A discussion I prepared on the anatomy of the spine for my anesthesia rotation during clerkship. It looks at the spine from an anesthesiologist's perspective and how it relates to spinal and epidural anesthesia.

1. Functional Anatomy of the Spine
With Anesthesiology Correlates
John Angelo Luigi S. Perez
St. Luke's Medical Center - QC
March 27, 2015

2. The spine is
composed of
33 vertebrae

3. Stacked vertebrae form the spinal
column

4. Parts of the vertebral body are
used as landmarks

5. The spinal cord is supplied by 2
main arteries

6. There are multiple layers that
wrap the spinal cord

7. There are multiple layers that
wrap the spinal cord

8. Correlations in Anesthesia
Spinal and Epidural Anesthesia

9. Surface landmarks are used to
determine the point of puncture

10. Puncturing below L1 prevents
cord trauma

11. What is
injected?
Where is it
injected?
What is
affected?
Dose?
Spinal Local
Anesthetic
CSF Cord Small
Epidural Epidural space Nerve
Roots
Large
There are key differences between
spinal and epidural anesthesia

12. Different structures are affected
in spinal and epidural anesthesia

13. Different structures are affected
in spinal and epidural anesthesia

14. Different structures are affected
in spinal and epidural anesthesia
Epidural Anesthesia
Spinal Anesthesia

15. Anesthetics have
different baricities
CSF
Hypobaric
Hyperbaric

16. Body position and baricity
interact
Hypobaric
Hyperbaric

17. Anesthesia is achieved in a gradient
M, Sen, Sym
Sen, Sym
Sym

18. Questions?
● Multiple components of support
● Anesthesia can be done differently
● Anatomy means safe anesthesia