SPINAL CORD

Aditya febriansyah
 OVERVIEW
• Derived from the caudal part of the neural tube.
• maintains segmental organization throughout development.
• surrounded by three membranes, the meninges.
• weighs about 30 g and comprises 2% of the weight of the adult brain
A. Location

• extends, in adults, from the foramen magnum to the inferior border of the first
lumbar vertebra; in newborns, it extends to the third lumbar vertebra.

• continuous with the medulla oblongata at the spinomedullary junction, a plane

defined by threes tructures: the foramen magnum, the pyramidal decussation, and the
emergence of the first cervical nerve anterior rootlets.

• lies within the subarachnoid space that extends caudally to the level of the second
sacral vertebra
B. Attachments
• suspend and anchor the spinal cord within the dural sac.
• arise from the pia mater, which closely invests the spinal cord.
1. Denticulate ligaments
• two tlattened bands of pial tissue that attach to the spinal dura comprising 21
pairs of tooth-shaped extensions.
2. Filum terminale
• an extension of pia mater that extends from the conus
medullaris to the dural sac {internus) and from the dural sac to
the coccyx (extemus).

3. Spinal nerve roots

• provide strong anchorage and fixation of the spinal cord to the
vertebral canal.
3. Shape
•An elongated and nearly cylindrical structure, approximately 1cm diameter
•Cervical (C5-T1) and lumbar (L1-S2) enlargment for the nerve supply of upper and
lower extremities
•Terminates caudally as the conus medularis
•In length, averages 45 cm for men, and 42 cm for females
Spinal nerves
•Consist 31 pair of nerve that emerge from the spinal cord : 8 Cervical, 12
thoracal, 5 lumbal, 5 sacral, and 1 coccygeus
•Contain both motor and sensory fibers

1. special consideration
•The first cervical nerve and the coccygeal nerve usually have neither the
posterior (sensory) roots nor the corresponding dermatome
•The first cervical nerve passses between atlas an and the skull
•With the exception C1, spinal nerve exit the vertebral canal via foramen
intervertbralis or sacral foramina
 2. fungctional components of spinal nerve fibers

 General somatic efferent (GSE)

Motor fibers of spinal nerves that innervate skeletal muscle
 General visceral efferent (GVE)
Motor fibers of spinal nerves that innervate cardiac muscle, smooth
muscle, or glands
 General somatic afferent (GSA)
Bring info from skin, skeletal muscle, tendons, and joints
 General visceral afferent (GVA)
Bring info from viscera (membranes, glands and organs
3. Components and branches of spinal nerves
• The spinal nerve is formed by the union of posterior and anterior roots
within the intervertebral foramen, resulting in a mixed nerve.
a. Posterior root
• enters the posterior lateral sulcus as posterior rootlets and conveys sensory input from the body
via the spinal ganglion.
• contains, distally, the spinal ganglion.
• joins the anterior root distal to the spinal ganglion and within the intervertebral foramen to form
the spinal nerve.
b. Spinal ganglion
• located within the posterior root and within the intervertebral foramen.
• contains pseudounipolar neurons of neural crest origin that transmit sensory input
•from the periphery (GSA and GVA) to the spinal cord via the posterior roots.

c. Anterior root
• emerges as anterior rootlets from the anterior lateral sulcus and conveys motor
output from visceral and somatic motor neurons.
• joins the posterior roots distal to the spinal ganglion and within the intervenebral
foramen to form the spinal nerve.
d. Cauda equina
• consists of lumbosacral (posterior and anterior) nerve roots (L2-Co) that
descend
•from the spinal cord through the subarachnoid space to exit through their
respective
•intervertebral or sacral foramina.
E. Spinal narve rami

• Posterior ramus
(1) innervates the skin and muscles of the back.
• Anterior ramus
(1) innervates the anterior and lateral muscles and skin of the trunk:, extremities and visceral
organs.
• Meningeal ramus
(1) innervates the meninges and vertebral column.
• Gray communicating rami
(1) contain unmyelinated postganglionic sympathetic fibers.
(2) associated with all spinal nerves.
• White communicating rami
(1) contain myelinated preganglionic sympathetic fibers and myelinated GVA fibers (splanchnic
nerves).
(2) found only in thoracolumbar segments of the spinal cord (TI-12).
E. Spinal nerva innervation
• One spinal nerve innervates the derivatives from one somite that includes the
following:
1. Dermatome
• consists of a cutaneous area innervated by the fibers of one spinal nerve
2. Myotome
• consists of muscles innervated by the fibers of one spinal nerve.
3. Sclerotome
•• consists of bones and ligaments innervated by the fibers of one spinal
nerve.
F. Surface structures and sulci
1. Anterior median fissure
• a deep anterior midline groove in which the anterior spinal artery is found superficially.
2. Anterior lateral sulcus
• a shallow groove from which the anterior rootlets emerge.
3. Posterior lateral sulcus
• a shallow groove into which the posterior rootlets entet.
4. Posterior intermediate sulcus
• a shallow groove that is continuous with the posterior intermediate septum.
• found between the posterior lateral and posterior median sulci but only rostral to T6.
• separates the fasciculus gracilis from the fasciculus cuneatus.
5. Posterior median sulcus
• a shallow posterior midline groove that is continuous with the posterior median septum
• Cont..
 INTERNAL MORPHOLOGY

• ln transverse sections, the spinal cord consists of central gray

matter and peripheral white matter.
A. Gray matter
• toward the center ofthe spinal cord.
• butterfly- or H-shaped that varies according to spinal cord level.
• contains a central canal.
• divided into cytoarchitectural areas called Rexed laminae, expressed with Roman numerals
• divided into three horns or cell columns on each side:
1. Posterior horn (column)
• receives and processes sensory input.
• found at all levels.
• includes the following nuclei:

a. Posteromarginal nucleus {Rexed lamina I)

• found at all cord levels.
• associated with light touch, pain, and temperature sensation.
• origin of some fibers of anterolateral system.
b. Substantia gelatinosa {Rexed lamina II)
• found at all cord levels.
• homologous to the spinal trigeminal nucleus.
• associated with light touch, pain, and temperature sensation.
• origin of some fibers of anterolateral system.

c. Nucleus proprius {Rexed laminae Ill and IV)

• found at all cord levels.
• associated with light touch, pain, and temperature sensation.
• origin of some fibers of anterolateral system.
d. Posterior thoracic nucleus (also known as Nucleus dorsalis of Clarke)
(Rexed lamina VII)
• found at the base of the posterior horn.
• extends from (C8) Tl to L2.
• homologous to the accessory cuneate nucleus of the medulla.
• subserves unconscious proprioception from muscle spindles and Golgi
tendonorgans (GTOs).
• the origin of the posterior spinocerebellar tract.
2. Lateral horn (column) (Rexed lamina VII)
• receives viscerosensory input.
• found between the posterior and anterior horns.
• extends from Tl to 12.
• contains the intermediolateral nucleus (column), a visceromotor nucleus that extends from Tl to
L2.
• contains preganglionic sympathetic neurons (GVE).
• contains, at Tl-T2, the ciliospinal center of Budge (sympathetic innervation of the eye).
3. Anterior horn (column) (Rexed laminae VII, VIII, and IX)
• contains predominantly motor nuclei.
• found at all levels.
• includes the following nuclei:
a. Spinal border cells
• extend from L2 to S3.
• subserve unconscious proprioception from GTOs and muscle spindles.
• the origin of the anterior spinocerebellar tract.
b. Sacral parasympathetic nucleus (Rexed lamina VII)
• extends from S2 to S4.
• gives rise to preganglionic parasympathetic fibers that
innervate the pelvic viscera via the pelvic splanchnic nerves.

c. Somatic motor nuclei {Rexed lamina IX)

• found at all levels.
• subdivided into medial and lateral groups that innervate axial
and appendicular muscles, respectively.
d. Spinal accessory nucleus (Rexad lamina IX)
• extends from Cl to C6.
• gives rise to the spinal accessory nerve (CN IX).
• innervates the sternocleidomastoid and trapezius.

e. Phrenic nucleus {Rexed lamina IX)

• extends from C3 to C6.
• innervates the diaphragm.
B. White matter
• consists of bundles of myelinated fibers that surround the central gray matter.
• consists of ascending and descending fiber pathways called tracts.
• divided bilaterally by sulci into three major divisions.
1. Posterior funiculus (posterior column)
• located between the posterior median sulcus and the posterior lateral sulcus.
• is subdivided above T6 into two fasciculi:

a. Fasciculus gracilis
• located between the posterior median sulcus and the posterior intermediate sulcus and
septum.
• found at all cord levels.
b. Fasciculus cuneatus
• located between the posterior intermediate sulcus and septum and the posterior lateral
sulcus.
• found only at the upper thoracic and cervical cord levels (Cl-T6).

2. Lateral funiculus
• located between the posterior lateral and anterior lateral sulci.

3. Anterior funiculus
• located between the anterior median fissure and the anterior lateral sulcus.
• contains the anterior white commissure:
a. located between the central canal and the anterior medial fissure.
b. contains decussating spinothalamic fibers.
• Cont..
C. Characterization of spinal cord levels
• based on regional variation in the shape of the gray matter and the presence
of the posterior intermediate sulci and septa.
1. Cervical cord
• posterior intermediate sulci and septa are present.
• anterior horns are massive from C3 to C8.
2. Thoracic cord
• Posterior intermediate sulci and septa are present from Tl to T6.
• The posterior thoracic nucleus is present at all thoracic levels but is most prominent at T11 and
T12.
• Lateral horns are present at all thoracic levels.
• Posterior and anterior horns are typically slender and H-shaped.
3. Lumbar cord
• The posterior thoracic nucleus is very prominent at Ll and 1.2.
• Contains massive anterior and posterior horns from L2 to L5; the substantia
gelatinosa is greatly enlarged.
• The lumbar section is difficult to distinguish from the upper sacral segments.
• The lateral horn is prominent only at Ll.
4. Sacral cord
• contains massive anterior and posterior horns; the substantia
gelatinosa is greatly enlarged.
• greatly reduced in diameter from S3 to S5.
5. Coccygeal segment
• contains posterior horns that are more voluminous than the anterior horns.
• has a greatly reduced diameter.
IV. MYOTATIC REFLEX
• a monosynaptic and ipsilateral muscle stretch retlex (MSR).

A. Afferent limb
• includes a muscle spindle (receptor) and a spinal ganglion
neuron and its Ia fiber.

B. Efferent limb
• includes an anterior hom motor neuron that innervates striated
muscle (effector).
TERIMAKASIH