Beruflich Dokumente
Kultur Dokumente
Chair person
Dr Sadashivaiah G
Professor
Dept of Gen. Medicine
Presenter
Dr Amar Patil
contents
Introduction
Segmental and Longitudinal Organization
Anatomy- cross section
Internal Structure of the Spinal Cord
(laminae and nuclei)
Blood supply of spinal cord.
Ascending And Descending tracts.
Cord syndromes.
Introduction
Sacral Kyphosis
Regions of the Spine
Cervical
Upper cervical: C1-C2
Lower cervical: C3-C7
• Thoracic: T1-T12
• Lumbar: L1- L5
• Sacrococcygeal: 9
fused vertebrae
in the sacrum
and coccyx.
Regions of the Spine
Line of gravity
Auricle of the ear
Odontoid
Body of C7
Anterior to
thoracic spine
Posterior to
L3
Mid femoral
heads
Internal Structure of the Spinal Cord
Pia Subarachnoid
mater space: filled
with CSF
Subdural
Arachnoid space
layer
Dura mater
Blood supply of spinal cord
penetrating branches
• anterior and part of gray matter
circumferential branches
• anterior white matter
Applied anatomy
Anterior spinal artery syndrome-
the primary blood supply to the
anterior portion of the spinal
cord, is interrupted,
causing ischemia or infarction of
the spinal cord in the anterior
two-thirds of the spinal cord
and medulla oblongata.
It is characterized by loss
of motor function below the level
of injury, loss of sensations carried
by the anterior columns of the
spinal cord (pain and
temperature)
Posterior cord syndrome is a condition caused by lesion
of the posterior portion of the spinal cord. It can be
caused by an interruption to the posterior spinal artery.
Unlike anterior cord syndrome, it is a very rare
condition.
Clinical presentation:
Loss of proprioception + vibration sensation + loss of
two point discrimination +loss of light touch
Venous Drainage
The spinal veins derived from the spinal cord substance
terminate in a plexus in the pia mater where there are
six tortous, often plexiform longitudinal channels,
-one along the anterior median fissure
- a second along the posterior median sulcus
- two situated on either side,
- one pair just behind and the other just in front of the
ventral and dorsal nerve roots.
These six vessels communicate freely with one other
and above pass into the corresponding veins of the
medulla oblongata and drain into the intracranial
venous sinuses.
Venous drainage-cont
Internal
jugular
Azygos Superior
vein vena cava
Thoracic
segmental Hemiazygos
veins vein
Inferior Lumbar
vena cava segmental
veins
Common
iliac
veins
Batson’s Plexus
2nd
1st
Light touch and pressure Free nerve endings Anterior STT Postcentral
Spinal lemniscus gyrus
cervical segments
fasciculus gracilis
Axons of 2nd order neuron “
internal arcuate fibres ” cross the
median plane( sensory
decussation)
Ascend as medial lemniscus
through medulla oblongata, pons,
and midbrain
Synapse on the 3rd order neuron in
ventral posteriolateral nucleus of
thalamus
Axon of 3rd order neuron leaves and
passes through the internal capsule,
corona radiata to reach the
postcentral gyrus of cerebral cortex
area 3, 1 and 2 )
pathways for
conscious proprioception
discriminative touch
vibratory sense
Clinical application
destruction of
fasciculus gracilia and cuneatus
LMN
Lower motor neuron are constantly bombarded by nerve
impulses( excitatory or inhibitory) that descend from
cerebral cortex, pons, midbrain and medulla.