The Spinal Cord - Functions

The spinal cord serves three principal functions:

1. Conduction 2. Locomotion 3. Reflexes

Chapter Fourteen The Spinal Cord and Spinal Nerves Lecture Outline
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The Spinal Cord - Functions

Conduction. The spinal cord contains bundles of nerve fibers that conduct information up and down the body, connecting different levels of the trunk with each other and with the brain It enables sensory information to reach the brain, motor commands to reach the effectors, and input received at one level of the cord to affect output from another level

The Spinal Cord - Functions

Locomotion. Walking involves repetitive, coordinated contractions of several muscle groups in the limbs Motor neurons in the brain initiate walking, but the simple repetitive muscle contractions that put one foot in front of another, over and over, are coordinated by groups of neurons called central pattern generators in the cord.
These neuronal circuits produce the sequence of outputs to the extensor and flexor muscles that cause alternating movements of the legs
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The Spinal Cord - Functions

Reflexes. Reflexes are involuntary stereotyped responses to stimuli They involve the brain, spinal cord, and peripheral nerves

Surface Anatomy
The spinal cord begins at the foramen magnum of the skull and passes through the vertebral canal as far as the inferior margin of the first lumbar vertebra (L1) or slightly beyond.

FIGURE 14.1

Surface Anatomy
In adults, it averages about 1.8 cm thick and 45 cm long It occupies only the upper two-thirds of the twovertebral canal The cord gives rise to 31 pairs of spinal nerves The first pair of nerves pass between the skull and vertebra C1, and the rest pass through the intervertebral foramina. The part supplied by each pair of spinal nerves is called a segment.
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Surface Anatomy
The cord is divided into cervical, thoracic, lumbar, cervical, thoracic, lumbar, and sacral regions, named regions, for the levels of the vertebral column through which the spinal nerves emerge A bundle of nerve roots called the cauda equina occupies the canal from L2 to S5
FIGURE 14.1
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Meninges of the Spinal Cord

The space between the sheath and vertebral bone, called the epidural space, is occupied by blood vessels, space, adipose tissue, and loose connective tissue

The dura mater forms a tough collagenous membrane sleeve called the dural sheath around the spinal cord

Anatomy of the Spinal Cord

The spinal cord is made up of regions of gray & white matter, and serves as an information highway. highway The spinal cord can range from 40-45 cm 40in length for an adult.

The arachnoid mater consists of a simple squamous epithelium, the arachnoid membrane, adhering to membrane, the inside of the dura, and a loose mesh of dura, collagenous and elastic fibers spanning the gap between the arachnoid membrane and the pia mater The pia mater is a delicate, translucent membrane that closely follows the contours of the spinal cord.
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Cross Sectional Anatomy

The spinal cord, like the brain, consists of two kinds of nervous tissue called gray and white matter.
1. Gray Matter: consists of neuronal cell bodies, dendrites, Matter: unmyelinated axons, axon terminals, neuroglia, and blood neuroglia, vessels. 2. White Matter: consists of myelinated & unmyelinated nerve Matter: axons, and blood vessels.

Gray Matter
Gray matter has a relatively dull color because it contains little myelin It contains the somas, dendrites, and proximal parts of the axons of neurons.
It is the site of synaptic contact between neurons, and therefore the site of all information processing in the central nervous system

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White Matter
White matter contains an abundance of myelinated axons, which give it a bright, pearly white appearance It is composed of bundles of axons, called tracts, tracts, that carry signals from one part of the CNS to another.

Gray & White Matter

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Internal Anatomy of the Spinal Cord

Gray Matter

The central gray matter consists of two dorsal (posterior) horns, and two thicker ventral posterior) horns, (anterior) horns. anterior) horns.
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Gray Matter

Spinal Nerve Roots

In the thoracic and lumbar regions, an additional lateral horn is visible on each side of the gray matter It contains neurons of the sympathetic nervous system, which send their axons out of the cord by way of the ventral root along with the somatic efferent fibers
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As a spinal nerve approaches the cord, it branches into a dorsal root and ventral root The dorsal root carries sensory nerve fibers, which enter the dorsal horn of the cord. The ventral horns contain the large somas of the somatic motor neurons, which send their axons out to the body.
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White Matter

FIGURE 14.2b

The white matter of the spinal cord consists of bundles of axons that course up and down the cord and provides avenues of communication between different levels of the CNS. These bundles are arranged in three pairs of columns; dorsal columns; (posterior) columns, a lateral columns, and ventral (anterior) posterior) columns, columns, anterior) columns.
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FIGURE 14.3 Tracts

of the Spinal Cord. All of the illustrated tracts occur on both sides of the cord, but only the ascending sensory tracts are shown on the left (red), and only the descending motor tracts on the right (green).

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Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Spinal Tracts

Spinal Tracts
Several of these tracts cross over from the left side of the body to the right, or vice versa, as they pass up or down the brainstem and spinal cord. As a result, the left side of the brain receives sensory information from the right side of the body and sends its motor commands to that side, while the right side of the brain senses and controls the left side of the body When the origin and destination of a tract are on opposite sides of the body, we say they are contralateral to each other. When a tract does not cross, so the origin and destination of its fibers are on the same side of the body, we say they are ipsilateral. ipsilateral.
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FIGURE 14.3

Ascending tracts carry sensory information up the cord and descending tracts conduct motor impulses down All nerve fibers in a given tract have a similar origin, destination, and function
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Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Copyright (c) The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Ascending Tracts

Descending Tracts

FIGURE 14.3

FIGURE 14.3

Ascending tracts carry sensory signals up the spinal cord Sensory signals typically travel across three neurons from their origin in the receptors to their destination in the sensory areas of the brain. 23

Descending tracts carry motor signals down the brainstem and spinal cord A descending motor pathway typically involves two neurons called the upper and lower motor neuron
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Descending Tracts

General Anatomy of Nerves and Ganglia

FIGURE 14.3

The upper motor neuron begins with a soma in the cerebral cortex or brainstem and has an axon that terminates on a lower motor neuron in the brainstem or spinal cord The axon of the lower motor neuron then leads the rest of the way to the muscle or other target organ 25

A nerve is a cordlike organ composed of nerve fibers (axons) and connective tissue

FIGURE 14.7a

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General Anatomy of Nerves and Ganglia

Each nerve fiber is enclosed in its own fibrous sleeve called an endoneurium Nerve fibers are bundled in groups called fascicles They are separated from each other by a perineurium A fibrous epineurium covers the entire nerve

FIGURE 14.7a

of a Nerve. A spinal nerve and its association with the spinal cord. 27

FIGURE 14.7a Anatomy

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General Anatomy of Nerves and Ganglia

A sensory nerve is composed of afferent fibers only A motor nerve of efferent fibers only A mixed nerve is composed of both Most nerves are mixed
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FIGURE 14.7a

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General Anatomy of Nerves and Ganglia

A ganglion is a swelling along the course of a nerve containing the cell bodies of the peripheral neurons
FIGURE 14.8

Spinal Nerves
Within the vertebral canal, each branches into a dorsal root which carries sensory signals to the dorsal horn of the spinal cord, and a ventral root which receives motor signals from the ventral horn
FIGURE 14.9 FIGURE 14.10

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Spinal Nerves
The dorsal root has a swelling, the dorsal root ganglion, containing unipolar somatic sensory neurons

Spinal Nerves
There are 31 pairs of spinal nerves, which enter and leave the spinal cord and emerge mainly through the intervertebral foramina

FIGURE 14.9 FIGURE 14.10

FIGURE 14.9

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Spinal Nerves
Cervical Nerves (8 Pairs) Thoracic Nerves (12 Pairs) Lumbar Nerves (5 Pairs) Sacral Nerves (5 Pairs) Coccygeal Nerves (1 Pair)

FIGURE 14.9

The Spinal Nerve Roots. Dorsal View.

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Cutaneous Innervation and Dermatomes

Each spinal nerve except C1 receives sensory input from a specific area of skin called a dermatome, derived from the embryonic dermatomes A dermatome map is a diagram of the cutaneous regions innervated by each spinal nerve Such a map is very simplified, however, because the dermatomes overlap at their edges by as much as 50%

Cutaneous Innervation and Dermatomes

Therefore, severance of one sensory nerve root does not entirely deaden sensation from a dermatome It is necessary to sever or anesthetize three successive spinal nerves to produce a total loss of sensation from one dermatome Spinal nerve damage is assessed by testing the dermatomes with pinpricks and noting areas in which the patient has no sensation

FIGURE 14.18

FIGURE 14.18

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Somatic Reflexes
A reflex is a quick, involuntary, stereotyped reaction of a gland or muscle to a stimulus Visceral reflexes are reactions of glands, cardiac muscle, and smooth muscle, controlled by the autonomic nervous system Somatic (spinal) reflexes are responses of spinal) skeletal muscles, controlled by the somatic nervous system
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FIGURE 14.18 A Dermatome Map of the Body. Anterior and posterior views. Each zone of the skin is innervated by sensory branches of the spinal nerves indicated by the labels. Nerve C1 does not innervate the skin. 39

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Somatic Reflexes
A somatic reflex employs a simple neural pathway called a reflex arc, in which signals travel from:
a somatic receptor through an afferent nerve fiber to the spinal cord or brainstem an integrating center in the CNS an efferent nerve fiber leaving the CNS, and finally to a skeletal muscle

FIGURE 14.19

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FIGURE 14.19 A Representative Reflex Arc. The monosynaptic reflex arc of the patellar tendon reflex. 42

Clinical Perspectives
Trauma is the most common disorder of the spinal cord, usually resulting from accidents Complete transection of the spinal cord immediately abolishes sensation and motor control in areas below the injury Spinal shock typically lasts up to 20 days from the injury Somatic and autonomic reflexes then begin to reappear, and may be exaggerated (hyperreflexia). hyperreflexia).

Clinical Perspectives
Flaccid paralysis is typically replaced by spastic paralysis as reflex functions return Paraplegia (paralysis of both lower limbs) and quadriplegia (paralysis of all four limbs) are common consequences of spinal cord injury, while hemiplegia (paralysis of one side of the body) usually results from a brain lesion

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