Spinal Cord: Regional Anatomy and Internal Structure
cervical and the coccygeal roots, and there are no
Topographic Organization
 spinal cord: least modified portion of the embryonic
neural tube & the only part of the adult nervous
system in which the primitive segmental
arrangement clearly is preserved
 it is a long, cylindrical structure invested by
meninges, which lies in the vertebral canal
 extends from the foramen magnum, where it is
continuous with the medulla, to the lower border of
the first lumbar vertera
 has two enlargements: cervical and lumbar or
lumbosacral, each associated with nerve roots
which innervate, respectively the upper and lower
extremitied
o Cervical Enlargment- consists of the four
lowest cervical segments and the first
thoracic segment, gives rise to the nerve
roots that form the brachial plexus and
provide innervation for the upper extremity
o Lumbar or Lumbosacral Enlargement- gives
rise to fibers that form the lumbar plexus
and the sacral plexus
 conus medullaris- conical termination of the spinal
cord
o tapered terminal portion of the spinal cord
o provides cutaneous innervation to the
saddle area, moto innervation for the
sphincters, and parasympathetic
innervation for the bladder
o at birth: the conus medullaris is located
near the L3 vertebra
o in the adult: located in between the L1 and
L2
 filum terminale- formed by a condensation of pia
mater, extending caudally from the conus
medullaris
o joins the dural tube at levels of the second
sacral vertebra, becomes invested by
dura,& continues as coccygeal ligament to
the posterior surface of the coccyx
o lies in the lumbar cistern surrounded by
lumbosacral nerve roots forming the cauda
equina
 consists of 31 segments, each of which receives
and furniches paired dorsal and ventral root
filaments: 8 cervical, 12 thoracic, 5 lumbar, 5
sacral, and 1 coccygeal
 sites of emergence of the spinal nerves do not
change, but there is a lengthening of root filaments
between the intervertebral or root filaments
between the intervertebral foramina and he spinal
cord
 cauda equina- large number of lumbosacral roots
surrounding the filum terminale
 spinal nerves emerge from the vertebral canal via
the intervertebral foramen
o first cervical nerve emerges between the
atlas and the occiput
o eight cervical root emerges from the
intervertebral foramen between C7 and T1
o all mor caudal spinal nerves emerge from
the intervertebral foramina beneath the
vertebrae of the same number
Internal Structure
 dorsal root fibers usually are absent in the first
corresponding dermatomes for these segments
 Measurements:
o Length of spinal cord (junction of the
medulla to the tip of the conus medullaris):
45cm (male), 43cm (female)
o Length of vertebral column: 70 cm
o Weight of the spinal cord: 35g
o Midthoracic region: 10mm (transverse dm);
8mm (sagital dm)
o Cervical enlargment (6th cervical): 13-
14mm (transverse dm); 9mm (sagittal dm)
o Lumbar enlargment (third lumbar): 12mm
(transver dm); 8.5mm (sagittal dm)
 Anterior median fissure
o Anterior surface
o Penetrates the cord for a depth of some
3mm
o Contains an epipial fold with sulcal
branches of the anterior spinal artery and
vein
 Posterior Median Sulcus
o Posterior surface
o Shallow
o Continuous with a delicate glial partition
 Posterior Median Septum
o Extends into the cord and reaches the
deep-lying gray matter
 Lateral to the midline posterior are two less distinct
sulci associated with spinal roots
o Posterolateral sulcus- a shallow furrow into
which filaments of the dorsal roots enter
the spinal cord
o Anterolateral Sulcus- marks the site of
emergence of ventral root fibers
 Posterior Intermediate Sulcus- indents the spinal
cord between the posterior median and
posterolateral sulci in the cervical and upper
thoracic spinal segments
 Posterior Intermediate Septum- glial partition
associated with the posterior intermediate sulcus
that extends internally toward the spinal
 In the transverse section the spinal cord consists
of:
o A butterfly-shaped central gray matter
composed of collections of cell bodies and
their processes
o A surrounding mantle of white matter
composed of bundles of myelinated fibers,
most of which are either ascending or
descending
 Spinal Cord functions are tremendously important
since it:
o Receives afferent inputs via the dorsal
roots from somatic and visceral receptors
in most parts of the body
o Gives rise to ascending pathways which
transmit impulses to higher levels of the
neuroaxis
o Gives rise to fibers emerging in the ventral
roots that innervate somatic and visceral
efforts
o Conveys descending pathways from higher
levels of the nervous system
o Participates in a variety of somatic and
autonomic reflexes
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 - embryonic layers become longitudinal columns of gray and white matter in the adult spinal cord, each having microscopic
landmarks and subdivisions
Gray Matter
- composed of neural elements supported by an interstitial neurological framework
- contains the nerve cells, dendrites, potions of
myelinated and unmyelinated nerve fibers, and glial cells
- the fibers are axons of nerve cells located in the gray
matter which pass into the white matter, or portions of
the axons in the white matter which enter the gray
matter to terminate there
- the preponderance of neurons, neuroglia and capillaries
imparts firm consistency to the butterfly or H-shaped
gray matter
- Neuropil
o Further enhances density by a multitude of fine
glial processes, fibrils, synaptic terminal and
dendrites, which invests neurons in an intricate
meshwork
o Remain unstained with H&E and cresyl violet
o It is where most dedritic plexuses are located
- Central Canal
o Surrounded by ependymal cells, is located in
the crossbar of the H-shaped gray matter
o Fetal and newborn: sharply delineated central
canal
o Adult: ependymal lining often is discontinuous
and the lumen may contain debris, round cells,
macrophages, and neuroglial processes
o Clumps of atrocytes rarely seen in other parts
of the gray matter surrounds the central canal
o Two slender bads of gray matter above and
below the central canal form the posterior and
anterior gray commisures
- PARTS
- Each half of the spinal cord has a:
o Posterior (dorsal) gray column or horn- extends
posterolaterally almost to the surface near the
root entry zone
o Anterior (ventral) gray column or horn- extends
anteriorly but does not reach the surface
o Lateral Horn- small and pointed structure near
the base of the anterior horn that characterizes
the thoracic spinal segment
o Gray Anterior and Posterior Commisure-
connects the gray matter of the two sides and
encompasses the central canal
o Central gelatinous substance (substancia
gelatinosa)- light granular area composed
mainly of neuroglia surrounding the central
canal
-
White Matter
- contains few neurons or dendrites but is composed
of ascending and descending myelinated and
unmyelinated nerve fibers
- longitudinally arranged fiber bundles and their
supportive neuroglial cells surround the gray
matter as the posterior, lateral and anterior white
funiculi
- superficial glial membrane- formed by processes of
astrocytes adherent to the deep surface of the pia
matter
- PARTS
o Anterior (ventral) white commisure- a
bundle of transverse fibers composed of
crossing fibers arising from nerve cells in
the gray matter found anterior to the gray
commisure
- Ascending and descending fibers occupying
particular regions of the white matter of the spinal
cord are organized into more or less distinct
bundles
o Tracts or Fasciculi
 Fiber bundles having the same, or similar
origin, course and termination
 White matter is divided into three paired
funiculi:
 Posterior funiculus
o Lies between the dorsal horn and the
posterior median septum
o Posterior intermediate septum-
divides each posterior funiculus into
two white columns, found in the
thoracic and cervical regions
 Lateral Funiculus
o lie between the the dorsal root entry
zone and he site where ventral root
fibers emerge from the spinal cord
 Anterior Funiculus
o Lies between the anterior median
fissure and he emerging ventral root
filaments
-

Segmental Variation
- Spinal cord vary in:
o In size and shape
o In the relative amounts if gray and white matter
- Cervical spinal segments contain the largest number of fibers in the white matter because:
o Descending fiber systems have not yet contributed fibers to lower segmental level
o Ascending fiber systems at each successively rostral segment reach their maximum
Cervical Segment Thoracic Segment Lumbar Segment Sacral Segment
Outline Oval, greatest Oval to circular Nearly circular Circular to
diameter transverse quadrilateral
White matter - Characterized by - contains relatively - relatively small
relatively large size, and absolutely less amount of white
relatively large white matter than matter
amounts of white cervical segments
matter, and oval
shape

Gray Matter - small diameter of the - relatively large

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 thoracic segments is
due primarily to the
marked reduction of
gray matter
Fasciculus gracilis - On each side, the - seen only at the upper - compose the
(medial) posterior funiculus thoracic segments (T1
is divided by a to T6) - not as broad as at
prominent posterior
intermediate
septum
Fasciculus - seen from the upper
cuneatus (lateral) thoracic segments (T1
to T6) down to the
more caudal levels
(blow T6) at the
posterior funiculus
amounts of gray
matter
- sacral segments
conspicuously
diminish in overall
diameter but retain
relatively large
proportions of gray
matter
posterior funiculus
higher levels,
especially near the
gray commisure, and
have a highly
characteristic
configuration

Posterior (dorsal) - Enlarged at upper - In general, the anterior - segments are nearly - large and thick
horn cervical segments (ventral) horn and circular in transverse
(C1 & C2) and in posterior (dorsal) section, have massive
lower cervical horns are small and anterior (ventral) and
cegments (C5 and somewhat tapered posterior (dorsal)
below) related to - First thoracic segment horns
the brachial plexus is an exception in that
it forms the lowest
Anterior (ventral) - Well-developed and segment of the -large and thick but is
horn extends into the cervical enlargement - anterior horn is well- not bayed out laterally
lateral funiculi in and contributes to the developed and have a as in lumbar spinal
the lower cervical brachial plexus blunt process that segments
segments extend into the lateral
- Anterior horn is funiculi
relatively small in
the uppe cervical
segments (C1&C2)
Lateral Horn - small but prominent , a
lateral horn is present
at all thoracic levels
- contains the
intermediolateral cell
which gives rise to
preganglionic
sympathetic fibers
Reticular - Reticular process Absent Absent Absent
Formation (reticular nucleus)
o Serrated
cellular area
near the neck
of the posterior
horn
o Present in all
cevical
segments
Significant Dorsal Nucleus of Clarke - resemble lower - presence of short
Structures - rounded collection of thoracic spinal gray thick commisure
large cells at the base segments in that they - substantia gelatinosa
of the medial aspect of contain the dorsal is particularly well-
the posterior horn nucleus of Clarke and developed in sacral
- present in all thoracic the intermediolateral segments accounts
segments but is column for the thickened
particularly wlell- o well-developed at posterior gray column
developed at T10 L1 and L2
through T12 - Transition between

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 - characteristic T12 and L1 is subtle,
appearance is their and these levels are
large vesicular dificult to identify
precisely

Innervation - upper thoracic spinal - motor cells in this

nerves, except for T1, process in segments
supply motor L3 through L5
innervation only to innervate large
axial musculture muscle group in the
- lower thoracic nerves lower extremities
supply the same -
muscles and the
abdominal
musculature 
anterior horns of lower
thoracic segment are a
little larger
Sulcus intermedius Present throughout Present in upper seven Absent Absent
posterior thoracic segments

Coccygeal Segment - resemble lower sacral spinal segments but are reduced in size
- posterior gray horn and especially the substantia gelatinosa are greatly increased in size,
while the anterior gray horn becomes smaller

Somatic Efferent Neurons

- referred to as α motor neurons
- contribute axons to the ventral roots of respective spinal nerve and are organized into named nuclear gourpss
- large multipolar neurons have 3 to 20 dendrites with ramifications which extend into laminae VII and VIII
- axons
o arise primarily from the axon hillock and are quite thin in the initial unmyelinated segment
o Exhibit a variable course in the gray matter, and increase in diameter as they enter the white matter
- Each cell has a large central vesicular nucleus and coarse Nissl bodies in the cytoplasm
- Largest in the lumbar and cervical enlargements and smaller in the thoracic segment of the spinal cord
- Scattered among the large anterior horn are γ neurons whose axons are destined for the muscle spindles
- SUBDIVISIONS:
MEDIAL NUCLEAR GROUP LATERAL NUCLEAR GROUP
- divisible into: - motor cell groups innervates the rest of the body musculature
o posteromedial group - thoracic segment: small and undivided and innervates the intercostal and other
 smaller anterolateral trunk muscles
 most distinct in the - cervical and lumbar enlargements: increased and a number of subgroups may be
cervical and lumbar distinguished
enlargements - especially prominent in those segments which participate in the innervation of
 may be missing in the the most distal portions of the extremities
sacral portions of the cord - muscle innervation  more distal muscles are supplied by the more lateral cell
o anteromedial group groups
 extends throughout the - from the most medial part of the anterior horn to its lateral periphery, α motor
whole cord and is most neurons successively innervate muscles of the trunk, shoulder and pelvic girdle,
prominent in C1, C2, C4, upper leg and arm, and lower leg and arm
T1, T2, L3, L4, S2 and S3 - retroposterolateral group supplies the muscles of the hand and foot
 nucleus of the hypoglossal - spinal border cells- multipolar neurons found along the lateral and medial borders
nerve in the medulla of the anterior gray horn in the thoracic, lumbar and sacral segments of the spinal
appears to be a rostral cord
continuation of this column - nucleus pericornualis anterior- formed by the border cells and are considered to
o medial motor cell column contribute fibers to the anterior spinocerebellar tract
innervates the short and long - neurons in the most ventral portion of the anterior horn between the medial and
muscles attached to the axial lateral cell columns in cervical segments C3, C4, and C5 giver rise to axons which
skeleton form the phrenic nerve
- Nucleus of Omuf- formed by neurons embedded in a tract of unmyelinated fibers
in the most ventral part of the sacral spinal cord
o Axons emerging from this nucleus contribute to the pudendal nerve
o supply muscles in the pelvic floor, including striated muscle sphincters
that contribute to urinary and fecal incontinence
o contributes fibers to the ischiocavernous and bulbospongiosus muscles,
and contains more neurons in men than in women

Visceral Efferent Neurons

- axons pass by way of the ventral roots and white rami communicantes to the various sympathetic ganglia
- small ovoid or spindle-shaped cells with thin, short dendrites, vesicular nuclei, and fine chromophilic bodies

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 - range in size from 12 to 45μ m
- SUBDIVISIONS:
INTERMEDIOLATERAL NUCLEUS
- located in Rexerd’s lamina VII and consists of several
adjacent cell columns
- most lateral apical cell groups constitutes the lateral horn,
which is characteristic of thoracic levels
- nucleus begins in the lower portion of C8 and extends
caudally through L2 or L3
- cell bodies are either spindle-shaped or ovoid with vesicular
nuclei and fine Nissl granules
- axons of neurons in the intermediolateral nucleus leave the
cord in the ventral roots of spinal nerves T1 and L3 to reach
the ganglionated sympathetic chain or in more peripheral
ganglia, along the aorta via the white rami communicantes
SACRAL AUTONOMIC NUCLEI
- scattered small neurons found along the lateral
surface at the base of the anterior gray horn in sacral
segments S2, S3 and S4
- bear a striking resemblance to those found in the
intermediolateral nucleus and occupy a corresponding
position in the lateral part of lamina Vii
- no lateral horn is present
- axons leave the cord in the corresponding ventral
roots as preganglionic (sacral) parasympathetic fibers
that form the pelvic nerves have multiple synapses
with many postganglionic vells located in or near the
wall of the pelvic viscera

Posterior Horn
- composed of neurons that belong to laminae I to VI
- neurons and their processes are confined entirely to the central nervous system
- receive collaterals or direct terminations of dorsal root fibers  send axons to either directly to anterior horn cells of the
same segments or to the white matter  bifurcated become ascending and descending longitudinal fibers  forms
intersegmental tracts of varying length
- cells vary in size, form and internal structure (organized to cell groups or scattered irregularly in the gray matter
- CELL GROUPS:
POSTEROMARGINAL NUCLEUS SUBSTANTIA GELATINOSA PROPER SENSORY NUCLEUS
- situated in lamina I - forms the outer cap-like - occupies the head and neck of the posterior
- forms a thin layer of cells covering portion of the head of the horn
the tip of the posterior (dorsal) horn posterior horn - corresponds to Rexed’s lamina III and IV
- Composed of large, tangentially - present at all spinal levels and - round or spindle-shaped cells predominates
arranged stellate or spindle-shaped is best developed in the dorsally and is oriented vertically
cells reaching a diameter of over 50 enlargements and in the first - in deeper parts, nucleus, round, triangular
μm two cervical spinal segments and polygonal cells with abundant Nissl
- Receive axons of primary afferent - corresponds to Rexed’s lamina substance are conspicuous
fibers conveying impulses related to II - dendrites radiate into the substantia
nociceptive and thermal stimuli and - nucleus is composed of tightly gelatinosa where they make synaptic
axons from cells in the substantia packed, spindle-shaped cells contact with primary afferent fibers
gelatinosa oriented radially that give rise - axons of larger cells cross in the anterior
- Axons contribute fibers to the o rich dendritic arborizations white commisure and contribute fibers to
contralateral spinothalamic tract - afferent fibers project to the the spinothalamic tract
and give rise to descending substantia gelatinosa in a - found at all spinal levels but are most
propriospinal projections that may radial fashion from the numerous in lumbosacral segments
influence motor neurons dorsolateral fasiculus, the - lateral to the nucleus proprius the reticular
- Found throughout the cord, and are posterior funiculus and parts of process of the posterior horn protrudes
most numerous in the lumbosacral the lateral funiculus finger-like extensions into the lateral
segments funiculus
- cells of this process are part of lamin V and
are called reticular nucleus
- most evident in cervical spinal segments

Intermediate Gray Zone

- belong to Rexed’s Lamina VII
- neurons & their processes are confined to central nervous system & receive collaterals or direct terminations of dorsal
root fibers
- form several distinct nuclear masses:
INTERMEDIOLATERAL
NUCLEUS
Described under Visceral Efferent Neurons
SACRAL AUTONOMIC
NUCLEUS
DORSAL NUCLEUS OF - forms a prominent round or oval cell column in the medial part of lamina VII
CLARK - extends throughout thoracic and upper lumbar segments
- begins to be well-defined in C8 and extends through the thoracic and upper lumbar
segments
- most prominent in T10, T12, L1
- Below L3 it becomes indistinguishable
- Large cells of the dorsal nucleus gives rise to the uncrossed fibers of the posterior
spinocerebellar tract
INTERMEDIOMEDIAL - extends virtually the entire length of the spinal cord
NUCLEUS - not as sharply outlined as the intermediolateral nucleus occupying the lateral horn
- consists of a group of small and medium-sized cells 10-24µm in size, with a triangular
shape that lie in the most medial part of lamina VII, lateral to the central canal

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 - receives a small number of fibers from the dorsal root at ll levels
- may receive visceral afferent fibers and serve as an intermediary relay in transmission
of impulses to visceral motor neurons
CENTRAL CERVICAL - located in the upper four cervical spinal segments
NUCLEUS - forms an interrupted cell column consisting of a series of discrete cell groups
- Cells:
o are fairly large, polygonal in shape and resemble motor neurons
o lie lateral to the intermediomedial nucleus
o receive direct projections from dorsal root ganglion cells and give rise to a
crossed cerebellar tract
- cell columns extending the length of the cord:
o nuclei cornucommissurales posterior
 thin strip of cells occupying the medial margin of the posterior horn
and extending along the border of the posterior gray commissure
 lies over the column of Clarke when the anterior is present
o nuclei cornucommissurales anterior
 is a similar cell group along the medial surface of the anterior horn
consist of small- and medium-sized spindle-shaped cells whose axons
probably form intersegmental tract in the posterior and anterior white
funiculi, respectively

Primary Afferent Fibers

- central processes of cells in the spinal ganglia enter the dorsolateral aspect of the spinal cord  dorsal roots break up
into a number of filaments, or rootlets  enter the spinal cord in a linear manner  divide into ascending and descending
branches  gives rise to numerous collaterals  primary ascending and descending branches extending into adjacent
spinal cord segments + collaterals  form anatomic basis of intersegmental reflexes (relay impulse to secondary sensory
pathway
- peripheral processes of spinal ganglion cells convey impulses centrally from various somatic and visceral receptors
- large fibers, shifting medially in the rootlets, enter posterior (dorsal) columns directly or traverse medial parts of
posterior horn
- medial bundle – thick myelinated fibers describes as representing the central processes of spinal ganglion cells conveying
impulses from large encapsulated somatic receptors such as meuromuscular spindle, neurotendinous organs,
Pacinian corpuscles and Meissner’s corpuscles
- lateral bundle - smaller, less conspicuous and composed of thinly myelinated fibers, is described as representing the
central processes of smaller ganglion cells related to free nerve endings tactile, thermal and other somatic and
visceral receptors
- Fine thinly myelinated and unmyelinated fibers of the lateral bundle of the dorsal root, conveying impulses related to
pain, thermal, and light tactile sense enter the medial part of the zone of Lissauer (fasciculus dorsolateralis)  terminate
directly in portions of laminae I and II
- Lamina I and II receive direct projection from cutaneous nociceptors, but have no direct input from cutaneous receptors
responding to innocuous stimuli
- Primary afferent fibers terminating in the inner zone of lamina II are a mixture of fine and small myelinated fibers related
physiologically to innocuous mechanoreceptive neurons

Zone of Lissauer
- composed of:
o fine myelinated and unmyelinated dorsal root fibers – enter medial parts of the bundle
o a large number of endogenous propriospinal fibers – interconnect different levels of the substantia gelatinosa
- Regarded as a modulator of synaptic transmission from primary to secondary sensory neurons
- Most of the primary afferent fibers entering lamina III and IV are intermediate o thick fibers that pass through or around
lamina II and, after a recurving course in the gray matter, approach cells in the proper sensory nucleus from a ventral
direction
- Primary afferent fibers largely terminate on dendrites of these neurons

Other Termination
- one of the principal sites of termination of large myelinated dorsal root fibers is the dorsal nucleus of Clarke
o receive fibers from all ipsilateral spinal roots except the upper cervical roots
o studies of dorsal root afferents to Clarke’s nucleus indicate:
 the greatest number of fibers come from dorsal roots of the hindlimb
 there is considerable overlap of different dorsal root fibers distributed to the nucleus
 fibers enter the nucleus via both ascending and descending collateral branches of the dorsal root
o Synapses: terminal fibers have long parallel contact with the dendrites of Clarke’s neurons, and usually large
terminal boutons are partially buried in depressions on the cell surface
 Giant synapses between dorsal nucleus are said to be larger than any other spinal cord synapses
o Dorsal root fibers become concentrated especially in the central part of lamina VI, and from this region fibers
pass in numerous small bundles into lamina IX where they arborize about the soma and dendrites of large motor
neurons
o Also give off collaterals which pass into lamina VIII
o Dorsal root fibers from group Ia afferent fibers projecting to lamina IX are involved in the monosynaptic myotatic
reflex

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 o Group Ib and group II afferent fibers also generate synaptic potentials in central part of laminae V, VI, VII

SPINAL NERVES AND PERIPHERAL INNERVATION fibers (see below)

PERIPHERAL NERVOUS SYSTEM -thicker -approximately 28% of
- Comprises cerebrospinal and autonomic groups of -size varies with axons in ventral root are
nerves as well as their associated ganglia (and respective ganglia UNMYELINATED
cellular and connective tissue elements which -first cervical and first -small number of
ensheathe them) coccygeal  exceptions myelinated sensory
- Peripheral to pial envelope through which central in that the dorsal root fibers
and peripheral nervous fibers are continuous at fibers are absent in many
many points individuals
Somatic division Autonomic division -about 2/3 of the afferent
sensory neurons of dorsal sensorimotor system for the fibers are
root and cranial ganglia viscera, smooth muscles, UNMYELINATED
that innervate skin, exocrine glands - Physiological classification of peripheral nerves
muscles, and joints and (dorsal root):
provide sensory A fiber C fiber
information about the Large afferent fibers which Small, unmyelinated, slow
environment outside the conduct rapidly conducting sensory fibers
body of dorsal roots
larger myelinated fibers  Smaller myelinated fibers 
Axons of somatic motor 3 spatially segregated convey sensory impulses to convey sensory information
neurons (cell bodies lie components: the spinal cord from to the cord from less
within CNS)  innervate 1. Sympathetic system elaborate receptors in specialized receptros and
skeletal muscles act in concert to maintain dermis, subcutaneous from free nerve endings in
homeostasis connective tissue, muscles, the kin, viscera, muscles,
2. Parasympathetic system tendons, joint capsules, and connective tissues of
3. Enteric nervous system - ligaments, periosteum, the body
exerts a local action to deep fascia
control activity of smooth - Physiological classification of ventral root nerves:
muscles at the level of GIT α fiber γ fiber B fibers
(gamma-
SPINAL NERVE efferents)
 General organization Enters Smaller, -Found only in ventral
- mixed spinal nerve/ common nerve trunk: unity of dorsal peripheral myelinated roots of spinal nerves T1
and ventral roots distal to ganglion and emerge from the nerve and fibers  arise to L2 and S2 to S4
intervertebral foramen  contains both sensory – supplies from smaller (parasympathetic)
afferent and motor – efferent fibers motor multipolar -Myelinated fibers are
- 31 pairs of segmentally arranged spinal nerves: impulses to neurons preganglionic axons of
1. Cervical = 8 a variable scattered visceral motor neurons
- 1st cervical nerve = suboccipital nerve  emerges number of among larger (general visceral
from vertebral canal between the atlas and occipital EXTRAFUSA cells of efferent) located in
bone L SKELETAL anterior gray intermediolateral cell
- 8th cervical nerve  emerges from intervertebral MUSCLE horn  column of the spinal
foramen between C7 & T1 FIBERS innervate cord
2. Thoracic = 12 INTRAFUSAL -Conduct more slowly
3. Lumbar = 5 SKELETAL and oncerned with
4. Sacral = 5 MUSCLE visceral reflexes
5. Coccygeal = 1 FIBERS of
- Spinal nerves emerge from the intervertebral neuromuscular
foramina caudal to the vertebrae of corresponding spindle
number Preganglionic visceral
- Arises from a region of spinal cord by 2 roots: efferent fibers (T1 to L2)
Dorsal sensory – afferent Ventral motor – efferent  leave ventral root to
root root enter the ganglia of the
>traverse the dural sac  penetrate the dura  reach sympathetic trunk
intervertebral foramen (where dorsal root sell into the through a WHITE
spinal ganglion that contains the cell bodies of origin COMMUNICATING
of sensory afferent fibers RAMUS

-Contain most fibers that -major portion composed SPINAL GANGLIA

convey somatic and of myelinated axons - Cell bodies of almost all sensory – afferent fibers
visceral sensory -vast majority are axons both somatic and visceral
information to CNS of large anterior horn - Aggregations of unipolar nerve cells  form spindle
-fibers are central cells  general somatic – shaped swellings on the dorsal roots  (aka)
processes of dorsal efferent (GSE) of spinal DORSAL ROOT GANGLIA  located in intervertebral
ganglion cells cord foramina immediately lateral to sites where the
-physiological division of -conduct rapidly and nerve roots perforate the dura mater
nerves (see below) have functional - C1 & C2 ganglia: lie on vertebral arches of the atlas
properties similar to A and axis

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 - C1: missing in some individuals -posterior Larger  Small nerve Connects
- Sacral nerves: inside the vertebral canal primary rami ventrolatera trunk which the common
- Coccygeal nerve: within dura mater -Supplies l portion of arises as spinal trunk
- Each surrounded by connective tissue capsule deep the body several with
continuous with epineurium of spinal nerve muscles and wall and all twigs from sympathetic
- Cells have peripheral location beneath the capsule skin of the the common ganglia and
 nerve fibers entering and leaving the ganglia form back extremities trunk and consists of
the core as well as ramus white and
- Trigeminal ganglion: cells and fibers more loosely superficial communica gray
arranged muscles of ns portions
- Dorsal root ganglia: interneural spaces contain the back
large and small axons, satellite cells, Schwann -branch repeatedly and Reenters White ramus
cells, and blood vessels become progressively intervertebr – myelinated
- Derived from NEURAL CREST smaller as they extend al foramen preganglioni
- Typical UNIPOLAR NEURONS whose cell body is peripherally  break up to supply c fibers
ovoid or spherical and often has indentations on its into individual nerve fibers meninges, passing
surface  terminate in receptors or blood from spinal
o Sensory neurons – less prominent Nissl effectors vessels, and cord to
bodies and scattered cytoplasmic -divide into: vertebral sympathetic
chromatin  each cell with variable 1. superficial (cutaneous) column ganglion
number of satellite cells peripheral nerves – mainly -also
o Unipolar ganglion cells  give rise to single sensory fibers of various contain
process (DENDROAXONAL PROCESS)  size afferent
bifurcates at a T – junction  peripheral -also contain efferent fibers from
and central branch  junction occurs at vasomotor, pilomotor, and the viscera
node of Ranvier (myelinated fibers) secretory fibers for blood whose cell
o Glomerular segment/ initial glomerulus – vessels, hair, and glands of bodies
proximal portion of the process which the skin situated in
follows a highly convoluted course 2. deep (muscular) spinal
o Peripheral process  terminates in a peripheral nerves ganglia
sensory ending (morphologic and -mixture of sensory and
physiologic characteristics of a peripheral motor fibers
axon) -somatic α & γ efferent
- 2 types of ganglion cells: fibers go to skeletal muscle
Larger cells Smaller cells fibers
Lighter – appearance Appear dark (obscure cells) -large (A) and small afferent
depended on amount of fibers pass centrally from
cytoplasmic neurofilaments receptors in the
-Angular and indented surface margins of perikaryon  neuromuscular spindles
represent interdigitations with the processes of and tendon organs
surrounding satellite cells -small pain afferents and
-numerous processes divide repeatedly or terminate as postganglionic vasomotor
elaborate end bulbs within capsule (C) fibers to the blood
- Satellite cells/ capsular nuclei/ capsular cells/ vessels also found in
amphicytes: derived from NEURAL CREST nerves that enter each
o Form a concentric layer which closely muscle
invests the perikaryon and its unmyelinated Cervical and Gray ramus
axonic coils lumbosacral –
o Round or elongated nuclei more dense than ventral rami unmyelinate
adjacent perikaryon  branch d
o Display plasma membrane redundancy in and postganglio
the form of folds on the surface that faces anastomose nic fibers
the neuron  form several layers and  cervical, which rejoin
interdigitate with surface evaginations of brachial, the dorsal
the perikaryon lumbosacral and ventral
o Outer surface invested with a basal lamina plexuses  rami to be
 continuous with that investing the regrouping distributed
myelin at the first internode of fibers to the body
o Capsule of satellite cells  separates occurs  wall
perikaryon from adjacent ganglionic each of
capillaries  fluid transport mechanisms  peripheral
increase in number after birth  role in nerves
metabolism of the ganglion cells which arise
from the
MIXED NERVE plexus
- Divides into 4 branches or rami after union of dorsal contains
and ventral roots: contribution
Dorsal Ventral Meningeal Ramus s from 2, 3,
ramus ramus ramus communica or 4 ventral
ns rami 

8
 peripheral c. Secondary degeneration of peripheral
nerves nerve fibers to muscle after central or
contain peripheral lesions
fibers which o Majority innervated by 2 or 3, occasionally
come from 4 ventral roots  injury to single ventral
several root  weak a muscle or have no apparent
spinal cord effect
segments o Only very short muscles of trunks and
Thoracic spinal column (e.g. abductor pollicis) –
nerves  formed from single myotomes and retain a
retain their monosegmental innervations  peripheral
segmental projection of fibers from individual spinal
distribution cord segments to specific muscle provides
unlike clue to myotonic origin of skeletal muscle
cervical and o Several muscles may receive fibers from a
lumbosacral single ventral root
ventral rami 2. Sclerotome  axial skeleton
3. Dermatome – a single dorsal root and its
CONNECTIVE TISSUE SHEATHS ganglion of the sensory fibers supplying
Epineurium Perineurium Endoneurium cutaneous area
Thick sheath of Perifascicular Intrafascicular o First outlined by mapping areas of
rather loose sheath which connective tissue cutaneous eruption and hyperalgesia in
connective surrounds which invade the herpes zoster (shingles)  often affects a
tissue which fascicles (fiber bundle  single ganglion
invests parallel bundles formed separates fibers o Most supplied by fibers of 3, occasionally
running nerve from septa into smaller and four dorsal roots  section of one spinal
fibers of each extending from smaller bundles  dorsal root produces virtually no loss in
peripheral nerve epineurium into invests each fiber cutaneous sensibility  greater overlap for
interior)  as delicate tactile sense than for pain and thermal
fascicles tubular membrane sense
repeatedly divide o C2  only spinal root whose section
and join adjacent produces an area of complete anesthesia
fascicles in an o Neither C3 nor branches of trigeminal nerve
interchange of supply cutaneous regions in the back of the
fibers  head
fascicular o No overlap in the areas supplied by three
arrangement divisions of trigeminal nerve
varies greatly at
different levels of - Trunk region: Correspondence between neural and
same nerve body metameres  each spinal nerve supplies the
Blood vessels and endothelial lined musculature and cutaneous area of its own segment
spaces communicate with lymph  dermatomes follow one another consecutively 
channels within smaller fascicles bands encircle the body from midposterior to
Dorsal and ventral roots receive investment of connective midanterior line
tissue as they pass through the pia  reinforcement of
additional connective tissue as roots pass thorugh - Limbs: metameres migrate distally into the limb
arachnoid and dura  dura becomes continuous with buds  arrange themselves parallel to the long axis
epineurium of spinal nerve (ROOT SLEEVE) of the future limb ( and rotation of lower
extremity) consecutive segments arranged about
SEGMENTAL INNERVATION an axial line  C4 dermatome lie adjacent to T2
- Corresponds to general metamerism of the body dermatome  dermatomes C5 through T1 lie in the
- Each pair of spinal nerves innervates symmetrically upper extremity (C5 – C7 preaxial; C8 – T2 postaxial)
arranged paired somites (metamere)  similarly; L2 & S3 lie adjacent posteriorly
- Paraxial mesoderm  embryonic somites 
differentiate into:
1. Myotome  muscle - Special features of dermatomal maps:
o Efferent fibers in ventral roots innervate 1. Nipple: located in region of T4 or T5 dermatome
somatic musculature (myotomes) and some 2. Umbilicus: T9 or T10 dermatome
ventral roots contain preganglionic 3. Inguinal region: L1 dermatome
autonomic fibers  autonomic ganglia  4. Anogenital region: S3 – S5 sacral nerve roots
postganglionic fibers  innervate blood
vessels, smooth muscle, glandular Reflex and Description Locations in
epithelium visceral and spinal cord of
o Dorsal roots contain most afferent fibers motor activities anterior horn
(somatic and visceral) cells
o Segmental innervations worked out by: Movements of C1 – C4
a. Selective stimulation of ventral roots the head
b. Pathologic changes which occur in Movements of C3 – C5
anterior horn cells when ventral root or the diaphragm
motor nerve is cut Movements of C5 – T1

9
 upper extremity
Biceps tendon Flexion of forearm C5 – C6
reflex on percussion of
biceps tendon
Triceps tendon Extension of C6 – C8
reflex forearm on
percussion of
triceps tendon
Radial periosteal Flexion of forearm C7 – C8
reflex on percussion of
distal radius
Wrist tendon Flexion of fingers C8 – T1
reflexes on percussion of
wrist tenons
Movements of T1 – T12
the trunk
Abdominal Ipsilateral
superficial contraction of
reflexes subjacent T6 – T7
abdominal muscles T8 – T9
on stroking the skin T10 – T12
of the:
Upper abdomen
(epigastric)
Middle
lower
Movements of L1 – S2
the lower
extremity
Cremasteric Elevation of T12 – L2
superficial reflex scrotum on stroking
skin on the inner
aspect of the thigh
Genital center for Smooth muscle: L1 – L2
ejaculation Skeletal muscle: S3 – S4
Vesical center T12 – L2
for retention of
urine
Patellar tendon Extension of leg on L2 – L4
reflex or knee percussion of
jerk patellar ligament
Gluteal Contraction of L4 – S1
superficial reflex glutei on stroking
skin over glutei
Plantar Flexion of toes on L5 – S2
superficial reflex stroking sole of foot
Achilles tendon Plantar flexion of L5 – S2
reflex or ankle foot on percussion
jerk of Achilles
Genital center of S2 – S4
erection
Vesical center S3 – S5
for evacuation of
bladder
Bulbocavernosus Contraction of S3 – S4
reflex bulbocavernosus
muscle on pinching
penis
Anal reflex Contraction of S4 – S5 and
external rectal coccygeal
sphincter on
stroking perianal
region

PERIPHERAL INNERVATION

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 Dorsal rami Ventral rami
-intermixing and anastomosing of adjacent nerve trunks
before reaching peripheral terminations
-primary dorsal rami remain -form more elaborate
relatively distinct but connections
interconnections common in -except for THORACIC
cervical and sacral regions NERVES (retain segmental
distribution)
-cutaneous areas supplied
by peripheral nerves do not -cervical and lumbosacral
correspond with cutaneous rami innervates
areas supplied by individual extremities  anastomose
dorsal roots (dermatomes) and branch  plexuses 
radical regrouping of
fibers occurs  peripheral
nerves contains fibers
contributed by 2 – 5
ventral rami

-Innervate intrinsic dorsal -supply ventrolateral

muscles of the back and muscles and skin of the
neck and overlying skin from trunk as well as
vertex to coccyx extremities

-middle of the back:

cutaneous area roughly
corresponds to that of
underlying muscles

-upper and lower portions of

trunk: widens laterally to
reach the acromial region
above and region of greater
trochanter below

-typical segmental
distribution with the field of
each overlapping with that
of adjacent segments above
and below (with certain
exceptions)
-each ramus divides: (both
contain sensory and motor
fibers)
1. medial branch
2. lateral branch – branches
of cervical rami are purely
MOTOR
1st or suboccipital nerve:
purely motor and terminates
in short posterior muscles of
the head (rectus capitis and
obliquus capitis)

2nd cervical ramus: greater

occipital nerve (main
branch)  ascends to region
of superior nuchal line 
beomces subcutaneous 
supplies scalp on the back
of the head to the vertex 
extending as far as coronal
suture  joined by a
filament from the 3rd cervical
ramus

Lateral branches of upper 3

lumbar and upper 3 sacral
rami  cutaneous twigs 
supply upper part of gluteal

11
area  extends laterally to
region of great trochanter 
SUPERIOR (LUMBAR) &
MEDIAL (SACRAL) CLUNIAL
NERVES

12