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- 1. ANATOMY OF VERTEBRAL COLUMN ANDSPINAL CORD MODERATOR : DR NIDHI PRESENTOR : DR RITIKA PG1
- 2. THE VERTEBRAL COLUMN .The vertebral column also known as spine ,spinal column or backbone. . It supports body weight & transmits it to the ground through lower limbs. . Spine is composed of vertebral bones and intervertebral disc. . About 71 cm in adult male . . About 61 cm in adult female. . The intervertebral disc contribute 1/5th of the length of the vertebral column.
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- 4. 7 Cervical (C) 12Thoracic (T) 5 Lumber (L) 5 Sacral (S) 4 Coccygeal
- 5. At each vertebrallevel, paired spinal nerves exit the CNS.
- 6. In thoracic ,lumbar& sacral regions, the no. of vertebrae corresponds to the number of spinal nerves, each nerve lying below the corresponding vertebra.
- 7. In the cervicalregion, there are 8 nerves, the upper 7 lying above the corresponding vertebrae & 8th below the seventh vertebra.
- 8. In the coccygealregion ,there is only one coccygeal nerve.
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- 11. The cervical, thoracic& lumbar vertebrae - movable. Sacrum & coccyx - immovable
- 12. The 1st cervicalvertebra is called ATLAS. . No body . No spine . Anterior arch & posterior arch The 2nd cervical vertebra is called AXIS. It has odontoid process(dens).
- 13. All 12 thoracicvertebrae articulate with their corresponding ribs. Lumbar vertebrae have large anterior cylindrical vertebral body.
- 14. Thoracic vertebra . Heartshaped body . Long, thin, vertical spine . Round vertebral foramen . Body/foramen ratio is 2 . Has impression for rib articulation
- 15. Lumbar Vertebra . Kidneyshaped body . Short,thick,horizontal spine . Body/foramen ratio is 3-4 . No impression for rib articulation
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- 19. The thoracic andsacral curves are called primary curves. The cervical and lumbar curves are called secondary curves. All curves are fully developed by age 10.
- 20. Newborn spinal curvature: C shape Singlecurve Adult spinal curvature: S shaped vertebral column 4 curves Secondary curvatures develop after birth.
- 23. Cervical & Lumbercurve are convex( bulging out). The thoracic & sacral curves are concave (cupping in).
- 25. FUNCTIONS OF THEVERTEBRAL COLUMN 1. Supports head. 2. Help maintain balance in the upright position. 3. Enclose and protect the spinal cord. 4. Permits movements . 5. Absorb shock during walking. 6. Serve as a point of attachment for the ribs,pelvic girdle and muscles of the back and upper limbs.
- 26. NERVOUS SYSTEM The nervoussystem has 3 functions: . Collection of sensory input . Integration . Motor output
- 28. STRUCTURAL CCNS: Brain &Spinal cord PNS: Nerves & ganglia Crainal & spinal nerves
- 29. FUNCTIONAL Sensory division(afferent) Motor division(efferent) Autonomic Somatic sese
- 31. SPINAL CORD The mainpathway for information connecting the brain and PNS. It is elongated, cylindrical, suspended in the vertebral canal and protected by vertebrae. Surrounded by meninges & CSF. The primary function of spinal cord is a transmission of neural signals between the brain &rest of the body. Sensory Motor Local reflexes
- 32. Extends from foramenmagnum to 2nd lumbar vertebra. Continuous above with the medulla oblongata. The tapered inferior end forms conus medullaris. It is connected to the coccyx called Filum Terminale.
- 33. 31 pairs ofspinal nerve 8 Cervical 12 Thoracic 5 Lumbar 5 Sacral 1 Coccygeal
- 34. Has two enlargements: Cervicalenlargement supplies the upper limbs. Lumbosacral enlargement supplies lower limbs.
- 36. It is 45cmin length. It extends lower border of L1&L2 in adults and L3 in children.
- 37. White matter decreases fromcervical to lumbosacral and gray matter increases from cervical to lumbosacral .
- 39. SPINAL MENINGES ● PIAMATER : Delicate inner layer Pia mater forms filum terminale. ● ARACHNOID MATER: It is the middle layer , which is web like structure filled with csf fluid that cushions the brain. ● DURA MATER: The tough outer layer
- 40. Spaces Epidural: contains internalvertebral venous plexus (batson plexus), blood vessels, connective tissue & fat. Subdural: contains serous fluid Subarachnoid: contains CSF & blood vessels within web like strands of arachnoid tissue, cisterns.
- 42. LIGAMENTS OF THESPINE . Anterior spinal ligament . Posterior spinal ligament . Tectorial membrane . Interspinous ligaments . Supraspinous ligament . Ligamentum flavum
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- 45. LIGAMENTUM FLAVUM It isconsist of right and left halves that join at an angle less than 90 degree. It is thinnest in cervical and upper thoracic regions. It is thickest in the lower thoracic and lumbar regions. Needle advancement is easier to appreciate when needle is introduced at a lower level. At the L2-L3 interspace, the ligamentum flavum is 3 to 5 mm thick. ,the distance from ligamentum flavum to the spinal meninges is 4-6mm. Consequently, a midline insertion of an epidural needle at this level is least likely in an inadvertent meningeal puncture with epidural anesthesia-analgesia.
- 48. Ventrally, the vertebral bodies& intervertebral disc are connected and supported by the anterior & posterior longitudinal ligaments.
- 49. Dorsally, the ligamentum flavum,interspinous ligament and supraspinousligament provide additional stability.
- 50. When we usemidline approach , needle passes through these 3 dorsal ligaments and through oval space present between bony lamina & spinous process of adjacent vertebrae.
- 51. Nerve blocks closeto the intervertebral foramen carry a risk of subdural or subarachnoid injection.
- 52. . The arteryof Adamkiewicz, or arteria radicularis magna, arising from the aorta. . It is typically unilateral & nearly always arise on the left side. . It providing the major blood supply to the anterior 2/3rd of the spinal cord. Injury to this artery can result in the anterior spinal artery syndrome.
- 53. ABNORMAL SPINAL CURVATURE ●SCOLIOSIS Lateral bending of the vertebral column ,usually in the thoracic region. ● KYPHOSIS Increase in the thoracic curve of the vertebral column. ● LORDOSIS (Hollow Back) Increase in the lumbar and cervical curve of the vertebral column.
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