~ ~ ~ SPINAL CORD ~ ~ ~ Ann Nguyen -- NYUCD 2008

Dr. Singh D1 Anatomy Notes -- Spring '05

there should be no intervertebral disc b/t atlas & axis

7C + 12T + 5L + 5S + 4Cx = 33 total vertebrae

8 C + 12T + 5L + 5S + 1Cx = 31 pairs of spinal nerves
accumulation of all the individual intervertebral foramina  vertebra canal = houses the spinal cord
note that the vertebral column is not straight, but has various curvatures

Primary Curves
- present at birth
• Thoracic = concave anteriorly
• Sacral = concave anteriorly

Secondary Curves
- develops later in life
• Cervical = concave posteriorly = develops when the baby starts holding his head up
• Lumbar = concave posteriorly = develops when the baby starts walking

Curve Deviations
• Kyphosis = exaggeration of thoracic curve (hunchback)
• Lordosis = exaggeration of lumbar curve (may be due to obesity, pregnancy)
• Scoliosis = deviation from the midline

Vertebral Ligaments
• Anterior Longitudinal Ligament = runs the entire length of the spine anteriorly
• Posterior Longitudinal Ligament = runs the entire length of the spine posteriorly
• Intertransverse Ligament (R&L) = connects adjacent transverse processes along the entire length of the spine
• Interlaminar Ligament / aka: “Ligamentum Flavum” = connect adjacent laminae along the entire length of the spine
• Interspinous Ligament = connect adjacent spinous processes along the entire length of the spine
• Supraspinous Ligament / aka: ”Ligamentum Nuchae” = especially strong in the neck region

Compiled for you by:

 Ann Nguyen -- NYUCD 2008
• Cauda Equina = the appearance of the descending and emerging L, S, Cx nerves resembles a horse’s tail D1 Anatomy Notes -- Spring '05

CNS (brain + spinal cord) = finishes development before skeletal components finish growing…
Therefore, the adult spinal cord does not extend the entire length of the vertebral column
The spinal cord ends b/t L1 – L2, but since the spinal nerve #4 must emerge b/t L4 – L5 …
All lumbar nerves must descend to a certain level before they can emerge

Cauda Equina

Meningeal Coverings
• Dura Mater (tough mother)
• Arachnoid Mater (very thin, flimsy, weblike)
• Pia Mater (clingy mother) = can’t be peeled from spinal cord
• Denticulate Ligament (21-22 pairs) = the triangular-shaped Pia Mater
where it gets pulled out & attaches to Dura Mater
landmark of separation b/t dorsal & ventral roots
• Epidural Space = b/t the outer dura mater and bone (vertebral canal) – contains protective fat
• Subdural Space = b/t dura & arachnoid (this is only a potential space that opens only when there is subdural hemorrhage)
• Subarachnoid Space = b/t arachnoid & pia
contains cerebral spinal fluid
spinal tap = below L2 (best b/t L3 – L4)

His Drawing
• Conus Medullaris = where the spinal cord ends b/t L1 & L2
• Filum Terminale Internum = where the Pia Mater collects at conus medullaris, then continues elongating down as a string
- Arachnoid finishes its continuation downward and connects to S2 vertebra
- Dura Mater also runs downward, connects to S2 vertebra,
then makes a turn (sleeve) towards the middle,
then meets in the middle w/ the Pia Mater at the coccyx level
• Filum Terminale Externum = where the Dura Mater ends Compiled for you by:
• Sacrococcygeal Ligament = filum terminale’s internum (PIA) + externum (DURA) running from sacral to coccyx
 Ann Nguyen -- NYUCD 2008
D1 Anatomy Notes -- Spring '05

• Grey matter = inside this is opposite • Dorsal Root / Spinal Ganglion = collection of sensory afferent cell bodies in the intervertebral foramina
• White matter = outside in the brain • Dorsal Root = sensory afferent fibers going towards CNS
• Dorsal Horn = sensory afferent fibers • Ventral Root = motor efferent fibers going away from CNS
• Ventral Horn = motor efferent cell bodies • Spinal Nerve (mixed) = the union of both Dorsal + Ventral Root fibers… splits into DPR + VPR…
• Dorsal Median Sulcus • Dorsal Primary Ramus
• Ventral Median Fissure - motor = muscular branches = supplies Erector Spinae deep muscles of the back
- sensory = posterior cutaneous branch (medial + lateral) = supplies skin of the central back
• Ventral Primary Ramus
- motor = muscular branches = supplies the neck, trunk, limb muscles
- sensory = lateral cutaneous branch (anterior + posterior)
- sensory = anterior cutaneous branch (medial + lateral)
• Dermatome = a particular region of skin that every spinal nerve will specifically innervate Ann Nguyen -- NYUCD 2008
D1 Anatomy Notes -- Spring '05
• Herniated Disc = when the intervertebral disc bulges under chronic stress, causing compression of spinal nerves  parasthesia, tingling, pain, paralysis

Descending Aorta  Intercostal Arteries large venous plexus anterior and posterior to the spinal cord
VPR of thoracic spinal nerves  Intercostal Nerves