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So you've got a cervical lordosis Karasik kyphosis lumber Low dose is onda say cruel and coccygeal uh, kyphosis. If the way to remember it really is bye sorry By memorizing the fact that number is low Doses of elidel on diffuse Just think as alternating curvature's that makes sense. Or if longest low dose is the one about thoracic Could be kyphosis So, Michael, be low doses. Uh, so that fits in the middle there intervertebral discs. These are the transfers for a minute. Cities that anterior of you of the spinal cord is a pasta review of the spinal cord. And these are your spine is processes. Um, And since your sacred on these are your constant your bones so the boat to perfects. Basically, there are seven thoracic 12 7. So Michael, 12th thoracic five longer. But a break on the but way to remember it is it's almost as if it's time he would have the three meals of your day at It's the for example, breakfast at seven o'clock natural 12 and then dinner at five o'clock. It's a bit of early dinner, but that's the way I remember it on and then use a cream is five, as is the lumber. And then your coccyx can range from about 3 to 4. I get very simple, easy person to person. And there are three functions, so it protects. So it protects the spinal cord. It provides an attachment site to the muscles on. Also, it articulates with the ribs on did the other, but a break so that you're able to undergo your bodily movements of for exactly a flexion and extension. Your rotation of the spinal cord is well, okay. Um right, So this is gonna be a little Oscar focuses? Well, because I think that's also something that we should touch up. Really? Um, so this is a terroristic spine. Now, when they ask you to pick up a typical spy, I was always pushed to picking up a torus. Explain because it had the typical features are mentioned very nicely laid out. You can also go for a lumber spine, which is a bit more basic, but long was fine. Stand to be quite well, Kia and the features on exactly, exactly, well, laid out. So if someone said if examined, told you, um, from a list of, you know, over time. So what? I normally just they've been out a tray of different what? Afraid on bail? Say pick one up. Explain the typical features of about a Great. So when you may been to ask you to do that, you follow a systematic approach. So you stopped from the front and go to the back. So you talk about the body you talk about. This is called the Pedicle. You talk about the lamina so pedicles at the front of the superior articular facet laminas at the back of the superior articular facet. Then you talk about the transplant process this, then you talk about the spine. It's processes ongoing. Finally, you talk about the Cipro for a A, and I've included three different views. And this is to be very realistic lateral view and the inferior of you just so you can appreciate, um, the vertebrae numb or three dimensional manner? Um, so moving on. So this is what it'll essentially look like. Okay. On. Do. Um yeah, this is what your specimen looked like, physically. So that start off with a PSA of I converted free. Now, as I said before, we're going to start with the body, then we're going to move onto the PEDICLE. Then we're gonna go to the lamina spinous processes transfers process. And finally, we're gonna talk about the, um, vertebral foramen. Now, these, um, were doing a different language. So it no, the words, But I'm just I just included this image is because they're really good quality. So looking as cervical vertebrae, it's body is actually quite small. And it's code now. I included a reference here, Can you see house? You see how small it is compared to a person's hand So they were to brought the psychological One is quite small and curved. Um, up and down is up. And then it's ah pedicle. It doesn't really have a lot of pedicle compared to the lenders are very short pedicles but a very long laminar compared to the pedicles on its finest grosses of the back is actually if it on when I said, If it I mean it's split into two. Okay, uh, so it's a benefit spinous process long ma'am in a short pedicle. And these are it's transverse processes. Now the trials was processes in survivor vertebrae have a hole in the middle called the so far, the transfers foramen on This is where the vertebral arteries run through because of the bunch of the arteries. Run through, upping to your, um, sculpt to follow the Brazil A arteries. And this is where the vertebral arteries run through. Uh, and also they have something called the cubicle of the transit process. And this is where the scaling muscles attach to the cervical vertebrae. So just to kind of recap what we said the body short curve. But the top curved at the bottle. Uh, you have the transverse processes which have a cubicle at the end of attachment of the scaling, Also contain a foramina for vertebral arteries to move through. Then you have the pedicle. You have the lamina on the pedicles. Quite sure the level is quite long on the spinous process of the back of stiff it Now, often they expect you to talk about the position of what we call the superior are taking the first set on the inferior articular facet. Okay, so the cervical vertebrae they turned to face upwards on backwards. Uh, the so the superior articular facet would face upwards and backwards and the inferior articular facet would face downwards and forwards. So the way to remember it if you can just remember the superior the opposite of disappear ist inferior, so superior of us upwards and backwards downwards would be front frontwards and forwards. Okay, so yet that's basically it. Now, when you pick up, if someone stays, explain a typical cervical vertebrae or if they say, pick up a cervical vertebrae. That explains speeches to me. Don't go picking up the atypical months on. But, um, I'll tell you how to distinguish The 18 goes from the typical, but it's very important that you don't do that because some of the atypicals of I could. But you actually don't have features of a typical cervical, but ever. So you're not really helping yourself, um, so save I can see to the atypical. Also, a good thing to mention is when you pick up the cervical vertebrae, you're going to explain it to the Examiner. Always start off with the sentence. This is a typical survive, converted. Great because there are a job because of, like, a multiple reasons. But But if you tell the Examiner that you know that this isn't it because of like a little bridge just looks better instead of you just go in. This is it's a cycle vertebra. Um so so even see to their 80 because of my ankle. But your brace on this is because so the first see one, it's called the actress. Um Andi. Firstly, if you look at the body, it really has little to no body. Um, yeah, it's got little to nobody. Really not got much of a pedicle. Even the lamina is a bit, I mean, the laminas there, but it's quite small. Um, the spinous process of the back. It's very small compared to the rest of the. So I converted. That's that's an important the intervention. It's also got a superior article facet, but the articulation happens between the skull instead of another cervical vertebrae. So we say that if it's superior, artful a facet to the occipital condyle of the scalp. Okay, um and then it's also got something called an articular facet for the dense on that goes on to our next structure here. So this is see, too, And this is the debts. Okay, So the deaths again see two is a atypical cervical vertebrae dance attach this to the body of the see too much it breaks. And again, this is a typical because no ever cervical vertebrae has a dense on do it except for that. And it's up for the fact that there's a superior articular facet for the actual lists. Everything else released the same so you can see there's a transfer's for a minute. Is the transverse process as transfers, too? Because all of those things that that and see to actually has a defense finest, grossly system. So I would say that See, one is more atypical than, say, two because it doesn't have a if it's Sinus process know, does it have a body? Uh, but really, that's up to interpretation. Eso yeah, So what makes the one and C two agent pickle? See? One doesn't have a body, and it has a very short spinous process on it's superior article FS. It's actually facing upwards completely and the articulate with the occipital contra and see to President's um, and it's superior attitude if s it's again up first thing, but facing vertically up in the axis. Now, if someone asked you to explain a atypical cervical vertebrae, don't just explain the atypical features. Okay, even though it's atypical, it's got it's still got some very typical features. So it's got the transformation. A It's got the lemon and the pedicle summation. You include those in your explanations and spoke, Um, if you have any questions, just stop shot out because I can't really see the shot at the moment, Okay? There's nothing. Um, So this is how big the to sit. So as you can see, the dense or the odontoid processes, some textbooks may call it actually fits in to the the little rain that's formed by the ligament attached to the wrists on. Um, yeah, this is basically how they stay in place. Otherwise, this would be moving all around. So this is your access on. This is your address. Sorry. Just one second. My thing. Start. Right. Okay. And where were we? Here. Right. So this is, um what a cadaveric sample of the actress and excess would look like. So Atlas would be sitting on top of the access life in this picture. The syringe is an other atypical one. Just because it doesn't have a different spine issue for assess. If this is C seven. See, someone is the last of this. Um Michael vertebrate eso. As you can see, we said that all of these have a big fits finest process. But see, seven actually doesn't have a different spine. It's process. I'm so this is C seven. Uh, so that's what makes it a typical on this finest process is actually quite long as well compared to the rest of this, uh, Vikas So that's going to terroristic now again. Body pedicle lamina transit process. It's finest process on articulating facets. So let's look at the first image here. All right, the second image here. Uh, so the body of this is slightly larger on the vertebral foramen is actually more circular, uh, than oh, it's rather smaller than that. If the cervical and it's actually you could say it's like a triangle shaped almost. It's articulating facets Here, Um, actually point upwards on d. Um, the point they point up toward vertically on its inferior articulating process points downwards, particularly so our words that bad if faces forward to articular surfaces facing backwards. And this is facing forwards on there just virtually placed on do something that is very specific to the thoracic vertebrae, but not to the rest of the vertebrae is. Actually they've got these costal facets. So these cost office is is is the period costs a facet inferior cost, a facet and the transfers cost of facet. These air the parts of the thoracic vertebrae that articulate with the ribs. So, as you can see here, this is like a overhead use aerial view, a superior view of thoracic vertebrae. The rib attaches to the body. He had the superior cost of facet. The rib also touches to the transfers process at the transfer. Cost transfers cost of Pass it. It's it's finest processes tend to point downwards, as opposed to the, um, more straightforward pointing spinous processes in the cervical, but a free and it's lamina. It's not as short as it is in the cervical. Um, sorry, it's pedicle is not as short as it is in the cervical, and it's lamina two pedicle ratio. Is Lemonis still longer? But I'd say it's always to say Okay, um, so yet that's basically that, um, and something that you also need to appreciate is if someone says pick up a terroristic vertebra from the trade off but it brings being given, uh, make sure you have to understand that not all that the rest, but to braid look to say so they'll come to go. A growth spurt doesn't like to call it as you go down City T one. It's body tends to be smaller than it's spinous process, but if you go down to teach 12, the body is much larger compared to, oh, the first body that t one body. And also it's almost like a similar size to its finest process. And the spinous processes actually get broader and shorter as he goes down the terroristic vertebrae. Um, so that's that. Now we go onto number to break now lumbar vertebrae again. This is one of my favorite, but really, you have to explain it to another ski examiner because these have the exact typical features. You would want to describe it if someone up was to ask. You describe the typical features in a vertical. So you've got the body. You've got the Sorry you got a body. You've got pedicles. You've got lamina. You've got your articulating facets. You got your spine, it's process. You go, your transfers process. None of this cost a facet, um, dens, all that business. It's just very straightforward. So this is a good vertebrae to go to. If someone asks you to pick up a typical vertebrae, something you do have to keep in mind is that it's superior articulating facets face in bird. So they're almost like looking at each other, as you can see on the inferior articulating facets of facing outwards as if they're not looking at each other. Uh, so if you were to explain this to an examiner, you'd start off with the body solutions in the body's climb brewing. Some people like juice, a little kidney shaped. The pedicles are relatively short again, but they're almost the same size to the lab in it. If you're unsure about the pedicles being same size to the lamina, don't mention it. Just say this is the pedicle. This is the lamina and just leave it at that. Okay, Uh, well, you can comment on the pedicle was slamming a size. It's really your cervical vertebrae. That's what I would mention that apart from that, if you have to pick up a number, but you could just say this is the pedicle sister Lamina The pedicle is the part that is anterior to the superior. Articulating facet on the laminitis apart posterior to the superior. Regulating Pass it again. Spine. Is processes that quite broad yet the quite broad that quite short. Um, yeah, that's about it. Really Understood why I called the vertebral foramina is actually quite small compared to the cervical foramina. Okay, um, and you could also say it's like a triangle shaped as well. Uh, but then again, if you just remember the size comparison as opposed to with its triangular or not, um, it would just be easier for you. And also remember, at the exam definitely be the specimens. They don't memorize what shape which you know what shape for Amitiza. Just look at the for a minute. Just explain what you see. Really? Um, know whether to the sacred now the same correct. This is the back of the sacred on the left side, on the right side of the front of the sacred. Let's start with the back of the sacred. So the stakes from actually articulates with the lumber The L5 vertebrate with it's superior article facet. So it just has to superior articulating facets here, and that's it Normal articulating facets. And as you can see, the five bones with the sacred march if used to each other and you get the spinous do pickles at the back. Uh, and you will also have something called a sickle high. It is at the back is low. So the top of the sacrum is called the sacred canal on the bottom of the sacred Canal School. The sacral hiatus. Now, this is where what we call the coccygeal filament. The end of the spinal cord travels through to attach to the coccyx at the bottom. Okay, so it travels through here, comes up and then attach to the bottom here, and you have dorsal sacred for a minute. Ventura low, anterior Safeco foramina. Uh, and then you also have the sacred per month tree. So this is that this is, um, this bit here. Let me just get my pointing to out. So it's just this bit here, Really? And it's the most anterior part of your kill. This So your pills help? This would be around about here and just take a premonitory is the most anterior part of your pelvis and office. You got your coccygeal bones here? Uh, yeah, that's about it. So this is a little table that I did, um, just showing you the different features. If he were to explain it to the examinal new if you were to get an Oscar station on, explain the differences between the vertical from and other started, but you bring themselves now like, um, it's of the spine. Again. I have not had a question with this, and I don't really know anyone who's had a question and also gestation with it. However, I guess they could throw a progress just questioning it. For example, so you have the anterior longitudinal ligament that runs at the front of the vertebral bodies. So this is the front of the vertebra. Okay, Now, this is the so this is the front of the vertebrae. This is the back of the working. So this is a cross section through the body of the vertebrae, and this is a cross section through this finest versus of the vertebrae. So you're entity anterior longitudinal ligament rounds at the front of the body of the budget. Three on your posterior longitudinal ligament front set the back of the bodies of the vertebrae. Now your ligament and flavor. As you know this the graphics aren't that great here. But I wanted to include this diagram because it shows you exactly where the ligamentum flavum runs as opposed to the posterior long sheet in a ligament. So that posterior longitudinal ligament runs at the back of the vertebral bodies. Onda ligament of flavor almost faces it and runs along the front of the spine. It's process is if you will. Okay, so behind this other spinous processes So this is where the ligamentum flavum this. Then you have your interstim unit ligaments that into spinous like, Oh, it's also called into spinous ligament and they run through basically the trances processes of the M. It's the body breaks and then you have the support spinous ligament. But which attaches to the tips of the's finest versus is of the bath. Okay. Um, yeah, again, this is a progress. Just question that I got to know the types of joints eso just just make sure that you know what sort of joints exists between the vertebrae themselves of what sort of what type of joint is the individual joint. What type of joint is the cycle? Perfect. Your joy. So the side of your physio joint is basically loratadine ribs attach to the budget. That's just as a word for that. See, I just know what those what type joins there? Because there was this just question. Um, I did on it so far shows that the spinal cord now we did, uh, Now we've done the vertebrate and the bones of the Spi. Now we can actually go to the spinal cord, so basically, it helps us send instincts. It helps us control our muscles on. It also helps us well. It helps control the autonomic system because those are the three things really now grow structures a spinal cord. It starts off reading with the pants and the medulla oblongata because of mid brain structures. Then it forms the traditional spinal cord as we know it, where you have a cervical enlargement and the lumber enlargement. Um, and then there's a Conus medullaris, so that's basically where the spinal cord terminates, and then you have to fill in terminal on. This is like a bit of connective tissue that attach it's a spinal cord to the coccyx. Now the survive, um, cervical and number enlargements actually present because a lot of your nerves, your arms and legs come off this bit a Z you can imagine because there's a lot of sensory and motor movement involved with the hands and feet. There are a lot of nerves that innovate these parts. So because there are a lot of nerves that have to come out from these parts originated these parts, they tend to be a little thicker around the top and the bottom of the spinal cord. Okay, Um yeah, And just know that the spinal cord terminates at the L2 L1 L2 IV disc level consultants love to ask you down. The war drowns for some reason. Um, it's a very common question that they asked not really a progress type questions. I don't really remember it being all set progress. Anyway, eso ignore the cartoon diagram. I just wanted to include a cadaveric, um, image here because the previous image I don't know whether you noticed it actually is missing a very important part of the spinal cord, which is called the Quarter Kleiner. So this is your quarterback liner um and that is found after. So if I look, if you look at a spinal cord again, so your constant model actually found the midbrain, you can see it as you go down. You have your cervical and large man here coming down even more. You have your number enlargement here. It's not as obvious as in the picture, but it's there. Then you have your Conus medullaris. You can see kind of cones on ends at the elbow, know to level, and you have your film terminal, which goes away down in attached to your coccyx. And then off that off the Conus medullaris, you can see the court like whiner. I'm coming off on those. Tend to innovate your genitals, your your bladder, your, uh, your medical, the Extendryl internal anus fingers and even your legs as well. Guess that that's really important. The cord. A coiner. Um, Now, let's look at the spinal cord structure. No, this is if you look at it here. This is a picture of the spinal cord that they've taken. See Concede the vertebral, the vertebral body. If the keppra here, the interventual disc the spinal cord lives in the budget Bill Canal on, if usually non that. You can see that as close to the pre. The gray matter is found in the middle of the spinal cord on the white matter is found on the outer part, the spinal cord. And this is because a lot of the, uh, no so body is actually found in the middle of the spinal cord on a lot of fits, accidents or the wiring is like, as I like to call it, I found in the ultracet outer part of the spinal cord. This is the This is the front of the spinal cord, and this is the back of the spinal cord. Now, something that used to confuse me is when people use the buds, um, spinal roots, um, spinal nerves interchangeably. And it's definitely is not interchangeable. Okay, Absolutely, is completely wrong. Now, as it does understand, spinal nerve, absurd nerves are quite small, and these little tiny nerves that we can't really see All right, the first order neurons in the second order neurons recurrent see them with the naked eye. So they actually form bundles called fascicle that I've depicted here by these little black lines. Okay, so fascicle is our about 6 to 8 of these little neurons bunched up. And these fascicle then bunch of people further to fall nerve roots. So this is your anterior nerve root. And this is your posterior nerve root. Okay, on your posterior in of root, basically, sensory on your anterior nerve root tends to be a motor. So when these to join up when the nerve roots join up there for this final enough. Okay, on, then the spinal nerve can further divides into a Ramus. Absolutely. Have a door so very much in an anterior. Ramos. And you look at that in a minute. But just understand physicals. You can go to see them here very built, but the festivals so mortally runs off your aunt's in general, they got bunch up to form fascicle the fascicle sponge up to form roots and the roots bunch up to form the spine owned up. Okay. Um, so, yeah, this is their 31 passed. This is just a bit of thumb, I guess. Extra knowledge. We want to read up on the glacier. Now. The reason is, do I included this picture and don't get confused is because sometimes they'll ask you about a white and great Ramos. Now, if you see this question, just understand that now. We spoke about a sensory, uh, dorsal root, and we spoke about a motor eventual drive and anterior door. So you also have done this time with sympathetic system has to come into play a swell. So the white and grayer a Ms is basically, like a little, uh, connection that allows the sympathetic says from the autonomic system to be part of the spinal nerves. Okay, so yet that's what the white and Great Ramos is. And, um, again, this is a cadaveric image of the spinal cord on, but I just wanted to hold in on the different layers of the spinal cord now, So as like, as with the break, you have the, um p a major, the drug noid and the jury mater. Now, you're not gonna be able t tell these three layers apart because, you know, at least you're not gonna be able to tell the p A and the erection or department rebuilt because they're actually quite close this stuff together. You will be able to tell the do, um eight. Apart from the wrist. So the deer eyes the very thick sheet like structure because you can see, um, it's quite think it's quite fibrous that holds the, uh that covers the spinal cord on. Do you have the arachnoid, which is like this thing? Flynn's a bit that covers the dura. So, as you can see, it's almost as if the jury is covered. Inkling film. So, like the clinic, the only that is basically Iraq, right? Uh huh. The pyramids. Although you can't see well, you can tell you apart from the ACLU, it a little extra broke off the pier. Me to call the dentist. You're late. Ligament this bit here. I'm like, at the shore why it's there. But the dentist relate. Ligament is actually a little external. A bit off the pier meter. Okay, so sometimes, um, this hasn't happened in Oscar station, but they've done it in a, uh, but with the anatomy demonstrators with the demonstrate actually got a picture of the spinal cord. Uh, was it picked Cairo? There's a picture with, but it was an actual spinal cord, but I think was a picture on day actually asked us to point to the dentist lately of it. But they had, like, put pins in the, um, different structures up here today. And they were, like, showing the dental a big mess of the dental clinic. Um, and it's quite close to the actual swine record. It's white as well. Like that. You're a mater, but it's closer than a year. A mater to the spinal cord. So denticle eight ligament. Then you have the arachnoid. Which kind of allies? Well, with the top of the jury mater on this is the urinating. Okay, See you. When they give an epidural injection, they tend to give it in the epidural space which lies here. So the epidural space is actually the space above the dura. Okay, subdural is underneath the jurors. Epic zero is about the Children. Um, so, yeah, this is the actual space you been giving it to. And the reason is to why they give it so no. Is because, um, this way, that sure that they're not going to hit the spinal cord itself. Okay, you might find some cord that quite a lying around, But you can never stop the court. It kinda because when you put the needle to a bunch of, um, you want of hanging nerves because the Kordech dryness in one chunking up, it's just a bunch of individual and of roots running down. You know, the chances of you hitting a quarter crying are very good. Whereas if you were to give a epidural injection right at the top here, you could stop the spinal cord and actually damages radicals. That's why they like to give it down here in the epidural space. Um, anything. You shouldn't be giving it into the spinal canal or anything, but, you know, of course, mistakes can happen. And just to avoid any damage to the spinal cord, they like to give the injection further down. So L3 L4 L5. That's where they like to inject this epidural injections. Um, so, yeah, Now we're looking at the internal structure. The spinal cord. Oh, sorry. And, um, so you've got the anterior siding for the posterior site? Um, you have your door so horns and your ventral horns. This is the central canal of the spinal cord. And that's where the that's continuous. With the ventricles of the brave, you get like CSF running down that basically on. Then you have what we call the anterior median. Fisher. This is the very deep fissure that lives in the middle. And then, of course, you have your spinal nerves and roots and stuff that come out. Okay, Um, so, yeah, these are the roots. Let's off physicals on. Then they form the anterior route and the posterior route, which gives rise to the spinal enough now, variations of the spinal cord. Um, this is just an information, really. As you go further down the spinal cord, this is what this is how, despite the cross section of the spinal cord change, so it will still have it's dorsal horns. It will still have. It's ventral horns. It's just that the shape of the spinal, the grey matter and contrast to the rest of the, um, spinal cord will change something that you should remember is that the cervical and a little bit of the correct sick actually have something called a lateral whole. Now the electoral hornets found between the anterior and pasta, the ventral and dorsal horns, uh, says he can see even this has got a bit of a natural whole, and this contains so body is from the preganglionic sympathetic new roads. Okay, It's just the only significant thing that you really need to know. So the survival and the terroristic have a natural war which lies between the ventral and dose. So, um, spinal whole. The Ventolin dose of horns on the lumbar sacral parts actually don't have the lateral. Okay, so that, as you can see, there's no natural one and a lump. It's a cruel but the terroristic. There's a little trouble in here. Initial natural born here. Uh, yeah. So my concern is it, captain? Right now, the gray much of the spinal cord is something that's being debated. You know, in the medical community, quite a lot. In terms of how do you want to classify it? They're different classifications, Uh, something that the medical textbooks that we use, um, such crossman. They like to use the wrecks to laminate classifications. So, basically, just given on the list of the different parts of the, uh, spinal cord and the difference, parts of the spinal cord represented front things, but you're not. You don't need to learn every single, you know, number and what they mean and they're they up just know the, you know, towards the back. You have your sensory. You're paying related bits of the gray matter of the spinal cord on drugs. The front you have, like, your pro price option, that sort of stuff related to a spinal court. Okay, Um, so that's basically that, um, So the bit of the great master of the spinal cord that you need to know is the substantia gelatin. You, sir, uh, on to a certain extent in you clearest pro pre. It's okay. So if you look at this So you're substantially gelatin osa here. So that's your part too. Okay. And your nucleus Crow Priuses. Your part three. They are actually involved in your pain pathways on something that you will have to learn about this school. Big gate, Think gait, period pain on. We'll get to that in a little bit. Um, but it's basically once you have, I'll get I'll recap. This one's we learn about spinal clinic trucks this well, but when you talk about pain, you're some standard schedule a gyn Oh, so also known as the second part. Second breaks laminae Number two is very important because they actually release chemicals related to the body interpreting pay. Okay, So even if you don't remember, Number three, at least remember Number two, which is substances urologist. Right now we get onto the dread it ascending and descending tracks. I'll tell you now there are more sending tracks that you need to know, then descended trucks. Technically, there's only one descendant track you need to know, So the ascending tracks both feel like a bit of a drag. But once we get through this and in trucks, the descending tracts will be pretty straightforward. So let's start off with the dose. A little column. Media Lemonis School party. Okay, so they are the pathways that are related to information that they basically sent information about the position of violence. It's called proprioception, Fine Touch and vibration. The case. You would also call a medial a meniscal pathway. Convey is pro prescription buying touch and vibration information. So as it can see, you have your first order neurons that come up through the spinal cord itself, actually ascending so they don't cross over or anything that travel. It's a naturally so on the same site, they sign up with their second order neurons. Uh, here with the nucleus, Cuny Ages and New Prescription is perspectively on. Then the second order neurons travel up to the Kalamazoo on. Then here, the second ordinary owns toe earn sign ups it the third order in Iran's to convey the messages to the cortex. No, What you need to know is that the upper limbs, the dorsal color medial meniscus part from the upper limbs, actually travel up and they terminate in the nucleus journey ages on do the lower limb. Once the first order lonely once go in terminating. The new prescription is now There are a couple of words that I'm included a ski words because when you describe this part ways examine its want you to use this words Progress test will ask you to pick this words from a name search. Okay, so I'm just going to explain the pathway as I did before. Except I've been used these scientific terms instead of just saying first order and your own second on in the wrong sign absolute sector. So as you show the first order, it begins at the receptors, travels up ipsilateral e on. Then, um they psyops of the second order neurons at the new prescription agents and you clear it. Nucleus person is depending over the upper or lower limb on these are found in the medulla oblongata. From here, the second under the Iran's. They actually deck a states of cross over to the other side. On this deck, a station is actually called the internal arcuate fibers. Okay, so now you can. I just called in the internal accurate fibers. They travel up, um, forming and they travel up to reach the talents on this bit. That's going up is actually called the medial lemon discus Now that just where it gets its name from dorsal column media luminous put carpet. And the reason that's why it's called a dorsal column is because straight at the back. So then it Sinuses have the Thomas, um, with third order neurons, and it throws up the third old in Iran's Rather travels to the postcentral drop postcentral guy Iris on the parietal lobe to relate this information. So the only scientific was you need to know really here, uh, you know, these are for the internal accurate fibers on do it. The second order new ones are no longer about second or neurons. One you take. Once the jackets say that actually called the media, let me discuss. Okay. And I hope that was helpful. It was a bit of a mouthful, even for me. Uh, but if you guys have any questions just popping check. Um, so, yeah, I just wanted to show you where exactly in the spinal cord, The dose, a call. A medial meniscus. Part ways. So it's called the door so common because it's right in the back. Okay. On your fasciculus basilisk is more media down your testicular cuny ages. Okay, so your lower limbs are more medial than your up a little d c. And the pathway on this is a better visual image of how, exactly they're laid out. So the lower the GCM Elmiron is, the more medial it will be. So cycle is medial to lumber. Just need your thoracic. Just need to cycle, uh, you know, going about that. Um, so, yeah, from your lecture on your brain stone. This is basically your fasciculus chrysalis. As our nuclear stress ileus and your nucleus, uh, cuny ages again. And once that come from, the lower limbs are more media than the ones that come from the upper limit on the you're on. Is that come from the loan in the's? Uh, once that terminates with the crystal is on the neuro psych. Come with the upper limit Other ones that are made with the Q t h is So that was your d CML pathway. If you have any questions, just put in checked. Um, let's do a spinal polemic. Now, spinothalamic is basically the, um once that can rate the famous in our African conveying pain and temperature, they also can convey crude touching pressure. Okay, So when you get spinothalamic, the first thing that you should really be thinking about is paid in temperature. Uh, but also it does crew touching pressure. Now, if you look at the spinal column IQ as opposed to delete TC does Uncle a medial meniscus. The deck is a shin, or the crossing over happens very lower down compared to the previous month for the previous one. As you can see it deficit id, you know, kind of near the medulla, um, the medulla region. But here you can see that the second order neurons they deck assayed almost at the level of this final cord. So you have your first order neurons that come through on the first or the neurons sign ups in the dorsal horn off the spinal cord. Also, remember the substantia gelatin know statistics where the first order you're on set up with the second order, it works. Then they cross over to the other side, forming the anterior electoral, um, spinal Kalanick pathways. Then they set all the way up to the palace. And then from the talents they go on to the, um, sensory low off, The more the cortexes degree. Okay, so not many, um, words. They're really for you to remember. Just remember that the deck a station happens quite early on. No, I a very low dose. Um, CIA. So your natural spinal canal make tracks night here on your anterior spinal and the tracks like here. So, as you can see quite close to the gray matter of the spinal house by home court, I'm almost hugging the greatest of the spinal cord, if you ask me. So this is your d c m l pathway, your physical a specific in your particular study. Eight hours that make up the D. C and your pathway. And this is where your lateral spinal column it tracks are a new anterior spinal tract. I understand that. Off information. Um, but if you have any questions, just let me know. No spinal, cerebral, the trucks. I'm not gonna go into too much information regarding this. They also help really Information regarding proprioception on day, like, really far out, um, of the spinal cord they like, quite naturally. Almost on the edge of the spinal cord is you can see in ghetto. Uh, yeah, they basically carry information from the muscles and tendons. You don't need to know the exact partly because they are quite complicated. But if you did want to remember some information regarding, then just remember that the eventual on dorsal spot on the Sabril attracts they carry information from the lower limbs. Um, on the, uh, rostral spinal cerebella and the cumulus spinocerebellar, they carry information from the apple lose if they ask you to 0.2 days. Two. I think that would be quiet being after Noski. Um, but I just remember your very own eventually and dorsal spine a cerebellar ataxia, which is where the right at the edge. But yeah, these. These two bullet points are really what you need to know. And the interesting thing about spinocerebellar tracks is that they only contain to you're on so they don't have a girl or in Europe, right? They just have a primary at Sorry, product. First order and second order. Not really a third order neuron. Uh, yeah. So that's basically that, um Okay, now descending tracks. You'll be happy to know that you only need to know one of this in detail. Okay, so these are your cortical spinal tracks now, descending means so. So far, we did, um, ascending trucks. Meaning it starts from my receptors going up to a brain. Now, we're gonna look at coming down from starting at the cortex, going down to our muscles. Then, uh, what rest of the body? Really? Okay, So this is your cortical spinal tract. Cortical to the spine. Okay, so you have your, um uh, you're on starting at the cortex. They initially form in structure called the Corona Radiata, which is this bit that looks like fireworks here. Really? So you have your, um, large corticospinal you're on's the actually staff in the cortex. The form the Corona radiata on day all joined together to form an internal capsule Because you have to understand that the brain is actually sending information from different parts of its cortex because it's put information from your visual sister from your, you know, vestibular system. Also, the system. It collects all this information, and it needs to send it down to the rest of the spinal cord. So it gets all these, Um, it gets old days. Um, you know, uh, and also you have to understand that a lot of the a lot of different types of muscle groups also involved in movement on a lot of these different muscle groups are controlled by different parts of the brain. So all these neurons, they start off from the cortex, forming the Corona radiata, which condensed to form the internal capsule, and they will go the way down to to the medulla. And here at the medulla, the lateral corticospinal tract deca states, not the anterior, just the lateral on. When the lateral corticospinal track deck a states, it forms what they call the pyramid structure. Um, I don't think I haven't image of it. No, I don't, but, uh, yeah, It's basically if you look at the medulla itself, it just looks like a little bumpy structure of the front of the lower part of the medulla. So it forms the pyramids. That's because the electoral corticospinal some of the corticospinal tracks. They deficit forming the lateral corticospinal tract, which then goes off to innovate the lower mortality rods. Now there's also a anterior corticospinal track, now the anterior corticospinal track. It doesn't depress eight at the pyramids. It doesn't deficit at the lower part of the Madonna. Instead, it travels. It's a naturally on devastates at the level it exits the spinal cord. Okay, so I away, Uh, the brain controls the contralateral part of your body when it comes to water actions, because when it comes to you actually doing stuff, muscle control is the contralateral part of your brain that controls the muscles of your body. So if you're moving your if you want to move your left arm, it will be the right side of your brain. That's actually controlling that. Because even though the anterior corticospinal tract doesn't deck a state at the pyramid, it does deficit when it comes to the act. Okay, so just a quick recap. I know I'm repeating myself a lot, but it's very important that you kind of get these terms and where everything decades eights into ahead because it can be quite confused, especially because we do all the tracks together same time. So you get your corticospinal new runs actually quite large and called bets cells. If you must know, um, they start for the cortex. They come down for me in the Corona radiata on the Corona radiata then condenses to form this internal capsule, which contains corticospinal neurons. They come down all the way here to the end of the medulla or the lower part of the medulla, where some off the corticospinal nerves deck a state forming the lateral corticospinal draft, which travels down and exits to It's respective, uh, at its respective spinal cord level. Where's anterior quarter goes out. Whereas some of the other corticospinal tracks travel absolutely without devastating. Uh huh, deficit at the level of the spinal cord that they exist. It okay on deputation, actually forms and what we call the pyramids of the middle of, uh, see you. That's basically what this is about. When you get to read up on it later on. So these are the different types of car the track. So you need to go. Do you have your DC ML, which is an ascending that we looked up? We also have your spinal tap lamic, which is also an ascending that we looked at. We have your spinal steroid Bella, which is also under sending that we looked at. And now we looked at the corticospinal tracks, which is this bit here. Okay, so that's where your quarter for style trucks. Life. Now, these are your other descending tracks. Now you don't need to really know about them in detail. Just know what they kind of do. Your rubrospinal. They controlled tone affects the muscles. Your check this final felt mediate reflex actions. Associate it with visual stimuli. Vestibular finals again. There's a bunch of things I'm not going to really off the site, Really? But just know what they do. You don't even need to do that part of it. Spinal vasculature again. Pretty simple. You have the arterial venous. Now you haven't Algeria spinal artery and a posterior spinal a tree. Now, remember that anterior medial fissure that we were talking about before. So your anterior spinal artery at your runs that onda, um, your post your spinal actually basically rounds of the back, the spinal cord. And, um, they actually branches of the bunch of relaxed Aries Onda. Um, yeah, that's basically that, um, So an interesting thing to really note is the artery of Adam kicks, right. So this is actually one of the largest segmental medullary arteries. Um, it's it's it's it's something that you would be able to pick up on the cadaver. And that's why I'm telling you this, right? If they put a pin on it and say, What is this? That would be really enough. But even if you can't remember our tree of Adam gimmicks, at least remember, it's one of the largest medullary arteries. Okay, so again, these are brand. Does final arteries actually branches off the vertebral arteries on Venus? Strain itch again. Pretty simple. There are three anterior and three posterior spinal veins on. They drain into the anterior on Boston area external plexuses Okay, on these plexuses, in turn, draining to what we called systemic segmental plexuses. So three, anterior and three posterior brains they drained into enter posterior internal next on a plexus. Um, and these in turn drain into systemic segmental Lexuses. Uh, stretch reflexes. Now, I wanted I was debating on whether or not to mention it, but we've got five minutes left. Supply now, now, stretched reflects. The only thing you really to know is that reflex actions are not controlled by the break. Obviously, that's why it's going up a reflex action. So what happens in every flex? Actually, basically, you have your muscle spindles. Um, these muscle spindles, they're all found together, and nothing was called a cold. I, um bottle or gold guide? A parrot is I'm not quite sure what that is, but so the spindle receptors of the stretch receptors are found in the muscle spirits. When a muscle spindle is stretched over a certain extent, information travels along these alpha motor Afrin. It's to east by a court, and they sign ups on two different alpha motor neurons, which bring about the stretch reflex or the you, uh, basically what? You That's your patella reflex when you kick your knee. When you took the, you could kick your foot when you talk to me. That's basically what happens now The sensitivity of this reflex is mediated by what we called. Hi, guys. I'm not sure if you can hear me at the moment, but I think so. I really use that speak. Currently in? Sure. I'm correct. The moment. I think she may have just cut out. Yeah. Yeah. Say sorry about that. I'm gonna check, see if she's got some message or anything but spare. That's for complete minutes. Here in mind? Yeah. How everyone, um, movie back in two minutes. She just reconnect them story about the guys. Um, she a panic here? Um, let me just I'll just go good to just stress stretch reflexes again. Um, I think that's where we entered. Um, so, yeah, the stretch reflex. Basically, um, So the muscle spindles in your muscles basically contain a, um, receptive that to text rich. Now, when these are triggered, the impulses travel up. The alpha multi runs into the spinal agreement of the spinal cord on. Then they sign ups with the different sorts of new ones that I involved in modulating the actual reflex on Ben. They sign ups back with the effort Alpha, Motrin, Iraq's, and these bring about the actual stretch refits now, because you don't want to be, uh, bring about leaf exaction every time your muscles stretched. This is modulated by a sense of gamma neuron that helps inhibit some of the responses. Okay, so they get my you're on real. Basically, check whether this stretch is more than what's what is, you know, traditionally normal or less, that's traditionally normal. And depending on whether it's a true reflects or not, the gamma will allow a reflex to happen. Uh oh. It won't have that reflex to happen. Okay, so this is basically a description of what I just explained. Um, yeah. Those are my references. Sorry about the visual to people. Difficulty. I had the end. If you guys have any questions, just, um, you'll be on the chat. If not, I think that's me. Done. Yeah, I'm just one of their mind. Everyone that, um, make sure you guys have registered on model because the feedback will be sent automatically by middle to you guys. And then once you fill the feedback in your get your tongue and pick, it's and also access to the slides and the recordings. So yeah, Thank you so much for coming on. But if you have any questions, just about means shoot or in the chat, all we have a question. Okay. So occupied It fired us and me limited. Because let me just go back to the presentation. So, um, your argument fibers essentially the bit that actually cross the bit of the second order neuron that actually crosses over. Okay, so let me just find that where is a PC and now could hear you. Oh. Oh. So your internal argument fibers is essentially this big? Okay, this is the ocular eight fibers, internal, accurate fibers off of this process. The bid that goes up is the medial meniscus, If that makes sense, so occupied. I don't know what you can see. My car. So not let me just get a pen. Was anything okay? So this big, um, this big here, that's your internal accurate fiber. This bit here. No, this way. Here. So the bit about that really is your medial medial meniscus. If that makes sense,