Chapter 13 – Spinal Cord

Anatomy of Spinal Cord

 Starts at Foramen Magnum
o Separates Spine from Brain
 Ends between Vertebrae L1/L2
 18 inches long and ½ inch wide
 Sulcus  Shallow Depression
o Posterior Median Sulcus (PMS)
 Fissure  Large Depression
o Anterior Median Fissure (AMF)
 Bilateral symmetry  grooves divide into L/R halves

Enlargements
 Due to gray matter in segment
 Involved with sensory and motor nerves of limbs
 Cervical Enlargement  Nerves of upper limbs
o Superior
 Lumbar Enlargement  Nerves of lower limbs
o Inferior

Distal End
 End of spine is at L1/L2
 Formation of Conus Medullaris
o Conical spine below L region
o Terminal End of Spine
 Filum Terminal  Thin, cordlike structure
o End of Conus Medullaris
o Anchors Conus Medullaris to Coccyx
 Cause Equina  Cluster of nerve fibers
o Below Conus Medullaris
o “Horse Tail”
 Spinal cord ends at the Sacrum for kids
o During growth  Muscles and Bones outgrow
Nervous System
o Spinal Cord becomes shorter
o Nerves are originally horizontal from spine
o Nerves end up being stretched as body grows
Spinal Cord Segments
 Each vertebrae segment gives a pair of spinal nerves
o Cervical, Thoracic, Lumbar, Sacral – Coccyx
o Nerves are named after segments
 Cervical Nerves  8
 Thoracic Nerves  12
 Lumbar Nerves  5
 Sacral Nerves  5
 Coccyx Nerves  1
o 31 Total Nerves
 C1 – C7 Nerves  Found above associated vertebrae
 C8 – Onwards  Found below associated vertebrae

Roots
 Roots are connection between nerves and spinal cords
 Ventral Root
o Efferent
o Motor Neurons
 Dorsal Roots
o Afferent
o Sensory Neurons
 Dorsal Root Ganglion
o Collection of Cell bodies/Soma of Sensory Neurons (PNS)
 Spinal Nerve
o Each side of spine
o Dorsal and Ventral Roots join together
 Mixed Nerves
o Carry Afferent and Efferent Fibers

Spinal Meninges
 Covering of Brain and Spine
 Meningitis  Infection of Meninges
 Protects CNS
 Transmits blood vessels
Meninges Layers
 Dura Mater
o Thickest and Toughest
o Outermost
 Arachnoid Mater
o Middle Layer
o Connective Tissue Fibers
o Forms a web  Subarachnoid Space
 CSF passageway
 Pia Matter  Deepest Later
o On Spine
o Follows Spine Shape

Meningeal Space
 Epidural Space
o Space between vertebra and Dura Matter
o Loose connective tissue and adipose
 Subdural Space
o Between Arachnoid and Dural Matter
o Potential Space (Usually Touching
 Subarachnoid Space
o Between Arachnoid and Pia Matter
o Arachnoid Trabeculae (Collagen/Elastin
Fibers)
o Filled with CSF
 Lined by Ependymal Cells

Spinal Cord
 Paired Denticulate Ligaments
o Pia to Dura Mater
o Aids side – side movement
 Blood Vessels
o On Pia Mater
o Within subarachnoid space
White and Gray Matter
 Gray  Inner Portion
o No Myelin
o Consists of Cell Bodies/Soma
o Forms Projections (Horns)
o Covers Central Canal
 Middle Passageway
 CSF Found (Ependymal Cells)
 White  Surrounds Gray Matter
o Myelination of axons
o Higher Lipid Content
o Tracts are located here
 Axons within CNS

Gray Matter Organization

 3 Gray Horns
 Lateral  Visceral Organ
o Prominent in Thoracolumbar Area
o Autonomic Nervous System
 Dorsal  Sensory Somatic
o Anesthesia  Sensation Loss
o Cluster of Nuclei
 Ventral  Motor Somatic
o Paralysis  Loss of movement
o Cluster of Nuclei
 Gray Commissure  Connects Left and Right Wings

White Matter Organization

 Arranged in Funiculus
 Dorsal
o Between PMS and Dorsal Horn
 Lateral
o Between Dorsal and Ventral Horn
 Ventral
o Between AMF and Ventral Horn
 White Commissures  Link Left and Right White Matter
o Anterior and Posterior Portions
 Ascending  Bottom Up
o Sensory
 Spinothalamic Tract
 Descending  Top Down
o Motor
 Corticospinal Tract
Spinal Nerves
 Each vertebra has 2 spinal nerves
o Left and Right
 Form Dorsal and Ventral roots
o Form Spinal Nerve
o Exits Vertebra by Intervertebral Foramen
o Nerves  Axons of PNS
 Surrounded by 3 connective tissue
o Contain blood vessels

Spinal Nerve Tissues

 PNS Organization
 Endoneurium (Inner)
o Surrounds Single Axons
 Fascicles
o Gathering of Axons
 Perineurium (Middle)
o Surrounds Fascicle
 Epineurium (Outer)
o Covers everything

Distribution of Spinal Nerves

 Lateral to intervertebral foramen
 Union of Dorsal and Ventral Roots
 Split after Foramen
 5 Branches
o Ventral Ramus (Large)
o Dorsal Ramus (Smaller)
 Off of Spinal Nerves
o Rami Communicants
 White and Gray
 Sympathetic NS
 Off of Spinal nerve
o Meningeal Branch
 Off Spinal Nerve
 Goes into Intervertebral Canal
 Covers Spine
Dermatomes
 Area of skin supplied by Pair of Spinal Nerve
 C1 does not have Dermatome
 Starts at C2
o Face is Cranial Nerves
 Diseases are present in Dermatomal Fashion
o Shingles
o Affect certain dermatome when active
o Gives idea of which vertebra is effected
 Referred Pain
o Mind thinks skin is in pain rather than organ
o Heart Pain
 Visceral Pain translated to Somatic Pain
o Different parts of heart can cause pain in skin
o Appendix  T10
 Right Side of Stomach
 Appendicitis  Dull Pain around T10
 Can Spread  Shifting Pain

Dorsal and Ventral Rami

 Spinal Nerve divides
 Dorsal  Segmental Distribution
o Each nerve goes to separate muscle/skin
o Independent of other nerves
 Ventral  T2 – T12 are Segmental
o Intercostal and Subcostal Nerves
 Inferior Part of Costal Groove
 Abdominal Region
o Forms Plexus  Network of Nerves

Cervical Plexus
 C1 – C5
o May participate in adjacent plexus
 Phrenic Nerve  Controls Diaphragm
o C3 – C5
o Signal comes from Medulla and Pons
o Damage on or above C3 – C5 is lethal
 Ansa Cervicalis  C1 – C3
o Nerve Supply to Neck Muscles
Brachial Plexus
 Most Complex
 Originates from C5 – T1
o C5 and C6 form Superior Trunk
o C7 forms Middle Trunk
o C8 and T1 form Inferior Trunk
 Trunks divide into divisions to Anterior and Posterior Portions
o Superior Trunk Divides
o Middle Trunk Divides
o Inferior Trunk Divides
 Divisions link together to form Cords
o Anterior Division of Superior Trunk + Anterior Division of Middle Trunk
 Lateral Cord
o Anterior Division of Inferior Trunk is by itself
 Medial Cord
o All Posterior Divisions link together
 Posterior Cord
 Naming relative to Axillary Artery
 Branches to major Nerves

Major Nerves
 Musculocutaneous Nerve  Lateral
o Ventral portion of arm
o All arm muscles
 Median Nerve  Lateral and Medial
o Lateral Anterior portion of forearm
 Flexors
o Thumb Muscles
 Flattens when nerve is damaged
 Ape Hand

 Ulnar Nerve  Medial

o Medial Anterior portion of forearm
 Flexor Carpi and Flexor Profundus
o Remaining muscles in hand (Besides Thumb)

 Axillary Nerve  Posterior

o Shoulder

 Radial Nerve  Posterior

o Back of arm to back of hand
o Damage can cause paralysis
 Causes wrist drop  No extension
Smaller Brachial Nerves

Ride Long Dick

Tits Not Soft
Let’s Love
Make Pussy Constantly Cum
Please Stop the Incest

Lumbar Plexus
 T12 – L4
o Mainly L1 – L4
 Major Nerves
o Genitofemoral
 Skin of Medial Side of Thigh and genitals
o Lateral Femoral Cutaneous Nerve
 Anterior, Lateral, and Posterior skin of thigh

o Femoral Nerve
 Quads

o Obturator
 Adductor Muscles
Sacral Plexus
 Segments L4 – S4
 Major Nerve
o Pudendal
 Perineum  Pubic Symphysis, Coccyx, Ischial Tuberosity
 During childbirth
 Anal (Inferior) and Euro (Superior) genital triangle
o Portion in middle is Perineum

o Sciatic Nerve
 Runs through thigh (Hamstring)
 United at knee  Popliteal
 Divides into Fibular and Tibial Nerve
 Fibular Nerve  Anterior and Lateral
 Affects extensors
 Foot Drop
 Tibial Nerve  Calf
Reflexes
 Rapid response to specific stimuli
o Somatic  Skeletal
o Autonomic  Parasympathetic or Sympathetic
 Reflex Arc  Pathway for a reflex
o Receptor  Sensory  Integration  Motor  Effector
o Knee Jerk Test

Classification of Reflexes
 Development
o Innate  From Birth (Suckling)
o Acquired  Repetition (Stopping Car)
 Response
o Somatic  Skeletal
o Visceral  Autonomic
 Circuit
o Monosynaptic  1 Synapse (Knee Jerk)
 Sensory  Motor
 No Interneuron
o Polysynaptic  2 or more Synapses
 Integration Center
 Processing
o Spine  Spinal Cord (Knee Jerk)
o Cranial  Brain (Light)
 Orientation
o Ipsilateral  Same Side (Knee Jerk)
o Contralateral  Opposite Side
Stretch Reflex
 Monosynaptic
o Very little delay
 Maintains Posture
 Knee Jerk
 Receptor within Muscle
o Muscle Spindle  Detects Muscle Stretch
o Sends information via Sensory Neuron
o Sends to Spine
 Connects to Motor Neuron
 Ipsilateral
 Causes contraction in muscle
o Allows you to stand
 Type A Neurons

Tendon Reflex
 Safety
 Prevents tension development
 Prevents tendon/muscle tearing
o Stops muscle contraction
 Golgi Tendon Receptors prevent such
 Wearing Heels
o Twisting Ankle
o Golgi Tendon reflex prevents muscle contraction
 Prevents Tearing

Withdrawal Reflex
 Move body away from pain
 Flexor Reflex
 Strength of response depends on strength of stimulus
 Pull Back  Flexion of Extremity

Crossed Extensor Reflexes

 Associated with Flexor Reflex
 As leg pulls up (Flexor)
o Other leg extends to balance body