脊 髓 疾 病diseases+of+the+spinal+cord

《脊 髓 疾 病diseases+of+the+spinal+cord》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、脊髓疾病(Diseasesofthespinalcord)DepartmentofNeurology,The2ndaffiliatedhospital,HarbinMedicalUniversityDiseasesofthespinalcordOutlineAcutemyelitisCompressivemyelopathySyringomyeliaSubacutecombineddegenerationofthespinalcordMotorneurondiseaseTheanatomyofthespin

2、alcordExternalcomponents:TheupperandlowerboundaryofthecordThecapsuleThespinalnervesTherelationbetweenthecordandspineTheanatomyofthespinalcord1.Externalcomponents:TheupperandlowerbournofthecordLength:42~45cm,Itisthecontinuationofmedulla(occipitalforamen).Th

3、elowerendformsterminalcone.Itoccupies2/3lengthofthespine.Lumbarenlargement:L1~S2,cervicalenlargement:C5~T2Terminalfilamentendontheperiosteumofthe1stcoccygealvertebraNextTheanatomyofthespinalcord1.Externalcomponents:Spinalnerves:31pairsofnervesweresentout:C

4、8,T12,L5,S5Thesegmentaldistributionofcutaneoussensoryinnervation见图1图2Theanatomicbaseofthespinalcord1.ExternalcomponentsThecapsule:图例Threelayercapsule:spinalduramater,arachnoid,tenuismaterThreespaces:epiduralspace:venousplexusandadiposesubduralspacesubarach

5、noidspace:CSFTheanatomyofthespinalcord1.Externalcomponents:ThecordofC1~8isonesegmenthigherthanthecorrespondspinerespectively,T1~8istwosegmenthigher,T9~12isthreehigher,thecount-partoflumbaristhe10~12ththoracicvertebra,sacralcordliesinthe12ththoracicvertebra

6、andthe1stlumbar.Theanatomyofthespinalcord2.Internalcomponents:Graymatter:shapelikeH.Anteriorhorn:motorneuron.ThefibersareanteriorrootPosteriorhorn:LateralhorninthemyelonofC8~L2andS2~4Whitematter:anteriorcolumn,lateralcolumn,posteriorcolumnTheanatomyofthesp

7、inalcord3.BloodsupplyAnteriorspinalartery:whichsuppliestheanteriortwo-thirdsofthecord供应脊髓全长和脊髓横断面前2/3区域。Posteriorspinalarteries:供应脊髓全长及脊髓后柱、后索，脊髓横断面后1/3区域。Radiculararteries:根动脉与脊髓前、后动脉吻合，构成冠状动脉(coronaryartery)环围绕脊髓表面，分出无数小支供应脊髓表面结构及脊髓实质外周部分的供血。C6、T9和L2处最大，

8、T4和L1为交界。见图Cordimpairments-ClinicalfeaturesMotordeficits:spasticorflaccidparalysisDisordersofsomaticsensation:见图posteriorhorn&root:节段性感觉障碍posteriorhorn:节段性分离性感觉障碍anteriorwhitecommissure:感觉分离现象spinalthalamictr