Spinal Cord Flashcards by Mayank Kamani

Spinal cord In Adults extending from _____ to ______

C1 to L1 (Lower Border)

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Spinal cord In Newborn extending from _____ to ______

When it comes to adult level

C1 to L3 (UpperBorder)

After 2 years it comes to Lower Border of L1

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Lower Triandular end of Spinal Cord

Conus medullaris

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What is Filum terminale

It is modification of Piamater from
L1 → First Coccygeal vertebra

Ligamentum Denticulatum is also a modification of Piamater

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Arachnoid mater and Subarachnoid space ends at

Lower border of S2

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Lumbar puncture can be done at the level of

L3 - L4

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Cranial dura is 2 Layered where as Spinal Dura is __________

It Converges at the level of __________ vertebra and continues upto __________

Spinal Dura is Single layered

Converge at S2 → upto Coccyx

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Enlargements in the Spinal cord

Cervical Enlargement and

Lumbar Enlargement

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Level of Cervical Enlargement

From C3 → T2 { brachial plexus}

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Level of Lumbar Enlargement

From L1 → S3 {lumbar plexus}

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Level of Maximum enlargement

38mm ~ at C6 Segment of Spinal cord

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Tooth like Projections on either side of spinal cord is ________

Each side how many projections are seen?

Ligamentum denticulatum

On each side 21 Projections are seen

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Ligamentum denticulatum is present between ______ and _______ Roots.

Ventral and Dorsal Root

It is an important landmark during the Neurosurgery

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Nuclei in Anterior horn of Spinal cord

Lateral Nucleus

Intermediate Nucleus

Medial Nucleus

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Lateral Nucleus of Anterior Horn of spinal cord innervates

Limb Muscles

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Intermediate nucleus of anterior horn of spinal cord innervates

Diaphragm ~ Phrenic Nerve (C3-C5)
Spinal part of Accessory Nerve (C1-C5)

Is not present throughout the spinal cord

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Nuclei of Intermediate Horn of Spinal Cord

IntermedioMedial nucleus ~ Parasympathetic outflow (S2-S4)

IntermedioLateral Nucleus ~ Sympathetic outflow (T1-L2)

Are not present throughout the spinal cord

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Nuclei of Posterior horn of spinal cord

Substantia gelatinosa
Nucleus proprius
Clarke’s column / Nucleus dorsalis
Visceral afferent

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Nucleus for Spinothalamic Tract

Nucleus gelatinosa

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From BODY ~ Pain, Temperature, Crude touch, Pressure

Carried by which tract?

Spinothalamic tract

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From FACE ~ Pain, Temperature, Crude touch, Pressure

Carried by

Trigeminal Nerve

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Substantia gelatinosa continues above as

Spinal nucleus of Trigeminal

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Nucleus proprius receives which tract

Dorsal column tract

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Clarke’s column or Nucleus dorsalis receives

Spinocerebellar tract

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Visceral afferent receives

Afferent from the viscera

LMN is formed by

Ant. Horn + Ventral Root + Spinal nerve arising from it

How Cortex is controlling the Facial nucleus on both sides

Upper part of Nucleus ~ by Ipsilateral Cortex Both Part of Nucleus ~ by Contralateral Cortex

Upper Part of Facial Nucleus innervates which part of face

Upper part of Face

Lower Part of Facial Nucleus innervates which part of face

Lower part of Face

Lower Part of Facial Nucleus is controlled by

By Contralateral cortex

Which part of Facial Nerve Nucleus get Fibres from both cortex

Upper part of Facial nucleus

Left UMN Palsy of Facial Nerve

Right / Contralateral ~ only lower half of the face affected

Right LMN palsy of Facial Nerve (Bell’s Palsy)

Right / Ipsilateral ~ entire half of the face is affected

Collection of axons in CNS with same origin, course, termination and function is called

Tracts

List Pyramidal tracts

1. Corticospinal Tract | 2. Corticonuclear Tract

Function of Pyramidal tract

Its for Gross movements

List Extra pyramidal tracts And their Functions

1. Rubrospinal tract 2. Vestibulospinal tract 3. Tectodpinal tract Modify the tone and posture of movement

Origin and function of Rubrospinal tract

Red nucleus in Midbrain → Spinal cord Facilitates ~ Flexors and Inhibits ~ Extensors

Function of Vestibulospinal Tract

Facilitates ~ Extensors Inhibits ~ Flexors

Origin and Function of Tectospinal tract

From Tectum of midbrain → Spinal cord It is for reflex movement of Head-Neck and Eyeball in relation to Visual stimulus

Feature of Lesion to ExtraPyramidal tracts →

Tremors

Feature of Lesion to Pyramidal tracts →

Hemiplegia

Pain and Temperature are carried by ___________ Tract

Lateral Spinothalamic Tract

Crude touch and Pressure are carried by ___________ Tract

Anterior Spinothalamic Tract

Fine touch, Proprioception, 2-Point Discrimination, Vibration and Stereognosis are carried by ___________ Tract

Dorsal column tract

Unconscious proprioception is carried by ________ tract

Spinocerebellar Tract

In the Spinal cord (location) Ant. Spinocerebellar Tract and Post. Spinocerebellar Tract

Lateral white column of spinal cord Anterolaterally~ ant. spinocerebellar Posterolaterally~ post. spinocerebellar

Spinothalamic tract 1st Order Neuron~ 2nd Order Neuron~ 3rd Order Neuron~

1st Order Neuron ~ Dorsal root ganglion 2nd Order Neuron~ Substantia gelatinosa 3rd Order Neuron~ VPL nucleus of thalamus

Lemniscus formed by Spinothalamic tract

Spinal Lemniscus in Brain Stem

Lesion of Spinothalamic tract in Brainstem or Spinal cord

Contralateral Loss of ; Pain Temperature Crude touch Pressure

Internal Arcuate Fibres are formed by

Crossing of fibres from Gracilis and Cuneate Nuclei Internal arcuate fibres ascend in brainstem as MEDIAL LEMNISCUS

Lemniscus formed by Internal Arcuate Fibres

Medial Lemniscus

Dorsal Column Medial Lemniscus Tract 1st Order Neuron~ 2nd Order Neuron~ 3rd Order Neuron~

1st Order Neuron~ Dorsal Root Ganglion 2nd Order Neuron~ Nuclei Gracile and Cuneate 3rd Order Neuron~ VPL nucleus of Thalamus

Lesion of Medial Lemniscus in the Brainstem

Contralateral Loss of; ``` Fine touch, Proprioception, 2-Point Discrimination, Vibration Stereognosis ```

Lesion of Dorsal Column in the Spinal cord

Ipsilateral loss of; ``` Fine touch, Proprioception, 2-Point Discrimination, Vibration Stereognosis ```

Posterior Spinocerebellar Tract Pathway 1st Order ~ 2nd Order~ Forms __________ white column, On _________ side Forms post. spinocerebellar tract Enters cerebellum through ____________

1st Order ~ DRG 2nd Order~ N. dorsalis / Clarke’s column Forms Posterolateral white column, On Same side Forms post. spinocerebellar tract Enters cerebellum through INFERIOR Cerebellar Peduncule

All ascending tracts decussate except

Posterior Spinocerebellar Tract

1st Crossing of Corticospinal Tract occurs at And in turn forms

80-85% Fibres cross at Lower End of Medulla Forms Lateral Corticospinal Tract and Descending down in the Lateral White Column

Uncrossed fibres from the Medulla descend as

Anterior Corticospinal Tract in the Anterior white column Even this uncrossed Fibres will cross in the spinal cord at the level of termination

Lesion in Corticospinal Tract above Medulla Decussation results in

Contralateral Hemiplegia

Lesion in Corticospinal Tract at the level of Spinal Cord results in

Ipsilateral Hemiplegia

Anterior Spinal Artery is a branch of

Vertebral Artery

Posterior Spinal Arteries are branch of

PICA / Vertebral artery

Segmental artery arise from {in Cranio-Caudal Sequence}

They are branches of; 1. Vertebral artery 2. Deep Cervical Artery 3. Intercostal Artery 4. Lumbar Artery

Anastomosis of Segmental arteries with long vessels (Ant. and Post. Spinal arteris) forms

Pial Plexus

Branches of Segmental Artery

Anterior/Ventral Radicular Artery Posterior/Dorsal Radicular Artery

Anterior Radiculomedullary Arteries are formed by

By anastomosis of Ant. Spinal Artery with Ascending and Descending branches of Ant. Radicular Artery

Branches of Ant. Radicular Artery + Anterior Spinal Artery forms

Anterior Radiculomedullary Arteries

Largest Anterior Radiculomedullary Artery

Artery of Adamkiewicz

Artery of Adamkiewicz arise from

1. Post. Intercostal artery of 9, 10, 11 spaces 2. Subcostal artery T12 3. Lumbar artery L1, L2

Tabes Dorsalis is due to Which Tract affected? Clinical Features?

Is due to Syphilis Dorsal column is affected Loss of Conscious Proprioception → Loss of Position Sense Can maintain Position by Visual input

Loss of Visual input in patient of Tabes dorsalis leads to

Loss of position sense and Tends to Fall Is called Romberg Sign

Hemisection of Spinal Cord seen in

Brown-Sequard Syndrome