Spine and spinal cord

Question 1

Location:
1 cervical enlargement
2 lumbosacral enlargement

Answer 1

1 C4 - T1
2 T11-S1

Question 2

Relationship between spinous processes and cord segments

Answer 2

Cervical +1
Upper thoracic +2
Lower thoracic +3
T11 +4
T12 +6
the rest of all other spinal segments are at L1 spinous process

Question 3

Anatomical basis of:
1 epidural anaesthesia
2 spinal anaestheia
3 caudal blocks
4 lumbar puncture

Answer 3

1 ends at S2 and continues as outer layer of filum terminal - extends from foramen magnum to sacral hiatus
- inject local anaesthetic around dura into epidural space

2 injection og local anaesthetic into CSF

3 identify sacral hiatus and inject local anaestehtic

4 subarachnoid space below conus = lumbar cistern.

Question 4

What is Brown-Sequard syndrome?

Answer 4

Brown-Sequard syndrome is a rare neurological condition where damage to one side of the spinal cord results in…
- ipsilateral: spastic paralysis below lesion, tactile, vibratory and position senses are disturbed
- contralateral: loss of pain and temperature (1/2 segments below lesion)
= essentially causing a “split” sensory loss

• it is considered an incomplete spinal cord injury
  -usually occurs from trauma like a stab wound to the neck or back

Question 5

Nerve root compression

Answer 5

Collapsed intervertebral disc affects the nerve root below

Osteophytes around the articular facet affect the corresponding nerve root

Question 6

Venous drainage from spinal cord? Form what? comunication between venous system?

Answer 6

• spinal veins (small, numerous, tortuous, bigger than arteries)
• form vertebral plexuses (internal and external)
• venous communications (along nerve roots, flow in both directions)

Question 7

Arterial supply of the spinal cord? What is unique feature? Branches of?

Answer 7

Anterior spinal artery = longest artery in the body + Posterior spinal artery
- Derived from vertebral arteries

Anterior and posterior segmental medullary arteries
- from ascending cervical, deep cervical, vertebral, posterior intercostal and lumbar arteries

Question 8

Landmarks for the below spinal processes:
C7
T3
T7
L4
S2

Answer 8

C7 - prominent eminence
T3 - root of the spine of the scapula
T7 - inferior angle of the scapula
L4 - highest point of iliac crest
S2 - sacral dimples

Question 9

Vertebral spine as landmarks for viscera:
C5
C7
T3
T4
T8
T10
T12
L1
L2
L3
L4
L5

Answer 9

C5 - cricoid cartilage, start of eosophagus
C7 - apex of lung
T3 - aorta reaches spine, tracheal bifurcation
T4 - aortic arch ends, upper border of heart
T8 - aortic hiatus, lower border of heart, central tendon of diaphragm
T10 - oesophageal hiatus, lower border of lung, cardia of stomach, upper body of kidney,
T12 - IVC hiatus, lowest level of pleura
L1 - hilum of kidney, SMA
L2 - spinal cord terminates, pancreas, duodenojejunal flexure
L3 - lower border of kidney
L4 - bifurcation of aorta
L5 - IVC begins

Question 10

What is syringomyelia?

Answer 10

tubelike enlargment of central canal
- affects decussating fibers = loss of pain and temperature sensation bilaterally
- followed by damage to anterior horn (muscle weakness, atrophy and loss of motor function)