Interpreting Radiology
R. Annie Gough in Injury Illustrated, 2020
The most common radiology-based personal injury case is the rear-end collision resulting in neck pain and cervical injury. An Anterior Cervical Discectomy (ACD) is the typical repair procedure. A client gets hit from behind by a speeding, sleeping, distracted, or drunk driver. They suffer acute neck pain. Whiplash is a combination of muscle strain in the anterior and posterior cervical muscles and sprain to the facet joints between the bones. The vertebral discs between the spinal vertebra bones can also be injured, displaced, and/or herniated. When a disc is herniated, it has been torn and disc material is likely to protrude and touch the spinal nerve roots or the spinal cord. When cervical disc material is displaced and touching or compressing nerve fibers, pain radiates locally or down the arms, sometimes into the shoulders or hands and fingers. These injuries are complicated when a client is hit from the side, or from the front while their head was turned, or countless other scenarios. Regardless, this acute pain can become chronic. The common surgical repair when conservative treatment and physical therapy offer no relief is the ACD. I cannot estimate how many cases of clients surgically treated with ACDs come across the desks of attorneys on this continent. There are a lot of them. I have seen so many. Regardless I always strive to create the best ACD exhibits for the client, based on their specific anatomy and injury.
The nervous system
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella in Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
The spinal cord is divided into four anatomical regions: cervical, thoracic, lumbar, and sacral. These regions are named according to the vertebrae adjacent to them during embryonic development. Each region is further subdivided into 31 functional segments: 8 cervical (C) segments, 12 thoracic (T) segments, 5 lumbar (L) segments, 5 sacral (S) segments, and 1 coccygeal (Co) segment. A pair of spinal nerves extends from each segment, with 1 nerve from the left side of the spinal cord and 1 nerve from the right side. Spinal nerves exit the CNS through the intervertebral foramina, or openings, between adjacent vertebrae. There are 31 pairs of spinal nerves: 8 cervical12 thoracic5 lumbar5 sacral1 coccygeal
SBA Answers and Explanations
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury in SBAs for the MRCS Part A, 2018
There are 12 pairs of cranial nerves and 31 pairs of spinal nerves. The central nervous system comprises the brain and spinal cord. A peripheral nerve is a mixed nerve containing motor, sensory, and autonomic (parasympathetic, sympathetic) elements. Parasympathetic outflow arises from the ‘craniosacral’ region; that is, from certain cranial nerves and sacral roots S2–4. Cranial nerves III (occulomotor), VII (facial), IX (glossopharyngeal), and X (vagus) carry parasympathetic fibres whose function is primarily secretomotor (e.g., salivary secretions in the case of cranial nerve VII) and ciliary motor (pupillary reflexes and accommodation in the case of cranial nerve III), while cranial nerves IX and X play an integral role in blood pressure regulation. Sympathetic outflow is principally ‘thoracolumbar’ (i.e., from spinal segments T1 through to L2). The sympathetic nervous system serves vasomotor (vascular tone), sudomotor (sweating), and pilomotor functions, in addition to controlling smooth muscle and sphincter tone and playing a key role in cardiovascular homeostasis.
Buyang Huanwu decoction improves neural recovery after spinal cord injury in rats through the mTOR signaling pathway and autophagy
Published in The Journal of Spinal Cord Medicine, 2023
Ying Nie, Yujie Fan, Xi Zhang, Xiaosong Li, Jian Yin, Meili Li, Zhaoyong Hu, Liang Li, Xiaoye Wang
RST transection model is often used in SCI repair research because of its clear bundle, simple operation, and small trauma. The RST transection operation was performed following the methods described before.3 Rats were anesthetized by intraperitoneal injection of 2% pentobarbital sodium (30 mg/kg), the cervical curvature was fixed in the prone position, and the soft tissue and superficial muscles were separated under the operating microscope. Part of the erector spinae attached to the right side of the C2 spinous process was removed to expose the ligamenta flava between the C3 and C4 vertebral arches, and the ligamenta flava was cut open to expose the spinal cord. A small incision was made through the dura mater following identifying the dorsal root of the spinal nerve. Then, the right dorsolateral funiculus of the spinal cord was transected using a No. 12 surgical blade. This operation completely transected the lateral funiculus (containing the RST) and partially injured the ipsilateral ventral funiculus and gray matter, leaving the dorsal columns intact. When the animal woke up, the right forelimb was flexed and close to the trunk, with uncoordinated movement, and the right forepaw could not open, indicating the success of the operation.
Communication between the gut microbiota and peripheral nervous system in health and chronic disease
Published in Gut Microbes, 2022
Tyler M. Cook, Virginie Mansuy-Aubert
Neuronal transmission allows for nearly instantaneous processing of sensory input or generation of motor output. This rapid signaling of peripheral neurons in the gut is critical for homeostatic mechanisms such as GI motility, secretion, and even immune response modulation.39 The peripheral nervous system (PNS) consists of vagal and spinal sensory (afferent) neurons, autonomic motor (efferent) neurons, and enteric neurons (Figure 2). Afferent neurons send information from the periphery to the brain or spinal cord, while efferent neurons project out from the central nervous system (CNS) to peripheral organs. Classifying by anatomical distribution, the twelve cranial nerves project from the brain/brainstem and spinal nerves from the spinal cord. The autonomic system is divided into sympathetic, parasympathetic, and enteric nervous systems (ENS).
Cervical spine thrust and non-thrust mobilization for the management of recalcitrant C6 paresthesias associated with a cervical radiculopathy: a case report
Published in Physiotherapy Theory and Practice, 2022
Christopher R. Hagan,, Alexandra R. Anderson,
Cervical radiculopathy (CR) is a relatively common diagnosis resulting from dysfunction of a spinal nerve root exiting the cervical spine (Woods and Hilibrand, 2015). This is often due to a compressive or inflammatory pathology from a space-occupying lesion such as a disc herniation, spondylotic spur, or cervical osteophyte (Ellenberg, Honet, and Treanor, 1994). The diagnostic criteria for CR are not well defined and have not been universally accepted (Wainner et al., 2003; Woods and Hilibrand, 2015). Imaging modalities most frequently used to assist in diagnosing CR are radiographs, magnetic resonance imaging (MRI), and computed tomographic (CT) scans (Woods and Hilibrand, 2015). Electromyography (EMG) can also be used and may assist in ruling out peripheral nerve disorders (Rubinstein et al., 2007). These tests are considered to be the most accurate for CR diagnosis. According to Rubinstein et al. (2007) there is currently no gold standard for the diagnosis of CR.
Related Knowledge Centers
- Cervical Vertebrae
- Lumbar Vertebrae
- Thoracic Vertebrae
- Spinal Cord
- Vertebral Column
- Mixed Nerve
- Body
- Nerve
- Sacrum
- Coccyx