Advanced Neuroanatomy

Spinal Cord
Lecture 4
 Objectives
• Gross Anatomy
• Peripheral Nerves
• Internal Structure:
– Grey/White
– Segmental Variations
– Cytoarchitectural laminations
• Spinal Cord Tracts
• Vasculature
 The Spinal Cord
• The spinal cord is like a long highway that
connects the brain to the body
• There is a lot of information carried in small
space and injury can be devastating
• It shows an elegant arrangement of sensory
and motor information
• This lecture will go over the anatomy of the
cord and how compartmentalization of
information occurs
 External Gross Anatomy
• Cylindrical structure surrounded by meninges
and CSF
• Lies within confines of vertebral canal and has
bones and ligaments along most of its
circumference
• 42-45 cm long/1 cm in diameter (2 cm at
widest)/35 grams
• Anatomically segmented in terms of nerve
roots only (otherwise a continuous structure)
• Cord begins below brainstem (at the level of
the foramen magnum) ending around L1
• Below L1 has spinal nerves only in a large pool
of CSF known as the cauda equina
• 31 pairs of peripheral nerves:
• 8 Cervical (C1-8)
• 12 Thoracic (T1-12)
• 5 Lumbar (L1-5)
• 5 Sacral (S1-5)
• 1 Coccygeal (Cox1)
• 30 Vertebrae:
• 7 Cervical
• 12 Thoracic
• 5 Lumbar
• 5 Sacral
• 1 Coccygeal
• C1-7 peripheral nerves are above
their corresponding vertebra
• C8 is located above T1
• The rest of the peripheral nerves
rest underneath their corresponding
vertebra
• Each nerve will be in relation with a specific
area of the body (skin, muscle etc.)
• This is because each spinal nerve retains its
relationship with a somite during
development
• For example, each spinal nerve innervates a
single dermatome
• A dermatome is an area of skin that is served by sensory neurons
originating from a spinal nerve ganglion
• These nerves provide information about sensation from that
particular region
Dermatomes
 The Spinal Cord is shorter than the
Vertebral Canal
• Until the 3rd month of fetal life, the spinal cord and
vertebral canal grow at the same rate
• After this, the body and vertebral column grows faster
• At birth, the spinal cord is at L3
• From a few months of age to adulthood, the spinal cord is
at L2
• Spinal nerves exit through the same intervertebral
foramina as in early development
• The spinal roots from the lumbo-sacral region are longer
 Meningeal Covering
• The Spinal Cord is suspended within an arachnoid-lined
dural tube
• Same three layers that cover the brain:
• Dura mater
• Continuous with the cranial dura
• Ends at the 2nd sacral foramen level
• Extends along nerve roots and is continuous with the
connective tissue that surrounds spinal nerves
• Arachnoid
• Inner surface of dura
• Also covers spinal nerve roots
• Subarachnoid space contains CSF
• Pia
• Adheres to the surface of the spinal cord
• Highly vascularized
• Important for lateral supports in conjunction with
arachnoid to suspend the spinal cord in the centre of the
dural sheath
• Denticulate ligament
• Pia-arachnoid tissue
• 21 points of attachment
Rostral End Middle Caudal End
 Cerebral Spinal Fluid (CSF)
• Lumbar cistern extends from end of the spinal
cord (at L1-2) to the end of the dural sheath at
vertebral level S2
• Filled with CSF and is the location of the Cauda
equina
– This is the site for lumbar puncture
• Caudal end of the spinal cord is anchored to the
end of the dural tube by the Filum Terminale
– This is an extension of the pia and some of the central canal
Dura and arachnoid continue to form epineurium of nerves as they leave
through the intervertebral foramina
 Types of Spinal Fibers
• Type A (myelinated)
– 4-20 µm in diameter
– Conduct high velocity impulses (15-120 m per second)
– Examples: motor fibers that innervate skeletal muscle and sensory
fibers

• Type B (myelinated)
– 1-4 µm in diameter
– Conduct impulses with velocity of 3-14 m per second
– Example: Preganglionic autonomic fibers

• Type C (unmyelinated)
– 0.2-1 µm in diameter
– Conduct impulses at velocity of 0.2-2 m per second
– Examples: Autonomic and sensory fibers, pain fibers
• Extends from foramen magnum
to the lower border of L1
• Dorso-ventral flattening along
its length
• Two large enlargements:
1. Cervical (C4 – T1)
• Brachial plexus
2. Lumbosacral enlargement (L2- S3)
• Lumbosacral plexus
• Conus medullaris
• Filum terminale
• Condensation of the pia mater
Dorsolateral sulcus

Ventrolateral sulcus
All levels of the spinal Cord have a
similar organizational cross sectional structure

Anterior White Commissure

M: 45 cm
F: 43 cm
35 grams
Vertebral column: 70 cm
LT
Intermediolateral column (T1-L3)∑

Clarke’s nucleus (T1-L2)

SG

Sacral para∑ nucleus (S2-S4)

 Sensory and Motor Arrangement
within the Spinal Cord
• There is a clear arrangement of sensory and motor area
within the cord
– Gray matter is at the center of the cord
– White matter is peripheral
• Tract connections to specific areas in the brain are
dissociated into different motor and sensory areas and
run through the white matter
• The gray matter has an arrangement of lamina (Lamina
of Rexed) crucial in the connection of sensory and motor
information
The Ventral Horn

The motoneurons
10 Layers: Laminae of Rexed
Interneurons
Descending axons from brain

Pelvic flo
The Dorsal Horn

The Sensory inputs

The Sensory Tracts
Sensory Modalities and Tracts
 Exteroception:
 Discriminative
 Dorsal column
 Light touch

 Pain
 Thermal
 Spino-thalamic tracts
 Proprioception
 Conscious
 Position of limbs

 Vibration

 Unconscious
 Spino-cerebellar:
 Coordination of  Dorsal
movements  Ventral
 Etc.

 Visceral sensations
The Dorsal Column
 Conscious proprioception:
 Vibration
 Position sense

 Discriminative exteroception:
 Two point discrimination
Can you match the levels?
???
Spinothalamic Tracts
• Thermo-algesic and light touch
• Cross over is not at the level of the medulla, but at the
level of the cord
• This can result in dissociated sensory loss in certain
types of spinal cord injury – depending on the level of
injury
 Spinothalamic Pathway
• Lies within the ventral horn of the spinal cord
• Run rostrally in two separate tracts:
– Anterior Spinothalamic Tract
– Lateral Spinothalamic Tract
• Within the brain stem, the two tracts fuse to become the
spinal lemniscus
– This tract terminates at the thalamus in the ventral posterior
nucleus
(VPL)
 Ant spino-thal

SPINOTHALAMIC TRACTS:
•Anterior spinothalamic: light touch
•Lateral spinothalamic: Thermo-algesic
 Sensory Information to the Cerebellum
• The spinal cord is an important source of
information used by the cerebellum in the
coordination of movement
• This information reaches the cerebellar
cortex through the Spinocerebellar tracts
• 3 tracts exist
 Spinocerebellar Tracts
• Dorsal (posterior) Spinocerebellar Tract
– Trunk and lower limbs
• Cuneocerebellar Tract
– Upper limbs
• Ventral (anterior) Spinocerebellar Tract
– Complex information from trunk and lower limbs
Cuneocerebellar tract
 Dorsal Spinocerebellar tract
Trunk and Lower extremities
• Dorsal (posterior) Spinocerebellar
• Primary
• Unconscious proprioception/tegumental pressure (trunk/lower limbs)
• Muscle spindles
• Golgi tendon organs
• Skin pressure receptors
• Courses in fasciculus gracillus until they get to target (cuneatus not formed)
• Secondary
• Dorsal nucleus of Clarke (lamina VII) – larger at lumbar/thoracic region
• T1-L2/3
• Forms dorsal spino-cerebellar tract (same side), this starts at L2 (because
Clarke starts at L2)
• Enters inferior cerebella peduncle (same side)
• Cerebellar cortex (same side) – medial zone (vermis)
DSCT:
(BLUE LINE)

•Trunk and lower

extremities

•Lateral gracilis

•Spinal relay:
Clarke’s nucleus
(T1- L2-3)

•PSCT
(ipsilateral)

•Inferior cerebellar
peduncle (ipsilat)

•Vermis
 Cuneocerebellar Tract
• Arm counterpart of the Dorsal Spinocerebellar Tract
• Therefore, same sensory modalities: unconscious propioception/tegumental
pressure
• Proprioceptive afferents entering at higher thoracic and mainly
cervical regions
• No relay at Clarke’s Nucleus
• Travels in the fasciculus cuneatus
• Reaches lateral (external) cuneate nucleus (not the same as the
cuneate nucleus!)
• Axons then form the Cuneocerebellar Tract
• Travels to the ipsilateral vermis through the inferior cerebellar
peduncle
 Ventral Spinocerebellar
Trunk and Lower extremities
• Ventral (anterior) Spinocerebellar
• May seem redundant as targets are same as dorsal spinocerebellar, conveys more complex
information
• Primary
• Golgi tendons
• Concerned with coordinated movements and posture
• Secondary
• Cells in Laminae V, VI and VII (dorsal and intermediate horn)
• Appearance is similar to motoneurons
• Receive afferents from periphery/spinal interneurons/descending tracts
• L1 to coccyx
• Axons cross midline at spinal cord level (anterior white commissure)
• Enter cerebellum through superior cerebellar peduncle and cross to contralateral cerebellar
cortex through the decussation of the SCP in the midbrain (vermis)
• Its presumed upper limb counterpart is the Rostral spinocerebellar
tract
• Lower cervical , function is unknown
• Ipsi lateral through inferior and superior cerebellar peduncles
THREE PATHWAYS TO THE CEREBELLUM

•Dorsal spino-cerebellar
•Clarke’s

•Ventral Spinocerebellar
•Rostral spinocerebellar

•Cuneocerebellar

ALL stay ipsilateral

1. Fasciculus gracilis (Goll)
2. Fasciculus cuneatus (Burdach)
3. Tractus spinocerebellaris
dorsalis (Flechsig)
4. Tractus corticospinalis lateralis
5. Tractus spinothalamicus
lateralis (Edinger)
6. Tractus spinocerebellaris
ventralis (Gowers)
7. Tractus rubrospinalis
8. Tractus spinotectalis
9. Tractus corticospinalis anterior
10. Tractus olivospinalis
11. Tractus spinoolivaris
12. Tractus tectospinalis
13. Tractus reticulospinalis
14. Tractus vestibulospinalis
15. Tractus spinothalamicus
anterior
Vascular organization