Contents Of The Vertebral Canal

Front 1

Name the Vertebral Canal Contents

Back 1

Spinal cord
Spinal meninges
Spinal vasculature
Spinal nerve roots

Front 2

Name the Two enlargements of the spinal cord

Back 2

1. C4-5 to T1-innervate upper limb
2. T11-12 to S3-innervate lower limb

Front 3

Name the Layers of the Spinal Meninges

Back 3

Pia Mater
Arachnoid Mater
Dura Mater

Front 4

Describe the Dura Mater

Back 4

Outermost covering; tough.
Forms dural sac, dural root sheaths, and coccygeal ligament.

Front 5

What are the Leptomeninges?

Back 5

arachnoid and pia mater developed together

Front 6

Describe the Arachnoid Mater

Back 6

Delicate, avascular.
Membranous layer lines dural sac and dural root sheaths.
Trabeculae (strands) span subarachnoid space

Front 7

Describe the Pia Mater

Back 7

Innermost covering; transparent.
Adheres to spinal cord.
Forms denticulate ligaments and filum terminale (internum)

Front 8

Describe the Spinal Cord Spaces

Back 8

Subdural Space: “Potential” space at dura-arachnoid interface

Subarachnoid space: Between arachnoid membrane and pia mater
Contains CSF

Epidural (extradural) space: Between wall of bony vertebral canal and dural sac
Contains internal vertebral plexus and fat

Front 9

Describe CSF

Back 9

CSF is a serum-like fluid, produced by the choroid plexus in the ventricles of the brain.

CSF circulates within and around the brain and spinal cord in the subarachnoid space.

CSF acts like a “shock absorber” for protection of the brain and spinal cord.

CSF also contains proteins, glucose, and other important chemical substances.

Front 10

Describe Lumbar Puncture in Adults

Back 10

The patient leans forward to separate the spinous processes of the lumbar spine. A needle is introduced into the dural sac (lumbar cistern) between the L3 and L4 vertebrae, and cerebrospinal fluid (CSF) samples are taken. Lumbar anesthesia may be administered in a similar fashion

Front 11

Describe Lumbar Puncture in Children

Back 11

The patient leans forward to separate the spinous processes of the lumbar spine. A needle is introduced into the dural sac (lumbar cistern) between the L5 and L6 vertebrae, and cerebrospinal fluid (CSF) samples are taken. Lumbar anesthesia may be administered in a similar fashion

Front 12

Describe Epidural Anesthesia Administration

Back 12

administered by placing a catheter in the epidural space without penetrating the dural sac, or by passing a needle through the sacral hiatus

Front 13

Describe Spinal Arteries in the Cervical Region

Back 13

Anterior spinal artery in anterior median fissure.
Two Posterior spinal arteries in posterorlateral sulci

Front 14

Describe the Segmental Spinal Arteries

Back 14

Segmental medullary arteries supply spinal cord.
Radicular arteries supply nerve roots.

Front 15

Describe the Artery of Adamkiewicz

Back 15

the largest anterior segmental medullary artery.
arises from a left posterior intercostal artery, which branches from the aorta, and supplies the lower two thirds of the spinal cord via the anterior spinal artery

Front 16

Name the veins of the Vertebral canal

Back 16

Anterior spinal veins.
Posterior spinal veins
Segmental medullary veins.
Radicular veins
Internal vertebral venous plexus: in epidural (extradural) space

Front 17

What is AVM?

Back 17

Arteriovenous malformation (AVM) – abnormal tangle of blood vessels where arteries shunt blood directly into veins, with no intervening capillary bed, creating a high pressure shunt.

Cells that normally get oxygen from the capillaries begin to deteriorate.

Front 18

What are some common signs of spinal AVMs?

Back 18

Sudden, severe back pain
Weakness in the legs or arms
Paralysis

Front 19

Describe Dorsal Root Function in the Spinal Cord

Back 19

Sensory

Front 20

Describe Ventral Root Function in the Spinal Cord

Back 20

Motor

Front 21

What is the DRG and where is it found?

Back 21

Dorsal Root ganglion, found inthe intervertebral foramen

Front 22

List the Spinal Nerve Segments

Back 22

31 pairs of spinal nerves:
8 cervical nerves (C1-C8)
12 thoracic nerves (T1-T12)
5 lumbar nerves (L1-L5)
5 sacral nerves (S1-S5)
1 coccygeal nerve (Co)

Front 23

Where does the C1 spinal nerve emerge?

Back 23

C1 spinal nerve emerges between skull and C1 vertebra

Front 24

Where do the C2-C7 spinal nerves emerge?

Back 24

C2 – C7 spinal nerves emerge above their respective vertebrae

Front 25

Where does the C8 spinal nerve emerge?

Back 25

C8 spinal nerve emerges below C7 vertebra

Front 26

Where do the T1-Co spinal nerves emerge?

Back 26

T1 – Co spinal nerves emerge below their respective vertebrae

Front 27

What would be the result of a cervical cord lesion?

Back 27

Quadriplegia

Front 28

What would be the result of a thoracic cord lesion?

Back 28

Paraplegia

Front 29

What would be the result of a lumbar cord lesion?

Back 29

Loss of some lower body function

Front 30

What would be the result of a conus/cauda equina lesion?

Back 30

Variable lower body function loss

Front 31

What is Quadriplegia?

Back 31

loss of movement and sensation in all four limbs

Front 32

What is paraplegia?

Back 32

loss of movement and sensation in the lower half of the body

Front 33

Describe a laminectomy.

Back 33

A laminectomy is a surgical procedure to decrease pain due to lumbar spinal stenosis. The spinous process and the laminae are removed over the area where stenosis is occurring.

Front 34

What are the layers pierced in sequence as a needle is used for lumbar puncture?

Back 34

Skin
Subcutaneous tissue
Thoracolumbar fascia
Supraspinous ligament
Interspinous ligament
Ligamentum flavum
Epidural space
Dura mater
Arachnoid
Subarachnoid space

Front 35

Describe Spondylosis

Back 35

A degenerative disease of the spinal column, especially one leading to fusion and immobilization of the vertebral bones

Front 36

What is Spondylolysis?

Back 36

Defect in the pars interarticularis

Front 37

What is Spondylolisthesis?

Back 37

forward displacement of a vertebra over a lower segment, usually of the fourth or fifth lumbar vertebra (often due to a developmental defect in the pars interarticularis)

Front 38

Describe the I’s and T’s organizational approach to differential diagnosis

Back 38

I’s
Infection
Inflammation

T’s
Tumor
Trauma

Other factors:
Somatic dysfunction
Genetics
Psychological
Nutrition
Environment

Front 39

Name the two enlargements of spinal cord

Back 39

1. C4-5 to T1 (innervate upper limb)
2. T11-12 to S3 (innervate lower limb)