Spinal Cord

Roughly cylindrical. Begins at foramen magnum, continuous with Medulla oblongata. Terminates inferiorly at the level of lower border of first lumbar vertebra in adults. In young relatively longer- lower border of L3. Occupies upper two-thirds of the vertebral canal. Surrounded by three meninges. Protection is provided by CSF in subarachnoid space.

Fusiformly enlarged in cervical region and lower thoracic and lumbar regions Cervical enlargement

Lumbar enlargement *

Inferiorly tapers into conus medullaris, from the apex prolongation -filum terminale attached to the posterior surface of the

coccyx.

Eight cervical segments

Twelve thoracic segments Five lumbar segments Five sacral segments

Cervical enlargement
Posterior median sulcus

Lumbar enlargement L1-S3

Conus medullaris

Filum terminale One coccygeal segment Spinal cord- posterior view

Posterior median sulcus Posterior white column Lateral white column Ligamentum denticulatum Anterior median fissure Spinal nerve Posterior root ganglion Duramater Posterior gray column Lateral gray column Anterior gray column Anterior roots of Spinal Nerve

Posterior roots of Spinal Nerve

Spinal cord covered with pia mater

Arachnoid mater

3 segments of spinal cord and coverings

 Cord possess anteriorly a deep midline fissureanterior median fissure Posteriorly a shallow furrow -posterior median sulcus. along the entire length- 31 pairs of spinal nerves are attached by Anterior or motor root and posterior or sensory root Each posterior nerve root possesses a posterior root ganglion- cells of which give rise to peripheral and central nerve fibres.

Posterior view of spinal cord and spinal nerves

 Spinal cord composed of inner core- gray matter outer core white matter On a cross section-Anterior and posterior gray

horns (columns) united by a thin gray

commissure contains a central canal. Small lateral gray horn present in thoracic and upper lumbar segments. Amount of gray matter in any level is related to the number of muscles innervated

Posterior gray column Gray commissure Anterior column Third cervical segment

Sixth cervical

Anterior white column Sixth thoracic Lateral gray column Posterior white column Third lumbar

Arrangement of gray and white matter

Third sacral

Nerve cells in anterior horns Multipolar alpha efferents to skeletal muscles gamma efferents to intrafusal fibres Posterior horns- four cell groups Two extend along the entire length Two restricted to thoracic and lumbar segments Substantia gelatinosa group situated at the apex of gray column. Nucleus proprius- anterior to substantia. Nucleus dorsalis (Clerks column)-at the base of posterior gray column extend C8-L3 L4 Visceral afferent group

Anterior gray commissure Fasciculus gracilis Fasciculus cuneatus Substantia gelatinosa Nucleus proprius

Posterior white column

Lateral white column

Anterior white column

Anterior median fissure Anterior white commissure

Lateral group of motor neurons

Transverse section of spinal cord at C5

Fasciculus gracilis Fasciculus cuneatus Posterior white column Substantia gelatinosa Nucleus proprius Lateral gray horn

Nucleus dorsalis

Anterior gray horn

Transverse section of Spinal cord at the level of T2

Posterior median sulcus Substantia gelatinosa Gray commissure

Nucleus proprius Nucleus dorsalis

Central canal

Motor neuron For Lower limb Anterior gray commissure Motor neuron for trunk muscles

Transverse section of the Spinal Cord at the level of L4

Posterior root

Substantia gelatinosa

Nucleus proprius

Preganglionic Parasympathetic outflow

Spinal cord at the level of S2

Nerve cells of lateral column Interomediolateral group -T1- L2 L3Preganglionic sympathetic fibres -

Cells in S2-S4 give rise to parasympathetic preganglionic fibres.

White matter of the spinal cord consists of myelinated nerve fibres which are arranged in the form of nerve tracts.

Some fibres serve to link different segments of the spinal cord.

 Others ascend from spinal cord to higher centres thus connect spinal cord to the brain
These are ascending tracts.

White matter may be divided into anterior , lateral and posterior white columns or funiculi.
Anterior column- lies between midline and the point of emergence of the anterior nerve roots. Lateral column -between anterior nerve root and entry of posterior root. Posterior column between post root and midline.

Ascending tracts- conduct information which may or may not reach consciousness. Two main groups of information Exteroceptive information originate from outside of the body. Pain, temperature and touch Proprioceptive information- originate from inside of the body. Muscle and joint sense

Receptor Association neuron Sensory neuron

Motor neuron Effector

General components of the reflex arc

 Information from the peripheral sensory endings

is conducted through by a series of neurons. Ascending pathway to consciousness consists of three neurons. First neuron- first order neuron-cell body is in the posterior ganglion. Its peripheral process connects with the sensory receptor ending. Central process enters the spinal cord through

posterior root to synapse with the second order

neuron.

 Second order neuron give rise to an axon that decussate and ascend to higher level of the CNS and synapse with third order neuron which usually located In the thalamus.
This gives rise to projection fibres that pass to sensory areas of the cerebral cortex. Many of the neurons in the ascending pathways branch and give a major input to reticular formation which activates the cerebral cortex.

Ascending tracts 1.Fasciculus gracilis present through out length. ascending fibres from sacral,lumbar and lower six thoracic spinal nerves. 2.Fasciculus cuneatus present in upper thoracic and cervical segments. Separated from fasciculus gracilis by a septum. Sensations Discriminative touch, Vibratory sense, Conscious muscle and joint

3. Lateral spinothalamic tract - carry impulses from pain and temperature receptors. 4. Anterior spinothalamic tract carry impulses from light touch and pressure receptors. Both pass as spinal lemniscus in brain stem. Unconscious 5.Anterior spinocerebellar muscle, joint sense 6. Posterior spinocerebellar 7.Spino-olivary conveys information to the cerebellum from cutaneous and proprioceptive organs

Posterior median sulcus

Central canal

Fasciculus gracilis Fasciculus cuneatus Posterior spinocerebellar Anterior spinocerebellar Lateral spinothalamic

Lateral corticospinal Rubrospinal Lateral reticulo spinal Vestibulospinal Anterior reticulo Tectospinal spinal

Anterior spinothalamic Anterior corticospinal Sensory Motor

Segmental organization of the tracts

Segmental organization of the tracts in the posterior lateral and anterior white columns

Descending tracts
The motor neurons situated in the anterior gray columns send axons to innervate skeletal muscle through the anterior roots of the spinal nerves. These motor neurons are lower motor neurons.

Lower motor neurons constantly receive impulses from medulla, pons, midbrain and cerebral cortex as well as those that enter along sensory fibres from posterior roots.

 The nerve fibres which descend in the white matter from different supraspinal nerve centres are segregated into nerve bundles called descending tracts. Supraspinal neurons and their tracts upper motor neurons. First order neuron has its cell body in the cerebral cortex. Axons descend to synapse in second order neuron.

 It is an internuncial neuron situated in the anterior gray column of the spinal cord.
Axons of second order neuron synapse with third order neuron- lower motor neuron in the anterior gray column, axons of which innervate the skeletal muscles.

Descending tracts:
1.Cortico spinal tract- concerned with voluntary, discrete,skilled movements especially those of distal parts of the limbs.

2.Reticulospinal tract - facilitate or inhibit voluntary movement of reflex activity.

3. Tectospinal tract concerned with reflex postural movements in response to visual stimuli. 4.Rubrospinal tract acts on both alpha and gamma motor neurons and facilitate the activity of flexor muscles and inhibit extensor or antigravity muscles.

5. Vestibulospinal tract acting on motor neurons in the anterior gray columns Facilitate the activity of extensor muscles and inhibit flexor muscles. Concerned with postural activity associated with balance. 6.Olivospinal tract- may play a role in muscular activity . 7. Descending autonomic fibres are concerned with control of visceral activity.

Blood supply of the spinal cord Receive arterial supply from three arteries. Anterior spinal artery Two posterior spinal arteries. These longitudinally running arteries are reinforced by segmentally arranged arteries which arise from arteries outside the vertebral column. These vessels anastomose on the surface of the spinal cord and supply gray and white matter.

Formation of two posterior spinal arteries

Basilar artery

Vertebral artery
Anterior spinal artery Posterior spinal artery

Anterior radicular artery Posterior radicular artery Segmental spinal artery

Transverse section of the spinal cord to show segmental and radicular arteries
Posterior spinal artery

Posterior radicular artery

Segmental spinal artery Anterior spinal artery Anterior radicular artery

Posterior spinal artery supply posterior one-third of the cord. They are small in the upper thoracic region First three thoracic segments are vulnerable to ischemia if segmental or radicular arteries in this region are blocked. Anterior spinal artery is formed by union of two arteries which arise from vertebral artery in side the skull.
It supplies the anterior two-thirds of the cord.

 In the thoracic segments of the anterior spinal arteries may be extremely small.
If radicular arteries be occluded in these regions, T4 and L1 segments are liable to ischemic necrosis segmental arteries from deep cervical, intercostal and lumbar arteries enter the vertebral column. divide into anterior and posterior radicular arteries accompany the anterior and posterior roots

 There are feeder arteries from aorta in the lower thoracic and upper lumbar levels. Venous drainage: Six tortuous longitudinal channels which communicate with the veins of the brain and venous sinuses. They drain mainly into internal vertebral venous plexus.