The spinal cord

Question 1

What has to happen to view the spinal cord?

Answer 1

A laminectomy has to be carried out to expose the posterior surface

Question 2

What is cut in a laminectomy

Answer 2

The dura mater to expose unerlying structures

Question 3

What parts of the vertebrae have to be removed to open up the spinal canal?

Answer 3

Lamina and spinous process

Question 4

What muscles overlie the lamina and spinous process?

Answer 4

L & R Erector spinae - & deep to them the transversospinales

Question 5

What ligaments might be encountered in a laminectomy?

Answer 5

Supraspinous ligament, Interspinous ligament, & Ligamentum Flavum

Question 6

What other structures apart from the spinal cord and the meninges lie in the spinal canal?

Answer 6

Anterior & Posterior Spinal arteries & veins – meninges – spinal nerve roots

Question 7

At what vertberal level does the spinal cord terminate in adults?

Answer 7

L2

Question 8

At what vertberal level does the spinal cord terminate in new borns?

Answer 8

L2/L3

Question 9

At what vertebrae do the dura and arachnoid mater terminate?

Answer 9

S2

Question 10

What happens to the pia mater inferior to the spinal cord?

Answer 10

Becomes the filum terminale

Question 11

What occupies the space between the end of the spinal cord and the termination of the dura and arachnoid?

Answer 11

CSF

Question 12

What is the clinical significance of the CSF beign lower than the end of the spinal cord?

Answer 12

Can sample CSF without damaging spinal cord

Question 13

At what vertebral level would you perform a lumbar puncture on an adult

Answer 13

L3/4

Question 14

How would you position the patient to gain access to the lumbar cistern and why?

Answer 14

Get them in left lateral position (if Doctor R handed) – curl in fetal position – maximum Lumbar flexion – to give as large a space as possible

Question 15

How many pairs of spinal nerves are there?

Answer 15

31

Question 16

Damage to a spinal nerve presents very differently to damage of the spinal cord.

Clinicians refer to the lesions of the spinal nerves after they leave the cord as lower motor neurone lesions.

What are upper motor and lower motor neurons?

Answer 16

The nerves that send messages to between the cerebral cortex & the spine are called upper motor neurons, & those that relay messages from the spinal cord to the muscles are called lower motor neurons.

Question 17

Where are upper and lower motor neurons located?

Answer 17

Upper motor neurons originate in the cerebral cortex & travel down the brain stem or spinal cord – while the lower motor neurons begin in the spinal cord & go on to innervate the muscles etc around the body.

Question 18

Is damage to the cauda equina classified as an upper or lower motor neurone lesion?

Answer 18

LMN lesion