The Spinal Cord, Spinal Reflexes

and Muscle Control

Dr Katia Mahn
[email protected]
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 The spinal cord

➢ 43-45 cm long
➢ 35 g

➢ 13.5 million neurons

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Protective structures

The vertebral column

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Spinal column

7 Cervical

12 Thoracic

5 Lumbar

5 Sacrum
Fused
4 Coccyx 5
Atlas (topmost
vertebra) and axis
form a joint
connecting the
skull and spine.

Atlas and axis are

specialized to
allow a greater
range of motion
than other
vertebrae.

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Lordosis (also, swayback) excessive anterior curvature of the lumbar vertebral column region
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Protective structures

The meninges

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External anatomy

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 Spinal Cord

Begins at the occipital

bone

Ends as cauda equina

at vertebral junction
L1/L2

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 Spinal Cord
Cervical enlargement
4th cervical vertebra to
the 1st
thoracic vertebra

Lumbar enlargement
T9 to L1

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 Spinal Cord

Cauda equina
The collection of
nerve roots at the
inferior end of the
vertebral canal

Spinal cord proper ends

anywhere between L3 and T12

Q.1 What is cauda equina syndrome?

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Internal anatomy

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 Spinal Cord – Grey Matter
➢ Projections of grey matter
- Dorsal horns (posterior horn) – interneurons
- Ventral horns (anterior horn) – somatic efferents
- Lateral horns are part of ANS (sympathetic branch)

Dorsal root Dorsal Horn

ganglion (DRG)

Lateral horn
Ventral Horn
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Spinal Cord Internal Anatomy

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Not all tracts are shown!

Simplified

Mixed
nerve

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A Spinal Reflex

Afferent cell body is in

DRG !!

This reflex arc is bi- or disynaptic. 23

Spinal nerves

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 Spinal Cord
31 pairs of spinal nerves:

• 8 cervical nerves

• 12 thoracic nerves

• 5 lumbar nerves

• 5 sacral nerves

• 1 coccygeal nerve 25
 2 breakout groups: myotomes and dermatomes.

Talk us through the human myotomes and dermatomes.

(Map and clinical significance; you may watch a dance

video to help)

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 Ganglia

• Neurones can cluster together

• In the brain this is called a nucleus
• In the spinal cord this is called a ganglion
• Many ganglia connected together may form a
plexus – network of intersecting nerves

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 Iliohypogastric nerve
abdominal muscle and skin
Saphenous nerve
sensation in medial leg
Subcostal nerve
gluteal skin, abdominal wall
Pudendal nerve
genitalia, bladder, rectum
Sciatic nerve
skin of leg, muscles: in back of
thigh, lower leg and foot
Femoral nerve
quads, hamstrings
Peroneal nerve
hamstrings, muscles
controlling ankle and foot
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 Spinal Cord - White Matter
• Contains bundles of nerve axons (tracts or fascicles)
• Grouped into 3 pairs of columns (funiculi)
• Allow communication within the CNS
• May be ascending or descending

Ascending = sensory

Descending = motor

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 Spinal Cord - White Matter
Transverse
Commissural fibres - Cross from one side to the other

Longitudinal
White matter is organised into tracts, in three
white columns (funiculi) on each side

dorsal (posterior)

lateral

ventral (anterior)
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Each spinal tract is composed of axons with similar functions
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Not all tracts are shown!
 Descending Pathways and Tracts
Deliver efferent impulses from the brain to the spinal cord

Direct pathways—(pyramidal tracts)

Serve to provide targeted volitional movements
Parkinson’s disease

Indirect pathways— (extrapyramidal tracts)

Prevent unwanted movements
Huntington’s chorea

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Responsible
for targeted
voluntary
movements

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 Motor neurons
synapse onto
skeletal muscle at
the
neuromuscular
junction

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Cerebellum (Located posterior to the pons)

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 Cerebellum- structure and function
• Butterfly-shaped
Vermis
• Two partially separated
hemispheres connected
by vermis (= worm)

• Functions (Fine tuning

and coordination)
i. Coordinating
muscular
movements
ii. Maintaining posture
iii. Maintaining balance
Cerebellar hemispheres 37
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 Medial hemispheres: trunk and Vermis: posture,
proximal limb musculature locomotion, gaze
Lateral hemispheres: planning and
mental rehearsal of complex tasks

Flocculonodular lobe
(vestibulocerebellum):
balance, eye movements

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Maintaining Muscle Length

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Proprioception – Muscle Spindle

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If only extrafusal
muscle
contracted:

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Adaptation /
Habituation

Intrafusal fibres
contract when
extrafusal do – reset
spindle length:

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Physiology of the SC:

Sensory tracts
Motor tracts
Reflexes

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 Ascending Pathways
• Two pathways transmit specific somatosensory
information to the sensory cortex via the
thalamus:
1. Dorsal column-medial lemniscal (DCML) pathway
decussation in medulla oblongata
2. Spinothalamic pathway

Q.3 Spinocerebellar tracts terminate in the … ?

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 Ascending Pathways
Dorsal column-medial lemniscal pathway
• Transmits input to the somatosensory cortex for
discriminative touch and vibrations

Gracile Cuneate
fasciculus fasciculus

Lumbar + sacral Cervical + thoracic

spinal nerves spinal nerves
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 Types of Pain
Fast Pain Slow Pain
• Acute, ‘sharp’, e.g. a pin- • Chronic, more intense, e.g. intense
prick ‘ache’
• Removes part of the • Debilitates the organism to prevent
organism from harm’s way over-activity until injury repairs
to prevent further damage
• Hyperalgesia (↑ sensitivity to
• Like most sensations, fast pain), allodynia (normal stimulus →
pain adapts – pain subsides pain)

A C

myelinated Unmyelinated
axons axons
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 Pathological Pain

Chronic pain:
• Chronic pain is particularly debilitating and can destroy
quality of life
• Often inappropriate: neuropathic pain persists in absence
of tissue damage
•Sometimes after healing the CNS fails to rest itself and
pain persists!
• Like any system, pain can ‘go wrong’ in which case it
serves no useful purpose
• E.g. following an injury, pathways in the CNS ‘rewire’ –
synaptic sensitivity increases so that the injured part is
hypersensitive to pain hyperalgesia 50
 Nociceptors
Q: What do they detect?

Nociceptor activation: the following cause Na+ influx

• Physical distortion of membrane, damage to nociceptor
• Changes in pH
• Chemicals released from damaged cells: K+, ATP, mast cell secretions
(e.g. histamine)
• Substance P: peptide released by damaged nociceptors
• Prostaglandins

Arachidonic acid (cell membranes) → arachidonate

Cyclo-oxygenase (COX)

Prostaglandins51
 Pain! Cerebral cortex

Thalamus
ST pathway
Noxious
Substance P stimulus
Nociceptor
ATP, Prostaglandins Sensitisation Activation Substance P

K+, Bradykinin Serotonin(5HT) Histamine

Damaged Tissue Platelets Mast

Cells

ST = spinothalamic Noxious stimulus 52

 Pain is Vital!
Congenital analgesia:
Some people are born without the ability to sense or perceive pain

Q.4 Why do these people usually die young?

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 Ascending Pathways
Anterolateral Spinothalamic pathways
• Lateral and ventral spinothalamic tracts
• Transmit pain, temp, coarse touch, impulses - lateral pathway
• Light touch and pressure - anterior pathway

Lateral spinothalamic
tract
Ventral spinothalamic
tract

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 Descending Pathways and Tracts
Indirect (extrapyramidal) system
• Axons follow 5 major tracts in spinal cord
• Reticulospinal and vestibulospinal tracts—
maintain balance
Lateral
reticulospinal tract

Medial Vestibulospinal
reticulospinal tract tract 58
 Descending Pathways and Tracts
Indirect (extrapyramidal) system
• Rubrospinal tracts — control flexor muscles (upper
body)
• Superior colliculi and tectospinal tracts mediate
head movements in response to visual stimuli

Rubrospinal tract

Tectospinal tract
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Maintaining Muscle Length

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Posterior column:
➢ Fine touch
➢ Light pressure
➢ Proprioception

Lateral corticospinal tract:

➢ Skilled voluntary movement

Lateral spinothalamic tract:

➢ Pain & temperature sensation

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 Dr Katia Mahn
[email protected]
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