Chapter 13

The Spinal Cord, Spinal Nerves, and

Somatic Reflexes
ANATOMY & PHYSIOLOGY
The Unity of Form and Function
TENTH EDITION
KENNETH S. SALADIN

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 Introduction
• Thousands of Americans are paralyzed by spinal
cord injury every year

• The spinal cord is the “information highway”

that connects the brain with the lower body

• In this chapter we will study the spinal cord and

spinal nerves

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 13.1 The Spinal Cord
• Expected Learning Outcomes
– State the three principal functions of the spinal cord.
– Describe the gross anatomy of the spinal cord and
spinal nerves and specify their location relative to the
anatomy of the skeletal system.
– Identify the anatomical features seen in a cross
sectional view of the spinal cord.
– Contrast the relative position of gray matter and
white matter in the spinal cord with the
corresponding arrangement of gray and white matter
in the brain

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 Functions of the Spinal Cord
• Conduction—nerve fibers conduct information up
(ascending) & down (descending) spinal cord—white or
gray matter? White matter
– Ascending tracts: Sensory, up to brain
– Descending tracts: Motor down to skeletal muscles
• Neural integration—neurons receive input from sources,
integrates it, and decides appropriate output (e.g., bladder
control) – white or gray matter? Gray matter
• Locomotion—groups of neurons that coordinate repetitive
sequences of contractions for walking
• Reflexes—involuntary responses to stimuli
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 Spinal Cord Anatomy
• Flattened cylinder
– Arises from the brainstem
– Extends from foramen magnum to L1-L2
– Longitudinal grooves on anterior and posterior
sides
• Anterior median fissure and posterior median
sulcus
– Gives rise to 31_ pairs of spinal nerves

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 The Spinal Cord, Posterior Aspect

Figure 13.1
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 Meninges of the Spinal Cord 1
• Meninges—three fibrous membranes that enclose
the brain and spinal cord
• From superficial to deep:
– Dura mater, arachnoid mater, and pia mater
• Space above meninges: epidural______ space
• Subarachnoid space filled with?
Cerebral spinal fluid

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 Lumbar Puncture/Spinal Tap

Figure 13.4

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 Meninges of the Spinal Cord 2

Figure 13.2a

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 Spina Bifida
• Congenital defect
• One or more vertebrae fail to completely enclose
spinal cord
– In 1 baby out of 1,000
• Lack of ____Folic acid (a B vitamin) increases risk

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 Gray Matter
• Pair of posterior (dorsal) horns and anterior (ventral)
horns; Why is it “gray”? There is no myalin
• Gray commissure connects right and left sides
– What is the hole in the middle called? What is in it?
– Central canal, cerebral spinal fluid
• Lateral horn (T2-L1)
– Contains neurons of sympathetic________ nervous
system
Figure 13.5

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 White Matter
• What is “white” matter? Which part of the neuron is
located here? Mylanated axons
• Columns or funiculi—three pairs
– Posterior (dorsal), lateral, & anterior (ventral) columns
– Are these called “nerves” or “tracts”?
– Tracts

Figure 13.5

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 13.1 The Spinal Cord
• Expected Learning Outcomes (continued)
– Trace the pathways followed by nerve signals traveling
up and down the spiral cord.
– Distinguish between ascending and descending tracts
in the spinal cord.
– Know definitions of ascending versus descending
tracts, decussation, & contralateral versus ipsilateral
– Explain how decussation occurs in sensory and motor
pathways & predict how decussation impacts the
correlation of brain damage.

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 Spinal Tracts
Figure 13.5

• Fibers in a given tract have similar origin, destination and

function
• Know definitions:
– Ascending tracts versus Descending tracts
– Decussation—cross midline to the opposite side
– Contralateral(opposite side) versus Ipsilateral same side)
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 Ascending Tracts
• Ascending tracts carry
sensory_________ signals up
the spinal cord
• First order neuron
– Receptor to spinal cord or
brainstem
• Second order
– Spinal cord or brainstem to
thalamus (gateway)
• Third order
– Thalamus to cortex
Figure 13.5 a

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 Descending Tracts

• Descending tracts—carry motor______

signals down brainstem and spinal cord
• Involve two motor neurons
– Upper and lower motor neurons
– Decussation of somatic neurons cross in
Medulla oblongata

Figure 13.7
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 Poliomyelitis and ALS 1
• Both diseases cause destruction of somatic motor
neurons
– Leads to skeletal muscle atrophy
• Poliomyelitis
– Caused by the poliovirus (spreads by fecal
contamination of water)
– Destroys motor neurons in brainstem and anterior horn
of spinal cord
– Signs of polio include muscle pain, weakness, and loss
of some reflexes
• Followed by paralysis, muscular atrophy, and
respiratory arrest
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 Poliomyelitis and ALS 2
• Amyotrophic lateral sclerosis (ALS) or Lou Gehrig disease
– Destruction of motor neurons and muscular atrophy
– Sclerosis (scarring) of lateral regions of the spinal cord
– Astrocytes fail to reabsorb the neurotransmitter
glutamate from the tissue fluid
• Accumulates to toxic levels
– Early signs: muscular weakness; difficulty speaking,
swallowing, and using hands
– Sensory & intellectual functions remain unaffected

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 13.2 The Spinal Nerves 1
• Expected Learning Outcomes
– Describe the anatomy of nerves and ganglia in general
and discuss how the structures root, nerve, ramus,
plexus, tract and ganglion relate to one another.
– Identify the dorsal root ganglia, dorsal and ventral
roots, and spinal nerves.
– Describe the attachments of a spinal nerve to the
spinal cord.
– Trace the branches of a spinal nerve distal to its
attachment
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 Anatomy of a Nerve

Figure 13.9

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 General Anatomy of Nerves and Ganglia 1
• Spinal cord communicates with the rest of the body
by way of spinal nerves

• Nerve—a cord-like organ composed of numerous

nerve fibers (axons) bound together by connective
tissue
– Mixed____ nerves contain both afferent
(sensory) and efferent (motor) fibers

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 General Anatomy of Nerves and Ganglia 2
• Nerve fibers of PNS surrounded by Schwann cells
forming neurilemma and myelin sheath around the
axon
• __Endoneurium_________—wrapping external to
neurilemma
• _____Perineurium_______—surrounds each
fascicles: bundles of nerve fibers
• _____Epineurium_____—covering of entire nerve
• Blood vessels penetrate connective tissue coverings
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 General Anatomy of Nerves and Ganglia 3

• Ganglion—cluster of neurosomas outside the CNS

– Enveloped in an endoneurium (continuous with nerve)

• Posterior root ganglion

– What type of neuron? Sensory neurons
– Are these neurons multipolar, bipolar, or unipolar?
Unipolar neurons
• What other ganglion do you need to know from lab?
Sympathetic chain ganglion

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 General Anatomy of Nerves and Ganglia 4

Figure 13.10

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 Spinal Nerves
• 31 pairs of spinal nerves (mixed nerves)
– 8 cervical (C1–C8)
• First cervical nerve exits between skull and
atlas
• Others exit at intervertebral foramina
– 12 thoracic (T1–T12)
– 5 lumbar (L1–L5)
– 5 sacral (S1–S5)
– 1 coccygeal (Co1)

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 Spinal Nerves Proximal Branches
• Each spinal nerve is formed from two roots
– Posterior (dorsal) root: sensory
• Posterior (dorsal) root ganglion—contains the
somas of sensory neurons
• enter posterior horn of cord
– Anterior (ventral) root: motor
– Cauda equina__________________: formed
from roots arising from L2 to Co1

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 Inferior End of
Spinal Cord

• Cauda equina (horse’s tail)

– dorsal & ventral roots of
lowest spinal nerves

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 The Spinal Nerve Roots and Plexuses

Figure 13.11
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 Spinal Nerve Distal Branches
• Outside the vertebra, the nerve divides into rami distal
branches:
– Anterior ramus:
• In thoracic region, it gives rise to intercostal nerve
• In other regions, anterior rami form plexuses
– Posterior______ ramus: innervates the muscles and
joints in that region of the spine and the skin of the back
– Communicantes______________ Rami (only in thoracic
region): autonomic nerve fibers
– Meningeal branch: reenters the vertebral canal

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 Branches of a Spinal Nerve

Figure 13.12
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 Rami of the Spinal Nerves

Figure 13.14

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 Branches of the Spinal Nerve

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 Shingles
• Chickenpox—common disease of early childhood
– Caused by varicella-zoster virus
• Virus remains for life in the posterior root ganglia_____
– Kept in check by the immune system
• Shingles (herpes zoster)—Common after age 50
– virus travels down the sensory nerves when immune
system is compromised
– Painful trail of skin discoloration and fluid-filled vesicles
along path of nerve

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 13.2 The Spinal Nerves 2
• Expected Learning Outcomes (continued)
– Name the five plexuses of spinal nerves and describe
their general anatomy.
– Name some major nerves that arise from each
plexus. Minimally held to lab list of major nerves.

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 Nerve Plexuses 1
• Anterior rami branch and anastomose repeatedly to
form five nerve plexuses
– Cervical plexus
– Brachial plexus
– Lumbar plexus
– Sacral plexus
– Coccygeal plexus

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 Nerve Plexuses 2
• Somatosensory function—carry sensory signals
from bones, joints, muscles, and skin
– Proprioception: brain gets information about
body position and movements from muscles,
tendons, and joints

• Motor function—primarily to stimulate muscle

contraction

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 Cervical Plexus
• Cervical plexus in the neck, C1 to C5
• Supply muscles of the shoulder and neck
• Phrenic nerve: to the diaphragm______________
– Irritation of phrenic nerve causes hiccups_______
– Damage to cord above C3 causes respiratory arrest

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 Brachial Plexus
• Formed by C5 toT1
• Innervates the upper limb & some of shoulder &
neck
– Axillary nerve:
• Deltoid_____________ and teres minor
– Radial nerve:
• Extensors______________ for forearm and wrist
– Ulnar nerve:
• Flexor carpi ulnaris________________
– Median nerve:
• All other wrist/finger flexors & pronator_______

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 Lumbar Plexus
• Formed by L1-L4
• Innervates thigh, abdominal wall, & iliacus muscle
– Femoral nerve: anterior_________ thigh
– Obturator nerve: medial_________ thigh

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 Sacral Plexus
• Formed by L4-S4
• Innervates the buttock and lower limb
• Sciatic nerve: posterior_________ thigh
– branches into Tibial & Common Fibular nerves
• Pudendal nerve: skin and muscles of perineum_

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 Nerve Injuries
• Radial nerve injury
– Passes through axilla
– Crutch paralysis
– Wrist drop
• Sciatic nerve injury
– Sciatica: sharp pain that travels from gluteal region
along the posterior side of the thigh and leg to ankle
– 90% of cases result from herniated intervertebral
disc or osteoporosis of lower spine
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 13.3 Somatic Reflexes
• Expected Learning Outcomes
– Define reflex and explain how reflexes differ from other motor
actions.
– Describe the general components of a typical reflex arc.
– Explain how the basic types of somatic reflexes function.
– Demonstrate a stretch reflex (e.g., patellar or plantar).
– Propose how specific reflexes would be used in clinical assessment
of nervous system function.

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 The Nature of Reflexes 1
• Reflexes—quick, involuntary, stereotyped reactions of
glands or muscle to stimulation
– Reflexes require stimulation
• Not spontaneous actions, but responses to sensory
input
– Reflexes are quick
• Involve few, if any, interneurons and minimum
synaptic delay
– Reflexes are involuntary
• Occur without intent and are difficult to suppress
– Reflexes are stereotyped
• Occur essentially the same way every time
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 The Nature of Reflexes 2
• Reflexes include glandular secretion and contraction
of all three types of muscle

• Somatic reflexes—reflexes involving the somatic

nervous system innervating skeletal muscle
• Autonomic reflexes involve?
Using glands and heart muscle and smooth muscle

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 Pathway of a somatic reflex arc
Somatic receptors: In skin, muscles, or tendons

Afferent_________ (sensory) nerve fibers

Integrating center

Efferent (motor) nerve fibers

Effectors_________: skeletal muscles

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 A Representative Reflex Arc

Figure 13.23
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 The Stretch Reflex 1
• Stretch (myotatic) reflex—when a muscle is stretched, it
“fights back” and contracts
• Helps maintain equilibrium and posture
– Head starts to tip forward as you fall asleep
– Muscles contract to raise the head
• Stabilize joints by balancing tension in extensors and
flexors, smoothing muscle actions
• Stretch reflex is mediated primarily by the brain, but its
spinal component can be more pronounced if muscle is
suddenly stretched by a tendon tap (knee jerk)

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 The Stretch Reflex 2
• Knee-jerk (patellar) reflex is a monosynaptic reflex
– One synapse between the afferent and efferent
neurons
• Testing somatic reflexes helps diagnose many diseases
• Reciprocal inhibition—reflex phenomenon that
prevents muscles from working against each other by
inhibiting antagonist when agonist is excited

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 Patellar Tendon Reflex

Figure 13.25
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 The Flexor and Crossed Extension Reflexes
Flexor reflex—the quick
contraction of flexor
muscles resulting in the
withdrawal of a limb from
an injurious stimulus

Triggers contraction of the

flexors and relaxation of the
extensors in that limb

Ipsilateral reflex

Figure 13.26

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 The Flexor and Crossed Extension Reflexes 4

Crossed extension reflex

—contraction of
extensor muscles in limb
opposite of the one that
is withdrawn
• Maintains balance by
extending other leg

Contralateral reflex

Figure 13.26

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