Human Anatomy & Physiology I – Dr Sullivan

Unit XIII – The Spinal Cord - Chapter 13

I. Anatomy of the spinal cord

a) The spinal cord is located within the vertebral canal, surrounded and protected by the vertebrae.
b) The vertebrae, the spinal meninges, vertebral ligaments, and cerebrospinal fluid offer protection to
the spinal cord
c) Protective coverings of the spinal cord
i) The spinal meninges: a three-layer connective tissue protective covering of the spinal
cord.
(1) Dura Mater: superficial layer made of dense irregular CT.
(a) surrounded by a layer of fat and connective tissue between the dura mater and the
internal wall of the vertebral canal called in a space called the epidural space.
(2) Arachnoid Mater: the middle layer
(a) avascular (no blood supply)
(b) the space between the arachnoid mater and the dura mater is called the subdural
space
(3) Pia Mater: The innermost layer made of a thin, transparent layer of CT that adheres to
the brain and spinal cord.
(a) contains many blood vessels that supply oxygen and nutrients to the brain and spinal
cord.
(b) Blood vessels are sheathed by pia mater as they supply the spinal cord with oxygen
and nutrients.
(c) space between the arachnoid mater and pia mater is called the subarachnoid space
(d) Denticulate ligaments: triangular-shaped membranous extensions of the pia mater
suspending the spinal cord within the dural sheath.
(i) they are comprised of pia mater and fuse with arachnoid mater and the interior
surface of the dura mater between the anterior and posterior roots of the spinal
nerves.
(ii) They protect the spinal cord from shock and sudden displacement.
d) External anatomy of the spinal cord:
i) The spinal cord runs from the medulla oblongata (the most inferior portion of the brainstem)
to the superior border of the 2nd lumbar vertebra
ii) The spinal cord is mostly cylindrical with a slight flattening on the anterior to posterior
aspect.
iii) There are two enlargements in the length of the spinal cord.
(1) Cervical enlargement: from C4 to T1
(2) Lumbar enlargement: from T9-T12
iv) Conus Medullaris: a conical tapering of the spinal cord at it’s most inferior aspect at about
the L1/L2 level.
v) Filum Terminale: an extension of the pia mater arising from the conus medullaris and
continuing to the coccyx
(1) Anchors the spinal cord to the coccyx.
vi) Cauda equina: After the spinal cord ends, nerve fibers continue from the spinal cord all the
way down to the inferior portion of the sacrum.
(1) Some nerve fibers exit bilaterally at each intervertebral foramen making up the lumbar
and sacral spinal nerves
vii) Spinal nerves (PNS): the bilateral paths of communication between the spinal cord and the
nerves innervating specific regions of the body.
(1) Named for the segment of the spinal cord from which they emerge
(a) 8 pairs of Cervical nerves
(b) 12 pairs of thoracic nerves
(c) 5 pairs of Lumbar nerves
(d) 5 pairs of Sacral nerves
(e) 1 pair of coccygeal nerves
 (f) **Most spinal nerves emerge between two vertebrae. The exception is CN1
(cervical nerve 1), which emerges between the occipital bone & the C1 vertebra. A
general rule of thumb is that the Cervical Spinal Nerves are named for the vertebrae
inferior to the nerve. i.e. if the first spinal nerve is between the occipital bone & the
cervical vertebra, it is called CN1 (cervical nerve one). This rule applies for CN1
through CN7. The 8th spinal nerve is called CN8, however (even though it’s between
C7 & T1 and there is no C8 vertebra). So after CN8, the remainder of spinal nerves
are named for the vertebrae superior to the nerve (i.e. the nerve that is between T4 &
T5 verterbrae is called the T4 nerve (or thoracic nerve 4).**
(2) Each spinal nerve is connected to the spinal cord by two bundles of axons called roots
(a) Dorsal roots: sensory impulses enter the spinal cord on neurons in the dorsal roots
(i) Dorsal Root Ganglion: swelling in the dorsal nerve root containing the cell
bodies of sensory neurons.
(b) Ventral roots: motor impulses leave the spinal cord on axons in the ventral roots
e) Internal Anatomy of the spinal cord (cross-section view)
i) the spinal cord has white matter and gray matter.
(1) The gray matter (unmyelinated nerve tissue) forms a butterfly-shape in the center of the
spinal cord with its ‘wings’ reaching the superficial corners of the cord.
(2) The white matter (myelinated & unmyelinated nerve tissue) surrounds the gray matter.
ii) Anterior median fissure: a deep, wide groove on the anterior spinal cord separating the right
& left anterior white columns
iii) Posterior median sulcus: a shallow, narrow furrow on the posterior side separating the right
& left posterior white columns.
iv) Gray commisure: where the gray matter crosses the midline of the spinal cord in the center.
v) Anterior white commissure: where the white matter crosses the midline of the spinal cord.
vi) Central Canal: a small space in the center of the spinal cord that runs the length of the cord.
vii) The gray matter is divided up into sections (all bilateral):
(1) Ventral Gray Horns: where the gray matter extends toward the anterior aspects of the
cord.
(a) contain motor neurons that will carry the impulses that contract skeletal muscle
(2) Dorsal Gray Horns: where the gray matter extends toward the posterior aspects of the
spinal cord
(a) contain sensory nuclei
(3) Lateral gray horns: small extensions of the gray matter laterally that do not reach the
superficial aspect of the spinal cord.
(a) contain motor neurons that carry impulses from the autonomic nervous system that
regulate smooth muscle, cardiac muscle, and glands.
viii) The white matter is divided up into sections called columns (all bilateral)
(1) Anterior white columns
(2) Posterior white columns
(3) Lateral white columns
ix) The white columns contain bundles of axons that have a common origin or destination and
carry similar information, called spinal tracts.
(1) Sensory tracts (ascending): conduct nerve impulses toward the brain
(2) Motor tracts (descending): conduct nerve impulses from the brain down the spinal cord.
x) Sensory and Motor Tracts
(1) Tracts: paths of CNS tissue through which nerve impulses are conducted perform CNS
functions
(2) Tracts travel along spinal cord white matter.
(3) The tracts can be named for the following:
(a) it’s position in the cord’s white matter
(b) where it begins and ends
(c) the direction of nerve impulse propagation
(i) rule: the position of the dendrites and cell bodies (start of a nerve impulse)
comes first and the position of the axon terminals (end of a nerve impulse)
 comes last in the name of the tract. Therefore, you can tell which direction the
nerve impulse travels.
1. Example: Anterior Spinothalamic tract
a. begins in the anterior white column of the spinal cord
b. ends in the thalamus
c. Is sensory and ascending because it begins in the cord and ends in the
thalamus (brain).
(d) Sensory information from receptors travel to the brain along two primary routes on
each side of the spinal cord.
(i) Spinothalamic tracts: carry impulses sensing pain, temperature, deep pressure,
and crude touch (poorly localized).
(ii) Posterior Columns (or Dorsal Column): carry impulses sensing proprioception,
discriminative touch, two-point discrimination, pressure, and vibration.
(e) Motor output travels from the brain down the spinal cord in two different descending
ways:
(i) Direct Pathways: carry nerve impulses from the cerebral cortex down the
spinal cord to initiate precise, voluntary movements of skeletal muscle.
a. These tracts are the: lateral corticospinal, anterior corticospinal, and
corticobulbar tracts.
(ii) Indirect Pathways: carry nerve impulses from the brain or brainstem down the
spinal cord to program automatic movements, help coordinate body movements
with visual stimuli, maintain skeletal muscle tone and posture, and play a role in
equilibrium.
1. Indirect pathways control the things that you don’t have to think about, i.e
balance, posture, hand-eye coordination.
2. These tracts are the: rubrospinal, tectospinal, and vestibulospinal tracts.
II. Reflexes
a) Another way in which the spinal cord helps to maintain the body’s homeostasis
b) Reflexes: fast, predictable, automatic responses to changes in the environment.
i) Cranial Reflexes: originate in the brain stem and travel through the cranial nerves
ii) Somatic Reflexes: involve contraction of the skeletal muscles
(1) i.e., knee-jerk reflex
iii) Autonomic reflexes: involve responses of smooth muscle, cardiac muscle, and glands.
(1) These reflexes are not perceived
c) Reflex Arcs
i) The pathway that a nerve impulse takes to create a reflex is called a reflex arc.
ii) A reflex arc includes 5 functional components
(1) Sensory receptor: responds to a specific stimulus and initiates a nerve impulse if the
stimulus is strong enough.
(2) Sensory Neuron: propagate the nerve impulse initiated by a receptor.
(3) Integrating center: a section of gray matter in the CNS that allows the sensory neuron and
the motor neuron to communicate.
(a) If the integrating center is a single sensory neuron creating a synapse with a single
motor neuron, it is known as a monosynaptic reflex arc.
(b) If the integrating center requires one or more interneurons to carry the impulse from
the sensory neuron to the motor neuron within the gray matter, it is called a
polysynaptic reflex arc.
(i) These are the more common of the two
(4) Motor Neuron: carries the motor command initiated by the integrating center to out of
the CNS to the part of the body needed to respond to the stimulus.
(5) Effector: The part of the body that responds to the motor nerve impulse.
(a) i.e. Quadricep muscles in a knee-jerk reflex
(b) The action of the effector is called a reflex.
(i) If the effector cell is skeletal muscle, it is called a Somatic Reflex
(ii) If the effector cell is smooth muscle, cardiac muscle, or a gland it is called an
Autonomic Reflex.
 iii) Reflexes enable the body to make very rapid adjustments to changes in the internal and
external environment. They are very predictable and therefore can give us useful information
of the state of the nervous system.
III. The Stretch Reflex
a) Monosynaptic reflex designed to protect the muscle from over-stretching
b) 5 steps to a stretch reflex
i) Slight muscle stretch stimulated muscle spindles (sensory receptor)
ii) Muscle spindle generates a nerve impulse that travels along a somatic sensory neuron through
the dorsal root of the spinal nerve and into the dorsal horn of the spinal cord.
iii) A synapse is created between the sensory neuron and a motor neuron in the integrating center
(the gray matter of the spinal cord).
iv) If the synapse’s EPSP is strong enough, it initiates an impulse along a motor neuron
(beginning in the ventral horn of the spinal cord’s gray matter) that travels through the
peripheral nerves to the appropriate muscle.
v) the axon terminals of the motor neuron create Neuromuscular Junctions (NMJ) with the
muscle fibers of the stretched muscle.
(1) Acetylcholine is the neurotransmitter released at the NMJ creating muscle action
potentials in the stretched muscle (effector) causing the muscle to contract and counteract
the stretching.
c) Reciprocal Innervation: While the muscle of the stretch reflex is contracting, the muscle that
opposes that muscle (or the antagonist) relaxes. This is a polysynaptic reflex arc using inhibitory
interneurons within the gray matter of spinal cord to allow the sensory and the motor neuron to
communicate.
(1) In the case of the knee-jerk reflex, the hamstring muscles relax.
d) Ipsilateral Reflex Arc: the motor impulse leaves the spinal cord from the same side that the
sensory impulse enters on.
(1) All monosynaptic reflex arcs are ipsilateral
e) Muscle Tone is regulated by the brain and allows muscle spindles to variably activate keeping a
light level of contraction in the muscles that give the muscle it’s normal tone.
IV. The Tendon Reflex
a) Controls muscle tension by relaxing the muscle to protect from injury caused by overtension.
b) Also an ipsilateral reflex arc.
c) Polysynaptic
d) 5 Steps
i) Tension on the muscle stimulates the tendon organ sensory receptor.
ii) Nerve impulses propagate along a sensory neuron into the dorsal root of the spinal nerve and
into the dorsal horn of the spinal cord.
iii) Within the spinal cord’s gray matter, the sensory neuron synapses with an inhibitory
interneuron, which in turn synapses with a motor neuron.
iv) The neurotransmitter used inhibits the motor neuron to that muscle generating fewer nerve
impulses (IPSP).
v) The over tensed muscle then relaxes and the tension is relieved.
e) Reciprocal innervation occurs here as well
f) The sensory neuron here also synapses with an excitatory interneuron which synapses and excites
motor neuron of the antagonist causing it to contract.
V. The Flexor and Crossed Extensor Reflexes
a) Flexor or Withdrawal Reflex: A polysynaptic reflex designed to protect you from a potentially
harmful stimulus
i) i.e. when you step on a sharp object (i.e. a tack) and immediately withdraw your foot
ii) Ipsilateral, polysynaptic reflex arc
iii) 5 Steps to Flexor/Withdrawal Reflex
iv) Nociceptors stimulated by tack
(1) Nerve impulse propagates to spinal cord
(2) The sensory neuron activates interneurons that extend to many spinal cord segments
(3) The interneurons activate many motor neurons from many different spinal cord segments
generating nerve impulses along peripheral nerves toward the muscles
 (4) Acetylcholine is relased into the synapse of the NMJ stimulating the muscles of the thigh
to contract pulling up your leg away from the tack.
(a) Since the muscle stimulated in this example is controlled by a different spinal
segment than the sensory area stimulated, it is considered an intersegmental reflex
arc. In this case, the Hamstrings are stimulated, but many muscle groups can be
stimulated if needed.
b) The Crossed Extensor Reflex
i) When you step on a tack and your leg withdraws upward away from the tack, you may begin
to lose your balance. Therefore, the flexor reflex may require another action to keep your
balance. This is the crossed extensor reflex.
ii) This is a Polysynaptic, contralateral reflex arc
iii) 5 Steps of the crossed extensor reflex
(1) The tack stimulates a nociceptor in the right foot
(2) Nerve impulses travel to the spinal cord
(3) Within the spinal cord, the sensory neuron activates several interneurons that cross the
anterior and posterior gray commisures at several spinal cord levels above and below the
level of initial stimulation.
(4) The interneurons synapse and excite motor neurons on the left side generating nerve
impulses toward the periphery of the body.
(5) The neurons release acetylcholine into the NMJs of the extensor muscles of the LEFT
thigh causing it to straighten and prepare to bear weight so you can balance yourself on it.
iv) Reciprocal innervation occurs in both the crossed extensor and the flexor/withdrawal reflexes.
VI. Spinal Nerves
a) Spinal nerves and their branches serve all parts of the body and connect the CNS to the muscles,
sensory receptors, and glands.
b) Spinal Nerves are part of the peripheral nervous system.
c) 31 pairs of spinal nerves are named and numbered for the vertebral level from which they emerge
from the spinal cord.
d) All spinal nerves emerge from the intervertebral foramen (IVF) except cervical nerve 1, or the C1
nerve. The C1 Nerve emerges from between the atlas (C1) and the occipital bone of the skull.
e) A Spinal nerve is made up of a dorsal and ventral root from the spinal cord and contains both
sensory and motor neurons. This is considered a mixed nerve.
f) Connective Tissue coverings of spinal nerves
i) An axon is surrounded by endoneurium
ii) A group of axons is called a fascicle and is surrounded by perineurium
iii) A group of fascicles bundled together along with blood vessels and fat are surrounded by
epineurium and called a spinal nerve.
g) Distribution of Spinal nerves
i) Branches: spinal nerves divide into branches just after it exits the IVF, known as rami or
more than one ramus.
ii) Dorsal Ramus: innervates the deep muscles and skin of the posterior surface of the trunk.
iii) Ventral Ramus: innervates the muscles of the upper and lower limbs and the skin of the
anterior and lateral surfaces of the trunk.
iv) Meningeal branch: re-enters the IVF and innervates the vertebrae, vertebral ligaments, blood
vessels of the spinal cord, and meninges.
v) Rami Communicantes: innervates components of the autonomic nervous system.
h) Plexuses
i) Plexus: a network of nerves made up of multiple nerve fibers from anterior rami and adjacent
nerves. Named nerves emerge from these plexuses to innervate specific structures.
ii) 4 pairs of major plexuses (all bilateral): cervical plexus, brachial plexus, lumbar plexus,
and sacral plexus.
iii) Intercostal Nerves: nerves the emerge from the T2-T12 spinal nerves to travel in between the
ribs and innervate structures in their immediate area.
iv) Cervical Plexus: formed by anterior rami of C1-C4 nerves and some of C5
 (1) Major functions: innervate the skin and muscles of the head, neck, superior part of the
shoulders and chest, motor to the diaphragm via the phrenic nerve and motor to the deep
neck muscles, levator scapulae, and middle scalene muscles.
(a) Severing the spinal cord above the origin of the phrenic nerve (C3-5) will result in
respiratory arrest because the diaphragm loses its innervation.
v) Brachial Plexus:
(1) Made up of the ventral rami of the C5-8 and T1 spinal nerves innervating the shoulder
and upper limbs (arms).
(2) 5 major nerves emerging and their muscular innervations:
(a) axillary: deltoid and teres muscles
(b) musculocutaneous: biceps brachii, coracobrachialis, brachialis
(c) radial: triceps brachii and forearm extensors
(d) median: most forearm flexors
(e) ulnar: most muscles of the hand, and some forearm flexors
vi) Lumbar Plexus: formed by the ventral rami of the L1-L4 spinal nerves innervating the
anterolateral abdominal wall, external genitals, and part of the lower limbs.
(1) Major nerves emerging and their muscular innervations:
(a) femoral: hip flexors and quads
(b) obturator nerves: adductors of hip
vii) Sacral Plexus: Made from the anterior rami of the L4-5 and S1-4 spinal nerves innervating
buttocks, perineum, and lower limbs.
(1) Major nerves emerging and their muscular innervations:
(a) Sciatic: Hamstrings and adductor magnus
(b) Tibial: gastrocnemius, soleus, plantaris, popliteus, and some plantar flexors of the
foot.
i) Dermatomes: specific sections of skin innervated by sensory neurons that send information to one
specific spinal nerve root. There is a bit of overlap in some dermatomes.
i) Important: C3-T1, L2-S2 – (know these dermatomes on Figure 13.19 pg 495)