Sacral cord segment function

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  • The sacral cord segments end at the L1/L2 vertebral level forming the conus medullaris whereupon descending spinal nerves continue on as the caudal equna below the level of L1/2 (one vertebrae lower in young children)
  • Rookie hint: if the vertebral pathology is below L2, there can’t be a cord lesion
  • This part of the cord contributes to the parasympathetic outflow tract and innervates the pelvic organs
  • Cutaneous Sensory function innervates the perineal region (hence abnormalities
  • Visceromotor and viscerosensory function controls important functions such as micturition, defaecation and sexual function (the embryonic cloaca)

Clinical assessment

  • History of urinary or faecal incontinence or retention
  • Sensory – perineal sensation (‘saddle anaesthesia’), urethral sensation tested tested by gently tugging on IDC
  • Motor – loss of anal tone

 

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