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    SPINAL CORD PHYSIOLOGY-Nyangares

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    SPINAL CORD PHYSIOLOGY-Nyangares

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    SPINAL CORD PHYSIOLOGY-Nyangares

    Uploaded by

    Campus Printers

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 45

    PHYSIOLOGY OF SPINAL

    CORD

    Dr. Nyangaresi
    contents

     Introduction
     Segmental and Longitudinal Organization
     Anatomy- cross section
     Internal Structure of the Spinal Cord
    (laminae and nuclei)
     Blood supply of spinal cord.
     Ascending And Descending tracts.
     Cord syndromes.
    Introduction
     Extent: Foramen magnum where
    it is continuous with the medulla
    to the level of the first or second
    lumbar vertebrae.
     Spinal nerves: 31 in number.

    Has four different regions:


    •Cervical
    •Thoracic
    •Lumbar
    •Sacral regions
    Spinal cord anatomy

    • Terminates at the conus


    medularis
    • The cauda equina begins below
    L1

    • Filum terminale extends from


    conus medularis to the coccyx.
    Spinal cord anatomy
    Grooves:
     Deep anterior fissure
     Shallow posterior median sulcus
     Lateral aspect two sulci:
     antero-lateral
     postero- lateral.
    Spinal cord anatomy
    Spinal cord anatomy
    Tracts of the spinal cord
    TRACTS: Groups of nerve fibers passing through spinal cord.
    Classification:
    1.Short tracts: connect different parts of spinal cord.
    Association tracts, which connect adjacent segments of spinal cord on the same
    side
    Commissural tracts, which connect opposite halves of same segment of spinal
    cord.

    2.Long tracts/projection tracts: connect the spinal cord with other parts of
    central nervous system
    Ascending tracts, which carry sensory impulses from the spinal cord to brain
    Descending tracts, which carry motor impulses from brain to the spinal cord.
    Ascending And Descending
    tracts
    The ascending tracts
    The ascending tracts
    Major ascending tracts

     Anterior spinothalamic
     Lateral spinothalamic
     Ventral spinocerebellar
     Dorsal spinocerebellar
     Posterior columns: F. Gracillis and Cuneatus.
    ascending sensory pathway
    ( in general form )
    from sensory endings
    to
    cerebral cortex
    ( note the three neurons chain )
    First order neuron

     Cell body in posterior root ganglion


     Peripheral process connects with sensory receptor
    ending.
     Central process enter the spinal cord through the
    posterior root.
     Synapse with second order neuron in spinal gray
    matter.
    VPL
    SECOND ORDER NEURON

    2nd

    1st

    • cross the mid line


    • in front of central canal
    ascending tracts in spinal cord
    Anterior and lateral spinothalamic tracts: crossing
    Anterior spinothalamic tract

    Function: Crude touch.


    Receptor: free nerve endings
    and merkel disk.
    Decussate or cross over: Yes.
    Clinical pearl: loss of sensation-
    contralateral
    Lateral spinothalamic tract

     Function: Pain and temperature


    sensation:
     Receptor: input from free nerve
    endings
     Decussate or cross over: Yes.
     Clinical pearl: Loss of pain and
    temperature sensation contralateral
    Fasciculus gracilis and fasciculus cuneatus
    Fasciculus gracilis and fasciculus cuneatus
     Function: Pain and temperature sensation:
     Fine tactile sensation
     Tactile localization
     Two point discrimination.
     Sensation of vibration (
     Conscious kinesthetic/proprioception
     Stereognosis (ability to recognize the known objects by touch
    with closed eyes.
     Decussate or cross over: No
     Clinical pearl: Loss of above function: ipsilaterally.
    [ nucleus G & C ]
    in medulla
    fasciculus cuneatus

    cervical segments

    upper 6 thoracic segments

    lower 6 thoracic segments


    lumbar segments
    sacral segments
    G
    C

    fasciculus gracilis
    Posterior and anterior spinocerebellar tract
    Function: Transmit unconscious proprioceptive information to the
    cerebellum

    Involved in coordination of posture and movement of individual


    muscles of the lower limb.

    Input: muscle spindles, Golgi Tendon Organs and pressure


    receptors.
    Spinoreticular tract

    The spinoreticular tract is an ascending pathway in the


    white matter of the spinal cord, positioned closely to
    the lateral spinothalamic tract. The tract is from spinal
    cord—to reticular formation to thalamus.
    It is responsible for automatic responses to pain, such
    as in the case of injury .
    Descending tracts
    Descending tracts
    PYRAMIDAL tracts

    CLASSIFICATION:
    1.Corticobulbar tracts.
    Fibres that travel from the cerebral cortex and terminate either in
    the brainstem
    Function: Motor control of cranial nerves
    2. Corticospinal: Fibres rise from cerebral cortex and terminate in
    the spinal cord.
    Function: involved in control of motor functions of the body.
    Corticospinal Tracts

     The corticospinal tracts begin in the cerebral cortex,


    from which they receive a range of inputs:
     Primary motor cortex
     Premotor cortex
     Supplementary motor area
     They also receive nerve fibres from the somatosensory
    area, which play a role in regulating the activity of
    the ascending tracts.
     Origin: cortex
     Descend through the internal capsule.
     Decussation: 80% decussate at caudal
    part of medulla.
     Divided to:
     lateral corticospinal tract: Those that
    cross/decussate at the medulla.
     Anterior corticospinal
    tract: descending into the spinal
    cord. They then decussate and
    terminate in the ventral horn of
    the cervical and upper thoracic
    segmental levels.
    Corticobulbar Tracts

     Origin: Primary motor cortex.


     Descend: converge and pass through the internal
    capsule to the brainstem.
     Termination: on the motor nuclei of the cranial
    nerves.
     Function: corticobulbar tract are involved in
    movement in muscles of the head.
     They are involved in swallowing, phonation,
    and movements of the tongue.
    Extrapyramidal Tracts
     Origin: brainstem, carrying motor fibres to the spinal cord.
     Function: involuntary and automatic control of all musculature,
    such as muscle tone, balance, posture and locomotion
    Extrapyramidal Tracts
     Example:
     Those that don’t decussate: The vestibulospinal and reticulospinal tracts
     Vestibulospinal: control balance and posture by innervating the ‘anti-
    gravity’ muscles
     Reticulospinal: It facilitates voluntary movements, and increases muscle tone.

     Those that decussate: The rubrospinal and tectospinal tracts


     Rubrospinal: responsible for large muscle movement as well as
    fine motor control
     Tectospinal: mediates reflex postural movements of the head
    in response to visual and auditory stimuli.
    Lower motor versus upper motor neuron
    Differences between upper and lower motor
    lesions.
    Cord syndromes

     Complete transverse cord lesion


     Central cord syndrome
     Anterior cord syndrome
     Posterior cord syndrome
     Brown- sequard syndrome.
    Cord syndromes

     Remember functions of:


     Lateral spinothalamic
     Anterior spinothalamic
     F. gracillis
     F. cuneatus.
     Corticospinal tracts.
    Brown-Sequard syndrome/Hemisection of
    the spinal cord
    below the level of lesion
    local segment
    on the side of lesion side of lesion
    lateral column damage Dorsal Root
    • UMNL • irritate
    • destruction
    dorsal column damage
    Ventral root
    • loss of position sense • flaccid paralysis
    • loss of vibratory sense
    • loss of tactile discrimination

    anterolateral system damage


    • loss of sensation of pain and
    temperature on the side opposite
    the lesion
    Features of brown Sequard syndrome – Same side.

    Sensory changes affected: Motor changes – Features of upper


    i.Fine touch motor
    ii.Tactile localization 1. Muscle tone increases, leading to
    spastic paralysis
    iii. Tactile discrimination
    2. Rigidity of limbs occurs
    iv. Sensation of vibration
    3. Muscle wastage does not occur
    v. Conscious kinesthetic sensation
    4. Superficial reflexes are lost
    vi.Stereognosis.
    Sensation preserved: why: carried by 5. Babinski sign is positive
    crossed fibers of spinothalamic tracts. 6. Deep reflexes are exaggerated
    i. Crude touch
    ii. Pain
    iii. Temperature.
    Features of brown Sequard syndrome –
    contralateral side

    Sensory changes affected: Not affected because, these


    sensations are carried by
    i.Crude touch uncrossed tracts
    ii.Pain i. Fine touch
    iii.Temperature. ii. Tactile localization
    iii. Tactile discrimination
    i v. Sensation of vibration
    v. Conscious kinesthetic
    sensation
    vi. Stereognosis.
    READ ON

     Tabes dorsalis
     Multiple sclerosis.
     Subacute combined degeneration
    Questions

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