[LEC] Lec 5.1 - Neuroana 1.docx

NEUROANATOMY

Central Nervous System

• Upper motor lesion
  • Hypertonia
  • Most common type of cerebral palsy: Spastic diplegia
  • Babinski sign

1. Brain

• CVA
  • L CVA 🡪 R Hemiplegia 🡪 Aphasia
  • Dt affectation of the left side of the brain
• TBI
• Multiple sclerosis
  • F > M (MS = Miss)
• Glasgow Coma Scale
  • 15: adult and child
  • 4: spontaneous eye opening
  • 5: mouth
  • 6: others
• Rancho Los Amigos
  • 4: agitated
  • 7: robot-like

1. Spinal Cord

• SCI

Peripheral Nervous System

• Lower motor lesion

  • Hypotonia

• 4 parts:

  • Ganglia
  • DRG: 1st order neuron
  • No VRG
  • 31 pairs of Spinal nerves
  • Spinal nerve below will exit what vertebral column
  • Ex. C4C5 🡪 C5
  • 12 pairs of Cranial nerves
  • Plexuses and their largest nerves
  • Cervical: Phrenic N. (C3 C4 C5 – diaphragm)
  • *Brachial: Radial / Musculospiral N. (C5 – T1)
    • located posteriorly
  • Lumbar: Femoral / Ant. Crural N. (L2 L3 L4)
  • Sacral: Sciatic N. (L4 L5 S1 S2 S3)
    • Entrapment: Piriformis Syndrome, Fat wallet, Injection Palsy

• Autonomic Nervous System

  • Visceral organs: involuntary
  • Subdivided into Parasympathetic and Sympathetic
  • Splanchnic: inside the cavity only

  

• Somatic Nervous System

  • voluntary
  • Skeletal muscles: voluntary, striated, efferent
  • skin: afferent
  • joints

Other terminologies

• Ganglion: Outside the CNS
• Nucleus: Inside the CNS
  • Basal ganglia → Basal nuclei
• Sympathomimetic medicine: mimics action
  • Epinephrine
• Sympatholytic medicine: opposite action
  • Beta blockers

AUTONOMIC NERVOUS SYSTEM

• Regulated by hypothalamus
• Maintains homeostasis (balance)
• 2 neuron hook-up
• Sympathetic: diffused, mass discharge

Rules about neurotransmission

1. All autonomic preganglionic are cholinergic.
2. All parasympathetic postganglionic are cholinergic.
3. Almost all sympathetic postganglionic are adrenergic

• Except for sweat glands & piloerector muscles 🡪 cholinergic

EFFECTS OF ANS STIMULATION

SPINAL NERVES

• 31 PAIRS
  • Cervical: 8 pairs (horizontal)
  • Thoracic: 12 pairs
  • Lumbar: 5 pairs
  • Sacral: 5 pairs
  • Coccygeal: 1 pair (horsetail)
• Termination of spinal cord: L1 L2 Vertebral levels
• Best site for lumbar puncture: L4-L5
  • Common for meningitis
  • Fetal position in sidelying
• up to 3 months of gestation: magkatapat sc and sn. pagtumanda: mas long vert column
• Tip on Spinal cord
  • Adult: end at lower border of L1
  • Children: end at L3
  • L2 vertebral fracture: No SCI (+) PNI → good prognosis

Components of Spinal Nerves

• Grey matter

• White Matter

• Dorsal Root - sensory; dermatome

• Ventral Root - myotome

• Spinal Nerve

• Gray Ramus

• White Ramus

• Dorsal Ramus - supplies dorsal aspect of trunk, skin, & ms

• Ventral Ramus - supplies anterior trunk, skin, & ms

• Dorsal Root Ganglion - round cells with 1 process leaving the body

  

DERMATOMES

• A strip of skin supplied by a single root

• Dorsal root

  

28 Key Sensory Areas

• No C1 Dermatome
• No coccygeal
• S4-S5 Combined (one level)

MYOTOMES

• A ms of group of ms supplied by a single root

• Ventral root

• ASIA = 10 myotomes

• start with C5

  • most common level of SCI (admitted)
  • most common Quadri (incomplete)

• Paraplegia - T1

• Above T1 - quadriplegia

  

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