Welcome to your 6th Anatomy part in the Final!

In this part, we will talk about Spinal Cord and Spinal Nerves.
SPINAL CORD AND
SPINAL NERVES The Great Thing in All Education is to Make Out Nervous System our
Ally instead of Our Enemy!

WHAT ARE THE DIVISIONS Central Nervous System consists of:

OF SPINAL CORD? 1. Brain, which integrates and processes information. It can
function with the spinal cord and can function independently.
2. Spinal Cord, which integrates and processes information. It
can function with the brain and can function independently.
WHAT IS SPINAL CORD?
Spinal Cord is 45 cm in Adults. It passes through Foramen
Magnum and extends from Medulla Oblongata to L1-L2 in Adults.
- It ends at the level of L4-L5 in children (LP).
- Spinal Cord ends by forming tail-like Filum Terminale.
- Spinal Cord is covered by Meninges (Dura, Arachnoid, Pia).
- Denticulate ligaments are bilateral triangular lateral extensions
of Pia mater that anchor the spinal cord to the dura mater.
• Spinal Cord regions correspond to the vertebrae. It consists of
Cervical, Thoracic, Lumbar, Sacral, and Coccygeal regions.
WHAT ARE THE FEATURES
OF SPINAL CORD? 1. Cervical Enlargement and Lumbosacral Enlargement: give rise
to networks of nerves called Plexuses.
2. Conus Medullaris: tapered, lower end of spinal cord.
3. Cauda Equina (‫)ذﻳﻞ اﳊﺼﺎن‬: Diagonal branching of spinal nerves after
spinal cord tapers down.
4. Filum Terminale: continuation of Pia matter after Spinal cord
ends. It becomes a component of Coccygeal ligament.
5. Anterior and Posterior Median Sulci.
WHAT ABOUT TRANSVERSE
1. White Matter (Periphery): consists of axons organized into
VIEW OF SPINAL CORD?
Tracts or Columns.
2. Grey Matter (Central): H-shaped. It contains cell bodies.
3. Central Canal: contains Cerebrospinal fluid (CSF).
4. Dorsal Root and Ventral Root: merge to form Spinal Nerve.
• Dorsal Root is Sensory. Extends from soma in Dorsal Ganglion.
• Ventral Root is Motor: contains motor fibers that move muscles.
WHAT ARE THE LAYERS OF
SPINAL NERVE? Each peripheral nerve consists of:
1. Epineurium (Outer): continues with Dura Matter.
2. Perineurium: layer surround a bundle of axons (Fascicle).
3. Endoneurium (Inner): layer surround a single axon.
WHAT ARE SPINAL
• There are 31 pairs of Spinal Nerves: 8 Cervical, 12 Thoracic, 5
NERVES? Lumbar, 5 Sacral, and 1 Coccygeal nerves.

CAN YOU TELL US ABOUT MOTOR

• Motor: Commands come from Brain and descend in Spinal Cord
AND SENSORY PATHWAYS?
→ Axons descend in Spinal Cord to specific level → Axons exit
Spinal Cord through Ventral Root → Formation of Spinal Nerve →
Go to certain muscles and control it.
• Sensory: Information comes from periphery → Run through
Spinal nerve to Spinal Cord → Make a connection in Dorsal Root
Ganglion → From this ganglion emerges Dorsal Root → Dorsal
Root enter Spinal Cord and ascend in it to the Brain.
WHAT ARE DERMATOMES?
Dermatome is the area of the skin of the human anatomy that is
mainly supplied by branches of a single spinal sensory nerve root.
• These Dermatomes are important clinically for Referred Pain.
- For Example, Heart attack pain is referred to the left shoulder,
because the nerve supply enter the spinal cord at same level of
nerves supplying left shoulder.

WHAT ARE THE NERVE 1. Cervical Plexus: nerves emerge from C1–C5.
PLEXUSES? 2. Brachial Plexus: nerves emerge from C5–T1.
3. Lumbar Plexus: nerves emerge from T12–L4.
4. Sacral Plexus: nerves emerge from L4–S4.

WHAT IS THE CERVICAL Cervical plexus is a network (plexus) of nerves (formed by the
PLEXUS? ventral rami of the upper five cervical nerves). This plexus has
Cutaneous (‫ )ﺟﻠﺪﻳﺔ‬and Muscular (‫ )ﻋﻀﻠﻴﺔ‬branches.
• These branches include Lesser Occipital, Greater Auricular,
Transverse Cervical, Ansa cervicalis, Phrenic (Diaphragm), and
Supraclavicular nerves.
- These branches supply structures in Head, Neck, and Chest.

WHAT ABOUT BRACHIAL

Brachial plexus  is a network (plexus) of nerves (formed by the
PLEXUS?
anterior rami of the lower four cervical nerves and first thoracic
nerve (C5, C6, C7, C8, and T1).
• This Plexus is formed:
a. Roots: which are anterior rami of C5-T1.
b. Trunks: Superior, Middle, and Inferior.
c. Divisions: Each trunk gives Anterior and Posterior divisions.
d. Cords: Lateral (merging of trunks), Posterior (extension of
middle trunk), and Medial (extension of inferior trunk).
e. Branches: Axillary, Musculocutaneous, Radial, Median, and
Ulnar nerves. These branches supply structures of upper limb.
WHAT ABOUT LUMBAR AND
Lumbar and Sacral plexuses are together called the Lumbosacral
SACRAL PLEXUSES? Plexus (T12 - S2). Each type of plexuses give multiple branches.
• Branches of Lumbar plexus:
a. Genitofemoral nerve.
b. Lateral femoral cutaneous branch.
c. Femoral nerve.
• Branches of Sacral plexus:
a. Sciatic nerve (gives common fibular and tibial branches). This
is the main nerve that supplies the Lower limb.
- This nerve receives input from L5, S1, S2, and S3.
b. Pudendal nerve.
WHAT ARE THE PARTS OF
Cardiovascular system consists of 3 main parts:
CARDIOVASCULAR SYSTEM?
1. Heart.
2. Blood vessels.
3. Circulating blood.

WHAT IS BLOOD? Blood is the red liquid that circulates in blood vessels.
• Blood is composed of:
1. Plasma: straw-colored liquid that all solutes of blood swim in.
2. White Blood Cells, which can be Granulocytes (Neutrophils,
Basophils, and Eosinophils) or Agranulocytes (Monocytes and
Lymphocytes).
3. Formed Elements, include Red Blood Cells (Erythrocytes) and
Platelets (Thrombocytes).
HOW CAN I SEE THESE
COMPONENTS OF BLOOD?
These components can be seen by:
1. Taking a blood sample.
2. Smearing the blood on a glass slide.
3. Staining the slide by a Single stain or a Mixture of stains (Azur,
Special, Hematoxylin & Eosin).

WHAT IS THE HEART?

The Heart is the organ that pumps 1 million gallons of blood each
year over 60,000 miles of blood vessels.
• Heart is located in the Mediastinum, which is the median part of
thoracic cavity between the two lungs. It is bounded anteriorly by
Sternum and posteriorly by Vertebral column.

WHAT ARE THE BORDERS • Superiorly: Superior thoracic aperture.

OF MEDIASTINUM? • Inferiorly: Diaphragm.
• Anteriorly: Sternum.
• Posteriorly: Bodies of vertebrae T1 - T12.
• Laterally: Left and Right Mediastinal Parietal Pleura.
WHAT ARE THE PARTS OF
• Heart is Cone-shaped and contain the following parts:
THE HEART? 1. Apex: directed anteriorly, inferiorly, and to the left.
2. Base: directed posteriorly, superiorly, and to the right.
3. Anterior Surface: deep to Sternum and Ribs.
4. Inferior Surface: which rests on the Diaphragm.
HOW CAN I DETERMINE THE
HEART FROM SURFACE? You can draw the shape of the heart on the chest by determining 4
point on the chest and connecting these points:
1. Superior right point at superior border of the 3rd right costal
cartilage, 3cm to the right of midline.
2. Superior left point at the inferior border of the 2nd left costal
cartilage, 3cm to the left of midline.
3. Inferior left point at 5th intercostal space, 9 cm from midline.
4. Inferior right point at superior border of the 6th right costal
cartilage, 3 cm from the midline.
WHAT ARE THE BORDERS OF
• Superior border, which is made by the great vessels. It extends
THE HEART?
from 3rd right costal cartilage to 2nd left costal cartilage.
• Right border, which is made by Right atrium. It extends from
3rd right costal cartilage to 6th right costal cartilage.
• Inferior border, made by Right atrium and ventricle. It extends
from 6th right costal cartilage to 5th left intercostal space.
• Left border, made by Left atrium and ventricle. It extends from
5th left intercostal space to 2nd left costal cartilage.

WHAT IS PERICARDIUM? Pericardium is the serous membrane that covers the heart.
• Pericardium is composed of 2 parts:
1. Fibrous Pericardium (Outer): dense irregular CT. It protects
and anchors the heart and prevents over-stretching.
2. Serous Pericardium (Inner): this is a delicate membrane. It is
further divided into:
a. Parietal Layer (Outer) b. Visceral Layer or Epicardium (Inner)
- There’s space between these two layers called Pericardial cavity.
This cavity contains a minimal amount of fluid to reduce friction.
WHAT ABOUT THE WALL OF
The wall of the heart is composed of (Outer → Inner):
THE HEART?
1. Epicardium (Visceral part of Serous membrane).
2. Myocardium, which contain cardiac muscle (Bulk of Heart).
3. Endocardium, which lines heart chambers and valves.

WHAT CAN WE SEE ON THE Sulci, are grooves that contain coronary blood vessels and fat:
SURFACE OF THE HEART? a. Coronary sulcus: encircles heart and marks boundary between
the atria and the ventricles.
b. Anterior interventricular: between ventricles anteriorly.
c. Posterior interventricular: between ventricles posteriorly.