DOCSLIB.ORG

Esophageal Carcinoma in Patients with Spinal Cord Diseases: a Report on Two Cases and One Patho-Physiological Hypothesis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Esophageal Carcinoma in Patients with Spinal Cord Diseases: a Report on Two Cases and One Patho-Physiological Hypothesis Prog Health Sci 2011, Vol 1 , No 2 Eosophageal carcinoma case report Esophageal carcinoma in patients with spinal cord diseases: a report on two cases and one patho-physiological hypothesis Ohry A.1,3*, Zeilig G.2,3 1Section of Rehabilitation Medicine, Reuth Medical Center, Tel Aviv, Israel 2Department of Neurological Rehabilitation, Sheba Medical Center, Ramat Gan, Israel 3Sackler Faculty of Medicine, Tel Aviv University, Israel ABSTRACT __________________________________________________________________________________________ Two patients developed esophageal cancer: one patient had cervical poliomyelitis and the other one sustained cervical spinal cord penetrating injury. The possible association between spinal cord disorder and the late appearance of esophageal cancer is discussed. Key words: eosophageal carcinoma, spinal cord ___________________________________________________________________________ *Corresponding author: Director, Section of Rehabilitation Medicine Reuth Medical Center Tel Aviv & Sackler Faculty of Medicine Tel Aviv University, Israel E-mail: [email protected] (Ohry Avi) Received: 4.10.2011 Accepted: 27.10.2011 Progress in Health Sciences Vol. 1(2) · 2011 · pp 187-191. © Medical University of Bialystok, Poland 187 Patients with chronic spinal cord The historical case report of President damage, tend to develop various complications in Roosevelt is worth mentioning: Ditunno, & the gastro-enterological tract: fecal impactions, Herbison wrote on FDR’s diagnosis, clinical course constipation, hemorrhoids, peptic ulcer disease, and rehabilitation from poliomyelitis [8]. (rarely) diverticulosis, rectal carcinoma or volvulus, “ FDR , War President of the United States hiatus hernia, and gastroesophageal reflux. and the only Chief Executive in history who was Dysphagia may occur in those who were ventilated, chosen for more than two terms, died suddenly and had a tracheostomy, whose spinal stabilizing instru- unexpectedly at 4:35 PM today at Warm Sprigs, mentation is protruding anteriorly, or in whom Ga., and the White House announced his death at naso-gasrtic tube was inserted for a long time. 5:48 o’clock. He was 63. The President, stricken by To the best of our knowledge, there are no a cerebral hemorrhage, passed from uncon- reports suggesting any association between spinal sciousness to death on the 83rd day of his fourth cord damage (SCD) and esophageal carcinoma. term and in an hour of high-triumph…” [9]. We present herewith two case reports: one His death was not sudden and not really patient developed this neoplasm at the age of 65, unexpected. Two articles discussed this matter 47 years after contracting poliomyelitis, and the [10,11]: obviously, the President with an old other, at the age of 55, 32 years after being shot at paralytic poliomyelitis syndrome, suffered also C4 resulting in a complete traumatic spastic from overweight, hypertension, cardiac failure, tetraplegia. recurrent respiratory infections, which are not so rare phenomena in these patients. On 28 April 1944 Poliomyelitis and esophageal carcinoma suspected “acute cholecystitis” was treated with codein. In Yalta Meeting, 3-10, February 1945, his Case 1: was born in 1930 and died in general condition apparently deteriorated: weight 1997. In 1948, he had contracted acute paralytic loss, cardiac failure, anemia, fatigue, bronchitis poliomyelitis, which eventually made him crushing headaches, and death due to “massive tetraparetic. He walked unaided with a waddling cerebral hemorrhage." Did he die eventually from pattern. He enjoyed physical – sportive activities metastatic melanoma? Above his eyebrow, we can and achieved a respectable academic career. 1n easily observe a nevus. However, we would like to 1967 he had contracted pneumonia and underwent put forward another hypothesis: we have described surgical repair of an inguinal hernia. He had a few patients who developed 30-40 years after suffered from chronic diaphragmatic hernia contracting paralytic poliomyelitis, spinal cord (gastritis, heartburn) which was explained by tumors (12-13), and we had published a hypothesis diaphragmatic weakness due to his old how this could occur [14]. This association was poliomyelitis. He never smoked. During the last never ruled -out. Reviewing the history of four years of his life, he had complained of many poliomyelitis [15] one can learn the peculiar symptoms suggested by himself and by his historical occurrence and epidemiology of this physicians as “post polio-syndrome” (PPS): fatigue, disease, the late appearance of complications (PPS) weakness, functional deterioration, arthralgia, or the rare incidence of sensory deficit [16] or myalgia difficulties in walking, and progressive malignant hypertension [17]. We may only kyphosis. During the last year, he complained on speculate what kind of malignancy eventually swallowing disorder –dysphagia, and some leads to FDR’s death. The enigma of the PPS and reduction in his bodyweight. Gain , these signs the probable association of late appearance of were attributed to the “diaphragmatic hernia” and various tumours, still interest researchers [18-21]. the PPS. When these signs had worsened, the diagnosis finally was made: inoperable esophageal Spinal Cord Injury and esophageal carcinoma carcinoma. Apparently, the “old chronic” post-polio signs and symptoms “masked” the newly Case 2: was born in 1945. During The Six appearance of the cancer, and caused a marked Days war, June 1967, he sustained a cervical delay of its diagnosis. gunshot wound, leading to a complete spastic There is a vast literature about the PPS [1- tetraplegia below C4. The esophagus was not 6]. Is an immunological proneness to infection in directly injured. He was discharged after one year PPS, predispose these patients to development of from the rehabilitation ward and was totally cancer? dependent on others in all ADL (activities of daily Are chronic “oncogenic” viral infections living). He obtained an academic degree and responsible for this association? worked with the aid of sophisticated electronic Besides PPS, we are aware of the accessories, until his last illness. During the years, appearance of new functional decline among those he underwent hemorrhoidectomy, suffered UTIs with chronic” stable non-progressive” disabilities and gastritis with reflux esophagitis, and [7]. depression. We had described in “Paraplegia” this 188 Prog Health Sci 2011, Vol 1 , No 2 Eosophageal carcinoma case report case among other tetraplegics who developed the (GERD) or the medications used to treat it are phenomenon of “silent unusual sepsis” [22]. associated with an increased risk of esophageal or On December 1998, he was admitted to gastric cancer, using data from a large population- the Rehabilitation Center because of dyspnea, loss based case-control study. Cases were aged 30-79 of appetite, dysphagia, anemia, pressure sores, years. History of gastric ulcer was associated with palpable supra-sternal mass and sleep disturbance. an increased risk of the noncardia gastric After a thorough investigation, an esophageal adenocarcinoma. Risk of esophageal adeno- carcinoma was found. Lung function was reduced carcinoma increased with frequency of GERD comparing to his previous one. Radiological symptoms; ever having used H2 blockers was investigations revealed: right shoulder unassociated with esophageal adenocarcinoma risk. osteoarthritic changes, bone absorption around the Risk was also modestly increased among users of sternoclavicular joint, at C6/7 small syrinx, bilateral antacids. Neither GERD symptoms nor use of H2 pleural effusions, hypodensic mass in the hepatic blockers or antacids was associated with risk of the hilar area, and the esophageal carcinoma which other three tumor types. Individuals with long- invaded the sternum. Esophageal biopsy showed standing GERD are at increased risk of esophageal reflux esophagitis and squamous-cell carcinoma. adenocarcinoma, whether or not the symptoms are Gastrostomy was performed. He refused of any treated with H2 blockers or antacids. Hamoui et al. “heroic” surgery and only conservative treatment [26] examined expression levels of several genes was given including local irradiations and important in carcinogenesis and compared chemotherapy. expression levels with alterations in esophageal acid exposure. Their data provide among the first DISCUSSION reported correlation of genetic changes and increased esophageal acid exposure in patients with These two cases have demonstrated the gastroesophageal reflux symptoms. The changes in possible association of cervical SCD (due to gene expression occur before any metaplastic poliomyelitis or trauma), chronic reflux esophagitis changes in the tissue are apparent, and may in the and gastritis and late development of fatal future be useful in predicting which patients will esophageal carcinoma. progress through a metaplasia-dysplasia carcinoma Esophageal reflux (GERD) syndrome, or sequence. While patients with Barrett's oesophagus Barrett's syndrome, may lead to esophageal develop oesophageal adenocarcinoma more carcinoma [23]. Engel et al [24], identified several frequently than the general population, it has risk factors for esophageal adenocarcinoma, gastric controversially been suggested that GERD) itself is cardia adenocarcinoma, esophageal squamous-cell a more important determinant of risk. In order to carcinoma and noncardia gastric adenocarcinoma: assess the validity of this suggestion, Solaymani- a few known risk factors account for a majority
Load more

Recommended publications
  • Distance Learning Program Anatomy of the Human Brain/Sheep Brain Dissection
    Distance Learning Program Anatomy of the Human Brain/Sheep Brain Dissection This guide is for middle and high school students participating in AIMS Anatomy of the Human Brain and Sheep Brain Dissections. Programs will be presented by an AIMS Anatomy Specialist. In this activity students will become more familiar with the anatomical structures of the human brain by observing, studying, and examining human specimens. The primary focus is on the anatomy, function, and pathology. Those students participating in Sheep Brain Dissections will have the opportunity to dissect and compare anatomical structures. At the end of this document, you will find anatomical diagrams, vocabulary review, and pre/post tests for your students. The following topics will be covered: 1. The neurons and supporting cells of the nervous system 2. Organization of the nervous system (the central and peripheral nervous systems) 4. Protective coverings of the brain 5. Brain Anatomy, including cerebral hemispheres, cerebellum and brain stem 6. Spinal Cord Anatomy 7. Cranial and spinal nerves Objectives: The student will be able to: 1. Define the selected terms associated with the human brain and spinal cord; 2. Identify the protective structures of the brain; 3. Identify the four lobes of the brain; 4. Explain the correlation between brain surface area, structure and brain function. 5. Discuss common neurological disorders and treatments. 6. Describe the effects of drug and alcohol on the brain. 7. Correctly label a diagram of the human brain National Science Education
    [Show full text]
  • Power Wheelchair Alternative Drive Controls in Spinal Cord Injury
    Power Wheelchair Alternative Drive Controls in Spinal Cord Injury Kristen Cezat, PT, DPT, NCS, ATP/SMS When a person with a spinal cord injury is unable to use a standard joystick on a Fact Sheet power wheelchair, an alternative drive control and location is required. Depending on the person’s level of injury and musculature that remains innervated, the more common locations of alternative drive control input devices include the head, neck, face, eyes, and tongue. A proportional drive control allows the wheelchair’s speed/direction to mirror the force/direction applied to the input device by the user, most often through a joystick. Proportional drive control options include1: • Standard Joystick: able to move in any direction at any speed. It is often the most intuitive device for adults with injuries at C5 and below. Joysticks are commonly located on either left or right arm rest but can be altered for Produced by location in midline if spasticity or contracture limits neutral shoulder/elbow alignment. • Alternative Joystick (often set at the user’s chin): joysticks vary in size and require less force and deflection to activate the joystick.1 air Drive ControlA non -Optionsproportional drive for control Clients uses commands with to turn on/offSpinal various functionsCord such as direction (forward, back, left, or right) of the wheelchair. Speed is predetermined and not variable to the strength of the command provided. Non- Injury proportional drive controls include1,2: a Special Interest • Sip-and-Puff Group of • Head Array • Head Array/Sip-and-Puff Combo Non-proportional drive controls can be either momentary or latched.
    [Show full text]
  • Basic Brain Anatomy
    Chapter 2 Basic Brain Anatomy Where this icon appears, visit The Brain http://go.jblearning.com/ManascoCWS to view the corresponding video. The average weight of an adult human brain is about 3 pounds. That is about the weight of a single small To understand how a part of the brain is disordered by cantaloupe or six grapefruits. If a human brain was damage or disease, speech-language pathologists must placed on a tray, it would look like a pretty unim- first know a few facts about the anatomy of the brain pressive mass of gray lumpy tissue (Luria, 1973). In in general and how a normal and healthy brain func- fact, for most of history the brain was thought to be tions. Readers can use the anatomy presented here as an utterly useless piece of flesh housed in the skull. a reference, review, and jumping off point to under- The Egyptians believed that the heart was the seat standing the consequences of damage to the structures of human intelligence, and as such, the brain was discussed. This chapter begins with the big picture promptly removed during mummification. In his and works down into the specifics of brain anatomy. essay On Sleep and Sleeplessness, Aristotle argued that the brain is a complex cooling mechanism for our bodies that works primarily to help cool and The Central Nervous condense water vapors rising in our bodies (Aristo- tle, republished 2011). He also established a strong System argument in this same essay for why infants should not drink wine. The basis for this argument was that The nervous system is divided into two major sec- infants already have Central nervous tions: the central nervous system and the peripheral too much moisture system The brain and nervous system.
    [Show full text]
  • Study Guide Medical Terminology by Thea Liza Batan About the Author
    Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails ­proficiency­in­communicating­with­healthcare­professionals­such­as­physicians,­nurses,­ or dentists.
    [Show full text]
  • Neurogenic Erectile Dysfunction. Where Do We Stand?
    medicines Review Neurogenic Erectile Dysfunction. Where Do We Stand? Charalampos Thomas 1,* and Charalampos Konstantinidis 2 1 Urology Department, General Hospital of Corinth, 20131 Corinth, Greece 2 Urology & Neurourology Unit, National Rehabilitation Center, Ilion, 13122 Athens, Greece; [email protected] * Correspondence: [email protected] Abstract: Erectile Dysfunction (ED) is the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance, causing tremendous effects on both patients and their partners. The pathophysiology of ED remains a labyrinth. The underlying mechanisms of ED may be vasculogenic, neurogenic, anatomical, hormonal, drug-induced and/or psychogenic. Neurogenic ED consists of a large cohort of ED, accounting for about 10% to 19% of all cases. Its diversity does not allow an in-depth clarification of all the underlying mechanisms nor a “one size fits all” therapeutical approach. In this review, we focus on neurogenic causes of ED, trying to elucidate the mechanisms that lie beneath it and how we manage these patients. Keywords: erectile dysfunction (ED); neurogenic; sexual dysfunction (SD); phosphodiesterase type-5 inhibitors (PDE5I); spinal cord injury (SCI); multiple sclerosis (MS) 1. Introduction Erectile dysfunction (ED) is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance [1]. Besides the obvious, it has tremendous effects on the patient’s psychosocial health, and it affects not only their quality of life but the lives of their partners [2]. Citation: Thomas, C.; Konstantinidis, The pathophysiology of ED remains a labyrinth since many pathways can co-exist, C. Neurogenic Erectile Dysfunction. thus contributing negatively. Where Do We Stand? Medicines 2021, Traditionally ED was divided into three large cohorts, organic, psychogenic and of 8, 3.
    [Show full text]
  • SCI Facts and Figures at a Glance 2019.Pdf
    Spinal Cord Injury Facts and Figures at a Glance 2019 SCI Data Sheet This data sheet is a quick Incidence reference on demographics and the use of services by people Given the current U.S. population size of 328 million people, a recent estimate showed that the annual with spinal cord injury in the incidence of spinal cord injury (SCI) is approximately 54 cases per one million people in the United United States (U.S.). Much of the States, or about 17,730 new SCI cases each year. New SCI cases do not include those who die at the information reflects recent data location of the incident that caused the SCI. collected since 2015. Historical Data Source: Jain NB, Ayers GD, Peterson EN, et al. Traumatic spinal cord injury in the United States, information reflects data 1993-2012. JAMA. 2015;313(22):2236-2243. collected since the early 1970s. Prevalence The estimated number of people with SCI living in the United States is approximately 291,000 persons, with a range from 249,000 to 363,000 persons. The National Spinal Cord Injury Database is a prospective Data Source: Lasfargues JE, Custis D, Morrone F, Carswell J, Nguyen T. A model for estimating spinal longitudinal multicenter study cord injury prevalence in the United States. Paraplegia. 1995;33(2):62-68. that currently captures data from an estimated 6% of new Age at Injury SCI cases in the United States. The average age at injury has increased from 29 years during the 1970s to 43 years recently. The database has demographic and condition status data Gender through 2018 for 33,406 people About 78% of new SCI cases are male.
    [Show full text]
  • The Nervous System: Sensory and Motor Tracts of the Spinal Cord
    15 The Nervous System: Sensory and Motor Tracts of the Spinal Cord PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • Millions of sensory neurons are delivering information to the CNS all the time • Millions of motor neurons are causing the body to respond in a variety of ways • Sensory and motor neurons travel by different tracts within the spinal cord © 2012 Pearson Education, Inc. Sensory and Motor Tracts • Communication to and from the brain involves tracts • Ascending tracts are sensory • Deliver information to the brain • Descending tracts are motor • Deliver information to the periphery © 2012 Pearson Education, Inc. Sensory and Motor Tracts • Naming the tracts • If the tract name begins with “spino” (as in spinocerebellar), the tract is a sensory tract delivering information from the spinal cord to the cerebellum (in this case) • If the tract name ends with “spinal” (as in vestibulospinal), the tract is a motor tract that delivers information from the vestibular apparatus (in this case) to the spinal cord © 2012 Pearson Education, Inc. Sensory and Motor Tracts • There are three major sensory tracts • The posterior column tract • The spinothalamic tract • The spinocerebellar tract © 2012 Pearson Education, Inc. Sensory and Motor Tracts • The three major sensory tracts involve chains of neurons • First-order neuron • Delivers sensations to the CNS • The cell body is in the dorsal or cranial root ganglion • Second-order neuron • An interneuron with the cell body in the spinal cord or brain • Third-order neuron • Transmits information from the thalamus to the cerebral cortex © 2012 Pearson Education, Inc.
    [Show full text]
  • Understanding Spinal Cord Injury: Part 1—The Body Before and After
    Understanding Spinal Cord Injury: Part 1— The Body Before and After Injury January 2015 SCI Fact Sheet This fact sheet is intended to be What is the spine? a starting point for The spine (also known as the “backbone”) is the connected column of bones running from your understanding the normal head to your lower back. A single bone is called a “vertebra” (pronounced VER-teh-brah), and functions of the spinal cord and multiple bones are called “vertebrae” (pronounced VER-teh-bray). The figure shows the spine and how those functions might vertebrae. change after spinal cord injury (SCI). The impact of injury is The figure also shows the five sections of the spine. different for everyone, so it is Each section is made up of a group of vertebrae. impossible to answer every question of interest. However, • At the top of the spine, at your neck, is the this fact sheet will answer a few cervical (C) section. There are 7 vertebrae in this common questions. section. Each vertebra is numbered top to bottom from C1 to C7. • Below the cervical section is the thoracic (T) section. There are 12 vertebrae here. Each is numbered from T1 to T12. • The lumbar (L) section follows. There are 5 vertebrae here. Each is numbered from L1 to L5. • The next section is the Sacral (S) section. This is also called the “sacrum.” Here the 5 vertebrae are fused together as one bone. • At the bottom of the spine, 3 to 5 vertebrae are fused together as one bone segment in the coccygeal (Cx) section.
    [Show full text]
  • Male Fertility Following Spinal Cord Injury: a Guide for Patients Second Edition
    Male Fertility Following Spinal Cord Injury: A Guide For Patients Second Edition By Nancy L. Brackett, Ph.D., HCLD Emad Ibrahim, M.D. Charles M. Lynne, M.D. 1 2 This is the second edition of our booklet. The first was published in 2000 to respond to a need in the spinal cord injured (SCI) community for a source of information about male infertility. At that time, we were getting phone calls almost daily on the subject. Today, we continue to get numerous requests for information, although these requests now arrive more by internet than phone. These requests, combined with numerous hits on our website, attest to the continuing need for dissemination of this information to the SCI community as well as to the medical community. “The more things change, the more they stay the same.” This quote certainly holds true for the second edition of our booklet. In the current age of advanced reproductive technologies, numerous avenues for help are available to couples with male partners with SCI. Although the help is available, we have learned from our patients as well as our professional colleagues that not all reproductive medicine specialists are trained in managing infertility in couples with SCI male partners. In some cases, treatments are offered that may be unnecessary. It is our hope that the information contained in this updated edition of our booklet can be used as a talking point for patients and their medical professionals. The Male Fertility Research Program of the Miami Project to Cure Paralysis is known around the world for research and clinical efforts in the field of male infertility in the SCI population.
    [Show full text]
  • Brain Anatomy
    BRAIN ANATOMY Adapted from Human Anatomy & Physiology by Marieb and Hoehn (9th ed.) The anatomy of the brain is often discussed in terms of either the embryonic scheme or the medical scheme. The embryonic scheme focuses on developmental pathways and names regions based on embryonic origins. The medical scheme focuses on the layout of the adult brain and names regions based on location and functionality. For this laboratory, we will consider the brain in terms of the medical scheme (Figure 1): Figure 1: General anatomy of the human brain Marieb & Hoehn (Human Anatomy and Physiology, 9th ed.) – Figure 12.2 CEREBRUM: Divided into two hemispheres, the cerebrum is the largest region of the human brain – the two hemispheres together account for ~ 85% of total brain mass. The cerebrum forms the superior part of the brain, covering and obscuring the diencephalon and brain stem similar to the way a mushroom cap covers the top of its stalk. Elevated ridges of tissue, called gyri (singular: gyrus), separated by shallow groves called sulci (singular: sulcus) mark nearly the entire surface of the cerebral hemispheres. Deeper groves, called fissures, separate large regions of the brain. Much of the cerebrum is involved in the processing of somatic sensory and motor information as well as all conscious thoughts and intellectual functions. The outer cortex of the cerebrum is composed of gray matter – billions of neuron cell bodies and unmyelinated axons arranged in six discrete layers. Although only 2 – 4 mm thick, this region accounts for ~ 40% of total brain mass. The inner region is composed of white matter – tracts of myelinated axons.
    [Show full text]
  • The Spinal Cord and Spinal Nerves
    14 The Nervous System: The Spinal Cord and Spinal Nerves PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • The Central Nervous System (CNS) consists of: • The spinal cord • Integrates and processes information • Can function with the brain • Can function independently of the brain • The brain • Integrates and processes information • Can function with the spinal cord • Can function independently of the spinal cord © 2012 Pearson Education, Inc. Gross Anatomy of the Spinal Cord • Features of the Spinal Cord • 45 cm in length • Passes through the foramen magnum • Extends from the brain to L1 • Consists of: • Cervical region • Thoracic region • Lumbar region • Sacral region • Coccygeal region © 2012 Pearson Education, Inc. Gross Anatomy of the Spinal Cord • Features of the Spinal Cord • Consists of (continued): • Cervical enlargement • Lumbosacral enlargement • Conus medullaris • Cauda equina • Filum terminale: becomes a component of the coccygeal ligament • Posterior and anterior median sulci © 2012 Pearson Education, Inc. Figure 14.1a Gross Anatomy of the Spinal Cord C1 C2 Cervical spinal C3 nerves C4 C5 C 6 Cervical C 7 enlargement C8 T1 T2 T3 T4 T5 T6 T7 Thoracic T8 spinal Posterior nerves T9 median sulcus T10 Lumbosacral T11 enlargement T12 L Conus 1 medullaris L2 Lumbar L3 Inferior spinal tip of nerves spinal cord L4 Cauda equina L5 S1 Sacral spinal S nerves 2 S3 S4 S5 Coccygeal Filum terminale nerve (Co1) (in coccygeal ligament) Superficial anatomy and orientation of the adult spinal cord. The numbers to the left identify the spinal nerves and indicate where the nerve roots leave the vertebral canal.
    [Show full text]
  • Anthropometric Cutoffs and Associations with Visceral Adiposity
    University of Birmingham Anthropometric cutoffs and associations with visceral adiposity and metabolic biomarkers after spinal cord injury Sumrell, Ryan; Nightingale, Tom; McCauley, Liron; Gorgey, Ashraf DOI: 10.1371/journal.pone.0203049 License: Creative Commons: Public Domain Dedication Document Version Publisher's PDF, also known as Version of record Citation for published version (Harvard): Sumrell, R, Nightingale, T, McCauley, L & Gorgey, A 2018, 'Anthropometric cutoffs and associations with visceral adiposity and metabolic biomarkers after spinal cord injury', PLoS ONE, vol. 13, no. 8, e0203049. https://doi.org/10.1371/journal.pone.0203049 Link to publication on Research at Birmingham portal General rights Unless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law. •Users may freely distribute the URL that is used to identify this publication. •Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research. •User may use extracts from the document in line with the concept of ‘fair dealing’ under the Copyright, Designs and Patents Act 1988 (?) •Users may not further distribute the material nor use it for the purposes of commercial gain. Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.
    [Show full text]