SPINAL CORD(external features)

Contents
Introduction Measurements Extent Positional changes of Spinal cord Coverings External features

Introduction
Elongated part of CNS Flattened anteroposteriorly Occupies upper 2/3td of vertebral column It provides attachments to 31 pairs of spinal nerve. It contains ascending and descending pathways Functions : executions of simple reflexes and transmission of impulses.

Measurements
Measures about: 45cm in males. 42 cm in females. Weight 30gms

Extent
From upper border of posterior arch of atlas to the lower border of L1 vertebra

Lower tapering end is called as CONUS MEDULLARIS The apex continues as FILUM TERMINALE.

Positional changes of Spinal cord

Upto 3rd month : Throughout the column At birth : L3 Vertebra In adults : lower border of L1. IMPORTANT FOR LUMBAR PUNCTURE

Coverings
Dura mater, Archnoid, Pia maters.

Dura mater
Extends from foramen magnum to lower border of S2 Epidural space is present.

Spinal dura mater

Only meningeal layer
Does not form folds Epidural space is present Do not enclose venous sinuses

Cranial dura mater

Two layers
Forms 4 folds. Epidural space is absent Dural venous sinuses are present

Arachnoid mater
Thin avascular transparent membrane Invests the cord loosely Continuous above with cranial archnoid mater Below terminate at the level of S2.

Pia mater
Thin highly vascular membrane closely invests the cord. Below the spinal cord it continues as filum terminale. Sub arachnoid space :

Processes of pia mater

1. 2. 3. 4. Filum terminale Sub archnoid septum Linea splendens Ligamentum denticulatum

Filum terminale
Delicate thin glistening thread like structure, extends from tip of conus medullaris to 1st coccygeal vertebra(dorsal aspect). 20cm in length,composed of non fibrous Central canal of cord extends into upper 5cm of filum terminale.. 2 parts filum terminale internum and externum

1. Filum terminale internum

Lies with in the dural sac 15 cm in length

2.

Filum terminale externum

Lies outside the dural sac 5 cm in length

2. Sub archnoid septum

Is mid sagittal fenesrated pial septum connects dorsal surface of spinal cord to arachnoid mater.

3. Linea splendens
Its thickening of pia mater enters into anterior median fissure

Ligamentum denticulatum
Thickened ribbon like bands on each side of spinal cord which presents tooth like extensions. 21 pairs Ist pair lies at the level of foramen magnum Last between T12 & L1

FUNCTION
It anchors the SP in the middle of sub arachnoid space.. IT serves as guide to neurosurgeons during cordotomy operations

External features

1. Fissures and sulci 2. Attachments of spinal nerves

3. Enlargements
4. Cauda equina

Fissures and sulci

Anterior aspect :- anteromedian fissure, 2 anterolateral sulci Posterior aspect:- posterior median septum, 2posterolateral sulci

Anterior aspect

Posterior aspect

Attachments of spinal nerves

Spinal segment

Spinal segments
Spinal cord is also segmented but nt visible externally Number of segments Correspond to no.of vertebrae except in cervical and coccygeal region 31 spinal segments Since Spinal Cord is smaller than vertebral column spinal segments are short & crowded. So both do not lie at same level, spinal segment lie above vertebral level.

Enlargements
Cervical enlargement Lumbar enlargement

Cervical enlargement
Extent

Lumbar enlargment

From C4 to T2 From L2 to S3 cord segments cord segment 35mm at S1 level

Widest 38mm at C6 circumference segment

Innervation

Muscles of upper limb

Muscles of lower limb

Cauda equina
Since the cord is short than the vertebral column, length and obliquity of spinal nerve root increase progressively downwards so as to emerge through respective intervertebral foramina.

Cauda equina
So lumbar, sacral and coccygeal run almost a vertical course. It consists roots of lower 4 pairs of lumbar,5 pairs of sacral and 1 pair of coccygeal nerves.

Factors protecting the cord and keeping it in position

Protected by vertebral canal, meninges hydrostatic cushioning effect of CSF Held in position by upward continuity with medulla oblongata and caudal fixation by filum terminale and cauda equina and by ligamentum denticulatum.

Lumbar puncture
Level Position sitting or lying on one side with fully flexed spine