Gross anatomy of the spinal cord spinal segment

Gross anatomy of the spinal cord, spinal segment, Dermatomes: Dr. Gábor GERBER

coccygeal sacral lumbar thoracic cervical

Intumescentia cervicalis (C 5 -T 1): Intumescentia lumbalis (L 2 -L 3):

cervicalis thoracalis lumbosacralis

• Dura mater spinalis • Arachnoidea mater Endorachis • Pia mater Ligg. denticulata Denticulate ligaments (purple) are bilateral thickenings of the collagen component of pia mater.

Spinal nerve Root vs. Ramus ! Ventral ramus plexus

Dermatom Area of skin innervated by the same spinal nerve

Head’s Zones (referred pain)

Herpes Zoster (shingles) viral infection

Blood supply Anterior spinal artery anterior 2/3 posterior spinal arteries posterior 1/3

Intercostal, segmental arteries Adamkiewicz artery T 10

• S 2: end of dural sac • filum terminale pars duralis

Lumbar puncture

Spinal, Epidural, Caudal anesthesia LAYERS TO PENETRATE Skin Supraspinal ligament Interspinal ligament Lig. flavum Endorachis Epidural space Dura mater spinalis Arachnoid mater Subarachnoid space

Tha for nk y you ou ra tte n tio n

SPINAL MENINGES 1) DURA MATER Envelops the cord, descends to S 2 vertebra, between L 2 and S 2 the sac contains only the cauda equina. Each nerve passes through the intervertebral foramen retaining its dural cover, it continues as perineurium. Endorachis - connective tissue „outer layer” of the spinal dura mater - epidural space (content: fat, internal vertebral venous plexus) 2) ARACHNOID MATER Lines the dural cavity, rather large subarachnoideal, but insignificant subdural space. LUMBAR PUNCTION - below L 2 3) PIA MATER Adheres to the spinal cord and roots, its lateral aspect gives rise to the denticulate ligament (21 on each side) reaching the arachnoid mater. It lies between the dorsal and ventral nerve roots.