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    Chapter 13: The Spinal Cord, Spinal Nerves, and Spinal Reflexes

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    Ezekiel Arteta
    The spinal cord contains gray matter containing nerve cell bodies and white matter containing nerve fiber tracts. It is protected by three meningeal layers and surrounded by cerebrospinal fluid. 31 pairs of spinal nerves exit the spinal cord, merging with peripheral nerves. Spinal nerves are organized into plexuses innervating different body regions. The spinal cord mediates reflexes through mono- and polysynaptic circuits in the central nervous system.

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    Chapter 13: The Spinal Cord, Spinal Nerves, and Spinal Reflexes

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    Ezekiel Arteta
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    The spinal cord contains gray matter containing nerve cell bodies and white matter containing nerve fiber tracts. It is protected by three meningeal layers and surrounded by cerebrospinal fluid. 31 pairs of spinal nerves exit the spinal cord, merging with peripheral nerves. Spinal nerves are organized into plexuses innervating different body regions. The spinal cord mediates reflexes through mono- and polysynaptic circuits in the central nervous system.

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    Ch 13-Spinal Cord

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    The spinal cord contains gray matter containing nerve cell bodies and white matter containing nerve fiber tracts. It is protected by three meningeal layers and surrounded by cerebrospinal fluid. 31 pairs of spinal nerves exit the spinal cord, merging with peripheral nerves. Spinal nerves are organized into plexuses innervating different body regions. The spinal cord mediates reflexes through mono- and polysynaptic circuits in the central nervous system.

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    613 views43 pages

    Chapter 13: The Spinal Cord, Spinal Nerves, and Spinal Reflexes

    Uploaded by

    Ezekiel Arteta
    The spinal cord contains gray matter containing nerve cell bodies and white matter containing nerve fiber tracts. It is protected by three meningeal layers and surrounded by cerebrospinal fluid. 31 pairs of spinal nerves exit the spinal cord, merging with peripheral nerves. Spinal nerves are organized into plexuses innervating different body regions. The spinal cord mediates reflexes through mono- and polysynaptic circuits in the central nervous system.

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    of 43

    Chapter 13: The Spinal

    Cord, Spinal Nerves,


    and Spinal Reflexes
    The spinal cord
    • Gross anatomy
    – 3 layers of meninges
    – Epidural space (fat & vessels)
    – CSF – subarachnoid space
    – Terminates at L1/2 vertebral level
    (conus medullaris)
    • Dura extends to S2 vertebral
    level
    – Connects via filum terminale &
    denticulate ligaments (pia)
    – 31 pairs of spinal nerves (mixed)
    • cauda equina
    – Cervical & lumbar enlargements
    Lumbar Tap
    Spinal Cord Anatomy
    • Conus medullaris – terminal portion of the spinal cord
    • Filum terminale – fibrous extension of the pia mater; anchors
    the spinal cord to the coccyx
    • Denticulate ligaments – delicate shelves of pia mater; attach
    the spinal cord to the vertebrae
    • Spinal nerves – 31 pairs attach to the cord by paired roots
    – Cervical nerves are named for inferior vertebra
    – All other nerves are named for superior vertebra
    • Cervical and lumbar enlargements – sites where nerves
    serving the upper and lower limbs emerge
    • Cauda equina – collection of nerve roots at the inferior end of
    the vertebral canal
    Cross-Sectional Anatomy of the Spinal Cord
    • Anterior median fissure – separates anterior funiculi
    • Posterior median sulcus – divides posterior funiculi
    The 3 Meningeal Layers
    • Dura mater:
    – outer layer of spinal cord
    – subdural space:
    • between arachnoid mater
    and dura mater
    • Arachnoid mater:
    – middle meningeal layer
    – subarachnoid space:
    • between arachnoid mater
    and pia mater
    • filled with cerebrospinal
    fluid (CSF)
    • Pia mater:
    – inner meningeal layer
    Structures of the Spinal Cord
    • Paired denticulate
    ligaments:
    – extend from pia mater to
    dura mater
    – stabilize side-to-side
    movement
    • Blood vessels:
    – along surface of spinal pia
    mater
    – within subarachnoid space
    Cross-sectional anatomy
    • Gray matter (cell
    bodies, neuroglia, &
    unmyelinated
    processes)
    – Posterior horns (sensory,
    all interneurons)
    – Lateral horns
    (autonomic, T1-L2)
    – Anterior horns (motor,
    cell bodies of somatic
    motor neurons)
    • Spinal roots
    – Ventral (somatic &
    autonomic motor)
    – Dorsal (DRG)
    Cross-sectional anatomy
    • White matter
    – 3 funiculi (posterior, lateral,
    anterior)
    • Ascending, descending,
    transverse
    – Consist of “tracts” containing
    similarly functional axons
    • All tracts are paired
    • Most cross over (decussate)
    at some point
    • Most exhibit somatotopy
    (superior part of the tracts
    are more lateral that
    inferior body regions)
    • Most consist of a chain of 2
    or 3 successive neurons
    Gray Matter: Organization
    • Dorsal half – sensory roots and ganglia
    • Ventral half – motor roots
    • Dorsal and ventral roots fuse laterally to form spinal nerves
    • Four zones are evident within the gray matter – somatic sensory
    (SS), visceral sensory (VS), visceral motor (VM), and somatic
    motor (SM)
    White Matter in the Spinal Cord
    • Fibers run in three directions – ascending, descending,
    and transversely
    • Divided into three funiculi (columns) – posterior,
    lateral, and anterior
    • Each funiculus contains several fiber tracts
    – Fiber tract names reveal their origin and destination
    – Fiber tracts are composed of axons with similar functions
    • Pathways decussate (cross-over)
    • Most consist of two or three neurons
    • Most exhibit somatotopy (precise spatial relationships)
    • Pathways are paired (one on each side of the spinal
    cord or brain)
    White Matter: Pathway Generalizations
    3 Connective Tissue Layers
    • Epineurium:
    – outer layer
    – dense network of collagen
    fibers
    • Perineurium:
    – middle layer
    – divides nerve into fascicles
    (axon bundles)
    • Endoneurium:
    – inner layer
    – surrounds individual axons
    Peripheral Distribution of Spinal Nerves
    • Each spinal nerve
    connects to the spinal
    cord via two medial roots
    • Each root forms a series of
    rootlets that attach to the
    spinal cord
    • Ventral roots arise from
    the anterior horn and
    contain motor (efferent)
    fibers
    • Dorsal roots arise from
    sensory neurons in the
    dorsal root ganglion and
    contain sensory (afferent)
    fibers
    Figure 13–7a
    Spinal Nerves: Rami

    • The short spinal nerves branch into three or


    four mixed, distal rami
    – Small dorsal ramus – to back
    – Larger ventral ramus – to plexuses/intercostals
    – Tiny meningeal branch – to meninges
    – Rami communicantes at the base of the ventral
    rami in the thoracic region – to/from ANS
    Nerve Plexuses
    • All ventral rami except T2-T12 form interlacing nerve
    networks called plexuses
    • Plexuses are found in the cervical, brachial, lumbar,
    and sacral regions
    • Each resulting branch of a plexus contains fibers from
    several spinal nerves
    • Fibers travel to the periphery via several different routes
    • Each muscle receives a nerve supply from more than
    one spinal nerve
    • Damage to one spinal segment cannot completely
    paralyze a muscle
    Spinal Nerve Innervation: Back,
    Anterolateral Thorax, and Abdominal Wall

    • The back is innervated by


    dorsal rami via several
    branches
    • The thorax is innervated
    by ventral rami T1-T12 as
    intercostal nerves
    • Intercostal nerves supply
    muscles of the ribs,
    anterolateral thorax, and
    abdominal wall
    The 4 Major Plexuses of Ventral Rami

    1. Cervical plexus
    2. Brachial plexus
    3. Lumbar plexus
    4. Sacral plexus
    Cervical Plexus
    • The cervical plexus is formed
    by ventral rami of
    C1-C4 (C5)
    • Most branches are cutaneous
    nerves of the neck, ear, back
    of head, and shoulders
    • The most important nerve of
    this plexus is the phrenic
    nerve
    • The phrenic nerve is the
    major motor and sensory
    nerve of the diaphragm
    Brachial Plexus

    • Formed by C5-C8 and T1


    (C4 and T2 may also
    contribute to this plexus)
    • It gives rise to the nerves
    that innervate the upper
    limb
    Trunks and Cords of Brachial Plexus
    • Nerves that form brachial plexus originate from:
    – superior, middle, and inferior trunks
    – large bundles of axons from several spinal nerves
    – lateral, medial, and posterior cords
    – smaller branches that originate at trunks
    Brachial Plexus: Nerves
    • Axillary – innervates the
    deltoid and teres minor
    • Musculocutaneous – sends
    fibers to the biceps brachii
    and brachialis
    • Median – branches to most
    of the flexor muscles of
    forearm
    • Ulnar – supplies the flexor
    carpi ulnaris and part of the
    flexor digitorum profundus
    • Radial – innervates
    essentially all extensor
    muscles
    Lumbar Plexus

    • Arises from (T12) L1-L4


    and innervates the thigh,
    abdominal wall, and
    psoas muscle
    • The major nerves are the
    femoral and the
    obturator
    Sacral Plexus
    • Arises from L4-S4 and
    serves the buttock, lower
    limb, pelvic structures, and
    the perineum
    • The major nerve is the
    sciatic, the longest and
    thickest nerve of the body
    • The sciatic is actually
    composed of two nerves:
    the tibial and the common
    fibular (peroneal) nerves
    Nerve plexuses - Summary

    • Cervical – C1-C4
    – Phrenic nerve
    • Brachial – C5 – T1 (roots/trunks/divisions/cords)
    – Axillary, MC, median, ulnar, radial
    • Lumbar – L1-L4
    – Femoral, obturator
    • Sacral – L4-S4
    – Sciatic (common peroneal/tibial), pudendal
    Dermatomes
    • Area of skin innervated by the
    cutaneous branches of a single
    spinal nerve.
    • All segments except C1 have
    dermotomal distribution
    • UE typically from C5-T1
    • LE typically from L1-S1

    Figure 13–8
    5 Patterns of Neural Circuits in Neuronal Pools

    1. Divergence:
    – spreads
    stimulation to
    many neurons
    or neuronal
    pools in CNS
    2. Convergence:
    – brings input
    from many
    sources to
    single neuron
    Figure 13–13a
    5 Patterns of Neural Circuits in Neuronal Pools

    3. Serial processing:
    – moves information
    in single line
    4. Parallel processing:
    – moves same
    information along
    several paths
    simultaneously

    Figure 13–13c
    5 Patterns of Neural Circuits in Neuronal Pools

    5. Reverberation:
    – positive feedback mechanism
    – functions until inhibited

    Figure 13–13e
    Reflex activity
    • 5 components of
    a reflex arc
    – Receptor
    – Sensory neuron
    – Integration center
    (CNS)
    – Motor neuron
    – Effector
    4 Classifications of Reflexes
    1. By early development
    – Innate or Acquired
    2. By type of motor response
    – Somatic or Visceral
    3. By complexity of neural circuit
    – Monosynaptic or Polysynaptic
    4. By site of information processing
    – Spinal or Cranial
    Spinal Reflexes
    • Range in increasing order of complexity:
    – monosynaptic reflexes
    – polysynaptic reflexes
    – intersegmental reflex arcs:
    • many segments interact
    • produce highly variable motor response
    Monosynaptic Reflexes
    • Have least delay
    between sensory
    input and motor
    output:
    – e.g., stretch
    reflex (such as
    patellar reflex)
    • Completed in
    20–40 msec
    Muscle Spindles
    • The receptors in stretch
    reflexes
    • Bundles of small,
    specialized intrafusal
    muscle fibers:
    – innervated by sensory and
    motor neurons
    • Surrounded by extrafusal
    muscle fibers:
    – which maintain tone and
    contract muscle
    Postural Reflexes
    • Postural reflexes:
    – stretch reflexes
    – maintain normal upright posture
    • Stretched muscle responds by contracting:
    – automatically maintain balance
    Polysynaptic Reflexes
    • More complicated than monosynaptic reflexes
    • Interneurons control more than 1 muscle
    group
    • Produce either EPSPs or IPSPs
    The Tendon Reflex
    • Prevents skeletal muscles from:
    – developing too much tension
    – tearing or breaking tendons
    • Sensory receptors unlike muscle spindles or
    proprioceptors
    Withdrawal Reflexes
    • Move body part away
    from stimulus (pain or
    pressure):
    – e.g., flexor reflex:
    • pulls hand away from hot
    stove
    • Strength and extent of
    response:
    – depends on intensity
    and location of stimulus
    Reciprocal Inhibition
    • For flexor reflex to work:
    – the stretch reflex of antagonistic (extensor)
    muscle must be inhibited (reciprocal inhibition) by
    interneurons in spinal cord
    Crossed Extensor Reflexes
    • Occur simultaneously,
    coordinated with flexor
    reflex
    • e.g., flexor reflex causes
    leg to pull up:
    – crossed extensor reflex
    straightens other leg
    – to receive body weight
    – maintained by
    reverberating circuits
    Integration and Control
    of Spinal Reflexes
    • Though reflex behaviors are automatic:
    – processing centers in brain can facilitate or inhibit
    reflex motor patterns based in spinal cord
    • Higher centers of brain incorporate lower,
    reflexive motor patterns
    • Automatic reflexes:
    – can be activated by brain as needed
    – use few nerve impulses to control complex motor
    functions
    – walking, running, jumping
    Superficial reflexes
    • Stroking of the skin elicits muscle contraction
    – Involves functional upper motor pathways as well as cord level
    reflex arcs
    • Plantar reflex (L4-S2)…Babinski is normal in infants
    – Usually indicative of CNS damage in adults
    • Abdominal reflex (T8-T12)
    – Absent with corticospinal lesion
    Spinal Cord Trauma: Transection
    • Cross sectioning of the spinal cord at any level
    results in total motor and sensory loss in
    regions inferior to the cut
    • Paraplegia – transection between T1 and L1
    • Quadriplegia – transection in the cervical
    region

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