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spinal cord, sensory tract, 中樞病變, 周邊病變, cervical enlargement : C4-T1…
spinal cord
structure
pia matter+white matter+gray matter+the layer of ependymal cell
dura matter+arachnoid+subarachnoid space+pia matter
gray matter
central canal
anterior horn : cell body of somatic motor neuron
posterior horn : central process of sensory neuron
lateral horn
sympathetic system : T1-L2
parasympathetic system : S2-S4
segment
cervical segment*8
thoracic segment*12
lumbar segment*5
sacral segment*5
coccygeal segment*1
plexus
cervical plexus(C1-C4)
部分頭部+頸部
phrenic nerve(C3-C5)
brachial plexus(C5-T1)
上肢+背部淺層肌群
median nerve : 腕隧道症候群
radial nerve : 上臂+前臂肌群
long thoracic nerve
lumbar pkexus(L1-L4)
腹部+部分下肢
femoral nerve(L2-L4)
sacral plexus(L4-S4)
sciatic nerve(L4-S3)
pudendal nerve
會陰+臀部+下肢
root→spinal nerve→ramus
ventral ramus : 正面軀幹+上肢+下肢
dorsal ramus : 背部軀幹
rami communicantes
馬尾神經叢 : root of lumbar nerve+sacral nerve+coccygeal nerve
DTR
BrachioradiaL reflex+Biceps reflex : C5+C6
Triceps reflex : C6+C7+C8
Patellar reflex : L2-L4
Achilles reflex : S1+S2
Superficial reflex
Abdominal reflex : T8-T12
提睪肌reflex : L1+L2
Plantar reflex : L5+S1
motor tract
lateral corticospinal tract(90%、medulla oblongata交叉)
anterior corticospinal tract(10%、spinal cord交叉)
sensory tract
posterior column(medulla oblonga交叉) : 本體覺、精細觸覺、震動覺
薄束(內側) : 訊息來自下肢及下身軀幹
楔狀束(外側) : 訊息來自上肢及上身軀幹
Romberg's test
實體辨識、圖形辨識、兩點辨識覺
lateral spinothalamic tract(spinal cord交叉) : 痛覺、溫覺
anterior spinothalamic tract(spinal cord交叉) : 粗觸覺、壓覺
中樞病變
DTR增強
Babinski sign(+)
Spasticity
Muscle atrophy(-)
周邊病變
DTR減弱
Babinski sign(-)
Flaccid
Muscle atrophy(+)
cervical enlargement : C4-T1 segment
lumbar enlargement : L2-L3 segment