1. Cervical enlargement (C3 to T2) 2. Lumbar enlargement (L1 to S3)

SPINAL CORD Flashcards by Deependra Singh

Length of Spinal Cord
Length of Vertebral Canal

⭐ 45 cm

⭐ 70cm

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Spinal Cord Extent

Upper border of ATLAS
⬇️
L1-L2 junction
(Lower border of L1)

In children till L3 L4

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Number of Vertebrae

33
C7
T12
L5
S5
Cx4

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Number of SPINAL SEGMENTS

31 segments
C8
T12
L5
S5
Cx1

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Development of Spinal Cord

Caudal part of Neural Tube (4th Week)

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Terminal portion of Spinal Cord

Conus Medullaris

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Which cranial nerves arise from Conus Medullaris

Last 4 segments
S3
S4
S5
C1

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EPICONUS?

Portion of spinal cord just above Conus Medullaris

L4
L5
S1
S2

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Dura meter and Arachnoid mater extend upto
🧠⚡ DAS²⚡

S2 vertebrae

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Filum Terminal extends upto
🧠⚡ FIX⚡

Coccyx 1 vertebra
.
Modification of PIAMETER from tip of Conus Medullaris to Dorsum of COCCYX1

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Cauda Equina

Nerves arising from the Conus Medullaris and Epiconus radiate outwards, like horse tail
⬇️
Known as CAUDA EQUINA

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Formula to get Spinal Segmental level from Vertebral Level
🧠⚡ We always talk in SEGMENTAL LEVEL⚡

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CAUDA Equina Syndrome

Asymmetric involvement of ROOTS
L2 S1
L3 S2
L4 S3
L5 S4
S5
Cx1

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Stand on
Sit on

Stand on S1
Sit on S3

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Conus Medullaris syndrome

Symmetric and B/L involvement of last 4 roots:
S3
S4
S5
Cx1

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Spinal ENLARGEMENT

Cervical enlargement (C3 to T2)
Lumbar enlargement (L1 to S3)

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Grey-White Matter Organization
⭐ Spinal Cord
⭐ Brain
🧠⚡ OPPOSITE TO EACH OTHER⚡

⭐ Spinal Cord
Grey : Inside
White: Outside

⭐ Brain
Grey: Outside
White: Inside

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Grey Matter of Spinal Cord

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Tracts of Spinal Cord

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DCML
Dorsal Column Medial Laminiscus

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DCML cross over occurs at

Anterolateral Pathway crosses over at

⭐ Medulla Oblongata

⭐ same Spinal cord Level

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⭐ Medial Leminiscus

⭐ Lateral Leminiscus

⭐

⭐ DCML fibers

⭐ Internal Arcuate Fibers

⭐ External Arcuate Fibers
✨ Posterior External Arcuate Fibers
✨ Anterior External Arcuate Fibers

⭐ Internal Arcuate Fibers
🎯 DCML fibers at Medulla Oblongata
🎯 Fibers that Cross over

⭐ External Arcuate Fibers
✨ Posterior External Arcuate Fibers
🎯 Uncrossed fibers from the lateral part of the arcuate nucleus to the inferior cerebellar peduncle.

✨ Anterior External Arcuate Fibers
🎯 Fibers from the arcuate nucleus coursing over the caudal end of the olive to the caudal cerebellar peduncle. Part of the pontocerebellar tract.

Carry sensation from

⭐ Fasiculus Cuneatus

⭐ Fasiculus Gracilis
🧠⚡C comes 1st then G ⚡

⭐ Upper Limb

⭐ Lower Limb

DCML ends on Which NUCLEI IN THALAMUS? DCML gives fibers to which NUCLEI in Spinal Cord

⭐ VPL (VENTRAL POSTEROLATERAL nucleus) ⭐ Nucleus Proprius : maintains reflex ARC

DCML fibers 3rd Order neurons pass through which limb of INTERNAL CAPSULE?

Posterior Limb of INTERNAL CAPSULE

Descending Tracts in Lateral Column 🧠⚡ RL⚡

Rubrospinal Tract Lateral Corticospinal tract

Descending Tracts in Anterior Column 🧠⚡ A VOTe⚡

Anterior Corticospinal tract Vestibulospinal tract Olivospinal tract Tectospinal tract

All tracts in spinal cord is represented in ARRANGEMENT except 🧠⚡ ML ➡️ CTLS⚡

Cervical ➡️ Thoracic ➡️ Lumbar ➡️ Sacral ⭐ Dorsal Column ML ➡️ SLTC SACRAL ➡️ LUMBAR ➡️ THORACIC ➡️ CERVICAL

Glove and Stocking Peripheral Neuropathy

Cervical Myelopathy Outer Cervical column fibers affected 1st ➡️ ➡️ Inner Sacral fibers affected

ViP makes you STAND UP ⚡️VIP activates Antigravity muscles⚡️ Sit on Rubber mat ⚡️Rubber mat activates gravity muscles⚡️

1. Vestibular spinal tract 2. Pontine Reticulo-spinal tract Sit down 1. Rubrospinal tract 2. Medullary Reticulo-spinal Tract

Vestibular Apparatus Function

✨ For standing up ✨ Activates and Increases tone of ANTI-GRAVITY Muscles

Red Nucleus functions Rubrospinal Tract ⚡️ If Red Nucleus spared: increased Gravity Muscle tone (Flexors of lower limb) As in Decorticate rigidity

Increases tone of GRAVITY muscles Flexors of Upper limb

Inner Grey Matter Types of Neurons

1. Golgi Type I neurons: Long Axons 2. Golgi Type 2 neurons: Short Axons

Decerebrate Vs Decorticate

Decerbrate vs Decorticate Lesion at

Blood supply of SPINAL CORD

1. Anterior Spinal Artery x1 2. Posterior Spinal Artery x2 3. Anterior Radiculomedullary artery 4. Posterior Radiculomedullary artery

Arteria Vasa Corona

Formed by anastamosis BETWEEN Anterior and Posterior Radiculomedullary artery with Anterior and Posterior Spinal artery

Artery of Adamkiewicz Synonyms

Artery of Adamkiewicz Artery of Lumbar Enlargement Arteria Radicularis Magna Radicular artery is noticeably larger that the others, located in Lower Thoracic or Upper Lumbar

Number of RADICULAR ARTERIES

10-23 Posterior RADICULAR Artery 6-10 Anterior RADICULAR Artery

Which spinal segments not supplied by RADICULAR Arteries

C1 C2 C3 C4

Vertical WATERSHED REGION in spinal Cord Horizontal WATERSHED REGION in spinal Cord

⭐ T3 T4 T5 T6 T7 T8 (MID Thoracic Region) ⭐ BETWEEN SUPPLY OF ANTERIOR AND POSTERIOR SPINAL ARTERY (in the LATERAL PART of SPINAL CORD)

Which tract is 1st involved in Spinal Cord Ischemia

LATERAL Corticospinal Tract

Posterior CORD Syndrome Seen in

HYPER-EXTENSION INJURY ⭐ DCML involved only

ANTERIOR CORD SYNDROME Seen in

✨ Anterior Spinal Artery Infarction ✨ TRAUMA Loss of Power, Pain, Temperature

DISSOCIATIVE SENSORY LOSS Seen in

Central CORD Syndrome Posterior Column spared, Spinothalamic Tract involved, MOTOR and ANS involved

CENTRAL CORD SYNDROME Seen in

Syringomyelia

Brown Sequard Syndrome ⭐ At the level of Lesion ⭐ Below the Level of Lesion 🧠💡DIM CST💡

⭐ At the level of Lesion ✨ Everything I/L Lost ⭐ Below the Level of Lesion I/L MOTOR I/L DCML SENSATION C/L SPINOTHALAMIC TRACT

B/L MOTOR WEAKNESS can NEVER BE DUE To

CEREBRAL LESION Cause: CORD

Diaphragm supply by DERMATOME

C3-C5 Phrenic Nerve

Fingers. Wrist Extensors Triceps

Little Finger: Sensory Wrist and Finger Flexion: Motor

BEEVOR'S Sign used for

Localizing SPINAL CORD LESION to T10-11 ⬇️ Upward movement of UMBILICUS when ABDOMINAL Wall Contracts

REASON for BEEVOR'S Sign

T10-T12 lesion : Paralyze the lower ABDOMINAL MUSCLES (but not UPPER abd walls) Normally, the rectus abdominis muscle contracts as a single unit with no predominance of upper half over the lower part or left over the right side. Therefore, normally on trunk flexion, the navel does not move. Weakness of upper part of rectus abdominis (Navel moves upward): Beevor’s sign Weakness of lower part of rectus abdominis (Navel moves downward): Inverted Beevor’s sign