Lab 3 Blood Supply and CSF. ARTERIAL SUPPLY TO SPINAL CORD & BRAIN.
21 Blood Supply of the Cord
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Blood Supply of
the Spinal Cord
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ArterialSupplyoftheSpinal
CordThe arterial supply of the spinal cordby the vertebral arteries.
It is also from the branches ultimatelyfrom the thoracic and abdominal aorta,called the radicular arteries.
Each vertebral artery (or posteriorinferior cerebral artery) gives rise to a
posterior spinal artery, which proceedsalong the line of attachment of thedorsal roots.
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ArterialSupplyoftheSpinal
Cord Each vertebral artery also gives rise to an anterior
spinal artery.
The 2 anterior spinal arteries fuse to form a singlemidline vessel.
This courses along the anterior median fissure ofthe spinal cord.
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ArterialSupplyoftheSpinal
Cord
The posterior spinal arteries and theanterior spinal artery supply uppercervical levels with from the vertebralarteries.
Below this, all 3 spinal arteries form amore or less continuous series ofanastomoses with radicular arteries.
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ArterialSupplyoftheSpinal
CordBeginning with lower cervical segments,the spinal cord depends on theradicular arteries for its survival.
The great radicular artery (ofAdamkiewicz), present at the spinalcord level T12-L2 may provide theentire arterial supply for the caudal 2/3
of the spinal cord.
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ArterialSupplyoftheSpinal
Cord
The very long anterior spinal artery is usually acontinuous vessel for the length of the spinal cord.
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ArterialSupplyoftheSpinal
Cord It gives rise to hundreds ofcentral and
circumferential branches.
These supply the anterior 2/3 of the spinal cord. This includes the base of the posterior horn and a
variable portion of the lateral corticospinal tract.
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ArterialSupplyoftheSpinal
Cord
The posterior spinal arteries are really more of aplexiform network of small arteries.
They supply the posterior columns,substantia gelatinosa, dorsal root entry zone, anda variable portion of the lateral corticospinal tract.
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AnteriorCordSyndrome
Anteriorcordsyndromeisveryrareandinvolvestheanteriortwothirdsofthespinalcord,leavingonlytheposterior
columnsintact.
Itmostcommonlyfollowsavascularinsultsuchasagreatvesselinjury,vertebralbodyfracture,oranteriorspinalcanalocclusivetumors.
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AnteriorCordSyndrome
Pa=entsusuallypresentwithanacutelossofmotorandmostsensoryfunc=onbelowtheleveloftheinjury.
Bowelandbladderfunc=onisusuallyaffectedbecauseofalossofsensoryinput.
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AnteriorCordSyndrome
Sparingoftheposteriorcolumnspreservessomedeeppressure,vibratory,andlighttouchsensa=on.
Theprognosisforrecoveryinthissyndromeisverylimited4.
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PosteriorCordSyndrome
Affectstheposteriorcolumn,dorsalroots,&partoflateralcor=cospinaltract
Dorsalroots Lossofallsensoryinnerva=onattheinvolvedsegment
Posteriorcolumn Vibra=on,Propriocep=on,stereognosis,2-pointdiscrimina=on,andfinetouchlossonbothsidesbelowtheinvolvedsegment
Partofcor=cospinaltract Varyingdegreesofmuscleweakness
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