Presented by Dr. Sharika .K.

U 1st MD

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It is a long cylibndrical greyish white structure covered by meninges and lies in vertebral canal. It extends from Foramen magnum above to lower border of L1 in adults ad upper border of L3 in children. It is the least modified portion of embryonic neural tube and only part of adult NS in wh primitive segmental arngt is clearly preserved. LENGTH45 cm in male 43 cm female.

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The spinal cord functions primarily in the transmission of neural signals between the brain and the rest of the body but also contains neural circuits that can independently control numerous reflexes and central pattern generators. The spinal cord has three major functions: A. Serve as a conduit for motor information, which travels down the spinal cord. B. Serve as a conduit for sensory information, which travels up the spinal cord. C. Serve as a center for coordinating certain reflexes
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Though s.c stops at L1 level ,meningeal layer conts down.Pia ad arachenoid extend down to S2 ad dura extend furthr down. Pia that extend down as connective tissue filament calld FILUM TERMINALE. S.C tapers as CONUS MEDULLARIS
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 There is disproportionate growth of S.C ad V.C. S.C is shorter than spinal canal, vertebral bodies

ad spinal cord segments donot currespond wth vertebral bodies..

Upto 3rd month of fetal life s.c occupies the

entire length of vertebral canal bt after that v .c exceeds s .c.

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 S C has 2 enlargements -----cervical ad lumbar -

give rise to brachial ad lumbosacral plexus respectvly.

It posses an ANTERIOR MEDIAN FISSURE ad

POSTERIOR MEDIAN SULCUS.

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 T.S , s.c consist of a

butterfly shaped or H shaped grey substance composed of collection of all cellbodies ad their processes.
And surrounding white

matter composed of bundls of myelinated fibres.

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 The grey matter consist of CELL COLOUMNS.each

half of s .c has POSTERIOR GRAY COLOUMN or POSERIOR HORN wh extends posterolaterally to surface. An ANTERIOR GRAY COLOUMN or ANTERIOR HORN extends anteriorly bt doesnt reach surface. At thorasic spinal segment a small pointed LATERAL HORN is evident near the base of antr horn.

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Spinal cord levels

31 Spinal segments Different levels of sc varies in

Size n shape In d relative amt of grey n white matter Disposition n configuratoion of grey matter.

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Cervical spinal segments contains

d largest no: of fibres in white matter. Grey coloumns r maximal at cervical n lumbar enlargements which r associated wit larger nerves that innervate d extremities:
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cervical segments
They r chara by their relatively large size , relatvly

lge

amt of white matter ad an oval shape.

Posterior columns r large in cervical segments. Transverse dia > ant dia

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THORACIC SEGMENTS
The small dia of thoracic segments is due primarily to

a marked reduction in grey matter.

The ant n post horns r relatively small except for T1. A small lateral horns is present at all thoracic

segments.

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LUMBAR SEGMENTS
These segments r nearly circular in transverse section. Have massive ant n post horns. Relatively less white matter than cervical segments. Upper lumbar resemble lower thoracic segment.

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SACRAL SEGMENTS
These r char by their small size. Large grey matter small amt of white matter

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 Spinal nerves : 31 pairs A part of PNS They r made up of bundles of nerve

fibers(axons) Attached to d spinal cord by ANT or MOTOR ROOTS n POST or SENSORY ROOTS. Each root attached to d cord by series of rootlets which extend whole length of cord.
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 31 pairs of SN leave d SC n pass laterally from each

spinal segment to d level of their respective intervertebral foramina A spinal nerve s a mixture of both sensory n motor nerves Dispropotionate growth-----length of root increases progressively from above downwards The site of emergence of SN do not change,but there s a lengtheng of root filaments bn ivf n sc which is most marked lumbar n sacral segments.
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The spinal nerve emerges from the

spinal column through an opening (intervertebral foramen) between adjacent vertebrae. This is true for all spinal nerves except for the first spinal nerve pair, which emerges between the occiput ad atlas.
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In d upper cervical region d SN

root run almost horizontally,but d roots of lumbar n sacral nerves below d termination of sc form a vertebral leash of nerves around filum terminale resemble horse tail called CAUDA EQUINA
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DIVISIONS OF SN
Ant n post rami: each contain both motor n sensory

fibers. ANT RAMUS supplies muscle n skin of anterolateral wall n all limbs. POST RAMI supplies post part.

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ANTERIOR ROOT
VENTRAL ROOT OR MOTOR FIBERS CARRY

IMPULSES AWAY FROM CNS

THEIR CELLS OF ORIGIN LIES IN D ANT GREY

HORN

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POSTERIOR ROOT
DORSAL ROOT OR SENSORY FIBERS .

CELL BODIES R SITUATED IN A SWELLING ON D

POST ROOT CALLED POST ROOT GAGLION

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 The muscles that one particular spinal root

supplies are that nerve's myotome, and the dermatomes are the areas of sensory innervation on the skin for each spinal nerve. Lesions of one or more nerve roots result in typical patterns of neurologic defects (muscle weakness, abnormal sensation, changes in reflexes) that allow localization of the causeating lesion.
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LEVEL OF EXIT
First seven arise above corresponding

cervical vertebra n 8th below C7 Other spinal roots exit below their corresponding vertebral bodies . Lumbar n sacral roots r very long since they descend from their respective cord segment to their exit points.
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SPINAL NERVES(31)
8 CERVICAL 12 THORACIC 5 LUMBAR 5 SACRAL 1 COCCYGEAL

VERTEBRA(33)
7 CERVICAL 12 THORACIC 5 LUMBAR 5 SACRAL 4 COCCYX

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SPINAL SEGMENT N V C
Region of spinal cord asso. Wit emergence of a pair of

spinal nerve. Spinal segment underline each vertebra r determined as below UPTO C7 ADD ONE T1-T6 ADD TWO T7 T9 ADD THREE 10-L1 & L2 11---L3 & L4 12---L5 30 www.similima.com

MENINGES OF SC
DURAcontinuous above thru F. magnum wit that of

brain n inferly ends on filum terminale at S2.Lies loosely in VC & separated from wall by EXTRA DURAL OR EPIDURAL SPACE. ARACHENOIDdo-.b/w conus medullaris ad lowerend of subarachd space lie cauda equina bathed in csf. PIAclosely covers sc below it fuses wth f terminale.

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ARTERIAL SUPPLY
Branchs of 1)vertebral arteries 2)radicularA One antr ad 2 postr spinal A. Antr spinal A ---ANT 2/3rd of sc.postr spinal A postr

1/3rd One radicular A in lumbar region s longer thn all other---ARTERY OF ADAMKIEWICZ.

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SPINAL CORD DISEASE

MOTOR DISTURBNCE;UMN paralysis below ad

LMN at the level. SENSORY CHANGE;partial or complete sensory loss below lesion. REFLEX CHANGE;exaggeratd below lesn.A period of areflexia ad flaccidity SPINAL SHOCK.aftr that spasticity develops over extensrs of LL ad flexors of UL.

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 SEXUAL REFLEXES---psychogenic erectn-T12- L3

reflex erectn S2 S4.

BLADDER DISTRNCE;sympath-L1 & L2

para-L3 &L4

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 The two areas of the spinal cord most

commonly injured are the cervical spine (C1C7) and the lumbar spine (L1-L5). (The notation C1, C7, L1, L5 refer to the location of a specific vertebra in either the cervical, thoracic, or lumbar region of the spine.)

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Cauda equina syndrome

(CES) is a serious neurologic condition in which there is acute loss of function of the lumbar plexus, neurologic elements (nerve roots) of the spinal canal below the termination (conus) of the spinal cord.
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