Spinal Cord Flashcards
Spinal cord In Adults extending from _____ to ______
C1 to L1 (Lower Border)
Spinal cord In Newborn extending from _____ to ______
When it comes to adult level
C1 to L3 (UpperBorder)
After 2 years it comes to Lower Border of L1
Lower Triandular end of Spinal Cord
Conus medullaris
What is Filum terminale
It is modification of Piamater from
L1 → First Coccygeal vertebra
Ligamentum Denticulatum is also a modification of Piamater
Arachnoid mater and Subarachnoid space ends at
Lower border of S2
Lumbar puncture can be done at the level of
L3 - L4
Cranial dura is 2 Layered where as Spinal Dura is __________
It Converges at the level of __________ vertebra and continues upto __________
Spinal Dura is Single layered
Converge at S2 → upto Coccyx
Enlargements in the Spinal cord
Cervical Enlargement and
Lumbar Enlargement
Level of Cervical Enlargement
From C3 → T2 { brachial plexus}
Level of Lumbar Enlargement
From L1 → S3 {lumbar plexus}
Level of Maximum enlargement
38mm ~ at C6 Segment of Spinal cord
Tooth like Projections on either side of spinal cord is ________
Each side how many projections are seen?
Ligamentum denticulatum
On each side 21 Projections are seen
Ligamentum denticulatum is present between ______ and _______ Roots.
Ventral and Dorsal Root
It is an important landmark during the Neurosurgery
Nuclei in Anterior horn of Spinal cord
Lateral Nucleus
Intermediate Nucleus
Medial Nucleus
Lateral Nucleus of Anterior Horn of spinal cord innervates
Limb Muscles
Intermediate nucleus of anterior horn of spinal cord innervates
- Diaphragm ~ Phrenic Nerve (C3-C5)
- Spinal part of Accessory Nerve (C1-C5)
Is not present throughout the spinal cord
Nuclei of Intermediate Horn of Spinal Cord
IntermedioMedial nucleus ~ Parasympathetic outflow (S2-S4)
IntermedioLateral Nucleus ~ Sympathetic outflow (T1-L2)
Are not present throughout the spinal cord
Nuclei of Posterior horn of spinal cord
- Substantia gelatinosa
- Nucleus proprius
- Clarke’s column / Nucleus dorsalis
- Visceral afferent
Nucleus for Spinothalamic Tract
Nucleus gelatinosa
From BODY ~ Pain, Temperature, Crude touch, Pressure
Carried by which tract?
Spinothalamic tract
From FACE ~ Pain, Temperature, Crude touch, Pressure
Carried by
Trigeminal Nerve
Substantia gelatinosa continues above as
Spinal nucleus of Trigeminal
Nucleus proprius receives which tract
Dorsal column tract
Clarke’s column or Nucleus dorsalis receives
Spinocerebellar tract
Visceral afferent receives
Afferent from the viscera
LMN is formed by
Ant. Horn + Ventral Root + Spinal nerve arising from it
How Cortex is controlling the Facial nucleus on both sides
Upper part of Nucleus ~ by Ipsilateral Cortex
Both Part of Nucleus ~ by Contralateral Cortex
Upper Part of Facial Nucleus innervates which part of face
Upper part of Face
Lower Part of Facial Nucleus innervates which part of face
Lower part of Face
Lower Part of Facial Nucleus is controlled by
By Contralateral cortex
Which part of Facial Nerve Nucleus get Fibres from both cortex
Upper part of Facial nucleus
Left UMN Palsy of Facial Nerve
Right / Contralateral ~ only lower half of the face affected
Right LMN palsy of Facial Nerve (Bell’s Palsy)
Right / Ipsilateral ~ entire half of the face is affected
Collection of axons in CNS with same origin, course, termination and function is called
Tracts
List Pyramidal tracts
- Corticospinal Tract
2. Corticonuclear Tract
Function of Pyramidal tract
Its for Gross movements
List Extra pyramidal tracts
And their Functions
- Rubrospinal tract
- Vestibulospinal tract
- Tectodpinal tract
Modify the tone and posture of movement
Origin and function of Rubrospinal tract
Red nucleus in Midbrain → Spinal cord
Facilitates ~ Flexors and
Inhibits ~ Extensors
Function of Vestibulospinal Tract
Facilitates ~ Extensors
Inhibits ~ Flexors
Origin and Function of Tectospinal tract
From Tectum of midbrain → Spinal cord
It is for reflex movement of Head-Neck and Eyeball in relation to Visual stimulus
Feature of Lesion to ExtraPyramidal tracts →
Tremors
Feature of Lesion to Pyramidal tracts →
Hemiplegia
Pain and Temperature are carried by ___________ Tract
Lateral Spinothalamic Tract
Crude touch and Pressure are carried by ___________ Tract
Anterior Spinothalamic Tract
Fine touch, Proprioception, 2-Point Discrimination, Vibration and Stereognosis are carried by ___________ Tract
Dorsal column tract
Unconscious proprioception is carried by ________ tract
Spinocerebellar Tract
In the Spinal cord (location)
Ant. Spinocerebellar Tract and
Post. Spinocerebellar Tract
Lateral white column of spinal cord
Anterolaterally~ ant. spinocerebellar
Posterolaterally~ post. spinocerebellar
Spinothalamic tract
1st Order Neuron~
2nd Order Neuron~
3rd Order Neuron~
1st Order Neuron ~ Dorsal root ganglion
2nd Order Neuron~ Substantia gelatinosa
3rd Order Neuron~ VPL nucleus of thalamus
Lemniscus formed by Spinothalamic tract
Spinal Lemniscus in Brain Stem
Lesion of Spinothalamic tract in Brainstem or Spinal cord
Contralateral Loss of ;
Pain
Temperature
Crude touch
Pressure
Internal Arcuate Fibres are formed by
Crossing of fibres from
Gracilis and Cuneate Nuclei
Internal arcuate fibres ascend in brainstem as MEDIAL LEMNISCUS
Lemniscus formed by Internal Arcuate Fibres
Medial Lemniscus
Dorsal Column Medial Lemniscus Tract
1st Order Neuron~
2nd Order Neuron~
3rd Order Neuron~
1st Order Neuron~ Dorsal Root Ganglion
2nd Order Neuron~ Nuclei Gracile and Cuneate
3rd Order Neuron~ VPL nucleus of Thalamus
Lesion of Medial Lemniscus in the Brainstem
Contralateral Loss of;
Fine touch, Proprioception, 2-Point Discrimination, Vibration Stereognosis
Lesion of Dorsal Column in the Spinal cord
Ipsilateral loss of;
Fine touch, Proprioception, 2-Point Discrimination, Vibration Stereognosis
Posterior Spinocerebellar Tract Pathway
1st Order ~
2nd Order~
Forms __________ white column,
On _________ side
Forms post. spinocerebellar tract
Enters cerebellum through ____________
1st Order ~ DRG
2nd Order~ N. dorsalis / Clarke’s column
Forms Posterolateral white column,
On Same side
Forms post. spinocerebellar tract
Enters cerebellum through INFERIOR Cerebellar Peduncule
All ascending tracts decussate except
Posterior Spinocerebellar Tract
1st Crossing of Corticospinal Tract occurs at
And in turn forms
80-85% Fibres cross at Lower End of Medulla
Forms Lateral Corticospinal Tract and Descending down in the Lateral White Column
Uncrossed fibres from the Medulla descend as
Anterior Corticospinal Tract in the Anterior white column
Even this uncrossed Fibres will cross in the spinal cord at the level of termination
Lesion in Corticospinal Tract above Medulla Decussation results in
Contralateral Hemiplegia
Lesion in Corticospinal Tract at the level of Spinal Cord results in
Ipsilateral Hemiplegia
Anterior Spinal Artery is a branch of
Vertebral Artery
Posterior Spinal Arteries are branch of
PICA / Vertebral artery
Segmental artery arise from {in Cranio-Caudal Sequence}
They are branches of;
- Vertebral artery
- Deep Cervical Artery
- Intercostal Artery
- Lumbar Artery
Anastomosis of Segmental arteries with long vessels (Ant. and Post. Spinal arteris) forms
Pial Plexus
Branches of Segmental Artery
Anterior/Ventral Radicular Artery
Posterior/Dorsal Radicular Artery
Anterior Radiculomedullary Arteries are formed by
By anastomosis of Ant. Spinal Artery with Ascending and Descending branches of Ant. Radicular Artery
Branches of Ant. Radicular Artery + Anterior Spinal Artery forms
Anterior Radiculomedullary Arteries
Largest Anterior Radiculomedullary Artery
Artery of Adamkiewicz
Artery of Adamkiewicz arise from
- Post. Intercostal artery of 9, 10, 11 spaces
- Subcostal artery T12
- Lumbar artery L1, L2
Tabes Dorsalis is due to
Which Tract affected?
Clinical Features?
Is due to Syphilis
Dorsal column is affected
Loss of Conscious Proprioception → Loss of Position Sense
Can maintain Position by Visual input
Loss of Visual input in patient of Tabes dorsalis leads to
Loss of position sense and Tends to Fall
Is called Romberg Sign
Hemisection of Spinal Cord seen in
Brown-Sequard Syndrome
