anatomi

Question 1

vad ingår i disco-ligamentous complex?

Answer 1

ALL- anterior longitudinal ligament
PLL - posterior longitudinal ligament
Ligamentum flavum
facet capsule - the strongest posterior component
intER and supra-spinosus ligament

Question 2

how do I see if an MRI is T2 weighted?

Answer 2

• Bone is just a little bit darker than CNS
• CSF is brighter than CNS
• If CSF is dark, it is due to turbulence or movement.

Question 3

Muskel och funktion associerad till C6, C7

Answer 3

musculus extensor carpi radialis
- extension av handled
-supination av handled

Question 4

EN ELLER FLERA
*Nedströms Perifer Nerv,
-Muskel och
– funktion/reflex
ASSOCIERAD TILL L5

Answer 4

• Kolla upp
• EHL =
  – Extension (dorsiflexion) of the big toe ( and sometimes dorsiflexion of the wrist)

Question 5

EN ELLER FLERA
*Nedströms Perifer Nerv,
-Muskel och
– funktion/reflex
ASSOCIERAD TILL C5, C6

Answer 5

• Axillary nerve
• Deltoid muscle
  –Abduction of arm over 90 degrees.
• Musculocutaneous nerve
• Bicep Brachii
  – Flection of elbow and reflex of bicep tendon.

Question 6

EN ELLER FLERA
-Muskel och
– funktion/reflex
ASSOCIERAD TILL C3, C4 och C5 samt en av CN.

Answer 6

Diaphragm
- breathing. Together with CN X, Vagal nerve.

Question 7

EN ELLER FLERA
*Nedströms Perifer Nerv,
-Muskel och
– funktion/reflex/sensorik
ASSOCIERAD TILL S1

Answer 7

• Kolla upp -
• gastrocnemius
  – plantar flexion of ankle (sträcka ut foten).
  – inversion of the ankle (går på utsidan av foten)
  –

Question 8

What is ending at the level of L2?

Answer 8

The conus medullaris

Question 9

What is terminating at S2 level?

Answer 9

the tecal sac

Question 10

how to test C5?

Answer 10

Flexion of elbow

Question 11

How to test C6?

Answer 11

Extension of wrist

Question 12

how to test C7?

Answer 12

elbow extension

Question 13

how to test C8?

Answer 13

m flexor digitorum profundum - flexa distala falangen isolerat.

Question 14

how to test Th1

Answer 14

Hand intrinsics - Abducera lillfinger.

Question 15

how to test L2? what muscle is innervated?

Answer 15

hip flexion. -Iliopsoas.

Question 16

how to test L3? what muscle?

Answer 16

Straighten the knee. Quadricep muscle.

Question 17

how to test L4? - muscle

Answer 17

Dorsiflect the foot (mot skenbenet -uppåt) -Tibialis anterior

Question 18

what spinal nerve lacks a corresponding vertebra?

Answer 18

C8

Question 19

how to test C7 and C8 together?

Answer 19

elbow and finger extension. ( tricpe and extensor digitorum

Question 20

What muscles are inervated by Th2-th9?

Answer 20

The intercostals. Use sensory levels to evaluate injuries.

Question 21

What is innervated by S2-S3?

Answer 21

• pedis flexor digitorum
  samt
  *flexor hallusis

Question 22

What is innervated by S1, S2?

Answer 22

• musculus gastrocnemius - plantar flexion
• Soleus - achilles reflex

Question 23

what is innervated by L5, S1?

Answer 23

• big toe extension (dorsiflexion) - EHL
• ankle plantar flexion (gastrocnemius)

Question 24

what does EHL stand for?

Answer 24

Extensor hallucis longus

Question 25

How to test L3?

Answer 25

straighten the knee - Quadricep tendon. + reflex.

Question 26

Test of L2?

Answer 26

Hip flexion - ileopsoas.

Question 27

Reflex mediated via S2-S4 nerves?

Answer 27

Bulbocavernous reflex. - contraction of the anal sphincter in response to squeezing the glans penis or tugging on a foley cathether in both sex.

Question 28

Inconus medullaris.what 3 scenarios might the bulbo cavernous reflex be gone?

Answer 28

* spinal shock ( might be the first sign of subsiding spinal shock that the reflex returns) * injuries to cauda equina * injuries to conus medullaris

Question 29

What nerve innervate the sensation of the level of nipples?

Answer 29

C5.

Question 30

What nerves innervate diaphragm?

Answer 30

* C3-C5 phrenic nerve and parasymathically - the vagal nerve.

Question 31

The intervertebral joints are the articulations between the adjacent vertebrae of the vertebral column. Each intervertebral joint is composed of three separate joints. Which?

Answer 31

* intervertebral symphysis (intervertebral disc joint) * 2 zygapophyseal (facet) joints.

Question 32

Vertebral bodies of the cervical region C3-C7 also has another joint. what is it called?

Answer 32

The uncovertebral joint. "Joints of Luschka"

Question 33

Except for the articular capsule of the joints there are other ligaments extending between different bony processes of the vertebra. Namely?

Answer 33

* intertransverse ligament * interspinous ligament * supraspinous ligament.

Question 34

when has the spinal cord finished its growth?

Answer 34

At the age of 4

Question 35

When has the vertebral column finished its growth?

Answer 35

At the age of 14-18 yp

Question 36

What is the PCML?

Answer 36

posterior column medial lemniscus pathway - sensory pathway of CNS for fine touch, 2point disrimination, proprioception and b vibration sensation.

Question 37

Two major structures comprise PCML. Which?

Answer 37

Posterior column and medial lemniscus

Question 38

Where does the dorsal column (posterior column) terminate?

Answer 38

In medulla oblongata

Question 39

the posterior column is formed by two great nerve fibre bundles. WHich?

Answer 39

* fasciculus gracilis and *faciculus cuneatus.

Question 40

What thalamic nucleus does the medial lemniscus relay through?

Answer 40

The VPL - ventral posteriolateral

Question 41

To where does the nerves from VPL project?

Answer 41

To the postcentral gyrus.

Question 42

where is the gracile nucleus and the cuneate nucleus situated?

Answer 42

In the superior, posterior medulla oblongata. The gracile nucleus is medial to the cuneate nucleus.

Question 43

what is internal arcuate fibers?

Answer 43

Fibers from The gracile and arcuate nuclei in medulla oblongata that cross over to the medial lemniscus, posteriomedially in the same plane of medulla.

Question 44

Why is it possible to get bilateral pain, temp, crude touch and pressure disruption from medio-ventral lesions of the spinal cord?

Answer 44

Because the white tract with 2nd nerves that have synaped in the posterior grey horn cross over in the ANTERIOR WHITE COMMISSURE from both sides.

Question 45

What structures are affected in a central medullary lesion?

Answer 45

From the ventral to dorsal side: * anterior white commissure * anterior (grey) horn * Lateral corticospinal tract * Descending autonomic fibers * Dorsal horn

Question 46

What functions are in the central medulla: From the ventral to dorsal side: * anterior white commissure (only one) * anterior (grey) horn (bilateral) * Lateral corticospinal tract (bilateral, possibly only the medial part) * Descending autonomic fibers (bilateral)

Answer 46

* -crossing bilateral aschening pain, temp, crude touch and pressure - -bilateral diminished sense of that at and below that level. * cellbodies of 1st (lower) motor neurons. - flaccid paralysis - hypOreflexes -Fasciculation fibrillations (later) Only in the affected segment. * UMN, deschending white matter only medial segment involved =upper extremities. - UMN signs of all segments below lesion - first upper than lower limbs depending on how wide the lesion is. - HypER reflexia - spastic paralysis * Depending on what segment is affected. In cervical and thoracic levels, Horner might be found -ptos, mios, anhydros

Question 47

What structures are affected in "posterior cord syndrome"?

Answer 47

* Dorsal white columns -aschending tracts. ATAXIA - sensory ataxia due to destruction of spino-cerebellar tract. - loss of proprioception, vibration sense and fine discriminative touch at the level and below. * (posterior grey horn = synapses from 1st to 2nd sensory fibers of crude touch, pain, temperature and pressure) - affected only in that level.

Question 48

What structures are affected in "anterior cord syndrome"?

Answer 48

2/3 of the anterior cord. * ventral horn * anterior white comissure * Spinothalamic tract - lateral and medial column * lateral corticospinal tract * descending autonomic fibers

Question 49

What is the "usual" cause of anterior cord syndrome?

Answer 49

* Adam Kiewitz injury/trombosis at Th10.

Question 50

What are the clinical signs of anterior cord syndrome?

Answer 50

* UMN injury from site and below . * urinary bladder dysfunction and fecal incontinence * LMN signs at the level of injury * crude touch and pressure sense lost from the level and below * temperature and pain lost from the anterior white comissure and lateral and anterior spinothalamic tracts.