VERTEBRAL CANAL

Meninges and Space

1. Dura mater
Most external membrane
Dense, strong, fibrous sheet that
encloses the spinal cord and cauda
equina
Continuous superiorly through the
foramen magnum with the meningeal
layer of dura covering the brain.
Ends on the filum terminale at the level
of the lower border of the S2 vertebra.
Separated from the walls of the canal
by the extradural space (epidural
space).
Extends along each nerve root and
becomes continuous with connective
tissue surrounding each spinal nerve
(epineurium) at the intervertebral
foramen.
The inner surface of the dura mater is
separated from the arachnoid mater by
the potential subdural space.
2. Subarachnoid mater
A delicate impermeable membrane
covering the spinal cord
Between the pia mater and the dura
mater
separated from the dura mater
by the subdural space that
contains a thin film of tissue fluid.
separated from the pia mater by
a wide space, the subarachnoid

space, which is filled with

cerebrospinal fluid
The arachnoid is continuous above
through the foramen magnum with the
arachnoid covering the brain.
Inferiorly, it ends on the filum terminale
at the level of the lower border of the S2
vertebra
Between the levels of
medullaris and the lower
subarachnoid space lie the
of the cauda equina
cerebrospinal fluid

the conus
end of the
nerve roots
bathed in

The arachnoid mater is continued

along the spinal nerve roots, forming
small lateral extensions of the
subarachnoid space.
3. Pia mater
A vascular membrane that closely
covers the spinal cord
It is continuous superiorly through the
foramen magnum
Inferiorly, it fuses with the filum
terminale.
Thickened on either side between the
nerve roots to form the ligamentum
denticulatum, which passes laterally to
be attached to the dura.
Extends along each nerve root and
becomes continuous with the connective
tissue surrounding each spinal nerve

Fig. 1 Meninges and spaces of the

vertebral canal
the Spinal Cord.
External Features of the Spinal Cord
and Blood Vessels

Midline longitudinal fissure

Spinal Cord

1. Anterior median fissure

Cylindrical, grayish-white structure.

2. Posterior median sulcus

Begins above at the foramen magnum,

where it continuous with the medulla
oblongata of the brain.
Level of termination: Adults- L1;
Children- L3.
The SC, tapers of inferiorly into the
conus medullaris.
In the apex of the conus medullaris the
filum terminale (prolongation of the pia
mater) descends to be attached to
the back of the coccyx.
Fusiform enlargements
1. Cervical Enlargement (C4-T1) origin
of brachial plexus
2. Lumber Enlargement (T11-L1)
origin of lumbosacral plexus
Fig. 2 Fusiform enlargements of

Arteries
Segmental spinal arteries:
a. Anterior and posterior radicular
arteries occurs at every vertebral
level; supply anterior and posterior roots
b. Segmental medullary arteries
pass directly to the longitudinally
oriented vessels, reinforces the anterior
and posterior spinal arteries

Arteria radicularis magna or artery of

Adamkiewicz largest segmental
medullary artery; arises from lower
thoracic or upper lumbar region (usually
on left side) and reinforces the arterial
supply to the lower portion of the spinal
cord, including lumbar enlargment

Anterior spinal vein midline

channel the runs parallel to the
anterior median fissure;
Posterior spinal vein midline
channe which passes along the
posterior median sulcus

Internal vertebral plexus found in the

extradural (epidural) space of the
vertebral canal; where longitudinal
vessels drain into; the vertebral plexus
drains into segmentally arranged vessels
that connect with major systemic veins,
such as the azygos system in the thorax
and
it
also
communicates
with
intracranial veins.
Cerebrospinal Fluid

Longitudinal vessels:
a. Anterior spinal artery originates
within the cranial cavity that arises from
the vertebral arteries, passes inferiorly
and is approximately parallel to the
anterior surface of the spinal cord
b. Posterior spinal arteries originate
in the cranial cavity, arising directly from
a terminal branch of vertebral artery
(posterior inferior cerebellar artery);
descends along the spinal cord each as
two
branches that bracket the
posterolateral sulcus and the connection
of posterior roots with the spinal cord.

Clear, colorless fluid

Formed mainly by choroid plexus

(Lateral, Third and Fourth ventricle
of the brain)

Circulates in the ventricular system

and enter the subarachnoid space.

It also circulates in the hemispheres

of the brain down to the spinal cord

The fluid enters the blood stream

through the arachnoid villi into the
superior sagittal venous sinus
(dural venous).

Functions
Veins
Two pairs of veins on each side bracket
the connections of the posterior and
anterior roots to the cord;

Removes waste products

Provides a fluid medium the
surrounds the SC.
Together with the bony and
ligamentous wall of the vertebral

canal, it effectively protects the SC

from trauma.
Lumbar Puncture
Indications:

To withdraw a sample of CSF for

examination
To inject drugs to combat
infection or induce anesthesia
To measure the pressure of the
CSF
For clinical diagnosis

Procedure
1. The patient lies on his side with his
vertebrae well flexed (this widens
the space between the adjoining
laminae)
2. The level of the fourth lumbar spine
is determined by drawing an

imaginary line joining the highest

points of the iliac crest.
3. The lumbar puncture needle is
passed into the vertebral canal
above or below the fourth lumbar
spine.
Structures pierced in the procedure
(in order)
1. Skin
2. Superficial fascia
3. Supraspinous ligament
4. Intraspinous ligament
5. Ligamentumflavum
6. Areolar tissue containing the internal
vertebral venous plexus in the epidural
space
7. Dura matter
8. Arachnoid matter
9. Subarachnoid space