VERTEBRAL COLUMN, SPINAL CORD & NERVES,& SUBOCCIPITAL REGION

Steven J. Zehren, Ph.D.

VERTEBRAL COLUMN

GENERAL REMARKS

FULLY ARTICULATED VETEBRAL COLUMN

7 Cervical

12 Thoracic

5 Lumbar

5 Sacral (=sacrum)

3 - 4 Coccygeal (=Coccyx)3 – 4 Coccygeal (=coccyx)

JOINTS OF VERTEBRAL BODIES: INTERVERTEBRAL DISCS

FUNCTION OF INTERVERTEBRAL DISCS

TYPICAL VERTEBRA

Vertebral foramen

TYPICAL VERTEBRA

(pedicle + lamina)

BOUNDARIES OF INTERVERTEBRAL FORAMEN

Pedicle

Pedicle

JOINTS OF VERTEBRAL BODIES: POSTERIOR LONGITUDINAL LIGAMENT

Posterior longitudinal lig.

POSTEROLATERAL HERNIATION OF NUCLEUS PULPOSUS

HERNIATION OF L4/L5 DISC

CURVATURES

PRIMARY AND SECONDARY CURVATURES

ABNORMAL CURVATURES

KYPHOSIS LORDOSISNORMAL

ABNORMAL CURVATURES

NORMAL SCOLIOSIS

MOVEMENTS

VERTEBRAL COLUMN PERMITS MOVEMENTS OF THE TRUNK AND PROVIDES A BASE ON WHICH THE HEAD CAN MOVE

REGIONAL DIFFERENCES

CERVICAL VERTEBRAE

Atlas

Vertebral a.

Posterioratlantooccipitalmembrane

VERTEBRAL ARTERY PASSES THROUGH FORAMINA TRANSVERSARIA OF CERVICAL VERTEBRAE

Ant. arch Facet for dens

Lateral mass

Post. archPost. tubercle

Groove for vertebral a.

Transverse pr.

Transverse foramen

Sup. facet foroccipital condyle

Dens Post. facet fortransverse lig.

Transverse pr.

Spinous pr.Inf. articular pr.

Sup. facet for atlas

Interarticular part

ATLAS (C1): SUPERIOR VIEW

AXIS (C2): POSTEROSUPERIOR VIEW

Tubercle fortransverse lig.

Ant. tubercle

Body

CERVICAL VERTEBRAE: ATLAS (C1) AND AXIS (C2)

THORACIC VERTEBRAE

LUMBAR VERTEBRAE

SACRUM AND COCCYX

SACRUM AND COCCYX

EPIDURAL ANESTHESIA

SPINAL CORD & SPINAL NERVES

GENERAL REMARKS

CENTRAL AND PERIPHERAL NERVOUS SYSTEMS

1st cervical n. (C1)exits above C1 vertebra

8th cervical n.exits below C7 vertebra

Conus medullaris (termination of cord)

Cauda equina

Termination of dural sac

Base of skull

Cervical enlargement (cord segments C4 – T1)

Lumbosacral enlargement(cord segments L2 – S3)

Internal filum terminaleof pia mater

Cervical nervesThoracic nervesLumbar nervesSacral & coccygeal nerves

STRUCTURE OF SPINAL CORD & SPINAL NERVES

T2

Dorsal horn

Ventral horn

Lateral horn (T1 – L2)

C5 T8

L1 L2 S2 S3

White matter

Central canal

Ventral median fissure

TYPICAL SPINAL NERVE ( T1 – L2)

(sensory)

(motor)

(mixed)

(mixed)

(mixed)

FUNCTIONAL COMPONENTS

CLASSIFICATION OF FIBER TYPES (FUNCTIONAL COMPONENTS) IN CRANIAL* AND SPINAL NERVES

Afferent(sensory)

Somatic(outer)

Visceral(inner)

General(wide distribution)

Special(restricted distribution)

From skin — pain, temp., touchFrom skeletal muscles & tendons,ligs. of joints -- proprioception

From retina – sightFrom inner ear – hearing & equilibrium

General From internal organs – visceral reflexes,fullness of hollow organs, pain

From taste buds – tasteFrom olfactory mucosa -- smell

Special

Efferent(motor)

Somatic

Visceral

General

Special

General

Special

To skeletal muscles not derived from pharyngeal arches

XXX – This category does not exist

To smooth muscle, cardiac muscle & glands

To skeletal muscles derived from pharyngeal arches

*Special components occur only in certain cranial nerves.

Paravertebral ganglion(of sympathetic trunk)

White ramus(presynaptic)

Gray ramus(postsynaptic)

Dorsal ramus

Ventral ramus

Prevertebralsympathetic ganglion

Dorsal ramus

Ventral ramus

Dorsal Root Ganglion (DRG)

FUNCTIONAL COMPONENTS OF SPINAL NERVES (SUMMARY)

MENINGES, CEREBROSPINAL FLUID (CSF) & LUMBAR PUNCTURE

SPINAL MENINGES (POSTERIOR VIEW)

Dura mater

Arachnoid mater

Pia mater

Denticulate lig.

SUBARACHNOID, SUBDURAL & EPIDURAL SPACES

Post. internal vertebralvenous plexus

Ant. internalvertebral venousplexus

Intervertebral v.

INTERNAL VERTEBRAL VENOUS PLEXUS COMMUNICATES WITH THE DURAL SINUSES INSIDE THE CRANIUM

Dural venous sinus

Int. vertebral venous plexus

SITE OF LUMBAR PUNCTURE

L2

S2

Lumbar cistern(containing CSF)

SUBOCCIPITAL TRIANGLE

Greater occipital n.(dorsal ramus of C2)

Occipital a.

Rectus capitis post. minor m.

Rectus capitis post. major m.

Semispinalis capitis m.

Vertebral a.

Obliquus capitis sup. m.

Suboccipital n.(dorsal ramus of C1)

Post. arch of atlas (C1)

Obliquus capitis inferior m.

SUBOCCIPITAL TRIANGLE

Posterior atlantooccipitalmembrane

Skull

Atlas (C1)

Suboccipital n.(dorsal ramus of C1)

Vertebral a.

FLOOR OF SUBOCCIPITAL TRIANGLE

POSTERIOR VIEW

END OF LECTURE