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www.medicinemcq.com

SPINAL CORD
DISEASES
Paraparesis
Quadriparesis

1
2

Where does the spinal cord
end?
๏‚จ
๏‚จ
๏‚จ

Adult spinal cord - 45 cm long
Originates at the medulla
Ends at the conus medullaris

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Fetal life
3

๏‚จ

Until the third month of fetal life
๏‚ค Spinal

๏‚จ

cord is as long as the vertebral canal

After the third month of fetal life
๏‚ค Vertebral

column elongates faster than the
spinal cord

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Adults
4

๏‚จ
๏‚จ

Vertebral column is longer than the spinal cord
Common cause of spinal cord disease
๏‚ค Diseases

of the vertebrae

๏ฎ Fracture
๏ฎ Infection
๏ฎ Secondary

deposits

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5

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6

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7

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8

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9

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10

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Adults โ€“ L 1
11

๏‚จ

๏‚จ

Spinal cord ends at the lower level of first
lumbar vertebral body
Cervical enlargement
๏‚ค Innervate

๏‚จ

the upper extremities

Lumbar enlargement
๏‚ค Innervate

the lower limbs

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Cauda equina (horse's tail)
12

๏‚จ

Different growth rates of the cord and spine
๏‚ค Vertebral

๏‚จ

๏‚จ

column is longer than the cord

Cord segments are above their
corresponding vertebrae
Lumbosacral region
๏‚ค Nerve

roots descend almost vertically below
the cord to form the cauda equina

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13

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14

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15

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Spinal cord has 31 segments
16

๏‚จ

8 cervical
๏‚ค Only

๏‚จ
๏‚จ
๏‚จ

seven cervical vertebrae

12 thoracic
5 lumbar
5 sacral
๏‚ค Sacrum

๏‚จ

formed by fusion of 5 vertebrae

Few small coccygeal

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Each segment
17

๏‚จ

Ventral (motor) root
๏‚ค Exit

from the vertebral column through
intervertebral foramina

๏‚จ

Dorsal (sensory) root

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18

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Ventral (anterior) roots
19

๏‚จ

Alpha motor neuron axons
๏‚ค To

๏‚จ

the extrafusal striated muscle fibers

Gamma motor neuron axons
๏‚ค To

the intrafusal muscle fibers

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Dorsal (posterior) roots
20

๏‚จ

Sensory
๏‚ค Convey

sensory information from the skin,
joints, and muscles to the central nervous
system

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C1 to C7 spinal nerves
21

๏‚จ

Exit above the same-numbered vertebral
bodies
๏‚ค C2

๏‚จ

spinal nerve root exits above C2 vertebra

C8 root
๏‚ค Exits

๏‚จ

between vertebral bodies C7 and T1

All the subsequent spinal nerves exit below
the same-numbered vertebral bodies.

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22

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SPINAL CORD LEVELS RELATIVE TO THE
VERTEBRAL BODIES
23

Spinal Cord Level
Upper cervical
Lower cervical
Upper thoracic
Lower thoracic
Lumbar
Sacral

Corresponding
Vertebral Body

Same as cord level
1 level higher
2 levels higher
2 to 3 levels higher
T10-T12
T12-L1
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T4 SPINE
24

๏‚จ
๏‚จ

Level with the sixth CORD segment
T12
๏‚ค S1cord

segment

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25

Hallmark of spinal cord
disease
๏‚จ

๏‚จ

Loss of motor and sensory functions below
the level of the lesion
Loss of autonomic functions occurs below
the level of the lesion
๏‚ค Loss

of urinary bladder tone
๏‚ค Paralytic ileus

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Horizontal level in the body
26

๏‚จ

Sensory level
๏‚ค Damage

๏‚จ

to the ascending spinothalamic tract

Motor level (i.e., paraplegia or quadriplegia)
๏‚ค Damage

to the descending corticospinal and
other motor tractsโ€ฆโ€ฆโ€ฆ..

For rest of the slides visit www.medicinemcq.com > Neurology

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Spinal cord diseases

  • 2. 2 Where does the spinal cord end? ๏‚จ ๏‚จ ๏‚จ Adult spinal cord - 45 cm long Originates at the medulla Ends at the conus medullaris www.medicinemcq.com
  • 3. Fetal life 3 ๏‚จ Until the third month of fetal life ๏‚ค Spinal ๏‚จ cord is as long as the vertebral canal After the third month of fetal life ๏‚ค Vertebral column elongates faster than the spinal cord www.medicinemcq.com
  • 4. Adults 4 ๏‚จ ๏‚จ Vertebral column is longer than the spinal cord Common cause of spinal cord disease ๏‚ค Diseases of the vertebrae ๏ฎ Fracture ๏ฎ Infection ๏ฎ Secondary deposits www.medicinemcq.com
  • 11. Adults โ€“ L 1 11 ๏‚จ ๏‚จ Spinal cord ends at the lower level of first lumbar vertebral body Cervical enlargement ๏‚ค Innervate ๏‚จ the upper extremities Lumbar enlargement ๏‚ค Innervate the lower limbs www.medicinemcq.com
  • 12. Cauda equina (horse's tail) 12 ๏‚จ Different growth rates of the cord and spine ๏‚ค Vertebral ๏‚จ ๏‚จ column is longer than the cord Cord segments are above their corresponding vertebrae Lumbosacral region ๏‚ค Nerve roots descend almost vertically below the cord to form the cauda equina www.medicinemcq.com
  • 16. Spinal cord has 31 segments 16 ๏‚จ 8 cervical ๏‚ค Only ๏‚จ ๏‚จ ๏‚จ seven cervical vertebrae 12 thoracic 5 lumbar 5 sacral ๏‚ค Sacrum ๏‚จ formed by fusion of 5 vertebrae Few small coccygeal www.medicinemcq.com
  • 17. Each segment 17 ๏‚จ Ventral (motor) root ๏‚ค Exit from the vertebral column through intervertebral foramina ๏‚จ Dorsal (sensory) root www.medicinemcq.com
  • 19. Ventral (anterior) roots 19 ๏‚จ Alpha motor neuron axons ๏‚ค To ๏‚จ the extrafusal striated muscle fibers Gamma motor neuron axons ๏‚ค To the intrafusal muscle fibers www.medicinemcq.com
  • 20. Dorsal (posterior) roots 20 ๏‚จ Sensory ๏‚ค Convey sensory information from the skin, joints, and muscles to the central nervous system www.medicinemcq.com
  • 21. C1 to C7 spinal nerves 21 ๏‚จ Exit above the same-numbered vertebral bodies ๏‚ค C2 ๏‚จ spinal nerve root exits above C2 vertebra C8 root ๏‚ค Exits ๏‚จ between vertebral bodies C7 and T1 All the subsequent spinal nerves exit below the same-numbered vertebral bodies. www.medicinemcq.com
  • 23. SPINAL CORD LEVELS RELATIVE TO THE VERTEBRAL BODIES 23 Spinal Cord Level Upper cervical Lower cervical Upper thoracic Lower thoracic Lumbar Sacral Corresponding Vertebral Body Same as cord level 1 level higher 2 levels higher 2 to 3 levels higher T10-T12 T12-L1 www.medicinemcq.com
  • 24. T4 SPINE 24 ๏‚จ ๏‚จ Level with the sixth CORD segment T12 ๏‚ค S1cord segment www.medicinemcq.com
  • 25. 25 Hallmark of spinal cord disease ๏‚จ ๏‚จ Loss of motor and sensory functions below the level of the lesion Loss of autonomic functions occurs below the level of the lesion ๏‚ค Loss of urinary bladder tone ๏‚ค Paralytic ileus www.medicinemcq.com
  • 26. Horizontal level in the body 26 ๏‚จ Sensory level ๏‚ค Damage ๏‚จ to the ascending spinothalamic tract Motor level (i.e., paraplegia or quadriplegia) ๏‚ค Damage to the descending corticospinal and other motor tractsโ€ฆโ€ฆโ€ฆ.. For rest of the slides visit www.medicinemcq.com > Neurology www.medicinemcq.com