Back 1a

  1. What are the two major parts of a typical vertebra?
    Body & arch

  2. List the seven processes of a typical vertebra.
    • 1 spine
    • 2 transverse processes
    • 4 articular processes (2 cranial & 2 caudal)
  3. Where do the spinal nerves leave the vertebral canal?
    Intervertebral foramen
  4. What is formed by all the vertebral foramina of all the vertebrae?
    Vertebral canal
  5. What is the laminae of a vertebrae?
    Roof (top of arch) of vertebral foramen
  6. What is the interarcuate space?
    Dorsal gap between adjacent vertebral arches
  7. With what does the atlas (C1) articulate?
    Occipital condyles of skull
  8. What are the large lateral masses of the atlas?
    Wings of the atlas (transverse processes)
  9. What peg-like process on the axis forms a pivot articulation with the atlas?
  10. What is the large ventral projection of the sixth cervical vertebra?
    Transverse process ("sled")
  11. What joint is formed by the atlas and the skull?
    Atlanto-occipital joint, "yes" joint
  12. The articulation of the axis with the atlas is known as the ___ joint.
    Atlantoaxial joint, "no" joint
  13. Name the fibrocartilages between the bodies of adjacent vertebrae.
    Intervertebral discs
  14. What are the two parts of an intervertebral disc?
    Annulus fibrosus and nucleus pulposus
  15. What elastic connective tissue structure attaches the 1st thoracic spine to the spine of the axis (C2) in the dog?
    Nuchal ligament, none in cat
  16. What elastic tissue fills the dorsal space (interarcuate space) between the arches of adjacent vertebrae?
    Ligamentum flavum, interarcuate or yellow ligament
  17. What connects the heads of a pair of opposite ribs, crossing the dorsal part of the intervertebral discs?
    Intercapital ligament
  18. What are the two paired "strap muscles" of the neck?
    Sternohyoideus and sternothyroideus muscles
  19. Name the muscle extending from the sternum to the head.
    Sternocephalicus muscle
  20. What forms "envelopes" around the muscles of the neck?
    Deep fascia of neck.
  21. What muscles are above the transverse processes of the vertebrae?
    Epaxial mm.
  22. Name the two major epaxial muscles of the back?
    Iliocostalis and longissimus mm.
  23. What muscles are below the vertebrae's transverse processes?
    Hypaxial muscles
  24. What is the hypaxial muscle in the neck and cranial thorax?
    Longus colli m.
  25. What is the main hypaxial/sublumbar muscle of the abdomen?
    Psoas major m.
  26. Where is the common carotid artery located?
    Besides the trachea in carotid sheath.
  27. What glandular structures are under the omotransversarius muscle just cranial to the shoulder?
    Superficial cervical (prescapular) lymph node
  28. List the two important structures enclosed in the carotid sheath.
    Common carotid artery, vagosympathetic trunk
  29. Where is the esophagus located in the middle of the neck?
    on left
  30. What is the gland just caudel to the larynx on the trachea?
    Thyroid gland
  31. What is the part of the hyoid apparatus crossing the midline?
    Basihyoid bone
  32. Name the five divisions of the spinal cord.
    Cervical, thoracic, lumbar, sacral & caudal
  33. What are the ascending and descending tracks of the spinal cord and what do they carry?
    • Ascending - sensory information
    • Descending - upper motor neurons (UMN), motor information
  34. Where does the spinal cord end in the dog?
    • Dog: L6 (6-7)
    • Cat: S1-3
    • Human: L2
  35. Ventral branches of spinal nerves interlace to form ____.
  36. What nerve travels along the dorsal border of the omotransversarius muscle?
    Accessory nerve (CrN 11)
  37. What plexus supplies some of the extrinsic and all of the intrinsic muscles of the thoracic limb?
    Brachial plexus
  38. Plexuses are formed by the ventral branches of spinal nerves in every region except which?
    Thorax (except T1-2) = intercostal nn.
  39. The ventral branches of the thoracic nerves T3-13 do not form a plexus, but pass in the intercostal spaces as _____ nerves.
  40. What plexus supplies the abdominal wall, pelvic limb, external genitalia, rump and perineum?
    Lumbosacral plexus
  41. What forms the spinal nerve? Into what do spinal nerves divide?
    • Roots (dorsal & ventral)
    • Branches (dorsal & ventral)
  42. How do spinal nerves leave the vertebral canal?
    Through intervertebral foramen
  43. What spinal nerve branches supply sensation from the skin of the abdominal wall?
    • Dorsal: upper flank (including area below transverse processes)
    • Ventral: rest
  44. What are the six major functional regions of the spinal cord?
    • Cranial cervical (C1-5)
    • Cervical (brachial) enlargement (C6-T1)
    • Thoracic and cranial lumbar (T2-L3)
    • Lumbar (lumbosacral) enlargement (L4-S2)
    • Sacral (S2-3)
    • Caudal (Ca1-5)
  45. What does the sacral region of the spinal cord supply?
    Reflex control of urination, defecation, sexual reflexes & parasympathetic outflow
  46. Where does the spinal cord end in the dog? cat?
    • Dog: about L6-7
    • Cat: sacrum
  47. What is the function of the proprioceptive fibers?
    Sense position of body parts to each other and to environment
  48. Over what structures do proprioceptive fibers travel?
    Peripheral nn., spinal cord, brain stem to cerebellum & cerebrum
  49. What is a dermatome? autonomous zone?
    Area of skin innervated by a nerve, only 1 spinal n. respectively
  50. What are upper (UMN) and lower motor neurons (LMN)?
    • LMN's: leave CNS as peripheral nerves
    • UMN's: in CNS, affect LMN's
  51. What is the function of most UMN (upper motor neurons)?
    Inhibit spontaneous activity of LMN until action desired
  52. LMN's are ______ ______ without the input of UMN's.
    spontaneously active
  53. List the meninges from outer to inner.
    Dura mater, arachnoid & pia mater
  54. List the spaces that are related to the meninges.
    • Epidural: between dura mater and periosteum
    • Subdural: potential space between the dura mater and arachnoid
    • Subarachnoid space: between the arachnoid and pia mater (CSF)
  55. What is the enlargement of the subarachnoid space between the medulla oblongata and cerebellum?
    Cisterna magna (cerebellomedullary cistern)
  56. What fills the gap between the dorsal edge of the foramen magnum and the atlas?
    Dorsal atlanto-occipital membrane
  57. What is the unpaired artery running longitudinally on the vertebral canal floor in the ventral median fissure the length of the spinal cord?
    Ventral spinal artery
  58. What are the paired, thin-walled, valveless vessels on the vertebral canal floor in the epidural space from the skull to the caudal vertebrae?
    Internal vertebral venous plexus
  59. What are the vessels located on the ventral surface of the tail?
    Median caudal artery & vein
  60. How are the dorsal and ventral edges of the vertebral canal checked in back radiographs?
    Check for alignment, they should be straight lines without step defects
  61. What should be evaluated in the area of the axis and atlas?
    The dens (odontoid process), it should be present and held in the ventral vertebral canal
  62. How are the intervertebral disc spaces in back radiographs evaluated?
    Triads (3 adjacent spaces) are compared for size differences
  63. Describe the appearance of the intervertebral foramen, considered "windows" to the spinal cord.
    Look like Snoopy's little bird buddy "Woodstock" or a "horse head" in profile
  64. How are the intervertebral foramen compared in back radiographs?
    For differences due to disc space differences
  65. What is a landmark in a lateral film of the caudal neck?
    "SLEDS" or tranverse process of C6
  66. How does a myelogram appear?
    Subarachnoid space lights up = two white lines (columns) separated by a space (the invisible spinal cord)
  67. What may narrowing of the intervertebral space indicate?
    Protruded disc
  68. Describe the three possible types of spinal cord lesion.
    • a. Extradural lesion: outside the dura mater
    • b. Intradural lesion: between spinal cord and dura mater
    • c. Intramedullary (spinal cord) lesion: inside cord
  69. What are the myelogram findings for the following lesions?
    a. Extradural lesion
    b. Intradural lesion
    c. Intramedullary lesion
    • a. Thinning or break of columns pushed inward at lesion, +- expanded cord/thinned columns in other view
    • b. Widening of subarachnoid space, +- expanded cord/thinned columns in other view
    • c. Expanded cord/thinned columns in all views
  70. What are the myelogram findings for the following lesions?
    a. Extradural lesion
    a. Thinning or break of columns pushed inward at lesion, +- expanded cord/thinned columns in other view
  71. What are the myelogram findings for the following lesions?
    b. Intradural lesion
    b. Widening of subarachnoid space, +- expanded cord/thinned columns in other view
  72. What are the myelogram findings for the following lesions?
    c. Intramedullary lesion
    c. Expanded cord/thinned columns in all views
  73. What is the disease of the cervical vertebrae in large breeds causing stenosis of the vertebral canal resulting in ataxia (unsteady gait)?
    Cervical spondylomyopathy, canine wobbler disease
  74. What is excessive ventral lumbar curvature?
    Lordosis (swayback)
  75. What is an excessive thoracic curvature?
    Kyphosis (hunchback in humans)
  76. What is lateral curvature to the spine?
  77. What clinical problem would a fractured dens cause?
    Spinal cord injury
  78. What is the removal of the right or left dorsal vertebral arch (lamina) to relieve pressure in the spinal canal?
  79. What is a hemivertebra?
    Wedge-shaped vertebra resulting in severe angulation to spine in thoracolumbar region.
  80. Define and give another name for Wobbler's disease.
    Cervical sponylomyelopathy - cervical spinal cord compression
  81. What are seen radiographically with spondylosis?
    • Spurs: osteophytes intervertebral spaces
    • Bridges (ankylose vertebrae)
  82. What is diskospondylitis?
    Infection of IV discs & adjacent vertebrae
  83. What is another name for vertebral osteomyelitis/vertebral abscess?
  84. What is spina bifida?
    Failure of 1 or more vertebral arches to close
  85. Basically what are the two types of intervertebral disease?
    • Type 1: disk rupture
    • Type 2: disk bulging
  86. A slipped disc results when the soft ___ ___ is squeezed to one side of the disc, causing the firm ___ ___ to protrude and possibly rupture.
    • Nucleus pulposus
    • Annulus fibrosus
  87. What can a slipped disc protruding into the vertebral canal compress?
    Spinal nerves or spinal cord itself
  88. Where is the annulus fibrosis thinnest?
  89. Why don't intervertebral disc commonly impinge on nerves in most of the thoracic region?
    Protection of intercapital ligaments
  90. Where is rupture of an intervertebral disc common?
    Thoracolumbar junction (T11-L2)
  91. Basically, what are the two types of intervertebral disease?
    • Disk rupture
    • Disk bulging
  92. What is the removal of the remaining nucleus pulposus from a rupture disc?
    Disc fenestration
  93. What is the surgery for cervical disc disease?
    Ventral decompression through longus colli m. to remove extruded disk
  94. What is the surgery for thoracolumbar disk disease?
    Dorsal laminectomy/hemilaminectomy & fenestration (remove nucleus pulposus)
  95. What is atlantoaxial subluxation/instability?
    Instability of C1-C2 joint due to dens problems (absence, malformation, failure to ossify or insufficient ligamentous support of the dens, rupture of ligaments of dens or fracture of dens)
  96. How would you place a tube for an emergency tracheostomy / tracheotomy?
    Skin incision in the ventral neck, separate the strap mm., cut between the cartilages of the trachea, insert tube
  97. Why can a broken neck result in respiratoy paralysis?
    Phrenic nerve to diaphragm arises in brachial & cervical plexuses
  98. Why is the jugular vein often used preferentially in venipuncture?
    Saves easier cephalic v. for emergencies
  99. What is a trans tracheal wash?
    Injection & aspiration of material into a from the trachea for lab work
  100. What is a myelogram?
    Injecting contrast medium into the subarachnoid space & radiographing
  101. Describe how a spinal tap or myelogram is done with a spinal needle.
    • Flex neck
    • Palpate: wings of atlas, spine (axis) & external occipital protuberance
    • Needle: midline, 1/2" cranial to line between wings, parallel to the caudal skull
    • Feel "pop" (dorsal atlanto-occipital ligament) & immediately stop
    • Pull out stylet & look for CSF fluid in the hub = right place (If hit bone, pull out and start again, or walk needle off bone into space
    • CSF tap: collect CSF for analysis
    • Myelogram: collect CSF for analysis & then inject contrast medium
  102. Where are CSF taps performed?
    Cisterna magna or lumbar cistern
  103. Where is a lumbar CSF tap performed in the dog & cat?
    L5-6 or forward or back 1 space
  104. What are the landmarks used for cerebrospinal fluid taps at the atlanto-occipital junction?
    Wings of the atlas, spine of the axis, external occipital protuberance
  105. Describe doing a thoracolumbar myelogram or CSF (spinal) tap.
    • Needle between L5-6 spines
    • Through yellow ligament into spinal canal - Midline critical
    • Through canal to vertebrae
    • Withdraw needle a little (mm) into ventral subarachnoid space
    • Remove stylet to see CSF in hub if correct
    • CSF tap: collect CSF
    • Myelogram: collect CSF, then inject contrast
  106. Where is epidural anesthesia given?
    Through lumbosacral space into epidural space
  107. What is the lumbosacral space?
    Interarcuate space between last lumbar vertebrae (L7) & sacrum
  108. Describe procedure for a epidural in the dog.
    • Thumb & third finger on cranial end of sacral tuberosities
    • Palpate (index finger) space between last lumbar spinous process (L7) & sacrum
    • Needle perpendicular, "pop" through yellow ligament into epidural space
  109. What are the clinical signs of meningitis?
    Cervical rigidity (due to pain [hyperesthesia]), fever and lameness
  110. What is the term for meningitis associated with inflammation of the underlying spinal cord?
  111. How do lumbar, sacral and caudal spinal cord segments and the vertebrae relate?
    They don't correlate with vertebrae of same number caudal to L4
  112. Why is it important to know relationship between the lumbar spinal cord segments and the vertebrae they overlie?
    To localize the spinal cord lesions
  113. An easy way to remember where spinal cord segments lie in relationship to the vertebrae of the same number?
    • L3 over vertebrae L3
    • Sacral segments: over 5th vertebral (dog), sacrum (cat)
  114. Where is the lesion if proprioception is lost?
    Peripheral n., spinal cord, brain stem, cerebellum, or cerebrum (thus anywhere)
  115. Does loss of proprioception localize the lesion?
    No, but a sensitive indication of a neurological problem
  116. How is proprioception evaluated clinically?
    Postural reactions (e.g. knuckle paw)
  117. Describe proprioceptive placing reaction in the dog and cat.
    Placing the animal's weight on its dorsal paw should result in immediate adjustment to normal placement
  118. How can knowing the spinal cord segments innervating myotomes and dermatomes be used clinically?
    Used to localize lesions
  119. Why should you palpate the entire body's muscles?
    Check for muscle atrophy (head & limbs)
  120. Why is a patellar tap performed in a physical exam?
    Test reflex arc of pelvic limb
  121. What easy, reliable reflexes are tested for peripheral reflex arcs?
    Patellar tap, anal sphincter, tail bone, withdrawl reflex
  122. How is the withdrawl reflex tested in a screening physical?
    Pinch toes of all 4 limbs
  123. Where does gait deficits without "head signs" localize the lesion?
    To spinal cord, peripheral nerves, neuromuscular junction or diffuse muscular lesion
  124. What is the term for weakness?
  125. What is complete to partial loss of voluntary motor activity?
    Paralysis and paresis (weakness)
  126. What suffixes are used to paresis and paralysis, respectively?
    • -paresis
    • -plegia
  127. Define the following:
    a. Monoparesis or monoplegia
    Only one limb involved
  128. Define the following:
    b. Hemiparesis or hemiplegia
    Both limbs on one side
  129. Define the following:
    c. Tetraparesis/quadraparesis or tetraplegia/quadriplegia
    All 4 limbs involved
  130. Define the following:
    d. Paraparesis or paraplegia
    Only the pelvic limbs involved
  131. What is the effect of UMNs damage on LMNs?
    LMNs increase their activity
  132. What localizes a lesion to the peripheral nerves, or spinal cord, or segment of brain stem LMNs arise from?
    LMN signs
  133. What is the memory aid for LMN signs?
    Thumbs down = everything decreased or disappears
  134. List 4 LMN disease signs (thumb down).
    • Decreased or absent tone (hypotonia to atonia)
    • Decreased to absent reflexes (hypo- to areflexia)
    • Flaccid paralysis
    • Rapid atrophy (neurogenic atrophy) 1 week
  135. List 4 UMN disease signs (thumb up).
    • Normal to increased muscle tone
    • Normal to increased reflexes (hyperreflexia)
    • Spastic paresis to paralysis
    • Slow (disuse) atrophy
  136. What is Shiff-Sherrington syndrome?
    Hyperextension of forelimbs with lesions to thoracic spinal cord (T3-L3 / area 3)
  137. Localize the lesion:
    a. UMN signs pelvic limbs, LMN signs thoracic limb
    C6-T2 (Area 2)
  138. Localize the lesion:
    b. UMN to all limbs
    C1-C6 (area 1)
  139. Localize the lesion:
    c. UMN to left pelvic, normal thoracic limb
    T3-L3 (Area 3) on left
  140. Localize the lesion:
    d. UMN signs to pelvic limb, hyperextended thoracic limb
    T3-L3 (area 3) + Shiff-Sherrington
  141. Localize the lesion:
    e. LMN signs to pelvic limb with normal thoracic limb
    L4-S1 (area 4)
  142. List presenting signs to transection of the spinal cord:
    a. C1-5 spinal cord (area 1)
    • No LMN signs to either limb
    • UMN & loss of proprioception to all 4 limbs
  143. List presenting signs to transection of the spinal cord:
    b. Cervical enlargement, C6-T2 (area 2)
    • LMN & loss of proprioception to thoracic limb
    • UMN & loss of proprioception to PL
  144. List presenting signs to transection of the spinal cord:
    c. T3-L3 (area 3)
    • Normal TL (+- Shiff-Sherrington)
    • UMN & loss of proprioception to PL
  145. List presenting signs to transection of the spinal cord:
    d. L4-S1 (area 4)
    • Normal TL
    • LMN & loss of proprioception to PL
  146. What do ascending sensory / afferent tracts carry?
    Sensory information including superficial & deep pain and proprioception
  147. What is indicated if a toe pinch elicits a withdrawl of limb, but no behavioral change?
    Spinal cord or brain stem lesion cranial to reflex center
  148. What type of prognostic sign is loss of deep pain?
    Bad prognostic sign
  149. What is usually the first sign in spinal cord compression?
    Loss of proprioception
  150. Localize lesion:
    loss of proprioception in pelvic limb, normal thoracic limb proprioception
    Between T1 & S1
  151. What is the cutaneous trunci (panniculus) reflex?
    Normal reflex: contraction of cutaneous trunci m. in response to a pin prick of trunk
  152. What is the path of the cutaneous trunci (panniculus) reflex?
    Sensation from skin of trunk over thoracic & lumbar spinal nn. to spinal cord, up cord to lateral thoracic n. (C8), out to cutaneous trunci m.
  153. Clinically what is the panniculus response used to evaluate?
    Level of thoracic spinal cord damage
  154. Where is the spinal cord damage if the panniculus response is absent caudal to the level of the 10th thoracic vertebrae?
    Level of T8
  155. Where are the dermatomes of the cutaneous trunci response located?
    1 or 2 vertebrae caudal to level of innervating cord segment
  156. What vessel is commonly used to bleed cattle?
    Median caudal v. (tail v.)
  157. What is a fibrocartilaginous embolism?
    Emboli occlude vessels in the spinal cord
  158. What clinical signs are seen with fibrocartilaginous embolism?
    Paresis/paralysis caudal to the lesion
  159. How is a presumptive diagnosis of fibrocartilaginous embolism made?
    From symmetric paresis with normal radiology
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