1. Nervous System. Spinal cord.

2. Spinal Cord
Functions to transmit messages to and from the brain (white matter) and to serve as a reflex center (gray matter).
Tube of neural tissue continuous w/ the medulla at the base of the brain and extends about 17” to just below the last rib. (Ends at L1)
Majority of the SC has the diameter of your thumb
Thicker at the neck and end of the cord (cervical and lumbar enlargements) b/c of the large group of nerves connecting these regions of the cord w/ the arms and legs.

3. Spinal Cord Surrounded by a single layered dura mater
and arachnoid and pia mater.
Terminates in cone shaped
structure called the conus medullaris.
The filum terminale, a fibrous extension of the pia mater, extends to the posterior surface of the coccyx to anchor the spinal cord.
The cord does not extend the entire length of the vertebral column – so a group of nerves leaves the inferior spinal cord and extends downward. It resembles a horses tail and is called the cauda equina.

4. Spinal Cord Notice the gross features of the spinal cord on the right.
31 pairs of spinal nerves attach to the cord by paired roots and exit from the vertebral canal via the intervertebral foramina.

5. Cross Sectional Anatomy of the Spinal Cord
Flattened from front to back.
Anterior median fissure and posterior median sulcus partially divide it into left and right halves.
Gray matter is in the core of the cord and surrounded by white matter.

6. Anatomy of Spinal Nerves

14. Part I: Spinal cord 1. Organization 2. Structure 3. Blood supply
- General
- Cauda equina
- Meninges
2. Structure
Grey matter
White matter
3. Blood supply
4. Spinal nerves
Typical n.
Components

15. 1. Organization
Cauda equina
Meninges

16. 2. Structure: Grey matter
Components: Nerve cells, Processes, Neuroglia, Blood vessels
Grey columns: Anterior, Posterior, Transverse, Lateral

17. Gray Matter Posterior horns contain interneurons.
Anterior horns contain some
interneurons as well as the cell
bodies of motor neurons.
These cell bodies project their axons via the ventral roots of the spinal cord to the skeletal muscles.
The amount of ventral gray matter at a given level of the spinal cord is proportional to the amount of skeletal muscle innervated.

18. Gray Matter
Lateral horn neurons are sympathetic motor neurons serving visceral organs.
Their axons also exit via the ventral root.
Afferent sensory fibers carrying info from peripheral receptors form the dorsal roots of the spinal cord. The somata of these sensory fibers are found in an enlargement known as a dorsal root ganglion.
The dorsal and ventral roots fuse to form spinal nerves.

19. Grey columns: Anterior: Posterior:
Medial group: skeletal muscles of the neck and trunk
Central group: cervical and lumbosacral segments & contains the phrenic, asccessory and lumbosacral nuclei
Lateral group: cervical and lumbosacral areas innervating skeletal muscles of the limbs
Posterior:
Substantia gelatinosa: concerned with pain, temperature and touch
Nucleus proprius: fibers from white posterior column associated with proprioception, 2-piont discrimination and vibration
Nucleus dorsalis (Clark’s column) from C8 – L3/4 proprioceptive endings in spindles
Visceral afferent nucleus from T1– L3 receives visceral afferent information

20. Grey columns (cont.) Transverse: Lateral:
Contains central canal that starts in the MO,
Inferiorly expands in the conus medullaris as the terminal ventricle: CSF & ependyma
Lateral:
From T1–L2/3
Give rise to preganglionic sympathetic fibers
Similar group in S2-4 give rise to preganglionic parasympathtic fibres

21. 2. Structure: White matter
Mixture of myelinated nerve fibers, neuroglia and blood vessels
Ascending tracts
Descending tracts
Ascending and descending tracts with the same origin, course and termination: Fasciculus
Intersegmental tracts

22. White Matter Myelinated nerve fibers.
Allows for communication btwn the brain and spinal cord or btwn different regions of the spinal cord.
White matter on each side of the cord is divided into columns or funiculi.
Typically, they are ascending or descending.
What does that mean?

24. Ascending tracts: Sensory, contain 1st, 2nd and 3rd order neurons
Pathways for temperature, pain, proprioception
Examples: Spinothalamic tract (lateral & anterior, fasciculus gracilis and cuneatus); Spinocerebellar tract (anterior & posterior); Cuneocerebellat tract.
Other: Spinotectal, spinoreticular, spino-olivary, visceral sensory

25. Descending tracts:
White matter from the supraspinal centers with 1st, 2nd and 3rd order motor neurons
Examples: Corticospinal, reticularspinal, tectospinal, rubrospinal, vestibulospinal, olivospinal, descending autonomic

26. 3. Blood supply: Spinal arteries
From vertebral, posterior intercostal, lumbar, lateral sacral, ascending cervical, deep cervical, iliolumbar aa.
Posterior spinal a. in close association to posterior spinal roots, but is insufficient to supply the spinal cord alone
Anterior spinal a. unite to for a single artery on the median fissure of the spinal cord.

27. Spinal arteries (cont.)
Radicular a. reinforce the spinal arteries by entering through the intervertebral foramina
Larger anterior radicular arteries: A. radicularis magna (artery of Adamkiewicz) from the left an intersegmental branch of the descending aorta, that supplies 2/3rds of the spinal cord

28. 3. Blood supply: Venous drainage
Internal (anterior & posterior) venous plexus
External venous plexus (anterior & posterior)
Basivertebral and intervertebral veins.

29. 4. Typical spinal nerve
Posterior (dorsal) root: Supplies synovial joints of the vertebral column, deep muscles of the back & overlying skin. Posterior root ganglia: Sensory, unipolar with satellite cells.
Anterior (ventral) root: Supplies the remaining areas: anterior & lateral regions of the trunk and limbs

30. Protection What is the major protection for the brain?
There are also 3 connective tissue membranes called the meninges:
Cover and protect the CNS
Protect blood vessels
Contain cerebrospinal fluid
The 3 meninges from superficial to deep:
Dura mater
Arachnoid mater
Pia mater

31. Spinal Cord
Functions to transmit messages to and from the brain (white matter) and to serve as a reflex center (gray matter).
Tube of neural tissue continuous w/ the medulla at the base of the brain and extends about 17” to just below the last rib. (Ends at L1)
Majority of the SC has the diameter of your thumb
Thicker at the neck and end of the cord (cervical and lumbar enlargements) b/c of the large group of nerves connecting these regions of the cord w/ the arms and legs.

32. Spinal Cord Surrounded by a single layered dura mater
and arachnoid and pia mater.
Terminates in cone shaped
structure called the conus medullaris.
The filum terminale, a fibrous extension of the pia mater, extends to the posterior surface of the coccyx to anchor the spinal cord.
The cord does not extend the entire length of the vertebral column – so a group of nerves leaves the inferior spinal cord and extends downward. It resembles a horses tail and is called the cauda equina.

33. Spinal Cord Notice the gross features of the spinal cord on the right.
31 pairs of spinal nerves attach to the cord by paired roots and exit from the vertebral canal via the intervertebral foramina.

34. Resembles a butterfly.
2 lateral gray masses connected by the gray
commissure.
Posterior projections are the posterior or dorsal horns.
Anterior projections are the anterior or ventral horns.
In the thoracic and lumbar cord, there also exist lateral horns.

36. Spinal Nerves
31 nerves connecting the spinal cord and various body regions.
8 paired cervical nerves
12 paired thoracic nerves
5 paired lumbar nerves
5 paired sacral nerves
1 pair of coccygeal nerves

37. Spinal Nerves
Each connects to the spinal cord by 2 roots – dorsal and ventral.
Each root forms from a series of rootlets that attach along the whole length of the spinal cord segment.
Ventral roots are motor while dorsal roots are sensory.

38. Spinal Nerves
The 2 roots join to form a spinal nerve prior to exiting the vertebral column.
Roots are short and horizontal in the cervical and thoracic regions while they are longer and more horizontal in the sacral and lumbar regions.
Almost immediately after emerging from its intervertebral foramen, a spinal nerve will divide into a dorsal ramus, a ventral ramus, and a meningeal branch that reenters and innervates the meninges and associated blood vessels.

39. Each ramus is mixed.
Joined to the base of the ventral rami of spinal nerves in the thoracic region are the rami communicantes. These are sympathetic fibers that we’ll deal with shortly.
Dorsal rami supply the posterior body trunk whereas the thicker ventral rami supply the rest of the body trunk and the limbs.