Spinal Cord and Nerves

Spinal Cord
 CNS tissue is enclosed within the vertebral column from the

foramen magnum to
 Provides two-way communication to and from the brain
 Protected by bone, meninges, and CSF
 Epidural space – space between the vertebrae and the dural

sheath (dura mater) filled with fat and a network of veins
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

Principal Parts
Principal Parts
1. 42-45 cm in length; 2.5 cm wide
2. cervical enlargement - C4:T1 supply upper limbs
3. lumbar enlargement - T9:T12 supply lower limbs
4. conus medullaris - tapers off to end at L1-L2
5. filum terminale - pia mater anchors cord to coccyx
6. cauda equina - (horse tail) nerves below L2

Spinal Cord
Figure 12.28a
Grey Matter areas vs. White Matter areas
1. grey matter - nerve cell bodies motor & interneurons
2. white matter - myelinated axons of motor & sensory

Cross-Sectional Anatomy of the Spinal Cord
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 12.30a
Regions in the Grey Matter - H shaped center
1. grey commissure - cross bar of the H
2. central canal - hole in the center
3. anterior (ventral) horns
4. posterior (dorsal) horns
5. lateral (intermediate) horns (T, L, S only)

Gray Matter and Spinal Roots
Figure 12.30b
Gray Matter: Organization
 Dorsal half – sensory roots and ganglia
 Ventral half – motor roots
 Dorsal and ventral roots fuse laterally to form spinal nerves
 Four zones are evident within the gray matter – somatic

sensory (SS), visceral sensory (VS), visceral motor (VM),
and somatic motor (SM)

Gray Matter: Organization
Figure 12.31
Spinal Nerves
 Thirty-one pairs of mixed nerves arise from the spinal cord and
supply all parts of the body except the head
 They are named according to their point of issue
 8 cervical (C1-C8)
 12 thoracic (T1-T12)
 5 lumbar (L1-L5)
 5 sacral (S1-S5)
 1 coccygeal (C0)

Spinal Nerves
Figure 13.6
Spinal Nerves: Roots
 Each spinal nerve connects to the spinal cord via two medial
roots
 Each root forms a series of rootlets that attach to the spinal
cord
 Ventral roots arise from the anterior horn and contain
motor (efferent) fibers
 Dorsal roots arise from sensory neurons in the dorsal root
ganglion and contain sensory (afferent) fibers

Spinal Nerves: Roots
Figure 13.7a
Nerve Plexuses
 All ventral rami except T2-T12 form interlacing nerve

networks called plexuses
 Plexuses are found in the cervical, brachial, lumbar, and
sacral regions
 Each resulting branch of a plexus contains fibers from
several spinal nerves

Nerve Plexuses
 Fibers travel to the periphery via several different routes
 Each muscle receives a nerve supply from more than one

spinal nerve
 Damage to one spinal segment cannot completely paralyze a
muscle

Spinal Nerve Innervation: Back, Anterolateral
Thorax, and Abdominal Wall
 The back is innervated by dorsal rami via several branches
 The thorax is innervated by ventral rami T1-T12 as

intercostal nerves
 Intercostal nerves supply muscles of the ribs, anterolateral
thorax, and abdominal wall

Spinal Nerve Innervation: Back, Anterolateral
Thorax, and Abdominal Wall
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 13.7b
Cervical Plexus
 The cervical plexus is formed by ventral rami of

C1-C4
 Most branches are cutaneous nerves of the neck, ear, back of

head, and shoulders
 The most important nerve of this plexus is the phrenic
nerve - the major motor and sensory nerve of the diaphragm

Cervical Plexus
Figure 13.8
Brachial Plexus
 Formed by C5-C8 and T1 (C4 and T2 may also contribute to

this plexus in some people)
 It gives rise to the nerves that innervate the upper limb

Brachial Plexus
There are four major branches of this plexus
 Roots – five ventral rami (C5-T1)
 Trunks – upper, middle, and lower, which form divisions
 Divisions – anterior and posterior serve the front and

back of the limb
 Cords – lateral, medial, and posterior fiber bundles

Brachial Plexus
Figure 13.9a
Brachial Plexus: Nerves
 Axillary – innervates the deltoid and teres minor
 Musculocutaneous – sends fibers to the biceps brachii and

brachialis
 Median – branches to most of the flexor muscles of arm
 Ulnar – supplies the flexor carpi ulnaris and part of the

flexor digitorum profundus
 Radial – innervates essentially all extensor muscles

Brachial Plexus: Distribution of Nerves
Figure 13.9c
Lumbar Plexus
 Arises from L1-L4 and innervates the thigh, abdominal wall,

and related muscles
 The major nerves are the femoral and the obturator

Lumbar Plexus
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 13.10
Sacral Plexus
 Arises from L4-S4 and serves the buttock, lower limb, pelvic
structures, and the related sacral areas
 The major nerve is the sciatic, the longest and thickest nerve
of the body
 The sciatic is actually composed of two nerves: the tibial
and the common fibular nerves

Sacral Plexus
Figure 13.11
Dermatomes
 A dermatome is the area of skin innervated by the cutaneous

branches of a single spinal nerve
 All spinal nerves except C1 participate in dermatomes

Dermatomes
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 13.12
White Matter in the Spinal Cord
 Fibers run in three directions – ascending, descending, and
transversely
 Divided into three funiculi (columns) – posterior, lateral,
and anterior
 Each funiculus contains several fiber tracks
 Fiber tract names reveal their origin and destination
 Fiber tracts are composed of axons with similar functions

White Matter: Pathway Generalizations
 Pathways decussate (cross to contralateral side of body)
 Most consist of two or three neurons in the pathway
 Most exhibit somatotopy (precise spatial relationships)
 Pathways are paired (one on each side of the spinal cord or

brain)

Ascending (Sensory) Tracts
Figure 12.32
Ascending Tracts
TRACT FUNCTION
1. anterior (ventral) spinothalamic - touch and pressure to thalamus
2. lateral spinothalamic tract - pain & temperature to thalamus
3. fasciculus gracilis & cuneatus - touch, 2-pt. discrimination
conscious proprioception, stereognosis, weight discrimination,
vibration
4. posterior spinocerebellar - subconscious proprioception
5. anterior spinocerebellar - subconscious proprioception

Nonspecific Ascending Pathway
 Nonspecific
pathway for pain,
temperature, and
crude touch within
the lateral
spinothalamic
tract
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 12.33b
Descending (Motor) Pathways
 Motor pathways involve two neurons (upper motor

neuron and lower motor neuron)

Descending (Motor) Tracts

Descending (Motor) Pathways
TRACTS FUNCTIONS
1. lateral & anterior corticospinal motor output from cortex motor to cells of
ant. horn
2. rubrospinal motor from midbrain to anterior horn for precise movement
3. tectospinal motor from midbrain to anterior horn; movements in
response to audiovisual/cutaneous stimuli
4. vestibulospinal motor from medulla to anterior horn; coordination/balance
5. lateral reticulospinal motor from medulla to anterior horn; inhibit
extensor reflexes
6. medial reticulospinal motor from pons to anterior horn; facilitate extensor
reflexes

The Direct (Pyramidal) Motor System
 Direct pathways originate with the pyramidal neurons in
the precentral gyri
 Impulses are sent through the corticospinal tracts and
synapse in the anterior horn
 Stimulation of anterior horn neurons activates skeletal
muscles
 Parts of the direct pathway, called corticobulbar tracts,
innervate cranial nerve nuclei
 The direct pathway regulates fast and fine (skilled)
movements

The Direct (Pyramidal) System
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 12.34a
Indirect (Extrapyramidal) Motor System
 Includes the brain stem, motor nuclei, and all motor

pathways not part of the pyramidal system
 This system includes the rubrospinal, vestibulospinal,
reticulospinal, and tectospinal tracts
 These motor pathways are complex and multisynaptic, and
regulate:
 Axial muscles that maintain balance and posture
 Muscles controlling coarse movements of the proximal
portions of limbs
 Head, neck, and eye movement
Indirect (Extrapyramidal) System
Figure 12.34b
Extrapyramidal (Multineuronal) Pathways
 Reticulospinal tracts – maintain balance
 Rubrospinal tracts – control flexor muscles
 Superior colliculi and tectospinal tracts mediate head

movements

White Matter: Pathway Generalizations
Figure 12.32
Spinal Cord Trauma: Paralysis
 Paralysis – loss of motor function
 Flaccid paralysis – severe damage to the ventral root or

anterior horn cells
 Lower motor neurons are damaged and impulses do not
reach muscles
 There is no voluntary or involuntary control of muscles

Spinal Cord Trauma: Paralysis
 Spastic paralysis – only upper motor neurons of the

primary motor cortex are damaged
 Spinal neurons remain intact and muscles are stimulated
irregularly
 There is no voluntary control of muscles

Spinal Cord Trauma: Transection
 Cross sectioning of the spinal cord at any level results in total
motor and sensory loss in regions inferior to the cut
 Monoplegia is paralysis of a single limb
 hemiplegia is paralysis of half of the body, monoplegia is

localized to a single limb or to a specific region of the
body. Monoplegia of the upper limb is sometimes referred
to as brachial monoplegia, and that of the lower limb is
called crural monoplegia
 Paraplegia – transection between T1 and L1, lower limbs
 Quadriplegia – transection in the cervical region, all limbs

Poliomyelitis
 Destruction of the anterior horn motor neurons by the

poliovirus
 Early symptoms – fever, headache, muscle pain and
weakness, and loss of somatic reflexes
 Vaccines are available and can prevent infection
 OPV, IPV, Salk and Sabin vaccine

Amyotrophic Lateral Sclerosis (ALS)
 Lou Gehrig’s disease – neuromuscular condition involving

destruction of anterior horn motor neurons and fibers of the
pyramidal tract
 Symptoms – loss of the ability to speak, swallow, and
breathe
 Death occurs within five years
 Linked to malfunctioning genes for glutamate transporter

and/or superoxide dismutase

Spinal Cord and Nerves

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Spinal Cord and Nerves

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Spinal Cord

 CNS tissue is enclosed within the vertebral column from the

 Protected by bone, meninges, and CSF

 Epidural space – space between the vertebrae and the dural

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

1. 42-45 cm in length; 2.5 cm wide

2. cervical enlargement - C4:T1 supply upper limbs

3. lumbar enlargement - T9:T12 supply lower limbs

4. conus medullaris - tapers off to end at L1-L2

5. filum terminale - pia mater anchors cord to coccyx

6. cauda equina - (horse tail) nerves below L2

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

1. grey matter - nerve cell bodies motor & interneurons

2. white matter - myelinated axons of motor & sensory

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

1. grey commissure - cross bar of the H

2. central canal - hole in the center

3. anterior (ventral) horns

4. posterior (dorsal) horns

5. lateral (intermediate) horns (T, L, S only)

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 Dorsal half – sensory roots and ganglia

 Ventral half – motor roots

 Dorsal and ventral roots fuse laterally to form spinal nerves

 Four zones are evident within the gray matter – somatic

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 All ventral rami except T2-T12 form interlacing nerve

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 Fibers travel to the periphery via several different routes

 Each muscle receives a nerve supply from more than one

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 The back is innervated by dorsal rami via several branches

 The thorax is innervated by ventral rami T1-T12 as

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 The cervical plexus is formed by ventral rami of

 Most branches are cutaneous nerves of the neck, ear, back of

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 Formed by C5-C8 and T1 (C4 and T2 may also contribute to

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

There are four major branches of this plexus

 Roots – five ventral rami (C5-T1)

 Trunks – upper, middle, and lower, which form divisions

 Divisions – anterior and posterior serve the front and

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 Axillary – innervates the deltoid and teres minor

 Musculocutaneous – sends fibers to the biceps brachii and

 Ulnar – supplies the flexor carpi ulnaris and part of the

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 Arises from L1-L4 and innervates the thigh, abdominal wall,

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 A dermatome is the area of skin innervated by the cutaneous

 All spinal nerves except C1 participate in dermatomes

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 Fiber tract names reveal their origin and destination

 Fiber tracts are composed of axons with similar functions

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings

 Pathways decussate (cross to contralateral side of body)

 Most consist of two or three neurons in the pathway

 Most exhibit somatotopy (precise spatial relationships)

 Pathways are paired (one on each side of the spinal cord or