Spinal Cord

Dr Ganesh Khemnar
Assistant Professor
Dept. of Anatomy
BVDUMC,Pune
 Functions
• The spinal cord with its 31 pairs of spinal
nerves serves two important functions.
• It is the connecting link between the brain and
most of the body.
• It is involved in spinal reflex actions, both
somatic and visceral.
 Basic Anatomy of the Spinal Cord
• The spinal cord extends caudally from the brain for about 45 cm and
has a width of ~14 mm. Its upper end is continuous with the brain
(medulla oblongata). The cord is slightly thicker than a pencil.
• There are 31 pairs of spinal nerves:8 cervical, 12 thoracic, 5 lumbar,
5 sacral, and coccygeal. The roots of the lumbar and sacral are
called cauda equina.
• Surrounding and protecting the spinal cord is the vertebral
column.
• The spinal cord is slightly flattened dorsally and ventrally,
with two enlargements-cervical and lumbosacral from
which the spinal nerves emerge that innervate the upper
and lower limbs.
Spinal Cord
 Basic Anatomy of the Spinal Cord
• The cervical enlargement supplies nerves to
the pectoral girdle and upper limbs.
• The lumbar enlargement supplies nerves to
the pelvis and lower limbs.
• Inferior to the lumbar enlargement, the spinal
cord becomes tapered and conical-conus
medullaris.
• Filum terminale-slender strand of fibrous
tissue that extends from conus medullaris.
 Spinal Nerves
• There are 8 cervical nerves(C), 12 thoracic(T), 5 lumbar (L), 5
sacral (S), and 1 coccygeal (Co).
• Each pair of spinal nerves passes through a pair of
intervertebral foramina located between two successive
vertebrae. Each spinal nerve caudal to the first thoracic
vertebra takes its name from the vertebra immediately
preceding it.
• The nerves are then distributed to a specific pair of segments
of the body.
• The spinal cord and the roots of its nerves are protected by
the vertebral column, its ligaments, spinal meninges and
cerebrospinal fluid.
Meninges
 Spinal Meninges
• The outer layer is called dura mater. This is a tough,
fibrous memebrane that merges with the filum
terminale.
• The middle layer, the arachnoid, runs caudally to the
S2 vertebral level. This is delicate and transparent.
• The innermost is called, pia mater. It is highly
vascular and tightly attached to the spinal cord and
its roots.
• Meningitis-bacterial or viral infection.
 Spinal Meninges
• Between the dura mater and periosteum of the
vertebrae is the epidural space that contains many
blood vessels and fat.
• Anesthetics can be injected here below the L3
vertebral level, from which it ascends to act upon
sensory neurons to help dull pain. This procedure is
called caudal block.(epidural block)
• Space between dura mater and archnoid-subdural
space-no CSF.
• Space between arachnoid and pia mater-subarchnoid
space-CSF, blood vessels, spinal roots.
Fig 14.2a The Spinal Cord and Spinal Meninges
 Fig 14.1 Gross Anatomy of the Spinal Cord
Copyright © 2009 Pearson Education, Inc., publishing as Pearson Benjamin Cummings
 Fig 14.2d The Spinal Cord and Spinal Meninges
Copyright © 2009 Pearson Education, Inc., publishing as Pearson Benjamin Cummings
Fig 14.3 Posterior View of Vertebral Column and Spinal Nerves
 • Anterior median fissure and posterior
Cross Section median sulcus
– deep clefts partially separating left and
right halves
of Spinal Cord • Gray matter: neuron cell bodies,
dendrites, axons
– Divided into horns
• Posterior (dorsal) horn
• Anterior (ventral) horn
• Lateral horn
• White matter
– Myelinated axons
– Divided into three columns (funiculi)
• Ventral
• Dorsal
• lateral
– Each of these divided into sensory or
motor tracts
 Cross section of Spinal Cord
• Commissures: connections between left
and right halves
– Gray with central canal in the center
– White
• Roots
– Spinal nerves arise as rootlets then
combine to form dorsal and ventral
roots
– Dorsal and ventral roots merge
laterally and form the spinal nerve
Gray Matter: Organization
 White Matter in the Spinal Cord

• Divided into three funiculi (columns) – posterior, lateral, and

anterior
– Columns contain 3 different types of fibers (Ascend., Descend., Trans.)
• Fibers run in three directions
– Ascending fibers - compose the sensory tracts
– Descending fibers - compose the motor tracts
– Commissural (transverse) fibers - connect opposite sides of cord
 White Matter
Fiber Tract Generalizations
• Pathways decussate (most)
• Most consist of a chain of two or three
neurons
• Most exhibit somatotopy (precise spatial
relationships)
• All pathways are paired
– one on each side of the spinal cord
White Matter: Pathway Generalizations
 Descending (Motor) Pathways
• Descending tracts deliver motor
instructions from the brain to the spinal
cord
• Divided into two groups
– Pyramidal, or corticospinal, tracts
– Indirect pathways, essentially all others
• Motor pathways involve two neurons
– Upper motor neuron (UMN)
– Lower motor neuron (LMN)
 Pyramidal (Corticospinal) Tracts
• Originate in the precentral gyrus of brain (primary motor area)
– I.e., cell body of the UMN located in precentral gyrus
• Pyramidal neuron is the UMN
– Its axon forms the corticospinal tract
• UMN synapses in the anterior horn with LMN
– Some UMN decussate in pyramids = Lateral corticospinal tracts
– Others decussate at other levels of s.c. = Anterior corticospinal tracts
• LMN (anterior horn motor neurons)
– Exits spinal cord via anterior root
– Activates skeletal muscles
• Regulates fast and fine (skilled) movements
 Corticospinal
tracts

1. Location of UMN cell

body in cerebral cortex
2. Decussation of UMN
axon in pyramids or at
level of exit of LMN
3. Synapse of UMN and
LMN occurs in anterior
horn of s.c.
4. LMN axon exits via
anterior root
 Extrapyramidal Motor Tracts
• Includes all motor pathways not part of the pyramidal system
• Upper motor neuron (UMN) originates in nuclei deep in cerebrum (not in
cerebral cortex)
• UMN does not pass through the pyramids!
• LMN is an anterior horn motor neuron
• This system includes
– Rubrospinal
– Vestibulospinal
– Reticulospinal
– Tectospinal tracts
• Regulate:
– Axial muscles that maintain balance and posture
– Muscles controlling coarse movements of the proximal portions of limbs
– Head, neck, and eye movement
 Extrapyramidal
Tract

Note:
1. UMN cell body location
2. UMN axon decussates in pons
3. Synapse between UMN and LMN
occurs in anterior horn of sc
3. LMN exits via ventral root
4. LMN axon stimulates skeletal
muscle
 Extrapyramidal (Multineuronal) Pathways

• Reticulospinal tracts – originates at reticular formation of brain;

maintain balance
• Rubrospinal tracts – originate in ‘red nucleus’ of midbrain;
control flexor muscles
• Tectospinal tracts - originate in superior colliculi and mediate
head and eye movements towards visual targets (flash of light)
 Main Ascending Pathways
• The central processes of first-order neurons branch diffusely
as they enter the spinal cord and medulla
• Some branches take part in spinal cord reflexes
• Others synapse with second-order neurons in the cord and
medullary nuclei
 Three Ascending Pathways

• The nonspecific and specific ascending pathways

send impulses to the sensory cortex
– These pathways are responsible for discriminative touch
(2 pt. discrimination) and conscious proprioception (body
position sense).
• The spinocerebellar tracts send impulses to the
cerebellum and do not contribute to sensory
perception
 Ascending Pathway
• Include the lateral and anterior
spinothalamic tracts
• Lateral: transmits impulses
concerned with pain and temp.
to opposite side of brain
• Anterior: transmits impulses
concerned with crude touch and
pressure to opposite side of brain
• 1st order neuron: sensory neuron
• 2nd order neuron: interneurons
of dorsal horn; synapse with 3rd
order neuron in thalamus
• 3rd order neuron: carry impulse
from thalamus to postcentral
gyrus
 Specific and Posterior Spinocerebellar Tracts
• Dorsal Column Tract
1. Medial lemniscal pathway
2. Fibers run only in dorsal column
3. Transmit impulses from receptors in
skin and joints
4. Detect discriminative touch and
body position sense =proprioception
• 1st order neuron - a sensory neuron
• synapses with 2nd order neuron in
nucleus gracilis and nucleus
cuneatus of medulla
• 2nd order neuron.- an interneuron
• decussate and ascend to thalamus
where it synapses with 3rd order
neuron
• 3rd-order (thalamic neurons)
•transmits impulse to somato-
sensory cortex (postcentral gyrus)
Spinocerebellar Tract
• Transmit info. about trunk and lower
limb muscles and tendons to cerebellum
• No conscious sensation
 Cerebral arterial circle ( circle of Willis )
• Formation: formed by anterior
communicating artery, both
anterior cerebral arteries,
internal carotid arteries,
posterior communicating
arteries, and posterior
cerebral arteries
• Position: lies on sella turcica
around optic chiasma, tuber
cinereum and mamillary
bodies
 Blood vessels of spinal cord
Arteries of spinal cord
Two sources
◦ Anterior and posterior spinal
arteries
◦ Branches of segmental
arteries: radicular arteries of
posterior intercostals arteries,
lumbar arteries, and lateral
sacral arteries
vascular ring ( vasocorona )
 Blood vessels of spinal cord
Spinal veins: drain into internal vertebral venous plexus
 Spinal Cord Trauma and Disorders

• Severe damage to ventral root results in flaccid paralysis (limp and unresponsive)
• Skeletal muscles cannot move either voluntarily or involuntarily
• Without stimulation, muscles atrophy.
• When only UMN of primary motor cortex is damaged
• spastic paralysis occurs - muscles affected by persistent spasms and
exaggerated tendon reflexes
• Muscles remain healthy longer but their movements are no longer
subject to voluntary control.
• Muscles commonly become permanently shortened.
• Transection (cross sectioning) at any level results in total motor and
sensory loss in body regions inferior to site of damage.
• If injury in cervical region, all four limbs affected (quadriplegia)
• If injury between T1 and L1, only lower limbs affected (paraplegia)
 Spinal Cord Trauma and Disorders
• Spinal shock - transient period of functional loss that follows the injury
• Results in immediate depression of all reflex activity caudal to lesion.
• Bowel and bladder reflexes stop, blood pressure falls, and all muscles
(somatic and visceral) below the injury are paralyzed and insensitive.
• Neural function usually returns within a few hours following injury
• If function does not resume within 48 hrs, paralysis is permanent.
• Amyotrophic Lateral Sclerosis (aka, Lou Gehrig’s disease)
• Progressive destruction of anterior horn motor neurons and fibers of the
pyramidal tracts
• Lose ability to speak, swallow, breathe.
• Death within 5 yrs
• Cause unknown (90%); others have high glutamate levels
• Poliomyelitis
• Virus destroys anterior horn motor neurons
• Victims die from paralysis of respiratory muscles
• Virus enters body in feces-contaminated water (public swimming pools)
 2 Primary Systems
Dorsal column-Medial
Corticospinal Tract
Lemniscal System
Dorsal Column (SC) -Medial Lemniscal (brain stem) System

• 1° sensory function – brings info from

sensory receptors in the periphery all the
way to the 1° somatic sensory cortex.
• Refer to the postcentral gyrus of parietal
lobe!
• Via the SC, brainstem, and thalamus.
• A 3-neuron-circuit (sites of synaptic
contact):
Dorsal Column (SC) -Medial Lemniscal (brain stem) System

i. DRG cells – bipolar (pseudounipolar) neurons receive

info from peripheral sensory receptors and bring it to SC
and bs, where the info is 1st processed (through dorsal
column). *synapse at relay nucleus in medulla: dorsal
column nucleus.
ii. Axons of these neurons from the dorsal column nucleus
cross over (decussate) here at the medulla and
continue as the medial lemniscus  thalamus.
iii. These next thalamic neurons send their axons into the
internal capsule (white mattter underlying the cortex)
 synapse at 1° somatic sensory cortex.
 Corticospinal Tract
• This pathway serves a 1° motor function –
bringing information down from the
primary motor cortex (where?) all the way
down to skeletal muscle in the periphery
(activating muscle contraction).
• This pathway contains only 1 synapse
(unlike the DCML system, which contains
__ (how many)?
 Corticospinal Tract
i. 1° motor cortical neuron (pre-central
gyrus of the frontal lobe)  internal
capsule  ventral surface of midbrain 
pyramids on ventral surface of medulla.
These axons decussate at caudal medulla and
travel in the lateral column of the SC 
synapse at motor neurons in the ventral
horn  these axons travel to the spinal
nerve (through ventral nerve roots)  to
synapse at the muscles.
 Overview of SC Anatomy –as it relates to
these systems
• Gray matter:
- dorsal (sensory) and ventral (motor) horns.
- intermediate zone – integration of sensory and motor
functions (inter-neurons, reflexes), which serve direct
spinal reflexes.
• White matter:
- nerve tracts (myelin)
- dorsal column (contains dorsal column)
- lateral column (contains motor descending axons)
- ventral column (will discuss later).
Many of the CNS slices we will view, such as this next slide,
are myelin-stained – so white mater appears dark.
Central canal – lowest component of ventricular system
Myelin-Stained Spinal Cord Sect.