However, if there is a full thickness tear in the annulus fibrosus, the nucleus pulposus will leak out of that tear. In a normal disc, all the nucleus pulposus remains inside the annulus fibrosus. The outer portion of the disc (called the annulus fibrosus) is like the dough of a jelly doughnut and the inner portion (nucleus pulposus) is similar to the jelly inside the doughnut. These discs are very similar to a jelly doughnut. The bones of the spine (vertebrae) are stacked on top of each other with soft cushioning discs located in between them (intervertebral discs). There are conditions that can affect the interstate (spinal cord), the exits (nerves) or both these are discussed later in this handout. Just as the interstate has multiple exits that allow traffic to enter and leave, the spinal cord has nerves that branch off and function similarly to these exits by allowing information (about motor and sensory function) to get to and from the spinal cord and on to the brain. The spinal cord is like a major interstate (I-95) that runs in a north/south direction (from the brain towards the lower back). When thinking about the function of the spinal cord, I like to use the following analogy: These nerve roots go to different parts of the body (arms, trunk, legs, bowel and bladder) and transmit information to and from those regions (eg the C5 nerve root carries sensation from the outside of the arm and shoulder region and allows you to raise your shoulder to the side). Each nerve exits from a “hole” that is formed where two vertebrae meet (called the “neural foramen”) and is thus named (eg the nerve that exits adjacent to the 5th cervical bone is called the C5 nerve root). Approximately 60 smaller nerves exit the spinal cord (30 to the right and 30 to the left) along its path from top (base of the brain) to bottom (the spinal cord generally ends at the disc between the first and second lumbar vertebrae). It conducts information between the brain and the arms and legs. The spinal cord is attached to the brain and is similar to a large electrical cable. Allow motion in the neck so that the head can turn.
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