Internal structure of Spinal cord

By
Dr. Rasha Elsisy
Head of anatomy department
 Spinal nerve

Spinal nerves arise as rootlets then combine to form dorsal and

ventral roots
Dorsal and ventral roots merge laterally and form the spinal
nerve
Cross Section of
Spinal Cord
Sulci of spinal
cord
1. Anterior median
fissure
2. Posterior median
sulcus
3. Two anterolateral
sulcus
4. Two posterolateral
sulcus
 Cross section of Spinal Cord
• Gray matter: neuron cell bodies,
dendrites, axons
– Divided into horns
• Posterior (dorsal) horn
• Anterior (ventral) horn
• Lateral horn

• White matter
– Myelinated axons
– Divided into three columns
• Ventral
• Dorsal
• lateral

• Commissures: connections
between left and right halves
– Gray with central canal in the
center
❖Grey commissure: Commissures of the
➢ Transverse bridge of grey Spinal Cord
matter connecting the
anterior and posterior gray
horns on each side
➢ Is pierced by the central
canal that divides it into
anterior and posterior
parts
❖White Commissure:
➢ Lies ventral to the gray
grey
commissure White
commissure
commissure
➢ Mainly contains
decussating nerve fibers
 Grey Matter:
❖ Consists of nerve cell bodies and their processes, neuroglia, and
blood vessels
❖ three main categories:
➢ Sensory neurons (Tract cells)
✓ located in the dorsal horns.
➢ Lower motor neurons
✓ located in the ventral horns (similar neurons in the lateral
horn are the preganglionic neurons of the autonomic
system).
➢ Interneurons (connector neurons)
✓ linking sensory and motor neurons, at the same or
different levels, which form spinal reflex arcs.
 Nerve Cell Groups in Dorsal Horn

4 main groups
1. Posteromarginal
nucleus
2. Substantia
gelatinosa
3. Nucleus
proprius
4. Nucleus dorsalis
(Clark’s column,
nucleus
thoracis)
 Nerve Cell Groups in Ventral Horn

❖Motor neurons,
also called
anterior horn
cells.
 Medial nuclei
• Ventro-medial and
dorso-medial.
• Supply muscles of
the neck and trunk
 Lateral motor nuclei
• Ventro-lateral and
dorso-lateral nuclei
• In cervical and
lumbosacral region
• Supply muscles of
limbs
 Central motor nuclei
• Phrenic nucleus
(c3,4&5): supply the
diaphragm
• Accessory nucleus
(upper cervical
segments):
Supply sternomastoid
and trapezius Central
nucleus
 Nerve Cell Groups in Lateral Horn
➢Extends from T1 to L2-
3 segments:
➢ Give rise to
preganglionic
sympathetic fibers
➢Extends from S2-4
segments:
➢ Give rise to
preganglionic
parasympathetic
fibers
 White Matter
❖Consists of mixture of
nerve fibers, neuroglia
and blood vessels.
❖White color is due to high
proportion of myelinated
nerve fibers
❖The white matter of the
spinal cord is arranged in
columns: anterior,
posterior and lateral.
❖The nerve fibers are
arranged as bundles,
running vertically through
the cord.
WHITE MATTER TRACTS

• Bundles or
fasciculi of fibers
that have the
same Origin,
Termination and
carry the same
Function.
 White Matter
❖Tracts are often named according to
their points of origin and destination,
e.g. spinothalamic, corticospinal.

Depending on their function, the spinal

tracts are divided into ascending and
descending tracts
❑The White matter of the spinal cord consists of
❑Ascending and Descending Nerve Fibers.
❑It is divided into Dorsal, Lateral & Ventral Columns or
Funiculi. 18
ASCENDING PATHWAYS
 Ascending tracts
• Sensory information coming from the sensory
receptors through peripheral nerves to spinal
cord either :
1. Link different segments of the spinal cord
2. Or ascend to higher centers connecting the
spinal cord with the brain.
 Ascending Pathways
• Three-neuron pathways:
1. (1st order neuron):
Its peripheral process pass from external
receptors and travel through dorsal roots of spinal cord to
reach (DORSAL ROOT GANGLION)
2. Second order neurons:
Make up tracts in spinal cord and brainstem
3. 3rd order neuron
From thalamus to primary sensory cortex
Travel through internal capsule
GENERAL RULES
 Sensations

Exteroceptive Proprioceptive
sensation: sensation
From outside the body from inside the body
Pain , temperature and
From muscle , joints
touch
Sense of position, tactile
sensation, vibration
• Three major pathways carry sensory information:
• Posterior column (Gracile & Cuneate fasciculi)
• Anterolateral pathway (Spinothalamic)
• Spinocerebellar pathway
• Spino oliveray & spinotectal pathways
 Exteroceptive sensation from the body except
the head
Pain and Spinovisualg •
Touch
temperature reflexes
Spinotectal tracts

Lateral Crude touch

spinothalamic ventral
tract spinothalamic
tract
Spinal
leminiscus
 Lateral spino thalamic tract
Site in the Crossed or un Its course in
Function spinal cord crossed the brain
stem
Carry pain , Lateral crossed Form spinal
temperature column leminiscus
 Ventral spino thalamic tract
Site in the Crossed or un Its course in
Function spinal cord crossed the brain
stem
Carry light Ventral crossed Form spinal
touch column leminiscus
Lesion of spinothalamic tract
 Spinotectal tract
Site in the Crossed or un Its course in
Function spinal crossed the brain
cord stem
Responsible Lateral crossed Pass to the
for reflex column tectum of
turning of the mid brain
head and eyes
in response to
cutaneous
stimulation
 Proprioceptive sensation
Conscious Unconscious
proprioceptive proprioceptive
sensation sensation
To cerebral cortex To cerebellum

1. Gracile tract(below T6) 1. Dorsal spino cerebellar tract

2. Cuneate tract( aboveT6) 2. ventral spino cerebellar tract
3. Cuneo cerebellar tract
 Gracile tract
Site in the Crossed or un Its course in
Function spinal crossed the brain
cord stem
Carry Posterior Pass Form medial
conscious column uncrossed in leminiscus
proprioceptive the spinal
sensation from cord
the lower half Cross in the
of the body medulla
 Cuneate tract
Site in the Crossed or un Its course in
Function spinal crossed the brain
cord stem
Carry Posterior Pass Form medial
conscious column uncrossed in leminiscus
proprioceptive the spinal
sensation from cord
the upper half Cross in the
of the body medulla
 DORSAL AND VENTRAL
SPINOCEREBELLAR TRACTS
 Dorsal spino cerebellar tract
Site in the Crossed or un Its course in
Function spinal crossed the brain
cord stem
Carry Lateral uncrossed Pass to the
unconscious column cerebellum
proprioceptive through
sensation from inferior
the lower half cerebellar
of the body peduncle
 Ventral spino cerebellar tract
Site in the Crossed or un Its course in
Function spinal crossed the brain
cord stem
Carry Lateral Cross in the Pass to the
unconscious column spinal cord cerebellum
proprioceptive and recross through
sensation from in the superior
the lower half cerebellum cerebellar
of the body peduncle
 Generalizations: Motor Paths
• Typical descending pathway consists of a
series of two motor neurons:
Upper motor neurons (UMNs)
Lower motor neurons (LMNs)
Does not take into consideration the
association neurons between UMNs and
LMNs
 Upper Motor Neurons
• Are entirely
within the CNS.
• Originate in:
Cerebral
cortex
Cerebellum
Brainstem
• Form
descending
tracts
 Lower Motor Neurons
• Begin in CNS.
• From anterior
horns of spinal
cord.
• Make up spinal and
cranial nerves.
 Descending tracts
Pyramidal System Extrapyramidal
System
Form direct link between the
cerebral cortex and spinal cord
and brain stem
Components:
Corticospinal Tract
Corticobulbar Tract
Form indirect link between
cerebral cortex and spinal cord
and reaches it outside the
pyramid
Includes:
Rubrospinal tracts
Vestibulospinal tracts
Reticulospinal tracts
Tecto-spinal tract
 CORTICOSPINAL TRACTS
• Provide a high degree of motor control:
(i.e., movement of individual fingers)
• Concerned with voluntary discrete &
skilled movement, especially of distal
parts of limbs
• Formed of one neurone
• Cells of origin: Large Betz cells in
precentral gyrus (primary motor cortex)
 CORTICOSPINAL TRACTS
LATERAL CORTICOSPINAL TRACT
• Formed of 75 – 90% of fibers
• Fibers decussate in the medulla (motor
decussation)
• Fibers descends in lateral white column
of spinal cord
• Fibers terminate in contralateral ventral
horn cells of spinal cord
 CORTICOSPINAL TRACTS
VENTRAL CORTICOSPINAL TRACT
• Formed of 10 – 25% of fibers
• Fibers descend uncrossed in medulla
• Fibers descends in ventral white column of
spinal cord
• Fibers decussate near to their termination in
the spinal cord
• Fibers terminate in contralateral ventral horn
cells of spinal cord
Extrapyramidal system
 Extra pyramidal tracts
• 2 from mid brain (crossed): - rubrospinal /
tectospinal
• 2 from vestibular nuclei (uncrossed): medial
vestibulospinal(medulla)/ lateral
vestibulospinal (pons)
• 2 from reticular formation(uncrossed) and
some crossed: medial reticulospinal (pons) /
lateral reticulospinal(medulla)
 Rubrospinal tract
Site in the Crossed or
Origin Function spinal un crossed
cord
Red nucleus • Support of Lateral crossed
in the mid the body column
brain
 Tectospinal tract
Site in the Crossed or
Origin Function spinal un crossed
cord
Tectum in the mediates Ventral crossed
mid brain reflex column
movement in
response to
visual stimuli
 Vestibulospinal tract
Site in the Crossed or
Origin Function spinal un crossed
cord
Vestibular important in Ventral uncrossed
nuclei in pons maintenance column
and medulla of posture
and
equilibrium
 Reticulospinal tract
Site in the Crossed or
Origin Function spinal un crossed
cord
Reticular Some of Ventral Some
formation in them is and crossed
pons and inhibitory lateral and some
medulla and other is column uncrossed
excitatory
 An introduction to reflexes

• Reflexes are rapid automatic responses

to stimuli
• Neural reflex involves sensory fibers to
CNS and motor fibers to effectors
 Reflex arc
• Wiring of a neural reflex
• Five steps
–Arrival of stimulus and activation of
receptor
–Activation of sensory neuron
–Information processing
–Activation of motor neuron
–Response by effector
Components of a Reflex Arc
Lesions of the spinal cord
Upper Motor Neuron (UMN) vs Lower Motor Neuron (LMN) Syndrome

UMN syndrome LMN Syndrome

Type of Paralysis Spastic Paresis Flaccid Paralysis

Atrophy No (Disuse) Atrophy Severe Atrophy

Deep Tendon Reflex Increase Absent DTR

Pathological Reflex Positive Babinski Sign Absent

 Spinal Cord Syndrome

Predominantly Motor Syndromes

• Poliomyelitis (Infantile
Paralysis)
- viral infection of lower motor
neuron
- LMN syndrome at the level of
lesion
Victim die from paralysis of
respiratory muscles
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