that project laterally between the dorsal and ventral roots.

 

Attach to inner surface of the dura, playing a role in stabilizing the position of the spinal cord.

Term

Lumbar cistern

(Spinal Tap)

Definition

Subarachnoid space btwn L2 and S2.

 

Preferred site to withdraw CSF b/c spinal cord is absent and the nerve roots of the cauda equina are mobile.

 

Needle usually introduced at L3/L4 (adult) or L4/L5 (child). L4 = iliac crest level.

 

Path: Skin->superficial fascia->surapsinous ligament-> interspinous ligament->ligamentum flavum->epidural space->dura->subdural space->arachnoid->subarach.

Term
Pathology for Meninges
Definition

Meningitis - an inflammation of the meningeal coverings of the brain and/or spinal cord, usually the result of a fungal, bacterial or viral infection.

 

Diagnosis confirmed by obtaining CSF via spinal tap.

Term
Dorsal Root
Definition

Consists of the processes of somatic sensory neurons and visceral afferent.

 

Transmit sensations such as temperature, touch, pain, pressure into the spinal cord as the result of stimulation of their highly specialized cutaneous receptors, located on the skin.-->exteroreceptors.

Term
Dorsal Root Embryology
Definition

Neural crest cells and alar plate join together.

 

 

Term
Ventral Root
Definition

Axons of Preganglionic sympathetic motor (efferent) and

somatic motor. Cell bodies in gray mater.

 

These transmit impulses or information out of the spinal cord that will elicit activity in a specific skeletal muscles.

 

Embryology: Neural crest cells and basal plates

Term
Conus Medullaris
Definition

at L2.

 

Tip of spinal cord

Term
Filum Terminale
Definition
Extension of pia mater that extends from conus medullaris to coccyx. Helps anchor the distal spinal cord. 
Term
Cauda Equina
Definition

Dorsal and ventral roots of the lumbar and sacral nerves.

 

Bath and float in CSF.

Term
Dorsal Root Ganglion
Definition

Cell bodies of sensory neurons.

 

Located outside dura mater.

 

In intervertebral foramen.

 

Derived from regularly arranged clusters of neural crest cells that migrate dorsally and laterally.

 

 

Term
Ventral Ramus
Definition

Somatic motor and sensory fibers and postganglionic sympathetic.

 

Supply bone, muscles, skin of anterior thoracic and abdominal wall.

 

Innervate skeletal muscle derived from segmentally arrange somites.

 

Bigger than dorsal rami.

Term
Dorsal ramus
Definition

Mix of somatic sensory and motor fibers and postganglionic sympathetic fibers.

 

Supply to bones, muscles, skin of posterior neck and trunk.

 

Smaller than ventral.

 

Also called Intercostal nerve. 

Term
Vertebral venous plexus
Definition

Network of valveless veins that course along the spine and provide a route for venous metastases of cancer cells from distal locations to spine and other organs located proximal (lungs and brain).

 

 

Term
Vertebral venous plexus drainage
Definition
Drains into intervertebral veins then into vertebral veins, ascending lumbar veins, azygous system and inferior vena cava.
Term
What is the main arterial blood supply to the spinal cord?
Definition

1. Single Longitudinal Anterior spinal artery

and 2 longitudinal posterior spinal arteries.

 

2. Paired dorsal spinal arteries

 

These are derived from branches of vertebral, deep cervical, intercostal and lumbar arteries.

Term
Intervertebral foramen
Definition
Site of dorsal root ganglion
Term
Herpes Zoster
Definition

Infection or inflammation of the dorsal root ganglion. 

 

Specific area of skin supplied by visceral afferent fibers with cell bodies in the affected dorsal root ganglion is reddened and has small lesions.

Term
Dermatomes
Definition

Geographically defined area of skin supplied by cutaneous branches of both ventral and dorsal rami of all spinal nerves.

 

"Referred pain" – somatic/visceral afferent relay info to same segment of spinal cord. Visceral afferent pain in heart sent back to spinal cord at same spot as exteroreceptors, somatic sensory cutaneous branches of chest and left arm (T1-T4/5).

Term
Genesis of cauda equina
Definition
In the embryo the spinal cord is the length of the vertebral column. But then very rapidly the vertebral column begins to grow at faster rate than the nervous tissue. So then ventral and dorsal roots of the lumbar and sacral region must be elongated to compensate for the distance btwn their spinal level of origina and the vertebral level at which they exit.
Term
Spina Bifida
Definition

Congenital condition - incomplete (bifid) formation of the vertebral arch in lumbosacral region. 

 

Types:

1. Occulta - Marked by patch of hair (L4-S1)

2. Meningocele - meninges/arachnoid ballooning out

3. Meningomyelocele - herniation of meninges and spinal cord has floated out of vertbral canal. Pulls whole spinal cord inferiorly at base of brain, stopping flow of CSF and infant would have hydrocephaly (water of the brain).

Term

Ancephaly

(Cranio)rachischisis totalis

Definition

Defect in the neural tube is restricted to the cranial area. 

Failure of entire neural tube to close or form results in this. And lack boney structure and brain.

 

Not compatible with life.

 

Ancephaly = "without head"

Term
Induction
Definition

Important embryological principle.

 

Interaction btwn 2 populations of cells. One group will go along specific pathway because near inducting group of cells.

Term
Hirshsprung's Disease
Definition

Occurs as result of lack of ganglia of preganglionic parasympathetics within walls of large intestine and subsequent absence of peristalsis.

 

Newborns and constipated and have distended abdomens. 

Term
Pheochromocytoma
Definition

Clusters of neural crest cells that fail to become part of the adrenal medulla may persis in a para-adrenal location organized as catecholamine-producing tumor.

 

Affected individuals present with transient episodes of high bp accompanied by severe headaches, heart palpitations and extreme nervousness.

Term
Injuries of cervical spine
Definition

1. Flexion - following rapid deceleration (head-on-collision)  Compression of anterior portion of vertebral body.

 

2. Vertical compression - diving accident. Burst fracture, when body and arch of vertebra are crushed. Bone particles sent into vertebral canal/spinal cord. Can result in quadripeligia. (usually C4,5)

 

3. Hyperextension - Rear end collision. Fracture of one or both sides of vertebral arch, again boney fragments sent. Tear drop fracture -due to escessive strain on anterior longitudinal ligament.

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