Clinical

Question 1

What layers are traversed by the needle during a lumbar puncture?

Answer 1

Skin, subcutaneous fat, supraspinous ligament, interspinous ligament, ligamentum flavum, dura mater, arachnoid mater. CSF is obtained from within the subarachnoid space.

Question 2

What is cauda equina syndrome?

Answer 2

Severe back and leg pain
Visceral symptoms resulting from compression of nerve roots as they descend within the spinal canal.
Can result in irreversible loss of bladder or bowel function and loss of lower limb function.

Question 3

Blood supply to the spinal cord

Answer 3

1x Anterior spinal artery- from vertebral artery, runs from foramen magnum to conus medularis
2x Posterior spinal arteries- from posterior inferior cerebellar arteries, runs to conus medularis and anastomoses with anterior spinal artery
Both receive segmental radicular artery inputs

Question 4

Central cord syndrome

Answer 4

Hyperextension injury
Compression of spinal cord between the ligamentum flavum posteriorly and the intervertebral discs anteriorly
Motor fibres supplying the upper limb run centrally within the corticospinal tract as opposed to those supplying the lower limbs which run peripherally.
Weakness more marked for upper limbs than lower limbs.