Spinal Cord: DR Ganesh Khemnar Assistant Professor Dept. of Anatomy BVDUMC, Pune
Spinal Cord: DR Ganesh Khemnar Assistant Professor Dept. of Anatomy BVDUMC, Pune
Spinal Cord: DR Ganesh Khemnar Assistant Professor Dept. of Anatomy BVDUMC, Pune
Dr Ganesh Khemnar
Assistant Professor
Dept. of Anatomy
BVDUMC,Pune
Functions
• The spinal cord with its 31 pairs of spinal
nerves serves two important functions.
• It is the connecting link between the brain and
most of the body.
• It is involved in spinal reflex actions, both
somatic and visceral.
Basic Anatomy of the Spinal Cord
• The spinal cord extends caudally from the brain for about 45 cm and
has a width of ~14 mm. Its upper end is continuous with the brain
(medulla oblongata). The cord is slightly thicker than a pencil.
• There are 31 pairs of spinal nerves:8 cervical, 12 thoracic, 5 lumbar,
5 sacral, and coccygeal. The roots of the lumbar and sacral are
called cauda equina.
• Surrounding and protecting the spinal cord is the vertebral
column.
• The spinal cord is slightly flattened dorsally and ventrally,
with two enlargements-cervical and lumbosacral from
which the spinal nerves emerge that innervate the upper
and lower limbs.
Spinal Cord
Basic Anatomy of the Spinal Cord
• The cervical enlargement supplies nerves to
the pectoral girdle and upper limbs.
• The lumbar enlargement supplies nerves to
the pelvis and lower limbs.
• Inferior to the lumbar enlargement, the spinal
cord becomes tapered and conical-conus
medullaris.
• Filum terminale-slender strand of fibrous
tissue that extends from conus medullaris.
Spinal Nerves
• There are 8 cervical nerves(C), 12 thoracic(T), 5 lumbar (L), 5
sacral (S), and 1 coccygeal (Co).
• Each pair of spinal nerves passes through a pair of
intervertebral foramina located between two successive
vertebrae. Each spinal nerve caudal to the first thoracic
vertebra takes its name from the vertebra immediately
preceding it.
• The nerves are then distributed to a specific pair of segments
of the body.
• The spinal cord and the roots of its nerves are protected by
the vertebral column, its ligaments, spinal meninges and
cerebrospinal fluid.
Meninges
Spinal Meninges
• The outer layer is called dura mater. This is a tough,
fibrous memebrane that merges with the filum
terminale.
• The middle layer, the arachnoid, runs caudally to the
S2 vertebral level. This is delicate and transparent.
• The innermost is called, pia mater. It is highly
vascular and tightly attached to the spinal cord and
its roots.
• Meningitis-bacterial or viral infection.
Spinal Meninges
• Between the dura mater and periosteum of the
vertebrae is the epidural space that contains many
blood vessels and fat.
• Anesthetics can be injected here below the L3
vertebral level, from which it ascends to act upon
sensory neurons to help dull pain. This procedure is
called caudal block.(epidural block)
• Space between dura mater and archnoid-subdural
space-no CSF.
• Space between arachnoid and pia mater-subarchnoid
space-CSF, blood vessels, spinal roots.
Fig 14.2a The Spinal Cord and Spinal Meninges
Fig 14.1 Gross Anatomy of the Spinal Cord
Copyright © 2009 Pearson Education, Inc., publishing as Pearson Benjamin Cummings
Fig 14.2d The Spinal Cord and Spinal Meninges
Copyright © 2009 Pearson Education, Inc., publishing as Pearson Benjamin Cummings
Fig 14.3 Posterior View of Vertebral Column and Spinal Nerves
• Anterior median fissure and posterior
Cross Section median sulcus
– deep clefts partially separating left and
right halves
of Spinal Cord • Gray matter: neuron cell bodies,
dendrites, axons
– Divided into horns
• Posterior (dorsal) horn
• Anterior (ventral) horn
• Lateral horn
• White matter
– Myelinated axons
– Divided into three columns (funiculi)
• Ventral
• Dorsal
• lateral
– Each of these divided into sensory or
motor tracts
Cross section of Spinal Cord
• Commissures: connections between left
and right halves
– Gray with central canal in the center
– White
• Roots
– Spinal nerves arise as rootlets then
combine to form dorsal and ventral
roots
– Dorsal and ventral roots merge
laterally and form the spinal nerve
Gray Matter: Organization
White Matter in the Spinal Cord
Note:
1. UMN cell body location
2. UMN axon decussates in pons
3. Synapse between UMN and LMN
occurs in anterior horn of sc
3. LMN exits via ventral root
4. LMN axon stimulates skeletal
muscle
Extrapyramidal (Multineuronal) Pathways
• Severe damage to ventral root results in flaccid paralysis (limp and unresponsive)
• Skeletal muscles cannot move either voluntarily or involuntarily
• Without stimulation, muscles atrophy.
• When only UMN of primary motor cortex is damaged
• spastic paralysis occurs - muscles affected by persistent spasms and
exaggerated tendon reflexes
• Muscles remain healthy longer but their movements are no longer
subject to voluntary control.
• Muscles commonly become permanently shortened.
• Transection (cross sectioning) at any level results in total motor and
sensory loss in body regions inferior to site of damage.
• If injury in cervical region, all four limbs affected (quadriplegia)
• If injury between T1 and L1, only lower limbs affected (paraplegia)
Spinal Cord Trauma and Disorders
• Spinal shock - transient period of functional loss that follows the injury
• Results in immediate depression of all reflex activity caudal to lesion.
• Bowel and bladder reflexes stop, blood pressure falls, and all muscles
(somatic and visceral) below the injury are paralyzed and insensitive.
• Neural function usually returns within a few hours following injury
• If function does not resume within 48 hrs, paralysis is permanent.
• Amyotrophic Lateral Sclerosis (aka, Lou Gehrig’s disease)
• Progressive destruction of anterior horn motor neurons and fibers of the
pyramidal tracts
• Lose ability to speak, swallow, breathe.
• Death within 5 yrs
• Cause unknown (90%); others have high glutamate levels
• Poliomyelitis
• Virus destroys anterior horn motor neurons
• Victims die from paralysis of respiratory muscles
• Virus enters body in feces-contaminated water (public swimming pools)
2 Primary Systems
Dorsal column-Medial
Corticospinal Tract
Lemniscal System
Dorsal Column (SC) -Medial Lemniscal (brain stem) System