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Questions and Answers
Which structure connects the pelvis from the lower limb?
Which structure connects the pelvis from the lower limb?
In Brown Sequard Syndrome, what is a typical clinical manifestation?
In Brown Sequard Syndrome, what is a typical clinical manifestation?
Which nerve is responsible for dorsiflexion and can lead to foot drop when affected?
Which nerve is responsible for dorsiflexion and can lead to foot drop when affected?
Which nerve supplies the extensor hallucis longus muscle responsible for great toe motor function?
Which nerve supplies the extensor hallucis longus muscle responsible for great toe motor function?
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Which type of paralysis results from a lack of descending cortical control of the vestibulospinal tract?
Which type of paralysis results from a lack of descending cortical control of the vestibulospinal tract?
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What is the function of the reticulospinal tract?
What is the function of the reticulospinal tract?
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Which tract of the spinal cord carries fine touch and conscious proprioception information?
Which tract of the spinal cord carries fine touch and conscious proprioception information?
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What is the function of the vestibulospinal tract?
What is the function of the vestibulospinal tract?
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What is the result of a CVA of the internal capsule affecting the corticospinal tract?
What is the result of a CVA of the internal capsule affecting the corticospinal tract?
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What is the function of the tectospinal tract?
What is the function of the tectospinal tract?
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Which nerve supplies the medial thigh sensory innervation?
Which nerve supplies the medial thigh sensory innervation?
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Which nerve gives sensory innervation to the medial part of the leg?
Which nerve gives sensory innervation to the medial part of the leg?
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Which nerve is affected in a fracture of the mid-shaft of the humerus leading to wrist drop?
Which nerve is affected in a fracture of the mid-shaft of the humerus leading to wrist drop?
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Passing through ligamentum flavum is a key step in which surgical procedure?
Passing through ligamentum flavum is a key step in which surgical procedure?
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Which ligament is most commonly torn in an inversion ankle injury?
Which ligament is most commonly torn in an inversion ankle injury?
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Which spinal cord tract is responsible for maintaining equilibrium and balance?
Which spinal cord tract is responsible for maintaining equilibrium and balance?
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Which spinal cord tract is responsible for transmitting unconscious signals for muscle tone regulation?
Which spinal cord tract is responsible for transmitting unconscious signals for muscle tone regulation?
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Which spinal cord tract is responsible for transmitting voluntary motor signals?
Which spinal cord tract is responsible for transmitting voluntary motor signals?
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Which part of the spinal cord provides motor innervation to arm and shoulder muscles?
Which part of the spinal cord provides motor innervation to arm and shoulder muscles?
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Which nerve supplies the medial part of the arm with sensory innervation?
Which nerve supplies the medial part of the arm with sensory innervation?
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Which part of the spinal cord is responsible for sensory information to the rest of the body?
Which part of the spinal cord is responsible for sensory information to the rest of the body?
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Which neural tract is responsible for coordinating movements associated with balance and posture?
Which neural tract is responsible for coordinating movements associated with balance and posture?
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Which part of the spinal cord supplies the back muscles and skin?
Which part of the spinal cord supplies the back muscles and skin?
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Which neural tract is responsible for voluntary motor movements?
Which neural tract is responsible for voluntary motor movements?
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Which neural system is responsible for coordinating subconscious motor movements?
Which neural system is responsible for coordinating subconscious motor movements?
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What is the term for the enlargement of the spinal cord in the cervical and lumbar regions?
What is the term for the enlargement of the spinal cord in the cervical and lumbar regions?
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Which tract in the spinal cord is involved in maintaining posture and balance?
Which tract in the spinal cord is involved in maintaining posture and balance?
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Which part of the spinal cord has smaller lateral horns containing preganglionic sympathetic neurons?
Which part of the spinal cord has smaller lateral horns containing preganglionic sympathetic neurons?
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What is the name of the tract that originates in the cerebral cortex and carries motor signals to the spinal cord?
What is the name of the tract that originates in the cerebral cortex and carries motor signals to the spinal cord?
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Which structure anchors the spinal cord to the dura and contains pial and arachnoid tissue?
Which structure anchors the spinal cord to the dura and contains pial and arachnoid tissue?
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What is the primary function of the corticospinal tract?
What is the primary function of the corticospinal tract?
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Which part of the brain is primarily associated with the extrapyramidal system?
Which part of the brain is primarily associated with the extrapyramidal system?
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In terms of spinal cord anatomy, where is the grey matter located?
In terms of spinal cord anatomy, where is the grey matter located?
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Which tract is responsible for regulating involuntary reflexes like posture and muscle tone?
Which tract is responsible for regulating involuntary reflexes like posture and muscle tone?
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What is the role of the vestibulospinal tract in the nervous system?
What is the role of the vestibulospinal tract in the nervous system?
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Which part of the CNS is responsible for maintaining the blood-brain barrier?
Which part of the CNS is responsible for maintaining the blood-brain barrier?
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Which nerve is responsible for plantar flexion along with Gastrocnemius, Soleus, and Plantaris muscles?
Which nerve is responsible for plantar flexion along with Gastrocnemius, Soleus, and Plantaris muscles?
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In case of an inversion ankle injury, which ligament is most commonly torn?
In case of an inversion ankle injury, which ligament is most commonly torn?
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Which nerve is affected in a fracture of the mid-shaft of the humerus leading to wrist drop?
Which nerve is affected in a fracture of the mid-shaft of the humerus leading to wrist drop?
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Which muscle is innervated by the Radial nerve and is responsible for thumb extension?
Which muscle is innervated by the Radial nerve and is responsible for thumb extension?
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Which nerve supplies the extensor compartment of the forearm and leads to a 'wrist drop' presentation in case of injury?
Which nerve supplies the extensor compartment of the forearm and leads to a 'wrist drop' presentation in case of injury?
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In the brachial plexus, which nerve is primarily responsible for sensory innervation of the lateral side of the forearm?
In the brachial plexus, which nerve is primarily responsible for sensory innervation of the lateral side of the forearm?
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Which structure within the femoral triangle is NOT encircled by the femoral sheath?
Which structure within the femoral triangle is NOT encircled by the femoral sheath?
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In cases of impingement of the S2 nerve root, which part of the leg is most likely to be affected?
In cases of impingement of the S2 nerve root, which part of the leg is most likely to be affected?
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Which artery is responsible for supplying blood to the structures within the cubital fossa?
Which artery is responsible for supplying blood to the structures within the cubital fossa?
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Which artery supplies blood to the posterior compartment of the leg?
Which artery supplies blood to the posterior compartment of the leg?
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What is the anatomical structure that herniates in a disc herniation?
What is the anatomical structure that herniates in a disc herniation?
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What is the most common cause of cauda equina syndrome?
What is the most common cause of cauda equina syndrome?
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Which nerve roots are most commonly affected in piriformis syndrome?
Which nerve roots are most commonly affected in piriformis syndrome?
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Which structure does the brachial plexus pass through before innervating the upper limb?
Which structure does the brachial plexus pass through before innervating the upper limb?
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Which structure is responsible for maintaining the stability of the intervertebral discs?
Which structure is responsible for maintaining the stability of the intervertebral discs?
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Which bundle of nerves can be impinged by a herniated disc, causing pain and altered sensation in the lower extremities?
Which bundle of nerves can be impinged by a herniated disc, causing pain and altered sensation in the lower extremities?
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Which part of the brachial plexus provides motor innervation to the flexor muscles of the arm?
Which part of the brachial plexus provides motor innervation to the flexor muscles of the arm?
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Which arteries provide the primary arterial supply to the leg?
Which arteries provide the primary arterial supply to the leg?
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Which artery is primarily responsible for the arterial supply of the leg?
Which artery is primarily responsible for the arterial supply of the leg?
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What is the primary function of the annulus fibrosus?
What is the primary function of the annulus fibrosus?
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What is the most common cause of cauda equina syndrome?
What is the most common cause of cauda equina syndrome?
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What is the main component of the brachial plexus?
What is the main component of the brachial plexus?
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Which arteries are responsible for the major longitudinal arterial supply of the spinal cord?
Which arteries are responsible for the major longitudinal arterial supply of the spinal cord?
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What are the two main components of an intervertebral disc?
What are the two main components of an intervertebral disc?
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Which nerve roots contribute to the formation of the brachial plexus?
Which nerve roots contribute to the formation of the brachial plexus?
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What is the main artery that supplies blood to the leg?
What is the main artery that supplies blood to the leg?
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Which structure of the intervertebral disc is prone to herniation?
Which structure of the intervertebral disc is prone to herniation?
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What condition is caused by the compression of the cauda equina nerves?
What condition is caused by the compression of the cauda equina nerves?
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What is the anatomical origin of the brachial plexus?
What is the anatomical origin of the brachial plexus?
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Which artery supplies blood to the posterior compartment of the leg?
Which artery supplies blood to the posterior compartment of the leg?
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What is the function of the annulus fibrosus in the intervertebral disc?
What is the function of the annulus fibrosus in the intervertebral disc?
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What is the primary symptom of cauda equina syndrome?
What is the primary symptom of cauda equina syndrome?
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Which nerve roots are commonly affected in piriformis syndrome?
Which nerve roots are commonly affected in piriformis syndrome?
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What is the function of the upper trunk of the brachial plexus?
What is the function of the upper trunk of the brachial plexus?
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Which nerve roots are commonly affected in cauda equina syndrome?
Which nerve roots are commonly affected in cauda equina syndrome?
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What is the primary arterial supply to the leg?
What is the primary arterial supply to the leg?
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Which structure is responsible for maintaining the stability of the intervertebral discs?
Which structure is responsible for maintaining the stability of the intervertebral discs?
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In cauda equina syndrome, which of the following structures are compressed?
In cauda equina syndrome, which of the following structures are compressed?
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Which structure is responsible for the blood supply to the annulus fibrosus in an intervertebral disc?
Which structure is responsible for the blood supply to the annulus fibrosus in an intervertebral disc?
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Impingement of the S2 nerve root can result in which neurological sign?
Impingement of the S2 nerve root can result in which neurological sign?
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Which nerve is primarily responsible for sensory innervation of the lateral side of the forearm within the brachial plexus?
Which nerve is primarily responsible for sensory innervation of the lateral side of the forearm within the brachial plexus?
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Which part of the brachial plexus is responsible for innervating the muscles of the shoulder and arm?
Which part of the brachial plexus is responsible for innervating the muscles of the shoulder and arm?
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What is the primary function of the annulus fibrosus in the intervertebral disc?
What is the primary function of the annulus fibrosus in the intervertebral disc?
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In cauda equina syndrome, which symptom is typically observed?
In cauda equina syndrome, which symptom is typically observed?
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Which structure anchors the spinal cord to the dura and contains pial and arachnoid tissue?
Which structure anchors the spinal cord to the dura and contains pial and arachnoid tissue?
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What is a typical symptom of impingement involving the S2 nerve root?
What is a typical symptom of impingement involving the S2 nerve root?
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Which nerve roots contribute to the formation of the brachial plexus?
Which nerve roots contribute to the formation of the brachial plexus?
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A patient presents with a popliteal artery cyst that is pulsatile, deep, and central in the knee. Which artery is most likely involved in this condition?
A patient presents with a popliteal artery cyst that is pulsatile, deep, and central in the knee. Which artery is most likely involved in this condition?
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In lumbar canal stenosis, which activity would exacerbate back pain according to the information provided?
In lumbar canal stenosis, which activity would exacerbate back pain according to the information provided?
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In cauda equina syndrome, which part of the spinal cord is commonly affected by impingement?
In cauda equina syndrome, which part of the spinal cord is commonly affected by impingement?
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Which nerve is primarily responsible for sensory innervation of the medial part of the leg based on the information provided?
Which nerve is primarily responsible for sensory innervation of the medial part of the leg based on the information provided?
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Which structure within the brachial plexus passes through the cubital tunnel and is associated with elbow-related symptoms?
Which structure within the brachial plexus passes through the cubital tunnel and is associated with elbow-related symptoms?
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Which artery is primarily responsible for the arterial supply of the leg?
Which artery is primarily responsible for the arterial supply of the leg?
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What is the function of the nucleus pulposus in the intervertebral disc?
What is the function of the nucleus pulposus in the intervertebral disc?
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What condition is caused by the compression of the cauda equina nerves?
What condition is caused by the compression of the cauda equina nerves?
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What is the primary symptom of impingement of the S1 and S2 nerve roots?
What is the primary symptom of impingement of the S1 and S2 nerve roots?
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Which bundle of nerves can be impinged by a herniated disc, causing pain and altered sensation in the lower extremities?
Which bundle of nerves can be impinged by a herniated disc, causing pain and altered sensation in the lower extremities?
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Which artery provides the primary arterial supply to the leg, but is also commonly affected in patients presenting with cauda equina syndrome?
Which artery provides the primary arterial supply to the leg, but is also commonly affected in patients presenting with cauda equina syndrome?
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What is the anatomical structure that herniates in a disc herniation, potentially leading to impingement of the S1 or S2 nerve roots?
What is the anatomical structure that herniates in a disc herniation, potentially leading to impingement of the S1 or S2 nerve roots?
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In the context of brachial plexus anatomy, which nerve roots contribute to the formation of the upper trunk?
In the context of brachial plexus anatomy, which nerve roots contribute to the formation of the upper trunk?
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Which spinal cord tract is responsible for maintaining equilibrium and balance, and can be affected in patients with cauda equina syndrome?
Which spinal cord tract is responsible for maintaining equilibrium and balance, and can be affected in patients with cauda equina syndrome?
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In cases of impingement of the S2 nerve root, which part of the leg is most likely to be affected?
In cases of impingement of the S2 nerve root, which part of the leg is most likely to be affected?
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Which artery is primarily responsible for the arterial supply of the leg?
Which artery is primarily responsible for the arterial supply of the leg?
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What are the two main components of an intervertebral disc?
What are the two main components of an intervertebral disc?
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Which part of the brachial plexus provides motor innervation to the flexor muscles of the arm?
Which part of the brachial plexus provides motor innervation to the flexor muscles of the arm?
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Which structure within the femoral triangle is NOT encircled by the femoral sheath?
Which structure within the femoral triangle is NOT encircled by the femoral sheath?
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Which neural tract is responsible for voluntary motor movements?
Which neural tract is responsible for voluntary motor movements?
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Which spinal cord tract is responsible for maintaining equilibrium and balance?
Which spinal cord tract is responsible for maintaining equilibrium and balance?
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Which nerve supplies the extensor hallucis longus muscle responsible for great toe motor function?
Which nerve supplies the extensor hallucis longus muscle responsible for great toe motor function?
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What is the term for the enlargement of the spinal cord in the cervical and lumbar regions?
What is the term for the enlargement of the spinal cord in the cervical and lumbar regions?
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Study Notes
Spinal Cord Anatomy
- Conus medullaris: lower end of spinal cord (L1/L2)
- Filum terminale: continuation of pia mater, anchored to coccyx
- Spinal meninges: dura mater, arachnoid, pia mater (continuous with brain meninges via foramen magnum)
- Denticulate ligament: attaches lateral aspects of spinal cord to dura
- Subarachnoid space: filled with CSF, no subdural space in spine
- Epidural space: contains fat and venous plexus
- Central canal: extends length of spinal cord, opens into 4th ventricle
Spinal Cord Functions
- Dorsal/ventral aspects of each segment: posterior/anterior roots, subarachnoid foramen, intervertebral foramina, posterior root ganglion, roots fuse to form mixed spinal nerve
- Anterior horn motor neurons: larger in cervical and lumbar enlargements
- White matter: outside, contains myelinated axons and support cells
- Grey matter: inside, contains neurons, cell processes, synapses, and support cells
Neuroanatomy
- CNS: 12 pairs of cranial nerves, 31 pairs of spinal nerves
- Primary vesicles: 4 weeks
- Secondary vesicles: 6-8 weeks
- Mature brain: forebrain (telencephalon, diencephalon), midbrain, hindbrain (metencephalon, myelencephalon)
- Cells of NS: neurons, glial cells (astrocytes, oligodendrocytes, microglia, ependymal cells)
- Cerebral hemispheres: sulci and gyri
- Cerebellum: folium (equivalent to sulci in cerebrum)
- Brain meninges: dura mater, arachnoid, pia mater
- Enteric nervous system: found in digestive system, myenteric plexus, submucosal plexus
Clinical Correlations
- Brown-Sequard syndrome: lateral hemisection of spinal cord
- Spinal cord injury: compression, red flag symptoms (saddle anaesthesia, diminished anal tone, urinary/faecal incontinence)
- Thoracic outlet syndrome: scalene triangle, subclavian artery, roots of brachial plexus
- Laminectomy: passes through ligamentum flavum
- Fractures of the hand: surgical neck of humerus (axillary nerve), mid-shaft of humerus (radial nerve), supracondylar part of humerus (median nerve)
Brachial Plexus
- Provides motor innervation to arm and shoulder muscles (except trapezius)
- Sensory innervation to whole arm (except medial part)
- Roots: anterior rami of spinal nerves C5-T1
- Trunks: located in the neck (upper, middle, lower)
- Divisions: enter axillary fossa (anterior, posterior)
- Cords: located in the axilla (lateral, medial, posterior)
- Nerves: musculocutaneous, median, ulnar, radial, axillary
Lower Limb
- L5 posterior nerve root lesion: more widespread
- Knee jerk: L2-L4 (femoral nerve)
- Sciatica: L4-S3, gluteal region, posterior compartment of thigh
- Ankle: gastrocnemius, soleus, plantaris (insert into Achilles' tendon), tibial nerve (S1, S2), calcaneal tendon reflex
- Lumbar canal stenosis: extension worsens backache, flexion improves### Arterial Supply of the Spinal Cord
- 3 major longitudinal arteries (1 anterior, 2 posterior) from vertebral arteries
- Segmental arteries from vertebral, intercostal, and lumbar arteries
- Radicular arteries that travel along dorsal and ventral roots
- Venous drainage via longitudinal and segmental veins
Tracts of the Spinal Cord
Dorsal Column / Medial Lemniscus
- Fine touch and conscious proprioception
- Fibers cross in the medulla
Spinothalamic Tract
- Carries pain, temperature, and deep pressure
- Fibers cross when they enter the spinal cord itself
Corticospinal Tract
- Fine, precise movements particularly of the distal limb muscles (digits)
- Tract forms pyramids on the anterior surface of the medulla (pyramidal tract)
- About 85% of the fibers cross in the caudal medulla at the decussation of the pyramids
- Crossed fibers form the lateral corticospinal tract while uncrossed fibers form the ventral corticospinal tract (cross segmentally)
Extrapyramidal System
Tectospinal Tract
- Input mostly to cervical segments
- Mediates reflex head and neck movement due to visual stimuli
Reticulospinal Tract
- Fibers originate in the reticular formation of the pons and the medulla
- Fibers from the pons facilitate extensor movements and inhibit flexor movements
- Fibers from the medulla facilitate flexor movements and inhibit extensor movements
- Influence voluntary movement
Vestibulospinal Tract
- Excitatory input to antigravity extensor muscles
- Antigravity muscles help keep the body upright (soleus, gluteus maximus, extensors of the back)
- Fibers originate in the vestibular nuclei of pons and medulla (which receive input from vestibular apparatus and cerebellum)
Cerebral Artery Stroke
- Arms affected in middle cerebral artery stroke
Spinal Cord
- Gives rise to 31 pairs of spinal nerves
- Cervical enlargement (brachial plexus); lumbar enlargement (lumbosacral plexus)
- Dorsal/Ventral aspects of each segment → Posterior/Anterior roots → subarachnoid foramen → intervertebral foramina → posterior root enlarged by (dorsal) root ganglion → roots fuse to form mixed spinal N. → Ant & Post Rami
Spinal Meninges
- Spinal cord terminates as conus medullaris (L1/L2), pia mater continues as filum terminale, which is anchored to the dorsum of the coccyx
- Spinal meninges continue with brain meninges via foramen magnum; denticulate ligament (pial, arachnoid tissue) that attaches lateral aspects of the spinal cord to the dura
- Subarachnoid space is filled with CSF
- No subdural space in spine
- Epidural space has fat and venous plexus
Other Topics
Thoracic Outlet Syndrome
- Scalene triangle
- Subclavian artery
- Roots of brachial plexus
- Hence widespread symptoms
Fractures and Injuries
- Fracture of surgical neck of humerus: axillary N
- Fracture of mid shaft of humerus: radial n
- Fracture of supracondylar part of humerus: median N
- Fractures of the hand
Lumbar Canal Stenosis
- Extension makes backache worse, so activities like walking down
- Flexion makes it better, so activities like walking uphill or cycling
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Description
Test your knowledge on the arterial supply and tracts of the spinal cord, including the major longitudinal arteries, segmental arteries, radicular arteries, and venous drainage. Quiz also covers the Dorsal Column/Medial Lemniscus tract for fine touch and conscious proprioception, and the Spinothalamic tract for pain and temperature sensation.
