Chapter 23 Special Imaging Procedure Myelography PDF

SPINAL CORD (MYELOGRAPHY) RADIOGRAPHIC PROCEDURE Prof. Akram Asbeutah, PhD Department of Radiologic Sciences Faculty of Allied Health Sciences Kuwait University Objectives • Radiographic anatomy of Spinal cord • Radiographic procedures of Spinal cord • Radiographic positioning of Spinal cord A-...

SPINAL CORD (MYELOGRAPHY) RADIOGRAPHIC PROCEDURE Prof. Akram Asbeutah, PhD Department of Radiologic Sciences Faculty of Allied Health Sciences Kuwait University Objectives • Radiographic anatomy of Spinal cord • Radiographic procedures of Spinal cord • Radiographic positioning of Spinal cord A- Radiographic AnatomySpinal cord The Spinal Cord function •Links PNS and brain •Helps coordinate impulses within CNS •Contained in and protected by vertebrae Spinal Cord Protection • Vertebral column & vertebral ligaments • Meninges • Cerebrospinal fluid Sp Nutrition and protect the spine Structures Covering the Spinal Cord • Vertebrae • Epidural space filled with fat ‫األم الجافيه‬ • Dura mater – dense irregular connective tissue tube • Subdural space filled with interstitial fluid ‫األم العنكبوتيه‬ • Arachnoid = spider web of collagen fibers • Subarachnoid space = CSF • Pia mater ‫األم الحنونه‬ – thin layer covers blood vessels – denticulate ligaments hold in place External Anatomy of Spinal Cord • Flattened cylinder • 16-18’’ long & 3/4 inch diameter • In adult ends at L2 • In newborn ends at L4 • Growth of cord stops at age 5 • Cervical enlargement – upper limbs • Lumbar enlargement – lower limbs Inferior End of Spinal Cord Adult ends in L2 PED ends L5 • Conus medullaris - cone-shaped end of spinal cord • Filum terminale – thread-like extension of pia mater – stabilizes spinal cord in canal • Caudae equinae (horse’s tail) – dorsal & ventral roots of lowest spinal nerves • Spinal segment – area of cord from which each pair of spinal nerves arises Internal Structure of the Spinal Cord • Un-myelinated – – – – tissue (gray matter) Dorsal horn Ventral horn Gray commissure Central canal • Myelinated axons (white matter) – Posterior median sulcus – Anterior median fissure – Ascending and descending tracts Spinal Cord & Spinal Nerves • • • Spinal nerves begin as roots Dorsal or posterior root is incoming sensory fibers – dorsal root ganglion (swelling) = cell bodies of sensory nerves Ventral or anterior root is outgoing motor fibers The Spinal Nerve • Spinal nerves formed from dorsal & ventral roots • Spinal nerves branch into dorsal & ventral rami – dorsal rami supply skin & muscles of back – ventral rami form plexus supply anterior trunk & limbs B- Radiographic Procedures of Spinal cord Definition, Indications, & Contraindications for Myelography Procedure Herniated nucleus pupolus Contraindications: Blood in CSF, arachnoiditis, High blood pressure in the brain increased intracranial pressure, & recent lumbar puncture Patient & Room Preparation for Myelography Procedure And nuerogolist Equipment for Myelography Procedure Alcohol swipes Contrast media Cotton Drapes Needles Equipment for Myelography Procedure Sleeping prone Or seating and Lowe his head Needle placement & Injection Process for Myelography Procedure CSF = 5-10 ml Average of CM 5-10 30 min to finish the procedure to go to MRI Contrast Media for Myelography Procedure C- Radiographic Positioning of Spinal cord Myeloraphy Positioning Cervical Region Myelogram Cervical Region Myelogram Cervical Region Myelogram Thoracic Region Myelogram Thoracic Region Myelogram Thoracic Region Myelogram Thoracic Region Myelogram Lumbar Region Myelogram Lumbar Region Myelogram a Blockage this is disc Lumbar Region Myelogram Lumbar Region Myelogram Lumbar Region Myelogram Blockage CT Myelogram CT Myelogram CT Myelogram CT Myelogram MRI Myelogram MRI Myelogram MRI Myelogram MRI Myelogram