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Questions and Answers
Which structure is responsible for connecting the third and fourth ventricles?
Which structure is responsible for connecting the third and fourth ventricles?
- Cerebral aqueduct (correct)
- Anterior medullary velum
- Striae medullaris
- Sulcus limitans
Which of the following best describes the anatomical arrangement of the ventral horn in relation to the basal plate during development?
Which of the following best describes the anatomical arrangement of the ventral horn in relation to the basal plate during development?
- Ventral horn is derived from the neural crest cells.
- Ventral horn develops from the alar plate.
- Ventral horn originates from the basal plate. (correct)
- Ventral horn forms independently of the basal plate.
A patient exhibits loss of pain and temperature sensation. Which spinal cord tract is MOST likely affected?
A patient exhibits loss of pain and temperature sensation. Which spinal cord tract is MOST likely affected?
- Lateral Corticospinal Tract
- Anterior Corticospinal Tract
- Posterior Funiculus
- Anterolateral System (correct)
Which of the following is a characteristic of interoceptive fibers in the spinal cord?
Which of the following is a characteristic of interoceptive fibers in the spinal cord?
Which artery provides the primary blood supply to the anterior aspect of the spinal cord?
Which artery provides the primary blood supply to the anterior aspect of the spinal cord?
A patient presents with a lesion affecting the dorsal columns. Which sensory deficit would you expect to observe?
A patient presents with a lesion affecting the dorsal columns. Which sensory deficit would you expect to observe?
Where does the spinal cord typically terminate in adults?
Where does the spinal cord typically terminate in adults?
Which structure anchors the spinal cord to the coccyx?
Which structure anchors the spinal cord to the coccyx?
In a spinal reflex arc, what is the role of the interneuron?
In a spinal reflex arc, what is the role of the interneuron?
Which region of the brainstem contains the superior and inferior colliculi?
Which region of the brainstem contains the superior and inferior colliculi?
Which of the listed structures is located in the medulla oblongata?
Which of the listed structures is located in the medulla oblongata?
The primary function of the denticulate ligaments is to:
The primary function of the denticulate ligaments is to:
A patient has damage to the lateral corticospinal tract. What type of deficit would MOST likely result from this damage?
A patient has damage to the lateral corticospinal tract. What type of deficit would MOST likely result from this damage?
What is the primary content within the spinal canal?
What is the primary content within the spinal canal?
What is the primary function of the venous plexus of veins (Batson's plexus)?
What is the primary function of the venous plexus of veins (Batson's plexus)?
What type of information is carried by the gracile fasciculus?
What type of information is carried by the gracile fasciculus?
A patient presents with unilateral neck pain, left arm pain, decreased arm strength, and numbness in the thumb and index finger. What is the MOST likely diagnosis?
A patient presents with unilateral neck pain, left arm pain, decreased arm strength, and numbness in the thumb and index finger. What is the MOST likely diagnosis?
Primary Neurulation gives rise to which sections of the spinal cord?
Primary Neurulation gives rise to which sections of the spinal cord?
What anatomical feature distinguishes the anterior (ventral) horn from the posterior (dorsal) horn in the spinal cord?
What anatomical feature distinguishes the anterior (ventral) horn from the posterior (dorsal) horn in the spinal cord?
Which of the following describes the primary function of the tectospinal tract?
Which of the following describes the primary function of the tectospinal tract?
Through which structure does the vertebral artery enter the cranium?
Through which structure does the vertebral artery enter the cranium?
The fourth ventricle shares a border with which structure?
The fourth ventricle shares a border with which structure?
A lesion to the reticulospinal tract would MOST likely affect what?
A lesion to the reticulospinal tract would MOST likely affect what?
What type of motor function loss would you expect with damage to the anterior corticospinal tract?
What type of motor function loss would you expect with damage to the anterior corticospinal tract?
You are assessing a patient that has damage to the posterior horn of the spinal cord. What type of deficit would you expect?
You are assessing a patient that has damage to the posterior horn of the spinal cord. What type of deficit would you expect?
Which of these are a part of the medulla oblongata?
Which of these are a part of the medulla oblongata?
Which of these best describes the 'basilar region' of the brainstem?
Which of these best describes the 'basilar region' of the brainstem?
A patient presents with loss of motor function in the right leg, but normal sensory function. Where is the MOST likely location of the lesion?
A patient presents with loss of motor function in the right leg, but normal sensory function. Where is the MOST likely location of the lesion?
Which of the following functions is associated with the reticular formation that is contained within the brainstem tegmentum?
Which of the following functions is associated with the reticular formation that is contained within the brainstem tegmentum?
What part of the fourth ventricle is the 'striae medullaris' located?
What part of the fourth ventricle is the 'striae medullaris' located?
Dorsal columns gracile and cuneate contain what type of matter?
Dorsal columns gracile and cuneate contain what type of matter?
In a myotatic stretch reflex, what is the role of the Ia sensory neuron?
In a myotatic stretch reflex, what is the role of the Ia sensory neuron?
Which is a function of the filum terminale?
Which is a function of the filum terminale?
The ventral (anterior) nerve root contains what type of fibers?
The ventral (anterior) nerve root contains what type of fibers?
Which region of the spinal cord contains Reed's laminae I-X?
Which region of the spinal cord contains Reed's laminae I-X?
If a person is experiencing lower extremities issues, which fasciculus is being impacted?
If a person is experiencing lower extremities issues, which fasciculus is being impacted?
Lumbar spinal nerves exit where?
Lumbar spinal nerves exit where?
Select the white matter.
Select the white matter.
Motor neurons reside within what region of the spinal cord?
Motor neurons reside within what region of the spinal cord?
Which is NOT a region of the brainstem?
Which is NOT a region of the brainstem?
Flashcards
Spinal Cord Segments
Spinal Cord Segments
The spinal cord is divided into cervical, thoracic, lumbar, sacral and coccygeal segments.
Spinal Nerve Roots
Spinal Nerve Roots
Each spinal nerve arises from the spinal cord via dorsal (sensory) and ventral (motor) roots.
Filum terminale externum
Filum terminale externum
Extension of the meningeal dura as filum terminale externum.
Batson's Venous Plexus
Batson's Venous Plexus
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Cervical disc herniation
Cervical disc herniation
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Lumbo-sacral disc herniation
Lumbo-sacral disc herniation
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White matter funiculi
White matter funiculi
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Dorsal Columns
Dorsal Columns
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Anterolateral System (ALS)
Anterolateral System (ALS)
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Lateral Corticospinal Tract (LCS)
Lateral Corticospinal Tract (LCS)
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Sensory Afferent Fibers
Sensory Afferent Fibers
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Motor Efferent Fibers
Motor Efferent Fibers
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Brainstem: Basilar Region
Brainstem: Basilar Region
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Brainstem: Tegmentum
Brainstem: Tegmentum
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Midbrain tectum
Midbrain tectum
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Fourth Ventricle
Fourth Ventricle
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cerebral aqueduct
cerebral aqueduct
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Study Notes
- Lecture covers Spinal Cord, Brain Stem Overview, gross anatomy and vasculature, the spinal column, disc herniation, spinal cord segments, Reed’s laminae, fiber tracts, and spinal reflexes
- Reading for the lecture includes Chapters 9 & 10, and Reading Question 3
Spinal Cord
- Gross anatomy and vasculature are components
- Involves spinal column and disc herniation
- Spinal cord and spinal segment divisions are included
- Reed’s laminae is a structural feature
- Fiber tracts are part of spinal cord anatomy
- Spinal Reflexes are triggered in the spinal cord
Brain Stem Overview
- Regions and regional anatomy are key
Developmental Organisation
- Primary neurulation concerns cervical, thoracic, and lumbar regions
- Secondary neurulation involves sacral and coccygeal areas
- Anterior basal plate forms the anterior (Ventral) horn and motor column
- Posterior alar plate becomes the posterior (Dorsal) horn and sensory column
- The neural crest forms the posterior (dorsal) root ganglion
Spinal Cord Segments
- Segments Include:
- Cervical C1-C8 (enlarged)
- Thoracic T1-T12
- Lumbar L1-L5 (enlarged)
- Sacral S1-S5
- Coccyx Co1
Spinal cord make up
- Dorsal sensory root and dorsal horn
- Intermediate gray matter
- Ventral motor horn and ventral root
- Dorsal, lateral, and ventral columns
Spinal Cord Segments
- Extends from T1-Coc1 behind the vertebral Column
- Meningeal dura, arachnoid, and denticulate ligaments cross the subarachnoid space
Gross Anatomy of spinal cord includes
- Cauda equina: spinal nerves in the lumbar cistern, L2 to Coc1
- Conus medullaris: end of the spinal cord
- Pia mater extends as the filum terminale internum
- Meningeal dura extends as the filum terminale externum
Spinal Column and Cord
- Vertebrae are composed of articulating processes which create nerve foramina
- Spinal Epidural fat is located in the spinal canal between the Batson’s venous plexus and dural sac
- Inter-vertebral discs consist of nucleus pulposus and annulus fibrosus
- Ligaments include ligamentum flavum, interspinous ligament, and posterior longitudinal ligament
Radiculopathy
- Cervical nerve roots exit above vertebrae with lateral herniation
- Lumbo-sacral nerve roots exit below vertebrae due to central, lateral, and posterolateral herniation
- Cervical disk herniation:
- C5-C6 disk herniation
- Unilateral neck pain, left arm pain, decreased arm strength, numbness in the thumb and index finger
- Lumbosacral disk herniation:
- L5-S1 herniation
- Unilateral back pain, left lower leg paresthesias and numbness, decreased sensation, Achilles tendon reflex
Divisions of spinal cord segment
- White Matter (Columns):
- Posterior funiculus
- Lateral funiculus
- Anterior funiculus
- Gray Matter:
- Reed’s laminae I-X
- Areas of the spinal cord include:
- Sensory areas (Dorsal Horn)
- Motor areas (Ventral Horn)
Divisions of spinal cord segment & Fasciculi vs Funiculus
- Fiber tracts, white matter (sensory) include;
- Dorsal columns, gracile, cuneate fasiculi = dorsal column medial lemniscus (DCML)
- Lissauer’s (posterolateral) tract
- Anterolateral spinothalamic tracts = anterolateral system (ALS)
- Spino-cerebellar tracts
- Fiber tracts, white matter (motor) include:
- Lateral corticospinal tract LCS (motor)
- Anterior corticospinal tract ACS (motor)
- Rubrospinal tract (motor)
- Other motor: recticulo-, vestibulo- & tecto-(spinal) tracts
- Neurons and nuclei, gray matter:
- Dorsal horn: substantia gelatinosa, Reed’s laminae
- Ventral (anterior) horn: Reed’s laminae
- Lateral (intermediate) horn: Clarke’s nucleus, Reed’s laminae
Sensory and motor components
- Sensory afferent fibers: heavily myelinated proprioceptive fibers terminate in laminae III-V, VII, MNs (touch, proprioception)
- Less myelinated exteroceptive fibers terminate in Lissaeur's tract or laminae I-V (pain, temperature)
- Interoceptive fibers terminate in laminae I, V-VII (visceral sensory from autonomic ganglia)
- GSA = somatic
- GVA = visceral
- Motor efferent fibers:
- Somatic efferents (heavily myelinated) supply skeletal muscles and spindles, MNs of laminae VIII, IX
- Visceral efferents supply visceromotor ganglia, MNs of intermediate zone, lamina VII
- GSE = somatic
- GVE = visceral
Spinal cord blood supply and drainage
- Vertebral artery branches, anterior & posterior spinal arteries, arterial vasocorona, central/sulcal arteries
- Segmental, medullary and radicular arteries
- The great radicular artery of Adamkiewicz is present
- Spinal Venous Drainage: consists of posterior, lateral and anterior spinal veins,
- Anterior & posterior radicular spinal veins, and posterior and anterior internal and external plexus
Spinal Cord segments
- S2, Gracile fasciulus are at the lower extremities and the anterolateral system is involved
- L4 the Gracile fasciulus is at the lower extremities and involves the LCS and rubrospinal tracts and anterolateral system
- T4 cord exhibits the gracile and cuneate fasciuli-dorsal columns and contains the LCS and rubrospinal tracts and anterolateral system
- C7 has the Gracile and cuneate fasciuli- dorsal columns, rubrospinal tracts and involves the anterolateral system
- C1 shows tracts, spinal trigeminal and spinal accessory nuclei.
Reflexes
- Reciprocal Inhibition occurs during:
- Myotatic Stretch Reflex
- Nociceptive Reflex
- Crossed Extension Reflex
- Neural circuit is for myotatic stretch reflex and crossed extension reflex
- Includes Muscle stretch reflex and autogenic inhibition
Spinal Reflexes
- Autogenic inhibition (inverse myotatic, Golgi tendon reflex)
- Withdrawal (flexor, nociceptive) reflex
- Crossed extension reflex
- What is the stimulus?
- How is appropriate behavior elicited?
- How are inappropriate behaviors denied?
Brainstem Overview
- The brainstem contains the midbrain, pons, and medulla oblongata.
- Basilar region consists of the long fiber tracts and cranial nerves (CNs).
- Tegmentum contains reticular nuclei and fibers.
- Midbrain tectum consists of the corpora quadrigemina
- Reticular system fiber tracts are in the poutine, medullary and midbrain tegmentum
- The 4th ventricle has roof and floor structures
- The landmarks are --Medulla / pons junction - cranial nerves VI, VII, VIII -achium Pontis / pyramids --pons midbrain junction - contains - cranial nerve IV, brachium pontis / cerebral peduncles --Midbrain thalamus junction - cranial nerve III, mammillary bodies ( posterior commissure)
- Medulla landmarks : Pyramids- Olive - Tubercles -Trigones
- Regions have the Colliculi & Mammillary Bodies and these are ALL made of Cranial Nerves!
- The cerebral aqueduct connects the 3rd/4th ventricles
- The 4th ventricle roof includes the: anterior medullary velum & caudal tela choroidea
- The 4th ventricle floor (rhomboid fossa) includes: hypoglossal and vagal trigones, sulcus limitans, striae medullaris and superior / inferior fovea & vestibular area
- The Foramina of Luschka and Foramen of Magendie are included
- Surface features gracile tubercle, cuneate tubercle,& facial colliculus are present.
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