1.4 The Spinal Cord

Question 1

What is the order of the Layers of the Spinal Cord, after removing the Laminae from the Vertebrae?
(Superficial to Deep)

Answer 1

1. Extradural Fat / Epidural Space
2. Dura Matter
3. Sub-Dural Space
4. Arachnoid Matter
5. Sub Arachnoid Space
6. Pia Matter
7. White Matter
8. Grey Matter
9. Ependymal Cell Membrane
   10 The Central Canal

Question 2

At what level does the Spinal Cord Terminate in an Adult?

Answer 2

L1 / L2

Question 3

At what level does the Spinal Cord Terminate in an Child?

Answer 3

L3 / L4

Question 4

At what level does the Dura Matter Terminate?

Answer 4

S2

Question 5

At what level does the Arachnoid Matter Terminate?

Answer 5

S2

Question 6

At what level does the Pia Matter Terminate?

Answer 6

It doesn’t, It forms the Filum Terminale, a fibrous ligament which blends with Dura Matter and anchors in the Coccyx

Question 7

What occupies the space between the end of the Spinal Cord, and the Termination of the Dura / Arachnoid Matter?

Answer 7

1. Cerebrospinal Fluid (CSF)
2. The Filum Terminale
3. The Cauda Equina

Question 8

What is the Clinical Significance of there being a lack of Spinal Cord below L1 / L2 (L3 / L4 in a child)?

Answer 8

Below this will be the site for a Lumbar puncture

Question 9

At what Vertebral Level would you perform a Lumbar Puncture?

Answer 9

L3-L4

Question 10

How would you position the Patient for a Lumbar Puncture and why?

Answer 10

In the Foetal Position in order to separate the Vertebrae as much as possible in that area

Question 11

How many pairs of Spinal Nerves are there?

Answer 11

31 pairs:
8 x Cervical (C)
12 x Thoracic (T)
5 x Lumbar (L)
5 x Sacral (S)
1 x Coccygeal (Ccx)

Question 12

What is the difference between Upper and Lower Motor Neurons?

Answer 12

Upper Motor Neurons connect the Spinal Cord and the Brain

Lower Motor Neurons connect the Spinal Cord and the Muscle / Sensory Area

Question 13

Is damage to the Cauda Equina classes as an Upper or a Lower Motor Neuron Lesion?

Answer 13

A Lower Motor Neuron Lesion, as it is not within the Spinal Cord