(麻醉学课件）5.1 Intrathecal Anesthesia 黎平（2节课）知识介绍.pptVIP

Most vertebrae have similar features: A vertebral body to support our body weight. Each has a midline spinous process and two transvers process. these process serve as attachments for ligaments and muscles for body movement. There are four articular processes for obstruction. Then we should be familiar with the important ligamentum of vertebral column. They provide structural support and help muscles maintain the unique shape of body. The vertebral column are mainly three ligamentum we should familiar with in clinical anesthesia. from the outside they are the : skin,Subcutaneous tissue , Yellow ligament” it is very tough(t^f) and springiness compared with others. so when the puncture needle penetrate(penitreite, 穿透) it ,we usually get the feeling like one thick paper be cut through. There are three spinal meninges we should know. This is the pia mater. arachnoid mater, and dura mater. the pia mater is a highly vascular membrane that closely invests the spinal cord. the arachnoid mater is a delicate nonvascular membrane closely attached to the innermost layer of the dura mater. There are two spinal spaces very important to understand the intrathecal anesthesia. between the innermost membranes ,pia mater and arachnoid mater formed the space of subarachnoid space. in this space, have CSF, spinal nerves, blood vessels. between the dura mater and ligamentum flavum it is the epidural space. the epidural space ,it extends from foramen magnum to the sacral hiatus . Epidural space is a potential space.there filled with connective tissue ,vessles ,et. between the dura mater and the arachnoid mater, the subdural space. .this space is not intentionally utilized by anesthesia clinician. In the vertebral canal, is the spinal cord . there are 31 pair of spinal nerve roots in spinal cord. 8 pair of Cervical nerve roots ,12 pair of Thoracic nerve roots, 5 pair of Lumber nerve roots , 5 pair of Sacral nerve roots and last the 1 pair of coccyx. The spinal