CONTENTS

1. INTRODUCTION
2. GENERAL FEATURES
3. MENINGEAL COVERINGS
4. ENLARGEMENTS
5. EXTERNAL FEATURES
6. INTERNAL STRUCTURE
7. SPINAL NERVES
8. TRACTS OF SPINAL CORD
9. BLOOD SUPPLY
10. APPLIED ANATOMY
INTRODUCTION
 The spinal cord is the long cylindrical lower part of central
nervous system.
 Itis the main pathway for information connecting the brain and
peripheral nervous system.
 It occupies upper two-thirds of vertebral canal.
 It is surrounded by the three meninges.
 It give rise to 31 pairs of spinal nerves .
 It retains the basic structural pattern.
GENERAL FEATURES

DIMENSIONS :
 The spinal cord is 18 inches or 45 cm in an adult male and 42 cm in an adult
female.
 The weight of spinal cord is 30 g.
LOCATION :
 In an adult it extends from upper border of atlas vertebra to the lower border
of L1 vertebra .
 In new-born , it extends up to L3 vertebra.
 Superiorly , it is continuous with the medulla oblongata .
 Inferiorly , it terminates as conus medullaris.
 Segment or part of spinal cord to which a pair of dorsal nerve roots and a pair of
ventral nerve roots is attached is called a spinal segment.
 As thespinal cord (45cm) is much shorter than the length of the vertebral column
(65cm) , the spinal segments do not lie opposite to the corresponding vertebrae.
 A vertebral spine is always lower than the corresponding spinal segment .
 The level of spinal segment with their vertebral level is sown in the table below:

Vertebral levels Spinal segments

C1-C7 C1-C8
T1-T6 T1-T8
T7-T9 T9-T12
T10-T11 L1-L5
T12- L1 S1-S5 and Co1
General features of spinal cord
MENINGEAL COVERINGS

 The spinal cord is surrounded by three meninges .

 Outermost – Dura mater , middle one – Arachnoid mater and innermost- Pia
mater
 The space between dura mater and arachnoid mater is called subdural space.
 The arachnoid and pia maters are separated by subarachnoid space which
contains CSF. The CSF is withdrawn from the subarachnoid space during
lumbar puncture.
 The spinal cord is enclosed only by the meningeal layer of dura mater .
 The space between the meningeal layer and endosteum of the vertebral canal is
called epidural space, where epidural anaesthesia can be given.
 Modifications of spinal pia mater

1. Ligamentum denticulatum:
21 pairs of teeth – like projections , fuse laterally with arachnoid and dura maters,
Highest process attaches superior to foramen magnum
Keeps the spinal cord in position
2. Linea splendens :
Thickening seen at the anteromedian sulcus in the lower part of the spinal cord.
3. The filum terminale :
20 cm long
After leaving through sacral hiatus ends by getting attached to the periosteun of
dorsal surface of first segment of coccyx.
It consists of two parts : Filum termnale internum – 15 cm ( upper part)
Filum terminale externum – 5 cm ( lower part)
coverings and spaces in spinal cord
 Enlargements

1. Cervical enlargement for supply of upper limb muscles :

This extends from C4 to T1 spinal segments with maximum diameter of
38mm at level of C6.
2. Lumbar enlargement for supply of muscles of lower limb :
It extends from level of L2 to S3 segments with maximum diameter of 35mm at
the level of S1 segment.

CAUDA EQUINA : Dorsal and ventral roots of right and left sides of L2 –L5 , S1-
S5 and Co1 nerves lie almost vertically around filum terminale . These are called
cauda equina as these resemble a horse’s tail.
External features

 Anteriorly , the spinal cord reveals a deep anterior median fissure lodging the
anterior spinal artery.
 Posterior median sulcus is a thin longitudinal groove from which a septum runs
in the depth of spinal cord.
 Each half is subdivided into – anterior , lateral and posterior regions by
anterolateral and posterolateral sulci.
 Ventral or motor nerve roots emerge from the anterolateral sulcus.
 Dorsal or sensory nerve roots enter spinal cord from posterolateral sulcus.
External features with enlargement
 Internal structure

In a transverse section of a segment of spinal cord :

 White matter, i.e. nerve fibres , lies outside .
 Grey matter lies inside.
 In the centre of grey matter there is the central canal containing cerebrospinal
fluid ( CSF).
 The canal is lined by single layer of ependymal cells.
 The grey matter is in the form of ‘H’ with a grey commissure joining the grey
matter of right and left sides .
 Grey matter comprises of one posterior horn and one anterior horn on each side in the
entire extent of the cord .
 Only in T1-L2 and S2-S4 segments ,there is an additional lateral horn for the supply of
the viscera. This horn is a part of autonomic nervous system.
DORSAL HORN:
 Found at all spinal cord levels
 Comprised of sensory neurons
VENTRAL HORN:
 Comprised of motor neurons
 That innervate skeletal muscle
 Shape and size of the horns differ in different segments due to functional reasons.
Shape of horns in different segments of spinal cord
Segments of spinal Posterior horn Lateral horn Anterior horn
cord
Cervical , oval shape Slender Absent Narrow in 1-3 segments
Broad in C4 –C8 segments
for supply of upper limbs
Thoracic , circular Slender Present for Slender in T2-T12
shape thoracolumbar segments , broad in T1
outflow segment
Lumbar , circular shape Bulbous Present only in Bulbous for supply of lower
lumbar 1 and 2 limbs
segments
Sacral , circular but Thick Group of cells in Bulbous for supply of lower
smaller sacral 2-4 segments limbs
for sacral outflow
Structure of the spinal cord
 spinal nerves

 Spinal nerves arise in pairs .

 There are 31 pairs of spinal nerves as 8 cervical ,12 thoracic, 5 lumbar , 5 sacral
and 1 coccygeal.
 Each spinal nerve arises by a series of six to eight dorsal and ventral nerve
rootlets.
 These rootlets unite in or near the intervertebral foramen to form the spinal nerve.
BRANCHES :
 Dorsal Ramus – It supplies the dorsal one-third of the body wall. They do not
supply the limbs.
 Ventral Ramus-It supplies the ventral two-thirds of the body wall including the
limbs.
 TRACTS OF THE SPINAL CORD
 A collection of nerve fibres that connects two masses of grey matter within the central
nervous system is called a tract .
 Tracts may be ascending (sensory) or descending (motor) .
 They are usually named after the masses of grey matter connected by them.
 Some tracts are called fasciculi or leminsci.
 Descending tracts are of two types :
 PYRAMIDAL or CORTICOSPINAL Tracts ( lateral and anterior)
EXTRAPYRAMIDAL Tracts – rubrospinal , medial reticulospinal , lateral reticulospinal ,
olivospinal , vestibulospinal and tectospinal.
 Ascending tracts – lateral spinothalamic , anterior spinothalamic , fasciculus gracilis ,
fasciculus cuneatus , posterior spinocerebellar , anterior spinocerebral, spino – olivary and
spinotectal.
Tracts of spinal cord
Blood supply

 The vertebral arteries are the main source of blood to the spinal cord
.
 The following arteries branch from the vertebral arteries to directly
supply the spinal cord :
1. One anterior spinal artery
2. Two posterior spinal arteries
3. Anterior and posterior radicular arteries
4. Arterial vasocorona – anastomose between
the spinal arteries
Applied anatomy

 Cauda equina syndrome – Damage to cauda equina results into :

Lower motor neuron type of paralysis due to compression of ventral nerve roots
Root pain due to involvement of dorsal nerve roots
Bladder and bowel movement is delayed
 Poliomyelitis – Viral disease involving anterior horn cells leading to flaccid
paralysis of affected segments . It is a lower motor neuron paralysis
If upper cervical segments affected , it may be fatal because of the involvement
of C4 segment which supplies the diaphragm through phrenic nerve.
 Applied anatomy

 Lumbar puncture – In a child , done at level of L4 Vertebra as spinal cord

extends till L3 vertebra at birth. In an adult , done at level of L3 Vertebra as
spinal cord ascends till level of L1 vertebra.

 Conus medullaris syndrome – Due to injury to S2-S4 segments of spinal cord

Features are : Anaesthesia in perineum
Involvement of bladder and bowel is early
Sexual functions are affected
 Applied anatomy

 Tabes dorsalis – Occurs during tertiary stage of syphills.

Degenerative lesions of dorsal nerve roots and of posterior white columns
Its feature is several pain in lower limbs and the lower limbs are mainly
affected..
Applied anatomy