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Functional Neuroantomy: Central Nervous System Organization
Functional Neuroantomy: Central Nervous System Organization

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Published by: georgefromba on Apr 23, 2009
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01/31/2013

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CNS Organization - Axes

Superior (above) Lateral (to the side)

Rostral

Medial (middle)

Anterior (in front of; toward the front)

Caudal Posterior (behind; toward the back)

Inferior (below)

Caudal

Fig. 1-9: Purves et al. Neuroscience, Sinauer Associates Inc: Massachusetts, 2001.

Spinal Cord Segments
Cervical – 7 Thoracic – 12 Lumbar – 5 Sacral – 5 Coccygeal – 1 31 in total

Dermatomes
Area of skin supplied by a single dorsal root. 1 pair per spinal cord segment
Left/Right None for C1

Consecutive segments are next to each other Clinical sign of where spinal cord lesion occurs

Myotomes
Groups of muscles innervated by a single spinal cord segment. 1 pair per
Left/Right

Meninges
Spinal cord is part of CNS Covered by 3 meninges
Pia – adheres to spinal cord Arachnoid Dura
not attached to bone. Epidural space

CSF between arachnoid and pia.

Cross-section
Butterfly shaped grey matter Surrounded by white matter Dorsal median septum Ventral fissure Dorsolateral sulcus Ventrolateral sulcus

Delineations of Grey Matter
Dorsal horn
Input from DRG

Ventral horn
Motor neuron output

Intermediolateral horn
Thoracic/upper lumbar Neurons of the sympathetic nervous system
part of autonomic nervous system rest & digest

10 Laminae of Rexed
I-IV: input layers (somatosensory) V & VI: proprioceptive VII: relay between midbrain and cerebellum VIII: modulate motor activity IX: main motor area X: neuroglia

Layer IX Architecture
Ventral horn Alpha motor neurons Flexors – dorsal Extensors – ventral Trunk – medial Limbs (periphery) lateral

White Matter Architecture
Posterior (dorsal) funiculus Dorsal Column-Medial Lemniscus
Ascending tract

Kinesthesia – position sense Discriminative touch Tests for:
Vibration sense Position sense 2-point Touch Form recognition

Posterior Column: DC-ML
Receptor (peripheral axon) Soma (unipolar) in DRG Proximal axon to spinal cord Dorsal column to medulla
Gracile and Cuneate nuclei

Cross-over (decussation) Medial lemniscus to thalamus
Ventral posterolateral nucleus

Primary somatosensory cortex (S1)
3 neurons to reach here

Spinocerebellar Tracts
Dorsal
Ascending Proprioception

Ventral
Ascending Golgi tendon organ afferents

Both terminate in cerebellum
Unconscious proprioception Unlike dorsal column-medial lemniscus which is conscious proprioception

Lateral Spinothalamic Tract
Pain – anterior Temperature - posterior Cordotomy
Lesion of anterior LST Relief of chronic pain

Corticospinal Tract
Descending tract Primary motor cortex (M1) Premotor cortex Pyramidal decussation
Cross-over at medulla

Lateral corticospinal tract Anterior corticospinal tract Skill/precision in movements
Does not initiate fine movements

Rubrospinal Tract
Rubro – ‘red’ nucleus
In midbrain

Ventral tegmental decussation
In midbrain

Corrects errors in movements of the corticospinal tract

Lateral Vestibulospinal Tract
Lateral vestibulospinal nucleus
Pons

Upright posture

Medial Vestibulospinal Tract
Medial vestibular nucleus
Medulla

Control of head position

Reticulospinal Tracts
Reticular Formation
Pons & Medulla

Modulate motor neurons Modulate sensory input
Modulate spinothalamic neurons in dorsal horn

Tectospinal Tract
Superior Colliculus (optic tectum)
Orienting Eyes

“Turn head in response to light”
Combined head/eye movements

Spinal Reflexes
Reflexes: movements that don’t need conscious control Hand in fire
Remove hand Then feel pain/heat

Circuit:
Dorsal horn input Ventral horn output

Stretch (Myotactic) Reflex
Doctor taps on tendon
Biceps – flex elbow Triceps – extend elbow Radial (wrist) – flex wrist Knee – extend knee Ankle – flex ankle

Counteracts external influences Helps maintain posture

Inverse Myotactic Reflex
Severe tension activates Golgi tendon organ Reflex relaxes muscle Prevents tearing of tendon

Withdrawal (Flexor) Reflex
Remove limb from pain Activate flexor muscles Inhibit antagonistic extensor muscles Polysynaptic

Crossed Extensor Reflex
When flexor reflex occurs, this occurs too Contralateral limb does the opposite
Flexor muscle relaxes Extensor contracts i.e. opposite limb extends

Maintains center of gravity Don’t want to fall in the fire!

Clinical Correlates of Spinal Cord Injury
Lesions prevent input/output Correlates are related to what each tract does normally E.g. Horner’s Syndrome

Dorsal Column Lesion
Loss or lessening of
Vibration sense Position sense 2-point discrimination Deep touch

Ipsilateral (same side) Dermatomes at and below lesion site

Lateral Spinothalamic Tract
Loss or lessening of:
Pain Temperature

Contralateral (opposite side) Dermatomes one or two segments below lesion
Due to cross-over

Dorsal Root Lesion
Loss of lessening of:
All sensory modalities

Ipsilateral Only the dermatome supplied by that DRG

ALS: Amyotrophic Lateral Sclerosis
Lou Gehrig’s disease Motor neuron disease Degenerative
Anterior horn Lateral corticospinal tract Bilateral

ALS: Amyotrophic Lateral Sclerosis
Signs
Paralysis Muscular atrophy Exaggerated myotactic reflexes Babinski sign
Run pen down sole of foot Big toe points up Other toes fan out

ALS: Amyotrophic Lateral Sclerosis
Life expectancy: 3-5 years ‘Locked in’
Paralyzed body Normal mind

2 deaths per 100,000 Cause unknown
Familial ALS
Chromosome 21 Defect in SOD1 – superoxide dismutase
Protects motor neurons from free radicals

Lou Gehrig
As a first baseman for the New York Yankees baseball team, Lou Gehrig played in 2,130 consecutive games from 1925 to 1939, setting a major league record and had a career batting average of .340. He once hit four home runs in a game. On July 4, 1939, he stood before 60,000 fans at Yankee Stadium and confirmed what everyone seemed to know, that the "Pride of the Yankees" had been dealt a terrible blow, diagnosed with amyotrophic lateral sclerosis (now often called Lou Gehrig's disease), a rare disease that causes spinal paralysis. Less than two years later, on June 2, 1941, he died in Riverdale, N.Y.

Lou Gehrig’s Speech
Fans, for the past two weeks you have been reading about a bad break I got. Yet today I consider myself the luckiest man on the face of the earth. I have been in ballparks for seventeen years and have never received anything but kindness and encouragement from you fans. Look at these grand men. Which of you wouldn't consider it the highlight of his career to associate with them for even one day? Sure, I'm lucky. Who wouldn't consider it an honor to have known Jacob Ruppert also the builder of baseball's greatest empire, Ed Barrow - to have spent the next nine years with that wonderful little fellow Miller Huggins - then to have spent the next nine years with that outstanding leader, that smart student of psychology - the best manager in baseball today, Joe McCarthy! Sure, I'm lucky. When the New York Giants, a team you would give your right arm to beat, and vice versa, sends you a gift, that's something! When everybody down to the groundskeepers and those boys in white coats remember you with trophies, that's something. When you have a wonderful mother-in-law who takes sides with you in squabbles against her own daughter, that's something. When you have a father and mother who work all their lives so that you can have an education and build your body, it's a blessing! When you have a wife who has been a tower of strength and shown more courage than you dreamed existed, that's the finest I know. So I close in saying that I might have had a tough break - but I have an awful lot to live for! Lou Gehrig - July 4,1939

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