12892558 the Gross Appearance of Spinal Cordlec by Emma

8/8/2019 12892558 the Gross Appearance of Spinal Cordlec by Emma

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THE GROSSTHE GROSS

APPEARANCE OF APPEARANCE OF

SPINAL CORDSPINAL CORD

Lecturer: Emmaruth B. Bautista,Lecturer: Emmaruth B. Bautista,PTRPPTRP



EXTERNALEXTERNAL ANATOMY ANATOMY



External AnatomyExternal Anatomy

Length: 42Length: 42--45 cm45 cm

Roughly cylindricalRoughly cylindrical

Superiorly: foramen magnumSuperiorly: foramen magnum Inferiorly: adult Inferiorly: adult-- lower border of 1lower border of 1st st

vertebravertebra

Young child: upper border of 3 Young child: upper border of 3rdrd lumbarlumbar

vertebravertebra Occupies upper 2/3 of vertebral canalOccupies upper 2/3 of vertebral canal

Covered by 3 meninges ( PAD )Covered by 3 meninges ( PAD )



EnlargementsEnlargements

Fusiformly enlarged:Fusiformly enlarged:

Cervical enlargement Cervical enlargement

BRACHIAL PLEXUSBRACHIAL PLEXUS

Lumbar enlargement Lumbar enlargement

LUMBOSACRAL PLEXUSLUMBOSACRAL PLEXUS





CSFCSF-- further protects SCfurther protects SC

Subarachnoid spaceSubarachnoid space CONUS MEDULLARISCONUS MEDULLARIS-- tapered end of SCtapered end of SC

FILUM TERMINALEFILUM TERMINALE-- prolongation of piaprolongation of pia

matermater Descends to attach to the posterior surface of Descends to attach to the posterior surface of

coccyxcoccyx





SegmentsSegments

CervicalCervical

ThoracicThoracic

LumbarLumbar SacralSacral

CoccygealCoccygeal





Longitudinal DivisionsLongitudinal Divisions

Anterior median fissure Anterior median fissure

Posterior median sulcusPosterior median sulcus

Ventrolateral sulcus Ventrolateral sulcus Dorsal lateral sulcusDorsal lateral sulcus



Spinal roots and NervesSpinal roots and Nerves

31 pairs of spinal nerves.31 pairs of spinal nerves.

Ventral root: MOTOR ROOTS Ventral root: MOTOR ROOTS Dorsal root: SENSORY ROOTSDorsal root: SENSORY ROOTS

DORSAL ROOT GANGLIONDORSAL ROOT GANGLION

Gives rise to peripheral & central nerve fibersGives rise to peripheral & central nerve fibers



Ventral Root Ventral Root

Biceps Biceps -- C5/6C5/6

Brachioradialis Brachioradialis -- C5/6C5/6

Triceps Triceps -- C7 (C6C7 (C6--8)8) Finger flexors Finger flexors -- C8 (C7C8 (C7--T1)T1)

Knee Knee -- L3 (L2L3 (L2--L4)L4)

Ankle Ankle -- S1 (L5S1 (L5--S2)S2)



Dorsal Root Dorsal Root Clinically important dermatomes Clinically important dermatomes C2 and C3C2 and C3 -- Posterior head and neck Posterior head and neck C4 and T2C4 and T2 -- Adjacent to each other in the upper Adjacent to each other in the upper thorax thorax

Nipple Nipple -- T4 or T5T4 or T5

Umbilicus Umbilicus -- T10T10 Upper extremity Upper extremity

C5C5 -- Anterior shoulder Anterior shoulder C6C6 -- Thumb Thumb

C7C7 -- Index and middle fingers Index and middle fingers

C 7/8C 7/8 -- Ring finger Ring finger C8C8 -- Little finger Little finger T1T1 -- Inner forearm Inner forearm

T2T2 -- Upper inner arm Upper inner arm

T2/3T2/3 -- Axilla Axilla





Branches of Spinal NervesBranches of Spinal Nerves

Posterior primary division.Posterior primary division.

Anterior primary division. Anterior primary division.

Rami communicantes.Rami communicantes. Recurrent meningeal branches.Recurrent meningeal branches.



INTERNALINTERNAL ANATOMY ANATOMY





Gray MatterGray Matter

HH--shaped pillarshaped pillar

HORNHORN--each arm of the Heach arm of the H

resulting in two anterior horns and tworesulting in two anterior horns and twoposterior horns.posterior horns.

gray commissuregray commissure-- The connecting middleThe connecting middle

portion is calledportion is called Related to the amount of muscleRelated to the amount of muscle

innervated at the level.innervated at the level.



The gray matter can be divided into 10The gray matter can be divided into 10laminae/layers or into 4 parts:laminae/layers or into 4 parts:

anterior or ventral horn (ie, motoranterior or ventral horn (ie, motorneurons; laminae VIII, IX, and part of neurons; laminae VIII, IX, and part of

VII), VII),

posterior or dorsal horn (ie, sensory part;posterior or dorsal horn (ie, sensory part;laminae Ilaminae I--VI), intermediate zones (ie, VI), intermediate zones (ie,associate neurons; lamina VII), and lateralassociate neurons; lamina VII), and lateralhorns (ie, part of the intermediate zone,horns (ie, part of the intermediate zone,

present in the thoracic and lumbarpresent in the thoracic and lumbarsegments, where sympathetic neurons aresegments, where sympathetic neurons arelocated).located).





White MatterWhite Matter

Divisions:Divisions:

Anterior column Anterior column

Posterior columnPosterior column Lateral columnLateral column

Consists of a mixture of nerves, neuroglia,Consists of a mixture of nerves, neuroglia,and blood vessels.and blood vessels.



Anterior Column Anterior Column

Contains alpha and gamma motorContains alpha and gamma motorneurons.neurons.

3 groups:3 groups:GROUPGROUP

MedialMedial

CentralCentral

LateralLateral

INNERVATIONINNERVATION

Mm of trunk, neck, abdomenMm of trunk, neck, abdomen& intercostals& intercostals

Phrenic, accessory, &Phrenic, accessory, &lumbosacrallumbosacral

Mm of the limbsMm of the limbs







Substantia GelatinosaSubstantia Gelatinosa

Located at apex of posterior gray columnLocated at apex of posterior gray column

Pain & temperaturePain & temperature

Great amount of Substance PGreat amount of Substance P



Nucleus PropriusNucleus Proprius

Anterior to the substantia gelatinosa. Anterior to the substantia gelatinosa.

Main bulk of posterior column.Main bulk of posterior column.

Receives from posterior WHITE column.Receives from posterior WHITE column. PROPRIOCEPTION, 2 PT.PROPRIOCEPTION, 2 PT.

DISCRIMINATION, VIBRATIONDISCRIMINATION, VIBRATION



Nucleus DorsalisNucleus Dorsalis

Clarks ColumnClarks Column

Base of the posterior gray columnBase of the posterior gray column

From C8From C8--L4 segment L4 segment Propioceptive endingsPropioceptive endings

( mm spindle & tendon spindle )( mm spindle & tendon spindle )



Visceral Afferent Nucleus Visceral Afferent Nucleus

Lateral to the nucleus dorsalis.Lateral to the nucleus dorsalis.

From T1From T1--L3 segments.L3 segments.

Receives visual afferent information.Receives visual afferent information.



LaminaeLaminaeLaminaLamina DescriptionDescription

II Responds to noxious stimuliResponds to noxious stimuli

IIII SG; High concentrations of Substance P.SG; High concentrations of Substance P.

III & IVIII & IV Nucleus PropriusNucleus Proprius

V V Responds to noxious stimuliResponds to noxious stimuli





LaminaeLaminae

VI VI Deepest layer of the dorsal horn; respondsDeepest layer of the dorsal horn; respondsto mechanical signals from joints & skinto mechanical signals from joints & skin

VII VII Anterior & posterior column; Anterior & posterior column;intermediolateral nucleus in the thoracic &intermediolateral nucleus in the thoracic &upper lumbar regionsupper lumbar regions

VIII & VIII &

IX IX

Medial & lateral nuclei of the anteriorMedial & lateral nuclei of the anterior

columncolumn

X X Around the central canal Around the central canal



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12892558 the Gross Appearance of Spinal Cordlec by Emma