the spinal cord flm 2009 a
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THE SPINAL CORD
A FIXED LEARNING MODULECOMPILED BY
Assoc Prof dr Hamiadji Tanuseputro
HAMIADJI 2009.
THE VERTEBRAL COLUMNTHE VERTEBRAL COLUMN
• GIVE THE DIVISION OF VERT. CL.• WHAT IS KYPHOSIS, LORDOSIS,
AND SCOLIOSIS?
THE VERTEBRAL COLUMNTHE VERTEBRAL COLUMN(INTERVERTEBRAL DISC)(INTERVERTEBRAL DISC)
DESCRIBE THE INTERVERTEBRAL DISCS.
VERT. COLUMN & SPINAL CORDVERT. COLUMN & SPINAL CORD•MAJOR REFLEX CENTRE - 45 cm
•EXTENT--FORAMEN MAGNUM TO LOWER BORDER L-1, NEWBORN- UPPER BORDER L-3
•TWO ENLARGEMENTS-CERVICAL, LUMBAR•ANT.MEDIAN FISSURE, POST.MEDIAN SULCUS
•CONUS MEDULLARIS --FILUM TERMINALE•CAUDA EQUINA (spinal roots)
•ASCENDING, DESCENDING TRACTS.
GIVE THE SALIENT FEATURESOF THE SPINAL CORD.
BECAUSE THE SPINAL CORD IS SHORT & VERTEBRAL COLUMN IS LONG
SPINAL SEGMENT ≠ VERTEBRAL LEVEL VERTEBRAL LEVEL SPINAL SEGMENTSPINAL SEGMENT
CERVICAL VERTEBRAE---- ADD 1 (e.g. C-3 vert. = C4 spinal segment)
UPPER THORACIC (T-1 to 6) -- ADD 2 (e.g. T-4 vert. = T-6 spinal segment) LOWER THORACIC (T-7 to 9)- ADD 3 (e.g. T-9 vert. = T-12 spinal segment)
T-10 THORACIC -------- L-1 & L-2 segment
T-11 THORACIC---------L-3 & L-4 segment
T-12 THORACIC---------L-5 segment
LUMBAR 1--Sacral & coccygeal segment
EXAMPLE. Most common cervical spinal injuries involve C4 or C5. A person who has had a burst fracture of the C5 vertebral body- injures C6 spinal cord segment and also the C4 spinal
roots that exits the spinal column between the C4 and C5 vertebra. will cause a loss of sensations in C4 dermatome and
weak deltoids (C4) due to injury to the C4 roots.. The wrist extensors (C6) should remain weak and sensation at and
below C6 should be severely compromised.
EXPLAIN REGARDING
THE DIFFERENCEBETWEEN
VERTEBRAL LEVELAND
. SPINAL SEGMENT.
THE SPINAL MENINGESTHE SPINAL MENINGES
SPINAL MENINGES
DURA MATER-Outer most- dense, fibrous (Foramen magnum to S-2) EPIDURAL SPACE
(NEGLIGIBLE SUBDURAL SPACE)
ARACHNOID MATER-Middle- delicate impermeable ( Foramen magnum to S-2)
( SUBARACHNOID SPACE-CSF, Fine strands of conn. Tissue)
PIA MATER- INNER - fine vascular ( Foramen Magnum to coccyx-as FILUM TERMINALE) Thickened on either side of nerve roots-pairs of LIGAMENTUM DENTICULATUM
• DESCRIBE THE SPINAL MENINGES.• WHAT IS THE EPIDURAL SPACE?• LIGAMENTUM DENTICULATUM?
• FILUM TERMINALE?
THE SPINAL MENINGESTHE SPINAL MENINGES
IDENTIFY:CONUS MEDULLARIS
FILUM TERMINALECAUDA EQUINA
DURAMATERARACHNOIDPIAMATER
LIG. DENTICULATUMSPINAL GANGLION
ROOTLETSSPINAL NERVE
THE SPINAL MENINGESTHE SPINAL MENINGES
STUDY THESE PICTURESCAREFULLY.
CONTENTS OF EPIDURAL SPACE?
POSTERIOR
DURAMATER
LIGAMENTUMDENTICULATUM
ROOT
GANLION
DURA
EPIDURAL
SPINAL SEGMENTSPINAL SEGMENT
SPINAL SEGMENT--CIRCULAR PART OF SPINAL CORD FROM WHICH ROOTLETS OF 1 SPINAL NERVE EMERGE. 31 spinal segments
corresponding to 8 CERVICAL, 12 THORACIC, 5 LUMBAR , 5 SACRAL & 1 coccygeal SPINAL NERVES.
DEFINE THE SPINAL SEGMENT!HOW MANY SEGMENTS ARE THERE?
HOW MANY SPINAL NERVES ARE THERE?
DERMATOME-THE AREA OF SKIN SUPPLIED BY A SINGLE
SPINAL NERVE
STUDYTHE
LOCATIONSOF THE
DERMATOMES
S3
T10
T4
C7
L5
C2
BRANCHES OF A SPINAL NERVE
COMMUNICATING TO SYMPATHETIC TRUNK
Gray rami communicantes White rami communicantes
POST.PRIMARY RAMUS
Dorsal cutaneous br. Muscular br. To erector spinae Articular to joints of vert. Col.
ANT.PRIMARY RAMUS
Lateral cutaneous br. Anterior cutaneous br. Proximal muscular br Distal muscular br.
NAME THE BRANCHESOF A TYPICAL SPINAL
NERVE.
BRANCHES OF A SPINAL NERVE
PLEASE LABEL THEBRANCHES OF THIS
SPINAL NERVE.
COMMUNICATING TO SYMPATHETIC TRUNK
Gray rami communicantes White rami communicantes
POST.PRIMARY RAMUSDorsal cutaneous br.
Muscular br. To erector spinae Articular to joints of
vert. Col.ANT.PRIMARY RAMUS
Lateral cutaneous br. Anterior cutaneous br. Proximal muscular br.
Distal muscular br.
DISTRIBUTION OF A TYPICAL SPINAL NERVE
FUNCTIONAL COMPONENTS OF A TYPICAL SPINAL NERVE
1. GENERAL SOMATIC AFFERENT
2. GENERAL SOMATIC EFFERENT
3. GENERAL VISCERAL AFFERENT
4. GENERAL VISCERAL EFFERENT
FUNCTIONAL COMPONENTS OF A TYPICAL SPINAL NERVE
1. GENERAL SOMATIC AFFERENT
2. GENERAL SOMATIC EFFERENT
3. GENERAL VISCERAL AFFERENT
4. GENERAL VISCERAL EFFERENT
FUNCTIONAL COMPONENTS OF A TYPICAL SPINAL NERVE
PLEASE EXPLAIN THE ROLEOF THE COMPONENTS
INDICATED BELOW.
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The arteries of the spinal cord form an anastomotic network
(vasocorona) that will give off branches into the spinal cord as
endarteries. There are no anastomoses inside the spinal cord
except at the capillary level.
ARTERIAL SUPPLY OF SC.ARTERIAL SUPPLY OF SC.
GIVE IN SHORT THE ARTERIALSUPPLY OF THE SPINAL CORD.
VASOCORONA
RADICULAR ART.
• The veins of the spinal cord have the same distribution as the arteries. They course along with the arteries and drain outward via the ventral and dorsal
roots into the massive internal vertebral venous plexus in the epidural space. • The veins are valueless and have ample connections with the veins in the
thoracic, abdominal and pelvic cavities!! (metastases).
THE VENOUS DRAINAGE OF SC.THE VENOUS DRAINAGE OF SC.
GIVE IN SHORT THE VENOUSDRAINAGE OF THE SPINAL CORD.
THE LUMBAR PUNCTURETHE LUMBAR PUNCTURE
L4
L3
LUMBAR PUNCTURE (Lumbar puncture)
a median puncturesitting or reclining positionthe body should be flexed
needle insertion between L3 – L4 (how to determine?)
Insertion should be in the direction toward the umbilicus
depth of insertion approx. 5 – 7 cm
HOW TO PERFORMTHE LUMBAR PUNCTURE?
ASCENDING & DESCENDING TRACTASCENDING & DESCENDING TRACT
DORSAL COLUMNSYSTEM
&ANTERO-LATERAL
SYSTEM&
SPINO-CEREBELLARSYSTEM
LATERAL CORTICOSPINAL
SYSTEM&
ANTERIOR-CORTICOSPINALSYSTEM
LABEL THESE PRINCIPALASCENDING & DESCENDING
TRACTS.
ASCENDING & DESCENDING TRACTASCENDING & DESCENDING TRACT
Crossing of Motor & Sensory Pathways
GENERALLY THE CEREBRAL CORTEX CONTROLS &RECEIVES THE CONTRALATERAL BODY. TRUE / FALSE.
WHAT IS THE ROLE OF THE THALAMUS?
THE ASCENDING TRACTSTHE ASCENDING TRACTS
DESCRIBE THE 3 PRINCIPALASCENDING TRACTS.
Post. Column. Syst. Anterolateral. Syst. Spinocerebellar. Syst.
THE DESCENDING TRACTSTHE DESCENDING TRACTS
DESCRIBEPYRAMIDAL
&EXTRAPYRAMIDAL
TRACTS&
COMMON MOTORPATHWAY
PYRAMIDAL TRACT
SENSORY FIBRES MOTOR FIBRES
THREE SENSORY SYSTEM
1. POSTERIOR COLUMN2. ANTERO-LATERAL3. SPINO-CEREBELLAR
THREE MOTOR SYSTEM1. EXTRAPYRAMIDAL2. PYRAMIDAL3.CEREBELLAR
COMMON MOTOR PATHWAY (ANTERIOR HORN CELLS)
AUTONOMIC SYSTEM
SYMPATHETIC
PARASYMPATHETIC
GENERAL SOMATIC AFFERENT GENERAL SOMATIC EFFERENT
GE
NE
RA
L V
ISC
ER
AL
AF
FE
RE
NT G
EN
ER
AL
VIS
CE
RA
L E
FF
ER
EN
T
SPINAL NERVESCRANIAL NERVES*
PERIPHERAL NERVOUS SYSTEM (SCHEMATIC)
* Special Visceral Afferent
Special Somatic Afferent
Special Visceral Efferent
THREE SENSORY SYSTEM
1. POSTERIOR COLUMNPOSTERIOR COLUMN2. ANTERO-LATERAL3. SPINO-CEREBELLARSPINO-CEREBELLAR
THREE MOTOR SYSTEM1. EXTRAPYRAMIDAL2. PYRAMIDAL3.CEREBELLAR
COMMON MOTOR PATHWAY (ANTERIOR HORN CELLS)
THREE MOTOR SYSTEM1. EXTRAPYRAMIDAL1. EXTRAPYRAMIDAL2. PYRAMIDAL3.CEREBELLAR3.CEREBELLAR
COMMON MOTOR PATHWAY (ANTERIOR HORN CELLS)
THANK YOUTHANK YOU
FOR STUDYING THISFOR STUDYING THIS
FIXED LEARNING MODULEFIXED LEARNING MODULE
HAMIADJI 2009.
•MAJOR REFLEX CENTRE - 45 cm•EXTENT--FORAMEN MAGNUM TO LOWER BORDER
•L-1, NEWBORN- UPPER BODER L-3•2 ENLARGEMENTS-CERVICAL, LUMBAR
ANT.MEDIAN FISSURE, POST.MEDIAN SULCUS•CONUS MEDULLARIS --FILUM TERMINALE
•CAUDA EQUINA (spinal roots)•ASCENDING & DESCENDING TRACTS
GIVE THE SALIENT FEATURESOF THE SPINAL CORD.
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