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