Cervical spinal nerves
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One of the most important understandings the technologist must gain is an appreciation for the fact that injury to a vertebra does not necessarily mean that there is an injury to the spinal cord; neither does injury to the spinal cord require a vertebral fracture for correlation. Neurological examination of the patient and radiographic interpretation by a radiologist is what determines what further testing is needed before a definitive diagnosis can be given. In many case instances the radiologist in consultation with a neurosurgeon may recommend a CT scan, and possibly magnetic resonance imaging, or even fluoroscopy guided spine motion studies. The point here is that the radiographer should be aware that injuries to spinal nerves or to “soft” tissue are issues in trauma care as well as awareness of bony injury. Traumatic injuries to the spinal cord or the spinal nerves may occur during a trauma event.
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A basic understanding of the gross anatomy of spinal nerves as part of ones understanding of the scope of trauma imaging and patient care is in order. In addition to the anatomy of the spinal nerves, the technologist should be aware that some sensory nerves carry more than just pain or the absence of pain; there is also touch, pressure distinction, two-point discrimination, temperature, proprioreception, and other sensory and motor functions. The complete picture of the patient is gathered by the physician performing the clinical evaluation, augmented with diagnostic testing. A brief review of the gross anatomy of the spinal nerves that exit the spinal cord is beneficial to ones imaging skills. It is difficult to know when an image is sufficient for diagnosis unless one knows what the elements of the diagnosis entail. Certainly a complete survey of the bony relationship to the spinal nerves and vertebral canal are necessary. Therefore, we should review the gross anatomy of the spinal nerves.
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A basic understanding of the gross anatomy of spinal nerves as part of ones understanding of the scope of trauma imaging and patient care is in order. In addition to the anatomy of the spinal nerves, the technologist should be aware that some sensory nerves carry more than just pain or the absence of pain; there is also touch, pressure distinction, two-point discrimination, temperature, proprioreception, and other sensory and motor functions. The complete picture of the patient is gathered by the physician performing the clinical evaluation, augmented with diagnostic testing. A brief review of the gross anatomy of the spinal nerves that exit the spinal cord is beneficial to ones imaging skills. It is difficult to know when an image is sufficient for diagnosis unless one knows what the elements of the diagnosis entail. Certainly a complete survey of the bony relationship to the spinal nerves and vertebral canal are necessary. Therefore, we should review the gross anatomy of the spinal nerves.
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The gross anatomy of the spinal nerves is that there are thirty-one pairs of spinal nerves having attachments to the spinal cord. These are arbitrarily divided into 8 pair of cervical spinal nerves, 12 pair of thoracic nerves, 5 pair of lumbar nerves, 5 pairs of sacral nerves, and one coccygeal nerve. The eight pair of cervical nerves exit the spine in the following way: the first cervical nerve exits above the first cervical vertebra between it and the skull, the second cervical nerve exits below the first cervical vertebra between C1 and C2, the third cervical nerve below the second cervical vertebra, the fourth cervical nerve from below the third cervical vertebra between C2 and C3, the fifth cervical nerve from below the fourth cervical vertebra, the sixth cervical nerve from below the fifth cervical vertebra, the seventh cervical nerve from below the sixth cervical vertebra, and the eighth cervical nerve from below the
seventh cervical vertebra between it and the first thoracic vertebra. Therefore, to effectively demonstrate potential injury to the eighth cervical spinal nerve the radiographer must demonstrate the vertebral body, apophyseal joints, and quadrilateral posterior architecture of both C7 and T1 vertebrae. The alignment of the 7th cervical and 1st thoracic vertebrae must also be demonstrated
The gross anatomy of the spinal nerves is that there are thirty-one pairs of spinal nerves having attachments to the spinal cord. These are arbitrarily divided into 8 pair of cervical spinal nerves, 12 pair of thoracic nerves, 5 pair of lumbar nerves, 5 pairs of sacral nerves, and one coccygeal nerve. The eight pair of cervical nerves exit the spine in the following way: the first cervical nerve exits above the first cervical vertebra between it and the skull, the second cervical nerve exits below the first cervical vertebra between C1 and C2, the third cervical nerve below the second cervical vertebra, the fourth cervical nerve from below the third cervical vertebra between C2 and C3, the fifth cervical nerve from below the fourth cervical vertebra, the sixth cervical nerve from below the fifth cervical vertebra, the seventh cervical nerve from below the sixth cervical vertebra, and the eighth cervical nerve from below the
seventh cervical vertebra between it and the first thoracic vertebra. Therefore, to effectively demonstrate potential injury to the eighth cervical spinal nerve the radiographer must demonstrate the vertebral body, apophyseal joints, and quadrilateral posterior architecture of both C7 and T1 vertebrae. The alignment of the 7th cervical and 1st thoracic vertebrae must also be demonstrated.
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the pattern for the exit of the eight pairs of cervical spinal nerves from the vertebral canal. These are mixed nerves carrying sensory and motor distributions
the pattern for the exit of the eight pairs of cervical spinal nerves from the vertebral canal. These are mixed nerves carrying sensory and motor distributions
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.The spinal nerves exit the vertebral column through the intervertebral foramina. Each intervertebral foramen is formed by the pedicles of adjacent vertebrae, which have notches on their superior and inferior borders. The inferior vertebral notch and superior vertebral notch of adjacent vertebrae form the intervertebral foramen (arrows-picture below). Within each foramen lies a dorsal root ganglion of a spinal nerve
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